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Tryptophan doesn’t work, then it does and then it doesn’t: could it be hormonal shifts, dietary factors and/or parasites?

By Trudy Scott 19 Comments

tryptophan result

Have you been in a situation where tryptophan doesn’t work, then it does work, and then sometimes it doesn’t work as expected? There is a reasonable explanation as to why it may not work initially – too much or too little was used. The variable results and the need to switch between lower and higher doses on an ongoing basis can happen but it’s not very pronounced unless there is a specific reason. In this blog I cover some of these reasons – hormone shifts, dietary factors and parasites/other digestive issues.

I’m writing this blog in response to a question that was posted on one of my speaker pages on the Anxiety Summit: Gut-Brain Axis. This is the actual question:

I tried to use tryptophan the first time (whole capsule) and got really high. Some time later I tried again, but used 1/4 of a capsule and had a good result. A few weeks later 1/4 of the capsule didn’t work at night. So I went up to half a capsule. And that’s where  I am now. But some nights (very rare) I can only get good results from a whole capsule. I use it along with the same amount of GABA. Is that a normal reaction for tryptophan?

I don’t know what brand of tryptophan she was using but assume 500mg was her starting dose and she now shifts between 125 mg (¼ capsule) and 250 mg (½ capsule) with variable results.

It’s not unusual for someone to not feel great on 500 mg if that dose is too much for their unique needs. She did the right thing by lowering her dose.  It’s also reasonable that someone may find 500 mg as an initial dose isn’t enough to reduce symptoms.

The variable results and the need to switch between 125 mg and 250 mg can happen but it’s not very pronounced unless there is a specific reason. Some of these reasons include hormone shifts, dietary factors, parasites/other digestive issues, thyroid issues, low lithium, product quality and environmental factors. More on all this below.

Hormone shifts/more serotonin is needed in the luteal phase

I have my clients track when the variability happens, with female clients documenting their cycles. Some women need more serotonin support in the luteal phase i.e. after ovulation and right up to before their periods. Some may even need additional tryptophan for the first few days of their periods too.

Write about tryptophan working well in the luteal phase in this blog – Tryptophan for PMS: premenstrual dysphoria, mood swings, tension, and irritability

In a study published in 1999, A placebo-controlled clinical trial of L-tryptophan in premenstrual dysphoria, tryptophan was found to reduce symptoms of PMS when used in the luteal phase or second half of the cycle (i.e. after ovulation):

37 patients with premenstrual dysphoric disorder were treated with L-tryptophan 6 g per day, and 34 were given placebo. The treatments were administered under double-blind conditions for 17 days, from the time of ovulation to the third day of menstruation, during three consecutive menstrual cycles.

They looked at dysphoria, which is defined as a state of unease or generalized dissatisfaction with life, plus mood swings, tension (and anxiety), and irritability and they found a 34.5% reduction of symptoms with tryptophan compared to 10.4% with placebo.

The paper concludes: “that these results suggest that increasing serotonin synthesis during the late luteal phase of the menstrual cycle has a beneficial effect in patients with premenstrual dysphoric disorder.”

It’s a small study but the results are powerful and it’s something I see clinically with my clients. The one big difference is that I typically have clients using tryptophan throughout the month.

But if you are seeing tryptophan work and then not work at similar times each month this is something to consider and track. And then if need be, increase and decrease tryptophan accordingly (and track again).

Dietary factors – collagen, gluten, sugar, wine and coffee

There are other factors to consider too and dietary impacts is one. For example, collagen leads to a higher need for tryptophan in susceptible individuals (due to it’s serotonin-lowering effects – I blog about this here)

Another dietary factor is accidental gluten exposure in susceptible individuals or a newly discovered gluten issue

High sugar intake, alcohol and/or caffeine consumption may also be a factor – contributing to added stress for the adrenals and depletions in zinc and the B vitamins. This can contribute to lowered serotonin and a need for a higher dose of tryptophan.

Now imagine if it’s just before her period and she adds collagen to her diet and she also eats out and gets zapped by gluten. Triple whammy for this woman!

And she goes to a party and happens to indulge in cocktails or wine, and then goes on a binge at the dessert table, followed by a few cups of coffee (or even one dessert and one cup of coffee).

A food-mood log really helps you figure things out.  And then, if need be, increase and decrease tryptophan accordingly.  And track again and address the dietary issues.

Parasites and other gut issues

If she has a very pronounced shift in symptoms for 4-5 days around a full moon each month – more severe insomnia, more anxious, more depressed – I would want to check for parasites.

I would also want to check for other digestion issues like dysbiosis, SIBO (small intestinal bacterial overgrowth), candida and liver health as they may all be factors. With SIBO and candida, dietary slip-ups may make symptoms worse right after the slip-up, for example increased bloating making sleep and anxiety worse.

Using tryptophan sublingually/opened on the tongue may bypass some of the digestive/liver  issues until they are resolved.

As mentioned above, if need be, increase and decrease tryptophan accordingly. And track again and address the underlying issues.

Other factors to rule out – thyroid, lithium, environmental factors and the product

Two other underlying root causes we always want to rule out when we see variable results using tryptophan (and any of the amino acids) are Hashimoto’s thyroiditis (because we can have variable thyroid results – sometimes hypo/low and sometimes hyper/high) and low levels of lithium (because this can affect the results we see with all the amino acids).

And we always check environmental factors like mold, EMFs and outside stresses. And look for infections like Lyme disease or EBV.  If the basics are not unearthing the solution we continue to dig deeper and do a full functional medicine workup. And adjust the tryptophan as needed.

And finally the quality of the product is key. I find Lidtke Tryptophan to be better than many other brands. I’ve also had many clients switch to Lidtke tryptophan and see better results and often need a lower dose.

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

If you are new to using the amino acids tryptophan/5-HTP and the other amino acids as supplements, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution (you can see the low serotonin symptoms here) and a brief overview here, Anxiety and targeted individual amino acid supplements: a summary.

If you suspect low serotonin 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.

I always appreciate good questions like this and hope this feedback has helped her and you too if you’ve experienced something like this (or if you do in the future). In case you’re wondering, this question was posted after someone tuned into my interview, “GABA & Tryptophan: Gut-Anxiety Connections” on the Anxiety Summit 5: Gut-Brain Axis.

Have you had a variable response to tryptophan (or 5-HTP) and can you relate to any of this?

What did you figure out to be the reason?

Feel free to ask your questions here too.

Tryptophan supplementation for anorexia?

By Trudy Scott 27 Comments

tryptophan and anorexia

This blog post highlights the potential importance of tryptophan supplementation in improving therapeutics in anorexia (and other eating disorders) and some of my insights about the 2017 anorexia-tryptophan study. I also share the high incidence of eating disorders, overlaps with anxiety and the case for tryptophan supplementation given the many low serotonin symptoms (anxiety, obsessive thoughts/behaviors, perfectionism, negative-self-talk, low self-esteem and depression) we see with anorexia and other eating disorders. And the importance of a comprehensive nutritional approach.

I’ve updated the original blog with newer research on low zinc and iron with males with eating disorders – and how this ties in with serotonin production and also pyroluria (read on below).

According to The National Eating Disorders Association (NEDA), eating disorders are

serious but treatable mental and physical illnesses that can affect people of all genders, ages, races, religions, ethnicities, sexual orientations, body shapes, and weights. National surveys estimate that 20 million women and 10 million men in America will have an eating disorder at some point in their lives.

While no one knows for sure what causes eating disorders, a growing consensus suggests that it is a range of biological, psychological, and sociocultural factors.

While NEDA does acknowledge that some of the causative factors may be biological, unfortunately there is no mention of nutritional psychiatry or tryptophan on the site. You’ll see this to be the case in the majority of conventional treatment centers.

The 2017 paper on tryptophan potential for anorexia

The paper, Improving therapeutics in anorexia nervosa with tryptophan, does acknowledge that the “growing body of evidence suggests that our diet is an important contributing factor in the development, management and prevention of a number of psychiatric illnesses.”

It discusses what we know about tryptophan being “the sole precursor” of serotonin, a neurotransmitter and that when used as a supplement it has therapeutic benefits when serotonin is low.

The author proposes that excessive dieting and food restriction decrease brain tryptophan and serotonin and propose the “potential importance of tryptophan supplementation in improving therapeutics in anorexia patients” (together with psychotherapy).

Given that anorexia has the “highest lethality of all psychiatric illnesses” and that there are currently “no FDA approved pharmacological treatments available” for anorexia, the urgency for implementing nutritional psychiatry approaches is high. The authors also share that the antidepressants and antipsychotics which are commonly used to treat the co-occurring anxiety, depression, OCD and psychosis are not very effective.

The author mentions a paper that used 250 mg tryptophan twice a day but based on my work with individuals with anxiety, we know an individualized approach is best.  A typical starting dose of tryptophan is 500mg used once or twice a day and I use the trial approach to determine the ideal dose for each person.

Incidence of anorexia and eating disorders in general

Here are a few select anorexia and eating disorder statistics from NEDA. I find much of this alarming and in some cases surprising (like the high incidence of males who are affected):

  • 40% to 60% of elementary school girls (ages 6-12) are concerned about their weight
  • 2% to 13% of adolescent girls meet the criteria for eating disorders
  • Males represent 25% of individuals with anorexia (they are at a higher risk of dying because they are often diagnosed later since many people assume males don’t have eating disorders)
  • Male athletes, especially those competing in sports that emphasize diet, appearance, size and weight, are at risk. In weight-class sports (wrestling, rowing, horse racing) and aesthetic sports (bodybuilding, gymnastics, swimming, diving) about 33% of male athletes are affected. In female athletes in weight class and aesthetic sports, disordered eating occurs at estimates of up to 62%.
  • In one study of ultra-Orthodox and Syrian Jewish communities in Brooklyn, 1 out of 19 girls was diagnosed with an eating disorder, which is a rate about 50 percent higher than the general U.S. population.
  • Despite similar rates of eating disorders among non-Hispanic Whites, Hispanics, African-Americans, and Asians in the United States, people of color are significantly less likely to receive help for their eating issues.
  • Elevated rates of binge-eating and purging by vomiting or laxative abuse was found for both males and females who identified as gay, lesbian, bisexual, or “mostly heterosexual” in comparison to their heterosexual peers.
[You can find the actual stats and studies quoted above at the NEDA stats link.]

 

Prevalence of anxiety and making the case for low serotonin

The prevalence of anxiety is high in those with eating disorders (which is one of the reasons for this particular blog):

  • Anxiety is also diagnosed in 48-51% of people with anorexia nervosa, 54-81% of people with bulimia nervosa, and 55-65% of people with binge eating disorder
  • Two-thirds of people with anorexia also showed signs of an anxiety disorder several years before the start of their eating disorder.

In one study, after dietary treatment (called refeeding), plasma tryptophan levels normalized in patients with anorexia:

Disturbance in serotonin function has been described as central to the psychobiology of this disorder 

Plasma TRP normalizes during the course of refeeding, supporting the hypothesis that serotonin function is disturbed in patients with anorexia nervosa.

We also see a large number of low serotonin symptoms in those with eating disorders:

  • Childhood obsessive-compulsive traits, such as perfectionism, having to follow the rules, and concern about mistakes, were much more common in women who developed eating disorders than women who didn’t.
  • Binge eating disorder patients … also had significantly higher levels of negative affect, and lower self-esteem
  • In a study of women with eating disorders, 94% of the participants had a co-occurring mood disorder
[You can find the actual stats and studies quoted above at the NEDA stats link.]

There are all classic low serotonin symptoms: obsessive thoughts/behaviors, perfectionism, negative-self-talk, low self-esteem and depression.

This further supports the rationale for tryptophan supplementation and is another reason for this blog. I have extensive experience in the use of tryptophan and 5-HTP and believe they should be part of all eating disorder programs.

There is one big difference in that typically we see afternoon and evening sugar and carb cravings with low serotonin-type anxiety. Whereas with anorexia, the low self-esteem, obsessive thinking and body dysmorphia (feeling shame or disgust with parts of their body or appearance) may prevent someone acting on these cravings. However, if there are sugar and carb cravings (and bingeing), this is the time they will typically occur.

Here are two recent blog posts that share case studies where tryptophan was used with success:

Anorexia and other eating disorders require a multidisciplinary team and a targeted nutritional approach

I don’t currently work with clients with anorexia as it requires a multidisciplinary team. I did, however, work with a few clients with anorexia when I worked at Recovery Systems over 10 years ago. They had a therapist, nutritionist and doctor on their team and a nutritional approach led to more improvements than they had experienced at prior in-house eating disorder clinics where they had received psychological support only or psychological support and medication. Our approach included addressing low serotonin with tryptophan or 5-HTP, addressing low zinc and low iron, low vitamin D, addressing the gut/microbiome, low B vitamins, low omega-3 fatty acids and more (based on the unique needs of the client).

I now refer eating disorder clients to Dr. James Greenbatt, MD, an eating disorder specialist and integrative psychiatrist. He has a wonderful book on the topic: Answers to Anorexia – a Breakthrough Nutritional Treatment That is Saving Lives, with the second edition coming out soon. In the first edition he does address neurotransmitter deficiencies but we differ in our approach.  He doesn’t use individual amino acids like tryptophan or 5-HTP and prefers to use a blend of amino acids based on a blood or urinary amino acid test.

In this article, New Approaches to Treating Anorexia, Dr. Greenblatt covers the multidisciplinary aspect, current treatment options, the limited medical options and the need for targeted nutrition therapy. Although this article doesn’t address tryptophan and low serotonin, he does discuss the key role of zinc, B vitamins and omega-3 fatty acids.

UPDATE: October 10, 2024

Given that most of the eating disorder research is conducted primarily in females, it’s encouraging to share the results of this 2022 paper, Sex differences and associations between zinc deficiency and anemia among hospitalized adolescents and young adults with eating disorders, which reports that “zinc deficiency is equally severe and anemia is more common in hospitalized males with eating disorders compared to females.”

Liquid zinc sulfate tastes like water when zinc levels are low. I saw those with anorexia being willing to drink it when I worked in Julia Ross’ Clinic, so it’s a relatively easy way to start to increase zinc levels and improve appetite.  Zinc and iron both help increase serotonin production, and zinc is key for pyroluria/social anxiety which is common in this population.

Also, with pyroluria, morning nausea negatively affects appetite so it’s often helpful to address this in conjunction with using amino acids. Vitamin B6 is part of the pyroluria protocol and is another serotonin co-factor. Evening primrose oil, also part of the pyroluria protocol, improves zinc absorption. This is all covered in the pyroluria chapter in my book.

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

If you are new to using the amino acids tryptophan/5-HTP, GABA or  tyrosine as supplements, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution (you can see the low serotonin symptoms here) and a brief overview here, Anxiety and targeted individual amino acid supplements: a summary.

If you suspect low serotonin 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 (or a loved one) been diagnosed with anorexia or another eating disorder?

Did you see the most success with an approach that included nutritional psychiatry and serotonin support with tryptophan or 5-HTP?

What else has helped?

Feel free to post any questions here too.

What if overthinking, fear, anxiety and worry (caused by low serotonin) is holding you back instead of low motivation/low dopamine?

By Trudy Scott 50 Comments

overthinking

One of the first things that comes to mind when someone is stuck and not able to get things done is low motivation caused by low catecholamines/low dopamine. But what if overthinking, fear, anxiety and worry (caused by low serotonin) is holding you back instead? The following case may help you figure it out if any of this applies to you.

William asked this question on one of the tyrosine blogs, justifiably thinking he may need tyrosine to get unstuck:

Excellent article. I may try tyrosine. I have anxiety and shut down when I am about to start something or my mind overthinks and I shut down with worry. I have problems sleeping. I take a group of things…GABA, glycine, 5-HTP but still wake at 3am.

Anyway I always have GOOD intentions of doing things when I wake in the morning….then it goes downhill. I was not always like this but got worse with STRESS from work and now I FIGHT myself to actually do something I used to LOVE to do. Makes me MAD!

I actually am AFRAID just thinking about taking Tyrosine {Not funny}

I FEAR so much it becomes stupid. I think of doing things and SHUT DOWN with worry.

I want my life back…life is too short to suffer knowing HELP is so close. What do you think? Love your articles…

I think this is a great question many others in my community may relate to so I’ve decided to do this as a blog post with his question and a longer response.

I thanked him for his kind words, saying I can’t offer advice via the blog but can share that we need to be careful with tyrosine when someone has sleep issues or anxiety. I also offered some brief thoughts which I’ll elaborate on here so you can understand my thinking as I work with someone.

Is it low motivation caused by low catecholamines/low dopamine?

The first thing that comes to mind when someone is stuck and not able to get things done is low catecholamines and low dopamine. The classic signs are lack of motivation, fatigue, poor focus and feeling depressed, often using sugary foods or drinks for an energy pick-up (especially in the afternoon).

William may feel that he has low motivation and needs tyrosine because he can’t get things done or he starts something and can’t complete it.

His intentions are good but he has to push himself or as he says “fight myself” to get things done. Because of this he feels tyrosine may be the next amino acid he should trial.

Why I would investigate and address low serotonin

William says he has anxiety and also has trouble sleeping. This could be related to low serotonin and/or low GABA.

However when someone has anxiety and insomnia and I hear the following words/phrases, I immediately think low serotonin should be investigated and addressed:

  • “My mind overthinks”
  • “I shut down with worry”
  • “I actually am AFRAID just thinking about taking Tyrosine”
  • “I fear so much”

All of the above can hold you back and look like low motivation when it is actually worry and fear that is holding you back.

Typically, with low serotonin, you could also second-guess things you do, experience negative self-talk, have a lack of confidence when doing things, get stuck because of perfectionism and may even feel like an imposter. You may also be very controlling and want to do it all yourself and not be willing to delegate – this can hold you back too.

All this and anything else on the list of low serotonin symptoms would further suggest we need to address this first.

Finding the ideal serotonin support for his needs

He is currently taking GABA, glycine and 5-HTP but still wakes at 3am. And he is still anxious.

I would work to optimize 5-HTP dosing (increasing every few days to see if more helps) or switch to tryptophan if the increased dose isn’t helping. Some folks do better one one versus the other and 5-HTP can raise cortisol in some instances causing a wired-tired feeling.

I’d do the same with GABA once the ideal dose of 5-HTP or tryptophan is found. This helps improve sleep and reduce anxiety too.

And I’d look into high cortisol in case this is causing his 3am awakenings.

Once he has ideal serotonin support for his needs, the overthinking will stop, the worry will go away and his fears will vanish – and he will be able to complete things he starts.

Being well rested because of a great night’s sleep is going to help a great deal too.

There may be a need for tyrosine now or later

I may be wrong and there may in fact be a need for tyrosine now. These cases illustrate tyrosine helping when it didn’t seem it would:

There may also be a need for tyrosine later and a trial will provide the answers.

Right now William is “AFRAID just thinking about taking Tyrosine” but once his serotonin levels are ideal he should no longer have this fear.

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

If you are new to using the amino acids tryptophan/5-HTP, GABA or  tyrosine as supplements, 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 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.

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.

As with all individual amino acids we use them for quick relief of symptoms. And we also always focus on the foundations like diet, the gut, adrenals and stress levels.

We appreciate William for asking this question so we all get to learn. Hopefully he’ll jump on and add to the discussion and share his results later.

Can you relate to his lack of motivation showing up as fear, worry and overthinking instead and holding you back?

What about these other low serotonin symptoms keeping you stuck: second-guessing, negative self-talk, lack of confidence, perfectionism, imposter syndrome and controlling?

Has using tryptophan or 5-HTP allowed you to get past some of this so you can get things done?

Did you also have to address low dopamine and actual low motivation, poor focus and fatigue with tyrosine?

Feel free to post any questions here too.

Rage, anxiety, cravings & insomnia in 11-year old girl with RAD/reactive attachment disorder: chewable tryptophan turns things around

By Trudy Scott 21 Comments

rad and tryptophan

Today I’m sharing the case of an 11-year-old girl who had huge rage issues, was angry much of the time, suffered from terrible anxiety, had crazy sugar cravings (for bread and colored candies) and had dreadful insomnia. Because of the insomnia she was also very fatigued and this likely drove some of her cravings and irritability too. She was adopted and had been diagnosed with RAD (reactive attachment disorder). During our first session, chewable tryptophan turns things around quickly – she smiles and is willing to make changes and quit the sugar and gluten. We also address low iron levels and with these 4 nutritional interventions this child’s behavior improves dramatically.

This book chapter, Reactive Attachment Disorder, states how The Diagnostic and Statistical Manual 5th Edition (DSM-5) classifies reactive attachment disorder as follows:

a trauma- and stressor-related condition of early childhood caused by social neglect or maltreatment. Affected children have difficulty forming emotional attachments to others, show a decreased ability to experience positive emotion, cannot seek or accept physical or emotional closeness, and may react violently when held, cuddled, or comforted. Behaviorally, affected children are unpredictable, difficult to console, and difficult to discipline. Moods fluctuate erratically, and children may seem to live in a “flight, fight, or freeze” mode. Most have a strong desire to control their environment and make their own decisions. Spontaneous changes in the child’s routine, attempts to discipline the child, or even unsolicited invitations of comfort may elicit rage, violence, or self-injurious behavior.

Reactive attachment disorder/RAD and low serotonin

There is no research on tryptophan helping to address RAD symptoms or trauma, but based on her low serotonin symptoms, a trial of tryptophan was the first thing I considered.

There is, however, evidence to indicate the role of low serotonin in RAD, as indicated by a study where antidepressants were successfully used. The authors mention how:

The absence of responsive and consistent caretaking can subject the developing brain to an inordinate amount of physiological stress, leading to increased cortisol production and consequential inefficiencies in the serotonin and the growth-hormone releasing systems.

Although not specific to RAD, another paper looking at trauma states that:

Serotonin and dopamine levels were found to be abnormal in the presence of PTSD.

As the field of nutritional psychiatry grows, I expect to see more and more research supporting the use of tryptophan and other amino acids for those suffering from symptoms like this. Symptoms that are caused by imbalances that are triggered by the trauma in their lives.

We know that therapy, EFT, EMDR and other approaches are crucial for trauma recovery (this family had already done some of this work) but we must start to incorporate nutritional support too.

The case study

Here are the details of this case study and the nutritional interventions. As I mentioned above, because of her severe rage episodes, a trial of tryptophan was the first thing I considered:

She was referred to me by a friend. The family didn’t have much money. And so, we had to really try and figure out a few simple interventions that we could use that were going to be effective.

This young girl had been adopted. She was diagnosed with reactive attachment disorder and her anger issues were just phenomenal. The mom had to physically put her body around her and hold her down when she was having one of her fits because she was worried that she was going to hurt herself and hurt other people.

She also had anxiety, huge cravings for colored candies and insomnia. She was so fatigued because she wasn’t sleeping well.

So sitting in my office with this young girl and her mom, we started to talk about the sweets and the candies and the need to give up the candies. She was fuming with me. She was sitting in a swivel chair. She turned her back on me and didn’t want to talk about having to give up candy at all.

I said, “Look, let’s not even talk about that, but would you take this chewable tryptophan here? And we’ll talk about it in a second.” I gave her 100 mg of the chewable tryptophan and continued discussing things with her mom.  She had no idea what it was going to do or how it would make her feel.

Within five minutes she turned her chair back, looked at me and she said, smilingly, “Yes, let’s do it. I can give up the candy.” She was smiling and she was happy.

So long story short, with this young girl, we started her on [chewable] tryptophan [and it turned things around quickly].

Chewable tryptophan – when I use it and when I don’t

I typically use 500mg Lidtke tryptophan for the adult clients I work with and prefer this company’s product because it is really high quality. It really does work better than many other tryptophan products on the market.

Lidtke also makes a chewable 100mg tryptophan which is also high quality, and the product I used with this young girl. Here are some benefits of this 100mg product:

  • It’s useful for doing the initial trial in order to figure out if tryptophan is going to help with low serotonin symptoms in children – because it’s a lower dose.
  • It’s especially useful for children for ongoing use (typically midafternoon and evening) because it’s a lower dose.
  • It’s also useful for adults who are “pixie dust” folks and do better with a lower dose of supplements in general or respond more severely to medications/alcohol/chemicals. We may start with a trial of the 100mg chewable and increase from there, also typically midafternoon and evening.

I don’t use the chewable 100mg tryptophan under these circumstances:

  • When the child (or adult) finds that 5 x100mg works for them at each time they need it. In this instance it’s best to switch to a 500mg tryptophan. Using it swallowed may work or it may need to be opened onto the tongue.
  • When the child (or adult) starts to consume the chewables like candy. They are sweet and do taste good and I’ve seen this happen. Because you are continually consuming something sweet you may end up over-consuming them if sugar addiction is one of your issues. You may also end up taking too much tryptophan.

If the chewable tryptophan is not available where you live, using a small amount of a powdered tryptophan or opening a capsule of the 500mg tryptophan is an option. Since it tastes bitter it can be mixed with mashed banana or inositol. (You can find all the Lidtke products in my online supplement store. The link is in the resources section below.)

Gluten and candies were also a huge issue, and she had low iron

There was more to her issues than only low serotonin:

Gluten was also a huge issue, so we got her off gluten and the candies. The tryptophan helped with this” (i.e. it made it easy to break the addiction and not feel deprived).

Tryptophan also helped her sleep. And it helped with the severe rage issues.

Obviously the gluten was contributing to the rage issues as well.

Her iron and ferritin levels were really low (possibly as a result of her gluten issues). So we added an iron supplement, and animal protein/red meat.

So with just four interventions – the gluten, the animal protein, getting her iron levels up and the tryptophan – this kid was just a new kid.

Here are some articles that are related to the above:

Keep in mind there is not a one-size-fits-all and these 4 simple nutritional interventions – tryptophan, gluten removal, adding red meat and addressing low iron – happened to be the combination that worked for this young girl.

Resources if you are new to using tryptophan as a supplement

If you are new to using the amino acid tryptophan as a supplement, 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 serotonin symptoms 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.

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 Lidtke chewable tryptophan 100mg, Lidtke tryptophan 500mg and other products that I use with my individual clients and those in my group programs.

We use an amino acid like tryptophan for quick relief of symptoms, like I did in this instance. Then we focus on the foundations like diet – like no gluten and red meat in this instance – and address all other imbalances, like her low iron. If cortisol was high we would have addressed that.

This case deserves it’s own blog post

In case you’re wondering, I first shared this case study in my interview, “Calming Anxiety, Aggression and OCD with Amino Acids and Food”, on the ADHD and Autism Summit in May 2021. Due to the interest in this case and the use of chewable tryptophan, I felt it deserved a deeper dive and its own blog post with links to some of the research and some practical information about the chewable tryptophan.

Have you used this chewable tryptophan product with success – personally, with your child or with a patient/client?

Have you found that addressing serotonin with tryptophan (or 5-HTP) helps resolve symptoms in a child diagnosed with RAD or a child with rage issues? What about helping with sleep problems, easing anxiety and stopping cravings too?

Have you addressed low iron levels and seen improvements with the removal of gluten too.

Feel free to post your questions here too.

 

Huge rise in anxiety in college students (and other mental health issues): amino acid supplements and nutritional psychiatry as a solution.

By Trudy Scott 17 Comments

anxiety in college students

Is your son or daughter finding college/university overwhelming? Is he or she battling with new or worsening anxiety, worrying about results, has fears about success or fitting in, lying awake imagining the worst outcomes or maybe feeling like a perfectionist and getting stuck? Perhaps they have poor self-confidence, feel like an imposter and may even have panic attacks.  These signs and symptoms are all common with the low serotonin-type of worry-in-the-head anxiety, which may also include PMS (premenstrual syndrome), obsessive tendencies and anger issues.

They may also be experiencing the low GABA type of tension-anxiety, where they lie awake at night stiff and tense and self-medicate with too much sugar, carbs, junk food and/or alcohol (and maybe even pot and other drugs). There may be intrusive thoughts too and panic attacks also triggered by low GABA.

What about focus issues/ADHD and low motivation, no ability to follow-through on tasks and projects, procrastination and missing deadlines? These are all classic signs of low catecholamine, which also includes low energy, and feeling depressed/sad/low/flat. Your son or daughter may just want to crawl up in their dorm bed and not do anything or may spend hours doing mindless activities like binge watching Netflix or scrolling mindlessly through social media.

All of these signs and symptoms point to low levels of neurotransmitters or brain chemicals: low serotonin, low GABA and low dopamine. We need the right raw materials to make these neurotransmitters and the majority of college cafeterias are not providing nutrient-dense foods and/or foods that are unique for each person’s biochemistry (more on this below).

The huge rise in anxiety and other mental health issues in college students

It’s no wonder that we are seeing a huge rise in anxiety and other mental health issues in college students. Way too many students are dropping out and so many are struggling unnecessarily.

This 2019 Harvard blog post shares some alarming stats:

Anxiety in college is very common. According to the American College Health Association Fall 2018 National College Health Assessment, 63% of college students in the US felt overwhelming anxiety in the past year. In the same survey, 23% reported being diagnosed or treated by a mental health professional for anxiety in the past year.

This article in Nature earlier this year, The problem is greater than it’s ever been’: US universities urged to invest in mental-health resources, highlights points from US National Academies of Sciences, Engineering, and Medicine report:

  • 68% of university presidents listed student mental health as one of their most pressing issues
  • the dropout rate for students with diagnosed mental-health problems ranges from 43% to as high as 86%
  • The students who said that they had more trouble with anxiety or depression after the lockdown also reported greater alcohol use

It states that faculty members should “receive formal training to address and support student well-being” and “students should learn about mental-health issues as part of their introductory training.” They also say “Hiring more counsellors could be an important step, but counsellors alone can’t turn the tide.” I agree with all this but recommend adding nutritional psychiatry awareness, training and resources too.

Poor diet and nutritional deficiencies are a major contributing factor even though it’s seldom discussed. The good news is that there are relatively simple solutions – amino acids as supplements for quick relief and diet as the foundation – but it does take work.

Using amino acids as supplements for quick relief

Amino acids, used as supplements, are a quick way to offer immediate relief of symptoms:  tryptophan or 5-HTP (for the low serotonin worry-type anxiety), GABA (for the tension-type anxiety) and tyrosine (for the low dopamine poor-focus and low symptoms). Here are some examples:

  • A 23-year-old female college student, adopted and exposed to alcohol while in the womb, has some learning struggles. She doesn’t want to miss a day of taking 5-HTP, because she says that “it keeps her on her toes,” which she says means that it “keeps me focused,” when studying.
  • Tyrosine helped a young man who was learning new software: “Within an hour the stress just melted away!”, alleviating his anxiety and panic attacks and creating a feeling of calm focus.
  • A newly qualified nutritionist shared how she suffered badly from imposter syndrome at the end of her nutrition degree and she felt socially awkward in so many outings and situations. Her anxiety and stress were through the roof and her sleep was poor. She said these wonderful results: “What really tipped the balance was the supplementation of tyrosine, tryptophan & GABA.”

If you are new to the amino acids, 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

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 use the amino acids for quick relief of symptoms and then focus on the foundations like diet and address other imbalances.

Diet as the foundation for students i.e. nutritional psychiatry

I first blogged about nutritional psychiatry in 2015 when the ISNPR position statement was published in World Psychiatry, the official journal of the World Psychiatric Association. This 2019 paper, Nutritional psychiatry: Towards improving mental health by what you eat provides an overview of the emerging field of nutritional psychiatry:

Does it matter what we eat for our mental health? Accumulating data suggests that this may indeed be the case and that diet and nutrition are not only critical for human physiology and body composition, but also have significant effects on mood and mental wellbeing. While the determining factors of mental health are complex, increasing evidence indicates a strong association between a poor diet and the exacerbation of mood disorders, including anxiety and depression, as well as other neuropsychiatric conditions.

The 2017 SMILES Trial is the first randomized controlled diet depression study and ONE THIRD of the dietary intervention group saw improvements in their depression symptoms.  This was just diet alone and switching from processed/junk food to real food with no specific dietary restrictions. Participants also reported improvements in anxiety symptoms. And the authors even addressed the cost factor, stating it was more affordable to eat this way.

Research supports this connection in college students. This is one of a growing number of studies, Eating behavior and relationships with stress, anxiety, depression and insomnia in university students, that concludes that:

unhealthy eating patterns are common in university populations and are related to anxiety, stress, and depression. Educational interventions to reduce unhealthy food consumption in university students can also result in psychological health improvements and/or vice versa.

Unfortunately, as students get more anxious and depressed their food choices get worse (especially for male students) and it becomes a vicious cycle. This paper, Examining the Role of Anxiety and Depression in Dietary Choices among College Students, reports:

Overall, a decrease in total caloric intake and an increase in sugar consumption were found as self-reported symptoms of anxiety and depression increased. In addition, there were sex differences in the relationship between depression and food choices. Men consumed more saturated fat as well as less fruits and vegetables as self-reported symptoms of depression increased. Results suggest symptoms of depression are a greater risk factor for poor nutrition in male college students than females.

It’s time for colleges/universities to recognize all this and teach about nutritional psychiatry. My book, The Antianxiety Food Solution is an excellent starting point for students, parents and educators (together with other blogs on this site).

Checking out cafeterias and cooking options

When looking at colleges are you also looking at what the cafeteria offers and if they cater for special diets (like gluten-free, dairy-free, Paleo etc) and/or offer real whole food, organic vegetables and fruit, grass-fed meat, wild fish and fermented foods?

Can students use a slow cooker, blender, Instant Pot or electric frying pan in their dorms?

Is there a dorm kitchen and can they take their own pots and pans (so non-stick pans can be avoided) and any of the above appliances?

Are there nearby living options that include a kitchen and a store with quality food for purchase?

I feel colleges/universities should be rated on all of the above in addition to everything else.

It all starts at home before they leave for college

Having a good college cafeteria and dorm kitchens is one step in the right direction, but these young adults also need to understand the impact of a breakfast of bagels and coffee or not having breakfast or the fact that gluten may trigger a panic attack and make them sad. They need to know how to shop and cook if there is a shared dorm kitchen or apartment. And they need to make the right choices when they do eat in the cafeteria or nearby restaurants (assuming good options are available). This all starts at home with you before they leave for college.

Katie shares this about her daughter who plans to use the college cafeteria for some meals and also cook in the apartment kitchen on weekends:

My daughter was just saying today how glad she is that she doesn’t have to figure out [the connection between increased anxiety, fatigue, brain fog, sadness and what they are eating] while learning how to live on her own and go to college. I changed how I ate 8 years ago for my PCOS and about 3 years ago she decided to give it a try after feeling so horrible but seeing my change. I’m so proud of her for embracing a healthier lifestyle in her teen years when everyone around her is subsisting off energy drinks and vending machine food. It makes me think that if we offer them a little education, they’ll make good choices for themselves.

This mom can also feel proud that she led by example for her daughter (and I appreciate them for letting me share here).

But I believe the colleges need to play a role in this too. They are providing food and this is a perfect educational opportunity that will serve their students (and future generations), solve the mental health crisis they are struggling with and prevent drop-outs (which is having an impact on their bottom-line).

Do you believe colleges/universities should be rated on all of the above in addition to everything else? What have you done to check out cafeterias and cooking options for your daughter or son?

Has your son or daughter benefited from any of the amino acids or eating real whole food (and according to their own needs?

Do you work in a college and are you seeing this rise in anxiety and depression? If yes, how do we get these changes implemented?

How do we educate students once they are at college (other than making sure campus food is excellent):

  • a lifestyle/diet/anxiety app with resources and tracking?
  • online training with a nutritionist/coach and access to an online forum and live Q&As?
  • one-on-one campus nutrition coaches?
  • make nutritional psychiatry part of the curriculum?
  • produce a documentary following the lives of students on campus and showing the transformation they experience?

Feel free to post your questions and ideas here too.

 

MegaSporeBiotic™: A spore-based probiotic for leaky gut, IBS, anxiety, depression, liver health and colitis

By Trudy Scott 44 Comments

megasporebiotic

MegaSporeBiotic™ is “a 100% spore-based broad-spectrum probiotic shown to maintain healthy gut barrier function” i.e. leaky gut. Research and clinical results show it is promising for irritable bowel syndrome (IBS) or SIBO (small intestinal bacterial overgrowth), recovery from liver injury caused by acetaminophen, and is protective in ulcerative colitis (an inflammatory bowel disease). Given the gut-brain connection and the fact that the majority of serotonin is produced in the gut, it’s not surprising that spore-based probiotics may also help ease anxiety and depression.

Here are some of the studies supporting this spore-based probiotic for gut issues:

The key findings of the present study is that oral spore-based probiotic supplementation reduced symptoms indicative of “leaky gut syndrome”.

The results demonstrated that patients treated with MegaSporeBiotic, compared with those treated with rifaximin followed by nutraceutical or low-FODMAP diet, had similar severity scores and rectal volume sensation test results for all parameters tested and statistically significant improvement in measurements of quality of life.

This is important because “Acetaminophen  is one of the most used analgesics [pain-reducing] and antipyretic [fever-lowering] agents in the world. Intoxication with acetaminophen is the main cause of acute liver toxicity in both the US and Europe.”

Pretreatment with probiotic spore-forming Bacillus strains and a supplement of amino acids in combination with immunoglobulins exhibited anti-inflammatory and antioxidant effects in an AA-induced rat model of ulcerative colitis.

In one study, Bacillus coagulans (one of the spore-forming strains in MegaSporeBiotic™), when used alone was shown to help ease depression and gut problems in IBS patients. It was a randomised, double-blind, placebo controlled, multi-centre, pilot clinical study and:

The improvement in depression and IBS symptoms was statistically significant and clinically meaningful. These findings support B. coagulans MTCC 5856 as an important new treatment option for major depressive disorder in IBS patients.

During The Anxiety Summit 5: Gut-Brain Axis, I interviewed Kiran Krishnan who is a microbiologist, one of the founders of Microbiome Labs and a co-creator of MegaSporeBiotic™. He reminds us about the gut-brain connection and how anxiety and mental health issues come from the gut “because the vast majority of serotonin in your body – more than ninety percent of it – is actually produced in the gut” and not in the brain.

He talks about the type of cell in the gut that produces serotonin – the enterochromaffin cell – and the fact that “spore forming bacteria are some of the best stimulators of the enterochromaffin cell to produce serotonin.”

With low levels of serotonin you’ll experience the worry-type of anxiety with ruminations, obsessing, panic attacks, insomnia (often lying awake worrying). Other low serotonin symptoms include low mood/depression, late afternoon and evening carbohydrate cravings, pain, PMS, irritability, rage and anger, TMJ, low confidence, imposter syndrome and perfectionism. This type of low-serotonin anxiety is different from the low GABA physical/tension type anxiety.

These cells also play a crucial role in gastrointestinal regulation, particularly intestinal motility. We know low serotonin also contributes to digestive/IBS-type symptoms.

You can see a list of all the low serotonin symptoms here.

Brandy’s positive feedback on digestive issues and mental health

Brandy Oto, a marriage, couple and family counselor, incorporates  an integrative nutrition approach with her clients and she shares this:

MegaSporeBiotic™ makes a HUGE difference in my body! I have used every probiotic I can think of. Megaspore has not only resolved my digestive issues and allows me regular bowel movements, I find my mental health is much better! I have decided to use it in my practice as well now. Clients consistently report better mental health!

I asked her how quickly she notices an improvement when using MegaSporeBiotic™ and what aspects of mental health improve for her and her clients. She shares this:

I personally notice physical and mental anxiety decrease usually about 4-5 days, bowel movements easy within a couple days, ability to tolerate foods I was sensitive to after 6 or so months on them.

Clients report all types of improvements from anxiety, depression, to digestive issues improving. I have even heard from one client that when she gets off the probiotic symptoms of schizophrenia return.

In Brandy’s mental health practice, she does use amino acids to address neurotransmitter deficiencies too (for example tryptophan or 5-HTP to address low serotonin symptoms like worry, fear, panic attacks). She uses this spore-based probiotic to address underlying issues that cause those deficiencies.

It’s not one or the other – the probiotics and amino acids are part of a comprehensive plan.

Not everyone raves about this probiotic and some folks report it either does nothing for them or is too strong for them. So, as with everything, it’s very individualized.

How do spore-based probiotics differ from other probiotics?

During the Anxiety Summit interview with Kiran, he explains how they differ from other probiotics and why this is important for them to get into the gut:

These are organisms that have a unique capability of covering themselves in a thick calcified protein-like coating. So it’s armor, essentially, around the bacterial cell.

This allows these bacteria to come in through the gastric system, through the oral route, and survive the gauntlet that bacteria have to go through just getting through the process of digestion.

So the first step is the stomach acid. The stomach acid is called the gastric barrier and that’s because it acts as an actual physical barrier through the function of hydrochloric acid to try to kill off as many microbes that are trying to enter the system through food and other exposure.

If something gets past the stomach acid then the second piece of the gauntlet are the bile salts. Bile salts are released into the duodenum itself. Those are very strong antimicrobials and part of their function is to act as an antimicrobial to protect the system against a lot of bacteria coming in on a regular basis.

And then the last part is the pancreatic enzymes that help you digest your food – they also act as antimicrobials.

So there’s this really difficult gauntlet that the microbes that are entering the system through the oral route have to go through in order to make it past these initial systems to get to the site of action in the deeper part of the intestines where they’re supposed to function as a probiotic.

These spores have developed this unique, natural capability of covering themselves in this armor which allows them to survive through all of that.

This study, Survival and persistence of Bacillus clausii in the human gastrointestinal tract following oral administration as spore-based probiotic formulation confirms the above for one particular strain and concludes that “Bacillus clausii spores survive transit through the human gastrointestinal tract.”

Where can I buy MegaSporeBiotic™?

megasporebiotic supplement facts

These are the spore-based bacteria contained in the MegaSporeBiotic™ product: Bacillus Licheniformis, Bacillus Indicus HU36™, Bacillus Subtilis HU58™, Bacillus Clausii and Bacillus Coagulans.

You can purchase MegaSporeBiotic™ directly from Microbiome Labs once you have set up an account with them under my name. Use this link (and make sure the Direct2Patient™ Code says tscott).

You can also read more about the product on the Microbiome Labs site here.

If you already have an account with Fullscript, my online supplement store, you can purchase from there too.

If you don’t yet have an account with Fullscript you can read more about how to set up an account here.

Let us know if you’ve used MegaSporeBiotic™ with success and how it helped you with anxiety, depression and/or gut and liver health.

Let us know if you’ve used another spore-based probiotic and which one? Or do you have a favorite probiotic that is not spore-based?

I’m going to a product review like this once a month so please let me know if you like this format with research, feedback and mechanisms.  And let me know what other products you’d like me to review.

Feel free to post your questions here too.