choking

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

December 25, 2020 By Trudy Scott 34 Comments

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.

GABA is the answer after 40 years of a lump-in-the-throat sensation, nervousness and muscle tension at work

November 20, 2020 By Trudy Scott 18 Comments

Earlier this year, I published a blog post on the sensation of having a lump in the throat when you feel anxious. It’s called globus pharyngeus which is defined as “the painless sensation of a lump in the throat and may be described as a foreign body sensation, a tightening or choking feeling.”

Globus means globe/sphere and it can actually feel like you have a golf-ball sized object in your throat. It’s very uncomfortable and quite terrifying outside of the anxiety that is often the trigger. I share my lump-in-the-throat story and my success with GABA in this blog: Anxiety and globus pharyngeus (lump in the throat): GABA to the rescue?

Pam recently shared her wonderful success with GABA on the above blog, after having dealt with what she calls “her throat thing” for 40 years!

I have dealt with this throat thing since I was a teenager. I’m now 57. It was only when I saw what you wrote about how yours came back after a scary airplane incident that I made the connection that GABA could help me. I saw that in the summer of 2019, so I spent about 40 years dealing with this until I found the GABA answer!

Mine comes up when speaking in front of others, such as work meetings, or even just one-on-one work discussions, and it was getting consistently worse. I would be swallowing constantly and trying to talk. Absolutely awful. Of course everyone could see it happening.

GABA solved this for me, and I can’t even describe how grateful I am!

How wonderful are these results! I am so happy for her and thanked her for coming back and sharing in the comments. I also asked some follow-up questions so I can continue to learn and so I can share so you get to learn too:

How much GABA helps and how do you take it (when you know you’ll be in this situation or a few times a day to get your levels up)?
Did you ever use a prescribed medication or were recommended something?
Have you seen any other benefits from using GABA – improved sleep, reduced anxiety in other situations, reduced cravings?
Have you made other changes too – like dietary changes such as gluten/sugar/caffeine/alcohol removal?

She shared this about timing and how GABA helps with anxiety-related physical/muscle tension and nervousness:

I take GABA Calm … one upon waking, 1 mid-morning, and 1 mid- afternoon. I take an extra one right at the time of a meeting.

That is the only change I made. I’ve never been on any prescription medication.

Other than the specific throat issue, I notice I’m generally less physically tense, with muscles not getting so knotted up in my face, scalp, neck, shoulders, and back, which is wonderful.

I work at a computer job, which causes lots of muscle tension, but I feel that anxiety-related muscle tension has reduced.

I notice that my muscles have less of that “immediate tightness” upon seeing someone whom I’m nervous to interact with.

This timing and dosage of GABA Calm is typically what I use with clients and what works so it was great to hear that it’s working for her. I was also so pleased to hear the anxiety-related muscle tension and nervousness has reduced too. This is also to be expected.

I did remind her to keep in mind that the amino acids are intended for short-term use. This could be a few weeks up to 6-12 months depending on each person. While using the GABA, I have my clients start to address all the dietary changes, gut health, nutritional deficiencies (zinc and B6 are needed to make neurotransmitters and key with pyroluria), toxin exposure (like BPA, phthalates, pesticides, fluoride etc), infections (like Lyme and co-infections, parasites, PANDAS/PANS) etc. and everything else that may be causing low GABA levels (as we covered in The Anxiety Summit 6).

Vagus nerve support is also key. I cover what I did for my vagus nerve in this blog that Pam referred to: Vagus nerve rehab with GABA, breathing, humming, gargling and key nutrients

Globus pharyngeus or this sensation of the-lump-in-the throat is way more common than most people realize and mainstream medicine seldom has a solution. Medications that are commonly prescribed for globus pharyngeus are benzodiazepines, antidepressants/SSRIs and sometimes PPIs/proton pump inhibitors. Cognitive behavior therapy has some success in some instances but it’s always best to get to the root cause of low GABA and address that with the amino acid GABA. And then figure out why GABA is low and address that too.

If you’re new to the amino acids here is a quick summary about 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. I propose that low GABA may be one possible root cause of globus pharyngeus.

I appreciate Pam for sharing her story and I’m sharing it here in order to give you practical solutions and hope. If she can find a solution to her 40-year the-lump-in-the throat and physical tension issues then anything is possible.

Please also share your lump-in-the-throat story and what has helped you. Or if you’re a practitioner, do share how you have helped your clients/patients who experienced this sensation.

Feel free to post your questions here too.

Anxiety and globus pharyngeus (lump in the throat): GABA to the rescue?

July 3, 2020 By Trudy Scott 57 Comments

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. Today you’ll read how low GABA may be one possible root cause of globus pharyngeus, which you may have experienced as a rather scary golf-ball-like lump or constriction in the throat.

Let me describe globus pharyngeus and then I’ll share my story with globus pharyngeus, why low GABA may be a factor (and supplemental sublingual GABA to the rescue) and other possible root causes that should be considered.

This 2015 paper, Globus pharyngeus: an update for general practice, defines it as follows:

Globus pharyngeus or globus sensation is the painless sensation of a lump in the throat and may be described as a foreign body sensation, a tightening or choking feeling.

Globus means globe or sphere and it can actually feel like you have a golf-ball sized object in your throat.

You may have experienced it without even knowing the medical name. Only a few of my clients and those in my community have ever heard the term. I also only learned about the name many years after my episode.

What is very surprising is that, according to the above paper, up to 45% of the population have experienced it.

My story with globus pharyngeus

I’m one of the 45% and for me it was a terrifying experience. As you may know, I experienced anxiety, PMS, fears and panic attacks in my late 30s and early 40s (it’s why I do this work).

Fortunately I only had one episode. It truly felt like I had a golf-ball in my throat and was horrifying. I knew I needed to swallow so I could get rid of this obstruction but at the same time I was terrified to swallow in case it got stuck and choked and killed me.

I remember going to the mirror to try and see this golf-ball sized object in my throat. I was so surprised that I couldn’t see anything.

Looking back, I suspect the addition of GABA Calm to my protocol prevented further episodes. I was also using progesterone cream at the time and this promotes GABA production too.

I’ve had many clients report that looking back they also realized their episodes stopped once they addressed their low GABA levels.

I was also under a great deal of stress at the time: work stress (long hours and my adrenals were a mess) and physical stress (due to amalgam removal, gluten issues, perimenopausal changes and much more).

Globus pharyngeus and GABA

The fact that the throat or pharynx “is a muscular tube that runs from the back of your nose down into your neck” is one reason for considering a muscle spasm and low GABA as a root cause.

The amino acid GABA, when used sublingually, eases muscle spasms within 15 seconds to 2 minutes. Some examples where we see this:

If you’re in the midst of an episode it’s impossible to open a capsule of GABA into your mouth. Until a client knows how much they can tolerate we start with 100-125 mg and increased based on the trial. Taking the powder and dabbing it with a wet finger and putting the finger to the inside cheek a few times is the best way for quick relief.

A product that is GABA-only in a capsule such as Enzymatic Therapy GABA or ProThera 500mg GABA are my choices for in-the moment relief (more on these in my supplement store here).

Source Naturals GABA Calm is my most popular GABA product and is my choice for everyday use.

Of course, I recommend this approach to doing nothing. The authors state: “simple reassurance may be all that is required” or “Advise patients to resist the urge to dry swallow.” We can do better.

Once your GABA levels are sufficient, it’s less likely to happen unless you’re under a great deal of stress and/or there are psychological factors at play:

There is increased reporting of stressful life events prior to development of symptoms and research suggests that as many as 96% of patients with globus sensation report an exacerbation of symptoms during times of emotional intensity.

During times of added stress, folks may experience other “physical symptoms such as palpitations, poor sleep, and feelings of panic.”