Earlier this year I blogged about how the calming amino acid GABA is often a solution for both anxiety and globus pharyngeus (lump in the throat) and a mom shared this about her son’s episodes of “choking” or tightening in his throat (to the point that he cannot swallow), especially when school stress gets high:
My son, (8 y.o.) has a history of public school use of physical aversion intervention for behaviors that result from a significant language impairment often reports “choking” or tightening in his throat to the point that he cannot swallow. When school stress gets high, he ceases to swallow his saliva which creates a long period of “spitting” out substances including food and natural spit as he is fearful of “choking” to death. During panic attacks he immediately reports “choking” which furthers his panic. You are the first practitioner I have come across that has explained the relationship between globus pharyngeus, stress reaction and low GABA levels. I always felt his throat tightening (involuntary muscle response) was a stress response but was not aware of it’s connection to GABA levels. Thank you for this informative piece!
I voiced my concern for what her son was going through and how I can’t imagine how scary it must be for someone his age, asking her to keep us updated on his progress.
And just over a month later she reported the success her son was having with GABA:
We started a GABA supplement which has positively impacted my son. While he still struggles with hypersalivation when in distress or anxious, his self-reports of feeling like he is “choking” or his throat is closing, has not been present since GABA has been started. We are about a month in and I am inspired that we will continue to have progress. I have been referring to your work as a source to everyone I know that struggles with anxiety. Thank you for all that you do from a very grateful parent.
What wonderful results for her son! Getting feedback like this warms my heart and I appreciate her for sharing so I can share here.
I did ask what GABA product he was using, how much/how often he uses it and how quickly he noticed an improvement but did not hear back. My recommendation is 125mg to start for adults and less for children and I like the GABA Calm product as it’s a sublingual form and easy to use for kids.
I also commented on the fact that he still has “hypersalivation when in distress or anxious.” I would focus on trying to reduce the anxiety with higher doses of GABA and also consider addressing low serotonin because of the anxiety, panic attacks and being “fearful of “choking” to death”.
The anxiety could trigger hypersalivation but the hypersalivation could also be as a result of a food sensitivity like gluten or dairy. Both these and other food sensitivities could also contribute to low GABA/low serotonin and be a trigger for anxiety.
Of course, bullying at school should always be considered and so should the social anxiety condition pyroluria, speech therapy, gut health and vagus nerve support.
Could this be a case of laryngopharyngeal reflux (LPR)?
I always like to try and connect the dots and wonder if this could be a case of laryngopharyngeal reflux (LPR)? I don’t know but it’s possible. This paper, Laryngopharyngeal reflux: A confounding cause of aerodigestive dysfunction, states that LPR is “defined by the retrograde passage of gastric contents beyond the upper oesophageal sphincter, with contamination of the larynx, pharynx and lungs” and states that “half of the laryngeal complaints referred to ear, nose and throat (ENT) services are ultimately diagnosed as LPR.
It also mentions globus pharyngeus and dysphagia (which is difficulty swallowing), sharing that changes in pH suggest reflux occurs in “50% of patients with hoarseness, 64% with globus, 55% with chronic cough and 35% with dysphagia.”
This same paper reports that “30% of patients with LPR-like symptoms report anxiety, compared with 6% of healthy controls.”
Prevalence of reflux disease in children and LPR symptoms by age
This paper, Laryngopharyngeal Reflux Disease in Children, reports that “Although the exact prevalence is unknown, it is estimated that nearly 1 in 5 children likely suffers from reflux disease.” This 1 in 5 number is for both GERD (gastroesophageal reflux disease) and LPR.
The authors also share that it usually presents with a different set of symptoms depending on age:
- Infants typically present with regurgitation, vomiting, dysphagia [difficulty swallowing], anorexia, failure to thrive, apnea, recurrent croup, laryngomalacia [softening of the laryngeal structure], subglottic stenosis [narrowing of the airway], or chronic respiratory issues.
- School-age children tend to demonstrate chronic cough, dyspnea [shortness of breath], dysphonia [hoarseness], persistent sore throat, halitosis [bad breath], and globus sensation.
- Older children may also complain of regurgitation, heartburn, vomiting, nausea, or have chronic respiratory issues.
Low levels of GABA, a calming neurotransmitter
In case you’re new to GABA: low levels of GABA, a calming neurotransmitter can lead to anxiety, fears and panic attacks. With low GABA, the anxiety is a physical kind of anxiety with muscle tension or muscle spasms. Low GABA may be one possible root cause of globus pharyngeus, which leads to a rather scary golf-ball-like lump or constriction in the throat – or as this young boy describes, episodes of “choking” or tightening in his throat.
The amino acid GABA raises GABA levels and in this instance helps ease this tightening, choking or throat muscle spasms.
To be clear, there is no research (yet) on the use of the amino acid GABA for these types of symptoms, however in one study gabapentin was compared to baclofen for the treatment of gastro-oesophageal reflux-induced chronic cough and in another study there were improvements with both proton pump inhibitors and gabapentin for globus pharyngeus. If GABA works I’m all for it, rather than these medications, which do have a long list of side-effects.
Has your child been diagnosed with globus pharyngeus or laryngopharyngeal reflux disease?
Have you observed episodes like this in your child, personally or with clients/patients and has GABA helped?
Have you found other contributing factors like low serotonin, food sensitivities, gut issues, vagus nerve issues or pyroluria?
Feel free to post your questions here on the blog too.
Trudy, I have tried GABA pills from a health food store and I get a full body flush from them. Thoughts?
Lisa
I typically see this when too high a dose of GABA is used – often 500mg to 750mg. It’s always best to start low and increase from there based on needs. A typical starting dose is 125mg or less for very sensitive folks.
Trudy,
My 19 up son (on the spectrum) has debilitating OCD. Have you ever treated this successfully with GABA?
Thank you for any insights
Shelley
I always start with the questionnaire/symptoms and a trial of GABA if there are low GABA symptoms i.e. physical anxiety. With OCD it’s more often that serotonin support is the first place to start, plus gluten removal and ruling out strep/PANDAS/PANS. Feel free to search the blog as I’ve written much about these approaches.
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Trudy, I had gotten over my anxiety through the conventional medication like xanor and lexapro and have been completely symptom free for 2 years. Since November 2018 I have shifted to supplements primarily due to pancreatic tumor (which was discovered accidentally since I am asymptomatic), I have been taking theanine, 200 mg, GABA 250 mg, tryptophan, 1000 mg, melatonin 5 mg, melatonin extended release, 5 mg all for my insomnia. However, I had had anxiety the past 2 months and sometimes I have to take xanor. Just like the boy mentioned above sometimes I feel like choking and experience breathing heaviness but my cardiologist cleared me. What would you recommend for my condition – Dosage and frequency. Thank you
Evelyn
Often our supplements need an adjustment so I start there with clients when they report this; we also look at what has changed that may be triggering the new anxiety like new supps or even something like collagen/gelatin (https://www.everywomanover29.com/blog/collagen-gelatin-lower-serotonin-increase-anxiety-depression/); and consider changes in hormones like progesterone and estrogen. And anything we know can lower GABA like gluten, pesticides, infections etc. We also look at vagus nerve support https://www.everywomanover29.com/blog/vagus-nerve-rehab-gaba/
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Judy as an adult recently diagnosed with Silent Gerd, I’ve found the prescribed omeprazole helps a lot. The chronic cough has subsided but this is not a med you can take indefinitely. Would GABA be an alternative? I am not a fan of any pharmaceuticals. Would appreciate any help on this.
Joanne
I always start with the questionnaire/symptoms and a trial of GABA if there are low GABA symptoms i.e. physical anxiety and the gerd/spasms/chronic cough. I blogged about my esophageal spasms/throat spasms/chronic cough here and the vagus nerve work I did in addition to GABA and other nutrients https://www.everywomanover29.com/blog/vagus-nerve-rehab-gaba/
As you are likely aware there are long term issues with PPIs (proton pump inhibitors) such as omeprazole/Prilosec. One of them is psychiatric side-effects. Here is one paper – Psychotic symptoms as a side-effect of omeprazole https://pubmed.ncbi.nlm.nih.gov/30536296/
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Hi Trudy,
Thanks for all the wonderful work you do!
In Traditional Chinese Medicine, we call this ‘lump in the throat’ sensation “plum pit Qi”, as if there were a plum pit lodged in the throat. We consider this to be a symptom of ‘Liver Qi Stagnation’. In TCM, the liver is responsible for the free flow of energy throughout the meridians/channels. When the liver energy is congested or stagnated, we become irritable, frustrated, our muscles and tendons become tense and our nature becomes rigid and stubborn. We often see a lot of liver Qi Stagnation in individuals with high stress levels, especially chronic stress. Acupuncture is extremely effective for treating stress by calming and relaxing both body and mind, and activating the parasympathetic nervous system. Acupuncture can “smooth/spread” the liver energy, releasing and unwinding the tension being held in the body. Give it a try if you’re suffering from any of the above symptoms!
Amber
You’re most welcome. Thanks for sharing this very interesting information! I’m a big advocate of acupuncture but think of it primarily for pain and endorphin boosting. With my climbing and other sporting injuries over the years I’ve had great success personally.
I’m curious if you see a correlation with this “plum pit Qi” and low GABA levels as indicated by other low GABA symptoms? You mention “our muscles and tendons become tense” but do your patients also report physical anxiety and a need to self-medicate with carbs or alcohol in order to calm down? Do you also use the amino acid GABA with these patients?
I just looked in pubmed and see acupuncture actually also boosts GABA and other neurotransmitters too – Acupuncture for Pain Management: Molecular Mechanisms of Action https://pubmed.ncbi.nlm.nih.gov/32420752/ I’m sure you already know this but sharing for other blog readers.
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I have the GABA Calm powder but it is hard to get the right dosage for our 11 year old girl. Are the sublingual pills easier to use?
Jeanie
The GABA Calm is 125mg and easy to break into half or quarter – so yes
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Hi Trudy, at stressful times i too have the same choking and tight throat sensations that this boy describes. I recently started Pharma Gaba lozenges (iherb were sold out of Gaba Calm) 1 x once a day before bed to start with. How often per day do you recommend taking these?
Mila
Dosage and timing depends on each person. If 1x once a day before bed eases choking, tight throat sensations and other low GABA physical anxiety symptoms then that is all that is needed. If not, I have clients increase slowly until they find what works for them.
I will get tightening of throat and choking if I unknowningly get MSG. I also had a very similar reaction to cheese which ended up very moldy within a weeks time. I know I am allergic to mold.
Rachel
Thanks for sharing and glad you have found your triggers.
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For the last 13 months I have the feeling os something been stuck in my throat, all test came back normal, ppis didn’t work. I have this sensation 24/7 but I can eat and drink ok. Do you think gaba can help me ?
Sheyla
I’ve had great success with this using GABA – personally and with clients. Here is another blog https://www.everywomanover29.com/blog/anxiety-and-globus-pharyngeus-lump-in-the-throat-gaba-to-the-rescue/
My son has anxiety of dying at night, highway panic and chronic procrastination that showed up in acid reflux and overall everyday worry edith anything new or different. He’s had trauma in early childhood and was removed from his home at 1 due to neglect. His anxiety it’s at times debilitating and he usually shows a freeze, flight, fight response. He’s behind in school as a result before he refuses help because of shame of not knowing his work. We did neurofeedback scan that showed slow processing and activity in the brain and the dr indicated fixed rumination suggesting autism but a therapist counteracted with disassociative tendencies. We’ve seen 16 therapists and just want natural remedies but there’s so many to choose from and have been scammed by natural remedy snakes oil men. We want to help because it’s tiring since we have to calm him down every night and spend hours until late using music, prayers and therapeutic brushes, fidget and other items. His pediatrician gave him straterra but we haven’t used it yet. Plz help us with a natural protocol for this child, he’s 13.
Juanita
With everything you describe I would think these areas are worth investigating initially: low serotonin (anxiety of dying at night, highway panic, overall everyday worry with anything new or different), low catecholamines (chronic procrastination), low GABA (anxiety/reflux) and adrenal/cortisol issues (freeze, flight, fight response). Diet and other nutrients are key too so if you’re new to all this my book “The Antianxiety Food Solution” is a great place to start. More here https://www.everywomanover29.com/store/aafsbook.html
EMDR and EFT would likely be very helpful for the trauma.
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Do you think Gaba can help with esophageal spasms? I have a daughter who has always been on the anxious side, particularly school anxiety that I think stems from her learning style being so different from the teaching style. But that’s another story. A move to a new state caused more anxiety and nearly two years ago she required surgery to help the flow of fluids from her right kidney. Shortly after that, she started saying that she felt like food was not passing through her throat properly and did have some regurgitation.
We have had manometry testing and it shows esophageal spasms and possible dismotility upon swallowing (one doctor believes that to be the case, one does not). I have wondered if this isn’t the manifestation of all the stress she has been under. Her solution is to not eat to avoid this feeling which on and off for 18 months has lead to weight loss. Her digestion is a mess and she experiences constipation. I’m inclined to try the GABA and tryptophan. What the doctors have offered has not worked but it is really hard to get her to be consistent with anything because she just wants to avoid the feeling.
Melanie
I always start with the questionnaire/symptoms and a trial of GABA if there are low GABA symptoms i.e. physical anxiety and the esophageal spasms. I’ve seen many wonderful outcomes. I blogged about my esophageal spasms/throat spasms here and the vagus nerve work I did in addition to GABA and other nutrients https://www.everywomanover29.com/blog/vagus-nerve-rehab-gaba/
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My wife has an issue with swallowing, random choking on saliva. In her case we found it to be a nut allergy/intolerance. The problem is not immediate, but rather hours, even the next day after consuming nuts, she would choke at random on her saliva or when drinking water which caused panic attacks.
She found that by avoiding all nut products, including almond milk, her choking episodes completely ceased.
Alex
Thanks for sharing. It’s wonderful she found her root cause. All possible food sensitivities should always be ruled out and a delayed reaction is very common. However, I must say, I would not have suspected nuts with these types of symptoms. I’m curious how she made the connection – was it IgG testing?
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Autonomic nervous system is a mess due to ptsd and trauma from chronic illness and narcissistic abuse, starting dealing with panic attacks after a dr messed me up, symptoms were and still arent pleasant, I was put on xanax, I reacted to all the SSRI’s bad, I was a long time uset of those for years becuz of bullying and just doing what drs told me to do, I was young and brain was still developing, I need to know if there is hope, I have lots of health things now that I I beleive are a result of the dr injury, I know now xanax is not good, I cant just stop it though, I’m so sensitive to everything, I cant find a good dr or drs to work with me emotionally or physically, feeling hopeless, I’m only 40 and am not able to work or function, I’ve been stuck in a toxic environment for 3 yrs, my husband is narcissistic, I need help, I need hope, I’m in survival mode and have no idea what to do anymore, I also have structural issues from dr injury which is effecting me from cranium to tailbone, depressed, anxious, mind racing all the time, nightmares, very little sleep due to chronic pain from injury for 8 yrs, depleted, if anyone responds please be mindful that I have ptsd and have a lot of triggers, looking for help and hope
Jodi
I am sorry to hear about the abuse and bullying. In addition to the nutrition work and amino acids (all covered in my book “The Antianxiety Food Solution” and on this blog – here is one example https://www.everywomanover29.com/blog/nutrition-solutions-psychological-stress-natural-disaster/), I’d seek help via a support group so you don’t have to do this alone. Therapy, EMDR and/or EFT (https://www.everywomanover29.com/blog/the-effect-of-emotional-freedom-technique-on-nurses-stress-anxiety-and-burnout-levels-during-the-pandemic/) would be of great help too.
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Gaba Calm Lozenges have alleviated my anxiety. I also have read how Gaba has helped many others with various conditions. My question is why can it not be taken long term?
Fina
It’s great to hear that Gaba Calm Lozenges have alleviated your anxiety. And yes GABA helps so many with physical anxiety and conditions like this. There is no evidence that I am aware of saying GABA can not be taken long term. Ideally we want to use GABA as a way for quick relief by boosting low levels the most effective way and then use diet and lifestyle and other approaches like gut health, avoiding toxins, addressing infections etc, to keep levels good.
Hi Trudy!
I am thinking About trying GABA calm . I have my whole life had anxiety, so has my grandmother and daughter, so i guess it runs in the family, do you now if we Can get a test to see if our Brian needs something? Like GABA.
I have had a lot of stress in my life and it seems like i cannot get over it, though I sold my business two years ago and know live a life that is not Busy and i eat Healthy. I am nervous every day that something bad would happend, and i get flashes of Old trauma from visiting the hospital several times because of accidents i had When I was Young. I Can feel the trauma physicly, so i cannot Fall a sleep and I also Wake up during the night so I have no energy. Do you Think GABA could help me? And if how Much should I start with and should it be pills or powder?
I had my hormones meassured and I am very low on estrogen and a little low on progesteron, so i have bought some progesteron creame, does GABA work with that? I am 49 years Old and are perimenopausal. I also have a disease Called Sjøgren.
I am thinking About buying your anxiety program, could that work for me? Thanks for inspiration, I just came across your website, and I am so excited.
Best regards
Jane
Jane
The best way to know if someone needs GABA is to look at the questionnaire/symptoms and do a trial. GABA does support progesterone production too. When I hear “I am nervous every day that something bad would happen” I also think low serotonin as a possible issue. With past trauma EMDR is very helpful too.
My book “The Antianxiety Food Solution” explains the amino acids well. The online programs are great if you feel you need guidance and have questions.
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Can gaba help keep a spiking pulse rate?
I have used it for better sleep but found after. Year and half, it left me tired. Started taking it again recently while I’m going through medical and emotional stress. It also reduces lower back pain due to tight muscles from a hyperactive autonomic nervous system.
Nancy
Good to hear about the benefits you see with GABA. I’m not sure what the question is?
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GABA supplements do not pass through the blood brain barrier and are a waste of money.
Kahni
Feel free to read these resources on the BBB controversy:
– GABA: Blood brain barrier controversy, concerns, best forms and how to do a trial for eliminating anxiety https://www.everywomanover29.com/blog/gaba-blood-brain-barrier-trial-anxiety/
– Dr. Datis Kharrazian’s GABA Challenge for a leaky blood brain barrier is a theory and we still have much to learn https://www.everywomanover29.com/blog/dr-datis-kharrazians-gaba-challenge-for-a-leaky-blood-brain-barrier-is-a-theory-and-we-still-have-much-to-learn/
Here are some additional cases of GABA easing anxiety
– PharmaGABA eases physical anxiety in a young man who has recently given up Adderall, alcohol and nicotine https://www.everywomanover29.com/blog/pharmagaba-eases-physical-anxiety-in-a-young-man-who-has-recently-given-up-adderall-alcohol-and-nicotine/
– Since starting GABA my child sleeps for the first time in years and really notices a difference in his carb cravings https://www.everywomanover29.com/blog/since-starting-gaba-my-child-sleeps-for-the-first-time-in-years-and-really-notices-a-difference-in-his-carb-cravings/
– GABA is the answer after 40 years of a lump-in-the-throat sensation, nervousness and muscle tension at work https://www.everywomanover29.com/blog/gaba-is-the-answer-after-40-years-of-a-lump-in-the-throat-sensation-nervousness-and-muscle-tension-at-work/