cortisol

Waking with a jolt, feeling shaky and anxious: low blood sugar/hypoglycemia, glutamine and eating for blood sugar stability

February 2, 2024 By Trudy Scott 22 Comments

Low blood sugar is one of a number of causes of waking in the night or early hours, often with a jolt and feelings of anxiety or feeling like you’re having a panic attack. As shared in a recent blog post, cortisol that is high at night can cause very similar symptoms.

Because of a low blood sugar question on the high cortisol blog, today I’m explaining the very different solutions to each root cause: glutamine and eating for blood sugar stability when you have low blood sugar versus Seriphos when you have high cortisol.

Katherine shares that she has low cortisol and suspects hypoglycemia or low blood sugar, and is hesitant about using Seriphos:

My last 4 point cortisol test showed mine is low throughout the day. But I’m having episodes where I’m waking up in the mornings feeling a jolt (every time I wake up from sleeping) and sometimes also shaky and anxious.

A functional pharmacist suggested my blood sugar may be dropping during the night and hypoglycemia could cause an adrenaline surge.

I don’t know. I’m nervous to try something [such as Seriphos] to lower cortisol when it seems mine is already too low.

I agree with her functional pharmacist that hypoglycemia is likely a factor as it often is with adrenal dysfunction and low cortisol. And I am glad Katherine is being cautious about using Seriphos.

I shared that Seriphos is not the solution in this instance because she doesn’t have high cortisol based on her adrenal saliva test (4 collections). Instead, she has low cortisol throughout the day and using Seriphos would lower her cortisol even further. What many folks don’t realize is that high cortisol and low cortisol can lead to similar symptoms of anxiety, shakiness and waking in the night and early hours.

The good news is it’s relatively easy to figure out if low blood sugar is causing your symptoms. First I have clients rate their symptoms on the low blood sugar questionnaire and do a trial of glutamine. Next is figuring out the dosing and timing of glutamine, looking at a current food log and making dietary changes as needed.

If Katherine notices improvements – typically seen within a week – it’s very likely that hypoglycemia is a factor.

Finally, if additional support is needed for her anxiety I’d consider looking at low GABA and low serotonin symptoms and doing a trial of GABA and/or tryptophan.

Longer term solutions include all the dietary changes mentioned in my book – gluten-free, no sugar, no caffeine or alcohol, using nutritional support for the adrenals and addressing toxins, infections, trauma etc.

Low blood sugar symptoms

First I have clients rate their symptoms on the low blood sugar questionnaire and do a trial of glutamine if they have low blood sugar symptoms.

Here are the low blood sugar symptoms which are rated on a scale of 1 to 10, with 10 being most severe:

Crave sugar, starch or alcohol any time during the day
Irritable, shaky, headachey – especially if too long between meals
Intense cravings for sweets
Lightheaded if meals are missed
Eating relieves fatigue
Agitated, easily upset, nervous
Waking in the night or early hours with a jolt of anxiety/shakiness

If the ratings indicate the possibility of low blood sugar i.e. any cluster of the above symptoms, we do a trial of the amino acid glutamine on the tongue and record before and after ratings of a few symptoms.

Glutamine is a key amino acid for blood sugar stability and helps quickly while the adrenals heal and the dietary changes are figured out.

Glutamine for low blood sugar: dosing and timing

Typically 500 mg glutamine is a good starting dose. I see many folks start too high, like 5000 mg / 5 g and up multiple times a day, and it’s not necessary. However, we increase based on individual needs and you may find you do need to use 500 mg -1000 mg two to three times a day. Using a glutamine powder is a great way to use it especially if you find you do need more than 500 mg each time.

When you use glutamine powder directly on the tongue (rather than mixed in water), the benefits are seen almost immediately.

For someone like Katherine, using glutamine throughout the day may set her up for night time or early morning low blood sugar. She may also find she needs to use some glutamine just before bed too.

GABA and/or serotonin support too?

Depending on the causes of her anxiety and shakiness, in addition to glutamine, Katherine may need to consider GABA and/or tryptophan too. We use the low GABA and low serotonin symptoms questionnaire and do trials of GABA and/or tryptophan/5-HTP.

All three amino acids can be used before bed and during the night if needed but trials are best done one at a time.

Glutamine for low blood sugar, healing the gut, to reduce sugar cravings and for better sleep

In addition to helping with blood sugar stability and sleep issues, glutamine also helps to heal the gut and helps reduce sugar cravings. Laura shared how it’s been helping her with all of this on another blog:

I am currently struggling with gastritis (inflammation of the stomach lining) as well as a lifetime of low blood sugar and irritability. I started glutamine a few days ago (15 grams a day) and I am amazed at how it has calmed my gut as well as calmed the sugar cravings. I am also sleeping better!

I did share that 15 g is considered a high starting dose of glutamine. She may well get similar benefits with much less.

Glutamine for early morning low blood sugar and headaches

As you can see in this case, Cat finds 500 mg glutamine just once a day works well for her unique needs:

I found a powder that I mix approximately 500 mg of with water. It works within about 15 minutes and keeps me going for about 2 – 3 hours — long enough to reach a reasonable time for lunch.

I’m thrilled to have this option as anytime that I travel, low blood sugar becomes a huge issue as I suffer from ketotic hypoglycemia and end up with massive headaches and vomiting for 6-8 hours.

Dietary changes for blood sugar control and adrenal support

All my clients keep a food log and we look at what they are eating on a typical day and when. It’s key to eat in a certain way in order to control blood sugar:. breakfast on waking, healthy snacks 3 to 4 x day and some folks do well with a snack before bed. These meals and snacks should include quality animal protein and healthy fats. This is all outlined in detail in the diet and low blood sugar chapters in my book “The Antianxiety Food Solution”.

A protein smoothie in the morning is a good option too and especially helpful if you have the social anxiety condition pyroluria, where morning nausea and a low appetite is common initially. This blog highlights a research paper about breakfast smoothies helping to reduce anxiety and hypoglycemia symptoms.

Nutritional support for adrenal function includes a good B vitamin complex, extra vitamin B5/pantothenic acid, vitamin C and adaptogenic herbs such as rhodiola and ashwagandha.

Glutamine product options – capsule vs powder

Products I recommend include Pure Encapsulations 500 mg l-glutamine (capsules opened on to your tongue) and Designs for Health l-glutamine powder as you find you need higher amounts. 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, Now l-glutamine 500 mg and Doctor’s best l-glutamine powder are products I recommend on iherb (use this link to save 5%).

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

We use the symptoms questionnaire to figure out if low blood sugar and/or low serotonin and/or low GABA and other neurotransmitter imbalances may be an issue for you.

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 importance of quality animal protein and healthy fats is also covered.

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 too). 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.

Have you had success with glutamine for blood sugar stability and waking with a jolt of anxiety/panic at night or in the early hours?

Have you used it for blood sugar stability, reduced cravings, leaky gut and anxiety during the day?

If yes, how much helps you? And how often do you use it?

Have dietary changes and adrenal support helped too?

If you’re a practitioner do you use glutamine and dietary approaches with clients/patients with low blood sugar?

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.

Seriphos to lower high cortisol: Help prevent an adrenaline-type surge and waking with anxiety and panic. Your questions answered

January 26, 2024 By Trudy Scott 16 Comments

When you have high night-time cortisol it can cause you to wake in the middle of the night with anxiety and/or feeling like you’re having a panic attack. If your cortisol is really high in the early morning (outside of the normal range), you can also wake with a jolt and feelings of anxiety and panic. Seriphos, a phosphorylated serine product, can help to lower your high cortisol and eventually prevent these symptoms.

Today I’m addressing your questions about how to use Seriphos to lower high cortisol and help prevent an adrenaline-type surge – like dosing/timing at night and in the early morning, how long you can take it for, cortisol salivary testing, interactions, brands and another option to Seriphos.

Soma shared her symptoms on Facebook when I said I’d be taking questions:

Can feel the adrenaline rush “crash” over me. I responded so so to beta blockers but still having fitful sleep and occasional “shocks” into wakefulness in the night as if tragedy struck … fight or flight upon waking. Tremendous night sweats. Generally hyper vigilant as a person.

This is her question: “What dosage and when to take (how soon before bed) is recommended?”

Addressing dosage and timing is a good place to start (and a common question) but I asked her if she has done a 4-5x cortisol salivary collection to confirm that her night time cortisol is high. She has not done this simple and very effective adrenal test and I highly recommend it before using Seriphos. The reason is that low cortisol can often have similar symptoms to high cortisol and using Seriphos is going to make things worse.

What dosage and when to take Seriphos (how soon before bed) is recommended?

Assuming Soma has done the adrenal saliva test and knows her middle of the night cortisol (5th saliva collection) is high, using 1-3 capsules a few hours before the high cortisol seems to be most effective. For example, for 2-4 am waking this typically means taking Seriphos right before bed. In some instances, taking 1 on waking in the night can help too (for a maximum of 3).

If her late evening 10 pm (4th saliva collection) is high too, the dose can be split. For example, taking 1 Seriphos at 7- 8 pm (a few hours before the high cortisol at 10 pm) and 1-2 right before bed for the 2 -4 am high cortisol.

The bottle states to use 1 capsule with water 15 minutes before a meal. I’m really not sure why they state this.

How to use Seriphos for high morning cortisol and adrenaline surge on waking?

Syd asks this question about high morning cortisol (as confirmed by saliva adrenal testing):

Opinion about using it for confirmed high MORNING cortisol? (Yup, I know cortisol is supposed to be highest in the morning, but this is off the charts, literally, high.)

“Adrenaline surge” or “catecholamine surge” is exactly how I’ve explained it to people!! No cognitive worrying, just that surge.

Because Seriphos works best taken a few hours in advance of high cortisol, I typically have clients use Lactium in this situation. It’s a hydrolyzed casein product that also lowers high cortisol. If casein is an issue then Relora is another option. I’ve blogged about both – Lactium here and Relora here.

One other option is to experiment with Seriphos – using it in the morning and also trying it at bedtime.

Should I take two Seriphos? I wake halfway through the night

Anne asks this question:

I only take one capsule? Should I take two? I wake halfway through the night, usually due to a full bladder. I fall back to sleep easily if I use a CBD gummy. Tested high for cortisol throughout the day on a DUTCH complete test, which measures at least 4 times.

Anne has done a DUTCH test which includes 4 adrenal saliva collections but doesn’t know if her cortisol is high in the middle of the night. As mentioned above, 1-3 capsules of Seriphos is ideal so I have clients start with 1 and increase to 2 and then 3. Since her cortisol is high throughout the day she may do better using Seriphos in the day and continuing with CBD at night when she wakes.

She may also want to consider low GABA and/or low serotonin as factors causing her to not sleep through the night. This applies to anyone using Seriphos to lower high cortisol. More on amino acids below.

If she does have bladder issues addressing this is key too.

For how long can Seriphos be taken?

It is recommended to take a one-month break after 3 months of Seriphos use. Ideally, once some or all the root causes of high cortisol are addressed (like gluten, stress, parasites, infections, trauma etc), you should be able to stop anyway. Or take a break, retest cortisol and then continue.

Does Seriphos have any interactions? And is there any cohort who should not use it?

Someone asked about using Seriphos with a beta blocker and someone else asked about using it with a SSRI. I’m not aware of any medication interactions but it’s best to always discuss with the prescribing physician.

What brands make Seriphos and where can I find it?

There is only one product and it’s called Interplexis Seriphos. You can purchase this from my online store (Fullscript – only available to US customers – use this link to set up an account) and you can also find it on iherb (use this link to save 5%).

Since I mentioned Lactium above, Biotics Research De-Stress contains 150mg hydrolyzed casein or lactium. You can find this in my online Fullscript too – use this link to set up an account. For non-US customers, Life Extension Bioactive Milk Peptides also contains 150mg hydrolyzed casein or lactium (you’ll see casein decapeptide and lactium on the label.) You can find this on iherb (use this link to save 5%).

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

We use the symptoms questionnaire to figure out if low serotonin or low GABA and other neurotransmitter imbalances may be an issue for you.

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. The importance of quality animal protein is also covered.

Have you had success with Seriphos (or Lactium or Relora) to lower high cortisol and help with anxiety, panic and/or adrenaline-type surges?

Have you used Seriphos in combination with amino acids and dietary changes?

If you’re a practitioner do you use Seriphos with clients/patients?

Feel free to share and ask your questions below.

Seriphos lowers high cortisol: prevent waking in the night and nighttime anxiety

October 20, 2023 By Trudy Scott 63 Comments

Seriphos is my favorite nutrient for lowering high nighttime cortisol in order to reduce night waking and nighttime anxiety. I’ve used it with success in the past and have just needed it again:

After coming back from Hawaii (I was there for just under 2 weeks), I was still waking a few times each night. Sometimes I would be awake for 2-3 hours! I’m a hot mess when I don’t get sleep through the night. With just 1 Seriphos before bed for 9 days I was sleeping through the night again. It was glorious!

High cortisol can be a temporary issue after international travel i.e. caused by jetlag and out of balance circadian rhythm. I will admit that I have a number of confounding factors – like my loss and grief (my darling mom has just passed away), being sprayed with insecticide on landing in Australia (which I suspect caused severe vertigo the day after I got back), and high blood pressure (and likely higher cortisol too) after drinking too much licorice tea for my voice loss. Whatever the causes of my high cortisol, Seriphos really helped me sleep through the night.

I ran out of Seriphos 2 nights ago and I was awake for 3 hours last night. I’ll be adding it back to my nighttime protocol as soon as my order arrives.

Seriphos is made by Interplexus and is a phosphorylated serine product. It is similar to the more recognized phosphatidylserine which is also used and known for lowering high cortisol – clinically and in the research. However, clinically, I have found Seriphos to be more effective and work more quickly.

UPDATE Feb 2024: I did end up tweaking my Seriphos dose a few times. After a few weeks I decided to trial 2 per night – this worked well. Then a few weeks later I trialed 3 per night – but after a few days I realized that even though it worked well for sleep it made me too tired the next day. For this reason I went back down to 2 Seriphos at bedtime.

UPDATE August 2024: I’m now using just 1 Seriphos at night and have added ox bile supplementation and a bright light panel in the morning because of bile issues. More on this below.

Seriphos for high cortisol due to trauma, loss of beloved cat and more

When I posted this on Facebook, I had a number of folks share how Seriphos has also helped them.

Kathy shared this: “I take two Seriphos at night for high cortisol that causes insomnia. It works well for me and helps me to relax. I have a significant trauma background that keeps me in fight or flight, so Seriphos is a must have at night. I do take a break from time to time if I am going through a less stressful time.”

Hopefully Kathy is also working on the trauma, doing trauma work and even incorporating other nutritional approaches which help so much with recovery – like zinc, vitamin D, a B complex, GABA and tryptophan etc. Taking a break from time to time is a good plan – I share more about this below.

Kim shared this: “Seriphos is a life saver – I started it when I was having cortisol/adrenaline issues a few years ago and have continued using it. I don’t ever want to be without Seriphos. A little over a month ago I unexpectedly lost my youngest cat. She was emaciated when I rescued her over 4 years ago and we turned around health issues. I feel so sad that she was dealt such a bad hand but we got her a loving home. My animals are everything to me and the grief is so difficult. She was a character and I love her so much.”

She uses one capsule in the evening but also uses a capsule during the day if she feels off. Hopefully Kim is also doing trauma work and other nutritional support too.

Janie shared this: “I have used it, years ago when my cortisol was off the charts, morning and at night. I was awake every night until 2am, unable to sleep. Seriphos certainly helped.”

She used 1 Seriphos per day for about 3 months.

Patricia said: “Please remember that there is Original Seriphos and the next gen Seriphos. I was one of thousands of people who had used original Seriphos for sleep and then they changed their formulation without telling us and then so very many of us were wide awake at night until we realized that they had changed the formulation.”

This happened in 2016/2017 and I blogged about that whole fiasco here – Seriphos Original Formula is back: the best product for anxiety and insomnia caused by high cortisol. You can read many other success stories on the blog and in the comments.

Address the causes of your high cortisol: jetlag, grief, toxins, licorice intake

As you can see from my example there can be a number of causes of high cortisol and you always want to address these causes while using Seriphos so you can eventually stop using it:

International travel i.e. caused by jetlag and out of balance circadian rhythm. I’m home so this is no longer a contributing issue.
Loss and grief can have physiological effects and high cortisol is one of many effects: “It appears that cortisol remains elevated for at least the first 6 months of bereavement. For some, cortisol elevation may become chronic”. The loss of my darling mom is going to take time but I am making time for grieving and I’m nurturing myself. As I navigate this period in my life I’ll continue to share what has helped me. I suspect I may need Seriphos for longer than the usual 3 months.
Being sprayed with insecticide on landing in Australia (which I suspect caused severe vertigo the day after I got back). It’s well-recognized that environmental toxins are hormone disruptors and affect the hypothalamic-pituitary-adrenal (HPA) axis and cortisol. I’m addressing this with active detoxification and my portable infrared sauna.
High blood pressure and likely higher cortisol too after drinking too much licorice tea for my voice loss. I have stopped the licorice consumption and my blood pressure is back to normal.

Other possible causes of high cortisol include day to day stresses, food sensitivities such as gluten, high sugar consumption, parasites and so on. Each factor needs to be addressed.

I do recommend Salivary cortisol testing before using Seriphos

Salivary cortisol testing is something I do with all my clients anyway. And I do recommend salivary cortisol testing before using Seriphos and the other cortisol-lowering nutrients mentioned below.

I will admit that I didn’t follow my own recommendation because I’ve had high nighttime cortisol in the past and recognized the symptoms. I had also identified all the above root causes and I desperately needed to sleep. I now have an adrenal saliva test kit on hand and will report back when I get the results.

Seriphos will only work for waking in the night if cortisol is high

One woman shared “I have never slept through the night in years. It would be delightful to get to the morning without waking.” Seriphos will very likely help if her cortisol is high.

Keep in mind there are many causes of not being able to sleep through the night and Seriphos will not help if cortisol is not high. Other root causes for insomnia/waking in the night (and nighttime anxiety) we consider and investigate are:

Low GABA and low serotonin (I always start with these while waiting for salivary cortisol results to come back),
Low melatonin

The following factors need to be addressed as root causes of sleep issues, anxiety and other symptoms (like gut issues, pain etc.), and also keep in mind that they are very possibly contributing to your high cortisol too:

Gluten and other food sensitivities
Caffeine and sugar intake
Oxalate issues and/or toxins exposure affecting bile production (this affected my sleep last year)
EMFs
Parasites and other gut issues like IBS/SIBO etc.
Disrupted circadian rhythms connected to liver/gallbladder/bile issues – more on that and bright light here. (Research does support a connection between high cortisol and cholestasis i.e. “stagnation, or at least a marked reduction, in bile secretion and flow.”)

A few folks reported they had tried Seriphos without success and it may well be that they don’t have high cortisol. Or they would possibly benefit from another approach to lower their cortisol (more on this below).

What are my options if I have high cortisol at night and Seriphos has the opposite effect?

One person said it had the opposite reaction. Joanne shared this: “Seriphos had the opposite effect on me. [One Seriphos] gave me extreme anxiety, kept me awake all night. Saliva tested consistently high cortisol at night so it should have helped. Been trying to work out why it would and how it might inform how I treat my insomnia.”

I’ve had a few clients do better with less than the recommended 3 per day and one not being able to use it at all. I suspect an allergic reaction or that it’s just too high a dose for some folks. The capsule could be opened and less could be used.

If this doesn’t work, other options for lowering high cortisol include lactium/hydrolyzed casein, Relora® (which contains Magnolia officinalis and Phellodendron amurense), essential oils such as bergamot and some herbal adaptogens. You can also read about some phosphatidylserine products I looked into when the Seriphos product was changed.

Forest bathing also helps to lower high cortisol levels and I recommend it for everyone.

Where does using Seriphos fit into everything else that I’m doing to address my insomnia and/or anxiety?

I typically don’t start with Seriphos right away with clients unless we know cortisol is high. As mentioned above I always start with assessing for low GABA and low serotonin and we do trials of the respective amino acids based on the symptoms questionnaire.

I also assess for low blood sugar and dietary factors like gluten, caffeine, sugar, quality animal protein intake etc. as covered in my book “The Antianxiety Food Solution.” More about my book here. It does include a chapter on the amino acids and how to use them too.

Then we start to dig deeper and would consider Seriphos or lactium for anxiety caused by high night time or even high morning cortisol or high cortisol at other times of the day.

With many folks all of the above often applies. And we continue with assessing for each of the 60+ nutritional and biochemical root causes of anxiety/waking in the night (which does include liver/gallbladder/bile issues).

Where do I purchase Seriphos and how much do I use? What about taking a break?

You can purchase Seriphos from my online store (Fullscript – only available to USA customers – use this link to set up an account) and you can also find it on iherb (use this link to save 5%).

The bottle states to use 1 capsule with water 15 minutes before a meal. Clinically, using 1-3 capsules a few hours before the high cortisol seems to be most effective. For 2-4am waking this typically means taking Seriphos right before bed. In some instances, taking 1 on waking in the night can help too (for a maximum of 3).

With high cortisol in the night and on waking, I have clients use Seriphos before bed and lactium on waking.

It is recommended to take a one-month break after 3 months of Seriphos use. Ideally, once the root causes of high cortisol are addressed, you should be able to stop anyway. Or take a break, retest cortisol and then continue.

I’ll share some research and how Seriphos differs from phosphatidylserine in a follow-up blog if there is enough interest.

I appreciate all the feedback from these women in my community.

Have you used Seriphos (a phosphorylated serine product) to help with high cortisol and waking in the night/nighttime anxiety caused by any of the?

What do you suspect the cause(s) of your high cortisol is or was? And have you confirmed high cortisol with a saliva cortisol test?

Have any of the other products mentioned above helped to reduce high cortisol? If yes, have you compared them with Seriphos?

Let me know if you’re interested in a follow-up blog that includes some research and how Seriphos differs from phosphatidylserine.

Feel free to share and ask your questions below.

Licorice intake, the renin-angiotensin-aldosterone-system and licorice-induced adverse effects on the cardiovascular system

October 13, 2023 By Trudy Scott 28 Comments

Licorice, today chiefly utilized as a flavoring additive in tea, tobacco and candy, is one of the oldest used herbs for medicinal purposes and consists of up to 300 active compounds.

The main active constituent of licorice is the prodrug glycyrrhizin, which is successively converted to 3β-monoglucuronyl-18β-glycyrrhetinic acid (3MGA) and 18β-glycyrrhetinic acid (GA) in the intestines.

Despite many reported health benefits, 3MGA and GA inhibit the 11-β-hydrogenase type II enzyme (11β-HSD2) oxidizing cortisol to cortisone. Through activation of mineralocorticoid receptors, high cortisol levels induce a mild form of apparent mineralocorticoid excess in the kidney and increase systemic vascular resistance.

Continuous inhibition of 11β-HSD2 related to excess licorice consumption will create a state of hypernatremia [high sodium], hypokalemia [low potassium] and increased fluid volume, which can cause serious life-threatening complications especially in patients already suffering from cardiovascular diseases.

The above is from the paper, Bioactive Candy: Effects of Licorice on the Cardiovascular System and builds on the recent licorice-hypertension blog, showing a “correlation between licorice intake, the renin-angiotensin-aldosterone-system and licorice-induced adverse effects on the cardiovascular system.”

Correlation between licorice intake, the renin-angiotensin-aldosterone-system and licorice-induced adverse effects on the cardiovascular system
From: Bioactive Candy: Effects of Licorice on the Cardiovascular System

Adverse effects on the heart

As you can see from the above image, there are many ways that licorice intake can adversely affect the heart.

Most folks are aware of the issues with licorice causing high blood pressure and some folks know it can lower potassium. However, many folks are not aware of some of these more severe cardiovascular consequences caused by high blood pressure and severely low potassium:

Hypertension is one of the major concerns for our healthcare system and was the leading contributor to premature death in 2015. It has been proven to be a major risk factor of cardiovascular diseases.

Some of the mechanisms include “increased stiffness of large arteries” and “pulmonary edema …caused by the sodium retaining effect of licorice” (this is high blood pressure in your pulmonary arteries, which carry oxygen-poor blood from your heart to your lungs. The earliest symptom is shortness of breath during your usual routine).

In addition to hypertension, the paper mentions the following:

“Cardiac arrhythmias are the most serious side effect caused by licorice intake due to severe hypokalemia” (i.e. irregular heartbeat due to low potassium).
“Depletion of the body’s potassium stores can cause a prolongation of the QT interval, which is closely connected with ventricular arrhythmias and tachycardia” (i.e. abnormal heartbeats and increased heart rate).
“As a consequence, several patients experienced a cardiac arrest with a subsequent recovery.”

I encourage you to read the entire paper in order to fully understand the “correlation between licorice intake, the renin-angiotensin-aldosterone-system and licorice-induced adverse effects on the cardiovascular system.”

Who may be more susceptible to the adverse impacts of licorice intake?

There are many documented health benefits of licorice and the above paper outlines how it may even benefit the heart. However some folks are more susceptible to the adverse effects and the above paper shares who may be more adversely impacted by licorice intake:

People aged over 40
Patients with a history of cardiac disease (and high blood pressure). I’ll also add those with family members with heart or blood pressure issues
Patients who are on medicines lowering potassium levels (such as thiazide or loop diuretics)
Patients treated with antihypertensive drugs such as ACE-inhibitors and diuretics
Patients suffering from diarrhea or alcoholism, which can worsen hypokalemia
Patients with congestive heart failure or resistant hypertension
Patients taking digoxin or warfarin to avoid the risk of toxicity

The authors also state that “women seem to be more susceptible to licorice intake. A possible explanation for this gender difference are many other hormonal (estrogenic and antiandrogenic) effects exhibited by licorice in addition to its activity via mineralocorticoid receptor.” And that licorice should also be avoided during pregnancy “because the conversion of cortisone into cortisol plays an important role in lung maturation.”

These other possible factors from this paper, Licorice abuse: time to send a warning message, should also be considered:

Patients with less common causes of hypokalemia that include Cushing syndrome, Conn’s syndrome and Anorexia nervosa
Patients with prolonged gastrointestinal transit time (The amount of glycyrrhetic acid reabsorbed depends on its transit through the small and large intestines, therefore patients with prolonged gastrointestinal transit times are more prone to toxicity after repeated intake)

And I’d add these as factors to consider too:

Someone with known high cortisol levels
Someone with dietary oxalate issues and/or kidney issues. Licorice tea is listed as low oxalate on the Trying Low Oxalates Facebook group but they will be updating their spreadsheet based on a paper I just shared with them – Oxalate in Foods: Extraction Conditions, Analytical Methods, Occurrence, and Health Implications “Licorice was the highest-oxalate food reported in this review with 3569.3 mg total oxalate/100 g FW (fresh weight).” (this is higher than spinach, sweet potatoes and rhubarb which are really high oxalate)

As with everything, there is no one-size fits all and we need to be diligent about what works for us and what can cause issues.

What are the lasting cardiovascular effects of high blood pressure caused by drinking up to 6 cups of licorice tea a day?

As I shared on the recent licorice-hypertension blog, high blood pressure is one of the many cardiovascular issues with licorice – Beware! Too much licorice tea can cause hypertension even if you have low or normal blood pressure

In that case report, Hypertension induced by liquorice tea, a 45-year-old woman with hot flushes, sweating and headaches, was found to have high blood pressure and low potassium (mild hypokalemia) when she visited her doctor.

She had been drinking up to six cups of liquorice/licorice tea per day and within 2 weeks of stopping this, all her symptoms, the hypertension and the hypokalemia entirely resolved.

This case report is eye-opening because she had always had low blood pressure. I share more about this, my concerns and a very similar incident that I experienced when drinking Throat Calm tea – on the above blog.

What I do want to add is this woman’s concern about possible longer term effects. She says this: “I don’t know if I’ve had any lasting effects on my body by drinking this tea on a daily basis for over a year.” Hopefully her medical team explained much of what I’ve shared here and she was given a thorough cardiovascular work-up.

My cautions for consuming licorice in any form

I am of the opinion that licorice should be treated like the medicinal/therapeutic herb that it is and only be used when working with a knowledgeable practitioner.

This statement in this paper, The cardiovascular complications of licorice, sums up my beliefs:

The health benefits of licorice are minor compared to the adverse outcomes of chronic use which is never justified nor recommended. The long-established belief among the community that licorice is a natural healthy substance free of side effects promotes its liberal consumption and predisposition to toxicity.

I recommend ongoing blood pressure home monitoring if you regularly consume licorice in any form. I also recommend looking at the list of factors that may make you more susceptible to the adverse effects of licorice and discussing these with your practitioner.

I’d also encourage a thorough cardiovascular work-up for anyone who has observed high blood pressure and/or low potassium after consuming licorice for any duration. My blood pressure increased from 110/80 to 137/84 in just a week and it concerned me enough that I went to the doctor to get my potassium checked (it was in range but was only tested 10 days after I quit the licorice tea). I’ll also be discussing all this with my cardiologist and I’ll update this blog when I learn more.

Learning about all this and reading all this research – together with my personal experience and feedback from my community – has been eye-opening to me and hopefully these licorice blogs will help to create more awareness.

Has intake of licorice from tea, candy, herbal products, cough medicines and even smoking cigarettes caught you by surprise?

How much licorice did you consume and over what period?

Did you know about the caution to avoid licorice if you have high blood pressure? What about if you have low blood or normal pressure?

Are you more susceptible to the adverse impacts of licorice intake? And which factors do you suspect played a part if you had issues?

Feel free to share and ask your questions below.

Are adrenal issues causing your anxiety? Highlights from the book: Adrenal Transformation Protocol by Izabella Wentz PharmD

April 21, 2023 By Trudy Scott 8 Comments

This is a guest post from my friend and colleague, Dr. Izabella Wentz, who just came out with her latest book, Adrenal Transformation Protocol (my Amazon link). The book is focused on healing your adrenals, and in it she shares specific strategies to support anxiety. Izabella shares a few of the many strategies with you here in this guest post.

You’ll notice that we share many common approaches:

Addressing low blood sugar (much more on that below)
Caffeine intake: Izabella recommends reducing caffeine but I have found many folks in my community need to quit altogether. I have noticed that those with panic disorders experience increases in symptoms such as nervousness, fear, nausea, heart palpitations, and tremors after consuming caffeine and said the effects were similar to how they felt during a panic attack.
Gluten elimination: Interestingly, I have found in my clinical experience and research that there is a connection between gluten and anxiety, social phobia, depression, and even schizophrenia.
Using herbal adaptogens, addressing nutrient deficiencies, and even pyroluria which can deplete key nutrients needed for adrenal health (especially when under high amounts of stress).

All of her approaches focus on adrenal health specifically and she has now taken over 3000 people on an adrenal healing journey. And 86% of them reported that their anxiety improved after going through her protocol.

By Dr. Izabella Wentz. PharmD

Stress is at the root cause of many chronic health issues, and very well may be at the root of your anxiety, too. Chronic stress can put a burden on our adrenal glands, resulting in an excess of stress hormones like cortisol. The body’s repeated exposure to cortisol can result in increased blood sugar levels, increased heart rate, and increased blood pressure, all of which can lead to feelings of anxiety.

The adrenals are two small glands, located on top of each kidney, that release hormones such as cortisol and adrenaline. Adrenal dysfunction generally occurs when your hypothalamic-pituitary-adrenal (HPA) axis is unable to effectively manage your stress response. The HPA axis describes the interactive feedback loop that takes place among these three endocrine, or hormone-producing, glands. If the communication among these three breaks down, your adrenals and their ability to produce important essential hormones can be jeopardized.

Overactive adrenals can leave you feeling like you’re constantly in “fight or flight” mode. First, your body releases high levels of stress chemicals like adrenaline and cortisol. To ensure you’re ready to defend yourself or run, these chemicals spike your blood sugar, as well as increase heart rate, blood pressure, and insulin levels – making you feel anxious, stressed and wide awake at night.

Chronic stress is one of the most common causes of adrenal dysfunction. Our bodies are well-equipped to respond to acute stressors (like being chased by a bear or getting out of the way of an oncoming car), where we experience activation of the fight-or-flight response, followed by a return to the rest-and-digest state.

However, many of us today face a never-ending presence of stressful, yet non-life-threatening, situations that can lead to the constant activation of the stress response.

With enough chronic stress, the HPA axis becomes overwhelmed and desensitized to the usual feedback loop, and stops sending messages to the adrenals to produce more hormones or less hormones, no matter what’s happening.^[1]

Other common causes of adrenal dysfunction include sleep deprivation, blood sugar dysregulation, and chronic inflammation (which are all forms of stress on the body).

Symptoms of poor adrenal function may include the following:

Feeling overwhelmed
Feeling anxious
Feeling tired despite adequate sleep
Trouble falling asleep or trouble staying asleep
Difficulty getting up in the morning
Dependency on caffeine
Cravings for salty foods (a.k.a. the “I just ate a whole bag of chips” syndrome)
Cravings for sweet foods
Increased effort required for everyday activities
Intolerance to exercise
Low blood pressure
Feeling faint/dizzy when getting up quickly
Easily startled
Mental fog or trouble concentrating
Alternating diarrhea/constipation
Low blood sugar (often presenting as feeling angry when hungry or, as I like to call it, “hangry”)
Decreased sex drive
Decreased ability to handle stress
Longer healing time
Mild depression
Less enjoyment in life
Feeling worse after skipping meals
Increased premenstrual syndrome (PMS)
Reduced ability to make decisions
Reduced productivity
Poor memory

If you have three or more of these symptoms, and if these symptoms developed after experiencing a period of acute or chronic stress, sleep deprivation, an infection, or toxic exposure, chances are that you have adrenal dysfunction.

The anxiety adrenal connection

Anxiety is a hallmark symptom of adrenal dysfunction. When the adrenals are compromised, your resilience to stress starts to go down, and you might start to feel more anxious.

Of course, anxiety and adrenal dysfunction run on a two-way street. Chronic stress and anxiety can tax the adrenals, and weakened adrenals can contribute to feelings of anxiety.^[2]

There’s another connection here that I’d like to highlight, and that is the thyroid. The thyroid is impacted by adrenal function, and anxiety can also be connected to thyroid conditions. In fact, I’ve noticed that up to 50 percent of my clients with anxiety have Hashimoto’s, an autoimmune thyroid condition.

A 2004 study found an association between the presence of a mood or anxiety disorder, and the presence of anti-TPO antibodies (indicating Hashimoto’s).^[3] It also noted that a slight reduction in thyroid hormone secretion (such as that found in subclinical hypothyroidism) may affect mood as well. Therefore, it’s also possible that the anxiety you are feeling is related to your thyroid.

Anxiety solutions: Use the ABC’s

One of the first places to start is with the ABCs of adrenal health – adaptogens, B vitamins, and vitamin C.

Adaptogens both tone down overactive systems and boost underactive systems in the body, and are thought to help normalize the HPA axis. Examples of adaptogenic herbs that may increase the body’s ability to resist stress include: ashwagandha, astragalus, reishi mushroom, dang shen, eleuthero, ginseng, jiaogulan, licorice, maca, schisandra, spikenard, and suma.

Ashwagandha in particular is helpful for stress and anxiety, and it can also support thyroid health. Research supports that ashwagandha may offer antidepressant, antioxidant, anti-inflammatory and neuroprotective benefits.^[4] It also may reduce anxiety, improve sleep, and even help address sexual dysfunction in women.^[5]

Rhodiola is another favorite for stress support, mood support, and improved sleep. Sometimes referred to as golden root, rhodiola focuses on our nervous system health. Izabella has found it to be helpful for those with depressed cortisol levels (which can happen in later stages of adrenal dysfunction).

One of the main chemicals in rhodiola is salidroside, found to have neuroprotective effects that reduce the impact of stress on the immune system and the neuro-endocrine system.^[6] Studies have found an anti-fatigue effect along with cognitive function improvements, such as memory improvements (during stressful conditions), and it’s also been shown to diminish depressive symptoms.^[7]

B vitamins and vitamin C tend to be depleted during times of stress and high cortisol production. In particular, deficiencies in pantothenic acid and biotin (vitamins in the “B” family), have been linked to decreased adrenal function in animals and humans.^[8]

Vitamin C is an important antioxidant that helps support the adrenals, mitochondria, collagen production, and immune function.^[9] It’s also needed for the production of cortisol.

Supplementing with the ABCs is a really good place to start if you’re experiencing anxiety or adrenal dysfunction.

Balancing blood sugar

One of the most important strategies to reduce your anxiety involves addressing blood sugar issues. Blood sugar swings can put us on an emotional rollercoaster.

After consuming carbohydrate-rich foods, some people find their blood sugar goes up too high, too quickly.

This leads to a rapid, sometimes excessive release of insulin (a hormone that regulates blood sugar levels). These insulin surges can cause low blood sugar, which can cause unpleasant symptoms such as anxiety, nervousness, lightheadedness, fatigue, excessive hunger, and “hanger”.^[10]

You can balance your blood sugar by reducing your intake of carbohydrates, and increasing your protein and fat intake. A low-carb or ketogenic diet (a low-carb diet where the body breaks down fats for fuel instead of relying on carbohydrates) could be beneficial for some.

Starting the day off by having a breakfast that is filled with good fats (for example, avocado or coconut milk), as well as a good source of protein, while limiting your intake of sugars (even from fruit). Some options include eggs with avocados, burger patties, or protein and fat-based smoothies. In addition to a good breakfast, eating frequent protein and fat-containing meals and snacks, help to balance your blood sugar throughout the day.

Eat on a schedule to avoid getting “Hangry”

It’s ideal to eat every two to three hours, and avoid high carbohydrate foods, to support balanced blood sugar. This will also help with energy levels, feelings of anxiety, and “hanger”. A typical day would look like this:

Start the day with an energizing Adrenal Kick Start (recipe is in the book), followed by a blood-sugar-balancing breakfast smoothie.
A mid-morning snack/caffeine-free latte/tea/green juice to help with blood sugar, hunger, hormones, and energy levels.
A nourishing and balancing midday lunch.
Another snack/caffeine-free latte/tea/green juice two to three hours later.
An easy-to-digest dinner is scheduled for the early evening to set up for restful sleep.
An optional after dinner snack or tea, to support restful sleep through stable blood sugar levels at night.

Reduce (and ideally eliminate) caffeine

If you’re currently drinking coffee, soda, green tea, or black tea, removing or reducing your intake of caffeine can be helpful for an immediate reduction in anxiety, and is supportive over time to your adrenals.

Some people who are slow metabolizers of caffeine and do not clear it effectively out of their body may not be able to have any caffeine at all – not even chocolate! Others who are fast metabolizers and are able to clear caffeine more quickly from their bodies, may be able to tolerate more daily caffeine without it impacting their anxiety levels.

Regardless of your genes and metabolism of caffeine, the weaker your adrenals and the more unbalanced your blood sugar levels are, the more likely you are to experience anxiety from caffeine. This is because caffeine forces more glucose to be produced by the liver, sending the body on a blood sugar rollercoaster that can trigger anxiety.

If you’re thinking about reducing your caffeine intake, do it gradually over time, instead of quitting cold-turkey, which can cause withdrawal symptoms such as headaches, fatigue and even vomiting.

There are ways to improve energy levels and sleep before trying to get off caffeine, such as supporting your mitochondria and tuning into the circadian rhythm.

[Trudy’s note: be sure to read my comment above about the need to eliminate caffeine altogether in many instances]

Address low magnesium

Research suggests that a magnesium deficiency may be associated with anxiety. Several studies have found that feelings of fear and panic can be greatly reduced with an increased magnesium intake.^[11] It has even been shown to have a positive effect on both post-traumatic anxiety and premenstrual anxiety, as well.^[12]

Even more interesting, is the understanding that magnesium also controls the hypothalamic-pituitary-adrenocortical (HPA) axis, which is the hub of the body’s stress response system.^[13] This could provide some explanation as to why a magnesium deficiency could lead to increased stress and anxiety when the HPA axis is out of balance. Other signs of a magnesium deficiency include headaches, insomnia, constipation, and menstrual cramps.

A magnesium supplement throughout the day may help, or at bedtime if you have insomnia or a racing mind when you’re trying to fall asleep. The citrate version is best if you tend to be constipated (magnesium citrate has stool softening effects), and I recommend the glycinate version if you tend to have normal bowel movements or diarrhea. Keep in mind that, for some people, magnesium glycinate can worsen anxiety symptoms. If you notice that your anxiety increases after taking magnesium glycinate, try switching to magnesium citrate.

Remove reactive foods

The most common food reactions responsible for anxiety symptoms are due to gluten, dairy, soy, grains (especially corn), sugar, caffeine (as discussed above), and surprisingly to some, nuts.^[14]

Doing targeted food sensitivity testing, or simply a trial of eliminating the suspect foods for a period of time (with an elimination diet), can help you uncover your food triggers.

If anxiety is not resolved using the strategies above, there are many advanced strategies for anxiety support, and the book provides plenty of information and options for testing.

Address copper toxicity

A toxic buildup of copper may be at the root of anxiety, racing thoughts, mood swings, fatigue, and insomnia.^[15] High-copper foods include shellfish, oysters, nuts, seeds, and chocolate. We can also absorb copper from our water and metal pipes and products. Certain medications (oral contraceptives, antacids, copper-rich multivitamins), excess estrogen, copper IUDs, and zinc deficiency can increase our exposure. Many people with adrenal dysfunction have a congested liver, so that is likely one reason copper toxicity is a common root cause.

Reducing copper containing foods, and increase zinc containing foods (non-organ meats, eggs, poultry).

Balance thyroid hormones

Having an excess amount of thyroid hormone can make us extremely anxious, irritable and on edge. This is commonly attributed to Graves’ disease, but can also occur in Hashimoto’s. The ideal TSH for most people is between 0.5-2 μIU/mL. Levels that are too high or too low indicate an imbalance of thyroid hormone levels and have been associated with various symptoms, including anxiety. Work with your doctor to test your thyroid and adjust medication if needed.

Address female hormone imbalances

Estrogen dominance and/or low progesterone may lead to many symptoms like irritability, mood lability, depression, and mood swings.^[16] If tests reveal low progesterone, supplementing with oral or topical bioidentical progesterone might just be the chill pill you need.

Address gut infections

An imbalance of gut bacteria can contribute to mood issues. There are also certain overgrowths and gut infections that can impact anxiety levels. For example, overgrowth of Streptococcus bacteria has been associated with obsessive-compulsive disorder.^[17] The book includes recommendations for further testing that can help you determine if you have an overgrowth or infection.

Address iron toxicity/overload

A buildup of too much iron can cause irritability and depression.^[18] Ferritin levels above 200 ng/dL in women (300 ng/mL in men) can indicate iron toxicity or overload. The book offers several different options for treatment.

Address mold toxicity

There is a big connection between mood issues and mold exposure.^[19] If your symptoms appeared or increased after moving into a new home, there’s a good chance your anxiety may be connected to mold exposure.

Address common nutrient deficiencies

Nutrient deficiencies are common in those with adrenal issues, and could be contributing to feelings of anxiety. Address these important nutrients for mood support: omega-3 fatty acids, folate (vitamin B9), iron, vitamin B12, and vitamin D.

Address the social anxiety condition called pyroluria

Symptoms of social anxiety have been associated with pyroluria, which is a condition where there are too many pyrrole molecules in your body.^[20] These molecules can deplete your system of essential nutrients that play an important role in mood and adrenal health.

[Trudy’s note: I’m really pleased to see pyroluria mentioned in this book, because it’s not often acknowledged as a condition. I also appreciate the reference, in the pyroluria section, to my work and book, The Antianxiety Food Solution.]

Adrenal Transformation Protocol – for anxiety

Adrenal Transformation Protocol (my Amazon link) provides comprehensive support for the many potential stressors the body can experience, so that you can heal anxiety using a whole body, root-cause approach.

When we address the root causes of adrenal fatigue and anxiety, like blood sugar imbalances, food sensitivities, and nutrient deficiencies, we can increase our resilience and reduce feelings of anxiety!

Adrenal dysfunction often begins after a stressful period in our lives. When the body puts cortisol front and center, rebuilding and repairing go on the backburner, and we can end up with a host of symptoms including fatigue, brain fog, and anxiety.

While most people can bounce back from small stressors, some of us can get caught up in a stress cycle that ends up affecting our physiology. When we are caught in this stress cycle, it throws our hormonal systems out of balance, and leads to us being stuck in “fight or flight” mode. Prolonged “fight or flight” mode eventually leads to burnout, and often contributes to anxiety.

Through years of research, patient study, and work with thousands of clients, my signature protocol has been shown to reverse symptoms of adrenal fatigue. It provides a foundation for optimal health, and can even be one of the keys to resolving anxiety.

In both my own work and Izabella’s, we have found that addressing the adrenals often results in the complete resolution of chronic stress symptoms!

Izabella has experienced multiple bouts of adrenal fatigue and has struggled with anxiety. She realized that her body was responding to the various stress triggers in her environment, and decided to send it safety signals instead, to put it into a healing and rebuilding state. The protocol worked so well for her that she piloted it as a program with a small group in 2020. Despite all of the things that happened in 2020, people reported that the program helped them rebalance their stress response.

Over 3000 people have now completed this protocol, with incredible results, and it’s all in her new book, Adrenal Transformation Protocol (my Amazon link). The book outlines a simple four-week plan to help you recover your adrenal function and resolve symptoms like fatigue, brain fog, depression, and anxiety. The protocol is designed to help you feel calm, strong, excited about life, and brilliant once more!

In addition to reduced brain fog, reduced fatigue, and better sleep, participants reported incredible results in mood – 86 percent reported reduced anxiety and 80 percent reported reduced feelings of nervousness.

Adrenal dysfunction can be a root cause of anxiety. If you’re still experiencing anxiety symptoms and feel like you’ve tried everything, but haven’t yet addressed your adrenal health, I’d highly recommend Adrenal Transformation Protocol (my Amazon link)!

Feel free to share your feedback once you’ve read the book.

Also, let us know if any of the above approaches have helped you address your adrenal issues?

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

^[1] Cook SB. Current Controversy: Does Adrenal Fatigue Exist?. Natural Medicine Journal. 2017;9(10).^[2] Faravelli C, Lo Sauro C, Lelli L, et al. The role of life events and HPA axis in anxiety disorders: a review. Curr Pharm Des. 2012;18(35):5663-5674. doi:10.2174/138161212803530907

^[3] Carta M, Loviselli A, Hardoy M et al. The link between thyroid autoimmunity (antithyroid peroxidase autoantibodies) with anxiety and mood disorders in the community: A field of interest for public health in the future. BMC Psychiatry. 2004;4(1). doi:10.1186/1471-244x-4-25.

^[4] Lopresti AL, Smith SJ, Malvi H, Kodgule R. An investigation into the stress-relieving and pharmacological actions of an ashwagandha (Withania somnifera) extract: A randomized, double-blind, placebo-controlled study. Medicine (Baltimore). 2019;98(37):e17186. doi:10.1097/MD.0000000000017186

^[5] Dongre S, Langade D, Bhattacharyya S. Efficacy and Safety of Ashwagandha (Withania somnifera) Root Extract in Improving Sexual Function in Women: A Pilot Study. Biomed Res Int. 2015;2015:284154. doi:10.1155/2015/284154

^[6] Lee Y, Jung JC, Jang S, et al. Anti-Inflammatory and Neuroprotective Effects of Constituents Isolated from Rhodiola rosea. Evid Based Complement Alternat Med. 2013;2013:514049. doi:10.1155/2013/514049

^[7] Cropley M, Banks AP, Boyle J. The Effects of Rhodiola rosea L. Extract on Anxiety, Stress, Cognition and Other Mood Symptoms. Phytother Res. 2015;29(12):1934-1939. doi:10.1002/ptr.5486

^[8] Pan L, Jaroenporn S, Yamamoto T, et al. Effects of pantothenic acid supplement on secretion of steroids by the adrenal cortex in female rats. Reprod Med Biol. 2011;11(2):101-104. Published 2011 Dec

^[9] Valdés F. Vitamina C [Vitamin C]. Actas Dermosifiliogr. 2006;97(9):557-568. doi:10.1016/s0001-7310(06)73466-4

^[10] Mathew P, Thoppil D. Hypoglycemia. In: StatPearls. Treasure Island (FL): StatPearls Publishing; July 23, 2022.

^[11] Boyle NB, Lawton C, Dye L. The Effects of Magnesium Supplementation on Subjective Anxiety and Stress—A Systematic Review. Nutrients. 2017 May; 9(5): 429. doi:10.3390/nu9050429.

^[12] Fromm L, Heath DL, Vink R, Nimmo AJ. Magnesium attenuates post-traumatic depression/anxiety following diffuse traumatic brain injury in rats. J Am Coll Nutr. 2004;23(5):529S-533S. doi:10.1080/07315724.2004.10719396

^[13] Sartori SB, Whittle N, Hetzenauer A, Singewald N. Magnesium deficiency induces anxiety and HPA axis dysregulation: modulation by therapeutic drug treatment. Neuropharmacology. 2012;62(1):304-312. doi:10.1016/j.neuropharm.2011.07.027

^[14] Vatn MH. Food intolerance and psychosomatic experience. Scand J Work Environ Health. 1997;23 Suppl 3:75-78.

^[15] Russo AJ. Decreased zinc and increased copper in individuals with anxiety. Nutr Metab Insights. 2011;4:1-5. Published 2011 Feb 7. doi:10.4137/NMI.S6349

^[16] Glick ID, Bennett SE. Psychiatric complications of progesterone and oral contraceptives. J Clin Psychopharmacol. 1981;1(6):350-367. doi:10.1097/00004714-198111000-00003

^[17] Mell LK, Davis RL, Owens D. Association between streptococcal infection and obsessive-compulsive disorder, Tourette’s syndrome, and tic disorder. Pediatrics. 2005;116(1):56-60. doi:10.1542/peds.2004-2058

^[18] Cutler P. Iron overload and psychiatric illness. Can J Psychiatry. 1994;39(1):8-11. doi:10.1177/070674379403900104

^[19] Harding CF, Pytte CL, Page KG, et al. Mold inhalation causes innate immune activation, neural, cognitive and emotional dysfunction. Brain Behav Immun. 2020;87:218-228. doi:10.1016/j.bbi.2019.11.006

^[20] Mensah A. Mood instability: Pyrrole disorder underlying cause bipolar, DMDD. Mensah Medical. https://www.mensahmedical.com/pyroluria-pyrrole-disorder/. Published July 12, 2016. Accessed February 8, 2023.

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.

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.

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.