Pyroluria

GABA and tryptophan combo provide immediate and noticeable relief for tremors and cervical dystonia in just 7 days

April 17, 2026 By Trudy Scott 13 Comments

I recently discovered your work and felt a sense of hope regarding an amino acid trial. I was diagnosed with Cervical Dystonia and Essential Tremor 15 years ago. I have tried Botox injections and various prescriptions (Bacolfen, Propranolol, Trihexyphenidyl, Gabapentin), with no success. Because alcohol is the only thing that currently provides relief for my spasms and head tremor, I’ve developed a habit of 2–3 glasses of wine nightly.

My neurologist recently suggested Deep Brain Stimulation (DBS), but I want to exhaust all natural options first.

After listening to some of your podcasts, I am ready to try a nutritional approach. I purchased your book today and am eager to start with GABA and potentially Tryptophan, but I need guidance on where to begin safely. I look forward to learning from you and your community.

Lisa shared this recently on a GABA blog post on the site. I responded saying how glad I am that she has found my site and work, and now has my book, “The Antianxiety Food Solution”. I also shared that if alcohol provides relief for her neck spasms and head tremors it’s a good clue that low GABA is an issue. It’s one of a number of possible issues including low serotonin, as she concluded, and these are the amino acids I would recommend starting with, ideally one at a time.

A week later she thanked me for my response and shared her initial wonderful results:

I began with a GABA trial and noticed subtle relief, but after adding 500 mg of L-Tryptophan a few days later, all I can say is WOW. The combination provided immediate, noticeable relief for my tremors. For the first time, I am truly hopeful about managing these dystonic tremors.

Read on to learn more about pyroluria and dystonia connection; tryptophan and tremors; my feedback about Lisa finding her optimal dose of amino acids and ideally using one amino acid at a time; more on alcohol and low thiamine, and GABA for healing a leaky gut; and additional resources if you need guidance using amino acids like GABA and tryptophan.

Pyroluria and dystonia connection

In my initial response to Lisa, I had also encouraged her to search the blog for dystonia and essential tremor as I have blogged about both. With regards to dystonia and pyroluria, I’ve had a number of wonderful success stories, even though mainstream sites like Mayo Clinic will tell you: “There is no cure for cervical dystonia. The disorder sometimes resolves without treatment, but sustained remissions are uncommon.”.

Lisa searched the blog and is very motivated despite her lack of success with Botox and various medications:

While I hadn’t researched pyroluria before, I completed your questionnaire and scored very high.

My next steps are to implement your pyroluria protocol, gradually find my optimal amino acid dosages, and pursue genetic testing.

Your book and expertise have been a turning point for me. I can’t thank you enough for opening this door to healing. I am truly humbled by your guidance.

I’m guessing she found both of these blogs – they are well worth a read:

There is an entire chapter on pyroluria in my book and she’ll be using zinc and vitamin B6 and other key nutrients like a B complex and evening primrose oil, all of which help pyroluria, help ease dystonia symptoms and help with neurotransmitter production.

I’m not surprised she has hope for the first time in 15 years! I also never get tired of feedback like this and look forward to sharing her ongoing improvements. I really do hope she shares all this with her neurologist too.

Finding her optimal dose of amino acids

I’m really glad to hear Lisa has grasped this key aspect of using amino acids such as GABA and tryptophan (and others like DPA for pain relief, another one she may benefit from in the future): finding her optimal dose.

We always start low during the initial one-off trial, track the response and then slowly but surely increase, continuing to track improvements. And drop back to a previous dose if there is an adverse effect.

I see too many folks give up too soon when they simply try one dose and then stop, or try only one product and stop or try tryptophan and stop when it doesn’t help (some folks do better on 5-HTP so both may be worth trialing). The same logic applies with GABA and theanine and sometimes a combination is better than one or the other.

Lisa was fortunate in finding an initial combination that works for her very quickly, although she does plan to optimize further. For others it can take longer with a number of permutations. But once you find your unique protocol, immediate and noticeable relief is what we expect.

My recommendation is to use one amino acid at a time

I will add that my advice is to trial one amino acid at a time and find the optimal dose and then move on to the next amino acid – it makes it so much easier to know which amino acid is helping. Lisa didn’t do this so I just want to point this out. Going forwards, it’ll be better if she just adjusts one at a time.

I did also mention the Serotonin QuickStart Program and GABA QuickStart Homestudy Program in case she hits a wall and needs additional help fine-tuning (more on these programs below).

Alcohol and low thiamine, and GABA for healing a leaky gut

Because of Lisa’s daily wine intake, it would also be prudent to consider and address low levels of thiamine, a common deficiency with excessive alcohol consumption. I write more about classic signs of thiamine deficiency here. Assessing for and addressing other possible nutritional deficiencies would be key too, because of leaky gut caused by alcohol intake.

The good news is that both GABA and tryptophan (and glutamine too) helps to heal leaky gut and also help break the addictive aspect of wine and other alcoholic beverages so it’s easier to quit. Feel free to search the blog for additional information on these topics.

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

We use the symptoms questionnaire to figure out if low serotonin or low GABA or other neurotransmitter imbalances may be an issue for you.

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 importance of quality animal protein and healthy fats is also covered.

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. Another option is the budget-friendly GABA QuickStart Homestudy Program.

If you need serotonin support, the Serotonin QuickStart Program is a good place to get help. This is also a paid online/virtual group program where you get my guidance on using tryptophan and 5-HTP safely, and community support during 5 LIVE Q&A calls. You can sign up to be notified when the next live launch of this program is happening.

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

Thanks to Lisa for asking these questions and sharing her feedback.

Now I’d love to hear from you – have you had success using GABA or tryptophan for tremors or cervical dystonia (or other types of dystonia)?

What about the pyroluria protocol for cervical dystonia (or other types of dystonia)?

Feel free to post your questions below.

Osteoporosis: two of my favorite self-help books by R. Keith McCormick DC (and some of my own story)

August 16, 2024 By Trudy Scott 5 Comments

In May 2023 I posted this on Facebook and it never made it on to the blog so here goes …. osteoporosis and two of my favorite self-help books by R. Keith McCormick DC:

Earlier this week I read this book, The Whole-Body Approach to Osteoporosis: How to Improve Bone Strength and Reduce Your Fracture Risk by R. Keith McCormick DC, and wow, I’m very impressed and learned a ton.

It actually consolidates and builds on what I learned from him at the in-depth and excellent interviews with him on the Osteoporosis Summit, hosted by my friend and colleague, Margie Bissinger, MS, PT, CHC (thanks Margie! – I’ve ordered his newest book too).

I really love how Dr. McCormicks walks us through him being a detective with clients (the cases are excellent). And his information and interpretation on advanced bone health tests (like CTX, P1NP), other basic blood work (CRP, homocysteine, fibrinogen, vitamin D etc.) and functional testing (celiac/gluten sensitivity labs) he does is invaluable.

I’m curious to see what updates he’s made (if any) in his newest book, Great Bones: Taking Control of Your Osteoporosis. Does he now prefer MK-4 to MK-7 (forms of vitamin K), if he addresses the tricky calcium-oxalate issues (I’m trying to figure this one out too) and if he also discusses Trabecular Bone Score (TBS) which can be included in the DXA.

I do like that he discusses prevention too – for younger women and men! He was in his 40s when he started to have osteoporotic fractures.

I’m in my early 60s and don’t have osteopenia or osteoporosis but I want to be proactive and do comprehensive testing. I do have concerns due to my dietary oxalate issues and calcium homeostasis as a result of this.

Read about both books below and more on my own osteoporosis story (yes, I do have osteoporosis after all!) and probable root causes.

The Whole-Body Approach to Osteoporosis

Here is the official blurb for this book:

No pill will cure you of osteoporosis. While medication can sometimes help, it won’t fully address the underlying causes of your osteoporosis or osteopenia. To restore bone health, you’ll need a targeted program combining the best bone-building strategies from traditional and holistic medicine. The Whole-Body Approach to Osteoporosis distills these complex strategies into a whole-body plan you can begin today to dramatically improve your bone strength and overall vitality.

This comprehensive guide includes information on:

- What to eat for stronger bones
- Choosing bone-building supplements and osteoporosis medications
- Foods and medications that may be contributing to bone loss
- Signs and symptoms that can help you monitor your bone health
- How lab tests can help you personalize your plan

It was published in 2009, and I found it to be eye-opening and a wonderful introduction to the comprehensive functional medicine, nutritional and lifestyle approach that needs to be considered when addressing bone health. It’s written for the layperson but is meaty enough for practitioners new to the mechanisms of bone building and bone breakdown, osteoporosis medication and the impacts of environmental toxins.

As I mentioned above, his information and interpretation on advanced bone health tests (like CTX, P1NP), and other labs that are important for bone health (CRP, homocysteine, fibrinogen, vitamin D etc.) is invaluable. He also covers the basics that I cover in my book/work – like eating real food, digestive health and celiac/gluten sensitivity.

It comes highly recommended and you can find it in bookstores and on Amazon here (my Amazon link).

Great Bones: Taking Control of Your Osteoporosis

Here is the official blurb for this book:

Dr. McCormick knows what potential dangers lurk for women and men who don’t understand the life cycle of bone, who don’t realize the role nutrition plays in bone health, who don’t know what can happen to bone even when they think they’re doing “everything right.”

In his mission to help readers — women and men, athletes and nonathletes, primary care physicians and specialists — Dr. McCormick explains not just the fundamentals of osteoporosis but also the pathophysiology of bone loss and what it takes to regain skeletal health.

If you’re a patient suffering from bone loss, Dr. McCormick helps you take control of your osteoporosis; if you’re a doctor, he lays out the most up-to date science so you can best serve your patients. Great Bones is a book everyone can use to achieve better skeletal health well into their 70s, 80s, and beyond.

This one was published in 2023 and is a hefty 714 pages (vs 200 pages for his first book). This book takes everything in his first book to the next level. And while it is more geared to practitioners it is easy enough to follow for the health-savvy layperson.

Every time I pick it up to search for something I learn so much more. Here are a few eye-opening gems:

Test CTX early morning and avoid biotin and collagen for 48 hours beforehand (I also heard him say this on the osteoporosis summits)
“Butyric acid can increase bone formation by lowering osteoclastic formation” (bone break down) “and stimulating the deposition of calcium into the collagen matrix”
“High concentration of lead are found in the cement lines – where mineralized bone meets non-mineralized collagen and where zinc concentration is highest” (and more information on how lead adversely affects our bones)
“Post-menopausal women excrete eight times more urinary zinc than women with normal bone density”

With regards to my questions I had before getting this book – he does use both forms of vitamin K (MK-4 and MK-7) and he also discusses Trabecular Bone Score (TBS) which is an add-on for the DXA and a good indicator of bone texture and quality.

Unfortunately he doesn’t address the tricky calcium-oxalate issues that I’m trying to figure out, other than a very brief mention on one page.

I’m eagerly waiting for a kindle version to come out so I can more easily search for advanced topics. My index is full of my scribbles as I find some topics buried within other topics, like some of the TBS information.

This book is also highly recommended and you can find it on Amazon here (my Amazon link).

My osteoporosis story (some of it anyway)

When I posted about these books in May 2023, I was planning to be proactive and do comprehensive testing to get a good baseline in my early 60s. After reading these books and two others, I had my first DXA in July that included a TBS and testing of my left forearm. I was shocked to find out I have osteoporosis, despite the fact I have exercised my entire life – running (road and trails), playing tennis and then squash, rock-climbing, doing weights to train for climbing, backpacking with heavy packs, mountain biking, skiing and wind-surfing.

Because of this I’m really passionate about getting the message out about testing early (for women and men) and being informed and proactive. Dr. McCormick suggests women do their first DXA at 50 and men at 55 (and earlier if they’ve had a fracture).

Given my many possible root causes, I now wonder if I should have tested myself at 40 years of age? As I mentioned above, my dietary oxalate issues and the disruption of calcium homeostasis is likely a major factor. I’ve added these as contributing factors too: my long-term gut issues (since childhood), gluten sensitivity, SIBO, my history and propensity for anxiety and panic attacks, my past exposure to toxic lead (in my 20s I worked in an oil refinery and was exposed to jet fuel at a small airport), the fact that I have pyroluria (the zinc and vitamin B6 connections – I’ll be publishing a blog post on this and osteoporosis) and my liver/bile issues (which play into the oxalate issues).

Dr. McCormick says this at the start of Great Bones … “you need to understand the causes” and I do so now I can work on all of this. I love that he also says: “In this book what you will find is hope – within realistic physiological limitations – that you can improve your bone health.”

Dr. Kim Millman’s healthier bones course

With these books and other reading I’m doing, I now have the knowledge and tools. I’ve seen some improvements in the last year and I’m ready to jump in and do further testing and additional adjustments to actually reverse my bone loss.

But I need more so I’ve just signed up to do Dr. Kim Millman, MD’s online Restore & Rebuild: 100 Days to Healthier Bones program. Dr. Millman was also a speaker on Margie’s osteoporosis summit and if you are also looking for support and expert guidance via an online program, this one is a no-brainer. There is also an opportunity to ask your questions. It’s really short notice and if you can’t make this cohort, I’ll share my feedback in case you make the 2025 class.

Dr. Millman shared this in one of her interviews with Margie: “I think that the most important thing to understand is that it is possible to reverse bone loss and drastically reduce your risk of fractures naturally. And in my 15 years of evaluating and treating the root causes of bone loss, my patients do not break bones, and they don’t feel fragile anymore. Their fear fades. They don’t feel vulnerable, and they return to living their most active lives and doing the things they love.”

Hearing this gives me even more hope and I’m excited!

And in case you’re wondering, I’m still glad I’ve read both these books and have them to refer back to again and again. Both are heavily referenced too and I love to look at the research.

Wrapping up and your feedback

Now I’d love to hear from you – do you have osteoporosis and have you read either of these books and have any gems to share?

Do you have another favorite book on bone health?

Have you done Dr. Millman’s program?

What age were you diagnosed with osteopenia or osteoporosis and were you surprised?

Have you been able to reverse your bone loss and drastically reduce your risk of fractures naturally?

What root causes do you feel play a role for you?

If you’re a practitioner working with clients/patients with osteopenia or osteoporosis I’d love your insights

Feel free to share and ask your questions below.

Anxiety and vomit phobia in an 8-year-old: within a week of starting vitamin B6 she made a complete turnaround

December 1, 2023 By Trudy Scott 15 Comments

Debbie, a mom in the community, shared this wonderful feedback about how vitamin B6 helped her daughter with terrible anxiety and a phobia of vomit:

My youngest (who is 8 now) started exhibiting terrible anxiety about a year ago, specifically around the phobia of vomit. Her anxiety is mostly about other people throwing up. But her anxiety became so strong it was preventing her from going to school or even staying in her classroom, kept her from eating (because her anxiety hurt her tummy) and even from wanting to do extracurricular activities that she previously loved but now was afraid to attend in case a child might throw up there.

We started her on weekly therapy sessions, and I started her on GABA and tryptophan. While the amino acids helped a little, it wasn’t enough to calm the thoughts that plagued her all day at school and home. Most days I still couldn’t get her out of the car for school.

Through your website and some other research, I decided to try supplementing her with vitamin B6. Within a week of her starting B6 she made a complete turnaround. The anxiety would still come when a kid at school would say their tummy hurt, but she was able to calm herself down within minutes and talk through the worry.

We still have some low days (especially if we haven’t taken her supplements in a few days) but overall, she’s a new kid. Even the school asked what we are doing differently to get her to be calm again.

It’s wonderful to hear that within a week of starting vitamin B6 she made a complete turnaround.

This blog addresses some of the possible mechanisms (possible serotonin and GABA support, and addressing pyroluria), how much vitamin B6 she had her daughter use and optimal dosing, plus other factors like a good multi or B complex.

Some of the possible causes and mechanisms: serotonin and/or GABA support

According to the Child Mind Institute, “Emetophobia, or the severe fear of vomiting or seeing others vomit, is surprisingly common. Kids who already tend to be anxious are more likely to develop it. It leads to fear of things they associate with vomiting. Often it starts with avoiding places where they (or someone else) threw up, or places that remind them of it.”

They discuss therapy and medications as solutions whereas I am discussing nutritional solutions that address the root causes. In this case: addressing low vitamin B6 and its impact on serotonin and/or GABA.

This letter, Vitamin B6: A new approach to lowering anxiety, and depression?, published in 2022, mention a few studies concluding that vitamin B6 supplements “significantly reduce feelings of stress, anxiety, and depression.” It does this via an impact on serotonin and GABA production and this results in the calming of the nervous system.

This 2022 paper, High-dose Vitamin B6 supplementation reduces anxiety and strengthens visual surround suppression, also discusses a GABA mechanism: vitamin B6 supplementation “increases inhibitory GABAergic neural influences, which is consistent with its known role in the synthesis of GABA.” (100 mg/day of vitamin B6 was used by the adult participants)

In this blog post you can read about the role of low vitamin B6 and iron in low serotonin, leading to anxiety and panic attacks.

How much vitamin B6 to use and is pyroluria a factor?

Debbie was not sure how much vitamin B6 to give her daughter:

The struggle I still have is knowing how much to dose her. There’s conflicting info out there as to how much is too much for kids. Right now I’m giving her Carlson liquid B6. I give her between 2-3 drops, which, if I’m doing the math correctly, is about 4-6 mg. She seems to be doing alright on that as long as we don’t miss a day. When we do miss, her anxiety becomes immediately irrational again. If you have any insight on dosing, please let me know. Thanks for all you do!

I shared this feedback with her: With phobia of vomiting I immediately think of the social anxiety condition pyroluria and the additional need for zinc, vitamin B6 and evening primrose oil.

This supports the fact that vitamin B6 helps her daughter and that missed days and increased stress means the anxiety returns.

With kids anxiety can often show up as tummy issues and nausea. And “emetophobics are particularly vulnerable to somatic symptoms, especially gastrointestinal symptoms such as nausea. Nausea, as an anxiety symptom, may be misinterpreted as an imminent episode of vomiting causing further symptoms in a vicious circle.” (from this paper about an 8 year old boy with emetophobia)

Debbie mentions her daughter gets a sore tummy when anxious. If she also feels nauseous on her bad days, that would be another clue to consider pyroluria. A common symptom is morning nausea and addressing pyroluria helps kids who experience this and also helps prevent vomiting. The nutrients for pyroluria are also key for neurotransmitter production (as mentioned above).

I shared that I’ve used 10 – 25mg of vitamin B6 in children this age who have pyroluria (plus the other pyroluria supplements and stress reduction).

Good dream recall with no nightmares is a good gauge of vitamin B6 status and a clue that enough is being used and easy enough to ask children and/or observe nightmares.

There are not many papers on the use of vitamin B6 in children. This study, Use of Nutritional Supplements Based on L-Theanine and Vitamin B6 in Children with Tourette Syndrome, with Anxiety Disorders: A Pilot Study used 2.8mg of vitamin B6 but they were also using theanine.

Supportive solutions: a child’s multi with B vitamins and other underlying factors

When an individual B vitamin like vitamin B6 is used, it’s always advised to use a B complex or a good multivitamin that contains all the B vitamins with sufficient amounts. For children I like a product like Klaire Labs Vitaspectrum ® Powder. This product may actually provide enough vitamin B6 in a situation like this – 1 scoop provides 15 mg of vitamin B6 – or it could be used with extra vitamin B6.

It goes without saying that all dietary and other nutritional factors, gut health, blood sugar handling, sleep, toxins, infections etc. may need to be addressed too.

I would also want to do further exploration into why vitamin B6 may be low, other than pyroluria – such as dysbiosis, inflammation, malabsorption, autoimmunity, low dietary intake, leaky gut, high sugar intake, gluten sensitivity or celiac disease and alcohol use disorder (in adults).

Why didn’t GABA or tryptophan help?

Debbie is well versed in amino acids, having used GABA for her PCOS (polycystic ovarian syndrome). It helped ease her lifelong anxiety, wean off anxiety medication, ovulate each month and stop her PCOS meds. She helped her older daughter with GABA too – she calls them her “happy pills.” And Debbie used tryptophan with success when collagen caused her to have panic attacks again. You can read her story on this blog.

I can’t be sure why GABA or tryptophan didn’t help her younger daughter. It’s where I would have started too, but we are all unique and what works for Debbie and her older daughter just didn’t work for her younger daughter.

It’s possible that a higher dose of GABA or tryptophan may have worked better, or other GABA or tryptophan products, or theanine or 5-HTP or inositol may have been an option.

It’s wonderful that vitamin B6 did work and I appreciate Debbie for sharing and allowing me to share as a blog. I love that the school also asked what they are doing differently to get her daughter to be calm again.

Additional resources when you are new to using amino acids or the pyroluria nutrients as supplements

We use the symptoms questionnaire to figure out if low GABA or low serotonin or low endorphins or low dopamine or low blood sugar may be an issue with vomit phobia.

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, sugar cravings, anxiety and mood issues.

As mentioned above, I would start with GABA and tryptophan (like Debbie did) and then start looking for other approaches that may help.

There is also an entire chapter on pyroluria where vitamin B6, zinc and evening primrose oil is addressed in detail.

This includes the products mentioned in this blog: Carlson 100mg B6 and Klaire Labs Vitaspectrum® Powder.

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 too). This is a paid online/virtual group program where you get my guidance and community support.

Does any of this resonate with you?

If yes, has vitamin B6 helped your child (or you) with anxiety and vomit phobia?

And is pyroluria also a factor that is being addressed?

Have either tryptophan or GABA or Klaire Labs Vitaspectrum® Powder helped too (alone or in conjunction with vitamin B6)?

Feel free to share and ask your questions below.

Side stitch when running or exercising: the anxiety/stress connection (and the pyroluria protocol of zinc and vitamin B6 as a solution?)

August 4, 2023 By Trudy Scott 21 Comments

If you get a painful side stitch when running or doing other exercise or experienced a side stitch when you were a kid, you may be as intrigued as I was to learn there is new research that points to an anxiety/stress connection. This cross-sectional observational study was done involving an anonymous survey of one hundred sixty-eight male and female adults who were running at least 10 miles/16 km per week.

The conclusion of this study, Thorn in Your Side or Thorn in Your Head? Anxiety and Stress as Correlates of Exercise-Related Transient Abdominal Pain, is as follows: “anxiety and stress are associated with the presence of ETAP.” A runner’s side stitch is referred to as ETAP i.e. exercise-related transient abdominal pain. The authors mention the fact that this is the first study to reveal this anxiety/stress connection. This is relevant given the numerous recent studies looking for a cause and no definitive solutions.

This research is also really intriguing to me given what Dr. Carl Pfeiffer MD, PhD, identified 50+ years ago in the 1970s i.e. side stitches are common in those with pyroluria/social anxiety. What’s important is the fact that the pyroluria nutrient protocol eases social anxiety and prevents side stitches in my clients. You’ll read feedback from individuals in the community who resonate with this research and the pyroluria connections. I share more about pyroluria below in case it’s new to you and a possible cause of the side stitch pain.

My feedback and feedback from others in the community

I have pyroluria and always got a left side stitch as a kid, in my teens when running and playing squash and in my 20s/30s when running. And then they stopped (and the social anxiety and related symptoms resolved) when I addressed my pyroluria with zinc, B6 and EPO, and a copper-free multi that contains manganese. I see these kinds of results with my clients all the time so a light-bulb went off when I read this new research .

I shared this research and the anxiety/stress/pyroluria connection on Facebook and asked: did you/do you get side stitches when running/exercising? Here is some of the feedback I received, where the pyroluria protocol did help.

Kameka shared this: “I had side stitches as a kid and as an adult. Running was the main exercise that caused it and it was usually the left side. Now that you mention it, I haven’t had them since I started supplementing for pyroluria. Also, my social anxiety is sooo much better as well!”

She did the symptoms questionnaire and the pyroluria urine test (which can give false negative results) and confirmed she takes vitamin B6, zinc, magnesium, and primrose oil.

Bec shared this: “I hated PE at high school for that reason. While everyone was running, I was suffering from side stitches (I think it was my right side) and having breaks. I have pyroluria with lots of symptoms. I do well with zinc and P5P.”

Not everyone reported an improvement with the protocol but many folks resonated with the side stitch/pyroluria connections:

Megan said: “Couldn’t run as a kid. A stitch every time. I can’t recall which side, never really paid too much attention. Looking at the pyroluria symptoms, I think I may have always had it.”

Janie exclaimed: “Oh, boy, did I!” (while distance running). She finds it hard to remember but thinks it may have been on her right side. She also shared that “tests for zinc come back normal, but I have many of the [pyroluria] symptoms, especially the less common ones. I scored high. I always want breakfast but all the other questions fit me like a glove, like pieces of a puzzle with my photo on the box.

My lack of dream recall is another sign. I take 25 mg of methylated B6, but still no dreams. The question regarding being seated in the middle of a restaurant…THAT IS ME!! My throat will feel like it’s closing up, so much tension.”

I explained that most zinc testing is not accurate and that we increase until we get symptom resolution. I also referred her to the pyroluria chapter in my book.

Susie shared this: “Yes I always got side stitches so I gave up running. I suspected pyroluria but not sure if I have it.”

Leah said “I’d say my daughter and I both [had side stitches] more when we were younger. Both socially anxious and pyroluria. Less exercising now too.”

Information if you’re new to pyroluria

Pyroluria is frequently associated with a type of anxiety characterized by social anxiety, avoidance of crowds, a feeling of inner tension, and bouts of depression. People with this problem experience varying degrees of anxiety or fear, often starting in childhood, but they usually manage to cover it up and push through. They tend to build their life around one person, become more of a loner over time, have difficulty handling stress or change, and have heightened anxiety symptoms when under more stress.

Also on the list of symptoms is this one: “Upper abdominal pain on your left side under the ribs or, as a child, having a stitch in your side as you ran.”

Addressing low levels of the mineral zinc and vitamin B6, together with some other nutrients and stress management, are key to addressing these symptoms.

Here is the complete symptoms questionnaire on the blog. This questionnaire can also be found in the pyroluria chapter in my book, The Antianxiety Food Solution. You’ll find the detailed supplement protocol and additional information on how to assess for low zinc and low vitamin B6 in this chapter too.

You can read more about the prevalence and associated conditions here. It’s most often considered a genetic condition but is possibly environmentally triggered too.

There are many pyroluria blog posts where I cover various aspects such as the importance of addressing pyroluria for recovery from MCAS and Lyme, pyroluria and Ehlers Danlos Syndrome, pyroluria and intrusive thoughts and many more. I encourage you to use the search feature on the blog.

A possible cause of the side stitch in pyroluria

Here is an excerpt from a paper published in 1974 by Dr. Pfeiffer and colleagues, Treatment of Pyroluric Schizophrenia Malvaria With Large Doses of Pyridoxine and zinc, describing why the side pain probably occurs:

This 15-year-old upper middle-class patient (now 19 after studying for four years) represents a case of nutrient deficiency in which vitamins (specifically B6) and the trace minerals manganese and zinc were inadequate for the development of normal knee joints and normal brain function.

The deficiency was sufficiently severe at its peak to cause prolonged psychosis, atypical seizures, arthritis, amenorrhea, constipation, and splenic pain. The pain is probably due to hemolytic crisis in which red cell fragments engorge the Kupfer cells of the spleen and liver, extend the capsule, and cause pain. The double deficiency is produced by the formation of KP [kryptopyrroles] which combines with pyridoxal and zinc.

Based on the above and other publications by Dr. Pfeiffer, when the stitch happens on the left side, my understanding is that the pain is in the spleen. And when it happens on the right side, the pain is in the liver area. Most individuals with pyroluria say they felt/feel their side stitch on the left side. Either way it appears to be caused by low zinc, low vitamin B6 and the other nutrients needed by those with pyroluria. And resolved when on the pyroluria protocol.

I would love to see these ETAP researchers take their anxiety/stress research one step further and identify how common pyroluria is in runners who get side stitches and if the pyroluria protocol prevents the side stitches.

My book as a resource and pyroluria supplements

As mentioned above, there is an entire chapter on pyroluria in 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 addressing these deficiencies. And be sure to share it with the practitioner/health team you or your loved one is working with.

Keep in mind that these nutrients are cofactors for making neurotransmitters and are a key part of my protocol when working with individual amino acids.

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 pyroluria supplements and amino acids that I use with my individual clients and those in my group programs. You can find them all in my online store.

Thanks to everyone who contributed to the discussion on Facebook. Now I would love to hear from you so I can approach the authors with their feedback and yours too.

Did you get a side stitch as a kid and did it affect your ability to take part in school sports?

Do you still get a side stitch when running or doing other exercises? If yes, does it hold you back and with which exercise?

Did/does the side stitch occur on the left or right side?

And do you have pyroluria? (based on the symptoms questionnaire and/or pyroluria urine test)?

Does the pyroluria protocol prevent your painful side stitches? And had you made the connection to pyroluria/anxiety/stress?

Are you seeing a similar pattern with your kid/s? (pyroluria, side stitch and the protocol helps them too)

If you have questions and feedback please share them here too.

My 12 year old son has ADHD, is impulsive, is a loner, craves carbs, and doesn’t do well or care about school – should he be on GABA?

July 21, 2023 By Trudy Scott 17 Comments

I’ve been reading your blogs and I’m trying to decide if my 12 year old son should be on GABA? He has ADHD, is impulsive, is a loner, craves carbs, and doesn’t do well or care about school.

Can you tell me what supplement he could be deficient and where to purchase? He is currently on ADHD medication (Focalin) during the school year.

Janice asked the above question about her 12 year old son. I wish it was as simple as just using the calming amino acid GABA but it’s seldom one amino acid that is the answer. GABA is often one of many supplements that may help and in this instance I suspect a combination of neurotransmitter imbalances (low GABA, low dopamine and low serotonin), pyroluria, other possible nutritional deficiencies and dietary factors are at play. Read on to hear my approach for working through what may help this young man improve his focus, reduce his carbs, actually care about school and doing well, reduce his impulsivity and help him fit in socially – and ultimately lead to him being a happier, calmer and healthier child.

GABA with preteens who have ADHD and spinning-type symptoms

I always start with one of the amino acids because we get quick results and immediate feedback. Since Janice asked about GABA, this is the GABA feedback I shared with her: I’ve had good results with GABA with preteens who have ADHD and spinning-type symptoms. One clue is when the craving of carbs is driven by stress i.e. stress eating. I always start with the symptoms questionnaire and have the parent rate each low GABA symptom on a scale of 1-10, with 10 being most severe, ideally in conjunction with their child.

I then have the child do a one-off trial of GABA and we observe improvements in the next 5-30 minutes. If the child reports any improvement in any of the symptoms – in this case focus and spinning driven by anxiety – the child continues with GABA and increases over the next few weeks to find the ideal dose for their needs.

Sometimes focus issues are so severe that it’s too challenging to rate symptoms before, doing a one-off trial of GABA and then rating symptoms afterwards. In cases like this, mom makes the decision to have their child use GABA before school, when they get home and possibly early evening too. Mom can observe their focus and spinning: like getting dressed and ready for school, settling down to homework in the afternoon and settling down for bed.

Relying on feedback from school is invaluable too. Stress related carb cravings are also assessed i.e. does he seek out sugar when stressed and anxious.

A mom shares how GABA helps her 11 year old daughter – GABA for children: ADHD, focus issues, irritability, anxiety and tantrums

My daughter hasn’t been diagnosed with ADHD but has a lot of ADHD qualities. We were having a huge amount of behavior problems as she is getting older (she’s 11). She has had amazing behavior at school and at home since giving it to her. She’s almost like a different child. GABA has truly changed our life.

…before the GABA she was irritable, she was fighting with her teacher and schoolmates, she couldn’t focus and was distracted by anything and everything, she was constantly disrupting the class and she was throwing major tantrums over ridiculous stuff (like her hair didn’t do what she wanted), she was mouthy and everything was a fight.

We are not seeing 99% of those behaviors at all anymore. She of course is still your typical pre-teen but if I say “no you can’t have that” our “no you can’t go there” her reaction is OK. Before it would have been a major fight or meltdown. Her teacher is reporting to me every day about her wonderful days.

Tyrosine for focus issues, low motivation and low energy type carb cravings

With focus issues I would also consider the role of low dopamine and do a trial of tyrosine. Other clues: are his carb cravings related to low energy and is there also low motivation tied to the fact that he doesn’t care about school? Are there also signs of depression or low mood?

We go back to the symptoms questionnaire and have the parent rate each low dopamine/low catecholamine symptom on a scale of 1-10, with 10 being most severe. Again, do this in conjunction with the child if possible.

We only do a trial of one amino acid at a time so we know what is working. Assuming the GABA has been helping, we’d do a trial of tyrosine next and look for improvements in focus, carb cravings (all neurotransmitter imbalances can lead to carb cravings), motivation and mood.

If the one-off trial approach is not an option, tyrosine is also used before school and right after school but no later than 3pm so as not to affect sleep. Again, the above symptoms are tracked.

In this blog both GABA and tyrosine help this teen: GABA helps 14-year-old with Tourette’s Syndrome (the tics and sleep), and tyrosine makes him happier and his mind sharper

Tryptophan or 5-HTP for ADHD/hyperactivity and afternoon cravings

Hyperactivity can also show up with low serotonin, and so can something like not caring about school i.e. a low mood. A clue here is when his carb cravings are more intense – with low serotonin it’s typically afternoon or evening.

We go back to the symptoms questionnaire and have the parent rate each low serotonin symptom on a scale of 1-10, with 10 being most severe. And again, it’s best to do this in conjunction with the child if possible and do a one-off trial of tryptophan or 5-HTP.

If that’s not possible, tryptophan or 5-HTP is used mid-afternoon and evening and symptoms are tracked. This can be layered in on top of the GABA and tyrosine if they are offering some relief.

Here is a blog post where a mom shares how 5-HTP helps her child – ADHD: 5-HTP melts have been a miracle for one of my adopted kids

5-HTP melts have been a miracle for one of my adopted kids. He had lots of trauma and off the charts ADHD. 5-HTP is better than methylphenidate (Ritalin) and we are now weaning off the non-stimulants.

Just 80 mg 5-HTP in the morning is all he needs. He was super ADHD, he had a para (teacher’s aide) in public school for years to keep him on track and this year at a school for ADHD the teachers were complaining that he was never on task. Now after a week it has changed his life.

Addressing pyroluria, low lithium, low zinc, low blood sugar and diet

Janice mentions her son is a loner so we’d look into pyroluria/social anxiety and add zinc, vitamin B6 and evening primrose oil (and other key nutrients). Keep in mind that zinc deficiency is common and is often low with ADHD.

She also mentions that he is impulsive. Impulsivity and ADHD is common with low levels of lithium. A big clue is a child having a roller-coaster of emotions. I use this low lithium questionnaire to assess for a need for low dose lithium (a nutritional supplement).

I consider low blood sugar with all my clients and with this young man low blood sugar may be contributing to his focus issues, low mood and desire for carbs. The amino acid glutamine helps as does breakfast and meals with quality animal protein and healthy fats.

And it goes without saying that dietary factors must always be addressed. My book is a great resource when are looking for a comprehensive dietary approach, which is needed with ADHD and the symptoms Janice describes – The Antianxiety Food Solution. There is also a chapter on low blood sugar, pyroluria and the amino acids.

If you are an adult and can relate to any of these symptoms and feelings, the same process applies. Just remember this: there is no one-size fits all since we all have unique biochemistry.

Side effects and longer term effects of stimulant medications

I appreciate Janice for reaching out and asking this question. Hopefully, implementing some or all of these changes, will allow her son to stop his stimulant medication, Focalin. This medication is similar to Ritalin (methylphenidate), which can cause the following side-effects: feeling sad or empty, irritability, loss of interest or pleasure, trouble concentrating, trouble sleeping (and many more).

These stimulant medications can also play a role in longer term health effects that include heart disease and the possibility of it being a gateway drug to other stimulants. The research on the latter is hotly debated but it is often seen clinically.

Resources if you are new to using amino acids as supplements

To recap, if you are new to using amino acids as supplements, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution (you can see all the symptoms of neurotransmitter imbalances, including low GABA, low serotonin, low dopamine, low blood sugar and low endorphins).

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.

As mentioned, 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, sugar cravings, anxiety and mood issues.

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 too). This is a paid online/virtual group program where you get my guidance and community support.

Have any of the above amino acids helped your child or you with the following symptoms: ADHD and poor focus, carb cravings and low mood/low motivation (doesn’t care)?

Has the pyroluria protocol helped your child or you be less of a loner?

Has low dose lithium helped your child or you with impulsivity and focus issues?

Have dietary changes helped too?

If you are a practitioner, are you using amino acids, the pyroluria protocol, low dose lithium and dietary changes with success in cases like this?

Feel free to post your questions and feedback here in the comments.

The importance of addressing pyroluria with chronic Lyme disease (and co-infections), MCAS (Mast Cell Activation Syndrome) and other chronic illnesses

August 5, 2022 By Trudy Scott 27 Comments

Pyroluria is a social anxiety condition that responds well to zinc, vitamin B6, evening primrose oil and a few other key nutrients, typically resulting in resolution of social anxiety symptoms within a few weeks with the correct combination and dosing. However there is much more to pyroluria than meets the eye. Addressing this biochemical imbalance is crucial for recovery from chronic Lyme disease (and co-infections), MCAS (Mast Cell Activation Syndrome) and other chronic illnesses caused by heavy metal toxicity, mold toxicity, multiple chemical sensitivities and Ehlers Danlos syndrome (amongst others).

Dr. Neil Nathan, MD, author of Toxic: Heal Your Body from Mold Toxicity, Lyme Disease, Multiple Chemical Sensitivities, and Chronic Environmental Illness (2018), shares this about pyroluria and chronic illness:

This biochemical imbalance is surprisingly common in chronically ill patients, and missing this diagnosis (by neglecting to test for and treat it) also denies us the opportunity to provide a simple, benign treatment that can help quiet down patients’ already overstimulated nervous systems.

(Here is my Amazon link to his book, which is excellent)

For over 15 years Dr. Dietrich Klinghardt has been saying you won’t see success with Lyme disease without also addressing pyroluria. He has seen a correlation with all his patients with chronic illness and pyroluria.

Let me quote from an article by Scott Forsgren, FDN-P and Dr. Dietrich Klinghardt, MD PhD: Kryptopyrroluria (aka Hemopyrrollactamuria): A Major Piece of the Puzzle in Overcoming Chronic Lyme Disease (a Townsend letter article published in 2017):

Based on testing with a lab in Holland, Klinghardt has found the incidence of KPU [Kryptopyrroluria or pyroluria] in Lyme disease to be 80% or higher; incidence of KPU over 75% in patients with heavy metal toxicity (lead, mercury, aluminum, cadmium, and others) and in children with autism over 80%.

These are very significant percentages of the patient population with chronic illness that may benefit from a treatment program that addresses KPU.

They also state what has long been known when it comes to pyroluria: symptoms are made worse by stress and “chronic infections, such as Lyme disease, may themselves serve as a trigger for the condition (of pyroluria).”

When it comes to MCAS, an updated version of this same article states that:

Klinghardt has worked with biochemists in Germany that are beginning to link KPU with mastocytosis or mast cell activation syndrome (MCAS).

They have observed that KPU treatment repairs the heme molecule, which notably stabilizes the mast cells and lowers the response to these relative rises in histamine.

I use the term pyroluria in this article, throughout my blog and in my book. It was coined by Carl Pfeiffer, MD PhD in the 1970s (after its discovery by Abram Hoffer in 1958). You’ll see these other terms used in various articles and in some of the older research: kryptopyrroluria (KPU), hemopyrrollactamuria (HPU), pyrrole disorder, mauve factor and sometimes malvaria.

As I shared in my interview with Dr. Kelly MCann on the summit, The Many Manifestations of Mast Cell Activation, it would be wonderful to get the terminology standardized and to get some case studies published. This would allow it to gain more acceptance in the mainstream and in functional medicine.

These papers, Discerning the Mauve Factor, Part 1 and 2, highlight some of the mechanisms as to why addressing pyroluria is so important:

“Treatment with nutrients – particularly vitamin B6 and zinc – reduces urinary excretion of HPL and improves diverse neurobehavioral symptoms in subjects with elevated urinary HPL.
Heightened HPL excretion classically associates with emotional stress, which in turn is known to associate with oxidative stress.
HPL correlated inversely with plasma glutathione
HPL is a promising biomarker for oxidative stress. HPL is known to cause non-erythroid heme depression, which lowers zinc, increases nitric oxide, and increases oxidative stress.”

The Forsgren/Klinghardt article above, covers additional mechanisms. With regards to MCAS specifically, the pyroluria supplements – zinc, vitamin B and evening primrose oil – all play a role in reducing histamine, providing immune support and reducing inflammation. And they provide nutritional support for the anxiety and mental health aspects of the condition – directly for pyroluria and indirectly via neurotransmitter support (since they are necessary cofactors for making serotonin and GABA).

Here is some of the research I gathered on some of the ways zinc, vitamin B6 and evening primrose oil (EPO) may help when it comes to MCAS:

This paper, Role of Zinc Signaling in the Regulation of Mast Cell-, Basophil-, and T Cell-Mediated Allergic Responses, states that “zinc signaling dysregulation is a leading health problem in inflammatory disease and allergy…. These findings may lead to future therapeutic applications for suppressing inflammatory or allergic responses.”
In this paper, Effect of pyridoxine on histamine liberation and degranulation of rat mast cells, the authors share that vitamin B6 “significantly inhibited rat mast cell degranulation and histamine release induced by egg albumin allergen.” This paper also discusses the lack of toxicity of vitamin B6 and “the possibility that other mechanisms of action may be involved, such as the improvement in tryptophan metabolism.”
This paper, Alterations of mast cell mediator production and release by gamma-linolenic and docosahexaenoic acid/DHA, was looking at mastocytoma (a type of mastocytosis) using a cell line as a model for canine atopic dermatitis (cells were incubated with the wasp venom peptide.) They found that “GLA decreased histamine release …and DHA diminished prostaglandin production.” Evening primrose oil is a source of GLA and fish oil is a source of DHA.

If you’re new to MCAS, Dr. Jill Carnahan has an excellent overview here: Mast Cell Activation Syndrome: Here’s What You Need to Know When Histamine Goes Haywire and I’ve blogged about PharmaGABA often being an issue and making anxiety worse when you have MCAS or histamine issues.

The ramifications of this biochemical imbalance are far-reaching

Here is the pyroluria questionnaire / symptoms list (from my book, The Antianxiety Food Solution). It has been updated with recently with additional conditions. You can read about pyroluria prevalence and associated conditions here.

Here are some of my pyroluria blog posts you may find useful (click each of the linked articles to read further). As you will see the ramifications of this biochemical imbalance are far-reaching:

Feel free to use the search feature on the blog to find additional information about pyroluria. I have written about it extensively. I have it myself and it’s really common – I see it in about 80% of my community – so I am pretty passionate about the topic.

Resources if you are new to pyroluria

If you are new to pyroluria, there is an entire chapter on the topic in 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 the pyroluria supplements on your own. And be sure to share it with the practitioner/health team you or your loved one is working with. We need the wider practitioner community to be aware of this condition and the importance of addressing it.

I use individual amino acids such as GABA and tryptophan with all my anxious clients and we always layer in the pyroluria protocol. There is also an entire chapter on the amino acids and they are discussed throughout the book in the sections on gut health, gluten, blood sugar control, sugar cravings, self-medicating with alcohol and more.

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 and pyroluria supplements that I use with my individual clients and those in my group programs.

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

Have you used the pyroluria protocol as part of your recovery from chronic Lyme disease or MCAS (or another chronic illness)?

Did you learn about this from your practitioner or elsewhere? (please share where)

If you’re a practitioner, is the pyroluria protocol part of your plan for clients and patients? And has it been a game-changer for them?

If you have questions please share them here too.