I’d been taking GABA before [my spine] surgery and really didn’t want to have to discontinue it. My surgeons have always insisted on me going off supplements in the week or more leading to surgery.
I’m sure they don’t want to have to be well versed on everything a person might be taking so they only allow prescription drugs.
The morning after the spine surgery, I had an anxiety attack and insisted on being allowed to take my GABA, which helped.
GABA helps tremendously in preventing me waking in the middle of the night or early morning in a panic. I take 500mg of NOW GABA sublingually before bed. I also take tryptophan and magnesium glycinate at bedtime and believe they help a bit, but GABA is the most effective.
It would be really helpful to be able to take needed supplements right up to surgery time.
LM posted this in response to my blog: GABA and theanine for sedation, anxiety, and cognition in preoperative surgical patients (a randomized controlled study) (more on this below).
She also said “This would be really nice” if doctors knew this! I’m with her – it would be really nice if doctors were aware of this research and allowed patients to use GABA and theanine right up to surgery and right afterwards too. This is especially relevant given the fact that GABA lowers blood pressure and high blood pressure is common after surgery (more on this below too).
Hopefully this GABA/theanine surgery research and the GABA/high blood pressure research will start to shift perspectives and guidelines, especially since increased anxiety also impacts the outcome of surgery. I share more on the research and my insights below.
The study: GABA and theanine are calming before a surgical procedure and don’t cause too much drowsiness
If you missed the blog post and study I shared above, here is the overview:
This novel study was planned to study and compare the effects of L-theanine and GABA on anxiety, sedation, and cognition in preoperative patients posted for major elective surgeries under general anesthesia.
The conclusion is that:
GABA and L-theanine result in effective preoperative anxiolysis with minimal sedation and improvement of cognitive skills.
In other words, both these amino acids are calming before a surgical procedure, don’t cause too much drowsiness and improve cognition.
Study participants used 500 mg GABA and 200 mg of theanine – but dosing is unique
The authors had the study participants use 500 mg GABA and 200 mg of theanine. Both were used as capsules and swallowed. If you’ve been following my work, you’re aware that I find sublingual (or powder or liposomal or topical) use of GABA to be more effective than swallowing a capsule. For this reason it’s possible that using a lower dose sublingually may be as effective or possibly even more effective.
As always, dosing of GABA (and other amino acids such as theanine) is individualized to the unique needs of the person. Ideally, the person has figured out their optimal dose for easing anxiety in their day to day life before going in for surgery. They may find that a higher dose is needed the weeks leading up to surgery and the day of surgery.
As LM shared, she uses “500mg of NOW GABA sublingually before bed”, and presumably started with a lower dose and worked up to 500mg i.e. the optimal dose for her unique needs. It’s very individualized with no-one-size fits all i.e. someone else may get similar benefits with 125mg.
You can read the entire blog post here: GABA and theanine for sedation, anxiety, and cognition in preoperative surgical patients (a randomized controlled study).
Why you are told to stop all supplements prior to surgery
My understanding is that being told to stop all supplements prior to surgery is because of potential concerns about effects on bleeding, anesthesia and blood pressure. Unfortunately, the study didn’t address this possible issue. This article has some information on supplements (and some meds) to stop before surgery/anesthesia stating:
you may need to take a break from some supplements and medications that can interfere with anesthesia. Surgical complications could include heart or bleeding problems, prolonged anesthesia effects, or increased blood pressure.
GABA lowers blood pressure which may be helpful right after surgery
High blood pressure is common after surgery and can have far-reaching implications. According to this paper, “Postoperative hypertension often begins ~10–20 minutes after surgery and may last up to 4 hours. If left untreated, patients are at increased risk for bleeding, cerebrovascular events, and myocardial infarctions.”
This is another reason GABA may actually be helpful to use right up to surgery and right afterwards – it lowers blood pressure.
This paper, United States Pharmacopeia (USP) Safety Review of Gamma-Aminobutyric Acid (GABA), published in 2021, reports the results of a 4-week study that investigated the tolerability of GABA supplementation in mildly hypertensive but otherwise healthy adults:
The authors first established an optimum dose in mildly hypertensive subjects (SBP/systolic blood pressure between 130 and 180 mm Hg) who were randomized to receive oral doses of GABA at 0 (placebo), 20, 40, or 80 mg/day for 4 weeks.
An intake of 80 mg/day of GABA was associated with a significant reduction of the BP in adults with mild hypertension, and no adverse effects were reported.
A subsequent study evaluated long-term effects of GABA at 80 mg daily versus placebo in mildly hypertensive subjects for 8 weeks:
At the end of the 8-week study, SBP [systolic blood pressure i.e. the top number] and DBP [diastolic blood pressure i.e. the bottom number] were on average 5% lower in all the subjects who received 80 mg/day of GABA compared to participants in the placebo group whose blood pressure levels remained above normal.
This is a substantial reduction when 80 mg of GABA a day is considered a very low dose. I typically have my anxious clients start with 125mg GABA and increase from there. They may end up using 125 mg GABA 3 or 4 times a day and sometimes 250 mg a few times a day or 500 mg once a day like LM is doing.
Additional resources when you are new to using GABA and other amino acids as supplements
As always, I use the symptoms questionnaire to figure out if low GABA may be an issue. The low GABA symptoms include: physical tension, overwhelm, fears, anxiousness, stiff and tense muscles, sleep issues, feelings of panic and stress-eating and drinking.
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
I appreciate LM for sharing how GABA helps her and her post surgery experience with anxiety and using GABA. It is wonderful that she was able to take her GABA supplement for the anxiety attack after her surgery. Let’s hope this research increases awareness amongst surgeons.
I’d love to hear from you – have you been told to stop all supplements before surgery, including GABA and other amino acids.
And do you feel increasingly anxious before surgery and other medical procedures and would GABA help i.e. is GABA and/or theanine part of your calming repertoire on a day-to-fay basis?
Have you ever discussed either of these two amino acids – GABA or theanine – with your surgeon or anesthetist prior to surgery and were they open to you using them before and right after surgery?
If you’re a practitioner do you recommend GABA and theanine to your anxious clients/patients and as a surgeon or anesthetist would you consider these amino acids in the future, based on this research?
Feel free to share your experiences and ask your questions below.
