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GABA for bladder pain/interstitial cystitis and urgency, IBS pain and anxiety?

By Trudy Scott 19 Comments

gaba for pain

Is there a place for using the amino acid GABA as a supplement to help with bladder pain/interstitial cystitis and urgency and also help with IBS (irritable bowel syndrome) pain – at the same time as easing physical anxiety caused by low GABA levels?

I’d like to share some quotes from this commentary, GABAB receptors in the bladder and bowel: therapeutic potential for positive allosteric modulators?

The bladder pain syndrome (or interstitial cystitis/painful bladder syndrome) is a spectrum of urological symptoms characterized by frequency, urgency and pain on bladder filling.

Bladder pain syndrome is often present in those who have IBS and abdominal pain and the authors mention the role of GABA in both:

Of further note is the co-morbidity between bladder pain syndrome and other functional pain syndromes, in particular, irritable bowel syndrome, a functional gastrointestinal disorder associated with visceral abdominal pain and altered bowel habit.

… it is tempting to speculate that GABAB receptor positive allosteric modulators may display efficacy in not only functional pain disorders of the bladder, but also of the bowel, through modulation of either central and peripheral GABAB receptors, or both

Positive allosteric modulators increase the activity of the receptor so in this case they are referring to increasing the activity of the GABAB receptor, reducing both bladder pain and gut pain.

This commentary and the original paper refer to ADX71441, which has been shown in animal studies to be “a novel positive allosteric modulator (PAM) of the GABAB receptor that has shown encouraging results in pre-clinical models of anxiety, pain, overactive bladder and alcohol addiction.”

We know GABA eases anxiety and pain and is extremely beneficial when it comes to alcohol and other addictions. In a recent blog post I shared how PharmaGABA eases physical anxiety in a young man who has recently given up Adderall, alcohol and nicotine.

And given that depression, anxiety and stress is higher in women with urinary incontinence it makes sense that an amino acid such as GABA may also help ease some of the symptoms of bladder pain syndrome when low GABA is a factor.

Depending on the root cause/s it’s likely addressing low serotonin, low endorphins and low vitamin D may play a role too. Of course, a full functional medicine and nutritional work up and review of diet is key too. Bladder dysfunction is seen in up to one third of celiac patients. This can cause leaky gut and nutritional deficiencies leading to low levels of neurotransmitters such a GABA and serotonin. Dietary oxalates can often be a factor with bladder issues and pain.

Considering all of this in conjunction with learning from/working with a pelvic floor physical therapist is key.  I highly recommend someone like Isa Herrera, MSPT, CSCS who hosts online masterclass training sessions for those with pelvic health issues. Her next series airs online mid-February and you can learn more and register here.

Here are some related blog posts that you may find helpful:

In case you’re new to GABA you can read more about it here: GABA for the physical-tension and stiff-and-tense-muscles type of anxiety.

The supplements blog lists GABA products I use with clients and recommend to those in my community.

I’m proposing that there is a place for doing a trial of the amino acid GABA (as a supplement) to help with bladder pain/interstitial cystitis and urgency, especially when there are symptoms of low GABA. If GABA helps to ease the visceral pain caused by IBS/SIBO, it may also help with bladder pain.

Have you observed less bladder pain when using GABA for easing physical symptoms of low GABA anxiety (stiff and tense muscles, overwhelm, lying awake tensely at night, anxious and using alcohol to self-medicate in order to calm down)?

Have you noticed any reduction in bladder urgency when using GABA for anxiety?

Do you also have IBS pain or SIBO (small intestinal bacterial overgrowth) pain that is eased by GABA?

Have the following helped: going gluten-free, lowering oxalates and/or working with a pelvic floor physical therapist?

If you’re a practitioner have you made any of these observations?

Please do share in the comments below and let me know if you found this helpful, what else has helped you or if you have questions.

GABA Calm is in short supply – what other GABA products are there for easing anxiety?

By Trudy Scott 90 Comments

gaba calm alternatives

Sheila contacted me via the blog asking about Source Naturals GABA Calm ~ I am from Brussels/Belgium. I cannot find the Source Naturals GABA Calm sublingual anymore. The one you recommend. I’ve been recommending this for years to clients since I read your book “The Antianxiety Food Solution.” I already contacted Source Naturals a few times but no response. Do you know why they have stopped selling this in Europe?

After doing some checking around and contacting Source Naturals it seems there is a world-wide shortage of Source Naturals GABA Calm 125mg lozenges. When I reached out to them I was told it’s indefinite (with no reason why) and to check back at the end of January. Two other people were told it would be available mid-January and mid-February so the messages are mixed.

Today I’m sharing some other GABA product options until GABA Calm comes back or in case it doesn’t or if there is another shortage in the future. It’s such a pity since it is so effective for so many folks as you can see in these blogs:

I also posted this message on Facebook to let my community there know and to find out what they were using instead.

gaba calm alternative question facebook

This is some of the feedback I received:

  • Mary ~ Oh my goodness! I just found it in my local Vitamin Shoppe tonight! There was one bottle left.
  • Diana ~I noticed. My son uses this, I’m a little worried.

I shared that there are other products that will hopefully work as well and asked everyone who was using something else: Do  you use it opened onto the tongue or swallowed? And if you’ve used Source Naturals GABA Calm in the past how does it compare for you?

A number of people said they like Thorne pharmaGABA capsules, someone said she like Now GABA Powder and a few people like Natural Factors pharmaGABA chewables:

  • Tara ~ I’ve only used Thorne PharmaGABA because of how it’s derived [fermented]. I just swallow the capsule and I’m immediately calm within 5-15 mins. I was previously prescribed a benzo & this is much better. 100mg is all I take when I feel a panic attack coming on. I’ve been thru a few years of absolute hell of benzo withdrawal coming off of my klonopin prescription. The GABA feels almost the exact same as the benzo except the benzo would actually cause rebound panic attacks (I didn’t realize it at the time) & the GABA does not.
  • Jane ~I use Now Foods GABA powder. A little under the tongue works well.I have found both effective. Powder good for rapid effect at home (1/4 teaspoon as needed). GABA Calm good to take out with you.
  • Meesh ~ I use the Natural Factors pharmaGABA (100mg) and it works great. I use it in combo with L-theanine 250mg (which also contains 20mg of magnesium)… and the combination is magic

I’ve updated the supplements blog with the above products and a few additional similar products so you have many options to select from based on your unique needs and taste preferences, and what’s available at the time:

  • Thorne PharmaGABA-100: the label says Gamma-Aminobutyric Acid (GABA) 100 mg but it also states that the product uses Pharma Foods International’s Gamma-Aminobutyric Acid (PharmaGABA®).  This is also pleasant-tasting when opened on to the tongue and is most effective when used this way. [AS OF NOV 24, 2021 THIS MAY ALSO BE UNAVAILABLE]
  • Thorne PharmaGABA-250: as above but contains 250mg of PharmaGABA®. This is also pleasant-tasting when opened on to the tongue and is most effective when used this way. [AS OF NOV 24, 2021 THIS MAY ALSO BE UNAVAILABLE]
  • Designs for Health PharmaGABA Chewables: gamma-amino butyric acid (pharmaGABA) 200 mg in 2 chewable tablets. It’s quick-acting and convenient like GABA-Calm because it’s chewable. This does contain xylitol, natural flavors, stevia and some other ingredients so taste may be a factor and xylitol can cause gas, bloating and diarrhea when too much is consumed.
  • Natural Factors PharmaGABA: gamma-amino butyric acid (pharmaGABA) 200 mg in 2 chewable tablets. It’s quick-acting and convenient like GABA-Calm because it’s chewable. However it also contains organic cane sugar and natural fruit flavors so it’s a little too candy-like for my preference, especially if you have low GABA-related sugar cravings. Also 2 chewable tablets – 4g of carbs which is almost 1 teaspoon of sugar!
    [January 22, 2021: I’ve included this as a stand-by option for occasional use until Source Naturals GABA Calm is readily available again or if Designs for Health PharmaGABA Chewables are not available.]
  • Now Foods GABA Powder: 1/4 Level Teaspoon (500mg). This is pleasant-tasting when opened on to the tongue and is most effective when used this way. The only challenge with powder like this is making sure you don’t use too much by mistake. And it’s especially challenging when you only need 100mg.
  • Quicksilver Scientific Liposomal GABA with L-Theanine: 2ml (4 Pumps) provides (Gamma Amino Butyric Acid) 240mg, L-Theanine 100mg and Phosphatidylcholine 120mg (from purified sunflower seed lecithin). It does contain ethanol so would not be suitable for alcoholics or young children.
  • GABA-Pro Calming Effect Chewable: This is a chewable that contains 100 mg of pharmaGABA in 1 tablet. It is pharmaGABA even though the product says GABA-Pro on the front and the label states Gamma Amino Butyric Acid (GABA). This product is a reasonable replacement for Source Naturals GABA Calm.  It does contain natural flavors and xylitol.
  • GABA-Pro Calming Effect: This contains 100 mg of pharmaGABA in 1 tablet. It is pharmaGABA even though the product says GABA-Pro on the front and the label states Gamma Amino Butyric Acid (GABA). This capsule can be opened onto the tongue.  It does contain rice flour which can be an issue if you have a rice allergy/sensitivity and/or SIBO.

I do want to add that Nutritional Fundamentals for Health GABA-T SAP is still a firm favorite of mine: gamma-Aminobutyric acid (GABA) 300 mg, l-Theanine 150 mg. This is pleasant-tasting when opened on to the tongue and works very well when GABA Calm can’t be used (because of the tyrosine or taste or sugar alcohols). It is also often used with GABA Calm – like GABA Calm in the day and GABA-T SAP at night or some combination.  I find best results when it is used opened on to the tongue and it offers a feeling of calm focus. It could easily be used as a substitute for GABA Calm in the short-term.

In case you’re new to GABA you can read more about it here: GABA for the physical-tension and stiff-and-tense-muscles type of anxiety.

UPDATE Nov 24, 2021:
=================

Source Naturals GABA Calm is in short supply again, so I’ve updated this blog with some other options (above) because the Thorne Products may also be unavailable for now:

  • GABA-Pro Calming Effect Chewable
  • GABA-Pro Calming Effect

Is Source Naturals GABA Calm a favorite of yours? And how has it helped you?  What have you found works as well – for physical anxiety, tension, insomnia, pain, sugar cravings, muscle spasms – when it’s not available?

If you’ve used a GABA product in capsules, do you use it opened onto the tongue or swallowed? And if you’ve used Source Naturals GABA Calm in the past how does it compare for you?

If you’re a practitioner do you use GABA Calm and/or other GABA products?

Please do share in the comments below and let me know if you found this helpful or if you have questions. And thanks for the questions and contributions so far!

ADHD: 5-HTP melts have been a miracle for one of my adopted kids

By Trudy Scott 77 Comments

ADHD and 5-HTP

A mom in my community responded to an ADHD blog sharing how 5-HTP melts have been a miracle for one of her adopted children – after one week! 5-HTP is not where I typically start with ADHD so I quizzed her to get more details and then went looking for the research to understand the mechanisms. This blog shares her rationale for using 5-HTP, the truly wonderful results her son experienced, some of the research and some possible serotonin/dopamine mechanisms. This is what she posted:

5-HTP melts have been a miracle for one of my adopted kids. He had lots of trauma and off the charts ADHD. 5-HTP is better than methylphenidate (Ritalin) and we are now weaning off the non-stimulants.

Just 80mg 5-HTP in the morning is all he needs. He was super ADHD, he had a para (teacher’s aide) in public school for years to keep him on track and this year at a school for ADHD the teachers were complaining that he was never on task.

Now after a week it has changed his life. I am so thankful for the anxiety summit. Thank you Trudy

This is truly wonderful to hear! I responded saying how thrilled I was to hear the impact it was having and asked why this mom decided to try 5-HTP? This amino acid, which is a serotonin precursor, is not typically my first choice for alleviating ADHD symptoms. I consider low GABA (and using GABA) or low catecholamines (and using tyrosine), together with dietary changes, blood sugar control, and assessing for low zinc, low iron and low omega-3s – as a starting point.

I wanted to know if he had low serotonin symptoms such as the worry, ruminating, and obsessive type of anxiety which could have possibly been driving the ADHD symptoms? Were there any other symptoms that were a clue that low serotonin may be a factor: insomnia (with fatigue the next day impacting focus) or sugar cravings in the afternoon/evening (causing blood sugar swings affecting focus and mood)?

Why she used 5-HTP and which low serotonin symptoms he had

This was her response about why she used 5-HTP and which low serotonin symptoms he had:

We have tried all the amino acids over the years. I tried 5-HTP this time because SSRIs were the only class of medication he has not tried. I thought maybe it was worth a try and I also found this study: Comparative study of efficacy of 1-5-hydroxytryptophan and fluoxetine in patients presenting with first depressive episode (where the therapeutic efficacy of 5-HTP was considered as equal to that of the SSRI fluoxetine).

As for cravings or insomnia: he is a kid who loves sugar so I’m not sure if it’s a craving or typical. He takes 0.3mg of melatonin each night because guanfacine, the non-stimulant, prevents the production of melatonin.

She also mentioned that she has followed me for years and that DPA, an endorphin-boosting amino acid, works for her. She is a dietitian and shares my handouts and blog posts with her clients, so she clearly felt comfortable experimenting with the amino acids with her son.

5-HTP products and dosing

I also asked which product they were using and how she landed at 80mg. She wanted a fast-acting supplement that would dissolve in his mouth and purchased Natrol 5-HTP:

They are 100mg but we are breaking off a little because he was falling asleep in class.

I reminded her that 5-HTP (or tryptophan) is typically best used late afternoon and evening so if someone is falling asleep in the day I’d switch to bedtime dosing.  If he needs it during the day for the ADHD symptoms then reducing the dose is the smart thing to do.

I love the sublingual/melt aspect of this product for quick results and because children do so well with a product that tastes pleasant.

However, I do not recommend this particular product because of very mixed ingredients information online. I have not seen the bottle of the actual product used but some of the online information states the product is gluten-free and soy-free and yet other information states it does contains gluten and soy. In some places they state it contains sucralose and an artificial flavor and in other places you see xylitol and natural flavor. This is all rather concerning. I’ll update this section as soon as I can confirm.

What does this mean for this mom? Now that she has figured out that 5-HTP helps her son, it’s best to find a better quality product so as not to cause other problems.

There are two chewable products in my online supplement store that come close to this product:

  • Serotrex Chewable: Two chewables contain 200mg theanine and 60mg 5-HTP. This could be used in the day or at night.
  • Designs for Health Insomnitol Chewables: Two chewables contain 10mg vitamin B6, 500mg inositol, 200mg theanine, 100mg 5-HTP and 3mg melatonin. This would need to be used at night instead.

Both of these contain theanine. Research shows that theanine reduces anxiety and improves cognition via “improvements in verbal fluency (especially letter fluency) and improvements in executive function (planning, multi-tasking etc).”

The research on 5-HTP and tryptophan for ADHD

This paper, The effects of 5-hydroxytryptophan on attention and central serotonin neurochemistry in the rhesus macaque, shares that

Individuals with depression and anxiety typically experience impaired executive function and emotional cognition, symptoms that are generally studied by examining disruptions in attention.

This study used 5-HTP as an intramuscular injection, rather than using it orally but the authors did report the following:

Our findings provide unique causal and mechanistic evidence suggesting that enhancing central serotonergic function results in categorically distinct changes in fundamental cognitive operations such as attention.

This paper, Does serotonin deficit mediate susceptibility to ADHD? summarizes the role of serotonin in ADHD, the interplay with dopamine and the use of oral tryptophan (a serotonin precursor similar to 5-HTP):

  • A chronic deficit of serotonin at the synapse may trigger symptoms of childhood ADHD (developmentally inappropriate levels of hyperactivity, impulsivity and inattention).
  • Studies from animal models of ADHD indicate intimate interplay between serotonin and dopaminergic neurotransmission.
  • Selective serotonin re-uptake inhibitors (SSRIs)…as non-stimulant drugs acting on the serotonin system are … clinically effective.
  • Oral administration of l-tryptophan, the amino acid precursor of serotonin, significantly alleviates ADHD symptoms.
  • Serotoninergic gene variants are associated with increased risk of ADHD.

I appreciate this mom for giving me permission to share here on the blog so we can inspire hope (and I wish for more and more improvements for this young boy):

My son is a 10-year old RAD (reactive attachment disorder) kid that was meth exposed and adopted at 3 years old. 5-HTP has worked so well. He has not thrown a fit in a month. Before fits were a daily occurrence. This might give hope to other parents.

Additional resources when you are new to using GABA, 5-HTP and other amino acids as supplements

As always, I use the symptoms questionnaire to figure out if low serotonin or low GABA or other neurotransmitter imbalances may be an issue.

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 (this is covered in an entire chapter too), 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.

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.

Wrapping up and your feedback

Have you found that 5-HTP (or tryptophan) helps/helped you or your child with ADHD symptoms? If yes, do you feel the ADHD was caused in part because of anxiety and/or fear and/or feeling inadequate and/or perfectionism and/or poor sleep (all signs of low serotonin)? Or were the main symptoms poor focus, low energy, low motivation and depression caused by low catecholamines/low dopamine? Or a mixture of both?

If you’re a practitioner working with children or adults with ADHD, have you had good results with 5-HTP or tryptophan?

Please do share in the comments below.

GABA eases anxiety and is protective against metabolic and reproductive disturbances in polycystic ovarian syndrome (PCOS)?

By Trudy Scott 40 Comments

gaba pcos

This question was recently asked in my online GABA Quickstart group program: What are your thoughts about using GABA with somebody who has polycystic ovarian syndrome (PCOS)? Are there any contraindications? My approach is always the same regardless of your diagnosis – if you have the low GABA symptoms of physical anxiety then it’s worth doing a trial to determine if supplementing with the calming amino acid GABA will help.

What is very interesting is that this rat study, Protective effects of GABA against metabolic and reproductive disturbances in letrozole induced polycystic ovarian syndrome in rats, reports some very specific benefits of GABA being protective against metabolic and reproductive disturbances in PCOS.

Letrozole or Femara, a non-steroidal aromatase inhibitor (i.e. it lowers estrogen production) is used to treat breast cancer in postmenopausal women and it induced PCOS in the rats.

The following benefits were found when GABA was used in the rats with PCOS:

  • reduced body weight
  • reduced body mass index
  • reduced testosterone
  • a favourable lipid profile
  • normal glucose tolerance
  • a decreased number of cystic follicles in the ovaries

These results are profound. But wait for it …”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).

The authors conclude as follows:

The results suggest that GABA treatment has shown protective effects in PCOS and provides beneficial effects either by reducing insulin resistance or by inducing antioxidant defence mechanisms.

The above paper didn’t measure anxiety levels but it’s very common with PCOS. According to this paper, Polycystic Ovary Syndrome: A Review of Treatment Options With a Focus on Pharmacological Approaches

after PCOS is diagnosed, studies show that more than 50% of patients develop prediabetes or diabetes, and there is an increased risk of myocardial infarction (MI), dyslipidemia, hypertension, anxiety, depression, endometrial cancer, and sleep apnea.

So it makes sense that using GABA will also help to ease any anxiety symptoms that are present. As always, look at the low GABA symptoms and if they exist rate them on a scale of 1-10 (with 10 being most severe), do a trial with GABA, and rate your symptoms afterwards, adjusting up or down as needed based on symptom relief.

A quick recap if you are new to GABA, these are the symptoms of low GABA:

  • Unable to relax or loosen up
  • Stiff or tense muscles
  • Feeling stressed and burned-out
  • Feeling worried or fearful
  • Panic attacks
  • Craving carbs for relaxation and calming
  • Craving alcohol for relaxation and calming
  • Craving drugs for relaxation and calming
  • Insomnia *
  • Have intrusive thoughts, perseverate or have an overactive brain
    Or have unwanted thoughts – thoughts about unpleasant memories, images or worries (Updated Nov 17, 2017: new GABA research on intrusive thoughts) *
  • Inability to prioritize planned actions *
  • Acrophobia (fear of heights) * – possibly other phobias too
  • Poor focus *
  • Rectal spasms *
  • Burning mouth *
  • Visceral pain/belly pain with IBS *

(* New additions that are not in my book “The Antianxiety Food Solution”)

Keep in mind that the above PCOS GABA paper was an animal study and GABA was not listed as a treatment option in the second paper above so my approach would be to use GABA for easing the physical anxiety symptoms. At the same time, share this blog and study with your prescribing physician and request if they will work with you to adjust your Metformin as they monitor your testosterone, lipids, glucose, insulin and cystic follicles in the ovaries, as well as weight and body mass index.

I look forward to human GABA PCOS studies in the near future. I also look forward to hearing back from you if you have PCOS and are using GABA for easing your anxiety symptoms AND are also seeing some of the above metabolic and reproductive improvements.

Given the prevalence of PCOS it’s important we use everything at our disposal to help:

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.

We must always use a comprehensive approach and this book by my friend and colleague, Amy Medling is wonderful: Healing PCOS.

Do you have PCOS and anxiety and has GABA helped? Have you also observed some of the above metabolic and reproductive improvements?

If you’re a practitioner working with women with PCOS, have you made any of these observations?

I’d also be curious to hear if you see changes in acne severity, amenorrhea (missed periods), excessive hair growth or infertility?

Please do share in the comments below.

GABA helps a stressed young boy with episodes of “choking” or tightening in his throat

By Trudy Scott 34 Comments

gaba throat relief

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.

Christmas tree phenols as a trigger for anger, meltdowns, anxiety, hyperactivity, insomnia, aggression, self-injury and autistic symptoms?

By Trudy Scott 16 Comments

christmastree phenols and anxiety

Are you aware that the aromatic oils that give pine trees their wonderful smell are phenols and that these phenols may be a trigger for anger and meltdowns, anxiety, hyperactivity, irritability insomnia, self-injurious behavior, digestive issues and autistic symptoms (such as stimming, swinging and hand-flapping)? All this can be caused by an indoor Christmas tree in susceptible individuals.

My colleague Julie Matthews writes about this here: Avoiding Holiday Havoc: Healthy solutions to avoid meltdowns and keep the holidays happy

“When phenols are not able to be broken-down and detoxified by a process called sulfation, which is low in many children with autism and ADHD”, they can cause these symptoms and also red cheeks and ears. She shares that “phenolic compounds come in many forms including artificial petroleum-based food additives, and salicylates (a type of phenol) found in plants and foods like strawberries and spices, as well as pine trees.”

In the above blog, Julie shares this story about a client with a 10-year old son with autism. He severely regressed during the holidays and it was because of the Christmas tree. This is what the mom shared:

During the Holidays our son regressed severely.  He became anxious, aggressive, and self-abusive. He cried and had tantrums regularly throughout the day. He couldn’t sleep anymore and was up for hours at a time, night after night. He was hand-flapping like crazy.  We have a swing in the house for him and he now wanted to swing all day long, constantly, and do nothing else. He lost eye contact and he stopped responding to his name.

Once the Christmas tree was removed the improvements were dramatic:

The next day, he was much calmer. He seemed to have “exhaled.” Within 48 hours, our son was completely back to normal.

I shared Julie’s blog on my Facebook page and a father in my community shared a similar experience about his autistic son’s severe reactions to phenols:

Yes! My autistic son who is sensitive to phenols, would completely meltdown during the holidays. We thought it was just the change in routine and his environment, but quite by accident we discovered fragrances seemed to make him worse. We got rid of the fragrances and holiday tree/decor and the improvement in our son was dramatic! We now realize it was the phenols.

My son’s reaction to phenols/fragrances are bright red cheeks/ears, dark under eye circles, headaches, inappropriate manic laughter, aggression/self injurious behavior, marathon meltdowns/screaming, incontinence, insomnia/less than 3 hrs sleep a night, bumpy rashes, GI issues/diarrhea, excessive sensory stimming (hand flapping, lip licking, running around and body slamming into things.) During the holidays, the intensity of these reactions shot through the roof.

They found out by chance that it was the Christmas tree that was causing his son’s issues each year. It started when he was a toddler and they figured it was the stress and changes of the holidays that was the issue. One year they didn’t put up a tree and they could not believe the difference. It was then they made the connection and learned more about phenols and made the necessary changes.

By reducing phenols in his diet and environment, and giving him Epsom Salt baths and enzymes (No-Fenol), most of the above symptoms were significantly reduced.

I suspect there are many families who are seeing similar meltdowns and have no idea it could be the Christmas tree. Keep in mind that the reactions may not be as severe as these two cases I’ve shared here. If you are seeing any increase in anxiety, irritability, sleep problems, digestive issues or other unusual behavior changes in your child, keep an open mind that it may be more than just the holiday changes.

Julie’s advice is this:

  • Since so many children with autism and ADHD react to salicylates/phenols – in her nutrition practice she finds an overwhelming majority react negatively – she suggests a cautious approach to holiday decorating for all families of a child with autism or ADHD. Simply avoid the pine Christmas tree.
  • If you are unsure about their sensitivity to salicylates/phenols you might ask yourself if your child is often hyper, irritable, or has red cheeks, and other common salicylate symptoms, or whether they crave salicylate-rich foods such as berries, grapes, apples, and ketchup. If so, explore salicylates further.

I encourage you to read Julie’s blog to gain a better understanding of salicylates and phenols. If you are a practitioner and want to learn more about low salicylates/phenols and other special diets her practitioner training is excellent.

I appreciate this mom and dad for sharing their experiences with their sons so we can all learn and help other families. I also so appreciate Julie’s expertise in this area and really look forward to digging further into the research and picking her brain so I can share more.

Could your holiday anxiety and/or insomnia be phenol issues too?

Julie works with children with autism and ADHD but as someone who works primarily with adults with anxiety, I’m going to be exploring sensitivity to salicylates/phenols further. Julie recently shared this with me: “if you start looking you’ll probably see a lot of your clients with anxiety have phenol issues.”

If you also notice any increase in anxiety, anger, irritability, sleep problems, digestive issues or other unusual behavior changes, keep an open mind that it may be more than just the holiday stress or winter blues/winter anxiety. It may well be phenol issues too.

Serotonin connection to phenol issues

I’ll be blogging more about this and the fascinating serotonin connection to phenol issues. You may have noticed that many of the symptoms these 2 boys experienced sound a lot like either low serotonin or high serotonin (both of which can occur in autism).  Serotonin is an endogenous phenol compound and this phenol issue is likely causing high serotonin.

When I asked Julie about this she shared this with me: “Yes, serotonin and dopamine are phenolic. And sulfation is important for the inactivation of dopamine and serotonin. So poor sulfation can lead to neurotransmitter imbalances.”

Using collagen to lower high serotonin?

I’ve blogged about how collagen can lower serotonin in susceptible folks and increase anxiety. It is also used by some folks to lower their high serotonin and make them calm. Misty reports using collagen ‘therapeutically’:

I use it to reduce tryptophan because I have a tendency toward high serotonin. I have suffered my entire life with ADD, tics as a child, grinding teeth, general anxiety, lack of motivation and later, IBS. In my 53 years I’ve never been as calm as I am now.

I don’t know if Misty has a phenol issue but I’m going to be exploring if collagen or gelatin could possibly be used to help lower the high serotonin and ease some of these severe phenol reactions quickly, in conjunction with other approaches like avoiding the foods and environmental exposures, enzymes and other nutrients, and Epsom salt baths.

Christmas tree syndrome, mold issues and toxic plastic trees

I hate to spoil the Christmas fun but here are a few other things to consider:

  • Christmas tree syndrome is also a real issue for many individuals
  • My friend and Enviornmental Toxins expert Lara Adler shares how mold from a real tree made her and her cat really sick “Within a few days of getting the tree, I broke out in a full-body rash that required a 10-day run of prednisone. I didn’t think it was the tree at first (it could have been something else), but then my cat, who was already dealing with GI inflammation and a gut issue developed asthma! Out of nowhere! She also ended up on prednisone. I got rid of the tree and both our symptoms never came back.”
  • She also shares some issues with plastic trees: they are often made from toxic PVC (polyvinyl chloride) with “softeners like lead and/or phthalates”, and often treated with endocrine-disrupting flame retardant chemicals. More about this on Lara’s blog here.

Have you observed a salicylate/phenol reaction with your child or client/patient? What about a less severe reaction with your child or with you personally?

Have the following helped you: avoiding the foods and environmental exposures like a Christmas tree, using enzymes like No-Fenol and other nutrients, and Epsom salt baths? In the midst of a very severe reaction has collagen or gelatin helped reduce symptoms quickly?

What about mold issues or allergies with a Christmas tree?

Feel free to post your questions here on the blog too.