calming

GABA and theanine for sedation, anxiety, and cognition in preoperative surgical patients (a randomized controlled study)

October 18, 2024 By Trudy Scott 7 Comments

L-theanine is a unique amino acid found in green tea. It prevents stress, produces anxiolysis, modulates alpha activity, and provides beneficial effects on mental state, including sleep quality.

Gamma-aminobutyric acid (GABA) is a non-proteinogenic amino acid and a phytochemical that is the main inhibitory neurotransmitter in the mammalian brain. It is beneficial in anxiety and stress regulation.

This overview of theanine and GABA come from this paper, Comparison of the effects of two amino acids, Gamma-aminobutyric acid (GABA) and L-theanine, on sedation, anxiety, and cognition in preoperative surgical patients – A randomized controlled study, a very promising paper published in May this year.

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.

There are a number of reasons why I feel this study is so promising: anxiety before surgery is very common; laryngospasms (or vocal cord spasms) during surgery are potentially life threatening and clinically we see GABA to be helpful outside of the surgical setting; and any research confirming the calming benefits of GABA (and other amino acids like theanine) supports what we see clinically and furthers the field. This is especially the case when it’s a randomized controlled study such as this one. More on all this below.

The study information and benzodiazepine comparison with GABA/theanine

It was a small study with a “total of 168 patients aged between 18 and 55 years .. who were randomly divided into three groups that received either oral L-theanine, oral GABA, or oral alprazolam 0.25 mg. The anxiety score, sedation score, and psychomotor and cognitive performance scores were noted 60 minutes before and after the administration of the drugs” and amino acids.

Alprazolam is an antianxiety medication known as a benzodiazepine which impairs “psychomotor performance and cause excessive sedation.” I’ve blogged extensively about many of the known issues with benzodiazepines.

Because of this it’s worth noting that the authors share this exciting information: “To our knowledge, our study is the first comparative study that compares GABA with L-theanine and alprazolam.”

This in itself is very encouraging but more so because the outcome “showed that oral L-theanine, oral GABA, and oral alprazolam were equally effective in producing anxiolysis.”

How much GABA and theanine was used in the study? And what is optimal?

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.

You can read the entire study here: Comparison of the effects of two amino acids, Gamma-aminobutyric acid (GABA) and L-theanine, on sedation, anxiety, and cognition in preoperative surgical patients – A randomized controlled study

Laryngospasms during anesthetic – could GABA help prevent this?

Laryngospasm is a life threatening complication during the perioperative period (time of surgery) with an incidence of 0.78-5% depending on the surgical type, patient age, pre-existing conditions and anesthetic technique.”

It is described as “the sustained closure of the vocal cords resulting in the partial or complete loss of the patient’s airway. Although described in the conscious state and associated with silent reflux, laryngospasm is a problematic reflex which occurs often under general anaesthesia.”

The authors state that “a clear management plan is required to avoid significant morbidity and even mortality.” They do discuss the use of magnesium “due to both an increased depth of anaesthetic and muscle relaxation” and the authors state that this “agent may have a role to play in the future prevention of laryngospasm, but more studies are needed.”

Clinically we see GABA to be helpful for the prevention of laryngospasms outside of a surgical setting (I blogged about this here) and it’s intriguing to consider that the use of GABA before surgery may actually help prevent or reduce the severity of this complication. I look forward to future research on this application of GABA.

Until then it may be worth discussing with your surgeon and anesthetist. I have a family member who is susceptible to laryngospasms and GABA powder rubbed on the inside of his cheek during an episode, stops the spasm and stridor (abnormal high-pitched sound) in a matter of 30 seconds. Prior to a recent surgical procedure, he discussed this with his surgeon and anesthetist. We were both pleasantly surprised that they were both interested and open to having him take GABA with him into surgery.

GABA for anxiety, stress, muscle spasms and pain too

I shared this excerpt in a recent blog but it’s worth sharing again: a number of studies have shown that “GABA is implicated in a large number of diseases including anxiety and stress disorders, pain, musculoskeletal disorders, sleep disorders, depression, addiction and withdrawal syndromes.”

Let’s consider GABA (and theanine) during the often stressful and anxiety-provoking periods leading up to surgery and on the day of surgery. It’s likely to help with muscle spasms, pain reduction and sleep too.

A few GABA product options – a sublingual, a powder and a cream

The authors had the study participants use 500 mg GABA, swallowed. As I mentioned above, using a lower dose sublingually may be as effective or possibly even more effective. Also, dosing of GABA (and other amino acids) is individualized to the unique needs of the person.

One product I use and recommend is Source Naturals GABA Calm lozenges. It’s a good low dose of 125 mg and is convenient and effective because it’s a sublingual lozenge.

Now GABA Powder is another product I use and recommend. It does need to be measured out to provide a 125 mg typical starting dose. I have clients use a handy mini measuring spoon like this one (my Amazon link) and share more about how to measure out GABA powder on this blog).

For Source Naturals GABA Calm lozenges and Now GABA Powder:

You can purchase these from my online store (Fullscript – only available to US customers – use this link to set up an account).
If you’re not in the US, you can purchase these at iherb (use this link to save 5%).

Somnium GABA Cream is another option that could be considered especially for children and those with special needs. It is available in the US and elsewhere with international shipping. Read more about the product and who else may benefit from using a cream, and grab my coupon code to save 15%.

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 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

I’d love to hear from you – does any of this resonate with you? Do you feel increasingly anxious before surgery and other medical procedures and is GABA and/or theanine part of your calming repertoire?

And have either helped you when experiencing a laryngospasm?

Have you ever discussed either of these two amino acids with your surgeon or anesthetist prior to surgery and were they open?

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 (especially in patients more prone to laryngospasm)?

Feel free to share and ask your questions below.

Berberine in perimenopause and menopause: improving mood, calming the anxious mind, and improving heart health, blood sugar and bone health

May 10, 2024 By Trudy Scott 15 Comments

… Berberine, an isoquinoline alkaloid derived from plants of the generis Berberis, has been recognized as being capable of decreasing oxidative stress, LDL, triglycerides, and insulin resistance and of improving the mood. This review describes the cellular and clinical effects associated with the use of berberine, which suggest that this molecule could be an effective natural supplement to ensure a smooth peri- and postmenopausal transition.

The above is from a paper published in 2015, Potential benefits of berberine in the management of perimenopausal syndrome.

These are just a few of the many benefits of berberine. Other research reports impacts on the microbiome, benefits for bone density and kidney health – all very relevant in perimenopause and menopause.

I feel that berberine may be a nutrient to consider, in addition to dietary changes, stress reduction and lifestyle changes, and targeted individual amino acids. Read on to discover some of the mechanisms and the benefits of using a comprehensive approach, and feedback from folks in the community who are using berberine with success.

Impacts on oxidative stress, blood sugar/insulin resistance, lipids and heart health, and mood

I encourage you to read the full paper in order to get an overview of the impacts on oxidative stress, blood sugar/insulin resistance, lipids and heart health, and mood. Here is a very high level summary:

Estrogen deficiency, increased cardiovascular risk, an “overproduction of reactive oxygen species (ROS)” and reduced nitric oxide (NO) which are important contributing factors when it comes to “menopause-related endothelial dysfunction, atherosclerosis, hypertension, cardiovascular, and renal diseases.” Berberine counters this via various mechanisms.
Type 2 diabetes is higher amongst menopausal women, causing high blood sugar and insulin resistance. This paper shares a study that found berberine “significantly lowered fasting blood glucose (FBG), hemoglobin A1c, triglycerides, and insulin levels in patients with Type 2 diabetes as well as metformin and rosiglitazone.” One way berberine does this is via “increased insulin receptor (InsR) messenger RNA and protein expression.”
“inactivity of LDL receptor (LDLR)” in liver cells leads to higher levels of oxidized LDL, a risk factor for “endothelial dysfunction and atherosclerosis.” One mechanism is that berberine improves LDLR expression and has lipid-lowering activity.
When it comes to mood issues, the increased oxidative stress, immune dysfunction and inflammation play a role because of “interactions between neurotransmitters, neuropeptides, oxidative and nitrosative stress, and cytokines.” Higher levels of inflammatory markers such as interleukin-6 (IL-6), C-reactive protein, interleukin-1-beta (IL-1β), and TNFα “can enter the brain and may cause alterations of the metabolism of serotonin and dopamine.” Berberine helps to counter this inflammatory cascade and “inhibits the expression of MAO” , increasing norepinephrine, serotonin, and dopamine – and improving mood and presumably reducing anxiety too.

Berberine benefits menopause — From: Potential benefits of berberine in the management of perimenopausal syndrome

Feedback from folks in the community

When I shared this research on Facebook I received much in the way of positive results.

Susan shared this: “A functional medicine doctor suggested I take it with every meal. My A1C was not bad, (5.3) but my last level was 4.8. This was over the course of about 1 year.”

Becky shared this: “I used it for about 6 months along with diet changes to drop my A1C. Have been holding steady since with dietary measures alone. I didn’t realize berberine also helped lower LDL. Mine is slightly elevated. Not enough that my traditional MD has called me on it, but I’ve adjusted my diet again and hearing this about berberine I think I’ll try going back on it.”

Liz shared this: “I had gained some caregiver weight so started on berberine twice a day and it was helpful. However my Doc quickly had me switch over to [a combination product with berberine, chromium and alpha lipoic acid] and it’s fabulous! Twice a day and I feel great, my carb cravings are at bay and my bloodwork and overall health has vastly improved in just a few months.”

Marcy shared this: “Yes!! My son had been steadily gaining weight from binge eating and medications. In October 2022 his triglycerides were through the roof and I was so worried about his health. I put him on 500 mg of Berberine twice a day. Fast forward to today, he has lost approximately 50 pounds and his triglycerides are normal. There were other factors that may have contributed to the weight loss such as therapy and more structured eating times, but I absolutely believe the Berberine supported all this!” (this was also a combination product with berberine and a small amount of alpha lipoic acid and grape seed extract)

Marcia shared this: “I’ve used Berberine for appetite suppression, which it seems to help with, though not enough for me to lose any weight. But it did also actually lift my mood, which I was not expecting.”

Berberine: the microbiota, the gut-brain connection and anxiety

The number of studies on berberine is impressive and growing by the day. It’s not discussed in the above paper, but this paper, Effects of Berberine on the Gastrointestinal Microbiota states this: “The mechanism underlying the role of berberine in lipid‐lowering and insulin resistance is incompletely understood, but one of the possible mechanisms is related to its effect on the gastrointestinal microbiota.” Given what we know about the gut-brain connection, this is another likely mechanism for mood and anxiety benefits.

In another paper, Berberine ameliorates ovariectomy-induced anxiety-like behaviors by enrichment in equol generating gut microbiota, the authors propose that the use of berberine “modulates the gut microbiota, stimulates equol production, and improves anxiety-like symptoms” … “suggesting a direct link between gut microbiota modulation and estrogen deficiency-induced anxiety.”

Berberine: osteoporosis and the kidneys

An osteoporosis study shows that berberine regulates “the estrogen and thyroid hormone signaling pathways to treat osteoporosis in a multi-target, multi-pathway, and multi-system manner.”

And berberine used in conjunction with calcium carbonate and vitamin D, helps to prevent drug-induced bone loss too: “berberine inhibits bone resorption and improves bone formation to prevent glucocorticoid-induced osteoporosis.” I’d be considering vitamin K and other approaches like working towards optimal homocysteine, addressing food sensitivities, addressing possible oxalate and gallbladder issues too. The latter are more common during and after perimenopause.

Interestingly berberine also improves kidney health. One study reports that berberine “significantly ameliorated chronic kidney disease by altering the composition of the gut microbiota and inhibiting the production of gut-derived uremic toxins.”

A comprehensive approach that includes amino acids

As I mentioned above, I feel that berberine may be a nutrient to consider, in addition to dietary changes, stress reduction and lifestyle changes, and targeted individual amino acids. Berberine is relatively new to me and not covered in my book “The Antianxiety Food Solution” but it’s a great resource for the rest.

Here are are few blog posts specific to amino acids in perimenopause and menopause:

The good news is that the amino acids provide immediate relief while the berberine is slower-acting and starting to have an impact.

Product recommendation: Thorne Berberine

There are many good berberine products available. I did some reading and research and landed on Thorne Berberine.

It is available from my online store (Fullscript – only available to US customers – use this link to set up an account) and it’s available via iherb (use this link to save 5%).

If you’re new to berberine, be sure to discuss the research and if it may be something to consider with your practitioner.

Additional resources when you are new to using amino acids as supplements

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

If, after reading this blog and my book, you don’t feel comfortable figuring things out on your own (i.e. doing the symptoms questionnaire and respective amino acids trials), a good place to get help is the GABA QuickStart Program (if you have low GABA symptoms too). This is a paid online/virtual group program where you get my guidance and community support.

Wrapping up and your feedback

I do always appreciate feedback from the community and being able to share it on the blog.

Now I’d love to hear from you – have you used berberine with success? How much have you used, which product and how has it helped?

Were you aware of all these benefits?

Have you also used amino acids and dietary approaches as you start to see hormonal shifts?

If you’re a practitioner do you berberine with your clients/patients?

And please let me know if it’s helpful that I’m now including product recommendations and where to get them.

Feel free to share and ask your questions below.

How to use GABA cream for a 9 year old boy who is anxious, has sensory issues, is a picky eater and has anger outbursts?

May 3, 2024 By Trudy Scott 8 Comments

Devon is looking for input on using a GABA cream product to help her anxious 9-year old son who has some anger and sensory issues. She’d like advice on timing too. He is a picky eater and doesn’t like GABA Calm. I share my insights about using GABA cream for raising levels of GABA (a calming neurotransmitter), some of the GABA sensory connections, the GABA anger connections and other factors to address (nutritional imbalances, diet and infections).

Here is her question and some additional background information from our online discussion:

My son has SPD/GAD (sensory processing disorder/generalized anxiety disorder). His anxiety is causing school refusal and a lot of angry outbursts. I suspect PANDAS but his primary care doctor doesn’t think he has that (I might try a different path).

He doesn’t have a problem with sleep, it is mostly anxiety/anger in the day. I am wondering if he can use this GABA cream during the day vs at night?Or would applying this at night help him through the day?

I am really hopeful that the GABA cream will help him attain a little more peace in his days.

Devon doesn’t recall if ARFID (Avoidant restrictive food intake disorder) was part of his diagnosis but he is a picky eater and

has a carb heavy diet that centers only around certain foods. He recently added corn on the cob and artichokes.

He has tried GABA here and there but can’t get past the flavor of the chewable so has never taken it consistently.

Any thoughts on this would be great. I have learned so much from your blog. Thank you for all of the info you share.

Using GABA cream for a child with these symptoms

Devon asked this question on the Somnium Nighttime GABA Cream blog where I write about using it for insomnia, anxiety, bloated belly, muscle spasms, MS (multiple sclerosis), ARFID, anorexia, Alzheimer’s and autism.

I shared that I’ve had many parents use GABA cream during the day with success to help with anxious feelings their children are experiencing. With sleep not being an issue for her son I would start really low and increase the amount and timing from there based on symptom resolution. A pea-size amount is recommended and I’d start with a 1/4 of this in the morning before school when the symptoms are causing school refusal.

Devon doesn’t mention if they noticed benefits with GABA Calm but we use sublingual /powder/liposomal GABA in a similar way. So when this has helped in the past it’s a good clue that GABA cream will help.

Sublingual /powder/ liposomal GABA is typically used morning, mid-morning, mid-afternoon, evening and during the night if needed. Similar timing can be followed with the cream, however, for some children (and adults) just once a day may be enough with additional use based on the situation, for example anger outbursts at a play date. The key to use is to start low and go slow and figure out what works for each child’s unique needs. More severe symptoms don’t necessarily mean more GABA is needed. The other key is consistency in order to increase GABA levels.

It can be applied behind the ears, inner forearm and belly but keep in mind that mom or the caregiver applying it will be getting a dose of GABA too.

A clue that too much is being used is increased sleepiness. If benefits are seen but the child is too sleepy another option is to use it at night and observe if benefits are carried through to the next day.

The GABA research: autism, social impairment and sensory issues

In this paper looking at autistic children, the authors report “increased cerebellar glutamate levels compared to neurotypical children” which means lower GABA levels. They also found that “altered excitatory/inhibitory signaling in the cerebellum was more clear-cut when analyses were restricted to male participants.” And this altered signaling of GABA/glutamate correlated with “more severe social impairment” in males.

This paper looking at adults with autism highlights the relationships “between sensory processing difficulties, loneliness, and anxiety.” And another study identifies “reduced inhibitory neurotransmission (reduced GABA) in a higher-order motor area, which modulates motor commands and integrates multiple sensory modalities” and “may underlie sensory hyper-responsiveness in ASD (autism spectrum disorder).”

Although Devon’s son hasn’t been diagnosed with autism, many of the studies have been done in this population and much can be gleaned from them.

There is also much clinical evidence supporting how GABA can help in situations like this and it’s not only in boys. This blog is just one example that highlights how GABA Calm helped a young girl improve her sleep issues, anxiety feelings and sensorimotor skills.

Picky eating, carb cravings, ARFID and the neurotransmitters

When the picky eating and carb cravings are driven by low GABA and stress/physical anxiety, GABA cream can help reduce those in the same way sublingual GABA does.

Anger is typically associated with low serotonin but can often be low GABA too. More here – GABA helps ease symptoms of anger, rage, and dark moods. I share one paper that reports “Gamma-aminobutyric acid (GABA), the primary inhibitory neurotransmitter, may be critical in the neurochemical control of aggressive behavior.”

I’d also consider low serotonin as a possible contributing factor because other signs are increased anxious feelings, and also late afternoon and evening cravings.

Devon is not sure if ARFID is part of her son’s diagnosis but addressing low serotonin can help if there is an element of fear around eating too. More on ARFID here.

Just like we track his anxious feelings and outburst of anger, tracking his eating is important too. And introducing one amino acid at a time so there is no confusion as to which one is helping which symptoms.

Pyroluria, low zinc, low vitamin B6, low magnesium and dietary factors

Zinc, vitamin B6 and magnesium are needed for neurotransmitter production i.e. to make GABA and serotonin. They are also very common deficiencies and looking at and addressing low levels are important. Zinc also affects appetite and low levels can make sensory issues more severe.

Devon shares that suspects his zinc levels a few years ago were good, based on the liquid zinc test. Levels can change and given her son’s school refusal I’d assess for the social anxiety condition called pyroluria (zinc and vitamin B6 are key). The liquid zinc is also a great way to increase zinc since it tastes like water if you are deficient.

Topical magnesium is an excellent option – as a spray, a roller (she has been using this with him) – or epsom salts baths are another option for increasing magnesium.

As always dietary factors need to be addressed as and when his sensory issues improve: real whole food, quality animal protein (especially at breakfast for blood sugar control), organic fruits and veggies, healthy fats, fermented veggies, gluten-free (and possibly grain-free), sugar-free and caffeine-free. And special diets may need to be considered too – low oxalate, low salicylate, low glutamate and/or low phenol.

PANDAS, Lyme disease and addressing the infection/s

Devon mentions that she suspects PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections) and it’s unfortunate that she is being dismissed but sadly it’s not unusual. It’s important to find a doctor who will support her in getting testing for this and either ruling it out or addressing the infection/s. You can read more about PANDAS and PANS here.

She doesn’t mention Lyme disease but I’m mentioning it because many infections can cause neuropsychiatric symptoms and should be considered.

The good news is that supporting low GABA, low serotonin and other imbalances, does provide much symptom relief. But we always want to get to the root cause as to why there are imbalances.

A topical GABA product: Somnium

Use this link to read more about Somnium and get the coupon code.

Additional resources when you are new to using GABA and other amino acids as supplements

As a reminder, low GABA can cause physical tension, anxious feelings, feelings of panic and problems sleeping, as well as self–medicating with alcohol or carbs to relax or fit in. As always, I use the symptoms questionnaire to figure out if low GABA or other neurotransmitter imbalances may be an issue.

If, after reading this blog and my book, you don’t feel comfortable figuring things out on your own (i.e. doing the symptoms questionnaire and respective amino acids trials), a good place to get help is the GABA QuickStart Program (if you have low GABA symptoms too). This is a paid online/virtual group program where you get my guidance and community support.

Wrapping up and your feedback

I do always appreciate questions like this so keep them coming so I can share and educate further. I will also update this blog once I hear back from Devon. She has purchased Somnium GABA Cream and plans to have her son use it.

And keep in mind, although this blog is specific for sensitive children and teens, it’s applicable to adults and folks who prefer a cream to a supplement.

Now I’d love to hear from you – does your child have low GABA levels and have you considered using a GABA cream?

If you have had success with Somnim please do share how it helps, how much you use and where you apply it?

Have you also addressed other nutritional imbalances, infections and diet?

If you’re a practitioner do you use GABA cream with your clients/patients?

And please let me know if it’s helpful that I’m now including product recommendations and where to get them.

Feel free to share and ask your questions below.

Tryptophan had the added benefit of turning me completely off alcohol when I took it to improve mood and sleep during perimenopause

May 12, 2023 By Trudy Scott 33 Comments

I started taking tryptophan 3 years ago to improve mood and sleep (not recognizing I was in perimenopause which it helped), but had the added benefit of turning me completely off alcohol! Lol. What serendipitous timing! I use amino therapy with pretty much all my perimenopause patients now. Thanks to you and Julia Ross’s work. Forever grateful.

Victoria shared this wonderful feedback about the benefits she experienced with tryptophan on a recent Facebook thread and kindly gave me permission to share.

Self-medicating with wine (and other alcoholic beverages) is common when we are anxious or stressed and typically we use it to wind down at the end of the day and to fit in socially. This is common when GABA levels are low and also happens due to low serotonin which declines from mid-afternoon into the evening.

I asked what she had been drinking and how often? And if it was calming for her? This was her response:

Red wine the minute I walked in the door in the evening. I guess it was calming… maybe more reward driven? It would be my reward for getting home from work via picking kids up from sport and doing a grocery shop and … (fill in the blank) that we working mums do and then having to walk straight into the kitchen to start on dinner.

The wine was like my little treat or reward to motivate me to just keep moving with my chores. No time to sit and unwind, just pour the wine and start chopping! Lol… I had tried to stop before but just couldn’t pick up a knife without the wine glass!

Within days, the tryptophan made the wine taste like cat’s pee! Haven’t touched it since. No desire at all. Almost hypnosis like?

How much tryptophan Victoria used and how did it help her quit?

Victoria used the Now Tryptophan 1000 mg at 3pm and 9pm for about a year, eventually stopping it and saying: “Alcohol still does not interest me at all.”

What wonderful results! A typical starting dose for tryptophan is 500 mg midafternoon and evening and she increased this to find her ideal dose of 1000 mg twice a day. She did report that 5-HTP didn’t work for her the way tryptophan did. This is not unusual as some folks do better with one versus the other.

She has a great explanation regarding how tryptophan helped her quit without having to use willpower. She had no time to sit and unwind ….. so she was experiencing some of the calming aspects of getting serotonin support with the amino acid tryptophan. This is a very common benefit.

Serotonin appears to regulate the secretion of beta-endorphins

It is interesting that Victoria mentions a reward/treat benefit which is often due to low endorphins rather than low serotonin. This paper, Roles of β-Endorphin in Stress, Behavior, Neuroinflammation, and Brain Energy Metabolism, states that β-endorphins, in addition to their “potent analgesic effects” i.e. pain relief (both physical and emotional pain), are also involved in “reward-centric and homeostasis-restoring behaviors.”

However, as stated in this same paper, beta-endorphins play a role in stress-relief (common with working moms like Victoria) and are closely connected with serotonin. In fact “serotonin appears to regulate the secretion of β-endorphins” and vice versa. The body is fascinating and so smart.

Amino acids for alcohol addiction: 5-HTP, DLPA and glutamine

We know that amino acids help with alcohol cravings and addiction and have even been used in inpatient settings. This blog illustrates this well – An amino acid supplement with DLPA, glutamine and 5-HTP (and a few other nutrients) eases alcohol withdrawal symptoms at an inpatient detoxification program.

The study authors state that: “the physiological craving for alcohol may be the result of a deficiency of the naturally occurring opiate like substances as well as other neurochemical deficits (i.e., dopaminergic, GABAergic, and serotonergic).

Both tryptophan and 5-HTP support low serotonin worry-type anxiety, low mood and insomnia. Victoria happened to benefit from tryptophan. Someone else may benefit more from 5-HTP or DLPA or glutamine or a combination as illustrated in the above study. And even GABA, which can help with stress-drinking or stress-eating, as well as physical anxiety.

DPA and DLPA support endorphins and provide the reward/treat benefits from red wine that Victoria mentions. You can read about the difference between DPA and DLPA here.

What if you have afternoon and evening sugar cravings instead of wine?

You may self-medicate with sugar, carbs, gluten, dairy instead of wine. Late afternoon/evening cravings are typically related to low serotonin when there are other low serotonin symptoms like low mood, anxiety, ruminations, worry, insomnia, PMS etc. You can see all the low serotonin symptoms here.

In this case, tryptophan or 5-HTP can be used in a similar way to stop the cravings with no willpower required and no feelings of being deprived. You’ll also experience reduced anxiety, improved mood and better sleep. Read more about this on this blog: Would using 5-HTP or tryptophan help when you crave sugar (as a sort of antidepressant) late afternoon/evening?

Other changes Victoria made and how is she doing now?

Victoria did also share that hot flushes “got me in the end though and I gave in to body identical progesterone for the final year of peri” and takes estradiol transdermally now that she is in menopause. Based on seeing these benefits while in perimenopause, she is now trialing tryptophan again for increased irritability. That is a huge plus with amino acids: once we’ve experienced the benefits, you have them at our disposal again and again in the future as your hormones or situation starts to change.

I love that she now uses tryptophan with her patients. She is a physio/physical therapist and exercise scientist turned Functional Health Practitioner having studied with IFM during the pandemic.

Of course, I thanked her for the kind words and shared how fortunate I was to work in Julia Ross’ clinic for 2 years. I also appreciate her for sharing this feedback and allowing me to share it here as a blog post so you get to learn, be inspired and have hope.

And finally, all this illustrates that there is no one-size-fits-all and we often get unexpected side-benefits when using amino acids.

Tryptophan and 5-HTP product options

Victoria happens to respond well to tryptophan and yet some folks do better with 5-HTP so it’s a matter of doing a trial of each.

Products I recommend include Lidtke 500 mg Tryptophan, and Pure Encapsulations 50 mg 5-HTP. You can purchase these from my online store (Fullscript – only available to US customers – use this link to set up an account).

If you’re not in the US, Doctor’s Best L-Tryptophan 500mg and Source Naturals 50 mg 5-HTP are products I recommend on iherb (use this link to save 5%).

Resources if you are new to using amino acids as supplements

If you are new to using amino acids as supplements, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution (you can see all the symptoms of neurotransmitter imbalances, including low GABA, low serotonin and low endorphins).

There is an entire chapter on the amino acids and they are discussed throughout the book in the sections on gut health, gluten, blood sugar control, sugar cravings, anxiety and mood issues.

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), if you need serotonin support, the Serotonin QuickStart Program is a good place to start. This is a paid online/virtual group program where you get my guidance on using tryptophan and 5-HTP safely, and community support during 5 LIVE Q&A calls. You can sign up to be notified when the next live launch of this program is happening. We take a deep dive into product options including Lidtke products and others if you’re not able to access Lidtke.

Low GABA can also affect sleep and cause stress eating. If you also have low GABA symptoms, the next step to get help is the GABA QuickStart Program. This is also a paid online/virtual group program where you get my guidance and community support. Another option is the budget-friendly GABA QuickStart Homestudy Program.

Wrapping up

Now I’d love to hear from you ….

Has tryptophan helped you quit alcohol easily when you could not do so with willpower alone?

Does tryptophan also help with your low mood, anxiety and sleep issues?

What about 5-HTP (some folks do better on one versus the other)?

And has either tryptophan or 5-HTP helped with other afternoon/evening cravings like sugar and other carbs?

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

How did you come up with the idea of using GABA on the tongue? (GABA is a calming amino acid supplement used to ease physical anxiety symptoms)

May 5, 2023 By Trudy Scott 27 Comments

Today I’m answering this question that has been asked of me a number of times: How did you come up with the idea of using GABA on the tongue? Since there is so much controversy about GABA and the blood brain barrier and whether GABA actually works, it’s time to address this question via a blog post. Using GABA on the tongue, under the tongue and/or on the inside cheek approach is also the most effective way to use GABA and when it’s not used in one of these ways many individuals end up saying GABA didn’t help ease their anxiety and other low GABA symptoms. I also define sublingual – the term I use when discussing this approach – and how this method is broader than just being sublingual. And I share a case study. More on all this below.

So how did I come up with the idea of using GABA on the tongue?

I’ve always had clients use a GABA capsule opened on to their tongue for the initial trial, based on them having low GABA symptoms of physical anxiety, stiff and tense muscles, tension, stress eating, insomnia, laryngospasms, intrusive thoughts and self-medicating with alcohol. Doing it this way means we get results right away (for example within 5 minutes they can say their physical anxiety has improved from 9/10 to say 6/10) and we know how to proceed in terms of dosing.

Then I’d have clients go home and swallow the GABA capsules. However not everyone continued to get the same benefits they experienced in the one-off trial so I’d suggest a higher dose, also swallowed.

Then I decided to have clients just continue to use GABA capsules opened or as powder or a liposomal product (more on these below) after the initial one-off trial. Having clients use GABA this way resulted in consistent and superior results and it’s what I continue to recommend.

The many benefits of this approach

There are many benefits to using this approach of using GABA on the tongue:

Seeing better results and in some cases getting results (fullstop!)when you were not seeing any benefits swallowing a GABA capsule
Better results when you have digestive and/or liver issues because GABA bypasses the liver and digestive system.
Quicker/almost immediate results (in 5-10 minutes and often quicker) which is more encouraging and gives you hope right away.
You need less GABA so it’s money-saving too.

I now have folks use all the amino acids this way and it’s working very well.

Defining sublingual, buccal and roof of the mouth and which is best

I use the term sublingual very broadly – under the tongue, in the cheek or on the tongue – for at least 2 minutes and not washed down with water or food right away.

It’s easier but technically sublingual means using GABA under the tongue. This way it is absorbed directly into the bloodstream for immediate use, bypassing the liver and digestive system.

When I talk and write about using GABA on the tongue or sublingually, I’m often asked: How is on tongue vs under tongue different or is it?

This paper, Sublingual Mucosa as a Route for Systemic Drug Delivery summarizes the benefits of sublingual delivery and which area of the mouth provides better results (for drug delivery)

Drug delivery via the oral mucous membrane is considered to be a promising alternative to the oral route. Sublingual route is useful when rapid onset of action is desired with better patient compliance than orally ingested tablets.

In terms of permeability, the sublingual area of the oral cavity (i.e. the floor of the mouth) is more permeable than the buccal (cheek) area, which in turn is more permeable than the palatal (roof of the mouth) area.

The portion of drug absorbed through the sublingual blood vessels bypasses the hepatic first‐pass metabolic processes giving acceptable bioavailability.

I find that either way works (under and on the tongue) and so does using it rubbed on the inside of the cheek/buccal area. I share more on that here – Paroxysmal laryngospasm with low GABA physical-tension-type-anxiety: Is GABA powder rubbed on the inside of the cheek a solution?

One way you could hedge your bets is to use a GABA powder (with some water) or lozenge or liposomal and swish it in the mouth, making sure it gets under the tongue, onto the cheek areas and on top of the tongue. Swish it for about 2 minutes before swallowing. And don’t wash it down with water or food right away.

Amanda’s feedback on GABA calm vs GABA capsules

When I shared some of this on Facebook, Amanda shared her positive feedback:

Sublingual is more effective and faster. I’ve been taking capsules at night and noticed improvement with sleep. Last week we decided to sell our house and I was soooo stressed with prepping and dealing with people.

I had a bottle of GABA Calm I ordered from your recommendation (I didn’t mean to order because I had lots of gaba capsules). I was so thankful because I took two of those and about 15 minutes later I was much more relaxed. They are so helpful!!

A common question I get is this: is GABA Calm better than plain GABA powder? Some folks prefer GABA Calm and others the powder. Either way we do increase to find the ideal dose and using powder allows us to go higher more easily.

But we are all unique and it’s a matter of finding what works best for your needs. Amanda also shared why she feels GABA Calm is so helpful:

GABA Calm also has tyrosine, magnesium, and taurine. It seems for me the combination of the magnesium and taurine with the GABA takes it from helpful to stellar. I know I have a history of low taurine so perhaps that’s why for me.

All this and the fact that it’s a lozenge that is dissolved in your mouth and absorbed quickly makes it so effective for her and so many of my clients.

Resources if you are new to using amino acids as supplements

There is an entire chapter on the amino acids and they are discussed throughout the book in the sections on gut health, gluten, blood sugar control, sugar cravings, anxiety and mood issues.

If, after reading this blog and my book, you don’t feel comfortable figuring things out on your own (i.e. doing the symptoms questionnaire and respective amino acids trials), a good place to get help is the GABA QuickStart Program (if you have low GABA symptoms too). This is a paid online/virtual group program where you get my guidance and community support.

What have you found, is GABA opened/sublingual more effective than a GABA capsule swallowed?

What works best for your unique needs – a powder, a chewable or a liposomal product?

And do you find it more effective under the tongue/sublingual, in the cheek/buccal or on the tongue? Or have you not noticed or perhaps find similar benefits with all three ways?

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

GABA Oolong tea in children with autism: improvements in sensorimotor skills, autism profiles, anxiety and sleep (new research)

December 2, 2022 By Trudy Scott 14 Comments

A small feasibility study, A double-blind, placebo-controlled, randomised-designed GABA tea study in children diagnosed with autism spectrum conditions, explored the effect of drinking GABA Oolong tea on sensorimotor skills, autism profiles, anxieties and sleep of children with autism.

It was a very small study with nine children (5 male and 4 female) but the results were very promising… “significant improvement in manual dexterity and some large individual improvements in balance, sensory responsivity, DSM-5 criteria and cortisol levels with GABA tea.”

In addition to reducing anxiety (in all but one participant – more on that below), the paper lists the following additional information related to sensory issues, cortisol levels and sleep:

Results also demonstrated that sensory responsivity improved in two-thirds of the participants and autism symptomology decreased in over half, with four of these individuals being positively re-classified on the DSM-5 scale
Differences between evening and morning cortisol levels, deemed the ‘carryover’ effect and cortisol awakening levels were also decreased in over two thirds of the participants, which we attribute to a reduction in stress response which may have helped to reduce sensorimotor responsivity in individuals with autism.
Contrary to our hypotheses, GABA Oolong tea did not appear to impact sleep, with no discernible differences noted in a range of sleep parameters compared with the placebo, despite parents’ subjective reports that their children appeared to sleep more deeply.

They conclude as follows … “These results suggest that sensorimotor abilities, anxiety levels and DSM-5 symptomology of children with autism can benefit from the administration of GABA in the form of Oolong tea.”

What is GABA Oolong tea?

When I shared this study and results on Facebook, I had a few people ask if they could simply add the amino acid GABA to their Oolong tea: “Is it just brewed tea with GABA powder added? Or does someone make a specific tea? I can totally add some GABA to my daily tea.”

It’s not regular oolong tea with GABA added, instead it’s specially fermented to increase GABA levels naturally. Amber GABA Oolong tea by Meileaf is the actual tea used in the study and they share this on the product page.

The farmers achieve this by alternating the leaves between air and a nitrogen rich environment (with no air) during the oxidation phase. This is done over a matter of hours and naturally increases the GABA levels in the tea leaves.

They also share this: “In order to be called GABA tea, the leaves must contain at least 150 mg of GABA per 100g (normal oolong has about 6 mg so that is 25 times higher).”

GABA Oolong tea does also contain theanine, caffeine and epigallocatechin gallate. There is a large part of the study dedicated to theanine so feel free to read that at your leisure.

How much GABA was ingested by study participants?

It was a surprisingly low dose of GABA! They were given 4 cups a day of the GABA Oolong tea and this provided a total of 39.2mg GABA for the day. The authors share this about the amount of daily GABA the study participants received:

With the GABA Oolong tea the dose would be approximately 280 mg per 100 g tea. Based on using 3.5 g per tea portion this equates to 9.8 mg of GABA; multiplied by 4 throughout the day, being 39.2 mg of GABA.

I’ve reached out to confirm which tea was used in the study since Meileaf mentions that this tea contains 205 mg of GABA per 100 g whereas the study states there was 280 mg GABA per 100 g tea. I see consistency with assessing GABA levels accurately being a possible issue (more on that below).

One of the first questions I had was how could such a small amount – 39.2 mg GABA for the day – be so effective? I typically have clients start with 125 mg GABA and they may end up using this dose 3 or 4 x day (so 375 to 500 mg GABA total for the day.)

That said, we are all unique and as I’ve shared, there can be an extremely large variation in dosing. In this blog I share how Syd gets sleep and body anxiety benefits with just 1.5 mg to 3 mg GABA and yet Christina’s agoraphobic client was able to leave the house with 3000 mg GABA.

My other questions: the placebo, caffeine, a histamine reaction, low cortisol and B1 depletion

With new research there are always many factors to consider and I have a number of other questions I’d love to see addressed:

Why did the placebo tea also contain GABA? It had 22.2 mg per day of GABA – about half that found in the GABA Oolong tea.
GABA Oolong tea does contain small amounts of caffeine and how would this affect susceptible individuals? One child was more anxious – was it due to caffeine or was it too much GABA for his needs or a histamine reaction due to the fermentation process (or something else)?
Do we need to be concerned about long term use and depletion of vitamin B1/thiamine which happens with regular tea.
And what about the effects if someone already has low cortisol levels?
Will there be standard levels and accurate measures of GABA in the various GABA Oolong teas that we can rely on? This applies to consumers and practitioners wanting to try this approach and for ongoing research.
How much of the effect was also due to addressing dehydration and helping with dietary oxalate issues which are known to be common in autism?

Hopefully new ongoing research with more participants will shed light on some of these questions.

I’d also love to see head to head research comparing GABA Oolong tea with supplementation of the amino acid GABA, and a study where both are used for possible synergistic effects.

I do appreciate that the authors attempt to address the GABA blood brain barrier (BBB) debate and how GABA could work, focusing on a permeable blood brain barrier in epilepsy and increased epilepsy in autism. This angle is new to me. I’ve addressed the leaky BBB at length here in my interview with Dr. Kharrazian (it’s a theory) and one of my interviews on a prior Anxiety Summit (there are many possible mechanisms and the peripheral effects).

If you’re new to symptoms of low GABA (and cases highlighting the calming effects of the amino acid GABA used as as a supplement)

GABA (gamma aminobutyric acid) is a calming neurotransmitter and the calming amino acid GABA used as a supplement can raise GABA levels. With low GABA levels you’ll feel a physical-tension and stiff-and-tense-muscles type of anxiety.

The other symptoms we see with low GABA are panic attacks, physical tension in certain settings like public speaking or driving, and the need to self-medicate to calm down, often with alcohol but sometimes with carbs and sugary foods. Insomnia can also be due to low GABA and you’ll experience physical tension (rather than the ruminating thoughts which is the low serotonin type of insomnia – although it’s not uncommon to experience both). GABA also helps with muscle spasms and pain relief when muscles are tight.

Here are are some case studies where you can read about the calming effects (and other benefits) of the amino acid GABA used as as a supplement:

Resources if you are new to using GABA and other amino acids as supplements

If you are new to using GABA or any of the other amino acids as supplements, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution (you can see all the symptoms of neurotransmitter imbalances, including low GABA and low serotonin).

There is an entire chapter on the amino acids and they are discussed throughout the book in the sections on gut health, gluten, blood sugar control, sugar cravings, self-medicating with alcohol and more.

Have you used GABA Oolong tea with clients/patients or personally? How much and what benefits have you seen? Which product have you used?

If you’ve also used the amino acid GABA sublingually and with success, I’d love to hear how much (and which product) and how it compares with GABA Oolong tea for anxiety, insomnia, sensorimotor skills and/or autism symptoms (as applicable to you, your child or other family member and/or your client/patient)?

If you have questions please share them here too.