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What if overthinking, fear, anxiety and worry (caused by low serotonin) is holding you back instead of low motivation/low dopamine?

By Trudy Scott 50 Comments

overthinking

One of the first things that comes to mind when someone is stuck and not able to get things done is low motivation caused by low catecholamines/low dopamine. But what if overthinking, fear, anxiety and worry (caused by low serotonin) is holding you back instead? The following case may help you figure it out if any of this applies to you.

William asked this question on one of the tyrosine blogs, justifiably thinking he may need tyrosine to get unstuck:

Excellent article. I may try tyrosine. I have anxiety and shut down when I am about to start something or my mind overthinks and I shut down with worry. I have problems sleeping. I take a group of things…GABA, glycine, 5-HTP but still wake at 3am.

Anyway I always have GOOD intentions of doing things when I wake in the morning….then it goes downhill. I was not always like this but got worse with STRESS from work and now I FIGHT myself to actually do something I used to LOVE to do. Makes me MAD!

I actually am AFRAID just thinking about taking Tyrosine {Not funny}

I FEAR so much it becomes stupid. I think of doing things and SHUT DOWN with worry.

I want my life back…life is too short to suffer knowing HELP is so close. What do you think? Love your articles…

I think this is a great question many others in my community may relate to so I’ve decided to do this as a blog post with his question and a longer response.

I thanked him for his kind words, saying I can’t offer advice via the blog but can share that we need to be careful with tyrosine when someone has sleep issues or anxiety. I also offered some brief thoughts which I’ll elaborate on here so you can understand my thinking as I work with someone.

Is it low motivation caused by low catecholamines/low dopamine?

The first thing that comes to mind when someone is stuck and not able to get things done is low catecholamines and low dopamine. The classic signs are lack of motivation, fatigue, poor focus and feeling depressed, often using sugary foods or drinks for an energy pick-up (especially in the afternoon).

William may feel that he has low motivation and needs tyrosine because he can’t get things done or he starts something and can’t complete it.

His intentions are good but he has to push himself or as he says “fight myself” to get things done. Because of this he feels tyrosine may be the next amino acid he should trial.

Why I would investigate and address low serotonin

William says he has anxiety and also has trouble sleeping. This could be related to low serotonin and/or low GABA.

However when someone has anxiety and insomnia and I hear the following words/phrases, I immediately think low serotonin should be investigated and addressed:

  • “My mind overthinks”
  • “I shut down with worry”
  • “I actually am AFRAID just thinking about taking Tyrosine”
  • “I fear so much”

All of the above can hold you back and look like low motivation when it is actually worry and fear that is holding you back.

Typically, with low serotonin, you could also second-guess things you do, experience negative self-talk, have a lack of confidence when doing things, get stuck because of perfectionism and may even feel like an imposter. You may also be very controlling and want to do it all yourself and not be willing to delegate – this can hold you back too.

All this and anything else on the list of low serotonin symptoms would further suggest we need to address this first.

Finding the ideal serotonin support for his needs

He is currently taking GABA, glycine and 5-HTP but still wakes at 3am. And he is still anxious.

I would work to optimize 5-HTP dosing (increasing every few days to see if more helps) or switch to tryptophan if the increased dose isn’t helping. Some folks do better one one versus the other and 5-HTP can raise cortisol in some instances causing a wired-tired feeling.

I’d do the same with GABA once the ideal dose of 5-HTP or tryptophan is found. This helps improve sleep and reduce anxiety too.

And I’d look into high cortisol in case this is causing his 3am awakenings.

Once he has ideal serotonin support for his needs, the overthinking will stop, the worry will go away and his fears will vanish – and he will be able to complete things he starts.

Being well rested because of a great night’s sleep is going to help a great deal too.

There may be a need for tyrosine now or later

I may be wrong and there may in fact be a need for tyrosine now. These cases illustrate tyrosine helping when it didn’t seem it would:

There may also be a need for tyrosine later and a trial will provide the answers.

Right now William is “AFRAID just thinking about taking Tyrosine” but once his serotonin levels are ideal he should no longer have this fear.

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

If you are new to using the amino acids tryptophan/5-HTP, GABA or  tyrosine as supplements, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution and a brief overview here, Anxiety and targeted individual amino acid supplements: a summary.

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

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.

As with all individual amino acids we use them for quick relief of symptoms. And we also always focus on the foundations like diet, the gut, adrenals and stress levels.

We appreciate William for asking this question so we all get to learn. Hopefully he’ll jump on and add to the discussion and share his results later.

Can you relate to his lack of motivation showing up as fear, worry and overthinking instead and holding you back?

What about these other low serotonin symptoms keeping you stuck: second-guessing, negative self-talk, lack of confidence, perfectionism, imposter syndrome and controlling?

Has using tryptophan or 5-HTP allowed you to get past some of this so you can get things done?

Did you also have to address low dopamine and actual low motivation, poor focus and fatigue with tyrosine?

Feel free to post any questions here too.

Alice in Wonderland Syndrome – is there a pyroluria connection?

By Trudy Scott 48 Comments

alice in wonderland syndrome

I first learned about Alice in Wonderland Syndrome (AIWS) during one of the Anxiety Summits. I’m surprised at how many queries I get about this syndrome and the fact that everyone who has reached out also has the social anxiety condition called pyroluria or suspects they have it.

This 2017 paper, Alice in Wonderland Syndrome: A real life version of Lewis Carroll’s novel, describes it as follows:

Alice in Wonderland Syndrome was originally coined by Dr. John Todd in 1955. The syndrome is named after the sensations experienced by the character Alice in Lewis Carroll’s novel Alice’s Adventures in Wonderland. Alice in Wonderland Syndrome consists of metamorphopsia (seeing something in a distorted fashion), bizarre distortions of their body image, and bizarre perceptual distortions of form, size, movement or color. Additionally, patients with Alice in Wonderland Syndrome can experience auditory hallucinations and changes in their perception of time. Currently, there is no known specific cause of Alice in Wonderland Syndrome. However, theories point to infections such as the Epstein-Barr virus, medications such as topiramate and associated migraines.

You can read about all the types of visual and non-visual distortions in this paper: Alice in Wonderland syndrome – A systematic review. This paper also includes a list of conditions in which Alice in Wonderland syndrome has been described in the literature, with infections and migraines being very common. The authors also feel that what we see in the published literature may only be the tip of the iceberg:

Since 1955, no more than 169 case descriptions of AIWS have been published. The literature indicates that this may be only the tip of the iceberg, with many individual symptoms of AIWS being experienced (albeit occasionally and only fleetingly) by up to 30% of adolescents in the general population.

The published case numbers have increased slightly (this paper was published in 2016) and it’s reported that many of the 30% of adolescents with AIWS experience non-clinical symptoms i.e. they are not severe enough to need treatment.

I still find “up to 30% of adolescents in the general population” to be very surprising for a syndrome which was once considered very rare and is frequently misdiagnosed.

Read on to hear from some folks in my community who have reached out and described their AIWS episodes. They all have pyroluria and I’d love to know if there is a possible connection.

Everything either looks really far away but massive or really close up but tiny

Sallie, a mom in my community, shared about her son and what he experienced in the comments section of the pyroluria prevalence and associated conditions blog. During his episodes, everything either looks really far away but massive or really close up but tiny:

I believe he has Alice in Wonderland syndrome. I have taken him to GP’s, pediatricians, optometrists, opthamologists and no one knew what was wrong. I spent about 6 months researching the possibilities myself and came across AIWS. When I showed him some of the journal articles, he was so relieved to finally have an answer. Since then, I have had a gut feeling that pyroluria and AIWS may be linked somehow.

She believes his AIWS may have been triggered by an infection when he was around 6 years of age. He developed sudden onset of vomiting, fever and delirium:

Still to this day, he distinctly remembers this night and recalls (like it was yesterday) not being able to stop looking at his hands because they were changing size and how far away/close up they were.

Once he was old enough to articulate what he was experiencing, he was able to tell me he feels weird, like he needs to go to a pitch-black room and lie down. Sometimes it coincides with a headache.

Everything suddenly appears as if far away then everything either looks really far away but massive or really close up but tiny. He feels dizzy while this happens also. Stress definitely increases the number of AIWS episodes.

Infections are reported as one (of possibly many) root causes of AIWS: “Reported causes include infection (especially with Epstein Barr virus), migraine, epilepsy, depression, and toxic and febrile delirium.”

Infections are common mental health triggers. Strep as a trigger for PANDAS/PANS is a classic example. I blog about Bartonella and sudden-onset adolescent schizophrenia here.

He has pyroluria and stress increases the number of episodes he experiences. My question is this: is there a link between the dumping of zinc and vitamin B6 during these times of stress and episodes of AIWS?

The feeling of being extremely small somatically (or physically), like how you feel when in a football stadium

Mike is a 21 year old male and thinks he may very well have pyroluria based on the questions. He also shares this in the blog comments about his AIWS experiences:

I have experienced sensations similar to Alice in Wonderland Syndrome throughout my life, more so during periods of stress. The feeling of being extremely small somatically (or physically), like how you feel when in a football stadium.

Again, he has pyroluria and his symptoms are worse during periods of stress. Keep in mind that stress makes pyroluria symptoms more intense too.

She usually experiences objects/people smaller than what they are but her more pronounced symptoms are sound distortions

Brenda, another mom in the community, shared this about her daughter’s dreams and PMS on the pyroluria questionnaire blog:

I’m quite certain that my 17 year old daughter has pyroluria. I counted 23 symptoms that she definitely exhibits. Her dream recall is so poor that she insists she doesn’t dream at all. I’m going to start her on zinc, B6 and evening primrose oil right away. Her PMS/premenstrual syndrome is so severe that I had decided to see a gyno to discuss birth control pills. Of course I won’t after listening to your interview with Karla Maree (on the Anxiety Summit).

She also asked if I was familiar with Alice in Wonderland Syndrome and if so do I think it may be connected to pyroluria?  She shares this about her daughter’s AIWS experiences:

My daughter has experienced occasional Lilliputian (trivial or small) hallucinations since childhood.  She usually experiences objects/people smaller than what they are but her more pronounced symptoms are sound distortions. She hears voices/noises (real, not imagined) much louder than they are in reality.

She does not have migraines, has never had mononucleosis or any of the other conditions listed as possible causes of Alice in Wonderland Syndrome. That’s why I’m thinking it may be caused by nutritional deficiencies.

This was my introduction to this syndrome and I appreciate her for asking the question. I did some reading of the research and the word “hallucination” got me thinking that a pyroluria connection was possible. The original work by Dr. Carl Pfeiffer with pyroluria was with individuals with schizophrenia.

However, the second paper mentioned above does state that “AIWS is characterized by perceptual distortions rather than hallucinations or illusions and therefore needs to be distinguished from schizophrenia spectrum and other psychotic disorders.”

We clearly have much to learn and I’m still curious to find out how often these two conditions do overlap – pyroluria/social anxiety and Alice in Wonderland Syndrome.

Resources if you are new to pyroluria

Pyroluria is a social anxiety condition and the physical and emotional symptoms are caused by deficiencies of vitamin B6 and zinc. When you experience high levels of stress, vitamin B6 and zinc will be further depleted, so you may notice worsening symptoms and more anxiety. Here is the symptoms questionnaire and additional resources if you are new to pyroluria:

Have you (or a family member) had episodes of Alice in Wonderland Syndrome? And do episodes coincide with times of added stress?

Do you also suspect pyroluria and has the pyroluria protocol or other nutritional interventions helped to reduce or stop the episodes?

I’d love to also hear anything else you’re willing to share: age at onset, age AIWS stopped, do you suspect an infection as the trigger (or a medication or toxins or something else?), do others in the family have AIWS episodes and how would you describe your AIWS episodes?

Feel free to post any questions here too.

Swings are fun for teens, college students and adults! And they reduce stress/anxiety, and improve mood, memory and PMS symptoms

By Trudy Scott 21 Comments

swings for anxiety

Earlier this month I met up with a dear childhood friend for a walk and catch-up and we both rediscovered the joy of swings. I always suggest a walk or hike or swim when meeting with friends and colleagues, and this time was no different except that I really wanted to go somewhere with a swing!

The reason that I wanted to find a swing set was because I had just read an article about swings and teen girls needing a better place to hang out. I love the outdoors and love to play, laugh and have fun, and I couldn’t resist it once I started looking at the research. I discovered all the wonderful benefits of improved mood, reduced anxiety and stress, improved cognition and memory, reduced PMS symptoms, improved social relationships and reduced pain.

These pictures are us swinging and catching up – we laughed and laughed and had such fun!  It’s hard to believe we’ve been friends for close to 50 years and it always feels like we were never apart when we do get together.

swings

Our swing experience made it extra special this time! You can see the pure joy on our faces!

Teen girls needing a better public space to hang out

The recent Bloomberg article I had read, Teen Girls Need Better Public Spaces to Hang Out shares this:

Making space for girls means rethinking which age groups need to swing and climb, how to encourage physical activity (and not just playing a sport), and how to make a safe, sheltered place for outdoor conversation.

And this about movement:

While lack of activity among teens is a major public health issue, many girls are looking for more creative, less competitive ways of moving their bodies.

It features really cool images of swings called “Swing Time.” They are designed by Höweler + Yoon Architecture and deliver “the kind of fun, physical outdoor experience with room for face-to-face conversation that many teen girls are looking for.”

As I mentioned above, I was immediately intrigued because I love the idea of outdoor play and social interaction in a safe place for young girls.

Beth Jones, a Mindset and Wellness Coach who works with teen girls and their moms incorporating movement, play and nutrition, posted the Bloomberg article on Facebook saying:

I love this idea so much. I used to love going to the playground in my teens to swing, hang out, just have a space for me. There’s a reason why my business logo has a girl on a swing. That swinging and twisting are also so great for the vestibular system and can help calm anxiety (the back and forth swinging). Maybe they should bring back some swings to middle and high schools.

I’m familiar with the use of swings in occupational therapy to address sensory processing disorders in children. But I was also very interested to know if there was any research on the health benefits of swings for teens and adults. I went searching and was very pleased with what I found, hence this blog post.

Before we get into the research I’d like to extend a big thanks to Beth Jones for the inspiration for all this! Now the research …..

PMS symptoms improved: mood, stress, anxiety, social relationships, pain and memory

This small study, Vestibular stimulation for management of premenstrual syndrome found the following benefits after 2 months of using the swing in females 18-30 years of age:

  • Depression and stress scores decreased
  • Anxiety scores decreased (although it was not statistically significant)
  • Serum cortisol levels decreased.
  • Social relationships improved
  • Systolic blood pressure decreased (there was no change in diastolic blood pressure and pulse rate)
  • Pain levels decreased
  • Spatial and verbal memory improved

These are amazing benefits using something as simple as a swing. I feel we could safely extrapolate to younger teen girls and even women above 30 years of age too.

Swings for stress management in college students

Vestibular stimulation using swings is the specialty of Dr. Mukkadan, Founder and Research Director of Little Flower Medical Research Centre in India. Together with his team, he published the above PMS paper and this paper on Vestibular Stimulation for Stress Management in Students.

They recommend “placement of swings in college campuses … which may be a simple approach to alleviate stress among college students.”

This is such a simple and yet powerful (and also fun!) intervention especially given the huge rise in anxiety and mental health issues in students. It would be a perfect approach to use in conjunction with amino acid supplements and nutritional psychiatry for these students.

According to another study published by his team, college students will also see improved spatial and verbal memory.

What about swings for teen boys and all adults too?

Once I saw the images in the Bloomberg article, and after reading the research, and after playing on swings again after all these years, my thinking started expanding. I believe everyone could benefit from using a swing.

I certainly wanted to swing right away (hence the walk and swing meet up with my friend a few weeks ago) and now seek out swings when I go for walks. I would love to see an area set aside in parks for teen girls (and boys too) and as Beth says, in middle and high schools too. And how about a designated area in parks for adults who want to swing too?

There are now parks with Liberty swings for children and adults in wheelchairs. The vestibular benefits of rocking chairs are helping veterans dealing with substance abuse and mood issues. I also see an application for stress reduction in the workplace. The opportunities are endless.

Here are some of my recommendations:

  • Seek out swings in parks. Give it a try to see how you feel and how much you enjoy it!
  • Advocate for swings in your communities, middle schools, high schools, colleges and place of business.
  • Get a rocking chair for yourself and/or older family members
  • Get a swing for your backyard (suitable for teens and adults). I’m looking into options for my backyard and will share more once I find some suitable options.

When did you last go for a swing as an adult? How much fun was it!?

If it’s been some time, does this – my pictures and the research – inspire you to want to look for a swing and have a go again?

Does your teen or college student seek out outdoor play like swings and see benefits?

If you are an OT/occupational therapist or exercise physiologist or other health professional using vestibular therapy with swings please do share so we can all learn.

Feel free to post any questions here too.

Using both tryptophan and GABA supplements together for easing anxiety: questions and answers

By Trudy Scott 71 Comments

tryptophan and gaba for anxiety

I get many questions about using both tryptophan and GABA supplements together for easing anxiety and today I’m sharing some of these questions and my answers. This will also give you the opportunity to ask questions you may have related to using both these amino acids together. You’ll also read about some reasons for the confusion about when to use GABA vs tryptophan, some success stories and some research.

Let’s start with this question since it’s one that I get asked many many times:

Should one use GABA and tryptophan together for helping with anxiety symptoms?

I have many clients who need and use both but it’s because they have low GABA and also have low serotonin, both driving different types of anxiety symptoms. It’s important to recognize that each amino acid supplement addresses a very different set of symptoms.

With low GABA levels they will have physical anxiety, tension, stiff and tense muscles and often self-medicate with alcohol in order to relax. Sleep may also be a problem with lying awake feeling tense. Because they also have low serotonin they will have the worry-in-the head type of anxiety, ruminations, and obsessions. They may also have panic attacks, negativity, anger, irritability, PMS, TMJ, lack of confidence and insomnia. (Here is a list of all the low serotonin and low GABA symptoms).

You should only use GABA and tryptophan together if you have both low GABA and low serotonin symptoms.  This will address these particular root causes.

My anxiety has improved significantly with GABA, should I also try tryptophan/5-HTP?

This is another common question I get about using tryptophan and GABA supplements together (paraphrased from one of the blog comments so I could share my feedback here):

I’m using GABA and my anxiety has improved significantly, however, the anxiety I feel in my body immediately upon waking is still bothersome. What would you recommend for the anxiety in my body on waking (that improves when I get out of bed, start moving around and as the day progresses)?

Could I try 5-HTP/tryptophan in addition to GABA?

We always want to capitalize on what is already working. GABA has improved her anxiety significantly, so I’d want to have her figure out how much it’s improved (for example from say 10/10 with 10 being worse to 5/10 with the GABA). Then we’d bump up the GABA to see if additional gains are seen. This could mean a higher dose at night and could also mean a small dose in the morning on waking. And then figure out the improvement and adjust up again if needed.

There is no reason why she shouldn’t try either tryptophan or 5-HTP too but only if she also has other low serotonin symptoms other than morning anxiety. And also, only once she has established the ideal dose for the GABA. She mentions “the anxiety in my body” so I suspect it’s the low GABA physical-tension type of anxiety. We often see low GABA and low serotonin go hand in hand so it’s very likely she’ll also benefit from serotonin support too.

Some reasons for the confusion about when to use GABA vs tryptophan

One reason for this confusion is that there are many combination products on the market that contain both GABA and tryptophan (and other nutrients). The company is trying to make a one-size-fits-all product in the hope it will help many folks. The problem is that it’s not individualized to your unique needs – which may be low GABA or low serotonin or both. Even if it is low GABA and low serotonin that you suffer from, a combination product may not work if, for example, you need a very small amount of GABA and need a much higher dose of tryptophan.

Another reason is that many well-meaning practitioners do not help their client/patients make the distinction between low serotonin and low GABA symptoms. This happens because they often don’t understand this either.

Another reason is that many folks jump in and start using these amino acids without really understanding how and why they work, how to use them and what to look out for. It’s why I highly recommend that everyone planning to use them reads my book first, The Antianxiety Food Solution.

GABA and tryptophan have helped immensely with ruminating thoughts and PTSD – can I stay on them indefinitely?

KJ posted these great results and her question on the blog:

Hi Trudy, I love your blogs and I’ve read your book, The Anti-Anxiety Food Solution – excellent! I have been taking GABA and tryptophan for about 6 months and they have helped me immensely with ruminating thoughts and PTSD. Sometimes I try to go off GABA and Tryptophan for a day or two, but the ruminating thoughts come back, so my question is, can I stay on GABA and Tryptophan indefinitely? I am 59, have no health problems and take no prescription medications.

It’s super to hear GABA and tryptophan have helped with her ruminating thoughts and symptoms of PTSD. I shared that there is no research on long-term use and we should always keep looking for the reasons serotonin and GABA are low and try to address these. Since she has my book I assume she has also implemented all the diet recommendations (no gluten, no caffeine, no sugar, eating for blood sugar control etc), addressed her gut health (candida, parasites, digestive enzymes etc) and looked at low zinc and low vitamin B6 too. There are many other factors to consider – I list 60+ nutritional and biochemical causes of anxiety here.

Jessica says GABA and tryptophan have been life-changing

Here is some feedback from Jessica about how GABA and tryptophan has been life-changing for her – and in only a matter of weeks:

I started taking Gaba and tryptophan about 3 weeks ago after reading about the benefits on this page. It’s been life changing!

I take 1000mg tryptophan at night and 100mg GABA in the morning. Ruminations and obsessive thoughts are almost non-existent now. I have less tension in the jaw and neck. I feel like I’m able to deal with everyday stressors that were overwhelming me prior to starting these supplements.

She started with the tryptophan and added the GABA after about a week.

Jessica clearly had both low serotonin and low GABA symptoms. The ruminations, obsessive thoughts and overwhelm were likely related to low serotonin. The jaw and neck tension are classic low GABA but serotonin support also helps with TMJ too.

Paula would not be able to sleep without GABA and tryptophan

Paula shared this feedback on the blog post where I write about GABA, Heartmath and EFT easing Micki’s mold-induced anxiety and panic attacks:

This was an interesting article because I use both GABA and Tryptophan and would not be able to sleep if I did not use them. I have also had chronic mold exposure. It never occurred to me that the reason I have to take these things in order to sleep is due to the mold in my system.

Toxic mold can impact neurotransmitter production and GABA and tryptophan can provide some relief while the mold is being addressed.

Some research where tryptophan and GABA have been used with success

Here is some research where tryptophan and GABA (and similar amino acids) have been used with success:

This study shares the case of a 13-year-old boy with an essential tremor that caused severe functional impairment. He responded to a Mediterranean diet and supplementation with GABA and tryptophan and was able to resume his plans to pursue a musical career as a guitar player.

The combination of theanine (an amino acid which also supports GABA levels) and 5-HTP (another precursor to serotonin) led to “significant decreases in parent reports of the children’s behaviour problems.”

Resources if you are new to using GABA and tryptophan as  supplements

If you are new to using the amino acid tyrosine as a supplement, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution and a brief overview here, Anxiety and targeted individual amino acid supplements: a summary.

As I mentioned above, if you suspect low levels of any of the neurotransmitters and do not yet have my book, The Antianxiety Food Solution – How the Foods You Eat Can Help You Calm Your Anxious Mind, Improve Your Mood, and End Cravings, I highly recommend getting it and reading it before jumping in and using amino acids so you are knowledgeable.

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 GABA and tryptophan products that I use with my individual clients and those in my group programs.

As with all individual amino acids we use GABA and tryptophan for quick relief of symptoms. And we also always focus on the foundations like diet, the gut, adrenals and stress levels.

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. 

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.

Do you have questions about using GABA and tryptophan together?

Have you used the combination of GABA and tryptophan with success? How did they help you and what was your timing and dosing?

Feel free to post your other related questions here too.

 

Tyrosine erases severe performance anxiety in a female musician: no more shaking, sweating, panic attacks and passing out

By Trudy Scott 42 Comments

tyrosine and musician anxiety

Today I’m sharing the case of a female musician with severe performance anxiety. It was so severe that she would shake, sweat and actually pass out. She also had problems breathing which happens when you’re having a panic attack. Surprisingly, the amino acid supplement tyrosine eliminates – or as she says, erases – all these anxiety symptoms very quickly. It’s surprising because tyrosine is typically not used for easing anxiety symptoms and is instead used to support the low catecholamine symptoms: low motivation, low energy, poor focus, feeling flat and depressed (the curl-up-in-bed kind), cravings for sugary foods for better energy and the need for caffeine.

I share her story in her own words and explore some possible mechanisms around serotonin, cortisol, dopamine and GABA.

Pam initially shared on a Facebook thread how tyrosine erased her extreme performance anxiety and we dug deeper. This is the start of the conversation:

I’ve been performing (music) ever since I was seven, but I always hated it. For extreme performance anxiety, I found, way too late, that 1,500mg of l-tyrosine simply erased the shaking and fainting, and I was “just nervous like everybody else.”

I responded saying what a great result this was and shared that I found it so interesting that tyrosine erased the shaking and fainting that she experienced with her performance anxiety.

As I mentioned above, tyrosine is typically not used for anxiety. Instead, it’s used to improve the low catecholamine symptoms of poor focus, low energy and low motivation. (More on this here)

I also always want to understand the mechanism as to why an amino acid helps ease anxiety symptoms – or in this case erased them. I share more on that below.

When I asked what she meant by “just nervous like everybody else“, this was her response:

It means pretty much everyone gets performance nerves, but not to the point of fainting on stage. Knowing intellectually that that was ridiculous did not make any difference in the fact that it occurred.

I don’t even remember why I tried tyrosine, but I do remember the first time I took it 40 minutes before a performance. I waltzed out on stage ahead of time and sat in my chair warming up, showing off even, to a hall that was filling with people.

That was and is inconceivable without the tyrosine support, which I have to assume is putting my dopamine at a normal level. Yes, I get a little wired, which can be a good thing, but passing out, having my intestines demand to be emptied, not being able to breathe [is this a panic attack?], shaking, sweating….it fixes all of that.

It’s wonderful to hear such powerful results from 1,500mg tyrosine and how quickly it works.  The latter is not surprising as this is typical with all the amino acids. They work quickly if it’s what you need and you have the ideal dose for your needs.

What is surprising is that tyrosine erased her severe performance anxiety symptoms. I immediately started trying to understand possible mechanisms.

What is the mechanism – a serotonin boost to improve confidence?

When I read “I waltzed out on stage ahead of time and sat in my chair warming up, showing off even, to a hall that was filling with people” I immediately thought of how tryptophan or 5-HTP works to give you a serotonin boost that improves your confidence.

However, Pam doesn’t feel the mechanism is related to low serotonin:

You would think, if it were serotonin, that SSRIs would be effective. They are not and cause me to have terror attacks.

She also shared that she recently gave 5-HTP a trial and it did nothing so that further supports her theory/gut feeling that her extreme performance anxiety is not related to low serotonin:

I think there is a belief system associated with serotonin that is not cognizant of the fact that the other neurotransmitters can be the culprits. I read someone’s web site sometime not that long ago, that detailed how to test all the major neurotransmitters, find out which ones were to low OR too high, and what amino acids to take to fix the imbalances. To me, this is a more comprehensive view than being stuck on serotonin.

Anxiety is not always caused by low serotonin or low GABA (although these causes are very common). I’m with Pam on finding which neurotransmitter imbalance you have. There is no one-size fits all and results can happen without us fully understanding why. It does sound like this is very much dopamine related for her but I wanted to understand how it was helping her.

What is the mechanism – lowering cortisol under extremely stressful situations?

I started looking into the research and found that one possible mechanism could be that tyrosine lowers the high cortisol that occurs after an extremely stressful situation – like going on stage to perform – and eases anxiety this way.

An animal study supports this theory: Dietary tyrosine suppresses the rise in plasma corticosterone following acute stress in rats:

Acute, uncontrollable stress increases norepinephrine (NE) turnover in the rat’s brain (depleting NE) and diminishes the animal’s subsequent tendency to explore a novel environment. Pre-treatment with tyrosine can reverse these adverse effects of stress, presumably by preventing the depletion of NE in the hypothalamus.

In the present study, we found that pre-treatment with supplemental tyrosine not only prevented the behavioral depression and hypothalamic NE depletion observed after an acute stress, but also suppressed the rise in plasma corticosterone. These results support a role for brain NE in stress-induced corticosterone secretion and demonstrate that supplemental tyrosine can protect against several adverse consequences of such stress.

Keep in mind that cortisol is the primary endogenous adrenal steroid in humans, whereas corticosterone is the primary adrenal corticosteroid in laboratory rats.

What is the mechanism – dopaminergic system influence on anxiety-like behavior?

I dug deeper into the research and found that there is evidence that dopamine plays an important role in anxiety modulation in different parts of the brain and that both dopamine D1 and D2 receptor mechanisms are important in mediating anxiety.

This paper, The Modulatory Role of Dopamine in Anxiety-like Behavior describes some of this, together with the role of GABA and glutamate:

The activity of dopaminergic system is modulated by several neurotransmitters, including glutamatergic neurons from the medial prefrontal cortex (mPFC), GABAergic fibers from the nucleus accumbens (NAc) as well as the ventral pallidum and cholinergic fibers from the pedunculopontine nucleus and the laterodorsal tegmental nucleus. Thus, changes in the glutamatergic, and GABAergic, as well as mediated transmission in the mesolimbic, mesocortical and nigrostriatal dopaminergic system may influence anxiety-like behavior.

In the past I’ve blogged about tyrosine for alleviating anxiety and panic attacks and creating a feeling of calm focus so this is not an isolated case but it is pretty unusual. As I share in the above blog, a man and a woman saw dramatic reductions in their anxiety when using tyrosine. GABA and tryptophan had not helped and both individuals were also under extreme stress. It was work stress in their cases and both of them felt that their ability to now focus in business situations eased their severe anxiety.

Regardless of the mechanism, Pam saw profound results and that is all that really matters.

My additional feedback on dosing and timing

Here is some additional feedback from me on dosing and timing. On one hand I recommend caution based on my experience with the amino acids. And on the other hand, what she did worked so I’m torn about her approach but am going to say it anyway:

  • A typical starting dose is 500mg tyrosine and I would never have anyone start with 1,500mg (even though it was the sweet spot for Pam). However, if she hadn’t used that dose, she would not have had the same results. I’m waiting to hear back if she started with 1,500mg tyrosine or worked up to this. (Pam also told a friend of hers about her results and the outcome was very different for her friend:“She tried 100mg of tyrosine and it caused her extreme nervousness, the opposite of me. I have to assume that 100mg put her at too *much* dopamine, and her genetic profile was significantly different from mine.” We are all unique and there is no one-size-fits-all.)
  • I would also be cautious about trying a new amino acid for the first time right before a major event like a musical performance. I have clients trial the amino acids at home before heading out. However, if she had done that she would likely have not experienced the desired results.

I feel it would be helpful to know if she had done a trial of GABA or tryptophan before using tyrosine but it seems she doesn’t recall this or why she decided to use 1,500mg tyrosine. If she hasn’t done I trial with both GABA and tryptophan, I would love her to consider this now in order to potentially take things up a notch further and ease her feelings of just being “nervous like everybody else”.

I appreciate Pam sharing her amazing results with tyrosine and I’m really happy for her! I’m waiting to hear back with details of what kind of musical performances she does. I’ll share this and the other information once I hear back.

I say it often and I’ll say it again – there is not a one-size-fits-all. This case illustrates this very well. Sometimes it’s methodical trial and error (my preference) and other times it’s hit and miss when nothing else seems to be helping.

Resources if you are new to using tyrosine as a supplement

If you are new to using the amino acid tyrosine as a supplement, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution and a brief overview here, Anxiety and targeted individual amino acid supplements: a summary.

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

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 tyrosine and other products that I use with my individual clients and those in my group programs.

As with all individual amino acids we use tyrosine for quick relief of symptoms, like Pam did. And we must also always focus on the foundations like diet, the gut, adrenals and stress levels.

Do you use or have you used tyrosine to help with performance anxiety – personally or with a patient/client?

And were you/are you surprised that this worked so well when tryptophan or 5-HTP or GABA had not worked as expected?

What other symptoms did/does the tyrosine help improve: focus, motivation, drive, low energy, low mood? And did/does it help reduce sugar cravings and the need for caffeine?

Feel free to post your questions here too.

Rage, anxiety, cravings & insomnia in 11-year old girl with RAD/reactive attachment disorder: chewable tryptophan turns things around

By Trudy Scott 21 Comments

rad and tryptophan

Today I’m sharing the case of an 11-year-old girl who had huge rage issues, was angry much of the time, suffered from terrible anxiety, had crazy sugar cravings (for bread and colored candies) and had dreadful insomnia. Because of the insomnia she was also very fatigued and this likely drove some of her cravings and irritability too. She was adopted and had been diagnosed with RAD (reactive attachment disorder). During our first session, chewable tryptophan turns things around quickly – she smiles and is willing to make changes and quit the sugar and gluten. We also address low iron levels and with these 4 nutritional interventions this child’s behavior improves dramatically.

This book chapter, Reactive Attachment Disorder, states how The Diagnostic and Statistical Manual 5th Edition (DSM-5) classifies reactive attachment disorder as follows:

a trauma- and stressor-related condition of early childhood caused by social neglect or maltreatment. Affected children have difficulty forming emotional attachments to others, show a decreased ability to experience positive emotion, cannot seek or accept physical or emotional closeness, and may react violently when held, cuddled, or comforted. Behaviorally, affected children are unpredictable, difficult to console, and difficult to discipline. Moods fluctuate erratically, and children may seem to live in a “flight, fight, or freeze” mode. Most have a strong desire to control their environment and make their own decisions. Spontaneous changes in the child’s routine, attempts to discipline the child, or even unsolicited invitations of comfort may elicit rage, violence, or self-injurious behavior.

Reactive attachment disorder/RAD and low serotonin

There is no research on tryptophan helping to address RAD symptoms or trauma, but based on her low serotonin symptoms, a trial of tryptophan was the first thing I considered.

There is, however, evidence to indicate the role of low serotonin in RAD, as indicated by a study where antidepressants were successfully used. The authors mention how:

The absence of responsive and consistent caretaking can subject the developing brain to an inordinate amount of physiological stress, leading to increased cortisol production and consequential inefficiencies in the serotonin and the growth-hormone releasing systems.

Although not specific to RAD, another paper looking at trauma states that:

Serotonin and dopamine levels were found to be abnormal in the presence of PTSD.

As the field of nutritional psychiatry grows, I expect to see more and more research supporting the use of tryptophan and other amino acids for those suffering from symptoms like this. Symptoms that are caused by imbalances that are triggered by the trauma in their lives.

We know that therapy, EFT, EMDR and other approaches are crucial for trauma recovery (this family had already done some of this work) but we must start to incorporate nutritional support too.

The case study

Here are the details of this case study and the nutritional interventions. As I mentioned above, because of her severe rage episodes, a trial of tryptophan was the first thing I considered:

She was referred to me by a friend. The family didn’t have much money. And so, we had to really try and figure out a few simple interventions that we could use that were going to be effective.

This young girl had been adopted. She was diagnosed with reactive attachment disorder and her anger issues were just phenomenal. The mom had to physically put her body around her and hold her down when she was having one of her fits because she was worried that she was going to hurt herself and hurt other people.

She also had anxiety, huge cravings for colored candies and insomnia. She was so fatigued because she wasn’t sleeping well.

So sitting in my office with this young girl and her mom, we started to talk about the sweets and the candies and the need to give up the candies. She was fuming with me. She was sitting in a swivel chair. She turned her back on me and didn’t want to talk about having to give up candy at all.

I said, “Look, let’s not even talk about that, but would you take this chewable tryptophan here? And we’ll talk about it in a second.” I gave her 100 mg of the chewable tryptophan and continued discussing things with her mom.  She had no idea what it was going to do or how it would make her feel.

Within five minutes she turned her chair back, looked at me and she said, smilingly, “Yes, let’s do it. I can give up the candy.” She was smiling and she was happy.

So long story short, with this young girl, we started her on [chewable] tryptophan [and it turned things around quickly].

Chewable tryptophan – when I use it and when I don’t

I typically use 500mg Lidtke tryptophan for the adult clients I work with and prefer this company’s product because it is really high quality. It really does work better than many other tryptophan products on the market.

Lidtke also makes a chewable 100mg tryptophan which is also high quality, and the product I used with this young girl. Here are some benefits of this 100mg product:

  • It’s useful for doing the initial trial in order to figure out if tryptophan is going to help with low serotonin symptoms in children – because it’s a lower dose.
  • It’s especially useful for children for ongoing use (typically midafternoon and evening) because it’s a lower dose.
  • It’s also useful for adults who are “pixie dust” folks and do better with a lower dose of supplements in general or respond more severely to medications/alcohol/chemicals. We may start with a trial of the 100mg chewable and increase from there, also typically midafternoon and evening.

I don’t use the chewable 100mg tryptophan under these circumstances:

  • When the child (or adult) finds that 5 x100mg works for them at each time they need it. In this instance it’s best to switch to a 500mg tryptophan. Using it swallowed may work or it may need to be opened onto the tongue.
  • When the child (or adult) starts to consume the chewables like candy. They are sweet and do taste good and I’ve seen this happen. Because you are continually consuming something sweet you may end up over-consuming them if sugar addiction is one of your issues. You may also end up taking too much tryptophan.

If the chewable tryptophan is not available where you live, using a small amount of a powdered tryptophan or opening a capsule of the 500mg tryptophan is an option. Since it tastes bitter it can be mixed with mashed banana or inositol. (You can find all the Lidtke products in my online supplement store. The link is in the resources section below.)

Gluten and candies were also a huge issue, and she had low iron

There was more to her issues than only low serotonin:

Gluten was also a huge issue, so we got her off gluten and the candies. The tryptophan helped with this” (i.e. it made it easy to break the addiction and not feel deprived).

Tryptophan also helped her sleep. And it helped with the severe rage issues.

Obviously the gluten was contributing to the rage issues as well.

Her iron and ferritin levels were really low (possibly as a result of her gluten issues). So we added an iron supplement, and animal protein/red meat.

So with just four interventions – the gluten, the animal protein, getting her iron levels up and the tryptophan – this kid was just a new kid.

Here are some articles that are related to the above:

Keep in mind there is not a one-size-fits-all and these 4 simple nutritional interventions – tryptophan, gluten removal, adding red meat and addressing low iron – happened to be the combination that worked for this young girl.

Resources if you are new to using tryptophan as a supplement

If you are new to using the amino acid tryptophan as a supplement, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution and a brief overview here, Anxiety and targeted individual amino acid supplements: a summary.

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

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 Lidtke chewable tryptophan 100mg, Lidtke tryptophan 500mg and other products that I use with my individual clients and those in my group programs.

We use an amino acid like tryptophan for quick relief of symptoms, like I did in this instance. Then we focus on the foundations like diet – like no gluten and red meat in this instance – and address all other imbalances, like her low iron. If cortisol was high we would have addressed that.

This case deserves it’s own blog post

In case you’re wondering, I first shared this case study in my interview, “Calming Anxiety, Aggression and OCD with Amino Acids and Food”, on the ADHD and Autism Summit in May 2021. Due to the interest in this case and the use of chewable tryptophan, I felt it deserved a deeper dive and its own blog post with links to some of the research and some practical information about the chewable tryptophan.

Have you used this chewable tryptophan product with success – personally, with your child or with a patient/client?

Have you found that addressing serotonin with tryptophan (or 5-HTP) helps resolve symptoms in a child diagnosed with RAD or a child with rage issues? What about helping with sleep problems, easing anxiety and stopping cravings too?

Have you addressed low iron levels and seen improvements with the removal of gluten too.

Feel free to post your questions here too.