Women's health

“Potion” of tyrosine, Endorphigen, GABA and tryptophan has been nothing less than a miracle for my depression and anxiety – how long can I remain on these?

August 11, 2023 By Trudy Scott 21 Comments

Amy shares how much her particular “potion” or combination of amino acids has helped her depression and anxiety and wants to know how long she can remain on them:

I currently take 500 mg of l-tyrosine in the morning, 1 Endorphigen 2xday, 1 GABA calm 2x day and 1000 mg of tryptophan before bed with some natural calm & true calm. This “potion” has been nothing less than a miracle. I feel pretty good.

The past few years have been rough, managing depression and anxiety with frequent relapse, and I finally feel ok.

I don’t want to wean off yet and am curious as to how long I can remain on these. Is it dangerous to keep on it too long? Is there a maximum time? I follow your blog and reached out to you last year. Your information has been extremely helpful. Thank you.

I’m glad to hear Amy is doing so well on this miracle combination and finally feels ok. Before stopping the amino acids, the goal is to address diet, gut health, nutritional imbalances, toxins and all the underlying factors that lead to low catecholamines, low endorphins, low GABA and low serotonin.

It’s fine to stop taking them and see how you do and add some or all of them back if you find you still need that neurotransmitter support. This is one of a few approaches I use with clients. But here are times when it’s best to wait and continue using them (like when on the pill and when affected by seasonal depression). I share my insights on this and other ways to cut back below.

How long can you remain on amino acids and when do you consider stopping them?

There is no set time frame for staying on the amino acids. As I mentioned above you can stop taking the individual amino acids and see how you do and then add some or all of them back if you find you still need that neurotransmitter support. This is one of a few approaches I use with clients.

Other approaches include: completely stopping one amino acid at a time and monitoring symptoms or reducing the amount one amino acid at a time, also monitoring symptoms. I prefer the latter especially with someone like Amy who has been “managing depression and anxiety with frequent relapse.”

I can also hear that she has some hesitation about stopping her “potion” and going with your gut is a good thing too. She also has a few confounding factors that make me feel staying on them longer may be in her best interest. One factor is her long-term use of birth control pills.

Long term use of birth control pills and the impact on mood and nutritional status

Amy also shares about her use of the birth control pill and how she suspects it’s a factor in her depression and anxiety:

I should also mention I just went off birth control pills. I have taken them since age 16 only stopping for 3 pregnancies and breastfeeding. I am 46. I’ve been on for painful periods. I made the decision to stop for fear of clots, cardiac issues and most importantly my mental well being. I truly believe they contributed to my depression. I believe I’m in perimenopause and have higher than normal anxiety. I’m extremely worried about my periods if I stop the pill and think my amino acid supplements help these worries and I cope better. That’s why I’m reluctant to stop the supplements but still worried about long term use.

Because Amy has been using the birth control pill for around 25 years I’d have her continue with the amino acids for now and address the effects on her gut health and nutritional status first.

Women taking the pill and other hormonal contraception are more likely to be depressed. A Danish study published in JAMA Psychiatry of more than 1 million women aged 15 to 34, with no prior history of depression, were included in the study and followed for 13 years. The researchers found that those women who used the pill were 23% more likely to be depressed and use antidepressants.

You can read more about the effects of the birth control pill on this blog and my book review of “Beyond the Pill” by Dr. Jolene Brighten. As you’ll read it causes vitamin, mineral, and antioxidant depletion (such as folate, B12, vitamin B6 and zinc).

She did actually come back and share that she tried and it didn’t work out going off the birth control pill. She was unable to manage the pain. She needs to address all these root causes first.

There is also no reason for her to be worried about long term use of the amino acids when they are clearly addressing her neurotransmitter imbalances.

The seasonal impact on mood and anxiety

I don’t have clients make changes to their amino acids in the Fall or Winter when there can be seasonal impacts on mood and anxiety. She had shared this too:

I’m more prone to depression this time of year. I think with these 2 factors [seasonal mood changes and the pill] I’ll stay on the regime until the spring.

This is a wise decision for Amy.

I would also hold off on making changes if someone is prone to airborne allergies. This is because there can be a higher need for neurotransmitter support when there are allergies.

Amy has already made many diet and lifestyle changes so she is heading in the right direction:

I have given my diet an overhaul. Not perfect but significantly less refined carbs and sugar. Plenty of fresh produce, healthy fats and protein ( especially animal). I also have committed to daily “body movement”: yoga, Pilates, max trainer, light weights or bike.

All of these changes are starting to support her overall nutritional status and resilience.

A recap of the amino acids Amy is using and the rationale for each one

If you’re new to using individual amino acids, here is a quick recap of the amino acids Amy is using and the rationale for each one.

She is using 500 mg of l-tyrosine in the morning. This supports low levels of dopamine/catchecolamines and improves the curl-up-in-bed kind of depression. You can read more about tyrosine here.

She is also using Endorphigen twice a day. This is a Lidtke product called Endorphigen and provides 500 mg DPA/d-phenylalanine per capsule. It raises endorphin levels, offering a mood boost, typically helping with weepiness and also emotional eating. You can read more about DPA here.

Amy is also using GABA Calm 2x day. This is a sublingual/chewable product made by Source Naturals and is a nice low dose of 125mg per chewable. You can read more about GABA here.

And finally, she is using 1000 mg of tryptophan before bed. This supports low serotonin and improves worry-kind of anxiety and depression, ruminating, obsessive tendencies and also sleep issues. You can read more about tryptophan here.

Keep in mind this is what Amy found works for her unique needs and would have done trials of the amino acids one by one to figure out which ones to use and how much of each to use. There is no one size fits all.

It’s not unusual for folks using the amino acids to describe their results as miraculous!

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, 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.

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.

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.

Thanks to Amy for sharing her results and asking this question.

Have you seen similar benefits when using individual amino acids? If yes, which ones have helped you?

What approach have you used to stop or reduce your doses?

And have you continued using the amino acids because of the effects of the pill, seasonal mood shifts or seasonal allergies (or some other reason)?

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

Dysphoric Milk Ejection Reflex (D-MER) is an abrupt emotional “drop” that occurs in some women just before milk release

June 23, 2023 By Trudy Scott 4 Comments

Dysphoric Milk Ejection Reflex (D-MER) is an abrupt emotional “drop” that occurs in some women just before milk release and continues for not more than a few minutes. The brief negative feelings range in severity from wistfulness to self-loathing, and appear to have a physiological cause.

The authors suggest that an abrupt drop in dopamine may occur when milk release is triggered, resulting in a real or relative brief dopamine deficit for affected women.

Clinicians can support women with D-MER in several ways; often, simply knowing that it is a recognized phenomenon makes the condition tolerable. Further study is needed.

The above abstract is from this paper published in 2011 – Dysphoric milk ejection reflex: A case report.

Alia Heise (AH) is co-author of this paper and coined the term D-MER. She is sharing her breastfeeding and D-MER experiences as the case.

Many women who are struggling with these feelings don’t ask for help and when they do they are often dismissed. The authors share it’s “a breastfeeding problem for which affected mothers seem only rarely to seek or receive help.” I’m sharing this case and more about D-MER for these reasons and because troubled mothers often stop breastfeeding.

Read on to learn about the dopamine hypothesis and how Rhodiola helped Alia.

Feedback from struggling moms

The authors share this description from a struggling mom:

If you read Harry Potter they talk about the creatures that suck the soul out of you and when they are around it makes you cold and you start to focus on negative things and fall into this abyss of negative thoughts – that is how D-MER was for me at times.

Someone in my community shared this when I posted the case on Facebook:

I experienced an extreme emotional response. I would describe it as a wave of huge anxiety… almost suicidal at times but only during letdown (it lasted only a couple of minutes if that, but it was so severe.)

I started noticing it when I would pump. After I researched it I figured out there was a name for it and a reason. I never could find anyone to help me… I remember mentioning it to my doctor and she had never heard of it. I just suffered through and so my breastfeeding/pumping journey ended at 6 months.

I appreciate Alie and the authors for helping to create awareness and these moms for sharing their experiences. Hopefully this information will mean fewer moms struggle alone with D-MER and more awareness amongst practitioners.

I share some highlights below but be sure to read the entire paper here – Dysphoric milk ejection reflex: A case report.

The spectrum of D-MER symptoms and a drop in dopamine hypothesized as the cause

Here is the spectrum of D-MER symptoms (as listed in the above paper):

Depression, wistfulness, homesickness, apprehension, hopelessness, hollowness in stomach (first 3 months)
Anxiety, dread, panic, irritability (6 to 12 months)
Anger, tension, agitation, paranoia (until weaning)

A drop in dopamine is hypothesized as the cause in susceptible mothers (also from the above paper):

Based on AH’s experiences, and until more is known, it is the authors’ very humble hypothesis that a drop in dopamine either facilitates or parallels each oxytocin spike in lactating human mothers, and that it is this dopamine drop that results in D-MER in susceptible mothers.

What adds value to Alia’s dopamine hypothesis is that bupropion, a dopamine reuptake inhibitor (i.e. a medication that increases dopamine), reduced her symptoms in a day and eliminated her symptoms in 5 days. She did, however, have to stop the medication due to side effects.

Rhodiola prevents the breakdown of dopamine, increasing it’s availability

Alia then learned about a herb called Rhodiola rosea that “is a monoamine oxidase inhibitor that prevents the breakdown of dopamine, increasing its availability.”

When she used Rhodiola her symptoms became much milder and when she missed taking Rhodiola her D-MER symptoms were worse. She didn’t notice any changes in her milk supply.

I will add that Alia used Rhodiola when her daughter was 14 months old and her D-MER symptoms were “somewhat reduced, but still extremely troublesome.” I have to wonder if she may have needed to use a higher dose when her daughter was a new-born and Alie’s symptoms were more severe.

Safety of Rhodiola when breastfeeding

The authors quote Sheila Humphrey, author of The Nursing Mother’s Herbal (my Amazon link) who groups Rhodiola with several other “tonic herbs” for which “there are no anecdotes, as yet, to suggest that they will affect breastfeeding babies.”

Dr Aviva Romm, MD, calls Rhodiola “The Spirit Calming, Anti-Anxiety Adaptogen” in this article about adaptogenic herbs

Rhodiola extract helps promote a calm emotional state and supports strong mental performance, optimal immune function, and hormonal balance. It is a key adaptogen for reducing anxiety. It improves mental and physical stamina, improves sleep, and reduces stress, “burn out,” and irritability.

She says to avoid Rhodiola if you have bipolar disorder and during pregnancy (due to lack of safety data), but considers it safe while breastfeeding.

But, as always, when it comes to nursing, I have clients work with their practitioner.

Future research on tyrosine and theanine during breastfeeding, and prevention

I would also love to see future research on the safety of tyrosine and theanine (and all amino acids) being used during breastfeeding, as another option for moms with D-MER.

Tyrosine is well-recognized as an amino acid that helps to boost dopamine levels and improve a low mood and may help ease some of the D-MER symptoms. Some individuals report how tyrosine also alleviates their anxiety and panic attacks and creates a feeling of calm focus.

Theanine, also an amino acid, supports GABA, dopamine and serotonin and I feel has a potential application in D-MER. There may well be a role for tryptophan (for serotonin support and the depression/self-loathing/anger/agitation/panic symptoms of D-MER) and GABA (for GABA support and the anxiety/tension symptoms of D-MER).

They may also help with postpartum anxiety, depression, OCD and intrusive thoughts.

I’d also like to see future research look at possible correlations between D-MER and low neurotransmitters before pregnancy/nursing. And if these women saw benefits with amino acids. Addressing low levels of neurotransmitters and the dietary factors I address in my book, The Antianxiety Food Solution, may help prevent this or at least reduce the severity of symptoms.

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.

Have you experienced D-MER and were you advised to use Rhodiola? And if yes, how did it help? What else helped?

Or did you get no help from your medical team?

Do you feel there is a possible correlation between your D-MER symptoms and low neurotransmitter symptoms you experienced before pregnancy/nursing? If yes, which amino acids helped you before you were pregnant?

If you are a practitioner, are you familiar with D-MER and have you seen Rhodiola help?

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

PCOS (polycystic ovarian syndrome): GABA helped ease lifelong anxiety, wean off anxiety medication, ovulate each month and stop PCOS meds

May 19, 2023 By Trudy Scott 19 Comments

I was diagnosed with PCOS (polycystic ovarian syndrome) when I was 27. (I’m currently 43 now). When diagnosed they immediately put me on birth control and metformin.

I also eventually went on anti-anxiety medication. I’ve been anxious my whole life, even as a kid, but my anxiety increased through my late 20s and peaked in my late 30s when panic attacks started taking over, even with anti-anxiety medication(Lexapro). It was debilitating.

I first heard about GABA/amino acids and how they can help with anxiety from a podcast you did with Wellness Mama about 3 years ago. I started to wean off my anxiety medication and I started taking GABA and noticed a huge difference [in my anxiety].

I eventually got off birth control and all medication for my PCOS and started regulating my cycle with diet, lifestyle changes and supplements, all while still taking GABA. Now I ovulate every month! Which I could never do on my own before.

Debbie shared this wonderful feedback on this blog: GABA eases anxiety and is protective against metabolic and reproductive disturbances in polycystic ovarian syndrome (PCOS)?

I love that GABA helped her so much with her anxiety and allowed her to get off her anxiety meds. And that GABA helped her resolve her PCOS, together with making diet, lifestyle changes and using other supplements too.

As you can read on the above blog, the study reports some very specific benefits of GABA being protective against metabolic and reproductive disturbances in PCOS. It’s an animal study but the results are profound: “the effects observed with GABA were comparable to that with metformin” with none of the side-effects (which can actually include anxiety, a racing heart, shakiness and depression).

If you’re new to PCOS, I share this in the above blog:

Research suggests that 5% to 10% of females 18 to 44 years of age are affected by PCOS, making it the most common endocrine abnormality among women of reproductive age in the U.S. Women seeking help from health care professionals to resolve issues of obesity, acne, amenorrhea, excessive hair growth, and infertility often receive a diagnosis of PCOS.

If you’re interested, here is the podcast where Debbie first learned about GABA – 105: Trudy Scott on How to Beat Anxiety & Resolve Panic Attacks

I commend her for taking control and making changes and then for seeking answers when her panic attacks returned.

Debbie started having panic attacks again – this time it was collagen causing low serotonin

Then about three and a half years ago, Debbie started having panic attacks again out of nowhere! She was very surprised and shared this:

I couldn’t understand why [I started having panic attacks again]. I wasn’t stressed. One attack even landed me in the ER (again). I was disappointed to be on this road again. Then I came across your interview talking about collagen and how it can lower your serotonin. I also have the MTHFR gene variant so I run low on serotonin already. I had started taking some collagen supplements not knowing that it was probably setting me into a panic attack mode.

As soon as I stopped taking collagen (and switched all my supplements that were in gelatin caps to veggie caps) I never had another episode again. Or if I felt one coming on, I know now to take Tryptophan to help counteract it.

Here is the interview she is referring to – Collagen Can Cause Anxiety and Insomnia with Trudy Scott: The Anxiety Summit 5

And here is the blog where I first wrote about this topic – Collagen and gelatin lower serotonin: does this increase your anxiety and depression?

Debbie mentions the MTHFR polymorphism and it’s impact on serotonin but another aspect is a predisposition to low serotonin in PCOS. This review paper, Neuroendocrine Determinants of Polycystic Ovary Syndrome, states that “different neurotransmitters (gamma-aminobutyric acid (GABA), glutamate, serotonin, dopamine, and acetylcholine) can also be involved in neuroendocrine etiopathogenesis [i.e. cause and development] of PCOS.”

As you’ll read in the latter collagen blog, collagen affects a subset of susceptible individuals in this way. We can now add PCOS to that list.

Different root causes of anxiety (low GABA and then low serotonin) and different solutions

Debbie’s story illustrates that things can change and we need to figure out the root cause and course-correct if anxiety and panic attacks show up again. Earlier on, her anxiety and panic attacks were caused by low GABA, which also contributed to her PCOS symptoms.

Then later, the addition of collagen lowered her serotonin levels, because as someone with PCOS she was susceptible. What helped her was stopping the collagen and using tryptophan as needed. This was smart of her to connect the dots with her panic attacks and collagen, and use tryptophan as needed.

I will add that another option would have been to continue using collagen and use tryptophan at the same time. I’m also not sure how big an impact gelatin capsules would have been but switching them clearly gave her peace of mind.

Debbie’s oldest daughter asks for GABA, her “happy pills”

She also shared this lovely feedback when she commented on the blog:

My oldest daughter who is 9 has been showing early signs of developing PCOS and other of my issues. When her mood started changing and she was getting angry out of nowhere and very dark and moody, I started her on a small dose of GABA. Immediately both of us saw the difference in her mood. She now asks for her “happy pills” daily because she doesn’t want to feel those dark feelings anymore. I wish this information was around when I was young. It could’ve helped so much of what I had to struggle with for years.

What an amazing healing journey Debbie has had and she gets to help her daughter too!

She thanked Katie Wells and myself saying: “I want to thank you so much for both of those podcasts/interviews that I feel literally helped save my life.”

I never get tired of hearing this and thanked her for the kind words. I also appreciate her for sharing her wonderful results and said I’d share it 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.

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.

Do you have PCOS and has GABA helped you or your loved one in any of these ways – easing anxiety and being able to quit anxiety meds, birth control and PCOS medications?

What other approaches have helped your PCOS?

Has collagen lowered your serotonin and does tryptophan or 5-HTP help?

What about low GABA and dark moods/anger – has GABA helped you or a loved one?

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

Increased kidney stones in postmenopausal women with lower estradiol levels. What about increased dietary oxalate issues too?

June 3, 2022 By Trudy Scott 20 Comments

Epidemiological data reveal that the overall risk for kidney stones disease is lower for women compared to age-matched men. However, the beneficial effect for the female sex is lost upon menopause, a time corresponding to the onset of fall in estrogen levels.

The above is from a 2013 paper, Serum estradiol and testosterone levels in kidney stones disease with and without calcium oxalate components in naturally postmenopausal women.

The aim of this study was to look at serum estradiol and testosterone levels of naturally postmenopausal women who had kidney stones.

It was a small study with 113 naturally postmenopausal women with newly diagnosed kidney stones (some with calcium oxalate stones and some with non-calcium oxalate stones) and 84 controls, all around 52 to 62 years of age.

The results were as follows:

Serum estradiol (E2) was significantly lower in kidney stones patients compared to controls (21.1 vs. 31.1 pg/ml)
Serum testosterone (T) levels did not significantly differ among the groups.

The authors came to the conclusion that “Naturally postmenopausal women with higher remaining estradiol levels appear less likely to suffer from kidney calcium oxalate stones.

These findings support the hypothesis that higher postmenopausal endogenous [produced by the body] estrogens may protect against kidney stones with ageing.”

This is very encouraging research because it means we can do something about it (more on that below).

My question is this: What about increased dietary oxalate issues in this age group? And can there be similar issues in perimenopausal women too? This study only looked at kidney stones but I propose that there is a connection and that declining estradiol is the common factor. I also propose that providing estrogen support may help to counter both issues – kidney stones and/or dietary oxalate issues with no kidney stones, especially with the clinical observations and feedback I have had (more on that below).

Now this may not be the case for all women and is clearly not the only factor when it comes to kidney stones and dietary oxalate issues. But I do feel it needs to be part of the discussion. In menopause, osteoporosis and heart disease are on our radar but kidney stones and dietary oxalate issues are not.

Dr. Felice Gersch talks about estrogen and calcium in bone health and osteoporosis

I really thought I was onto something after hearing Dr. Felice Gersh, MD (a integrative gynecologist who focuses on women’s health and menopause) talk about estrogen and calcium in bone health/osteoporosis on The Osteoporosis Summit earlier this year. This is some of what she shared:

Estrogen affects everything! So estrogen is involved in the development of bone, but it’s even more complex. For example, estrogen allows the proper absorption of calcium, so that you get proper absorption of calcium from food in the gastrointestinal tract. That involves having proper estrogen levels. And having proper estrogen levels allows the reabsorption of calcium in the kidneys so that you don’t excrete a lot of calcium that you shouldn’t be excreting.

As soon as I heard calcium and the kidneys, the light bulbs went off and I started looking for some research. I didn’t expect there to be much because a higher incidence of kidney stones in menopause and the estrogen connection is not something I’ve heard discussed by menopause experts. However, the above study was one of many. Here are a few more studies that support this connection:

Estrogen replacement increased the citrate and calcium excretion rates in postmenopausal women with recurrent urolithiasis (urolithiasis is kidney stone disease)
Etiological role of estrogen status in renal stone formation

Interestingly this 2021 paper, Association between sex hormones and kidney stones: analysis of the National Health and Nutrition Examination Survey, reports that there is “no independent association between sex hormones (testosterone and estradiol) and history of kidney stones in either males or females.” This conclusion may be related to the fact that there are fewer studies that include women. I look forward to future research in this area and until then we use the other research and what we see clinically.

How common are dietary oxalate issues in my community of perimenopausal and menopausal women?

I posted the 2013 study and this question on Facebook to see how common an issue it is:

If you have dietary oxalate issues (with or without kidney stones) I’m curious if there is a hormonal connection and specifically if things got worse for you in perimenopause, and got really bad in menopause (as estrogen declines even further). This has certainly been the case for me.

Here is some of the feedback I’ve received on this post and related posts:

Cynthia shared this: “Really interesting! I definitely had oxalate issues (perimenopause) provoked by ruptured appendix/SBO/abscesses and fistula formation (13 day hospitalization)….I had to remove all oxalates and go full carnivore for 9 months….I’m still oxalate sensitive and had not been before…. I will definitely be sharing this with my communities….there are SO many middle aged women with oxalate issues”

Kirsten shared this: “Interesting to know. At the age of 49 (I am now 51), for the first time in my life I developed kidney stones – probably the most painful experience of my life. I eliminated vitamin C supplements and some oxalates (I had a daily dose of “green juice” that I was consuming as well that I no longer take) however I never understood the relationship between estrogen and their development. I am not post menopausal as of yet -but definitely experiencing symptoms common in peri-menopause… Perimenopausal symptoms include – anxiety (the worrying type) which is at its worst around the time I menstruate (taking 5-HTP which helps but doesn’t completely resolve), night sweats, hypoglycemia, HPA dysfunction (which could be a result of perimeno as well as its own issue – or both). If I don’t keep my stress levels in check, everything becomes exacerbated – meditation helps too.”

Leah shared this: I developed oxalate issues after menopause (I’m in my 60s) and didn’t realize what is was until I read your post about it during the early days of the pandemic when people were overdosing on vitamin C (at least you were trying to figure out if there was a connection at the time). With more research, I discovered a product called Kidney Cop that I still take (though I never get stones, only skin issues on my face). I also switched to liposomal vitamin C and amla and cut back on the offensive [high oxalate] foods for me. I do also experience a similar effect when I use collagen powder with peptides (skin issues). When I switched to a powder that didn’t contain peptides but has collagen types 1-5 in it, I had no issues. I don’t know if this is oxalate-related or not, but the skin issue is the same (clear fluid-filled bumps around my mouth and chin only).”

A number of women in the Facebook group Trying Low Oxlaates have shared comments like this: “I was never bothered by oxalate issues before menopause” and “I can tell you that my oxalate problems became far worse – along with everything else, pyroluria, copper toxicity etc – in perimenopause.”

Personally, my severe dietary oxalate issues started in 2012, when I was 52, and it manifested as excruciating foot pain. It was a combination of hot-burning-coals-pain and shards-of-glass-pain. Later it affected my left eye and more recently it impacted my sleep in a big way. I eat low oxalate and use vitamin B6 and calcium citrate (carefully timed) to keep symptoms away. My next plan is to see if addressing my low estrogen will help even more (more on that below).

Approaches to support declining estrogen levels in perimenopause and menopause

Briefly, here is a summary for supporting declining estrogen levels in perimenopause and menopause:

Diet and lifestyle including exercise and stress-reduction
Amino acid support as needed (GABA supports progesterone and tryptophan supports estrogen) and the pyroluria protocol of zinc, vitamin B6 and evening primrose oil (more on this here)
Adrenal support
Essential oils such as geranium and rose otto and clary sage and other oils to help with anxiety and stress
Liver and kidney support
Avoiding environmental toxins, especially xenoestrogens (plastics, fragrances, pesticides etc) which bind to estrogen receptor sites
Maca – the research on Femmenessence Maca-Pause for bone and cardio health is very encouraging and I suspect there may be benefits for dietary oxalate issues and kidney stones too (when there is a low estrogen trigger). I will be trying this approach and I’ll report back on what I find.
Other herbal approaches for hormonal support: Black cohosh, red clover, dong quai (which, interestingly, are reno-protective too)
Bioidentical hormone replacement therapy

This section deserves an entire blog post and is important to address over and above the mood issues, increased anxiety, compromised sleep, low libido, vaginal issues and hot flashes – because of the impacts for heart health, cognitive decline and bone health.

Kidney stones and dietary oxalate issues in men

This 2016 paper addresses kidney stones in males and makes the testosterone connection for men under 60 years of age: Possible role of elevated serum testosterone in pathogenesis of renal stone formation

Urolithiasis [kidney stones] occurs with greater frequency in males with incidences three times higher compared to females indicating some role played by androgens. Stone formation in renal tissues before puberty is similar between males and females, whereas greater frequency is seen in the third to the fourth decade of life when the levels of serum testosterone are also the highest in males.

With advancing age, the probability for stone formation also decreases as consistent with the decline in serum testosterone levels with more than 20% of healthy men over 60 years of age presenting with serum levels of hormone below the range for young men.

This paper does also support the menopausal estrogen connection I’ve mentioned above: “With females, the frequency for stone formation is considered more compared with premenopausal postulated mainly due to low estrogen levels.”

There is so mention of dietary oxalate issues but we do see this clinically.

My other resources on oxalates if this is new to you

This blog, Oxalate crystal disease, dietary oxalates and pain: the research & questions, came out of my quest for finding a medical explanation/term for my own pain caused by dietary oxalates and a desire to gain a better understanding for my clients who experience similar pain.

You can read an overview of oxalates, my pain issues with dietary oxalates, a deeper dive into the condition called oxalate crystal disease (with some of my insights and questions), and the autism and atherosclerosis research.

As I mentioned above, my severe dietary oxalate issues started in 2012 (when I was 52) and it manifested as excruciating foot pain. It was a combination of hot-burning-coals-pain and shards-of-glass-pain. Later it affected my left eye.

You can also read how oxalates can contribute to anxiety, sleep issues (this has been a more recent issue for me), headaches, fatigue and other symptoms.

When I did the research for this older blog I didn’t come across any studies related to menopause and estrogen levels.

I published this blog, Coronavirus and vitamin C for immune support: new pain or more severe pain due to oxalate issues?, to help folks identify the increase in different types of pain they were seeing as a result of using high dose vitamin C. This could be joint pain, eye pain, foot pain, vulvodynia, bladder issues, insomnia, gut pain, kidney pain, changes in thyroid health/labs, bone pain etc.

This blog, Vitamin C causes oxalate formation resulting in pain, anxiety, and insomnia (when there is a defect in ascorbic acid or oxalate metabolism)? is part 2 and reviews some of the research on vitamin C/ascorbic acid being a possible trigger for the formation of oxalates in certain instances.

I do mention the big disconnect that we see in this research is always the mention of kidney stones. The missing piece – in the research and in many articles – is that you can have issues with dietary oxalates when there is no kidney disease/no kidney stones. I propose similar logic for dietary oxalate issues in perimenopause and menopause with declining estrogen levels i.e. dietary oxalate issues with or without kidney stones.

If you’re in perimenopause or menopause have approaches for supporting estrogen (estradiol) made your dietary oxalate issues and/or kidney stones less severe? Please share what has helped and if you have both – dietary oxalate issues and kidney stones/kidney disease.

If you’re a younger woman and have dietary oxalate issues and kidney stones/kidney disease, have you noticed any hormonal connections?

If this doesn’t affect you personally, have you seen the benefits of supporting estrogen with your perimenopausal/menopausal female clients/patients who have dietary oxalate issues and kidney stones/kidney disease?

If you’re male and have had dietary oxalate issues and/or kidney stones have you found they get less severe as you get older and testosterone declines?

If you have questions please share them here too.

DLPA (DL-Phenylalanine) eases PMDD/PMS symptoms in women who experience declining endorphin levels in the second half of their cycles

March 18, 2022 By Trudy Scott 26 Comments

Mood swings, intense sugar cravings, comfort/binge eating, sadness, anxiety, crying, cramps and increased pain, irritability, anger, fatigue, cognitive dysfunction, overwhelm, feelings of unease and dissatisfaction, aggression, heartache, and/or insomnia are common for many women during the second half of the menstrual cycle i.e. in the luteal phase. You may relate to all or some of these symptoms. And you may have been diagnosed with or may identify with PMS (premenstrual syndrome) or PMDD (premenstrual dysphoric disorder – similar to PMS but more serious).

Research shows improvements of these symptoms with the amino acids tryptophan (which provides serotonin support) and GABA (which supports GABA levels). Although there is no research that the pyroluria protocol improves symptoms it’s something I see clinically all the time. (I’ve written about this extensively and share more on this below)

A really interesting study published in 1989 identified low endorphins and low catecholamines as a probable cause for some women – Prevention of Late Luteal Phase Dysphoric Disorder Symptoms with DL-Phenylalanine in Women with Abrupt β-Endorphin Decline: A Pilot Study

I recently came across the above paper and prior to this, had not considered this as a primary root cause. Here is the excerpt from the abstract:

Twenty-two women with late luteal phase dysphoric disorder were treated with DL-phenylalanine during the 15 days prior to menses in a double-blind crossover study.

DL-Phenylalanine was shown to be more effective than placebo in attenuating many symptoms characteristic of luteal phase dysphoric disorder. This amino acid was chosen because of its hypothesized actions in attenuating the symptoms associated with the sharp decline in central β-endorphin levels during the late luteal phase in women with luteal phase dysphoric disorder.

Let’s review a few terms… Late luteal phase dysphoric disorder is a synonym for PMDD. The luteal phase is one stage of the menstrual cycle and occurs after ovulation and before your period. When you feel dysphoric you feel very unhappy, uneasy, or dissatisfied. With the downward endorphin shift at this time, period pain and other pain can be worse, and weepiness and emotional symptoms increase. The need for comfort or reward eating also increases. The study authors suggest these PMDD symptoms may “closely resemble those seen during morphine or heroin withdrawal.”

Based on my experience I do feel comfortable extrapolating these findings to PMS and even peri and post-menopausal women who experience some or all of these symptoms (other than actual periods and period issues in post-menopausal women).

Study participants, dosing and timing of DLPA and improvements

The participants in the study were white, middle-class, and between 24 and 29. Each woman took one 750 mg of DLPA at breakfast and lunch for the 15 days prior to the expected onset of their periods.

In the study groups, it was found that “initial improvement started at the end of the first month of DLPA therapy. Continued therapy brought increased relief from symptoms by the end of the second month. Interestingly, the greatest period of improvement occurred during the washout period” at the end of the third month possibly due to a delayed action of DL-phenylalanine.

The authors make the following conclusion:

DL-phenylalanine was found to be safe, well-accepted, and without significant side effects. The significant improvement it produced with many of the symptoms characteristic of Late Luteal Phase Dysphoric Disorder [PMDD] suggests that it may prove a useful addition to the therapeutic armamentarium for this syndrome.

Keep in mind that a typical starting dose of DLPA is 500mg used 2-3 x per day and it’s typically used between meals for best effects. Ideal is also to customize dosing to your unique needs. In this study, everyone received the same dose at the same time. For these reasons it’s even more impressive to see results like they did.

It makes sense but I have just not used DPLA alone and only in the second half of the cycle

It’s a very small pilot study but given my experience with the amino acids DLPA, DPA and tyrosine, and the vast number of women I have worked with who had symptoms like the above, it makes sense. Using the above three amino acids in combination with dietary changes, tryptophan, GABA and the pyroluria protocol, this approach has offered relief for many of my clients. I have just not used DPLA alone and only in the second half of the cycle.

In case you’re wondering why I mention the three amino acids DLPA, DPA and tyrosine above, it’s because:

DLPA (the amino acid used in this study) supports both endorphins and catecholamines (dopamine is one of them)
Or DPA (supports endorphins only) can be used with tyrosine (supports catecholamines only) instead of DLPA which does both

I blog about the differences between DLPA and DPA here, together with all the symptoms we look at when considering doing a trial.

In this study, they used DLPA which boosts endorphins and catecholamines. As I share in my DPA vs DLPA blog, I prefer DPA (d-phenylalanine) for endorphin support when symptoms are severe. But DPA is not always available so DLPA is a good alternative, assuming the person can handle the catecholamine support. Some people can’t and there are some contraindications too.

I’d love to see follow-on research covering the following:

A larger group of women using DLPA
Individualizing the dosing of DLPA to each person’s unique needs
Correlating results with the low endorphin and low catecholamine symptoms questionnaire
Comparing DLPA alone with a combination of DPA + tyrosine (with each individualized based on unique needs)

Serotonin and GABA support for PMS/PMDD, and the pyroluria protocol

In this paper, Premenstrual Dysphoric Disorder the authors share that PMDD

comprises emotional and physical symptoms and functional impairment that lie on the severe end of the continuum of premenstrual symptoms. Women with PMDD have a differential response to normal hormonal fluctuations.

It’s recognized that serotonin and GABA play a role:

This susceptibility may involve the serotonin system, altered sensitivity of the GABAA receptor to the neurosteroid allopregnanalone [a naturally occurring neurosteroid which is made from the hormone progesterone], and altered brain circuitry involving emotional and cognitive functions.

They share SSRIs that are considered as the first-line treatment. Second-line treatments include oral contraceptives, calcium, chasteberry, and cognitive-behavioral therapy.

However, as I share in this blog, research supports the use of tryptophan – Tryptophan for PMS: premenstrual dysphoria, mood swings, tension, and irritability

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

I mention GABA in this blog and the fact that many anxious women I work with also have pyroluria or signs of low zinc and low vitamin B6 and adding these nutrients, together with evening primrose oil, provide additional hormonal and neurotransmitter support, and help with the social anxiety.

Resources if you are new to using DLPA (or other amino acids) as supplements

If you are new to using DLPA or the other amino acids as supplements, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution (you can see the low endorphin and low catecholamine symptoms.)

If you suspect low levels of endorphins and/or low levels of catecholamine and do not yet have my book, The Antianxiety Food Solution – How the Foods You Eat Can Help You Calm Your Anxious Mind, Improve Your Mood, and End Cravings, I highly recommend getting it and reading it before jumping in and using amino acids on your own so you are knowledgeable. And be sure to share it with the team you or your loved one is working with. Blog posts like this are intended to add value to the chapter on amino acids, which contains detailed information on doses and time of the day for dosing.

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

There is no Endorphin QuickStart Program (yet!) but be sure to let me know in the comments if you are interested in learning more about endorphin support with DLPA, DPA and other nutritional approaches to boost this key neurotransmitter. Ditto for the Dopamine QuickStart program and the use of tyrosine and DLPA for catecholamine support.

As I mentioned above GABA and serotonin support are key for PMS/PMDD and other hormonal imbalances too. 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). This is a paid online/virtual group program where you get my guidance and community support. Another option is the budget-friendly GABA QuickStart Homestudy Program.

If you 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.

Wrapping up and your feedback

Now I’d love to hear from you.

Have you considered that there may be different types of PMS (premenstrual syndrome) or PMDD (premenstrual dysphoric disorder) i.e. a different combination of root causes and therefore different solutions?

And have you had success with DLPA alone (providing both endorphin and dopamine support) or by using a combination of DPA (endorphin support only) and tyrosine (catecholamine/dopamine support only).

If you’re peri or post menopausal have you also seen success with any of these amino acids?

Have the other amino acids, tryptophan and GABA or the pyroluria protocol helped too?

And are you interested in the Endorphin Quickstart or Dopamine Quickstart programs?

If you’re a practitioner please share what you’ve seen with clients/patients.

Feel free to ask your questions here too.

What is the difference between DPA and DLPA (amino acids) and which one do I use for weepiness, heart-ache, pain and energy?

March 11, 2022 By Trudy Scott 75 Comments

Today we address a very common question I get: “What is the difference between DPA and DLPA?” The follow-up question is this: “And what symptoms do they help with?” These are both amino acids that help to boost certain feel-good neurotransmitters. DPA (d-phenylalanine) supports endorphins, whereas DLPA (dl-phenylalanine) supports both endorphins (to a lesser extent than DPA) and catecholamines (to a lesser extent than tyrosine).

Depending on your imbalances and symptoms, they could help with weepiness, heart-ache, comfort eating, emotional support, pain relief, better focus and energy, and even improved motivation.

I mostly recommend DPA (which I call a-hug-in-a-bottle) and share the reasons why below, but some people do really well with DLPA. It’s a matter of figuring out the best one and dose for your unique needs.

DPA for low endorphin symptoms

DPA (d-phenylalanine) is an amino acid that destroys the enzyme that breaks down endorphins. Endorphins are feel-good chemicals that you experience with an endorphin rush when you go for a run or when someone gives you a big hug, when you show kindness to someone or an individual does something nice for you.

Taking the amino acid, DPA, as a supplement helps to raise your endorphins and helps when you feel weepy and overly emotional and reduces the need to self-medicate with treats as a reward or for comfort.

This amino acid is a favorite with so many of my clients and community because it makes them feel so lovely … a warm and fuzzy feeling. I often call it a-hug-in-a-bottle!

Here are the low endorphin symptoms I have my clients rate if they are considering a trial of DPA:

Heightened sensitivity to emotional pain
Heightened sensitivity to physical pain
Crying or tearing up easily
Eating to soothe your mood, or comfort eating
Really, really loving certain foods, behaviors, drugs, or alcohol
Craving a reward or numbing treat

Tyrosine for low catecholamine symptoms

Tyrosine is the amino acid that boosts catecholamines and helps with focus, motivation, energy (especially when you crave carbs for energy) and the blah kind of depression. It’s wonderful for helping you easily quit coffee/caffeine (when you are using it to “self-medicate” due to low catecholamines). It also provides support for the thyroid.

Here are the low catecholamine symptoms I have my clients rate if they are considering a trial of the amino acid tyrosine:

Depression and apathy
Easily bored
Lack of energy
Lack of focus
Lack of drive and low motivation
Attention deficit disorder
Procrastination and indecisiveness
Craving carbs, alcohol, caffeine, or drugs for energy

DLPA for both low endorphin and low catecholamine symptoms

If someone has both low endorphin and low catecholamine symptoms, a trial of DLPA could be considered. DLPA supports both endorphins (to a lesser extent than DPA alone) and also catecholamines (to a lesser extent than tyrosine used alone). You could think of it as doing half and half of each.

Low endorphin symptoms:

Heightened sensitivity to emotional pain
Heightened sensitivity to physical pain
Crying or tearing up easily
Eating to soothe your mood, or comfort eating
Really, really loving certain foods, behaviors, drugs, or alcohol
Craving a reward or numbing treat

And low catecholamine symptoms:

Depression and apathy
Easily bored
Lack of energy
Lack of focus
Lack of drive and low motivation
Attention deficit disorder
Procrastination and indecisiveness
Craving carbs, alcohol, caffeine, or drugs for energy

Why I prefer my clients use DPA and tyrosine, rather than DLPA

Many people do well with DLPA (you can read one example below) but over the years I have streamlined my amino acid recommendations and seldom suggest DLPA. Here are the reasons why I prefer DPA:

DPA is not stimulating and doesn’t affect sleep. However, DLPA can be stimulating for anxious folks (and the majority of my clients have anxiety). For this reason, DLPA can not be used later than 3pm as it can affect sleep and for some folks with really bad sleep issues it can’t be tolerated later than mid-morning (in a similar way to tyrosine).
I like to have clients use DPA alone so we can clearly identify the benefits they are experiencing for their low endorphin symptoms and then use tyrosine alone so we can clearly identify their low catecholamine benefits.
There are no precautions or contraindications with DPA. However, DLPA has the same precautions as tyrosine. This limits using it for endorphin support. These are the precautions:
- Overactive thyroid/Grave’s disease: tyrosine, DLPA (avoid)
- Phenylketonuria (PKU): tyrosine, DLPA (avoid)
- Melanoma: tyrosine, DLPA (avoid)
- High Blood pressure: tyrosine, DLPA (watch)
- Migraine headaches: tyrosine, DLPA (watch)
- Bipolar disorder: tyrosine, DLPA, glutamine (watch)
The women I work with who do have low endorphin symptoms have reported superior benefits from DPA compared to DLPA, especially for emotional pain and emotional eating.
Some folks can’t tolerate tyrosine and these same folks have a hard time with DLPA.

The one disadvantage with DPA is that it’s not as widely and readily available as DLPA. It often needs to be purchased online (I list some brands below).

Here is some feedback from folks to give you an idea how these amino acids have helped them.

As you’ll see, there are some individuals who do well with DLPA so it’s really a matter of looking at the symptoms and doing a trial.

DPA helps Missy with weepiness and a deep heart-ache (and tastes like dark chocolate)

Missy shares how DPA helped her deep heart-ache sort of feeling:

I have found I was using this product incorrectly. If you are feeling fine, you do not feel much of anything from it. But today I was weepy and felt that deep, heart-ache sort of feeling. I chewed 1000 mgs (2 capsules) and it DID help lift that awful feeling within 15 minutes.

Notice that she said if you’re feeling fine you don’t feel much at all. This is true of all the amino acids – they only make a difference when you need them.

Missy said that she chewed the capsule, however around 2019, the gelatin capsule was replaced with a cellulose capsule. It’s much more palatable when it’s opened up into the mouth. I blog more about opening the capsule here.

She also reported what about half my clients say:

Tastes like slightly bitter dark chocolate 🙂

The remainder of my clients don’t like the taste at all, although many say the taste grows on them. I’ve always been in the dark chocolate camp and find it quite pleasant tasting.

DLPA helps Toby with energy and pain relief (he has CFS and fibromyalgia)

Toby has a diagnosis of CFS (chronic fatigue syndrome) and fibromyalgia and shared how DLPA helps him:

I’ve played around with (I think) all variations of these aminos and have found unequivocally (in the sense of definite and fast observable changes as opposed to none) that DLPA is the one that works for me. I have wondered what that means. I am male, 45, diagnosed with CFS and fibromyalgia and have speculated that in lay terms the DLPA gives me a bit of energy and pain relief (endorphins). Is that a logical conclusion?

He posted an image of the DLPA product he used and said this:

After putting it on my tongue, very quickly I get an agreeable boost in energy and pain relief. I have not experienced this with DPA or tyrosine.

Based on what I’ve covered above with the symptoms you can see that Toby has made a very logical conclusion. He is getting both endorphin support (the pain relief) and catecholamine support (the energy).

Resources if you are new to using DPA or DLPA as supplements

If you are new to using the amino acids DPA or DLPA as supplements, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution (you can see the low endorphin and low catecholamine symptoms.)

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 DPA and DLPA products that I use with my individual clients and those in my group programs.

For DPA I have used the Lidtke Endorphigen product for years and it’s a firm favorite with my clients (and I’ve used it myself).

I recently purchased a bottle of Doctor’s Best D-Phenylalanine to test and it works just as well as the Lidtke product.

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

Do you have any of the low endorphin and/or low catecholamine symptoms and have you seen benefit with DPA, DLPA and/or tyrosine? If yes, please share what benefits.

Has this blog provided clarification on DPA vs DLPA, and will you be changing how you use these amino acids going forward?

If you’re a practitioner please share what you use with clients/patients.

Feel free to ask your questions here too.