GABA

The morning after a spine surgery, I had an anxiety attack and insisted on being allowed to take my GABA, which helped

February 28, 2025 By Trudy Scott 12 Comments

I’d been taking GABA before [my spine] surgery and really didn’t want to have to discontinue it. My surgeons have always insisted on me going off supplements in the week or more leading to surgery.

I’m sure they don’t want to have to be well versed on everything a person might be taking so they only allow prescription drugs.

The morning after the spine surgery, I had an anxiety attack and insisted on being allowed to take my GABA, which helped.

GABA helps tremendously in preventing me waking in the middle of the night or early morning in a panic. I take 500mg of NOW GABA sublingually before bed. I also take tryptophan and magnesium glycinate at bedtime and believe they help a bit, but GABA is the most effective.

It would be really helpful to be able to take needed supplements right up to surgery time.

LM posted this in response to my blog: GABA and theanine for sedation, anxiety, and cognition in preoperative surgical patients (a randomized controlled study) (more on this below).

She also said “This would be really nice” if doctors knew this! I’m with her – it would be really nice if doctors were aware of this research and allowed patients to use GABA and theanine right up to surgery and right afterwards too. This is especially relevant given the fact that GABA lowers blood pressure and high blood pressure is common after surgery (more on this below too).

Hopefully this GABA/theanine surgery research and the GABA/high blood pressure research will start to shift perspectives and guidelines, especially since increased anxiety also impacts the outcome of surgery. I share more on the research and my insights below.

The study: GABA and theanine are calming before a surgical procedure and don’t cause too much drowsiness

If you missed the blog post and study I shared above, here is the overview:

This novel study was planned to study and compare the effects of L-theanine and GABA on anxiety, sedation, and cognition in preoperative patients posted for major elective surgeries under general anesthesia.

The conclusion is that:

GABA and L-theanine result in effective preoperative anxiolysis with minimal sedation and improvement of cognitive skills.

In other words, both these amino acids are calming before a surgical procedure, don’t cause too much drowsiness and improve cognition.

Study participants used 500 mg GABA and 200 mg of theanine – but dosing is unique

The authors had the study participants use 500 mg GABA and 200 mg of theanine. Both were used as capsules and swallowed. If you’ve been following my work, you’re aware that I find sublingual (or powder or liposomal or topical) use of GABA to be more effective than swallowing a capsule. For this reason it’s possible that using a lower dose sublingually may be as effective or possibly even more effective.

As always, dosing of GABA (and other amino acids such as theanine) is individualized to the unique needs of the person. Ideally, the person has figured out their optimal dose for easing anxiety in their day to day life before going in for surgery. They may find that a higher dose is needed the weeks leading up to surgery and the day of surgery.

As LM shared, she uses “500mg of NOW GABA sublingually before bed”, and presumably started with a lower dose and worked up to 500mg i.e. the optimal dose for her unique needs. It’s very individualized with no-one-size fits all i.e. someone else may get similar benefits with 125mg.

You can read the entire blog post here: GABA and theanine for sedation, anxiety, and cognition in preoperative surgical patients (a randomized controlled study).

Why you are told to stop all supplements prior to surgery

My understanding is that being told to stop all supplements prior to surgery is because of potential concerns about effects on bleeding, anesthesia and blood pressure. Unfortunately, the study didn’t address this possible issue. This article has some information on supplements (and some meds) to stop before surgery/anesthesia stating:

you may need to take a break from some supplements and medications that can interfere with anesthesia. Surgical complications could include heart or bleeding problems, prolonged anesthesia effects, or increased blood pressure.

GABA lowers blood pressure which may be helpful right after surgery

High blood pressure is common after surgery and can have far-reaching implications. According to this paper, “Postoperative hypertension often begins ~10–20 minutes after surgery and may last up to 4 hours. If left untreated, patients are at increased risk for bleeding, cerebrovascular events, and myocardial infarctions.”

This is another reason GABA may actually be helpful to use right up to surgery and right afterwards – it lowers blood pressure.

This paper, United States Pharmacopeia (USP) Safety Review of Gamma-Aminobutyric Acid (GABA), published in 2021, reports the results of a 4-week study that investigated the tolerability of GABA supplementation in mildly hypertensive but otherwise healthy adults:

The authors first established an optimum dose in mildly hypertensive subjects (SBP/systolic blood pressure between 130 and 180 mm Hg) who were randomized to receive oral doses of GABA at 0 (placebo), 20, 40, or 80 mg/day for 4 weeks.

An intake of 80 mg/day of GABA was associated with a significant reduction of the BP in adults with mild hypertension, and no adverse effects were reported.

A subsequent study evaluated long-term effects of GABA at 80 mg daily versus placebo in mildly hypertensive subjects for 8 weeks:

At the end of the 8-week study, SBP [systolic blood pressure i.e. the top number] and DBP [diastolic blood pressure i.e. the bottom number] were on average 5% lower in all the subjects who received 80 mg/day of GABA compared to participants in the placebo group whose blood pressure levels remained above normal.

This is a substantial reduction when 80 mg of GABA a day is considered a very low dose. I typically have my anxious clients start with 125mg GABA and increase from there. They may end up using 125 mg GABA 3 or 4 times a day and sometimes 250 mg a few times a day or 500 mg once a day like LM is doing.

Additional resources when you are new to using GABA and other amino acids as supplements

As always, I use the symptoms questionnaire to figure out if low GABA may be an issue. The low GABA symptoms include: physical tension, overwhelm, fears, anxiousness, stiff and tense muscles, sleep issues, feelings of panic and stress-eating and drinking.

If you suspect low levels of any of the neurotransmitters and do not yet have my book, The Antianxiety Food Solution – How the Foods You Eat Can Help You Calm Your Anxious Mind, Improve Your Mood, and End Cravings, I highly recommend getting it and reading it before jumping in and using amino acids on your own so you are knowledgeable. And be sure to share it with the practitioner/health team you or your loved one is working with.

There is an entire chapter on the amino acids and they are discussed throughout the book in the sections on gut health, gluten, blood sugar control (this is covered in an entire chapter too), sugar cravings, anxiety and mood issues.

The book doesn’t include product names (per the publisher’s request) so this blog, The Antianxiety Food Solution Amino Acid and Pyroluria Supplements, lists the amino acids that I use with my individual clients and those in my group programs.

If, after reading this blog and my book, you don’t feel comfortable figuring things out on your own (i.e. doing the symptoms questionnaire and respective amino acids trials), a good place to get help is the GABA QuickStart Program (if you have low GABA symptoms). This is a paid online/virtual group program where you get my guidance and community support.

If you are a practitioner, join us in The Balancing Neurotransmitters: the Fundamentals program. This is also a paid online/virtual program with an opportunity to interact with me and other practitioners who are also using the amino acids.

Wrapping up and your feedback

I appreciate LM for sharing how GABA helps her and her post surgery experience with anxiety and using GABA. It is wonderful that she was able to take her GABA supplement for the anxiety attack after her surgery. Let’s hope this research increases awareness amongst surgeons.

I’d love to hear from you – have you been told to stop all supplements before surgery, including GABA and other amino acids.

And do you feel increasingly anxious before surgery and other medical procedures and would GABA help i.e. is GABA and/or theanine part of your calming repertoire on a day-to-fay basis?

Have you ever discussed either of these two amino acids – GABA or theanine – with your surgeon or anesthetist prior to surgery and were they open to you using them before and right after surgery?

If you’re a practitioner do you recommend GABA and theanine to your anxious clients/patients and as a surgeon or anesthetist would you consider these amino acids in the future, based on this research?

Feel free to share your experiences and ask your questions below.

Exploring the Therapeutic Potential of Gamma-Aminobutyric Acid (GABA) in Stress and Depressive Disorders through the Gut–Brain Axis

January 31, 2025 By Trudy Scott 4 Comments

Research conducted on individuals with depression reveals that major depressive disorders (MDDs) coincide with diminished levels of the inhibitory neurotransmitter γ-aminobutyric acid (GABA) in the brain, as well as modifications in the subunit composition of the primary receptors (GABA_A receptors) responsible for mediating GABAergic inhibition.

Furthermore, there is substantial evidence supporting the significant role of GABA in regulating stress within the brain, which is a pivotal vulnerability factor in mood disorders. GABA is readily available and approved as a food supplement in many countries.

Although there is substantial evidence indicating that orally ingested GABA may affect GABA receptors in peripheral tissues, there is comparatively less evidence supporting its direct action within the brain.

Emerging evidence highlights that oral GABA intake may exert beneficial effects on the brain and psyche through the gut–brain axis. While GABA enjoys wide consumer acceptance in Eastern Asian markets, with many consumers reporting favorable effects on stress regulation, mood, and sleep, rigorous independent research is still largely lacking.

Basic research, coupled with initial clinical findings, makes GABA an intriguing neuro-nutritional compound deserving of clinical studies in individuals with depression and other psychological problems.

This is the abstract from a recently published review paper: Exploring the Therapeutic Potential of Gamma-Aminobutyric Acid in Stress and Depressive Disorders through the Gut–Brain Axis

Does GABA exert calming and mood benefits via the gut-brain axis or is it really just a placebo effect? This paper discusses both possibilities. I’m excited by the former (and share more about this below) but I do not agree with the latter. Based on my clinical and personal experience, the calming effects of the amino acid GABA, used as a supplement (when you have low GABA symptoms/levels and used in a very specific way), is not a placebo effect. I also discuss this and share some cases that clearly confirm there is no placebo effect. Read on to be enlightened and encouraged about the power of GABA.

GABA and the microbiota-gut-brain axis

The authors describe the microbiome-gut-brain axis as “the bidirectional communication between the gastrointestinal tract, including its resident microbiota and the brain, linking emotional and cognitive centers of the brain with peripheral intestinal functions.”

They acknowledge that while we don’t quite understand the exact mechanisms of this bidirectional communication, “the vagus nerve, the endocrine and immune system, and the synthesis and metabolism of metabolites and neurotransmitters in the gut are critically involved.” This is exciting given what we know about the blood brain barrier.

If you are new to this concept of the gut-brain axis or want to read some of the latest updates, I encourage you to read the paper and learn about the benefits of probiotics (such as Lactobacillus and Bifidobacterium, and Lactococcus, Enterococcus, Streptococcus, and Leuconostoc) and prebiotics i.e. psychobiotics; and fermented foods – for mood improvement and stress reduction.

You’ll read this about GABA (both as a metabolite produced by the microbiome and as a supplement):

found in the enteric nervous system it contributes significantly to gut-brain axis functions and related disorders, including depression, anxiety, inflammatory, and cardiovascular disorders (they refer to GABA as a crucial ‘postbiotic’ i.e. a metabolite produced by the microbiome)
while GABA may not directly cross the blood-brain barrier in humans, an indirect influence through the enteric nervous system could potentially provide a viable pathway for the impact of GABA dietary supplements
although the connection between oral GABA administration i.e. GABA supplementation, the vagal nerve, and GABA levels in the brain has not been firmly established, considering the existing evidence, it represents a promising avenue for future research.

The last two bullets are worth emphasizing because one of the most common myths is that “GABA supplements don’t work because GABA is too big a molecule to get across the blood brain barrier.” It really doesn’t need to get through the blood brain barrier in order to be calming.

I share more about this in a blog I published in 2023 – you can read it here.

GABA is a lifesaver and helps with mycotoxin-induced anxiety

Joie has Sjogren’s, Hashimoto’s, fibromyalgia & collagenous colitis (all diagnosed after severe mold exposure) and shares how GABA

has been a life saver for me (for my anxiety), and I share this with all I know who experience anxiety. I also use L-theanine at night because of insomnia. The 5-HTP has helped somewhat for sleep. L-tryptophan didn’t seem to make a difference. However the 5-HTP has made a significant difference in lessening my daily pain levels, which I am most grateful for.

Micki Contini, MS CNC, a board-certified holistic health and nutrition consultant, is a friend and colleague whose life was hugely impacted by mold toxicity. She shares this about how GABA helped her:

As they started tearing my house apart for remediation, I started eating GABA Calm like candy. At the beginning I had to have a lot more than I do now. GABA Calm takes me down a notch and I feel my shoulder coming away from my ears and I get closer to relaxing.

Here are a few other blogs that illustrate just how calming GABA can be when used as a supplement:

If GABA works it’s a placebo effect?!

I find this statement in the conclusion of the review to be confusing given all that the authors share about the gut-brain axis, vagus nerve and bidirectional communication:

The dietary supplement form of GABA is readily accessible to consumers. While many individuals assert that they derive advantages from using these products, it remains uncertain whether these supplements provide benefits beyond what could be attributed to a placebo effect.

Their argument about conflict of interest and small sample sizes when it comes to studies doesn’t hold water with me.

As I mentioned above, based on my clinical experience, the calming effects of the amino acid GABA, used as a supplement when you have low GABA levels (and used in a very specific way), is not a placebo effect.

The following two cases clearly confirm there is no placebo effect (and these are just a few of many which I plan to share with the authors).

My 6 year old was having panic attacks getting out of the car for Kindergarten

My 6 year old son was having panic attacks getting out of the car going to Kindergarten and taking two GABA Calm has completely relieved him of his fears. He has been going for 3 straight weeks in a row.

I thought it may be low serotonin since this happened last winter as well but I gave him 5-HTP for a couple months and it didn’t seem to affect him and his anxiety. We had to have him repeat Kinder this year.

But wow, the GABA has been fabulous and Kindergarten is in full swing because of your help.

Lisa, a mom in the community, shared these wonderful results about her son. This is most definitely not a placebo effect.

You can read the entire story on the blog here. The school is actually in shock at how well carpooling is going for him.

GABA lessens anxiety, agitation and defiance in 98 year old mother who has been “sundowning” for a couple of years

My mother is 98 and has been “sundowning” for a couple of years. It starts around 3pm, sometimes earlier. Some days it’s no big deal. It is on those other days when she starts and then it goes to anxiety, agitation, then she can get sort of defiant which is so not her. She is a gentle soul, friendly, and kind so this is difficult on her as well as our family.

I just started to use my pestle and mortar to crush up a 125 mg GABA CALM supplement (Source Naturals) and I mix a little into her flavored yogurt when I start to see her having difficulty. I give it to her throughout the day. She only gets the 125 mg amount so I feel safe with that.

I believe that I do notice it lessens her anxiety. I pray that this will be helpful for her because that anxiety can be really draining for her. I have not noticed any adverse reactions.

This is another heartwarming success story shared by Marsha who used GABA Calm with her mother. It’s yet another one that is not a placebo effect either. You can read the entire blog post here.

My personal GABA results are also not a placebo effect

I can also share from first-hand experience that GABA was a life-saver for me in my late 30s when I had no idea what a panic attack was and knew very little about GABA other than the fact it calmed me down very quickly!

I still use GABA in various situations to this day: to help with back spasms after a fall, to help with rectal spasms, to help with throat spasms/pain caused by crying (after the loss of my darling mom), to help me sleep solidly and before doing an on-stage presentation, and much more.

GABA is effective and safe when used in a very specific way

Many people use GABA and report it didn’t work or that they had a strange or uncomfortable reaction to their GABA supplement (such as tingles or flush or feeling dizzy). I’m on a mission to educate folks how GABA is effective and safe when used in a very specific way:

Only if you have low GABA levels and symptoms of physical tension, overwhelm, fears, anxiousness, stiff and tense muscles, stress eating, drinking to calm down or fit in socially (you can see all the symptoms here)
Starting with a low dose of around 125mg (and less if you’re sensitive)
Only using it as a sublingual, powder or capsule opened on to the tongue, liposomal or GABA cream (to see results in 1-10 mins and to bypass the digestive system)
Titrating up (and sometimes back down) to find the ideal dose for your unique needs
Being open to trialing different products and forms and sometimes combining GABA with theanine
Understanding that there can be nuances to using GABA, making one change at a time and not giving up too soon
Tracking carefully and course-correcting as needed

I educate anxious individuals about all of the above and offer guidance and encouragement in the GABA Quickstart 2.0 online group 5 week program.

I hope this summary, the review paper and the cases leave you feeling enlightened and encouraged about the power of calming GABA.

Additional resources when you are new to using GABA and other amino acids as supplements

As always, I use the symptoms questionnaire to figure out if low GABA or other neurotransmitter imbalances may be an issue.

Wrapping up and your feedback

Have you experienced the benefits of GABA for stress and/or low mood? Do you believe it’s more than a placebo effect?

And are you excited to understand the possible mechanisms and read the research? Or do you just want to know how GABA could help you and how to use it?

Have you tried GABA without success or only had limited success? Feel free to share and I’ll provide my feedback.

Feel free to ask your questions below.

Understanding the function of the GABAergic system and its potential role in rheumatoid arthritis (for pain, anxiety, sleep issues and more)

January 3, 2025 By Trudy Scott 2 Comments

This is a great question posed by a woman in my GABA/anxiety online group program:

Can GABA be good for rheumatoid arthritis, and in its early stages? If so, in what ways would someone see signs of improvement with GABA?

When I looked into some of the recent research on GABA and rheumatoid arthritis I was fascinated. A 2023 review paper, Understanding the function of the GABAergic system and its potential role in rheumatoid arthritis, discusses the relationship between rheumatoid arthritis (RA), an autoimmune condition, and GABA (gamma-amino butyric acid), a calming neurotransmitter.

The authors discuss “a new mechanism of action in RA” and the fact that “bidirectional communication occurs between the brain and immune system…and neuroinflammatory responses in the brain.”

The paper discusses GABA and neurosignalling, immunomodulatory effects and inflammation, stating that the:

GABAergic system may modulate the abnormal pain response in RA patients.

So to answer her question, if she has low GABA levels we would expect to see some reduction in her RA pain.

As always, we look for the signs and symptoms of low GABA regardless of the diagnosis or possible diagnosis. So if someone has low GABA symptoms of physical tension, overwhelm, fears, anxiousness, stiff and tense muscles, focus issues, pain, stress eating or drinking to calm down, and poor sleep, we consider a trial of the amino acid GABA, and could expect improvements in all or some of the above symptoms.

I would also recommend that she tracks markers of inflammation (like hs CRP, IL-6, IL-1β, and TNF-α) and RA markers to see if they shift in a positive direction with her use of GABA too.

I share more below about the incidence of anxiety and sleep issues in rheumatoid arthritis and some of the mechanisms covered in the review paper. Also, there are lab tests to track and there are other nutritional approaches for supporting an autoimmune condition such as RA.

Some of the mechanisms covered in the review paper

This image from the paper and the explanation provides some insights on the mechanisms at play.

Glutamate interacts with glutamate decarboxylase (GAD65 and GAD67) to produce gamma-aminobutyric acid (GABA).
Binding of GABA to GABA-A receptors inhibits macrophage activation and decreases the release of inflammatory factors such as IL-6, IL-1β, and TNF-α. Antigen presentation by antigen-presenting cells, however, is impaired, inhibiting CD4⁺ T cell proliferation and differentiation and reducing the expression of inflammatory factors such as IL-6, IL-1β, and TNF-α.
Pain signaling activates the P38/MAPK pathway, whereas GABA binding to GABA-A receptors inhibits P38/MAPK. The P38/MAPK signaling pathway contributes to inflammation and is involved in the activation of myocardin-related transcription factor A (MRTFA), myocardin-related transcription factor B (MRTFB), and serum response factor (SRF) that played key roles in fibroblast activation.

gaba and rheumatoid arthritis — Figure 1. Understanding the function of the GABAergic system and its potential role in rheumatoid arthritis

The authors don’t mention the use of the amino acid GABA as a supplement for RA but do list a number of clinical trials (mostly diabetes patients) where GABA has been used with success. It’s a start and I look forward to future research in this area.

Anxiety, depression, insomnia, cognitive issues and stress-eating in RA

This paper, Psychiatric aspects of rheumatoid arthritis: Review of literature, reports that

Among the major psychiatric disorders found in RA, the anxiety and depressive disorders are prevalent (13 to 48% of patients), as well as suicide, insomnia and tiredness. The impairment of quality of life is markedly after age 65.

This paper, A 30-Day Adjunct Wellness Intervention for the Management of Extra-Articular Symptoms of Rheumatoid Arthritis: A Formative Study, also mentions “cognitive and physical dysfunction” and “stress-related eating” in addition to anxiety, depression and insomnia in RA patients.

Doing a trial of GABA (and other amino acids such as tryptophan and d-phenylalanine/ DPA), will confirm which symptoms are related to which neurotransmitter deficiencies. It’s exciting to consider a very possible role of GABA and other amino acids given the fact that “individuals with rheumatoid arthritis (RA) continually fall short of treatment targets using standard drug therapies alone”

Looking further than GABA and other amino acids: a gluten-free diet and other root causes

With RA we obviously want to address more than just GABA (and other amino acids). Gluten removal is recommended but I do want to mention that the research is surprisingly mixed. This paper, Efficacy of gluten-free diet in patients with rheumatoid arthritis states that

Gluten seems to be a glycoprotein with a clinically relevant inflammatory effect. Several observational studies and anecdotal cases reported a correlation between gluten and various diseases, including autoimmune diseases, such as rheumatoid arthritis. This study aimed to evaluate whether gluten-free diet could be effective in controlling inflammation and ongoing rheumatoid arthritis symptoms.

We report 4 cases of patients with long-standing rheumatoid arthritis with no response to several conventional and biotechnological drugs, treated with a gluten-free diet concurrently with the drug therapy. Our patients presented different degrees of response to the diet, in terms of disease remission and improvement of symptoms. Our cases confirm that a gluten-free diet may improve symptoms of rheumatoid arthritis, even in patients resistant to conventional drug therapies.

Many other papers dismiss the role of gluten and inflammatory diets. This one is an example of a number of similar papers.

The benefits of addressing neurotransmitter imbalances with GABA and other amino acids means the addiction is stopped and quitting bread and cookies now no longer requires willpower,

Here are some autoimmune recipe resources:

In addition to dietary changes, a full functional medicine approach is warranted as there is much research supporting the benefits of the following for RA: omega-3 fatty acids, olive oil, low vitamin B6, addressing heavy metals such as mercury and much much more.

I cover 60+ root causes of anxiety here – I’d be carefully assessing each of these root causes for RA too.

Additional resources when you are new to using GABA and other amino acids as supplements

As always, I use the symptoms questionnaire to figure out if low serotonin or low GABA or other neurotransmitter imbalances may be an issue.

Wrapping up and your feedback

Do you have rheumatoid arthritis (RA) or another autoimmune condition and has GABA helped?

Were you aware of these possible connections?

What about dietary and nutritional approaches?

Feel free to share your feedback and ask your questions below.

Calming GABA, tryptophan to relinquish the evening bottle of red wine, theanine for focus and the pyroluria protocol

November 29, 2024 By Trudy Scott 5 Comments

gaba tryptophan theanine

I’m 61 years old postmenopausal. 2 GABA Calm under my tongue the second my eyes open in the morning. I keep it at the bedside. So that’s 250mg.

In the beginning I would also use two if I woke up at 2AM with a panic attack. That doesn’t happen as much anymore. I keep a bottle in my purse for panic attacks during the day. I haven’t had one of those in a couple of years. When I have a low stress week ahead, such as no social interaction scheduled, I go several days without any, but then that clutch in my chest reminds me to start back.

I also am diligent in treating my Pyroluria (diagnosed with a urine test)…it makes a difference. Daily zinc, B vitamins (especially 15mg methylfolate/day – check out the research papers on that dose being as effective as most antidepressants, I’m heterozygous not homozygous, MTHFR), Magnesium Threonate.

I am having good results with 1000 mg L-Tryptophan/day. I’ve just started adding another 1000mg/day in a bid to relinquish my evening bottle of red wine.

I keep a bottle of L-theanine on hand if I have a day ahead that I need to focus. ADHD does not improve with age!! I seriously liked it better in my day when my third-grade teacher labeled me a “dreamer”. Fortunately, I live on a farm and the cows don’t seem to mind that it takes me a bit to focus long enough to get the chores done.

I also have a regular yoga practice and I do physical work outside and in the winter use a SAD light.

I will also add that the last 8 months I have been in a very stressful family situation at home and the above regimen is holding.

If anyone has stuck with this wandering post to the end, don’t give up. Keep fighting to find what works for you.

Jennifer responded with the above in response to my question on Facebook about your starting GABA dose and if it’s changed over the years based on stress levels, hormone changes and life events.

I thanked her for sharing and for her encouraging words for others in the community and asked if I could share her feedback as a blog. She said yes saying “I have learned so very much from the stories of others on the page” – so here we are …

Stories offer hope, motivation and inspiration and we do learn so much from them.

I also told her that she is a poster child for how we want to use GABA and share more about that and her desire to relinquish her bottle of wine (and how amino acids make it easier) below.

She is a poster child for how we want to use GABA

Initially a higher dose of GABA may be needed and then as GABA levels increase and we also start to address other underlying root causes, less GABA is needed on a regular basis.

Initially Jennifer needed 4 x GABA Calm (for a total of 400mg/day) and then just 250mg GABA per day once she addressed pyroluria and B vitamin deficiencies. Yoga also supports GABA production.

On some low-stress days she doesn’t need any GABA at all, but she wisely keeps some in her purse for “panic attacks during the day” (but hasn’t had one in a couple of years).

She had struggled with perimenopause: “I must say that postmenopausal is a hell of a lot better, even with the paper thin skin and wrinkles, than the hell that was perimenopause!!!!”

And she did mention her phenyl-GABA mistake/ignorance and the fact that I helped her identify this issue 5 years ago. If you’re not aware, phenyl-GABA or phenibut can cause similar tolerance, dependence and discontinuation issues to benzodiazepines. More on phenibut here.

All of the above very likely contributed to her higher need for GABA initially.

Additional serotonin support to relinquish her evening bottle of red wine

Jennifer is already supporting her serotonin with 1000mg tryptophan per day, a SAD light in winter and physical exercise on the farm.

Afternoon and evening cravings are common when serotonin isn’t optimal – this can be carb/sugar cravings and/or also a need to self-medicate with wine. The first step is to recognize and acknowledge that a bottle of wine each evening is too much.

This amount of alcohol affects the liver, contributes to leaky gut, can cause blood sugar swings and reduces B vitamins, especially thiamine/vitamin B3. And it could also be considered an added “stress” if you have pyroluria.

Most of us are aware of these harmful effects and yet cannot easily quit. Her use of the word relinquish is a clue as to how she feels about this i.e. some common synonyms of relinquish are “abandon, resign, surrender” which “may suggest some regret, reluctance, or weakness.”

But because she understands the power of amino acids, she plans to increase her tryptophan from 1000mg to 2000mg to address this addiction without the need for willpower or with no feelings of regret or surrender.

If you are new to using this tryptophan for this purpose, this blog is worth reading: Tryptophan had the added benefit of turning me completely off alcohol when I took it to improve mood and sleep during perimenopause

Theanine for when she needs additional focus

Theanine provides a feeling of calm focus, offering support for the following neurotransmitters: GABA, serotonin and dopamine.

Jennifer also uses 400mg of theanine (Suntheanine) for her focus issues, using it only on days she needs it. She says “I rarely have a day when I would need more than 3-4 hours of paperwork concentration as my life on the farm and keeping up with grandchildren is more physical than mental focus.”

Now that she has used GABA, tryptophan and theanine with success, she has these amino acids in her toolbox whenever she needs them in the future and when she needs to increase the dose if the situation requires a change.

A few GABA product options – a sublingual and a powder

Jennifer used Source Naturals GABA Calm lozenges, a product I recommend. It’s a good low dose of 125 mg and is convenient and effective because it’s a sublingual lozenge.

Now GABA Powder is another product I use and recommend. It does need to be measured out to provide a 125 mg typical starting dose. I have clients use a handy mini measuring spoon like this one (my Amazon link) and share more about how to measure out GABA powder on this blog).

For Source Naturals GABA Calm lozenges and Now GABA Powder:

You can purchase these from my online store (Fullscript – only available to US customers – use this link to set up an account).
If you’re not in the US, you can purchase these at iherb (use this link to save 5%).

Additional resources when you are new to using GABA, tryptophan and other amino acids as supplements

As always, I use the symptoms questionnaire to figure out if low GABA, low serotonin or other neurotransmitter imbalances may be an issue.

Wrapping up and your feedback

I appreciate Jennifer for sharing and giving me permission to share her story on the blog. Despite the wine and her very stressful family situation I am thrilled she says she is doing well. I also love that she ends with this: “… don’t give up. Keep fighting to find what works for you.”

I’d love to hear from you – has any of this worked for you?

Feel free to share about your GABA success and how much it helps you and if this has changed over time. And let us know what you feel has contributed to the need for less or more GABA i.e. which other root causes have you addressed?

Feel free to share if tryptophan (or another amino acid) has helped with quitting wine or another alcoholic beverage.

And do share if you use theanine for calm focus.

Feel free to share and ask your questions below.

GABA and theanine for sedation, anxiety, and cognition in preoperative surgical patients (a randomized controlled study)

October 18, 2024 By Trudy Scott 7 Comments

L-theanine is a unique amino acid found in green tea. It prevents stress, produces anxiolysis, modulates alpha activity, and provides beneficial effects on mental state, including sleep quality.

Gamma-aminobutyric acid (GABA) is a non-proteinogenic amino acid and a phytochemical that is the main inhibitory neurotransmitter in the mammalian brain. It is beneficial in anxiety and stress regulation.

This overview of theanine and GABA come from this paper, Comparison of the effects of two amino acids, Gamma-aminobutyric acid (GABA) and L-theanine, on sedation, anxiety, and cognition in preoperative surgical patients – A randomized controlled study, a very promising paper published in May this year.

This novel study was planned to study and compare the effects of L-theanine and GABA on anxiety, sedation, and cognition in preoperative patients posted for major elective surgeries under general anesthesia.

The conclusion is that: “GABA and L-theanine result in effective preoperative anxiolysis with minimal sedation and improvement of cognitive skills.”

In other words, both these amino acids are calming before a surgical procedure, don’t cause too much drowsiness and improve cognition.

There are a number of reasons why I feel this study is so promising: anxiety before surgery is very common; laryngospasms (or vocal cord spasms) during surgery are potentially life threatening and clinically we see GABA to be helpful outside of the surgical setting; and any research confirming the calming benefits of GABA (and other amino acids like theanine) supports what we see clinically and furthers the field. This is especially the case when it’s a randomized controlled study such as this one. More on all this below.

The study information and benzodiazepine comparison with GABA/theanine

It was a small study with a “total of 168 patients aged between 18 and 55 years .. who were randomly divided into three groups that received either oral L-theanine, oral GABA, or oral alprazolam 0.25 mg. The anxiety score, sedation score, and psychomotor and cognitive performance scores were noted 60 minutes before and after the administration of the drugs” and amino acids.

Alprazolam is an antianxiety medication known as a benzodiazepine which impairs “psychomotor performance and cause excessive sedation.” I’ve blogged extensively about many of the known issues with benzodiazepines.

Because of this it’s worth noting that the authors share this exciting information: “To our knowledge, our study is the first comparative study that compares GABA with L-theanine and alprazolam.”

This in itself is very encouraging but more so because the outcome “showed that oral L-theanine, oral GABA, and oral alprazolam were equally effective in producing anxiolysis.”

How much GABA and theanine was used in the study? And what is optimal?

You can read the entire study here: Comparison of the effects of two amino acids, Gamma-aminobutyric acid (GABA) and L-theanine, on sedation, anxiety, and cognition in preoperative surgical patients – A randomized controlled study

Laryngospasms during anesthetic – could GABA help prevent this?

Laryngospasm is a life threatening complication during the perioperative period (time of surgery) with an incidence of 0.78-5% depending on the surgical type, patient age, pre-existing conditions and anesthetic technique.”

It is described as “the sustained closure of the vocal cords resulting in the partial or complete loss of the patient’s airway. Although described in the conscious state and associated with silent reflux, laryngospasm is a problematic reflex which occurs often under general anaesthesia.”

The authors state that “a clear management plan is required to avoid significant morbidity and even mortality.” They do discuss the use of magnesium “due to both an increased depth of anaesthetic and muscle relaxation” and the authors state that this “agent may have a role to play in the future prevention of laryngospasm, but more studies are needed.”

Clinically we see GABA to be helpful for the prevention of laryngospasms outside of a surgical setting (I blogged about this here) and it’s intriguing to consider that the use of GABA before surgery may actually help prevent or reduce the severity of this complication. I look forward to future research on this application of GABA.

Until then it may be worth discussing with your surgeon and anesthetist. I have a family member who is susceptible to laryngospasms and GABA powder rubbed on the inside of his cheek during an episode, stops the spasm and stridor (abnormal high-pitched sound) in a matter of 30 seconds. Prior to a recent surgical procedure, he discussed this with his surgeon and anesthetist. We were both pleasantly surprised that they were both interested and open to having him take GABA with him into surgery.

GABA for anxiety, stress, muscle spasms and pain too

I shared this excerpt in a recent blog but it’s worth sharing again: a number of studies have shown that “GABA is implicated in a large number of diseases including anxiety and stress disorders, pain, musculoskeletal disorders, sleep disorders, depression, addiction and withdrawal syndromes.”

Let’s consider GABA (and theanine) during the often stressful and anxiety-provoking periods leading up to surgery and on the day of surgery. It’s likely to help with muscle spasms, pain reduction and sleep too.

A few GABA product options – a sublingual, a powder and a cream

The authors had the study participants use 500 mg GABA, swallowed. As I mentioned above, using a lower dose sublingually may be as effective or possibly even more effective. Also, dosing of GABA (and other amino acids) is individualized to the unique needs of the person.

One product I use and recommend is Source Naturals GABA Calm lozenges. It’s a good low dose of 125 mg and is convenient and effective because it’s a sublingual lozenge.

For Source Naturals GABA Calm lozenges and Now GABA Powder:

You can purchase these from my online store (Fullscript – only available to US customers – use this link to set up an account).
If you’re not in the US, you can purchase these at iherb (use this link to save 5%).

Somnium GABA Cream is another option that could be considered especially for children and those with special needs. It is available in the US and elsewhere with international shipping. Read more about the product and who else may benefit from using a cream, and grab my coupon code to save 15%.

Additional resources when you are new to using GABA and other amino acids as supplements

As always, I use the symptoms questionnaire to figure out if low low GABA or other neurotransmitter imbalances may be an issue.

Wrapping up and your feedback

I’d love to hear from you – does any of this resonate with you? Do you feel increasingly anxious before surgery and other medical procedures and is GABA and/or theanine part of your calming repertoire?

And have either helped you when experiencing a laryngospasm?

Have you ever discussed either of these two amino acids with your surgeon or anesthetist prior to surgery and were they open?

If you’re a practitioner do you recommend GABA and theanine to your anxious clients/patients and as a surgeon or anesthetist would you consider these amino acids in the future (especially in patients more prone to laryngospasm)?

Feel free to share and ask your questions below.

Fran suffered from proctalgia fugax alarmingly frequently for over 10 years: GABA is the only thing that helps and has absolutely changed her life

October 4, 2024 By Trudy Scott 4 Comments

Trudy, your information about GABA has absolutely changed my life. I was suffering from proctalgia fugax alarmingly frequently over the last 10 + years, not just during the night but also during the day, at work, while driving, anywhere… which caused so much anxiety and stress for me. I had many episodes where I had vasovagal episodes and passed out (which instantly resolved the symptoms but left me exhausted and battered.)

Now, because of your information I have a strategy that seems to work almost all the time- I take half a teaspoon of GABA powder sublingually as soon as I feel the twinge coming on. I sit on the ground in a safe place where I can either slump left or right without hitting my head (seriously! ).

I open the “breathing app” on my phone (free app) and focus on breathing in time with the inflating and deflating ball on the screen . I have more powder if the symptoms are not fading. Reducing the panic by controlling my breath is absolutely crucial, and the GABA powder short cuts the whole episode.

In the past, before GABA, I have had episodes that lasted over an hour. I have small tubs of GABA stashed in my handbag, gym bag, office, car etc. This has been the only thing that helped. Thank you

Fran posted this wonderful feedback about how the amino acid GABA, used as a supplement, is life-changing for her proctalgia fugax. If, like Fran and I, you’ve experienced these anal cramps (or butt cramps or anal sphincter spasms or “cramps in your bottom”), I know you can relate to how intense the pain can often be.

Today’s blog highlights more about this condition in case proctalgia fugax is new to you or if this application of GABA is new to you. I also discuss GABA dosing and some insights that may help Fran (and her son) get even more relief. And I share some of the latest research which unfortunately doesn’t offer much in the way of a solution.

How much GABA does Fran use?

I thanked Fran for sharing her wonderful success using GABA for proctalgia fugax. And I acknowledged how stressful it is to not know when the next episode will happen and then to be in such pain for over an hour in some instances. Like Fran, I’ve had a few clients also report passing out due to the pain.

She mentions using “half a teaspoon of GABA powder sublingually” as soon as she feels the twinge coming on. The key here is use it as soon as you feel the twinge of pain and using it sublingually like Fran does is perfect. Half a teaspoon of the powder is around 1500 mg GABA, which is a very high dose (a typical starting dose is 125 mg GABA).

I first blogged about GABA as a solution for my agonizing rectal pain and spasms in 2017. I find that 125 mg to 250 mg GABA works well for my needs and have had similar feedback from others in the community. I share this to illustrate the variability in the amount that may help.

For Fran, increasing the amount of GABA may help with prevention. But given the high dose she is already using I suspect that as time goes on and her GABA levels increase, it’s possible that her need to sit on the ground and use the breathing app may no longer be needed. She may find her GABA levels rebound with consistent GABA use throughout the day, even when she is not experiencing rectal spasms.

She does also mention feelings of panic so it’s possible that low serotonin may also be a factor. If this is the case then a trial of tryptophan or 5-HTP is worth considering.

GABA helps Fran’s son too

Fran added this PS to her comment:

Ps my 21 yo son has started experiencing these symptoms recently and he follows the process of taking GABA and using the breathing app and hasn’t had an episode last longer than a few minutes. I am so grateful that he hasn’t experienced a full blown episode of proctalgia fugax.

How wonderful that this helps her son too!

For both of them, I’d recommend trying to figure out what may be contributing to their low GABA levels and addressing those root causes. My book is a great starting point to address dietary factors, gut health, low zinc, low vitamin B6, toxins and infections that may play a role.

What is proctalgia fugax pain like and how is it treated medically?

This recent paper, Chronic anal pain: A review of causes, diagnosis, and treatment shares that “chronic anal pain is a relatively common problem affecting up to 11.6% of the US population.” Proctalgia fugax is one type of chronic anal pain and in this paper the pain is described as follows:

“Short-lasting (seconds or minutes) sharp deep rectal stabbing or cramping. No radiation. No anorectal pain between episodes.
The pain can occur night or day and vary in severity from uncomfortable to unbearable.”

It’s really disappointing to me that the solution offered is simply reassurance and an explanation:

From a treatment perspective, the problem with diagnosing proctalgia fugax is that symptoms are generally too brief or infrequent to treat. Thus, the key is patient reassurance and explanation, such as describing the condition as a “cramp in your bottom” that is harmless and not indicative of any serious bowel disease.

It may be harmless but I’ve had clients describe the pain as excruciating and agonizing, with many saying it’s worse than childbirth.

As you read above, these episodes caused Fran “so much anxiety and stress”, caused her to pass out and left her feeling “exhausted and battered.” I don’t know what her medical team told her but I believe we can do better than what these authors are proposing.

The first time I experienced a proctalgia fugax episode, I was terrified and beside myself, not knowing what it was or what to do. The pain was extremely severe and lasted about an hour. I eventually figured out the solution because I had used GABA for my own anxiety and to ease tense muscles and other kinds of pain.

GABA for anxiety, pain and muscle spasms (and more)

A number of studies have shown that “GABA is implicated in a large number of diseases including anxiety and stress disorders, pain, musculoskeletal disorders, sleep disorders, depression, addiction and withdrawal syndromes.”

It’s time that GABA supplementation is recognized and used more for pain, muscle spasms and anxiety – everything that Fran and her son experience. I’d love to get some cases like this published so we can get the message out in a bigger way and have the research catch up with what we are seeing clinically. If you know of anyone who could help in this regard please do comment below or reach out.

A few GABA product options – a sublingual, a powder and a cream

Fran used a GABA powder, possibly similar to Now GABA Powder (which does need to be measured out to provide a 125 mg typical starting dose). Keep in mind, some individuals need less to start and some like Fran may need more.

When using GABA powder I have clients use a handy mini measuring spoon like this one (my Amazon link) and share more about how to measure out GABA powder on this blog).

Source Naturals GABA Calm lozenges (a good low dose of 125 mg) is another GABA product I recommend and is helpful in cases of proctalgia fugax because of the lozenge instead of it being a powder that needed to be measured.

For Source Naturals GABA Calm lozenges and Now GABA Powder:

You can purchase these from my online store (Fullscript – only available to US customers – use this link to set up an account).
If you’re not in the US, you can purchase these at iherb (use this link to save 5%).

Somnium GABA Cream used before bed may prevent an episode in the night and is less likely to stop an episode that is in full force. It is available in the US and elsewhere with international shipping. Read more about the product and who else may benefit from using a cream, and grab my coupon code to save 15%.

Additional resources when you are new to using GABA and other amino acids as supplements

As always, I use the symptoms questionnaire to figure out if low low GABA or other neurotransmitter imbalances may be an issue.

Wrapping up and your feedback

I appreciate Fran for sharing her success with GABA and the success her son has experienced too. I do hope this information has been helpful for you and for them too.

Now I’d love to hear from you – does any of this resonate with you? Have you had success like this with GABA? What solution has your medical team offered?

If you’re a practitioner is GABA one of the amino acids you use with your clients/patients?

Feel free to share and ask your questions below.