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Insomnia

GABA, 5-HTP and melatonin isn’t working anymore for my insomnia and tryptophan gives me a migraine – what should I do?

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Today I’m addressing a great question I received on a recent tryptophan blog about insomnia and the use of the amino acids GABA and 5-HTP in a combination product together with melatonin, and what the next steps should be when you are not getting the expected results. And if continuing with tryptophan is a good idea when it seems to be causing a migraine and isn’t leading to a whole night’s sleep. Here is the question:

I have suffered from insomnia for most of my life. I just got your book and am loving it! Thank you for all that you do. My symptoms seem to be high for both low GABA and low serotonin [here is the questionnaire].

I also believe I have a blood sugar problem, so I’m starting to follow your suggestions for that.

I’ve been taking a supplement for sleep that has both GABA and 5-HTP in it, along with melatonin. It worked for a year, however it just recently stopped working.

I thought maybe I should try tryptophan. After taking only 220 mg per night, along with 5 mg of melatonin, I was able to sleep, but not through the entire night. However, the next day I woke up with a horrible headache/migraine. I know it was the tryptophan because I did a trial and tried a night without it and then again with it and the nights I took it, sure enough, the migraine would return.

I must add that I had bloodwork done and tested low for melatonin, which is why I was adding the melatonin into my protocol.

My question is: do I continue with a higher dose of GABA, 5-HTP and melatonin, since it worked for a year i.e. do I up the dosage of the supplement I’ve been taking? Or do I continue trying different doses of tryptophan?

I shared this response in my comment (with some additions for this blog post).

Always first address the nutritional foundational aspects

Firstly, I was glad to hear she is loving my book The Antianxiety Food Solution (my Amazon link) and implementing dietary changes. This is so foundational to any protocol for both anxiety and insomnia. Too often, someone hears me talking about the amazing amino acids and forgets the nutritional basics of real whole food, quality animal protein (like wild fish, pastured eggs and chicken, grass-fed red meat), organic veggies and fruit, healthy fats (like olive oil, coconut oil and butter), fermented foods and broths, and no gluten, caffeine or sugar.

I don’t ever have clients push through

With regards to her trial of tryptophan I shared that I don’t ever have clients push through on a product that is causing any adverse effects, and especially when it’s a migraine. She was smart and trialed the tryptophan twice to make sure it was the tryptophan that caused the migraine and not something else.

Capitalize on what has worked and increase one at a time

With regards to the GABA, 5-HTP and melatonin I shared that I always like to capitalize on what has worked in the past (or is currently working) and would rather increase the 5-HTP and/or melatonin and/or GABA one at a time.

Notice that I said increase these products one at a time. She is taking a combination product so it’s impossible for her to do this. Maybe her GABA levels are now good (because her progesterone levels have improved due to be on a regular zinc supplement or because she has been doing regular yoga sessions) and maybe she needs more serotonin support (because her estrogen levels are off because of recent exposure to xenoestrogens in plastics).

Even though is research showing that a combination product containing GABA and 5-HTP improved sleep and sleep duration more than the use of either of the two amino acids alone, based on her feedback, if we were working together I would have her do each of the GABA, 5-HTP and melatonin separately. This way it’s easy to mix and match and increase one and possibly lower the other, until the ideal combination is found for her unique needs at this time in her life.

She may even find she only needs GABA or only needs 5-HTP or only melatonin. She may also find she needs sublingual melatonin for helping her fall asleep and timed-release melatonin for helping her stay asleep.

She mentions the amino acid questionnaire so it sounds like she is clear on her symptoms: low GABA physical anxiety affecting her sleep and low serotonin mental worry-type of anxiety affecting her sleep. So as she trials the individual amino acids she can see how she does symptom-wise in order to find the ideal amount.

Other factors to consider with insomnia

It’s often straight-forward with the amino acids and the great thing is that one you have the correct combination you will see results in a few days to a few weeks. But There are other factors we may need to consider with insomnia:

  • Keep in mind that 5-HTP can raise cortisol and low blood sugar can indicate adrenal issues so looking at high cortisol as a factor in the sleep problems would be something to consider. A 4-collection saliva test will measure this and my favorite product for lowering high cortisol is Seriphos. Other nutrients for adrenal support may be needed too.
  • Just addressing low blood sugar can often improve insomnia. Eating to support blood sugar swings, early morning sunlight and no blue light after dark can make a world of difference.
  • Other sleep factors we always want to consider: sex hormone imbalances, parasites (they are more active at night and can keep you awake and play a role in high cortisol), accidental gluten exposure, SIBO (small intestinal bacterial overgrowth), candida, sleep apnea and mouth breathing, EMFs (WiFi in the home, commuting with the iphone on, a new cordless phone etc.) and medication side-effects (benzodiazepines are a common one).

I really appreciate questions like this being posted on the blog so others like you also get to benefit. This question also demonstrates just how our needs for certain nutrients can change over time and how we may to keep adjusting what we are doing.

In case you have questions about specific products that I use with clients, here is my supplements blog and more information on GABA for the physical type of anxiety and 5-HTP/tryptophan for the worry-type of anxiety.

Can you relate to this scenario? Feel free to ask your questions about sleep, GABA, 5-HTP, tryptophan and melatonin and share your experiences with these products and how they have helped you or if you’ve had issues with any of them.

I wake in the middle of the night with a jolt of fear, feelings of dread or feeling depressed

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Waking in the night feeling anxious and with a jolt of fear, having a panic attack, experiencing feelings of impending doom, with a pounding heart and even feeling depressed is a common issue I see with clients and it’s a common question that I’m often asked on my blog and on Facebook.

Here is a typical question you may relate to:

I usually wake between 5-6 am and have this overwhelming feeling of dread and start thinking of all the things I have to get done. And then I can’t fall back asleep. What is this?

Or this one:

Does anyone have severe depression when waking up in the middle of the night, but never during the day or before falling asleep. It doesn’t go away until after I’m fully awake and upright in the morning.

Low serotonin?

Serotonin is known to dip later in the day and at night and we know low serotonin can cause depression and insomnia/waking in the night, so my first thought would be to assess for low serotonin and address this if it is the case. I use the questionnaire and trial method.

I always start with tryptophan, but may switch to 5-HTP if that’s not working as expected as some people do better on one versus the other. We add melatonin if the tryptophan or 5-HTP isn’t quite enough to help with the waking.

There are many possible causes of low serotonin so over the course of the next few months these will be addressed too, on a case by case basis. Some of the causes in include: a poor diet, low stomach acid, malabsorption, low zinc, low B6, low iron, low magnesium, dysbiosis and/or parasites and/or candida, the birth control pill, MTHFR defects (with this defect expressing) etc.

Low GABA?

Low GABA levels may be a factor too as this can contribute to insomnia and waking, especially when there is physical tension. New research reports GABA’s involvement in unwanted thoughts and it’s a common factor in my community and clients. Again, I use the questionnaire and trial method to find the ideal amount of GABA for each person.

High cortisol?

High cortisol in the night can also be a factor and I suspect this when someone says they wake with a jolt of fear or feels what they describe as an adrenalin rush. Saliva testing can confirm cortisol levels and Seriphos is the best product I’ve found to lower high cortisol. Addressing low blood sugar and finding the root cause of the adrenal issues are also key. General adrenal support with B vitamins and adaptogenic herbs are often needed too.

Hormone imbalances and/or PMS?

Here is another typical question you may relate to:

I’ve had the worst week regards 3am panic attacks, lurid dreams and wake up aching. It always feels like the end of the world and yet I get up and stagger out to do my morning routines and all is right with the world (apart from physical aches and pains). I have often had bouts of this. It’s a week to go until my period.

If the anxiety or panic attacks are cyclical and tied to your menstrual cycle I will still start with a trial of tryptophan which has been shown to help PMS, tension, depression and mood swings. Serotonin support also helps with fibromyalgia-type aches and pains.

A trial of GABA is often needed too and can help with alleviating the panic attacks, waking and some of the aches. Other factors like a gluten sensitivities, adrenal issues and high oxalates may also play a role in physical aches.

Lurid dreams clues me into the possibility of low vitamin B6, which is an important co-factor for making both GABA and serotonin, as well as being important for alleviating PMS symptoms and the social anxiety condition called pyroluria. The pyroluria protocol, with vitamin B6, zinc and evening primrose oil, helps both the social anxiety as well as PMS symptoms and insomnia.

Address the basics

You may be looking for the perfect supplement to help and while the amino acids come pretty close to being that, it goes without saying that you want to always address the basics. This means making sure you are eating a real whole food diet with quality animal protein and getting that animal protein at breakfast in order to balance blood sugar. The following needs to be eliminated too: caffeine, gluten and sugar. Some individuals do even better on a ketogenic diet.

Looking at sleep hygiene factors fall under the basics too: a dark, cool and quiet room, no PC or iPhone late at night, no iPhone or other EMF sources close by, sunlight exposure in the early morning etc.

And we mustn’t forget stress reduction, exercise and nature.

Address other bigger issues

Medication side-effects must always be considered. Here are a few examples:

Hashimoto’s thyroiditis must also always be considered especially when there are fluctuations in mood, anxiety and sleep. These fluctuations in mood and anxiety can happen at any time of the day and not necessarily in the night.

If the insomnia and middle of the night anxiety and depression persists we continue to dig and look at dietary histamine and oxalate issues, SIBO, parasites and other digestive issues.

If we are still not seeing results then a referral for Lyme disease, mold, sleep apnea and heavy metals may be needed.

My checklist

My checklist when I start when working with someone with issues similar to the above. This will be tweaked based on each person’s own biochemistry and where they are in terms of diet, supplements and lifestyle:

  • Low serotonin? Do a tryptophan or 5-HTP trial
  • Low melatonin? If tryptophan or 5-HTP trial isn’t quite enough then add melatonin
  • Low GABA? Do a GABA trial
  • Low blood sugar? Add quality protein at breakfast, plus glutamine
  • High cortisol? Support the adrenals and use Seriphos or something else to lower the high cortisol
  • PMS/sex hormone imbalances or Hashimoto’s? Address with diet, nutrients and hormone support as needed
  • Low magnesium, low zinc, low B6, low iron? Assess for these deficiencies and address them
  • Gut health issues like leaky gut, dysbiosis, candida, parasites, SIBO? Address these issues
  • Histamine, oxalate or other dietary issues? Address these issues
  • Medication side-effects? Figure out which one is an issue and work with the doctor to taper if needed and address why the medication was initially prescribed.
  • If the issue persists – a referral for Lyme disease, mold, sleep apnea and/or heavy metals

As you can see there are many overlaps with some of the 60+ root causes of anxiety.

Here is additional information on tryptophan for low serotonin, GABA for low GABA and glutamine for low blood sugar, plus the list of supplements I use with clients.

As always, if the amino acids are new to you, review the precautions and be smart about using them. My book The Antianxiety Food Solution (Amazon affiliate link) has an entire chapter on the amino acids, plus chapters on diet, gut health, caffeine, blood sugar and more.

We’d love to hear which of the above approaches have helped with your insomnia and waking with a jolt of fear or dread or pounding heart.