Tryptophan

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

December 1, 2023 By Trudy Scott 15 Comments

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Why didn’t GABA or tryptophan help?

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

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

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

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

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

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

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

There is an entire chapter on the amino acids and they are discussed throughout the book in the sections on gut health, gluten, blood sugar control, sugar cravings, anxiety and mood issues.

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

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

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. You can find them all in my online store.

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

If, after reading this blog and my book, you don’t feel comfortable figuring things out on your own (i.e. doing the symptoms questionnaire and respective amino acids trials), a good place to get help is the GABA QuickStart Program (if you have low GABA symptoms too). This is a paid online/virtual group program where you get my guidance and community support.

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.

Does any of this resonate with you?

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

And is pyroluria also a factor that is being addressed?

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

Feel free to share and ask your questions below.

Seasonal PMDD/PMS and hormonal binge eating, wine drinking and anxiety – symptoms ramp up from October

November 17, 2023 By Trudy Scott 3 Comments

Someone in the community asked for help for the seasonal aspect of her PMDD symptoms i.e. more severe symptoms in winter …

My PMDD symptoms massively increase around the beginning of October right through to March. Would love some advice.

The binge eating and wine drinking is becoming habitual

She specifically mentions binge eating and wine drinking but I assume her other PMDD symptoms – such as anxiety, tension, anger, irritability, depression, sadness, hopelessness, insomnia, overwhelm, low energy, breast tenderness, headaches, pain, bloating, and/ or weight gain – are more severe at this time too.

As you can see, her symptoms are much more severe from October through March (winter in the Northern Hemisphere). If you live in the Southern Hemisphere you could expect more severe symptoms from May through September (or thereabouts).

There is a seasonal aspect to PMDD (premenstrual dysphoric disorder) and PMS (premenstrual syndrome and other hormonal imbalances. It’s not well recognized despite the fact that it’s documented in the research and seen clinically.

My feedback for her is to look into and address low serotonin, low GABA and/or low endorphins with the respective amino acids (adjusting up and down based on the season and symptoms), using recognized SAD (seasonal affective disorder) approaches and addressing pyroluria if needed (the nutrients are cofactors for neurotransmitter production.) I share more about each of these approaches and the research below.

The research: patients with PMDD have substantial seasonal patterns in mood and premenstrual symptoms

Premenstrual dysphoric disorder (PMDD) “accounts for the most severe form of PMS with the greatest impairment of women’s functioning and perceived quality of life, often prompting them to seek treatment.”

This older paper from 1997, Seasonality of symptoms in women with late luteal phase dysphoric disorder

Out of 100 patients treated in a subspecialty clinic in a university teaching hospital, “a significantly higher rate of seasonal affective disorder (38% versus 8%) as determined by Seasonal Pattern Assessment Questionnaire criteria.”
Also, 25% of the patients with seasonal variations in their premenstrual symptoms, consider them marked or a severe problem

The authors conclude that:

These results suggest that patients with LLPDD [or PMDD] have substantial seasonal patterns in mood and premenstrual symptoms. These seasonal patterns have implications for the clinical assessment and treatment of LLPDD [or PMDD]. For example, light therapy may be beneficial for women with seasonal worsening of LLPDD [or PMDD].

As you look at the research keep in mind the fact that late luteal dysphoric disorder (LLDD),“is now known as premenstrual dysphoric disorder (PMDD)”, as mentioned in the above paper and other older studies.

Seasonal variations in serotonin and GABA

Seasonal variations in serotonin have long been documented with much research on the winter blues. This paper, The chronobiology and neurobiology of winter seasonal affective disorder describes winter seasonal affective disorder (SAD) as “a mood disorder characterized by the predictable onset of depression in the fall/winter months, with spontaneous remissions in the spring/summer period.” They also state that “The typical patient with SAD is a premenopausal woman who experiences carbohydrate craving, hypersomnia, and prominent fatigue during winter depressive episodes.”

There is less awareness about GABA seasonality but GABA levels may also be lower in the winter months. In this animal study, Effect of the pineal gland on 5-hydroxytryptamine and γ-aminobutyric acid secretion in the hippocampus of male rats during the summer and winter, it is reported that: “GABA secretion in the hippocampus of rats had a seasonal rhythm consisting of increased secretion in summer and decreased secretion in the winter.” I share more about this and the seasonality of GABA here.

It makes sense that supporting these lower levels in winter is going to help with the more severe PMDD symptoms that correlate with each neurotransmitter imbalance.

One solution: address low levels of neurotransmitters with amino acids

As you can see the PMDD symptoms mentioned above could fall into the categories of low GABA, low serotonin and/or low endorphins (and possibly low dopamine/catecholamines and low blood sugar too: binge eating, wine drinking, anxiety, tension, anger, irritability, depression, sadness, hopelessness, insomnia, overwhelm, low energy, breast tenderness, headaches, pain, bloating, and/ or weight gain.

(You can read this StatPearls ebook for the full description of the above symptoms: Premenstrual Dysphoric Disorder)

It’s for this reason I always have clients with PMDD (and other hormonal issues) do the Amino Acids Mood Questionnaire and trials of the respective amino acids.

Using a food mood log and tracking what time of day you binge eat and drink wine (and all the other symptoms) is a clue as to which amino acids may help most. I would expect tryptophan, GABA and DPA would be at the top of the list, and possibly tyrosine and glutamine too.

Because of the seasonality aspect, a higher dose is likely to be needed in the winter time so if you’re just starting your amino acid trails keep this in mind. If you are already using amino acids with success in summer, then bumping up the amounts during winter is going to help further. And then be sure to reduce amounts once winter is over.

Hopefully you’ve also been working on diet, gut health, liver health, adrenal function, toxin removal and other factors to reduce or eliminate PMDD/PMS so the amino acids are not needed long term.

How targeted individual amino acids may help – some examples

As you can see from one study, tryptophan can help with premenstrual dysphoria/sadness, mood swings, tension, and irritability.

Low endorphins and low dopamine may also be a factor. I share more on this blog: DLPA (DL-Phenylalanine) eases PMDD/PMS symptoms in women who experience declining endorphin levels in the second half of their cycles

Here are some specific amino acid cases around binge eating/cravings and excessive wine drinking:

None of the above are specific to seasonal changes in symptoms but illustrate the use of amino acids.

Supportive solutions: a SAD lamp when serotonin is low and addressing pyroluria

The late luteal phase dysphoric disorder paper above doesn’t mention amino acids (which is unfortunate but not surprising) but it does mention light therapy. I do recommend the use of a SAD lamp (full spectrum light) when there are low serotonin symptoms that get more severe in the winter.

With PMDD/PMS and other hormonal imbalances, we also always consider pyroluria and the use of higher amounts of zinc, vitamin B6 and evening primrose oil. The “stress” of winter and increased sugar consumption can deplete zinc and vitamin B6 for everyone but more so if you have pyroluria. These nutrients are also key for hormonal imbalances.

Additional resources when you are new to using amino acids as supplements

We use the symptoms questionnaire to figure out if low GABA or low serotonin or low endorphins or low dopamine or low blood sugar may be an issue with your seasonal PMDD/PMS.

There is an entire chapter on the amino acids and they are discussed throughout the book in the sections on gut health, gluten, blood sugar control, sugar cravings, anxiety and mood issues.

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

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

Now I’d like to hear from you

Does any of this resonate with you? If yes, has any of the above helped with the seasonal aspect of your PMDD, PMS or other hormonal issues?

Feel free to share and ask your questions below.

I have osteoporosis – within a week of starting collagen I experienced profound insomnia, was much more anxious and had tons of worrying thoughts

August 18, 2023 By Trudy Scott 14 Comments

Nancy shares her unpleasant experience when using collagen for her osteoporosis and asks how she can use tryptophan and possibly add the collagen back:

I have osteoporosis and recently started taking a collagen peptide product (Fortibone). At the same time, I started taking a bone support formula containing calcium, magnesium, vitamin D, vitamin K2, boron, etc.

Within a week I began experiencing such PROFOUND insomnia. I felt like I was wide awake and could not drift off till 4 am each morning. Also, when I laid down at night, I was much more anxious than I normally am and had tons of worrying thoughts flitting thru my mind.

Within a couple weeks of the insomnia starting, I thankfully caught your talk about collagen and folks who are susceptible to it, at the 2023 Osteoporosis Summit. The puzzle pieces clicked together; I’m a MAO-A. I immediately stopped the collagen and the bone support supplement.

I understand supplementing with tryptophan may be the fix for being able to reintroduce the collagen.

I appreciate her for sharing her experience on one of my collagen blogs and thanked her, saying how glad I was that she heard my interview about this.

Read on to learn about how collagen and gelatin lower serotonin in susceptible individuals; discover if supplementing with tryptophan may be the fix for being able to reintroduce the collagen; how best to use tryptophan in a situation like this; and additional resources if you need guidance using an amino acid like tryptophan or 5-HTP.

Collagen and gelatin lower serotonin in susceptible individuals

Intake of collagen (and gelatin) can lower serotonin in susceptible individuals and cause these symptoms she experienced. I first blogged about this in 2017 but it’s still not common knowledge even amongst practitioners and companies selling collagen products.

The good news is that awareness is growing. Dr. R. Keith McCormick does mention the serotonin-collagen connection in his excellent book Great Bones – Taking Control of Your Osteoporosis (my Amazon link). He does not, however, offer tryptophan as a solution.

If this is new to you, this blog post describes why it happens (i.e. collagen does not contain any tryptophan), lists many of the tryptophan depletion studies and who may be more susceptible to this effect – Collagen and gelatin lower serotonin: does this increase your anxiety and depression?

Here is a more recent blog on the topic too: Collagen causes increased anxiety, low mood, irritability, insomnia, gut issues and an itchy skin: some questions and my answers

The causes of these symptoms can be due to the serotonin-lowering effects of collagen but also the dietary oxalate impact, a histamine reaction and/or a glutamate reaction to collagen.

Could supplementing with tryptophan be the fix for being able to reintroduce the collagen?

Nancy said “I understand supplementing with tryptophan may be the fix for being able to reintroduce the collagen.” Hearing her symptoms – profound insomnia, increased anxiety and worrying thoughts flitting through her mind – led me to the same conclusion, especially since they all started soon after starting collagen.

We know she has the MAOA (monoamine oxidase A) genetic polymorphism – this does make her more susceptible to the serotonin-lowering effects of collagen. Other factors that may make her more susceptible (explained in the 2017 blog above) are current or prior depression and/or OCD (obsessive compulsive disorder) or family history of these conditions and being a smoker. In addition to a MAOA defect is having a 5-HTTLPR genetic polymorphism.

To confirm the likely low serotonin connection, it would have been helpful to know if she also experienced other low serotonin symptoms: panic attacks and phobias, lack of confidence, depression, negativity, imposter syndrome, PMS, irritability, anger issues and afternoon/evening cravings.

It would also be helpful to know if her symptoms resolved when she stopped using the collagen.

But the best way to confirm is to do a trial of tryptophan and observe if these symptoms resolve when using collagen.

How to use tryptophan in a situation like this?

She asked these specific questions about using tryptophan:

I bought the Lidtke brand which is a 500 mg. capsule. How do I dose this? I realize you said to trial dose it but:

1) what time of day is best to take it?

2) is it taken on an empty stomach or can it be taken with food?

3) should I start taking the tryptophan BEFORE restarting the collagen and be watching for the night time anxiety/insomnia symptoms to reappear?

4) if the insomnia, anxiety do reappear, how much do I titrate up and is there a max dose of tryptophan? If I’m taking more than one capsule a day, should they be taken at one time or divided throughout the day?

Tryptophan is always taken midafternoon and evening on an empty stomach/away from protein and increased until there is symptom resolution.

For clients in a similar situation who have stopped the collagen but still have insomnia, anxiety and worry symptoms, I have them start on tryptophan before adding back collagen and adjust the tryptophan dose up if needed once collagen is reintroduced.

If symptoms resolved when the collagen was stopped, tryptophan would be trialed as soon as symptoms show up when collagen is reintroduced.

With tryptophan, 500 mg is a typical starting dose but less may work in a situation like this. I’ve had clients use up to 1500 mg tryptophan 2 x day. It’s really individualized with no one-size fits all.

I did mention my book, The Antianxiety Food Solution, as an excellent resource for Nancy. There is an entire chapter on the amino acids and how to use them. I recommend everyone read it before using any of the amino acids as supplements.

Resources if you are new to using amino acids as supplements

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

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

There is an entire chapter on the amino acids and they are discussed throughout the book in the sections on gut health, gluten, blood sugar control, sugar cravings, anxiety and mood issues.

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), if you need serotonin support, the Serotonin QuickStart Program is a good place to start. This is a paid online/virtual group program where you get my guidance on using tryptophan and 5-HTP safely, and community support during 5 LIVE Q&A calls. You can sign up to be notified when the next live launch of this program is happening. We take a deep dive into product options including Lidtke products and others if you’re not able to access Lidtke.

Low GABA can cause physical tension and overwhelm, affect sleep and cause stress eating. If you also have low GABA symptoms, the next step to get help is the GABA QuickStart Program. This is also a paid online/virtual group program where you get my guidance and community support. Another option is the budget-friendly GABA QuickStart Homestudy Program.

Wrapping up and your feedback

Thanks to Nancy for sharing her experience with collagen and asking this question.

Have you used collagen for bone health/osteoporosis or for other reasons? And have you experienced insomnia, and increased anxiety and worrying?

Were your symptoms due to low serotonin and did tryptophan allow you to continue with collagen or add it back if you stopped it?

Or were your symptoms caused by oxalates in collagen, a histamine reaction and/or a glutamate reaction?

Has Fortibone led to improvements in your bone health? If yes, how long have you been using it and which collagen product (a number of products contain Fortibone)?

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

Pathological Demand Avoidance (PDA) in children with autism – how much is behavioral and how much is due to low serotonin?

June 9, 2023 By Trudy Scott 14 Comments

Pathological Demand Avoidance (PDA) is a condition associated with Autism Spectrum Disorder (ASD). It is a rare behavioral phenotype of ASD that is characterized by an overwhelming or obsessional need to resist or avoid demands, which can often lead to sensory overwhelm causing meltdowns and violent outbursts.

Although children in general may often try to avoid demands, children with PDA engage in avoidant behaviors at a greater level.

The key underlying factor is the extreme levels of anxiety associated with a loss of control, which can feel like a panic attack. Because of high levels of anxiety, they will often respond with a “No” even to tasks or activities that they normally enjoy and can spend a great deal of energy trying to gain control of situations and people.

(from an Australian PDA article: What is Pathological Demand Avoidance (PDA) and how can we address it? so I changed the spelling of behavioural and characterised to be American)

This is a typical overview of PDA and the common recommendations (as outlined in the above article) are all behavioral interventions: be an active listener and build trust, depersonalize requests, provide indirect praise, use humor and so on. Many parents find these helpful but the biochemical imbalances that trigger these behaviors are being ignored and/or there is a lack of awareness. I’d like to change this so more children and teens get quick relief.

There may be many different root causes such as low serotonin, low GABA, low blood sugar, gluten sensitivities, low zinc, low vitamin B6, low vitamin D, toxins, infections, phenols, salicylates etc. Today I’m going to discuss low serotonin and my rationale for reaching this conclusion. It’s also one of the quickest root causes to confirm (more on that below).

My rationale for proposing that Pathological Demand Avoidance (PDA) in children with autism is related to low serotonin

If we take the description above, all of these symptoms are classically found when a child (or adult) has low serotonin:

Extreme levels of anxiety
Can feel like a panic attack
Overwhelm
Meltdowns and violent outbursts
Loss of control
Spending a great deal of energy trying to gain control of situations and people (i.e. controlling)
Obsessional need to resist (any kind of obsessing is common when serotonin is low)

The second reason I suspect low serotonin with PDA is the timing of these behaviors i.e. later in the day. The article mentions that “A child with PDA can be very calm, cool and compliant at school and behave much worse at home. This is not because of incompetent parenting but because they have reached their tolerance levels and need to release that suppressed anxiety.”

This may well be a factor, however low serotonin symptoms are recognized as being more severe in the afternoon/evening when serotonin levels start to decline. If these children have low serotonin then it makes sense that these symptoms would start to increase once they get home.

My third reason is that low serotonin is common in autism/autism spectrum disorder (ASD).

Low serotonin is common in autism/autism spectrum disorder (ASD)

This paper, Vitamin D hormone regulates serotonin synthesis. Part 1: relevance for autism, summarizes it as follows: “The disruption of the serotonergic system is one of the most consistent observations associated with autism. Serotonin in the brain promotes prosocial behavior and correct assessment of emotional social cues.”

Their recommendations are vitamin D and tryptophan supplementation which they say “may be a simple method of increasing brain serotonin without negative side effects.”

Testing for low levels of vitamin D and supplementing accordingly is important.

Are there other low serotonin symptoms and using a trial of tryptophan to confirm

As mentioned above, low serotonin is also one of the quickest root causes to confirm. As always, regardless of the diagnosis, we assess for low serotonin by rating symptoms on a scale of 1 to 10 (with 10 being most severe) and do a trial of tryptophan (chewed or a capsule opened on to the tongue). You will have your answer very quickly because we rate improvements in symptoms in the next 5 to 30 minutes.

In addition to the above symptoms we also look for these: worry-in-your-head and ruminating type of anxiety, phobias, lack of confidence, depression, negativity, imposter syndrome, PMS, irritability, insomnia and afternoon/evening cravings for carbs and sugar.

Lidtke is the only brand of tryptophan that I recommend simply because I see it work so well and because of quality issues with tryptophan in the past. Here are the Lidtke tryptophan products I recommend:

Lidtke Chewable Tryptophan 100 mg is a good for doing a trial and works when lower doses are needed as with children.
Lidtke Tryptophan 500 mg can be used for doing a trial. I open the capsule and use 100mg for a child. Going forward this product is helpful when higher doses are needed, especially at night. When opened it doesn’t taste very good but can be mixed with inositol or even glutamine powder or mashed banana.

You can read more on this blog: Tryptophan for the worry-in-your-head and ruminating type of anxiety, see the full list of low serotonin symptoms here and find the tryptophan products on the supplements blog here.

If you’re new to PDA, the DSM and low serotonin/other biochemical factors

Professor Elizabeth Newson was a developmental psychologist known for her work with children in the autism spectrum. This is her 2003 paper on the topic – Pathological demand avoidance syndrome: a necessary distinction within the pervasive developmental disorders

It’s not part of the DSM-5, the standard classification of mental disorders used by mental health professionals in the United States. This article, A Brief History of Pathological Demand Avoidance, offers a good backstory and shares why families want it to be part of the DSM.

Whether or not it becomes a distinct condition or autism subtype in the DSM, I’d like to see low serotonin (and likely low vitamin D) being recognized as one root cause. And acknowledging that there may be many other biochemical/nutritional approaches that should also be explored.

These symptoms are listed in the above article, in addition to avoidance behaviors, and all could fall into typical low serotonin symptoms:

verbal and physical aggression when feeling loss of control
self-injurious behavior
property destruction
refusal to participate in self-care such as bathing or brushing teeth (is this depression?)
inability to attend social events (is this fear and social anxiety?)
controlling what noises are allowed in a home, such as no music, or only certain music
inability to allow parents to have friends visit the home (is this also controlling?)
are often combative with siblings
issues with food, what to eat, when to eat, who to eat with
conflict with siblings

As mentioned above we also look into low GABA and low blood sugar (trials of GABA and glutamine will give quick confirmation too), gluten sensitivity, low zinc, low vitamin B6, toxins, infections, phenols, salicylates and so on. Of course, Nutritional and Dietary Intervention for Autism Spectrum Disorder is crucial.

Some success stories and connecting the dots with low serotonin

These two success stories illustrate how successful tryptophan and GABA can be and also how quickly they offer relief:

This blog post illustrates similar low serotonin symptoms and end-of-the-day timing in adults with Alzheimer’s – Sundowning in Alzheimer’s and dementia: melatonin/tryptophan for the agitation, restlessness, anxiety, disturbed sleep and aggression. It’s low serotonin that is the cause, regardless of the diagnosis.

This blog illustrates another mechanism for these types of disruptive behaviors: Christmas tree phenols as a trigger for anger, meltdowns, anxiety, hyperactivity, insomnia, aggression, self-injury and autistic symptoms? There is a serotonin connection when there are phenol issues too.

Resources if you are new to using amino acids as supplements

There is an entire chapter on the amino acids and they are discussed throughout the book in the sections on gut health, gluten, blood sugar control, sugar cravings, anxiety and mood issues.

If you also have low GABA symptoms, the next step to get help is the GABA QuickStart Program.This is also a paid online/virtual group program where you get my guidance and community support. Another option is the budget-friendly GABA QuickStart Homestudy program.

Now I’d like to hear from you

Have you been told your child may have Pathological Demand Avoidance (PDA)? Have you only been offered behavioral change tools and how have they helped?

Has low serotonin (and other biochemistry imbalances) been discussed too?

What symptoms does your child have and are things worse later in the day?

Has tryptophan helped reduce the above low serotonin symptoms in your child? How much helps and how quickly?

Or do you find 5-HTP works better? If yes, how much helps and how quickly?

What other biochemical changes have helped?

If you’re a practitioner, are you hearing about increased discussion of Pathological Demand Avoidance (PDA) and do you address low serotonin with your clients/patients?

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

Would using 5-HTP or tryptophan help when you crave sugar (as a sort of antidepressant) late afternoon/evening?

June 2, 2023 By Trudy Scott 29 Comments

Would using 5-HTP or tryptophan also help when you crave sugar (as a sort of antidepressant) late afternoon/evening? ~ Kimberley

This question was posed in response to my recent blog post about using tryptophan or 5-HTP to help with alcohol cravings/addiction in the late afternoon/evening – to help you wind down and relax, improve mood and sleep, and also as a reward/treat.

I said yes it is often the same cause when it happens late afternoon/evening and when there are other low serotonin symptoms like low mood, anxiety, worry, insomnia etc. When serotonin is low we self-medicate with wine, sugar, carbs, gluten, dairy and chocolate etc. in order to feel good, get a mood boost and reduce stress. 5-HTP or tryptophan stops the sugar cravings, acts as an antidepressant (improving mood) and eases other low serotonin symptoms too.

It turns out Kimberley was craving sugar late afternoon: “it’s definitely late afternoon for me, while I’m making dinner. Maybe it’s time to go back on 5-HTP.”

And then 2 days later she posted how quickly 5-HTP helped when she added it back mid-afternoon:

I was taking a break from tryptophan/5-HTP and realized after reading this post that that might be a mistake! So I added 5-HTP back in mid-afternoon and my sugar cravings are almost completely gone. It’s funny how I forget the symptoms of low neurotransmitters. Thanks for reminding me!

5-HTP works quickly when it’s low serotonin

How wonderful are these results for Kimberley. I never get tired of hearing feedback like this! I appreciate her sharing and giving me permission to share as a blog so you get to learn and be inspired too.

It’s not unusual for 5-HTP to work this quickly and when it does it’s a clue that the symptoms are related to low serotonin and that she found the ideal dose for her needs.

Kimberley had good results with 5-HTP in the past so she went back to what had worked for her before and it worked for her again.

But do keep in mind, some folks do better with 5-HTP and some do better with tryptophan so it’s a matter of doing a trial of each one each.

50 mg 5-HTP: the sadness and despair lifts in a few minutes

A week later she kindly came and shared additional details in the comments of the tryptophan/ 5-HTP alcohol cravings blog, saying:

It’s possible that I was already in the middle of my daily, mid-afternoon chocolate chip binge when I saw your post

I took a 50 mg 5-HTP along with my mid-afternoon Endorphigen capsule, and within just a few minutes I felt the sadness and despair that I often feel in the late afternoon, start to lift. I was astonished at how quickly it worked! I didn’t open the capsule, or chew it, I just swallowed it with water and had a snack afterwards. I really can’t thank you enough for asking that question because I was really struggling with low mood and sadness almost every day.

Even though KImberley had used 5-HTP with success in the past, she was still astonished how quickly it worked and how effective it was. She was also surprised she had forgotten her prior low serotonin symptoms:

Up until January I had taken 5-HTP in the mid-afternoon and then Tryptophan at bedtime, but I wanted to try a program to support my thyroid. That program told me that too much serotonin is often at the root of gut damage, so I weaned myself off of the 5-HTP and tryptophan. I didn’t really notice much difference, except the daily sugar cravings.

I’m not sure how I could so easily forget the symptoms of low serotonin, but I did.

Your question really was a God-send for me, Trudy. It reminded me that there was an option for feeling better (in fact, MUCH better than sugar makes me feel) that didn’t involve something that’s not good for me.

And I really did feel remarkably better the same day, and those results have continued.

Thanks again, Trudy, for continuing to bring these topics up. Some of us are forgetful and need reminding. Usually, when you have symptoms of low serotonin there are enough other issues going on in your life that it’s easy to overlook the obvious. So I’m very grateful that you asked the question, because I feel so much better able to deal with my circumstances now that I’m back on the 5-HTP. Blessings to you!

I am curious about the program that told her too much serotonin is often at the root of gut damage and if they suggested stopping 5-HTP and tryptophan. It doesn’t make any sense to me. I’ll report back when I learn more about this.

More tired during the day and a headache: what to consider

She did mention “I’m finding myself more tired during the day and have also had a headache for the last few days.” I would suspect chocolate/caffeine withdrawal may have caused her headache.

With feeling more tired I’d also watch the dose of 5-HTP. She may find less is better for her needs.

She is also trying tryptophan at bedtime so that may be making her more tired the next day. Doing one amino acid at a time is often the best way to know how each one is affecting you.

Finding what works for your unique needs

Here are some other amino acid/sugar cravings blog posts that illustrate how we all have unique needs and different biochemical imbalances:

The individual amino acids glutamine, GABA, tryptophan (or 5-HTP), DPA and tyrosine are powerful for eliminating sugar cravings, often within 5 minutes

The individual amino acids glutamine, GABA, tryptophan (or 5-HTP), DPA and tyrosine are powerful for eliminating sugar cravings, often within 5 minutes. It seems that this wonderful benefit – over and above the anxiety-reducing and mood-boosting benefits – is often overlooked or poorly understood.

GABA for ending sugar cravings (and anxiety and insomnia)

For Melissa, an unexpected result was that she stopped craving sugar (chocolates, ice cream and truffles) after about a week of taking GABA for her travel anxiety.

It’s a matter of finding what works for your sugar cravings and unique needs. GABA worked for Melissa and yet 5-HTP works for Kimberley – for their sugar cravings.

Here is the tryptophan/5-HTP alcohol cravings blog that started the discussion: Tryptophan had the added benefit of turning me completely off alcohol when I took it to improve mood and sleep during perimenopause. In this case, tryptophan helped Victoria quit the wine that she was self-medicating with in order to feel good and relax.

Resources if you are new to using amino acids as supplements

There is an entire chapter on the amino acids and they are discussed throughout the book in the sections on gut health, gluten, blood sugar control, sugar cravings, anxiety and mood issues.

Wrapping up

Now I’d love to hear from you ….

Has 5-HTP helped reduce your cravings and/or feelings of despair and sadness? How much helps and how quickly?

Or do you find tryptophan works better for you? If yes, how much helps and how quickly?

What sugary food/s do you self-medicate with in order to feel good?

If you’re a practitioner, do you use this approach with your clients/patients?

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

Tryptophan had the added benefit of turning me completely off alcohol when I took it to improve mood and sleep during perimenopause

May 12, 2023 By Trudy Scott 33 Comments

I started taking tryptophan 3 years ago to improve mood and sleep (not recognizing I was in perimenopause which it helped), but had the added benefit of turning me completely off alcohol! Lol. What serendipitous timing! I use amino therapy with pretty much all my perimenopause patients now. Thanks to you and Julia Ross’s work. Forever grateful.

Victoria shared this wonderful feedback about the benefits she experienced with tryptophan on a recent Facebook thread and kindly gave me permission to share.

Self-medicating with wine (and other alcoholic beverages) is common when we are anxious or stressed and typically we use it to wind down at the end of the day and to fit in socially. This is common when GABA levels are low and also happens due to low serotonin which declines from mid-afternoon into the evening.

I asked what she had been drinking and how often? And if it was calming for her? This was her response:

Red wine the minute I walked in the door in the evening. I guess it was calming… maybe more reward driven? It would be my reward for getting home from work via picking kids up from sport and doing a grocery shop and … (fill in the blank) that we working mums do and then having to walk straight into the kitchen to start on dinner.

The wine was like my little treat or reward to motivate me to just keep moving with my chores. No time to sit and unwind, just pour the wine and start chopping! Lol… I had tried to stop before but just couldn’t pick up a knife without the wine glass!

Within days, the tryptophan made the wine taste like cat’s pee! Haven’t touched it since. No desire at all. Almost hypnosis like?

How much tryptophan Victoria used and how did it help her quit?

Victoria used the Now Tryptophan 1000 mg at 3pm and 9pm for about a year, eventually stopping it and saying: “Alcohol still does not interest me at all.”

What wonderful results! A typical starting dose for tryptophan is 500 mg midafternoon and evening and she increased this to find her ideal dose of 1000 mg twice a day. She did report that 5-HTP didn’t work for her the way tryptophan did. This is not unusual as some folks do better with one versus the other.

She has a great explanation regarding how tryptophan helped her quit without having to use willpower. She had no time to sit and unwind ….. so she was experiencing some of the calming aspects of getting serotonin support with the amino acid tryptophan. This is a very common benefit.

Serotonin appears to regulate the secretion of beta-endorphins

It is interesting that Victoria mentions a reward/treat benefit which is often due to low endorphins rather than low serotonin. This paper, Roles of β-Endorphin in Stress, Behavior, Neuroinflammation, and Brain Energy Metabolism, states that β-endorphins, in addition to their “potent analgesic effects” i.e. pain relief (both physical and emotional pain), are also involved in “reward-centric and homeostasis-restoring behaviors.”

However, as stated in this same paper, beta-endorphins play a role in stress-relief (common with working moms like Victoria) and are closely connected with serotonin. In fact “serotonin appears to regulate the secretion of β-endorphins” and vice versa. The body is fascinating and so smart.

Amino acids for alcohol addiction: 5-HTP, DLPA and glutamine

We know that amino acids help with alcohol cravings and addiction and have even been used in inpatient settings. This blog illustrates this well – An amino acid supplement with DLPA, glutamine and 5-HTP (and a few other nutrients) eases alcohol withdrawal symptoms at an inpatient detoxification program.

The study authors state that: “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).

Both tryptophan and 5-HTP support low serotonin worry-type anxiety, low mood and insomnia. Victoria happened to benefit from tryptophan. Someone else may benefit more from 5-HTP or DLPA or glutamine or a combination as illustrated in the above study. And even GABA, which can help with stress-drinking or stress-eating, as well as physical anxiety.

DPA and DLPA support endorphins and provide the reward/treat benefits from red wine that Victoria mentions. You can read about the difference between DPA and DLPA here.

What if you have afternoon and evening sugar cravings instead of wine?

You may self-medicate with sugar, carbs, gluten, dairy instead of wine. Late afternoon/evening cravings are typically related to low serotonin when there are other low serotonin symptoms like low mood, anxiety, ruminations, worry, insomnia, PMS etc. You can see all the low serotonin symptoms here.

In this case, tryptophan or 5-HTP can be used in a similar way to stop the cravings with no willpower required and no feelings of being deprived. You’ll also experience reduced anxiety, improved mood and better sleep. Read more about this on this blog: Would using 5-HTP or tryptophan help when you crave sugar (as a sort of antidepressant) late afternoon/evening?

Other changes Victoria made and how is she doing now?

Victoria did also share that hot flushes “got me in the end though and I gave in to body identical progesterone for the final year of peri” and takes estradiol transdermally now that she is in menopause. Based on seeing these benefits while in perimenopause, she is now trialing tryptophan again for increased irritability. That is a huge plus with amino acids: once we’ve experienced the benefits, you have them at our disposal again and again in the future as your hormones or situation starts to change.

I love that she now uses tryptophan with her patients. She is a physio/physical therapist and exercise scientist turned Functional Health Practitioner having studied with IFM during the pandemic.

Of course, I thanked her for the kind words and shared how fortunate I was to work in Julia Ross’ clinic for 2 years. I also appreciate her for sharing this feedback and allowing me to share it here as a blog post so you get to learn, be inspired and have hope.

And finally, all this illustrates that there is no one-size-fits-all and we often get unexpected side-benefits when using amino acids.

Tryptophan and 5-HTP product options

Victoria happens to respond well to tryptophan and yet some folks do better with 5-HTP so it’s a matter of doing a trial of each.

Products I recommend include Lidtke 500 mg Tryptophan, and Pure Encapsulations 50 mg 5-HTP. You can purchase these from my online store (Fullscript – only available to US customers – use this link to set up an account).

If you’re not in the US, Doctor’s Best L-Tryptophan 500mg and Source Naturals 50 mg 5-HTP are products I recommend on iherb (use this link to save 5%).

Resources if you are new to using amino acids as supplements

There is an entire chapter on the amino acids and they are discussed throughout the book in the sections on gut health, gluten, blood sugar control, sugar cravings, anxiety and mood issues.

Low GABA can also affect sleep and cause stress eating. If you also have low GABA symptoms, the next step to get help is the GABA QuickStart Program. This is also a paid online/virtual group program where you get my guidance and community support. Another option is the budget-friendly GABA QuickStart Homestudy Program.

Wrapping up

Now I’d love to hear from you ….

Has tryptophan helped you quit alcohol easily when you could not do so with willpower alone?

Does tryptophan also help with your low mood, anxiety and sleep issues?

What about 5-HTP (some folks do better on one versus the other)?

And has either tryptophan or 5-HTP helped with other afternoon/evening cravings like sugar and other carbs?

If you have questions and other feedback please share it here too.