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Trigeminal neuralgia and anxiety: GABA, tryptophan, St. John’s Wort, acupuncture, DPA, gluten, herpes and Lyme disease

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trigeminal neuralgia and anxiety

I get a surprisingly high number of questions about trigeminal neuralgia asking if there is a role for the amino acids GABA or tryptophan to help ease some of the nerve and associated face pain. It’s surprising because trigeminal neuralgia is considered a rare neurological disorder.

Nerve pain is not my area of expertise (anxiety is), and because anxiety and depression is common in this population, there are very likely similar underlying causes (more on that below). The targeted individual amino acids that we use for anxiety, also help to ease pain, so I’m sharing some of what I know in case it helps you or a loved one.

Read on to learn more about this condition and GABA, tryptophan, DPA, acupuncture, St. John’s Wort, Lyme disease, herpes and B vitamins.

About trigeminal neuralgia and the incidence

The NIH fact sheet defines trigeminal neuralgia (TN) as

a chronic pain condition that affects the trigeminal or 5th cranial nerve, one of the most widely distributed nerves in the head. TN is a form of neuropathic pain (pain associated with nerve injury or nerve lesion.) The typical or “classic” form of the disorder (called “Type 1” or TN1) causes extreme, sporadic, sudden burning or shock-like facial pain that lasts anywhere from a few seconds to as long as two minutes per episode.  These attacks can occur in quick succession, in volleys lasting as long as two hours.  The “atypical” form of the disorder (called “Type 2” or TN2), is characterized by constant aching, burning, stabbing pain of somewhat lower intensity than Type 1.  Both forms of pain may occur in the same person, sometimes at the same time. The intensity of pain can be physically and mentally incapacitating.

The incidence of new cases is approximately 12 per 100,000 people per year and women are impacted more than men.

A number of studies show anxiety, depression and insomnia are common when someone has trigeminal neuralgia. The question is this – is the pain causing the anxiety, depression and insomnia OR are there common underlying physiological causes for both. It’s likely a combination of both especially when it comes to idiopathic trigeminal neuralgia i.e. when there is no known cause. Known causes include head injury, multiple sclerosis, dental procedures, tumors and cysts.

By using some of the approaches outlined below, we may see pain relief and improved mood, less severe anxiety and better sleep.

When to consider GABA and serotonin support

There is no research on either GABA or tryptophan/5-HTP helping with symptoms of trigeminal neuralgia, however medications that work on both GABA and serotonin are typically prescribed for trigeminal nerve pain. For this reason I would consider a trial of GABA and/or tryptophan (or 5-HTP if other low GABA physical anxiety symptoms and low serotonin worry-type anxiety symptoms are also present. You can find the symptoms list here.

There is research-based and clinical evidence that GABA and serotonin support help with other types of pain:

Both help with the anxiety, low mood and insomnia that is often present with pain conditions like this.

St. John’s Wort for nerve pain and mood

In one case report, Hypericum perforatum (St. John’s Wort) as a possible therapeutic alternative for the management of trigeminal neuralgia (TN), a 53-year-old Hispanic female patient with a history of trigeminal neuralgia used an over-the-counter preparation of St. John’s Wort and found it relieved her pain completely.

St. John’s Wort is a herb that is primarily “used for depression but also is used for rheumatism, gastroenteritis, headache and neuralgias. ” This case report is one of many studies on this herb and trigeminal neuralgia and other neuralgias (nerve pain).

It has anti-inflammatory and antioxidant effects and also supports serotonin and GABA production which further supports the above recommendations to trial the amino acids.  GABA and tryptophan would also be safe options if St. John’s Wort can’t be used as in the case of blood thinners, the birth control pill and other medications

Pain relief with endorphin support: acupuncture and DPA

Acupuncture offers pain relief via endorphin boosting and can be an option for the treatment of  trigeminal neuralgia, also offering relief for the “secondary myofascial pain associated with it.”

DPA (d-phenylalanine) is an endorphin-boosting amino acid that may also offer some pain relief. It can also be used to wean off prescription pain medication and improve sleep.

Other research-based pain-relief approaches for trigeminal neuralgia

Physical therapy, chiropractic care, using a custom dental appliance, and addressing myofacial pain may offer relief or be part of the solution.

There are some less recognized approaches too:

All of the above can also improve mood and insomnia and reduce anxiety too.

Other factors to consider: B vitamins, Lyme disease, herpes and gluten

As with any condition, a full functional medicine work up should be done to rule out and/or address gluten issues, low vitamin B6/B1/B12, and even herpes zoster and Lyme disease as a root cause (or contributing factor).

Current approaches and emerging interventions – disappointing for a 2021 paper

I was excited to read the title of this paper, Trigeminal Neuralgia: Current Approaches and Emerging Interventions, published late this year. The authors share that it “summarizes over 150 years of collective clinical experience in the medical and surgical treatment of trigeminal neuralgia.”

What is disappointing is there is no mention of any of the approaches listed in this blog. It’s published by neurosurgeons so it is understandable that they would say: “The first-line treatment remains anticonvulsant medical therapy. Patients who fail this have a range of surgical options available to them.”

Medications and/or surgical options may work well for you but if not, you need to know there are other options. You may also be looking for a medication-free or non-invasive approach.

Keep in mind that this is what you’ll be offered unless you work with a functional medicine practitioner.

I do agree with and am encouraged by these statements:

  • What is increasingly clear is that there is no catch-all medical intervention that is effective for all patients with trigeminal neuralgia, likely reflective of the fact that it is likely a heterogenous group of disorders that jointly manifests in facial pain.
  • Ultimately, elucidation of the molecular mechanisms underlying trigeminal neuralgia will pave the way for novel, more effective and less invasive therapies.

Complementary approaches: NIH fact sheet

What is encouraging is that the NIH fact sheet I link to above, does mention low-impact exercise, yoga, creative visualization, aromatherapy and meditation.

Other than the standard medications (carbamazepine, oxcarbazepine, topiramate, gabapentin, pregabalin, clonazepam, phenytoin, lamotrigine and valproic acid and tricyclic antidepressants such as amitriptyline or nortriptyline) and surgical options they do also mention acupuncture, chiropractic, biofeedback and nutrients.

Botox is listed too but I have concerns about this approach.

This blog is not intended to be a comprehensive approach for pain relief for trigeminal neuralgia but rather some options you can consider and explore with your practitioner – especially when you also have anxiety, depression and insomnia too.

Resources if you are new to using tryptophan/5-HTP, GABA and DPA as supplements

If you are new to using the amino acids as supplements, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution (you can see the low serotonin, low GABA and low endorphin symptoms) and a brief overview here: Anxiety and targeted individual amino acid supplements: a summary.

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 so you are knowledgeable. And be sure to share it with the team you or your loved one is working with.

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 acid products that I use with my individual clients and those in my group programs.

Has any of the above approaches helped you or your loved one? If not, what has helped you?

What conventional treatment have you had and did it help? Were you offered any of the above non-medication and non-surgical treatment approaches?

If you’re a practitioner, has any of this helped? Please share your treatment approaches too.

Feel free to ask your questions here too.

GABA lozenge relieves excruciating pelvic floor/rectal pain and spasms within 30 seconds: a solution for proctalgia fugax

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gaba lorenze

Have you experienced excruciating pain in the rectum as a result of spasms in your anal sphincter? You may not even know this condition is called proctalgia fugax and you may struggle with the agonizing pelvic floor pain with no quick solution. You may also not get much help from your doctor because the management of proctalgia fugax remains challenging.

The good news is that there is a simple solution that eases the spasms and stops the pain very quickly, typically in less than 2 minutes and sometimes as quickly as 30 seconds. Ashlee discovered how quickly a GABA lozenge worked to give her immediate relief from her scary and excruciatingly painful spasms.

Here is Ashlee’s wonderful feedback on the blog I wrote on this topic a few years ago after this started happening to me:

I want to personally thank you for this article and option of GABA to relieve the excruciating pain I was having.

After research I realized that my pelvic floor was having spasms. Such a new and scary feeling to have been having, and finding your advice and immediate relief of GABA changed everything!

Of course the scariest part initially is the pain and the “what is happening feeling!” But it’s quickly followed up with “when will this happen again, where will I be, and what do I do in that situation?”

I would highly recommend the GABA lozenges which I got at the vitamin store down the street. I carry them in a little baggie with me now just in case an episode happens. I did have an episode happen when I was on site of a job, and thankfully had the GABA lozenge to immediately relieve the pain, literally (within 30 seconds!! INCREDIBLE!)

The option otherwise (and what I did when it first happened) was to soak in a warm bath or with a heating pad, which obviously is not an option if you are at work or not at home.

The other options as suggested online are even scarier… resorting to electric shock up the rectum to ease the spasms! Yikes!

I thanked her for sharing how well the GABA lozenge works for her, saying how happy I am for her! I also let her know that I’d love to share it as a new blog post because it offers so much hope to others (hence this blog).

GABA Calm lozenge and other low GABA symptoms

I assume Ashlee is referring to Source Naturals GABA Calm lozenges which contains 125mg of GABA and is a sublingual lozenge. They do really work this quickly for spasms, pain and anxiety too. GABA always works best when used in a sublingual form like this or when a GABA capsule is opened onto the tongue.

I agree with her – it’s a good plan to keep GABA on hand in case she gets the spasms during the day. I also recommend having GABA next to the bed because it often seems to happen in the middle of the night.

I did ask if using GABA has also helped with easing her other low GABA symptoms. These can include:

  • physical anxiety and overwhelm
  • intrusive thoughts
  • stiff and tense muscles or other muscle spasms/pain
  • insomnia (often the type where you lie awake feeling stiff and tense)
  • stress eating carbs or sugary treats
  • self-medicating with wine or other alcoholic beverages in order to relax and fit in

You can see the entire list of low GABA symptoms here.

(I’ll share an update when I hear back from Ashlee.)

My experience, definition of proctalgia fugax, incidence and overview

I acknowledged her comment about it being very scary the first time it happens. I first blogged about this after it happened to me in 2017 and I figured out GABA worked very quickly for my excruciatingly painful spasms. It was really scary!

You can read about my experience and triggers on this blog: How GABA eases agonizing rectal pain and spasms in under 2 minutes.

The above blog also

  • defines this condition called proctalgia fugax which leads to rectal spasms and sharp fleeting pain in the lower rectum or anus. In some people it can be more than fleeting and is often described as excruciating and agonizing
  • shares how others describe the pain and how common it is (up to 18% of the population, more common in women and affects individuals between 30 and 60 years of age).
  • discusses heating pads as a solution (they also work but can take 20 minutes to take effect and that is simply too long when you are moaning and writhing in pain)
  • mentions medications that are commonly prescribed
  • describes using 30-60 seconds of finger pressure as one possible solution
  • reviews the BEST solution – sublingual GABA. Theanine and taurine can also help

Electrical stimulation of the anorectal muscles or botox – as treatment approaches

When I had first researched this a few years ago, I had not read about “electric shock up the rectum to ease the spasms” that Ashlee mentioned in her comment.  I went looking and found this on Webmd:

For severe proctalgia fugax, electrical stimulation of the anorectal muscles may provide relief. This treatment option involves inserting a small, finger-sized probe into the rectum and using a low voltage current to relax spastic muscles through vibration.

This may be similar to the 30-60 seconds on finger pressure I described but I’ll take the GABA supplement thank you!

This article also mentions botox injections which I am aware is often done. But this opens up another whole can of worms with toxicity issues and the risk of increased panic attacks with botox.

I also share additional information here: How to address rectal spasms with GABA, pelvic floor work, gluten removal and squats

Management of proctalgia fugax remains challenging and treatment outcomes modest at best

A paper, Proctalgia Syndromes: Update in Diagnosis and Management, published June 2020 by gastroenterology departments in Ireland, Romania, Italy and the USA recognizes that “functional anorectal pain syndromes” are complicated and “are a neglected yet often disabling clinical entity resulting in significant economic and psychological burden to the patient.”

They acknowledge that “management of proctalgia fugax remains challenging and treatment outcomes modest at best” and conclude that “further investigation of treatment approaches in proctalgia fugax is required.”

I plan to reach out to the authors and share these wonderful results that individuals are reporting with the use of sublingual GABA. I would also love to get some case studies published so this approach becomes common knowledge.

Resources if you are new to using GABA and the amino acids as supplements

If you are new to using the amino acids GABA and the other amino acids as supplements, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution (you can see the low GABA symptoms here) and a brief overview here, Anxiety and targeted individual amino acid supplements: a summary.

If you suspect low GABA or 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 so you are knowledgeable. And be sure to share it with the team you or your loved one is working with.

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 acid products that I use with my individual clients and those in my group programs.

Have you ever experienced this rectal pain and spasms/proctalgia fugax? Has GABA worked for you? What else has helped?

If GABA helped ease the spasms and pain, how quickly did it work and what product did you use? Did it help with some of the other low GABA symptoms too?

Have you been able to figure out possible triggers or root causes other than low GABA?

If you’re a practitioner, have you seen this with clients or patients and has GABA helped them?

Feel free to ask your questions here too.

Wean off prescription pain medication, improve sleep and reduce emotional eating with DPA (an endorphin-boosting amino acid)

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dpa

A question about using the amino acid DPA (d-phenylalanine) to help wean off prescription pain medication was posted on the blog. She was also hoping it would help ease her pain while she was weaning and improve her poor sleep too. I share my feedback on DPA for weaning, timing of vitamin C, additional information for sleep support and using DPA for emotional eating too. Concerns about oxalates and pain are mentioned and the importance of a comprehensive approach.

Here is the question that was posted:

Hi Trudy, I am trying to get off prescription pain medication and have read that DPA really helps – do you have any knowledge and/or experience with this?

There is a very popular opiate withdrawal support website that recommends DPA 500mg 3x/daily. Since amino acids need to be taken away from food and other amino acids, I feel like it could be very easy to make the DPA go to waste if not taken at exactly the right time every day.

The insomnia is the worst part of opiate withdrawal for me – days can go by with only 20-45 minutes of sleep. I have a little one to care for and the stress of no sleep just makes me want to give up.

No sleep worsens my physical pain as I toss and turn for hours on end. It isn’t a surprise that then causes terrible emotional distress.

One more question…since Vitamin C does help withdrawal does it affect/break down DPA?  I take a liposomal version multiple times a day.

Here is my response: Yes, DPA (d-phenylalanine) does help with withdrawal from prescription pain medication and I’ve used it for this purpose with great success with many clients. It does need to be used away from protein and the dosing can vary for each person.

A starting dose of DPA is 500mg and it can be used 3- 4 x day to start, and we increase from there based on the unique need of each person. We typically adjust the DPA up as the prescription medication is tapered very slowly, and under the guidance of the prescribing physician.

I share more about her vitamin C and insomnia questions below.

If you are new to DPA and endorphin support

DPA/d-phenylalanine is an amino acid used as a supplement.

DPA destroys the enzyme that breaks down/inhibits endorphins and in essence raises endorphin levels. Endorphins are feel-good chemicals that you experience with an endorphin rush when you go for a run or when someone gives you a big hug, when you show kindness to someone or an individual does something nice for you.

Taking the amino acid, DPA, as a supplement helps to raise your endorphins and helps when you feel weepy and overly emotional and reduces the need to self-medicate with treats as a reward or for comfort (more on that below). This amino acid is a favorite with so many of my clients and community because it makes them feel so lovely.

In addition to helping with emotional pain, DPA also helps with easing physical pain. And for this reason it can be used to help get off prescription pain medications.

In summary, these are the signs of low endorphins:

  • Heightened sensitivity to emotional pain
  • Heightened sensitivity to physical pain
  • Crying or tearing up easily
  • Eating to soothe your mood, or comfort eating
  • Really, really loving certain foods, behaviors, drugs, or alcohol
  • Craving a reward or numbing treat

DPA and endorphin support for pain: the research

Here is one paper, which discusses how DPA inhibits or breaks down enkephalins (endorphins are closely related compounds) and as a result helps with depression and pain, and acts as an anti-inflammatory: “proven to be beneficial in many human patients with chronic, intractable pain.” The authors also state that a compound such as DPA “may alleviate other conditions associated with decreased endorphin levels such as opiate withdrawal symptoms.”

This paper discusses beta-endorphins and the reward mechanism and how they can induce euphoria, reduce pain and ease addictions and distress: “Long known for its analgesic effect, the opioid beta-endorphin is now shown to induce euphoria, and to have rewarding and reinforcing properties.”

I would love to see DPA used instead of pain meds when possible or used in conjunction with prescription pain medications when they are needed.

I am also very curious to know which opiate withdrawal support website is recommending DPA. I’m so pleased to hear this because it helps so much – for physical pain relief and for weaning off pain medications.

Is DPA the same as DLPA?

DLPA (dl-phenylalanine), although similar sounding, is not the same as DPA and only offers about half as much endorphin support. It also provides dopamine/catecholamine support (i.e. focus, motivation, mood, energy) and this aspect means DLPA has the same precautions as tyrosine. It also means DLPA can affect sleep if used from midafternoon onwards.

I seldom have clients use DLPA and prefer DPA for endorphin support and tyrosine for dopamine/catecholamine support if needed.

Keep in mind, the amino acid DPA, is not the same as the omega-3 fatty acid called docosapentaenoic acid and also abbreviated as DPA.

The brand of DPA that I recommend for my clients

The brand I recommend for my clients is Lidtke Endorphigen. You can read about it and the other supplements I recommend on the supplements blog here.

My recommendation has always been to chew the DPA capsule for the best effects and to get results quickly (in 2-5 minutes). Instead of chewing the whole capsule I now recommend opening the capsule into your mouth. You can read more about using DPA and some client feedback here.

lidtke endorphigen

I’ve used Endorphigen personally too and it’s always with me as part of my travel first-aid kit. I write about using DPA, GABA and acupuncture for pain relief after my back injury and I had DPA, GABA and arnica on hand when I sprained my ankle while hiking in Red Rocks.

Benefits include reduction of emotional/comfort eating too

As I mentioned above, with DPA there is the bonus benefit of endorphin support to help end emotional/comfort eating where you are seeking treats as a reward i.e it helps with physical pain and emotional pain.

You may relate to this if you are someone who would say or think “I just LOVE chocolate-chip cookies!” or “PLEEEEASE don’t make me give up my treats, it’s all I have left after I gave up my coffee and wine! I deserve something nice!”

This emotional attachment to sweet treats and reward-eating is very common with low endorphins.

Using vitamin C with the amino acids and watching for oxalate pain adverse effects

She is correct, vitamin C is best used away from the amino acids so as not to reduce the beneficial effects.

I do caution clients to find the right amount of vitamin C as too much can increase pain in individuals with dietary oxalate issues. I write about oxalate crystal disease here and vitamin C and oxalates here. Both can aggravate insomnia too and increase anxiety.

Address low serotonin, low GABA and/or high cortisol for sleep too

With sleep issues we may also look into supporting low serotonin with tryptophan or 5-HTP,  and/or low GABA levels with GABA and/or theanine. These amino acids can also help with reducing pain in some instances.

Opioids have an endocrine effect via impacts on the hypothalamic-pituitary-gonadal axis, affecting sex hormones levels and cortisol levels. Endocrine dysfunction can adversely impact sleep and make anxiety worse, and needs to be addressed. GABA and serotonin support can help with some of the sex hormone imbalances and Seriphos helps when cortisol is too high.

A comprehensive approach is key

Of course, a comprehensive approach is key, so it’s important to remove inflammatory foods (gluten, maybe all grains, sugar, caffeine, unhealthy fats etc), add fish oil if omega-3s are low and include anti-inflammatory nutrients such as turmeric.

And we always want to figure out the root cause of the pain and address it. Also, ruling out if dietary oxalates (and vitamin C) are an issue is important and often overlooked.

I’m a big fan of working with a physical therapist and acupuncturist too.

Resources if you are new to using the amino acids as supplements

If you are new to using the amino acids, DPA, tryptophan or GABA, as supplements and want to know more, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution and a brief overview here, Anxiety and targeted individual amino acid supplements: a summary.

If you suspect low endorphins, low serotonin or low GABA levels 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 so you are knowledgeable.

Can you relate to any of this? Has DPA helped your pain and/or helped you withdraw from prescription pain meds? And did you even know this was an option?

Did it also help you sleep and make you less anxious/worried because of the reduction in pain?

What about less emotional eating when using DPA/Endorphigen?

Feel free to post your questions too.

Tryptophan ends TMJ pain, headaches and worry, and improves mood and sleep: a success story

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tryptophan success story

Today I’m sharing a success story on how the amino acid tryptophan, taken as a supplement, ends  TMJ (temporomandibular joint) pain and headaches in a woman in my community. She had the added benefits of an improved mood and less worrying and her sleep improved too.

There is evidence to support the low serotonin connection to TMJ and pain like fibromyalgia and I share that research below.

Before I share the success story, in case you’re new to neurotransmitter imbalances, the other symptoms we see with low serotonin are the worrying-type of anxiety, panic attacks and phobias, lack of confidence, depression, negativity, imposter syndrome, PMS, irritability, anger issues, insomnia and afternoon/evening cravings. Tryptophan can be used to boost serotonin levels and improve these symptoms as you’ll see below.

Right after speaking on the recent Trauma and Mind-Body Super Conference, Renee shared her wonderful success story on Facebook:

Out of all the interviews I felt yours gave the most actionable steps. I was taking amitriptyline for TMJ and didn’t like the side effects, however what other options did I have? Not many according to my GP [general practitioner]. Luckily I found your suggestion of tryptophan. And I can’t explain how much of a change it made! I weaned off the medicine and took tryptophan instead and not only did it help the TMJ but also helped me feel more even emotionally.

I am being referred for trauma therapy and I am optimistic that I will be discomfort free soon.

So huge thanks for sharing your knowledge. It helped me at a time when I was really starting to think there were no ‘natural’ options and conventional meds were all I could take.

I checked in with her, thanking her and acknowledging her wonderful feedback. I also asked how much tryptophan made this difference and how quickly she saw an improvement. And what side-effects she was seeing with the medication. She shared this:

I am a week into taking tryptophan, and I’m taking 500mg. I saw improvements with the TMJ within an hour of taking it. My jaw felt loose and I had no headaches, I also felt more ‘even’ mood wise. Like an underlying worry had gone. [worry is a classic symptom of low serotonin – more on that here]

I also had some stress yesterday that usually would have made me crumble, but instead I was able to stand up for myself and see subjectively the extent of the issue and resolve it. I am amazed!

My original medication (amitriptyline) had given me extreme dry mouth, which I found hard to manage, the headaches were also not relieved as much as I had hoped, plus I was having sessions of palpitations.

I haven’t had any palpitations from the day I started tryptophan whereas the dry mouth took some time to subside.

These really are wonderful results and typical that we’d see results this quickly with tryptophan if the root cause of the TMJ and headaches is low serotonin. It can sometimes take a few weeks to find the ideal dose but Renee found it with the initial trial amount of 500mg.

The tryptophan also improved her sleep (and the palpitations and dry mouth side-effects from the medication stopped):

I was struggling to get to sleep and stay asleep, suffering bouts of insomnia, prior to any medication. I still am sleeping well taking tryptophan which I am pleased about.

She did however share that the timing of the tryptophan was making her too sleepy too early in the evening and she was planning to shift the timing:

I am finding tryptophan is making me feel drowsy in the evening, so I am trying different times during the day to take it. Hopefully I can push back the tiredness to perhaps 8/9 at night to coincide with bedtime.

My advice to her was that I have my clients use tryptophan MA (mid-afternoon) and evening and if MA makes them too sleepy they just do an evening dose. That can be enough for TMJ the next day. Sometimes more than 1 x 500mg in the evening is needed for easing TMJ and headache pain that night and the next day too.

I did check with her about weaning off the medication as cold-turkey quitting of psychiatric medications are dangerous and not advised. She shared this:

I weaned off over 1 week, but I was only in it for 8 weeks in total before I found tryptophan.

A slow taper under the guidance of the prescribing doctor is always recommended (more on this for amitriptyline/Elavil withdrawal here).

Here is some research supporting this serotonin/TMJ connection:

…both temporomandibular disorders myalgia (TMDM) and fibromyalgia (FM) have been linked to central and peripheral changes in serotonin availability.” (tryptophan is not used in this study which also makes the serotonin/anxiety connection)

Over the 4 weeks of the study, there was a greater reduction in reported clinical pain and a greater increase in pain tolerance threshold in the tryptophan group than in the placebo group. The tryptophan group was given “three grams of tryptophan in conjunction with a high carbohydrate, low fat, low protein diet.”

If you suspect low serotonin symptoms and are new to using the amino acids and do not have my book I highly recommend getting it and reading it before jumping in to taking supplements: The Antianxiety Food Solution – How the Foods You Eat Can Help You Calm Your Anxious Mind, Improve Your Mood, and End Cravings.

There is a complete chapter on the amino acids and one for pyroluria, plus information on real whole food, sugar and blood sugar, gluten, digestion and much more.  If you’re not a reader there is now also an audible version.

Here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution and additional information on Anxiety and targeted individual amino acid supplements: a summary

Please also read and follow these Amino Acid Precautions.

This lists The Antianxiety Food Solution Amino Acid and Pyroluria Supplements that I use with my individual clients and those in my group programs.

We appreciate Renee sharing her success story. Please share your TMJ/headache tryptophan success story if you have one. And feel free to post your questions here too.

RICE, arnica, GABA and DPA for my sprained ankle

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sprained ankle

I’m in the USA for 2 conferences and I just spent 3 super days visiting my brother and his family in Las Vegas. We had a super hike in Red Rocks National Park.

We went early to avoid the heat and it was fabulous until I slipped on some sand when going down a steep section in the way out.

I twisted my ankle and at the time I thought this is bad! This is very bad!

It was a big relief that I was able to walk out. I walked very slowly and used my sister-in-law’s shoulder in the steep sections, always keeping my foot flat.

However when we got home I found I could not put any weight on it at all. The pain was really bad if I tried! How was I going to be able to navigate airports, hotels, conferences, speaking on stages and standing at my booth over the next 10 days?

At Mindshare, I’m thrilled to have been selected to present on The Future of Health, a 5 min TEDx type talk. My topic is: Why Social Anxiety, Introversion and Loneliness can be Lethal and a Simple Nutritional Solution. It will be videotaped and I’ll be sure to share with you.

[UPDATE: January 2020 – Here is the blog post with a link to the presentation and additional information on pyroluria]

I’ve also be nominated for a Rising Tide award at Mindshare.

And I’m presenting at the Integrative Medicine for Mental Health (IMMH) conference on “GABA for Anxiety, ADHD, Autism, Insomnia, and Addictions: Research and Practical Applications.”

I had to get it healed as quickly as possible!

iced foot

I pampered my foot for the next 12 hours, keeping it elevated and alternating between ice and using a compression bandage.

The RICE – rest, ice, compression, elevate – technique really does work.

I was taken care of my my darling nieces and little Rascal, the taco-terrier came to check on me from time to time.

I could not stand on my foot at all that first day. When I did need to get up, I used the crutches. I was keeping well- hydrated so there were frequent bathroom breaks.

I also used arnica cream topically and arnica homeopathic pills orally 3 times a day.

It was pretty painful that first day so I also used DPA (d-phenylalanine), an amino acid which is great for physical pain. I also decided to use GABA, a calming amino acid  – this helped me relax and feel calm, sleep better and I suspect it helped ease some of the muscle stiffness and the pain too.

By the next day I was able to walk very carefully and 2 days later I was walking with almost no limp. I did continue with all of the above RICE, arnica, GABA and DPA supplements too.

bruised foot

This is how my foot looks 4 days later. There is slight bruising and very little swelling. I can walk without a limp and can now wriggle my toes with no pain.

[UPDATE: July 2021]

I injured my knee last week (the diagnosis is patellofemoral pain syndrome) and I have been hobbling around (I had to use crutches for 2 days), doing physical therapy sessions, doing home exercises from the physical therapist, and using the RICE, arnica, GABA and DPA approach outlined above. It’s doing so much better in just a week but this injury got me thinking “why does this happen to me and how can I prevent it again?”

I have pyroluria and one of the classic set of symptoms with pyroluria is this: “Joints popping, cracking, or aching; pain or discomfort between the shoulder blades; or cartilage problems” (due to low zinc). That’s my first clue.

Because of the pandemic and being mostly home, I’m not taking the pyroluria supplements consistently. That’s my second clue.

I do have Lyme disease. There is a pyroluria-Lyme connection, and it’s well recognized that the Borrelia burgdorferi spirochete often affects the musculoskeletal system. That’s my third clue.

I also have dietary oxalate and pain issues and with the oxalate-vitamin B6 connection, I suspect this may be my fourth clue.

Now I plan to dig deeper into this particular set of pyroluria symptoms and look at the mechanisms at play that cause knee/ankle/hip/shoulder and other injuries to tendons, joints and cartilage (I’ve had many injuries over the years). It’s fascinating what I’m learning so far.

Stay tuned for an entire blog post on the topic. Until then please do share your experiences below if you have pyroluria and/or Lyme disease and/or dietary oxalate issues, and have or have had a lot of injuries.  Keep in mind that just having pyroluria is enough to have these types of injuries and it’s the Lyme and oxalate issues that add to the problems.  Having Ehlers Danlos Syndrome (EDS) adds to the complexity too.

If you’re new to pyroluria, this blog with my Mindshare video, Why social anxiety, introversion and loneliness can be lethal and a simple nutritional solution, has the following information:

  • A brief overview of pyroluria
  • A link to the Pyroluria Questionnaire from my book The Antianxiety Food Solution (which has an entire chapter on the topic).
  • A discussion on how I first discovered the pyroluria-introversion connection
  • And information on loneliness and the sociability/vagus nerve connections

Do you have pyroluria (social anxiety or introversion) or score high on the pyroluria questionnaire?

Have you noticed you are more injury prone when you are not on the pyroluria protocol or that your injuries stopped or became less frequent once you discovered you have pyroluria and started supplementing? And then got worse again when not supplementing?

What kinds of injuries have you had or have now?

Do you also have Lyme disease and/or dietary oxalate issues?

Have you used a similar approach for an ankle or knee injury – RICE, arnica, GABA and DPA?

What other tips do you have for a sprained ankle or knee injury?

GABA oral rinse reduces burning mouth pain

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Burning Mouth Syndrome (BMS) is a chronic pain condition characterized by persistent burning in the mouth. It affects mostly females, especially postmenopausal women, and conventional approaches are often not very successful. You’ll often see articles and papers with the terms ‘refractory’ and ‘unknown etiology’/unknown causes.

Medications like SRNIs and benzodiazepines

Some studies report limited success with medications like venlafaxine/Effexor, an SRNI and topical and oral use of benzodiazepines such as clonazepam/Klonopin. In this paper, Refractory burning mouth syndrome: clinical and paraclinical evaluation, comorbidities, treatment and outcome, 8 participants saw their pain diminish by half within 3 months.

Another paper, The Effect of Clonazepam Mouthwash on the Symptomatology of Burning Mouth Syndrome: An Open Pilot Study, reports success with a benzodiazepine mouthwash in half the participants.

Other than the poor quality of life and having to continue to live with pain, the bigger concern is the side-effects of medications like these, plus concerns with tolerance and then issues with withdrawal.

New oral GABA research for burning mouth

It’s for this reason that I’m excited about the recent research, γ-Aminobutyric acid (GABA) oral rinse reduces capsaicin-induced burning mouth pain sensation: An experimental quantitative sensory testing study in healthy subjects, that finds that both and men and women experienced immediate benefits when using GABA for burning mouth pain.

The burning mouth pain was caused by the application of capsaicin to the tongues of thirty healthy males and females. Capsaicin is the compound that makes chili peppers hot. (I find it interesting that capsaicin was the compound used to cause the burning mouth sensation because this same compound is used in topical creams and patches to ease pain.)

The study concludes as follows:

Capsaicin-induced burning tongue pain and decreases in WDT (warm detection) and HPT (heat pain) can be ameliorated by rinsing the mouth with lidocaine and GABA solutions.

Rinsing the mouth with an oral GABA containing solution ameliorated burning pain and increased heat sensitivity produced by application of capsaicin to the tongue. This finding suggests that GABA can act as a local analgesic agent in the oral cavity.

Lidocaine, a numbing medication, was part of the GABA solution in this study, but because it has side-effects that may include anxiety, I recommend a trial of a GABA-only solution to ease the burning mouth pain.

Using a GABA-only oral solution

Using a GABA-only oral solution makes sense given that the likely mechanism of action of topical benzodiazepines in burning mouth pain is via local action on peripheral GABAA receptors found in the nerve fibers of the tongue.

This is also very feasible based on how effective GABA is for other pain such as proctalgia fugax/rectal spasms, and the visceral pain and muscle tension in your gut caused by the bloating symptoms of SIBO (small intestinal bacterial overgrowth) and muscular back pain after a fall.

How much GABA will help?

As with any use of GABA and the other amino acids, how much will help depends on each person’s unique biochemistry and needs at the time. In the same way I do a trial of GABA with my anxiety clients to determine how much would help, I do the same with burning mouth pain (and other pain situations).

I recommend a trial of a GABA-only product and starting low with 100 to 200mg of GABA swished held in the mouth with some water for a few minutes. This can be used three or four times a day in between meals and with the mg increased slowly based on results.  You can find the GABA supplements I recommend here.

GABA is an amino acid that is recognized for calming physical anxiety and tension and since anxiety (and depression) is very common in those with burning mouth pain, the GABA is going to provide calming benefits too.

As with any health condition, finding the underlying root causes using a comprehensive functional medicine approach is key. One such root cause may be low GABA and using oral GABA is going to address this one and provide some relief while other root causes are identified and addressed.

These other root causes can be very varied as explained in the paper Burning Mouth Syndrome. They can include: age-related reduction in estrogen and progesterone levels, lower cortisol, diabetes mellitus and hypothyroidism, allergic reactions to foods, additives and even metals in the mouth, autoimmune connective tissue disorders, nutritional deficiencies (B1, B2, B6, B12. folate, and/or zinc), smoking and candida, and medication side-effects as mentioned above.

Have you experienced burning mouth pain and seen relief with GABA or other nutritional approaches?

If you’re a practitioner, is burning mouth pain common in your postmenopausal clients or patients and what approaches have you found most successful? Have you found GABA to be helpful?

If you are still suffering with burning mouth please share the following when you comment:

  • Your age (it seems to be more prevalent in women 59 and older)
  • If you have anxiety and/or depression now and have been prone to either in the past
  • How you score on the low GABA questionnaire and which symptoms you relate to? This will provide a clue that low GABA may be an issue and the oral GABA rinse is more likely to help
  • How you score on the low serotonin questionnaire (same link as GABA questionnaire above) and which symptoms you relate to? SSRIs have been shown to help in some cases and we know tryptophan/5-HTP help with pain so serotonin support may help too. Perhaps a tryptophan or 5-HTP rinse is worth a trial too?
  • How long it’s been an issue, what approaches you’ve tried and which approaches have helped (even if they only helped a short while or helped the pain a little)
  • Current and past medications (burning mouth is caused by certain medications)

I’d love to gather a list of all this so we can help you and more women who suffer with these awful symptoms.