Tryptophan

What causes low serotonin? Use tryptophan/5-HTP to help with the anxiety, overwhelm and worry right away and address all the root causes

May 13, 2022 By Trudy Scott 18 Comments

Low serotonin has a number of root causes which can be different for each person. If you do have low serotonin levels you always want to figure and address why it’s low. This can take time to figure out and resolve so you want to be using either tryptophan or 5-HTP (and sometimes both) to boost your serotonin levels and get symptom relief quickly. This helps with the worry, overwhelm, anxiety, insomnia, carb cravings, TMJ, irritability, PMS, anger, OCD, low mood and ruminations right away. It also helps with the worry and overwhelm triggered by sometimes complex and challenging root causes.

Here is a list of some of the many factors that may cause low serotonin for you:

stress and adrenal dysfunction (high cortisol affects your sex hormone and neurotransmitter production, inlcuding serotonin)
eating junk food and sugar (a Western diet “of processed or fried foods, refined grains, sugary products, and beer was associated with a higher odds of mood disorders”
consuming caffeine (which reduces zinc and B vitamins, needed to make serotonin)
not consuming enough quality animal protein (amino acids are the building blocks of our neurotransmitters, and grass fed red meat provides zinc, iron and omega-3s – all needed to make serotonin)
low stomach acid (meaning you can’t digest the protein you’re consuming)
gluten issues (leading to low serotonin and other nutritional deficiencies such as low iron, low vitamin D etc.)
low vitamin D (“Brain serotonin is synthesized from tryptophan by tryptophan hydroxylase 2, which is activated by vitamin D hormone”)
low iron/ferritin levels (iron is a cofactor for making serotonin)
dysbiosis and microbiome imbalances (we make so much serotonin in the gut)
candida (in one study short exposure to serotonin resulted in antifungal activity)
liver issues (affecting how you process xenoestrogens)
low bile production (affecting how you digest the healthy fats you’re eating)
sex hormone imbalances (serotonin and estrogen are very closely linked and women make less serotonin than men. In one study, tryptophan improved the low serotonin PMS symptoms)
thyroid imbalance (“it is postulated that one mechanism, among others, through which exogenous thyroid hormones may exert their modulatory effects in affective illness is via an increase in serotonergic neurotransmission”)
histamine imbalances (in one study “Acute LPS-induced inflammation increases CNS histamine and decreases CNS serotonin)”
the birth control pill (which lowers zinc and vitamin B6, both of which are needed for serotonin production)
statins (leading to cholesterol that is too low)
mold exposure/mycotoxins/mold poisoning
heavy metal toxicity such as lead (and tryptophan and ascorbic acid can help ease the anxiety)
Lyme disease and other co-infections (serotonin was found to be low in cerebrospinal fluid in patients with post-Lyme disease syndrome i.e. chronic Lyme)
collagen consumption (in susceptible folks this can lower serotonin levels)
seasonal allergies (“Cytokines may lead to a mood disturbance via the expression of the IDO enzyme, which shifts the synthesis of tryptophan from serotonin to kynurenine. The resultant acute tryptophan depletion results in decreased brain serotonin”)
genetics (one example is the MTHFR polymorphism)
low zinc, low vitamin B6 (and other B vitamins), low selenium, low magnesium etc. – all needed to make serotonin
oxalates (which can bind to zinc and deplete it)
a high copper diet (nut flours on Paleo diets can be problematic), copper IUD, copper pipes etc. (which can cause low zinc)
lack of nature (forest bathing reduces cortisol which affects serotonin production)
lack of exercise
lack of sunshine (like in the winter when serotonin declines)

When I posted some of this list on Facebook earlier this week, there was a great deal of interest, hence this blog. I’ve included one relevant link for each one so you can read further on the topic.

When I posted it I also asked this: “Have you figured out your root cause/s that are contributing to your low serotonin levels? And has tryptophan or 5-HTP helped while you’re figuring it all out?”

Leanne has mold, dysbiosis, Lyme, low vitamin D, bile issues and more

Leanne responded and gave me the go ahead to share especially if this helps someone else (I appreciate that!) She shared she has identified these root causes:

Mold. Dysbiosis. Possible Lyme/co-infections. Low vitamin D. Bile and motility issues. Liver issues. Stress. Low HCL. Those are the ones I’m aware of. And taking each and every day to work on them. It takes time to heal

I agree it takes time to heal and can be a longer journey for some folks, especially when there are a number of underlying factors. She is in a good frame of mind, saying pragmatically, it takes time to heal. This confirms her serotonin levels are robust i.e. she is not in a state of overwhelm and worry. Sure enough, when I asked if tryptophan or 5-HTP has been helping this was her response:

5-HTP and GABA calm initially helped me in my first round of going through this back in 2015. Then I discovered l-tryptophan about a year ago and that seemed to be a better help over 5-HTP.

Since I’ve just identified that histamine is an issue and started a low histamine diet this past week I noticed less of a need for l-tryptophan as I did before. My body is calming down significantly. And my digestion is working a little better.

But I still have to address mold, SIBO, candida, parasites and possibly Lyme and underlying hidden viruses.

So I know these amino acids will play a key part in supporting me as I dive deeper into addressing them all.

It’s wonderful the amino acids have helped her so much and they will most likely continue to help. A quick comment on her preference for tryptophan over 5-HTP – some folks do better on one vs the other.

Regarding the histamine issues/root cause, it’s good that she is now addressing this. Already she needs less tryptophan (for now). Things may fluctuate in the future again as she peels away the onion layers of root causes. She may find she needs tryptophan again or a higher dose or needs to get back on the GABA.

As you can see she has been working on her health for some time. This is not unusual. Slow and steady is just fine, especially when there is so much going on.

The amino acids are intended for short-term use while diet and underlying root causes are addressed. But when the list is long this is a common reason for the ongoing need for serotonin support. Keep in mind, your list may be a short one and may be quick to resolve. And not everyone has the same root causes.

Resources if you are new to using tryptophan or 5-HTP as supplements

If you are new to using tryptophan or 5-HTP as supplements, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution (you can see all the low serotonin symptoms).

If you suspect low levels of serotonin or 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 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, 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 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 also a paid online/virtual program with an opportunity to interact with me and other practitioners who are also using the amino acids.

Have you figured out your root cause/s that are contributing to your low serotonin levels? And does this give you a better understanding of your own issues?

Do you have any other root causes I may have missed? (when I posted this list on Facebook, a few people pointed out I had missed a few. I’ll update the list and continue to add as we discover new connections).

Has tryptophan and/or 5-HTP helped you feel less overwhelmed and worried while you’re figuring it all out?

Have you adjusted doses of tryptophan and/or 5-HTP as things change and root causes are addressed/resolved?

If you’re a practitioner, do you have anything to add and do your clients/patients find this useful?

If you have questions please share them here too.

Drastic reduction in intrusive thoughts, anxiety and fears (and better sleep) with GABA, tryptophan, 5-HTP and the pyroluria protocol

May 6, 2022 By Trudy Scott 29 Comments

It’s not uncommon for an adult woman to have had intrusive thoughts her entire life and not even recognize that they are connected to her anxiety levels. She is often unaware that there is anything she can do to actually ease her anxiety and reduce the bad thoughts (such as fearing horrible things happening to her husband and children). Enter the amino acids: GABA, tryptophan, 5-HTP and the pyroluria protocol (zinc, vitamin B6 and evening primrose oil). They can do all of this and more. Kimberly shared her own experience and success on a blog post about intrusive thoughts and these specific nutrients. Here is her story in her own words:

Oh my goodness, I’m realizing after reading this, that intrusive thoughts are something I’ve had my entire life. As a child, this manifested in thoughts of what might happen to my one stable parent when we were apart. More recently, I feared horrible things happening to my husband or children. Like the author of the original blog wrote, these intrusive thoughts reflect a greater anxiety. But I didn’t realize this until I began experimenting with your protocols.

I first tried GABA when I felt extremely anxious, but not on a regular basis. Next, I added the pyroluria protocol, which did bring some relief to the intrusive thoughts. Fast forward to today, when I also take 5-HTP, tryptophan and GABA regularly and have noticed a drastic reduction in those thoughts/fears. It’s like a miracle.

My fear level is maybe 15% of what it used to be, if that.

I also find that I can use extra GABA at night if I wake up and can’t shut off my mind. It works like a charm to help me get back to sleep. What a blessing to have these amino acids.

I’m a calmer, more serene person than I’ve ever been, without (for the most part) the crippling, irrational fears I used to experience. Thank you, as always, Trudy. You are also a tremendous blessing.

I thanked her for sharing and said how glad I was that she is connecting more and more dots. It’s very common to suddenly realize you’ve had these intrusive thoughts your entire life. With her amazing results, combining all the above nutrients she is a poster child for this approach that I use with my clients. I’m thrilled for her miracle outcome and so very happy for her.

I’m sharing her story here as a new blog so I can provide her with some additional approaches to explore and so you can see how these amino acids and other nutrients have worked for someone else (and get your own insights.) I’m also sharing my feedback on how she approached things.

Additional approaches to her to explore: adjusting what is working for her now

Her fear level is maybe 15% of what it used to be but ideally we want to improve on that by fine-tuning what she is doing and capitalize on what is working. Know this – it’s not unreasonable to expect that to get to zero!

If we were working together this is what I’d suggest (assuming she hasn’t already done this):

Review the low GABA and low serotonin questionnaires and adjust the GABA and/or tryptophan/5-HTP based on any symptoms that remain with a score above zero.
After that, if there are still some troubling low serotonin symptoms experiment with different doses and timings of tryptophan and 5-HTP – some people do better on one vs the other
Also, if there are still some troubling low GABA symptoms, experiment with a few different GABA products. I’ve had folks try up to 5 different products before they find the perfect one for their needs
If she can see the social anxiety and other pyroluria signs remain, we’d adjust zinc, vitamin B6 (and possibly add P5P) and evening primrose oil.

With all of the above, I’d have her do one change at a time and carefully document everything in her food-mood log.

Identifying if the remaining fear/intrusive thoughts are more pronounced in the second half of her cycle

It may simply be a matter of identifying if the remaining fear/intrusive thoughts are more pronounced in the second half of her cycle i.e. after ovulation. As I shared on the blog, one study showed that “women in the ‘early luteal’ phase… had more than three times as many intrusive thoughts.”

She may need to adjust the amino acids up during this period and it may be that over the next 2 months she sees these symptoms resolve with her current approach, as her hormones become balanced. It’s typical to see this in 2-3 months.

My feedback on her approach

Here is my feedback on how she did things and why I love her approach:

She experimented with GABA some of the time – as needed – based on what she was learning from me from blogs, my book and interviews.
She made one change at a time, adding the pyroluria protocol next
Then she added tryptophan and 5-HTP (hopefully one at a time)
And then her use of the amino acids became regular. This last aspect of consistency is a needle mover for so many of my clients.
She now tweaks things and takes extra GABA at night if needed. This may be needed after a tough day or if you’ve been glutened or exposed to insecticides.

I will add that the sequence could have been varied and still have had a similar successful outcome, for example, amino acid consistency from day 1 and then adding the pyroluria protocol (this is what I typically do with clients).

However, it’s my goal to empower women like Kimberly to take charge, learn, make changes, listen to their bodies, learn some more and adjust to see further improvements. It makes me immensely happy when I hear that she is a calmer, more serene person than she’s ever been. I feel confident that she’ll be able to get to zero intrusive thoughts with the tips I shared above.

She may or may not also need to consider other possible root causes of intrusive thoughts: low magnesium, low iron, diet (a low carb/high fat intrusive thoughts case study) and gluten issues.

Psychiatric medication discontinuation syndrome, Lyme disease, mold toxicity, heavy metals, toxins, infections, TBI and trauma can also be factors with intrusive thoughts and anxiety, but with her huge improvement I’d suspect these root causes are unlikely for her.

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

If you are new to using GABA or tryptophan/5-HTP as a supplement, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution (you can see all the low GABA and low serotonin symptoms).

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 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, blood sugar control, sugar cravings, self-medicating with alcohol and more.

My book also has an entire chapter on pyroluria (with the protocol and questionnaire). The questionnaire is on the blog too, together with many other related posts (simply search for pyroluria).

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

Do you experience intrusive thoughts or did you have them in the past? Feel free to describe them if you feel comfortable doing so.

And did you think you’d be able to reduce the horrible intrusive thoughts with a nutritional approach?

What helped reduce them for you? If you used a similar approach, how did it look for you?

If you’re a practitioner, have you found this approach to help reduce intrusive thoughts and ease anxiety in your clients/patients?

If you have questions please share them here too.

An amino acid supplement with DLPA, glutamine and 5-HTP eases alcohol withdrawal symptoms at an inpatient detoxification program

April 8, 2022 By Trudy Scott 11 Comments

An amino acid supplement with DLPA, glutamine and 5-HTP (and a few other nutrients) eases alcohol withdrawal symptoms at an inpatient detoxification program. Other than anxiety (I’ll share more on this below), there was also a significant decrease in psychiatric symptoms. Here is an excerpt from the study, The use of a food supplementation with D-phenylalanine, L-glutamine and L-5-hydroxytriptophan in the alleviation of alcohol withdrawal symptoms:

We described the use of a food supplementation with D-phenylalanine, L-glutamine and L-5-hydroxytryptophan in the alleviation of alcohol withdrawal symptoms in patients starting a detoxification therapy.

Since abstinence from ethanol causes a hypodopaminergic and a hypoopioidergic environment in the reward system circuits, manifesting with withdrawal symptoms, food supplements that contains D-phenylalanine, a peptidase inhibitor (of opioid inactivation) and L-amino-acids (for dopamine synthesis) were used to replenish a lack in neurotransmitters and alleviate the symptoms of alcohol withdrawal.

First I cover some translation issues and then more about the actual product and study results. I also share my commentary on the amino acids and dosing used in the study (and the fact that anxiety did not resolve). I include how to apply this information if you have a loved one in an alcohol treatment/rehab program or if you recognize social drinking is an issue for you. And I wrap up with additional resources if you are new to using GABA as a supplement, the GABA Quickstart online program and the practitioner training.

The study was completed and published in Slovenia and there are a few translation issues I’d like to clarify:

The study title states D-phenylalanine (DPA) was in the amino acid product, however DL-phenylalanine (DLPA) was actually used. You can read about the difference between DPA and DLPA here. In summary, DPLA works on both dopamine and endorphin support and DPA works on endorphin support only.
As you can see from the excerpt above, hypodopaminergic refers to low dopamine and hypoopioidergic refers to low endorphins. During withdrawal from ethanol/alcohol, both low dopamine and low endorphins cause withdrawal symptoms.
L-5-hydroxytryptophan is incorrectly spelled as L-5-hydroxytriptophan and reward system is incorrectly spelled as reword system. (Clarifications are provided for facilitating online searches in the research literature.)

More about the product, the study and the conclusion

It was a small randomized, double blind study with just 20 patients and the amino acid product was used for 40 days of the inpatient alcohol detox or rehab program.

This is the actual combination product used:

300 mg DLPA

150 mg glutamine

5 mg 5-HTP

1 mg vitamin B6

50 mg calcium gluconate

25 mg magnesium oxide

0.01 mg folic acid

Psychiatric symptoms were measured using the SCL- 90R and included assessing for “somatization, obsessive-compulsive, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid, and psychoticism.” During their rehab there was a significant decrease in these categories of psychiatric symptoms in the study group, except for their anxiety symptoms.

The authors conclude that “abstinence causes a major stress for the patients. The use of a food supplement containing D-phenylalanine [it was actually DL-phenylalanine], L-glutamine and L-5-hydroxytryptophan alleviates the withdrawal symptoms.”

As expected, once alcohol consumption was stopped, cortisol levels, liver enzymes and total bilirubin all decreased in the study group and the control group.

My commentary on the amino acids and dosing used in the study (and the fact that anxiety did not resolve)

Keep in mind the same dosing was used for all study participants. What I use clinically with folks with low levels of these neurotransmitters, is an individualized approach based on each person’s needs, for endorphin and dopamine support (from the DLPA), blood sugar support (from glutamine) and serotonin support (from 5-HTP). This means identifying symptoms in each category and doing a trial of each respective amino acid, starting low and increasing based on symptom resolution.

Given that anxiety symptoms didn’t resolve in the study group, I would have loved to see the amino acid GABA included, also dosed according to individual needs. GABA helps ease the physical tension-type anxiety and low GABA tension often drives the need to self-medicate with alcohol in order to relax and fit in socially.

The authors do mention GABA too: “the physiological craving for alcohol may be the result of a deficiency of the naturally occurring opiate like substances as well as other neurochemical deficits (i.e., dopaminergic, GABAergic, and serotonergic).

Also, an animal study shows that GABA helps with gut damage caused by alcohol consumption, so there is this additional benefit.

A higher dose of glutamine and/or 5-HTP may have also helped ease anxiety. They used 150 mg glutamine whereas a typical starting dose for glutamine is 500 mg (and we increase from there). Going up to 1000 mg to 1500 mg three or 4 times a day is not unusual and is typically very beneficial for alcoholics – for blood sugar stability, an additional calming effect and for healing the leaky gut which has been damaged by the alcohol consumption.

With regards to 5-HTP, they used 5 mg 5-HTP which is considered extremely low. I wonder if it was in fact 50 mg, which is a typical starting dose? Going up to 150 mg 5-HTP use 2 or 3 times a day is not unusual. Serotonin support with 5-HTP (or tryptophan) is very beneficial for the worry-type of ruminating anxiety.

For some individuals DLPA may have been too stimulating and contributing to anxiety via a dopamine boost. For these individuals, DPA may have been a better option for endorphin support.

I am not in favor of folic acid and prefer methylfolate, and although magnesium is an important cofactor for neurotransmitter production, magnesium oxide does not provide much usable magnesium.

Outside of the amino acids and other nutrients used, a vitamin B1 (thiamine) deficiency would need to be addressed and any other deficiencies (such as all the B vitamins, zinc, vitamin D, magnesium etc.) caused by chronic alcohol consumption. This is not a comprehensive list and a full functional workup will help to identify all possible deficiencies.

Despite my quibbles, the outcome of the study is very encouraging, I appreciate the researchers and I hope to see it replicated and refined in other settings.

How to apply this information if you have a loved one in an alcohol treatment/rehab program

Unfortunately the amino acids are seldom incorporated at in-patient detox and rehab centers but they should be. Your options are to:

Share this study and my blog with the treatment center
Educate yourself (on using the questionnaire and doing the amino acid trials) so you can use them with your loved one once rehab is over. This is key for preventing a relapse and for swapping alcohol addiction for sugar or caffeine or nicotine addiction.
Introduce one amino acid at a time so you can figure out which one/s they need and how much
Read my book, The Antianxiety Food Solution – How the Foods You Eat Can Help You Calm Your Anxious Mind, Improve Your Mood, and End Cravings, and share a copy with the treatment center (and your loved one and their treatment team)
Address diet, nutritional deficiencies and gut health

Keep in mind that the amino acids are used with success for cocaine, heroin and other drug addictions.

How to apply this information if you recognize social drinking is an issue for you

New research shares that “low-level alcohol consumption is commonly perceived as being inconsequential or even beneficial for overall health, with some reports suggesting that it may protect against dementia or cardiovascular risks”, however, as the authors suggest “even low-level alcohol consumption is associated with premature brain aging.”

Social drinking is the norm and is way too prevalent. And it’s often used as a calming measure in order to relax and fit in socially. If this sounds like you:

Educate yourself (on using the questionnaire and doing the amino acid trials) so you can use them to quit drinking easily with no willpower and no feelings of being deprived. This is key for preventing the swapping out the need for alcohol (to relax or fit in socially) with a sugar or caffeine or nicotine addiction. In this case, GABA helps a young man who has recently given up alcohol, Adderall and nicotine.
Introduce one amino acid at a time so you can figure out which one/s you need and how much
Read my book, The Antianxiety Food Solution – How the Foods You Eat Can Help You Calm Your Anxious Mind, Improve Your Mood, and End Cravings, and share a copy with your loved one/spouse/partner and practitioners/therapists.
Address diet, nutritional deficiencies and gut health

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

If you are new to using the amino acids as supplements, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution (you can see all the low neurotransmitter symptoms).

There is a section on alcohol but keep in mind that all the sections on sugar craving/addiction apply to alcohol addiction and self-medicating with alcohol too. Some individuals use alcohol to numb out and some use sugar. Many use both and once alcohol addiction is addressed, it’s often replaced with sugar and caffeine addiction. This is why addressing neurotransmitter imbalances is key.

If you don’t feel comfortable reading my book and figuring things out on your own (doing the symptoms questionnaire and doing respective trials), you can get guidance from me in the GABA Quickstart Program (online/virtual).

If you are a practitioner, join us in The Balancing Neurotransmitters: the Fundamentals program. It’s an opportunity to interact with me and other practitioners who are also using the amino acids.

Have you used amino acids with success as part of an alcohol detox program (for yourself or for a loved one)? Or to help stop social drinking of alcohol?

Which neurotransmitter imbalances were driving your need to self-medicate with alcohol and which amino acids helped?

If you’re a practitioner do you use the amino acids (via an individualized approach) to help with alcohol withdrawal and cessation with your patients and/or clients?

Feel free to ask your questions here too.

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

December 31, 2021 By Trudy Scott 25 Comments

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

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

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

About trigeminal neuralgia and the incidence

The NIH fact sheet defines trigeminal neuralgia (TN) as

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

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

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

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

When to consider GABA and serotonin support

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

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

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

St. John’s Wort for nerve pain and mood

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

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

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

Pain relief with endorphin support: acupuncture and DPA

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

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

Other research-based pain-relief approaches for trigeminal neuralgia

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

There are some less recognized approaches too:

Photobiomodulation on trigeminal neuralgia: systematic review “Photobiomodulation appears to be as effective as conventional therapies” that include medications and surgery and yet without the side-effects. Photobiomodulation, also known as red light therapy, is also beneficial for anxiety and mood regulation.
Palmitoylethanolamide and Its Formulations on Management of Peripheral Neuropathic Pain – Palmitoylethanolamide (shortened to PEA) “has anti-inflammatory and anti-hyperalgesic effects, due to the down-regulation of activation of mast cells”
Therapeutic potential of cannabinoids in trigeminal neuralgia – there is growing evidence that “cannabinoids may be effective in alleviating neuropathic pain and hyperalgesia [extreme pain sensitivity]” via “inhibiting neuronal transmission in pain pathways.”

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

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

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

Current approaches and emerging interventions – disappointing for a 2021 paper

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

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

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

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

I do agree with and am encouraged by these statements:

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

Complementary approaches: NIH fact sheet

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

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

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

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

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

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

If you suspect low levels of any of the neurotransmitters and do not yet have my book, The Antianxiety Food Solution – How the Foods You Eat Can Help You Calm Your Anxious Mind, Improve Your Mood, and End Cravings, I highly recommend getting it and reading it before jumping in and using amino acids so you are knowledgeable. And be sure to share it with the team you or your loved one is working with.

The book doesn’t include product names (per the publisher’s request) so this blog, The Antianxiety Food Solution Amino Acid and Pyroluria Supplements, lists the amino acid products that I use with my individual clients and those in my group programs.

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

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

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

Feel free to ask your questions here too.

Increasing tryptophan or 5-HTP temporarily when a winter dip in serotonin causes more severe anxiety, OCD and/or the winter blues

December 24, 2021 By Trudy Scott 16 Comments

Don’t forget that serotonin takes a dip in winter when the days are shorter and there is less light. If you’re currently using tryptophan or 5-HTP to boost low serotonin and ease low serotonin symptoms – worry-type anxiety, panic attacks, insomnia, ruminations, PMS, irritability, negativity, perfectionism, obsessiveness, lack of confidence, anger/rage, afternoon/evening cravings – you may find you need to increase your dose for a few months.

This will especially be the case if you check off winter blues or more severe winter anxiety (yes it’s a thing and published in the research) on the low serotonin symptoms list.

I shared this on Facebook last week and the feedback ranged from surprised to curious to confirmatory.

In this blog I’m sharing some of the feedback and some of the supporting evidence, as well as other factors to consider.

The addition of 5-HTP in the morning and a light box

Kathy thanked me for the reminder and shared the changes she makes in the winter months:

Thanks for the reminder! I need to increase my dose this time of year… I can feel myself feeling “down”. I take 500 mg Tryptophan before bed and 100 mg 5-HTP in the morning before breakfast. I also use a light box in the morning while eating breakfast, which helps.

This is an increase from her typical dosing in the spring and summer when she only takes tryptophan at night before bed.

She also only uses her light box or SAD (seasonal affective disorder) lamp in winter. You can read more about SAD/full spectrum lamps here. They are also a wonderful way to boost serotonin and mood in the winter.

My daughter’s anxiety and OCD goes through the roof

Mark shared about his daughter’s anxiety and OCD (obsessive compulsive disorder):

Every year from October – March, my daughter’s anxiety and OCD goes through the roof. At first we thought it was the transition from summer to school, then the craziness of the winter holidays and suspected mold allergy. Now, based on this information, a winter/less light induced dip in serotonin may be an additional factor we hadn’t considered. We’ll try adjusting her 5-HTP dose and see if we gain some improvement. Thanks for the tip.

It’s really common for families to attribute the more severe anxiety and OCD to the stress and craziness of the winter holidays. And of course suspected mold issues do need to be looked into and addressed. But even then, the dip in serotonin can compound all these factors.

Planned tryptophan bump for Christmas sugar cravings and holiday family stress

Carol shared this about her plans to temporarily boost serotonin:

I am one of those light weights that was able to do one 500 mg pill a day of tryptophan. But I do think that it would help to bump it up to two a day to get me through the Christmas sugar cravings AND holiday family stressful get togethers! I’m all about taking the minimum effective dose but this is helpful to know that there could be a temporary boost just to get you through this time!

It’s wonderful that 500mg tryptophan is enough for her and I’m all for a minimum effective dose! However the winter dip in serotonin – and increased sugar cravings and family stress – is a common reason many folks bump up the dose for a month or more.

You may also find you made the change intuitively. Linda shared this: “I had made the adjustment. I just did not realize the reason why.”

A question about timing of 5-HTP and what to do in Spring

Suzanne shared that she uses a SAD light (also called a light box) and finds that it helps. She asks:

Can I just take the 5-HTP on days with no sun or is it better to have it build up in my system? When spring rolls around, do I taper off or can I just stop taking it?

This is my feedback: I haven’t had anyone just use 5-HTP on cloudy days but it’s worth a trial. If you are noticing increased anxiety and mood changes only on cloudy days and using the SAD lamp on those days helps, then using 5-HTP on those days may be enough. If not, use 5-HTP consistently/daily through the winter months.

Amino acids do not need to be tapered but I find my clients do better when they are reduced over a few weeks. Some folks also choose to just stop taking them and do fine.

I appreciate all the feedback and the great questions. I’ll report back when I hear how Mark’s daughter does with the adjusted 5-HTP and how Carol does with the bump in tryptophan (and any other feedback I get from these folks).

Some of the research and possible mechanisms

There are many studies that support serotonin changes and seasonal variations in mood. Here are just two of them:

Effect of sunlight and season on serotonin turnover in the brain “Alterations in monoaminergic neurotransmission in the brain are thought to underlie seasonal variations in mood, behaviour, and affective disorders… turnover of serotonin by the brain was lowest in winter. Moreover, the rate of production of serotonin by the brain was directly related to the prevailing duration of bright sunlight… Our findings are further evidence for the notion that changes in release of serotonin by the brain underlie mood seasonality and seasonal affective disorder.”
Sunshine, Serotonin, and Skin: A Partial Explanation for Seasonal Patterns in Psychopathology? “one contributory facet may be the role of sunshine on human skin. Human skin has an inherent serotonergic system that appears capable of generating serotonin.”

Other factors to consider: low vitamin D, sugar, pyroluria and phenols

There are other low-serotonin related factors to consider too:

Low vitamin D is common in the winter and sufficient levels are needed for making serotonin. This paper, Vitamin D and the omega-3 fatty acids control serotonin synthesis and action, part 2: relevance for ADHD, bipolar disorder, schizophrenia, and impulsive behavior describes how“Brain serotonin is synthesized from tryptophan by tryptophan hydroxylase 2, which is transcriptionally activated by vitamin D hormone. Inadequate levels of vitamin D (∼70% of the population) and omega-3 fatty acids are common, suggesting that brain serotonin synthesis is not optimal.”
The increased consumption of sugar at this time can lead to reduced zinc, magnesium and B vitamins (like vitamin B6 and thiamine) and this can further reduce serotonin levels, which relies on these nutrients as cofactors for production. By boosting serotonin with additional tryptophan or 5-HTP you can actually reduce some of the cravings.
If you have the social anxiety condition called pyroluria, the added stress of family and holiday gatherings can also contribute to zinc and vitamin B6 being dumped, and further impacting serotonin production.
Christmas tree phenols can be a trigger for anger, meltdowns, anxiety, hyperactivity, insomnia, aggression, self-injury and autistic symptoms in susceptible individuals

Resources if you are new to using tryptophan and 5-HTP as supplements

If you are new to using the amino acids as supplements, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution (you can see the low serotonin 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.

Have you noticed this winter dip in serotonin and made adjustments to your 5-HTP or tryptophan? And do you feel less anxious, less obsessive, not as low and with fewer sugar cravings?

Do you find that using a SAD lamp/full spectrum light at this time helps even further?

Were you aware that serotonin dipped in winter and could be playing a role for you? Or did you think it was just the stress and overwhelm of the holidays (and /or some of the emotional upheaval some of us face at this time)?

If you’re a practitioner, have you seen this with clients or patients?

Have you also noticed you need to adjust your GABA and other amino acids at this time too (both GABA and dopamine show seasonality)?

Feel free to ask your questions here too.

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

November 26, 2021 By Trudy Scott 19 Comments

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.

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.