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Tryptophan

Anxiety case study: a very very slow SSRI taper with tryptophan and other nutritional support

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anxiety case study

Today I’m sharing an update from someone in my community who is tapering from an SSRI (Cipralex/lexapro) in the best way possible – very methodically and doing a very very slow taper, using compounded medication and nutritional support. It is a team approach with a supportive doctor monitoring for serotonin syndrome, her pharmacist compounding her medication and input from me.

She has an excellent diet that contains enough healthy protein and fats, plenty of vegetables, and no sugar or caffeine. She has the basic nutrients covered and is on the pyroluria protocol (these nutrients help make serotonin). She is using the amino acid tryptophan for serotonin support as she tapers. And she is out walking in nature and practicing mindfulness.

All of this sets her up for success and being able to avoid antidepressant discontinuation syndrome.

Here is her story:

I began tapering off 10 mg of Cipralex in November 2017. I have my little “Support Team” that includes a compounding pharmacist and my GP. Feeling very fortunate that I have these people as my taper has not exactly gone as planned (although far better than my last two attempts)

Originally, the plan was to go down by 10% of the dose and stay at that dose for 4 weeks. That didn’t work for me. I was fine when I dropped from 10mg to 9, but after my next 10% drop I experienced that familiar withdrawal hell. I got a little scared, but stuck with it, and decided to stay at that dose for a bit longer. While I leveled out, I did a lot of reading about how SSRIs work. I learned about the 1/2 life of Cipralex (all SSRIs have a different 1/2 life) and what was actually happening physiologically as my body adjusts to the lower dose. It’s a recovery process.

With that new knowledge, I decided to try another approach. I knew I couldn’t handle a drop of 10%. So, I started to taper at a rate of 0.1mg once a week (far less than 10%!). By day three at the new dose, I could feel the withdrawal, but it was far less severe. Small drops=small “withdrawal wave”. I discovered that I am able to manage a 2% drop of the current dose and I have been able to drop that % each week. So, I’m still reducing by 8% a month, which means I am close to the original plan of dropping by 10% a month. At this time I am at 6.24mg.

Yes, it is a very slow process and I have a long way to go, but it’s working. I have read that some people have to reduce by 1% of their current dose and remain at that dose for 4 weeks to allow their body the time to heal and adjust to life on the lower dose. Having the liquid compound has made such a difference! You sure would have difficulty accurately shaving off a pill by 2%!! If anyone is trying to come off of this drug, do your best to find a compounding pharmacist!

I find that I must stick to a very healthy diet. I eat a lot of fresh, raw and cooked vegetables. I mean a LOT of vegetables. I eat good sources of protein and walk for at least 45 min almost every day. I steer clear of sugar and caffeine. Both make my withdrawal much worse.

Every day I take omega 3, vitamin C, vitamin D, vitamin B complex. I take the supplements for pyroluria, vitamin B6, evening primrose oil and zinc. I take magnesium at night. I took Trudy’s amino acids course online and did all of the amino acid trials. I discovered all I really need is tryptophan. It has made a huge difference for me. Yes, I take Lidke tryptophan. For us Canadians, it can be ordered online.

I practice mindfulness. I’ve read a lot about the anxious brain (the reason I took Cipralex in the first place) so I understand what is happening now, what is real and what is just noise in my head.

Antidepressant discontinuation syndrome

This is the best way to taper SSRI medications in order to avoid withdrawal effects, also known as discontinuation syndrome which can be very severe for some folks.

Accordingly to this paper, Antidepressant discontinuation syndrome occurs in about 20% of patients who reduce the dose or abruptly stop an antidepressant that they have been taking for one month. This paper states that “symptoms are usually mild….occur within two to four days after drug cessation and usually last one to two weeks.”

It also states that occasionally symptoms “may persist up to one year…and if the same or a similar drug is started, the symptoms will resolve within one to three days.”

I typically hear from individuals who fall into the category of severe symptoms that are persisting past 2 weeks. It’s not uncommon to see symptoms continue for a year and often longer in some cases.

Also from the above paper, is the mnemonic FINISH which summarizes these symptoms:

  • Flu-like symptoms (lethargy, fatigue, headache, achiness, sweating)
  • Insomnia (with vivid dreams or nightmares)
  • Nausea (sometimes vomiting)
  • Imbalance (dizziness, vertigo, light-headedness)
  • Sensory disturbances (“burning,” “tingling,” “electric-like” or “shock-like” sensations) and
  • Hyperarousal (anxiety, irritability, agitation, aggression, mania, jerkiness).”

How you will feel if your serotonin is low and how to learn more

With low serotonin you will have the worry-in-your-head and ruminating type of anxiety, panic attacks and phobias, lack of confidence, depression, negativity, imposter syndrome, PMS, irritability, anger issues, insomnia and afternoon/evening cravings.

If you suspect low serotonin symptoms and are new to using the amino acids and do not have my book I highly recommend getting it and reading it before jumping in to taking supplements and navigating this with your prescribing physician: The Antianxiety Food Solution – How the Foods You Eat Can Help You Calm Your Anxious Mind, Improve Your Mood, and End Cravings. You may need to lend him/her a copy of my book too.

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

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

Please also read and follow these Amino Acid Precautions.

This lists The Antianxiety Food Solution Amino Acid and Pyroluria Supplements that I use with my individual clients and those in my group programs – you will find the Lidtke Tryptophan here. You can also read more about why I prefer the Lidtke tryptophan on this blog.

I would like to end off by saying how much I appreciate this woman and others sharing their stories like this so we can all learn!

Please also share your taper story and what you did to make it easier.  If you had challenges share those too. Let us know if you can relate to any of the above FINISH symptoms and how long they lasted.

Feel free to post your questions here too.

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

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tryptophan success story

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Here is some research supporting this serotonin/TMJ connection:

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

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

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

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

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

Please also read and follow these Amino Acid Precautions.

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

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

When using GABA for anxiety does tolerance increase and which amino acid to use for a low mood?

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gaba and tolerence

Today I’m sharing some great questions I’ve received about GABA and serotonin support for anxiety and low mood, and my feedback to give you some ideas on what to look for as you use the amino acids for your own issues (or with clients/patients if you’re a practitioner).

I cover possible reasons for ongoing low GABA levels, long-term use of the amino acids, low mood associated with menopause, problems with mainly sugar- and gluten-free, the role of the adrenals and thyroid, the amino acids I’d start with for low mood, how lithium orotate may help, how to know if collagen is causing a low mood and making you more anxious, and some resources for you.

GABA tolerance has increased

Gaba has been a lifesaver for my anxiety! I also use taurine sometimes for anxiety too, and that has helped too. Right now, I take 1000 mg [of taurine]. As for GABA (I now take 1000 mg of that also) I have noticed that my tolerance for it has increased.

Here is my feedback: I’m really pleased GABA and taurine are helping ease your anxiety. I have not seen tolerance to be a factor with my clients using GABA and I’m not aware of any research on this topic. I would look into what could be depleting GABA at a faster rate so you seem to need more and more.

This could be caused by:

  • increased stress which lowers zinc and increases cortisol
  • poor gut health and dysbiosis (there is a bacteria in the gut that may consume GABA – it’s called gabavorous)
  • low zinc and low B6 (which are needed to make GABA and other neurotransmitters)
  • toxin exposure (we’re now seeing that GABA has a protective effect – this blog covers have GABA is protective of the thyroid after fluoride exposure)
  • thyroid problems (the amino acids are less effective in this instance)

Keep in mind that long-term use of the amino acids is not the plan. Once the diet is addressed and the other underlying biochemistry, nutrient deficiencies, toxins etc. are addressed they should no longer be needed. At most, an occasional “top-up” may be needed.

Low mood associated with menopause

Which amino acids would you recommend for low mood associated with menopause? No panic attacks but a crashing low mood for 24hrs or more before slight recovery, a few easy days and then the cycle begins again. Diet is mainly sugar- and gluten-free. Any suggestions would be appreciated, thank you

Here is my feedback: When I hear “diet is mainly sugar- and gluten-free” with mood swings I always look into gluten exposure and blood sugar dips. Keeping a food mood log is an easy first step to see if the low mood is tied to what is being eaten and when.

I would recommend the complete removal of gluten and sugar. Gluten can trigger depression, anxiety, OCD and lead to many psychiatric symptoms. Blood sugar swings can cause both depression and anxiety. The amino acids make it easy to quite sugar and gluten – no willpower required and no feelings of deprivation. Do the questionnaire and do a trial of the amino acids that apply. Based on the above symptoms I’d suspect tryptophan and tyrosine may help and are always a good first step while everything else is being figured out.

I would also look at adrenal function as they take up the slack in menopause and rule out Hashimoto’s thyroiditis and Graves (as you can get mood swings with both as the thyroid levels shift).

Low lithium can also cause mood swings too and lithium orotate can help to keep an even mood, allowing the amino acids to be more effective.

Finally, I’d want to know if collagen, gelatin or bone broths have recently been added to your diet and are being consumed in an on-an-off pattern that correlates with the low mood. Certain susceptible individuals find that it lowers serotonin and increases depression and anxiety, and causes insomnia.

Next steps are a full workup looking at sex hormones, low zinc, low B6, low magnesium, the gut, EMFs, sleep and other dietary factors like salicylates, histamine, glutamates etc. We look at all the possible 60+ nutritional and biochemical root causes and address them or rule them out.

It’s also important to have a good support system in place for those very low days – friends and family members, being part of a community and even keeping a mental health support line number close at hand.

And of course, I always say this: get out in nature, get some exercise, hug someone and have a good laugh.

Resources for you

  • My book The Antianxiety Food Solution (my Amazon affiliate link) has an entire chapter on the amino acids GABA, tryptophan, tyrosine, and DPA (and how to use them), a chapter on blood sugar balancing and glutamine and a chapter on gluten issues (and much more). Read it and become a savvy health-advocate for yourself. Become someone who is well-informed about the amino acids, the precautions and nuances, and all the nutritional approaches for anxiety-relief. Share a copy with your doctor and point out the references.
  • If figuring it out alone or reading my book feels overwhelming to you, or you’re afraid to use the amino acids on your own, my home-study Amazing Aminos for Anxiety program walks you through a step-by step approach on how to figure out which symptoms are tied to which neurotransmitter deficiency, and how to trial each respective amino acid. Stay tuned for a special upcoming launch with live Q and A calls so you can get your questions answered. (If you have recently purchased the homestudy ONLY version we will be contacting you to invite you to participate.)
  • Here is a blog to read if you’re new to GABA: GABA for the physical-tension and stiff-and-tense-muscles type of anxiety
  • Here is a blog to read if you’re new to tryptophan: Tryptophan for the worry-in-your-head and ruminating type of anxiety (it’s a blog about low serotonin anxiety but applies to low-serotonin low mood too)
  • Here is a blog to read if you’re new to tyrosine: Tyrosine for focus, motivation, energy, a good mood and possibly even anxiety
  • You can find the amino acids in my supplement store here.

Can you relate to either of these questions? And are you good at playing a detective to figure out why something may not be working as expected?

What has worked for your anxiety and/or low moods?

Feel free to post questions in the comments too.

And let me know if you’re interested in the homestudy program with live Q and A calls. (If you have recently purchased the homestudy ONLY version we will be contacting you to invite you to participate.)

Sjogren’s syndrome: tryptophan and GABA for anxiety, and moisturizing for dry skin and inflammation?

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sjogren's syndrome

A few weeks ago I blogged about a new pilot study about the use of a skin moisturizer twice a day reduced inflammation in older adults. I use the inflammation research to question if this may be applicable and helpful for you if you suffer from anxiety, extrapolating that it may well be given the added benefits of touch and an oxytocin boost.

I received a number of great questions about how to apply this information and have decided to share a question from someone with both Sjogren’s syndrome and anxiety, in order to illustrate how I’d work with someone like this.

Here is the question I received:

I would like to know how much of one’s body needs to be moisturized, and if it is also necessary to be done twice per day? Such a simple but effective way to help with anxiety. Will be slathering a lot more in the future! I have Sjogren’s so everything is dry – skin, mouth, eyes, hair. I have been trying to keep my face much “moister” and I am sure my wrinkles have lessened. I find rice bran oil is also quite good.

I’m going to address her moisturizing question below and share more about anxiety in Sjogren’s syndrome and some nutritional solutions, but first let me explain what Sjogren’s syndrome is.

An overview of Sjogren’s syndrome

Let me explain what Sjogren’s (SHOW-grins) is in case you’re not familiar with this condition. It’s an autoimmune condition and is described as follows on the Mayo Clinic site:

often accompanies other immune system disorders, such as rheumatoid arthritis and lupus. In Sjogren’s syndrome, the mucous membranes and moisture-secreting glands of your eyes and mouth are usually affected first — resulting in decreased tears and saliva.

Although you can develop Sjogren’s syndrome at any age, most people are older than 40 at the time of diagnosis. The condition is much more common in women.

The site goes on to say that other than dry eyes and mouth, some people experience joint pain and stiffness, swollen salivary glands, skin rashes or dry skin, vaginal dryness, persistent dry cough and prolonged fatigue. It’s worth a read to learn more about complications like more dental cavities, yeast infections, vision issues, problems in the lungs, kidneys or liver, the risk of lymphoma and peripheral neuropathy.

My feedback about moisturizing

In the study, moisturizing was done twice a day. I’m not sure how much of the body needs to be moisturized but if everything is dry, I’d want to moisturize as much as possible.

Given that chronic inflammation is a major factor in Sjogren’s and other autoimmune conditions like systemic lupus erythematosus, it’s feasible to expect similar benefits in terms of reduced inflammation. Hopefully we’ll see research on autoimmune conditions in the future.

When it comes to anxiety, I do want to make it clear that I was and still am extrapolating from the research on inflammation and measuring reduced anxiety was not part of the study. Moisturizing may or may not help with anxiety and I certainly wouldn’t only use this intervention.

Anxiety in Sjogren’s – low serotonin and GABA?

You may not be aware that anxiety/depression is very common in Sjogren’s. In one study they

found 33.8% patients with anxiety, and 36.9% had depression, which were significantly higher than controls.

I use a comprehensive nutritional and lifestyle approach to help my clients ease their anxiety and as I mention above, I would not only rely on moisturizing.

I would use the serotonin questionnaire to determine if low serotonin is contributing to the anxiety (the worry-in-the head and rumination type of anxiety) and do a trial of tryptophan or 5-HTP.

Interestingly, a number of studies suggest the involvement of the serotonin system in the development of Sjogren’s, with one study reporting

Significantly lower platelet levels of serotonin in Sjogren’s patients as compared to healthy controls.

They didn’t find a correlation between the levels of serotonin and how severe the Sjogren’s symptoms were, which falls in line with what we know about biochemical individuality and why doing a trial of tryptophan or 5-HTP (to find your ideal dose) is the best approach for serotonin support.

I would use also the GABA questionnaire to determine if low GABA (physical tension type of anxiety) is a factor, and do a trial of GABA.

If you recall, in the Mayo Clinic description above, stiffness is a common symptom of Sjogren’s and GABA eases stiffness.

I haven’t found any research on GABA in Sjogren’s, but one case study reports that a patient experiencing athetoid movements (a movement dysfunction, characterized by involuntary writhing movements), reported symptom improvement with hydroxychloroquine (which can have severe psychiatric effects in susceptible individuals), pilocarpine, gabapentin, and clonazepam. The latter two medications work on the GABA system.

You can find the tryptophan and GABA products I use with my clients here.

Poor sociability in Sjogrens – could this be related to pyroluria?

A study published earlier this year is reportedly the first study to conclude that patients with Sjogren’s score “high on neuroticism and anxiety and low on sociability.”

If social anxiety is a concern, I’d have her do the pyroluria questionnaire and address this if needed.

If you recall, in the Mayo Clinic description above, joint pain and dental cavities are common symptoms. These are also very common with pyroluria, so using a nutritional approach helps ease the social anxiety, and improves joint issues and mouth health.

The other factor that makes me suspect pyroluria may be common in Sjogren’s is that it’s considered a systemic connective tissue disorder, together with systemic lupus erythematosus and rheumatoid arthritis. You can read more about pyroluria and connective tissue disorders on the pyroluria prevalence blog and the Ehlers Danlos/joint hypermobility blog.

Poor mouth health is also common with histapenia/low histamine so I’d want to look into this too.

You can find the pyroluria supplements I use with my clients here.

Sjogren’s and the Autoimmune-Paleo diet

Since Sjogren’s is an autoimmune condition, following an Autoimmune-Paleo (AIP) diet is key too. Here are some books that are well-worth making part of your library, even though they are not specific to Sjogren’s syndrome they offer support for autoimmune conditions (and many individuals often have more than one autoimmune disease)

I haven’t dived into the research on all the other autoimmune conditions and the above connections (low serotonin, low GABA and pyroluria) but it’s highly likely similar connections exist. So, if you have any autoimmune condition and anxiety this could all apply for you too.

If you have been diagnosed with Sjogren’s syndrome please share if GABA and tryptophan have helped ease your anxiety, and if the pyroluria protocol has helped you with social anxiety?

And let us know if moisturizing is helping your dry skin and possibly reducing inflammation and anxiety too?

Sleeping through the night for the first time in many years: a trial and error approach to find the ideal tryptophan product

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If you have trouble sleeping through the night (or even have anxiety or panic attacks), finding the nutritional/biochemical root causes and addressing them is going to provide relief but it’s not always straightforward to find your root cause or causes (there are often more than one). Also, what works for you today may not work for you in 2 years time and may not work for your friend who has similar symptoms. You have to be a detective yourself and/or work with a health professional who can put all the puzzle pieces together.

I recently read a Facebook comment where someone was really frustrated about all the trial and error work that may be involved:

I’m just so tired of all this trial and error work trying to figure out why I’m anxious and depressed can’t sleep more than 4 hours a night. It’s been going on way too long I just want answers and a solution to all this. Enough already!

While I feel for this woman, I do acknowledge that it can sometimes be challenging to put all the puzzle pieces together. Other times we are able to figure things out very quickly. I’d like to share some feedback from Lorraine on the tryptophan-PMS-anxiety blog to illustrate how one small change made a big difference for her and it was a matter of trial and error.

Lorraine shares her great results with this Tryptophan Complete tweak for her insomnia:

Trudy, after listening to your talks about Lidtke Tryptophan I decided to give the Tryptophan Complete a try. I’ve taken one capsule each on the last two nights instead of two of the Tryptophan 500mg caps. Both nights I slept straight through all night and had a hard time waking up in the morning. I’ve struggled with insomnia for many, many years. The 500mg Lidtke Tryptophan supplements were helping but I was still waking up during the night. For me to sleep all night is almost miraculous.

I’ve been also taking Progesterone (low on testing), Magnesium, L-Theanine and Melatonin.

I recently added phosphatidylserine, and Holy Basil because saliva testing showed high cortisol at bedtime and off the charts high in the morning. I’m hoping to start eliminating some of those other supplements now that I’m sleeping so well.

I want to thank you for the Anxiety Summits and your book and updates on Facebook and newsletters. I have learned so much from you!

I’ve blogged about which product to use for boosting serotonin: Tryptophan 500mg or Tryptophan Complete (by Lidtke)?. I share this

  • I like to have my clients do a trial of the amino acidsso they can find the ideal dose for their needs and right now I still feel this would still be the best approach to take – using 500mg tryptophan. Once you have figured out you do well with tryptophan-only product and have your dose, then consider reducing it slightly after about 2-3 weeks and adding in additional Tryptophan Complete.
  • The other option is this: if you don’t get the expected results with Tryptophan 500mg, then try the Tryptophan Complete. You may need the other ingredients for it to work well for you.

Lorraine chose to do the latter – switching to Tryptophan Complete – since she didn’t get ideal results with Tryptophan 500mg and it worked for her. I will add that even though she slept straight through all night, I don’t like that she had a hard time waking up in the morning and when that happens, I recommend less tryptophan. It’s very possible that the ideal combination would be 1 x Tryptophan 500mg and 1 x Tryptophan Complete (my first suggestion).

Here is my quick commentary on the other products she’s using for her insomnia:

  • Progesterone and theanine: Testing progesterone levels are important before using progesterone. Both theanine and GABA support GABA production and when GABA is low, we often see low progesterone. With both low GABA and low progesterone, sleep and anxiety can be worse.
  • Magnesium: This mineral is commonly low and is needed to make both serotonin and GABA.
  • Melatonin: This is made in the body when there is sufficient serotonin and may not be needed long-term once she has good levels of serotonin (which the tryptophan product/s are helping her make).
  • Phosphatidylserine and holy basil: High cortisol is a common root cause of both insomnia and anxiety and saliva testing is an excellent way to confirm this. Phosphatidylserine can be used to lower high cortisol although I have found even better results with a phosphorylated serine product called Seriphos. Holy basil or tulsi is an adaptogenic herbal product that provides adrenal support helping with sleep problems and easing anxiety and stress.

In Lorraine’s case, her insomnia was caused by low serotonin (hence the need for tryptophan, melatonin and magnesium), low GABA/low progesterone (hence the need for progesterone, theanine and magnesium) and high cortisol (hence the need for phosphatidylserine and holy basil).

She shares she’s hoping to start eliminating some of these other supplements now that she’s sleeping so well. So, this would be another trial and error approach, stopping and/or reducing one at a time and seeing how she does. Or she may well find she needs to continue with everything for some time.

As you can see, for Lorraine it was a matter of trial and error to find her solution, but it was well worth it to get the “miraculous results” she experienced: sleeping though the night for the first time in many years!

Some of these products may work for you but it’s going to be a matter of trial and error to find your root cause/s and solution.

In case they are relevant for you, these products mentioned in this blog can all be found in my online Fullscript store:

I’d love to hear how you’ve used a trial and error approach either on your own or with the help of your practitioner to find the nutritional solution for your insomnia and/or anxiety?

If you’re a practitioner, please do share an example of how you’ve used this approach with a client or patient.

If you’ve had frustrations with this trial and error approach, please share them too.

Feel free to post your questions here too.

Using amino acids for anxiety and depression: does the right dose ever change or need a tweak?

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If you are using targeted individual amino acids for anxiety and/or depression and doing well on them, you’ll likely get to the point when you’re asking questions like how to discontinue them and does the right dose ever change or need a tweak, especially after some stressful life events. Amy posted this question in the comments section of the blog on using tyrosine to create a sense of calm energy (paraphrased and formatting for ease of reading)

Trudy you are a God send! I stumbled upon your work after following Julia Ross. I have depression and anxiety. I’m currently taking:

1000 mg tyrosine 2x daily

500 mg glutamine morning, 1000mg mid-morning and afternoon

500mg DPA (Endorphigen) 3 x daily (previously I was using DLPA but your recommended DPA was so much better and less stimulating)

50 mg 5-HTP afternoon and

1500mg tryptophan at night

I used the amino acids to treat what used to be referred to as “atypical” depression: loss of motivation, tiredness, lethargic, intense carb craving, feelings of guilt and hopelessness. I would become paralyzed with depression, barely able to get through the days. When I was younger I treated these episodes with antidepressants but as I got older could no longer tolerate the side effects. I’m also still on birth control pills at the age of 46 and believe I may be in perimenopause but can’t stop the pills for medical reasons.

Tyrosine gave me my energy back, glutamine cut the carb cravings. DPA and True Calm work wonders for my anxiety.

I watch my sugar intake and always consume lots of animal protein. I’m so grateful for this solution.

After trialing this seems to be the right combo. I always get confused when is it time to discontinue supplements? Do you stop or slowly reduce or taper?

Does the “right” dose ever change? I’ve been on this combo about 2 months. I’ve felt great but some anxiety/panic creeping back up …. wondering if supplements need a tweak or is this just the result of some stressful life events. Advice appreciated!

I was really pleased to hear the wonderful results she was having and glad that she had trialed the amino acids to find the correct amount for her unique needs and situation. I don’t see this happening often enough and it really is the most effective way to get results. It’s what I do with all my clients – methodical, step-by-step trialing of each amino acid, one at a time and carefully documenting results (both good and bad) in order to find the optimal dose of each one.

When and how to discontinue the amino acids?

To answer her question about when and how to discontinue this is my feedback:

Once you are feeling back to your old self with no more anxiety, panic attacks or depression, you may choose to stop everything at once, but I prefer to slowly lower the amount of one amino acid at a time and add back if your symptoms come back. They don’t need to be “tapered” but doing it this way it helps with preventing your original anxiety and depression symptoms going back to really bad in one big swoop and having to start all over again.

I will add that I have had feedback from someone saying when she stopped tryptophan abruptly she felt the same withdrawal effects as when she weaned off meds but based on my experience this is very rare.

After posting her question Amy made some adjustments – taking less of all of them. As I mentioned above I find it better to lower the amount of one amino acid at a time – kind of reverse of the trialing method you use when starting the amino acids. Also, since she mentioned she felt anxiety/panic creeping back up, I would have expected her to increase some of the calming amino acids.

Does the right dose ever change or need a tweak?

And to answer Amy’s other question: does the right dose ever change or need a tweak?

Yes, the “right dose” can change based on stressful life events especially if you have pyroluria – stressful life events can cause you to dump more zinc and vitamin B6 affecting serotonin and GABA production and increasing the social anxiety.

Amy does mention that she’s on the birth control pill and this depletes zinc and vitamin B6 and hence serotonin) and has an impact on the microbiome – so this may well be playing a role in the need to tweak doses.

There are many other factors that could lead to the need to adjust the amino acids (or other supplement protocols):

  • hormonal changes like PMS, perimenopause or menopause
  • something contributing to leaky gut like adding back gluten or accidental exposure to gluten
  • antibiotics (affecting the microbiome and serotonin/GABA levels)
  • artificial sweeteners (because of their effect on the microbiome and hormones)
  • starting on other medications (since many cause nutritional depletions)
  • adding in a new food like collagen/gelatin (for some people collagen and gelatin may lower serotonin levels)
  • running a marathon (it likely depletes zinc and may ramp up cortisol)
  • a formulation changing completely without you knowing (one example is Seriphos – used to lower high cortisol – where the core ingredient changed completely and the labeling stayed the same)
  • a product changing from using gelatin to cellulose capsules (this may be problematic if you have SIBO)
  • you move into a new home and get mold exposure
  • you get a new dog or cat and start using Frontline Plus for fleas (fipronil, the active ingredient, targets GABA receptors and recent research points to increased anxiety, aggressive behavior, memory problems)
  • you have started using a sauna (depletion of zinc and other minerals, as well as stirring up toxins)
  • your need for serotonin support increases as you head into winter-time (some low serotonin folks are more susceptible to the winter blues)
  • a recent course of fluoroquinolone antibiotics (impacts on magnesium and GABA levels and the mitochondria)
  • you may no longer need them

This is not a complete list of reasons that could impact you but this will give you an idea of what to start to think about.

Hopefully this shows how important it is to monitor how you’re doing and adjust as needed (either up or down) and think about what is changing in your life.

If you’d like to read about the amino acids products Amy uses – the same ones I recommend and use with clients – you can find them listed on my supplements blog.

We appreciate Amy for allowing me to share her results and posting these questions which are a great learning opportunity for you.  She shared this with me:

I hope my “story” is helpful. Keep doing this important work! I work in the behavior health field. My colleagues think this is radical thinking and continue to only support the medical model. I’ve done a lot of my own research and trial and error. I wish there were more-open minded clinicians.

Hopefully with success stories like this, all the nutritional psychiatry research and behavioral health practitioners like Amy who have experienced it first hand and/or with clients/patients and family, we’ll change how mental health care is approached.

Do success stories like this lead you to be more open-minded about anxiety nutrition solutions? Have they worked for you?

And have you found the ideal dose of amino acids and then needed to adjust them up or down based on any of the above? How methodical were you in doing your adjustments?