If you get a painful side stitch when running or doing other exercise or experienced a side stitch when you were a kid, you may be as intrigued as I was to learn there is new research that points to an anxiety/stress connection. This cross-sectional observational study was done involving an anonymous survey of one hundred sixty-eight male and female adults who were running at least 10 miles/16 km per week.
The conclusion of this study, Thorn in Your Side or Thorn in Your Head? Anxiety and Stress as Correlates of Exercise-Related Transient Abdominal Pain, is as follows: “anxiety and stress are associated with the presence of ETAP.” A runner’s side stitch is referred to as ETAP i.e. exercise-related transient abdominal pain. The authors mention the fact that this is the first study to reveal this anxiety/stress connection. This is relevant given the numerous recent studies looking for a cause and no definitive solutions.
This research is also really intriguing to me given what Dr. Carl Pfeiffer MD, PhD, identified 50+ years ago in the 1970s i.e. side stitches are common in those with pyroluria/social anxiety. What’s important is the fact that the pyroluria nutrient protocol eases social anxiety and prevents side stitches in my clients. You’ll read feedback from individuals in the community who resonate with this research and the pyroluria connections. I share more about pyroluria below in case it’s new to you and a possible cause of the side stitch pain.
My feedback and feedback from others in the community
I have pyroluria and always got a left side stitch as a kid, in my teens when running and playing squash and in my 20s/30s when running. And then they stopped (and the social anxiety and related symptoms resolved) when I addressed my pyroluria with zinc, B6 and EPO, and a copper-free multi that contains manganese. I see these kinds of results with my clients all the time so a light-bulb went off when I read this new research .
I shared this research and the anxiety/stress/pyroluria connection on Facebook and asked: did you/do you get side stitches when running/exercising? Here is some of the feedback I received, where the pyroluria protocol did help.
Kameka shared this: “I had side stitches as a kid and as an adult. Running was the main exercise that caused it and it was usually the left side. Now that you mention it, I haven’t had them since I started supplementing for pyroluria. Also, my social anxiety is sooo much better as well!”
She did the symptoms questionnaire and the pyroluria urine test (which can give false negative results) and confirmed she takes vitamin B6, zinc, magnesium, and primrose oil.
Bec shared this: “I hated PE at high school for that reason. While everyone was running, I was suffering from side stitches (I think it was my right side) and having breaks. I have pyroluria with lots of symptoms. I do well with zinc and P5P.”
Not everyone reported an improvement with the protocol but many folks resonated with the side stitch/pyroluria connections:
Megan said: “Couldn’t run as a kid. A stitch every time. I can’t recall which side, never really paid too much attention. Looking at the pyroluria symptoms, I think I may have always had it.”
Janie exclaimed: “Oh, boy, did I!” (while distance running). She finds it hard to remember but thinks it may have been on her right side. She also shared that “tests for zinc come back normal, but I have many of the [pyroluria] symptoms, especially the less common ones. I scored high. I always want breakfast but all the other questions fit me like a glove, like pieces of a puzzle with my photo on the box.
My lack of dream recall is another sign. I take 25 mg of methylated B6, but still no dreams. The question regarding being seated in the middle of a restaurant…THAT IS ME!! My throat will feel like it’s closing up, so much tension.”
I explained that most zinc testing is not accurate and that we increase until we get symptom resolution. I also referred her to the pyroluria chapter in my book.
Susie shared this: “Yes I always got side stitches so I gave up running. I suspected pyroluria but not sure if I have it.”
Leah said “I’d say my daughter and I both [had side stitches] more when we were younger. Both socially anxious and pyroluria. Less exercising now too.”
Information if you’re new to pyroluria
Pyroluria is frequently associated with a type of anxiety characterized by social anxiety, avoidance of crowds, a feeling of inner tension, and bouts of depression. People with this problem experience varying degrees of anxiety or fear, often starting in childhood, but they usually manage to cover it up and push through. They tend to build their life around one person, become more of a loner over time, have difficulty handling stress or change, and have heightened anxiety symptoms when under more stress.
Also on the list of symptoms is this one: “Upper abdominal pain on your left side under the ribs or, as a child, having a stitch in your side as you ran.”
Addressing low levels of the mineral zinc and vitamin B6, together with some other nutrients and stress management, are key to addressing these symptoms.
Here is the complete symptoms questionnaire on the blog. This questionnaire can also be found in the pyroluria chapter in my book, The Antianxiety Food Solution. You’ll find the detailed supplement protocol and additional information on how to assess for low zinc and low vitamin B6 in this chapter too.
You can read more about the prevalence and associated conditions here. It’s most often considered a genetic condition but is possibly environmentally triggered too.
There are many pyroluria blog posts where I cover various aspects such as the importance of addressing pyroluria for recovery from MCAS and Lyme, pyroluria and Ehlers Danlos Syndrome, pyroluria and intrusive thoughts and many more. I encourage you to use the search feature on the blog.
A possible cause of the side stitch in pyroluria
Here is an excerpt from a paper published in 1974 by Dr. Pfeiffer and colleagues, Treatment of Pyroluric Schizophrenia Malvaria With Large Doses of Pyridoxine and zinc, describing why the side pain probably occurs:
This 15-year-old upper middle-class patient (now 19 after studying for four years) represents a case of nutrient deficiency in which vitamins (specifically B6) and the trace minerals manganese and zinc were inadequate for the development of normal knee joints and normal brain function.
The deficiency was sufficiently severe at its peak to cause prolonged psychosis, atypical seizures, arthritis, amenorrhea, constipation, and splenic pain. The pain is probably due to hemolytic crisis in which red cell fragments engorge the Kupfer cells of the spleen and liver, extend the capsule, and cause pain. The double deficiency is produced by the formation of KP [kryptopyrroles] which combines with pyridoxal and zinc.
Based on the above and other publications by Dr. Pfeiffer, when the stitch happens on the left side, my understanding is that the pain is in the spleen. And when it happens on the right side, the pain is in the liver area. Most individuals with pyroluria say they felt/feel their side stitch on the left side. Either way it appears to be caused by low zinc, low vitamin B6 and the other nutrients needed by those with pyroluria. And resolved when on the pyroluria protocol.
I would love to see these ETAP researchers take their anxiety/stress research one step further and identify how common pyroluria is in runners who get side stitches and if the pyroluria protocol prevents the side stitches.
My book as a resource and pyroluria supplements
As mentioned above, there is an entire chapter on pyroluria in 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 addressing these deficiencies. And be sure to share it with the practitioner/health team you or your loved one is working with.
Keep in mind that these nutrients are cofactors for making neurotransmitters and are a key part of my protocol when working with individual amino acids.
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 pyroluria supplements and amino acids that I use with my individual clients and those in my group programs. You can find them all in my online store.
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 and pyroluria protocol.
Thanks to everyone who contributed to the discussion on Facebook. Now I would love to hear from you so I can approach the authors with their feedback and yours too.
Did you get a side stitch as a kid and did it affect your ability to take part in school sports?
Do you still get a side stitch when running or doing other exercises? If yes, does it hold you back and with which exercise?
Did/does the side stitch occur on the left or right side?
And do you have pyroluria? (based on the symptoms questionnaire and/or pyroluria urine test)?
Does the pyroluria protocol prevent your painful side stitches? And had you made the connection to pyroluria/anxiety/stress?
Are you seeing a similar pattern with your kid/s? (pyroluria, side stitch and the protocol helps them too)
If you have questions and feedback please share them here too.
