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I have chronic insomnia and I started getting headaches with GABA, 5-HTP and melatonin

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A combination of GABA (gamma-aminobutyric acid) and 5-HTP (5-hydroxytryptophan) can often improve sleep duration more than the use of either of these two amino acids alone. I blogged about this and the supporting research published in 2016.

Eve asked this question about her chronic sleep problems and headaches that she suspects are being triggered by the supplements:

I have chronic insomnia and I have been using 100mg 5-HTP, 250mg GABA and 1mg melatonin during the night for a week but the second day I used them I started getting a headache. Do you have idea what happened and can you please help me?

I shared this feedback about each person having unique needs and that I trial one amino acid at a time to find the ideal dose and then once we have a good baseline with good results and no adverse effects, we add the next one if needed. With 3 new supplements being started at once, we don’t know which one may be helping and which one (or more) is causing headaches.

A reminder I give all my clients is NOT to push through with the amino acids when you are experiencing any adverse effects. Headaches are more common with tyrosine rather than 5-HTP or GABA but too much of any one of the amino acids may cause a headache and with some folks, even a small amount can cause a headache especially if it’s not needed. At the first sign of a headache my advice is to stop the latest supplement added and see how you do. If 3 where started at one time, as in this situation, stop all 3 and add them back one at a time, watching for headaches and benefits.

Eve didn’t say which GABA product she was using. Source Naturals GABA Calm is the one I most often recommend, and the small amount of tyrosine could be causing her headaches. If this is the case, a switch to a GABA-only product or a GABA-theanine product may be what is needed.

It’s always important to also review the amino acid precautions before use. If you have migraines, tyrosine may make them worse.

But I do want to also add that some folks cannot tolerate 500mg tyrosine at all and yet they do just fine with the 25mg of tyrosine in the GABA Calm product (and sometimes up to 75mg of tyrosine when three GABA Calm lozenges are needed at once).

It’s also good to be aware that some folks do better on tryptophan versus 5-HTP so if it is the 5-HTP that is the problem I’d consider a trial of tryptophan. The best way to do that is to replace the 5-HTP with tryptophan (and I recommend Lidtke 500mg tryptophan).

You want to also look carefully at each of the products in case there are fillers that could be causing the headaches.

If it turns out that none of these are working i.e. the problem with sleep isn’t because of low serotonin and low GABA, then we ask these questions and address them:

  • is there a gut issue i.e. is there candida, parasites and/or dysbiosis?
  • is night-time cortisol high?
  • is gluten or other grains an issue? or was there accidental gluten exposure?
  • is caffeine or alcohol consumption a problem?
  • is there EMF and WiFi exposure?
  • are there medication side-effects?
  • has there been mold exposure or some other environmental trigger?

Have you had issues when trialing amino acids for sleep or anxiety and then figured out what the problem was?

Vitamin B6 improves dream recall (which can be used to monitor vitamin B6 status)

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It’s exciting to see new research confirming the connection between vitamin B6 and dream recall. In this new study, Effects of Vitamin B6 (Pyridoxine) and a B Complex Preparation on Dreaming and Sleep (which was randomized, double-blind and placebo-controlled), 100 participants from across Australia were given 240 mg vitamin B6 (pyridoxine hydrochloride) before bed for five consecutive days. Other study participants were given a B complex. This is the outcome of the study:

  • vitamin B6 significantly increased the amount of dream content participants recalled but did not significantly affect dream vividness, bizarreness, or color, nor did it significantly affect other sleep-related variables
  • participants in the B complex group showed significantly lower self-rated sleep quality and significantly higher tiredness on waking

Here are my thoughts on these results:

  • It’s wonderful to read that Vitamin B6 improves dream recall – this is what I see with my clients all the time.
  • With an optimal dose of vitamin B6, I would expect changes in “dream vividness, bizarreness, or color” and this also what I also see with my clients. If they are having horrible/vivid/bizarre dreams, the vitamin B6 changes them to pleasant dreams OR if dreams were not recalled prior to supplementation, they are now remembered and pleasant. The dose of 240 mg was used across the board but based on what we know about biochemical individuality, 240mg may be too much for some folks and not enough for others, so this could have impacted the results.
  • It’s not surprising that the B complex taken at bedtime impacted sleep. It’s known to be stimulating and it’s not something I’d advise any client to do. For this reason, I don’t feel it was the ideal control for this study.

The lead researcher is Dr. Denholm Aspy and his primary research focus is lucid dreaming. On his researcher profile on the University of Adelaide website, he describes lucid dreaming and the potential benefits:

In a lucid dream, the dreamer realizes that they are dreaming and can then explore and even control the dream. Lucid dreaming has a wide range of potential benefits and applications such as creative problem solving, treatment for recurrent nightmares and improvement of motor skills through rehearsal in the dream environment (e.g. for elite athletes or people recovering from physical trauma).

He shares that the purpose of his research is to address exploration of the potential applications of lucid dreaming and to “develop reliable ways to induce lucid dreams.” Looking for potential applications of lucid dreaming is very interesting and new to me.

Vitamin B6/dream recall research and pyroluria (a social anxiety condition)

However, this vitamin B6/dream recall research is of particular interest to me because of my work with pyroluria, a social anxiety condition which responds really well to supplementation with zinc, vitamin B6 or P5P (pyridoxal-5-phosphate) or a combination of both, and a few other key nutrients.  Here is the pyroluria questionnaire.

One of the classic signs of pyroluria is poor dream recall, stressful or bizarre dreams, or nightmares, signs which the late Carl Pfeiffer, MD attributed to low vitamin B6 status. He suggested that your dreams and dream recall serve as a good indicator of your need for vitamin B6. You should dream every night and you should remember your dreams. They should be pleasant—the kind of dreams where you wake up and want to close your eyes and continue dreaming.

Going back to the above discussion of lucid dreaming, in lucid dreams “the dreamer is aware of dreaming and often able to influence the ongoing dream content.” This is exactly how I would describe my dreams when I have good levels of vitamin B6 and my clients say the same.

Keep in mind that if you do have pyroluria, you may need to increase your dose of vitamin B6 in times of stress. Vitamin B6 can also be depleted by oral contraceptives because they cause both low vitamin B6 and zinc, reduce serotonin levels and increase anxiety. Vitamin B6 can also be depleted by antidepressants, diuretics, and cortisone, so if you start or stop taking any of these, you may need to adjust the amount you supplement.

If this intrigues you and you’re new to pyroluria, I write about dreams and vitamin B6 in the pyroluria chapter of my book, The Antianxiety Food Solution. My blog is also a wealth of information on pyroluria:

Dream recall and vitamin B6 status is important even if you don’t have pyroluria

Observing your dream recall and hence vitamin B6 status is important even if you don’t have pyroluria. This is because vitamin B6 it has been implicated as a co-factor in more than 140 biochemical reactions in the cell, playing a role making amino acids and neurotransmitters, making fatty acids, and even quenching reactive oxygen species (ROS).

This is partial list showing the importance of vitamin B6 (with both research and clinical evidence) for:

You may also wonder what the mechanism of action is? How does vitamin B6 impact your dream recall? One hypothesis is that vitamin B6 is a co-factor nutrient used in the conversion of tryptophan to serotonin which is then used to make melatonin. Vitamin B6 is also an antioxidant, is anti-inflammatory, and modulates immunity and gene expression.

If you’re looking for a quality vitamin B6 product, my supplements blog lists a range of vitamin B6 supplements that I use with clients and those in my group program.

Monitoring your dream recall is one very simple way to assess changes in your vitamin B6 status. And we now have new research supporting this. I look forward to follow-on studies by these authors, learning more from them about lucid dreaming and I hope to be able to offer some of my insights from clinical practice.

*** I address some concerns about vitamin B6 toxicity in this blog: Why is vitamin B6 toxic for some and why don’t symptoms resolve when vitamin B6 is stopped? I have yet to see any signs of toxicity in my clients, but I have also not ever recommended more than 500mg/day. However, I was recently made aware (thanks to some folks in my community) that there are some individuals who have issues with very small amounts of vitamin B6.  If you have experienced any issues with using vitamin B6 supplementation please share.

What are your dreams like and do you use your dreams to monitor your vitamin B6 status? What improvements have you noticed by addressing low vitamin B6 levels?

If you’re a practitioner do you use dream recall as an indication of vitamin B6 status?  Have you seen adverse issues with vitamin B6 supplementation and at what doses?

TouchPoints™ neuroscience device for stress relief, improved sleep and focus and reduced cravings

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TouchPoints™ basic are non-invasive neuroscientific lifestyle wearables that use patent pending neuroscience to relieve stress, improve sleep, performance, and focus, and can reduce cravings and anger.

I shared some information about these TouchPoints™ neuroscience devices a short time ago and it created some interest. This week I was just on a private call with one of the founders, Dr. Amy Serin and I’m so impressed with what I learned about these EMDR-type devices that I’m sharing their indiegogo campaign (happening right now) for the new lower price point device (the basic). The Basic device doesn’t use an iphone or ipad. I am somewhat concerned about EMFs with their other device and I’m still looking into this to determine if it is an issue.

This Basic device can be worn on a wrist-band or can be worn on a belt, socks, shirt etc.

I have NOT yet used one of these devices myself or with clients but I have purchased one to test and will share more as I learn more. Please do share your experiences too!

As with addressing any imbalance too much of something can be problematic. I received this feedback from a colleague who is a psychotherapist:

We use bilateral stimulation in our work with various gadgets – bilateral music with headphones, bilateral tappers etc. It’s been used with EMDR for 20 years. I haven’t seen this gadget before but the idea is not new. It can also be TOO activating and increase sympathetic arousal for some people.

If they work you I do see these as a great add-on to the nutrition work I do for anxiety (diet, adrenals, amino acids like GABA etc.) and could be especially helpful if you can’t tolerate supplements right now (like during a benzodiazepine taper or being highly sensitive).

You can find all the details here

 

Tryptophan and melatonin make a big difference but why do I still wake at 4am?

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waking-up-early

I get many questions on the blog about problems with sleep: not able to fall asleep, not waking rested and waking in the early hours and not being able to go back to sleep. By far the most common question is “Why do I still wake at 4am and can’t go back to sleep?”

So let me share one of the typical questions I receive and my feedback in the hope that something you read here may help you or someone you’re working with. Here is the question:

I purchased Lidtke l-Tryptophan and time release melatonin and notice a big difference in my sleep. Instead of waking up every two hours I’m sleeping better but still wake up at 4 am and can’t get back to sleep. GABA hasn’t helped. What can I take to get back to sleep and what are your thoughts on Seriphos Phosphorylated Serine? I think my anxiety has to do with my adrenals because I wake up in a sweat and am way past menopause.

Since she is seeing a big difference with tryptophan and timed-release melatonin, low serotonin is the likely root cause of her insomnia or at least one of the root causes. We always want to capitalize on what is already working. Too many people don’t see expected results with 1 x 500mg tryptophan at bedtime and 1mg timed-release melatonin and start looking for other solutions when the answer may be right in front of them.

Here are the steps I’d follow with a client with similar sleep challenges:

  • Try more tryptophan, increasing it slowly over the course of a few weeks in the hope that it more will provide more serotonin support. This is what I call an amino acid trial where you rate and log your improvements as you incrementally increase – with the goal of finding an optimal amount for your needs. We all have different needs and post menopause it’s not uncommon for women to experience anxiety, depression and insomnia related to low serotonin and fluctuating sex hormones. We also always want to capitalize on what is already working.
  • Also, to add to what’s working, add tryptophan mid-afternoon if it’s not already in place. When someone scores high on the low serotonin questionnaire the typical timing of tryptophan is mid-afternoon and an hour before bed (always away from protein). Serotonin levels start to decline mid-afternoon hence the benefits of a mid-afternoon dose. Start low and increase slowly.
  • I would also suggest trying the tryptophan opened up (at both times) to see if this makes a difference.
  • Taking a tryptophan at the 4am waking can help you go back to sleep so this is worth trying. For some people 500mg at 4am is too much and using 125mg or 250mg works well. You determine the amount based on how you feel when you do get up. If you were able to go back to sleep easily buy wake groggy then it’s too much.
  • Some people are reporting better results with Lidtke Tryptophan Complete (which has all the co-factor nutrients) so this may be worth trialing too. I’d start by adding to what is already in place.
  • If we get benefits with any of the above by are not quite there then I would suggest additional timed-release melatonin until sleep improves.

This is always done slowly and methodically over the course of a few weeks. I always have my clients carefully log what they try and what is working and not working.

Other factors we’d make sure are addressed:

  • What GABA was used, was it trialed (starting low and increased) and was it used sublingually?
  • Is high cortisol at night a factor? Doing an adrenal saliva test will provide the answer. If it is then the Interplexus Seriphos is the best for lowering it. It’s best to take 1-3 x Seriphos about 2-3 hours before the high cortisol.  [UPDATE: INTERPLEXUS SERIPHOS WAS REFORMULATED IN 2016 – PLEASE SEE BELOW FOR MORE ON THIS]
  • Is gut health a factor? Look into SIBO, gluten sensitivity, other food sensitivities, dysbiosis and parasites (which are often active in the early hours and can cause night sweats)
  • Is there a sex hormone imbalance? Even with someone way past menopause, the night sweats mean this should be ruled out. The addition of amino acids starts to balance the hormones but more support may be needed.  
  • Is any caffeine (even decaf) still being consumed?
  • Is blood sugar stable? Make sure to have breakfast with animal protein and healthy fats and the same at each meal and for snacks. Consider a trial of glutamine during the day and just before bed for added blood sugar stability
  • Are medications a factor? Current medications or prior use of benzodiazepines or SSRIs can affect sleep even long after they have been tapered.
  • Is sleep apnea a factor?

We also address all the usual sleep hygiene factors: dark room, cool room, quiet room, no cell phone or clock radio on the bedside table, no late night computer use and getting some early morning light.

Many essential oils can provide added benefits when diffused at night or mixed with a carrier oil and used topically. One lovely combination I share on the Essential Oils Revolution 2 (happening now) is lavender, roman chamomile and neroli which helps both insomnia and anxiety.

There can be many other possible root causes of insomnia: autoimmunity, Lyme disease, pain, past trauma or grief and even genetic polymorphisms, all covered on the recent Sleep Success Summit.

Have you used tryptophan or other amino acids like GABA (for the more physical tension) and melatonin to reduce or eliminate early morning waking episodes?

If you’re a practitioner, have you helped your clients/patients with this methodical approach?

What else has helped you?

Update August 27, 2016 : INTERPLEXUS SERIPHOS HAS BEEN REFORMULATED -I am doing research to find suitable alternatives. For now, feel free to read through the comments below for discussions about this.  Once I have some useful information I’ll create a new blog post. 

Update November 18, 2016: Here are some possible alternatives to Seriphos

Update January 20, 2017: The Original Formula of Seriphos has been reintroduced you can read more about this here

 

Lavender, roman chamomile, and neroli essential oils for anxiety and sleep

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Lavender, roman chamomile, and neroli essential oils for anxiety and sleep

Lavender, roman chamomile, and neroli essential oils have been found to be beneficial for anxiety and sleep in patients going through a surgical procedure. 

The aromatherapy blend was in a ratio of 6 :  2 : 0.5  for lavender: roman chamomile: neroli.  

Participants received 10 treatments before percutaneous coronary intervention/PCI (formerly known as angioplasty with stent) and the same essential oil blend was inhaled another 10 times after the procedure.

Here are the details of the study: Effects of aromatherapy on the anxiety, vital signs, and sleep quality of percutaneous coronary intervention patients in intensive care units

The purpose of this study was to investigate the effects of aromatherapy on the anxiety, sleep, and blood pressure (BP) of percutaneous coronary intervention (PCI) patients in an intensive care unit (ICU). Fifty-six patients with PCI in ICU were evenly allocated to either the aromatherapy or conventional nursing care.

Outcome measures patients’ state anxiety, sleeping quality, and BP (blood pressure).

The aromatherapy group showed significantly low anxiety and improving sleep quality compared with conventional nursing intervention.

If these surgical patients could see these results imagine how these essential oils could help you if you suffer from anxiety and/or sleep issues.

Join us on the Essential Oils Revolution 2 to hear me cover this and  and other essential oils combinations for anxiety and insomnia.

essential-oils-revolution-banner

Here is the summit registration link:
https://qt247.isrefer.com/go/EOR16reg/trudyscottcn/

Have you found that this combination helps you with anxiety and sleep?  What ratio works for you?

 

Sleep restriction for insomnia – Dr. Breus on the Sleep Success Summit

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sleep-success-summit

As you probably know, insomnia is often a big issue if you have anxiety and/or depression. I like to address low serotonin, low GABA and low blood sugar for the sleep and mood issues but sleep issues can be caused by so many factors.

The Sleep Success summit addresses so many of these other factors: the adrenals, the thyroid, the gut, hormone health (all of which can impact sleep), plus topics on sleep apnea (and the inflammation connection), MTHFR, autoimmunity, using essential oils, sleep problems we see in kids and so much more.

sleep-summit-speakers

Dr. Michael Breus is the host of the summit and is interviewed by Sean Croxton: “An Interview with The Sleep Doctor.” He shares:

We know that when people aren’t able to stay asleep or fall asleep there is always some type of a mental component, either anxiety or depression (60-70% of the time)

There are just not a lot of people out there treating insomnia other than just prescribing pills and I’m not a big fan of that. Now you have two problems – you have a sleep problem and you have a pill problem.

I learned something new listening to Dr. Breus’ interview. He uses an evidence-based technique called “sleep restriction” to help his patients with insomnia.   He says it trains your brain to know when to sleep and it works for about 50% of his patients.   When the “sleep restriction” technique isn’t enough he uses cognitive behavior therapy to help with the negative thoughts and worry around the lack of sleep and supplements. He does use medications short-term (a few weeks only) to break the insomnia cycle.

I’m so intrigued by this “sleep restriction” method that I went looking for the research and found this study published just last month: 70% of the women receiving cognitive behavioral therapy for insomnia (CBT-I) said they had no more insomnia after 8 weeks and 84% said they had no more insomnia after 24 weeks!

A randomized clinical trial was conducted among 106 perimenopausal or postmenopausal women aged 40 to 65 years with moderate insomnia symptoms and 2 or more daily hot flashes.

Telephone-based cognitive behavioral therapy for insomnia (CBT-I) – which included sleep restriction, stimulus control, sleep hygiene education, cognitive restructuring, and behavioral homework – was compared to menopause education MEC/ information about menopause and women’s health.

At 8 and 24 weeks, 33 of 47 women (70%) and 37 of 44 (84%) in the CBT-I group, had scores in the no-insomnia range, compared with 10 of 41 (24%) and 16 of 37 (43%) in the MEC group.

Dr. Breus’ expertise is CBT-I and he is new to the naturopathic and nutritional world so we do have some professional differences of opinion, like buying Cosco magnesium (I would suggest looking for a quality product just like I do with all supplments) and avoiding 5-HTP and melatonin (although I do agree we do need to be informed consumers when using them).  The good news is that because he’s new to this he does ask great in-depth questions of the experts on the summit.

Other great interviews to check out:

  • Ben Lynch, ND – Are Your Genes Affecting Your Ability to Sleep?
  • Izabella Wentz, PharmD, FASCP – Getting to the Root Cause of Hypersomnia and Thyroid Fatigue
  • Magdalena Wszelaki, HHC – Your Hormones Could Be Affecting Your Sleep
  • Alan Christianson, NMD – Heal Your Adrenals and Get Better Sleep
  • Daniel Kalish, DC – How Sleep Influences Functional Medicine
  • Amy Myers, MD – Sleep, Functional Medicine and Autoimmune Function
  • Eric L. Zielinski, DC, MPH(c), BA – Sleep and Essential Oils: What’s the Connection?
  • Emily Fletcher – How Meditation Cured my Insomnia!
  • David Wolfe – How Your Environment Could Be Affecting Sleep! (Earthing and grounding for better sleep + Analyzing your environment to sleep better)

You can REGISTER HERE

You can PURCHASE HERE (it’s summit special pricing until the summit ends) 

I’d love to know if you’ve ever done cognitive behavioral therapy for insomnia (CBT-I) and if it helped you?   Is yes did it include all of the following: sleep restriction, stimulus control, sleep hygiene education, cognitive restructuring, and behavioral homework? Please share in the comments.