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Tryptophan supplementation for anorexia?

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tryptophan and anorexia

This blog post highlights the potential importance of tryptophan supplementation in improving therapeutics in anorexia (and other eating disorders) and some of my insights about the 2017 anorexia-tryptophan study. I also share the high incidence of eating disorders, overlaps with anxiety and the case for tryptophan supplementation given the many low serotonin symptoms (anxiety, obsessive thoughts/behaviors, perfectionism, negative-self-talk, low self-esteem and depression) we see with anorexia and other eating disorders.

According to The National Eating Disorders Association (NEDA), eating disorders are

serious but treatable mental and physical illnesses that can affect people of all genders, ages, races, religions, ethnicities, sexual orientations, body shapes, and weights. National surveys estimate that 20 million women and 10 million men in America will have an eating disorder at some point in their lives.

While no one knows for sure what causes eating disorders, a growing consensus suggests that it is a range of biological, psychological, and sociocultural factors.

While NEDA does acknowledge that some of the causative factors may be biological, unfortunately there is no mention of nutritional psychiatry or tryptophan on the site. You’ll see this to be the case in the majority of conventional treatment centers.

The 2017 paper on tryptophan potential for anorexia

The paper, Improving therapeutics in anorexia nervosa with tryptophan, does acknowledge that the “growing body of evidence suggests that our diet is an important contributing factor in the development, management and prevention of a number of psychiatric illnesses.”

It discusses what we know about tryptophan being “the sole precursor” of serotonin, a neurotransmitter and that when used as a supplement it has therapeutic benefits when serotonin is low.

The author proposes that excessive dieting and food restriction decrease brain tryptophan and serotonin and propose the “potential importance of tryptophan supplementation in improving therapeutics in anorexia patients” (together with psychotherapy).

Given that anorexia has the “highest lethality of all psychiatric illnesses” and that there are currently “no FDA approved pharmacological treatments available” for anorexia, the urgency for implementing nutritional psychiatry approaches is high. The authors also share that the antidepressants and antipsychotics which are commonly used to treat the co-occurring anxiety, depression, OCD and psychosis are not very effective.

The author mentions a paper that used 250 mg tryptophan twice a day times a day but based on my work with individuals with anxiety, we know an individualized approach is best.  A typical starting dose of tryptophan is 500mg used once or twice a day and I use the trial approach to determine the ideal dose for each person.

Incidence of anorexia and eating disorders in general

Here are a few select anorexia and eating disorder statistics from NEDA. I find much of this alarming and in some cases surprising (like the high incidence of males who are affected):

  • 40% to 60% of elementary school girls (ages 6-12) are concerned about their weight
  • 2% to 13% of adolescent girls meet the criteria for eating disorders
  • Males represent 25% of individuals with anorexia (they are at a higher risk of dying because they are often diagnosed later since many people assume males don’t have eating disorders)
  • Male athletes, especially those competing in sports that emphasize diet, appearance, size and weight, are at risk. In weight-class sports (wrestling, rowing, horse racing) and aesthetic sports (bodybuilding, gymnastics, swimming, diving) about 33% of male athletes are affected. In female athletes in weight class and aesthetic sports, disordered eating occurs at estimates of up to 62%.
  • In one study of ultra-Orthodox and Syrian Jewish communities in Brooklyn, 1 out of 19 girls was diagnosed with an eating disorder, which is a rate about 50 percent higher than the general U.S. population.
  • Despite similar rates of eating disorders among non-Hispanic Whites, Hispanics, African-Americans, and Asians in the United States, people of color are significantly less likely to receive help for their eating issues.
  • Elevated rates of binge-eating and purging by vomiting or laxative abuse was found for both males and females who identified as gay, lesbian, bisexual, or “mostly heterosexual” in comparison to their heterosexual peers.
[You can find the actual stats and studies quoted above at the NEDA stats link.]

 

Prevalence of anxiety and making the case for low serotonin

The prevalence of anxiety is high in those with eating disorders (which is one of the reasons for this particular blog):

  • Anxiety is also diagnosed in 48-51% of people with anorexia nervosa, 54-81% of people with bulimia nervosa, and 55-65% of people with binge eating disorder
  • Two-thirds of people with anorexia also showed signs of an anxiety disorder several years before the start of their eating disorder.

In one study, after dietary treatment (called refeeding), plasma tryptophan levels normalized in patients with anorexia:

Disturbance in serotonin function has been described as central to the psychobiology of this disorder 

Plasma TRP normalizes during the course of refeeding, supporting the hypothesis that serotonin function is disturbed in patients with anorexia nervosa.

We also see a large number of low serotonin symptoms in those with eating disorders:

  • Childhood obsessive-compulsive traits, such as perfectionism, having to follow the rules, and concern about mistakes, were much more common in women who developed eating disorders than women who didn’t.
  • Binge eating disorder patients … also had significantly higher levels of negative affect, and lower self-esteem
  • In a study of women with eating disorders, 94% of the participants had a co-occurring mood disorder
[You can find the actual stats and studies quoted above at the NEDA stats link.]

There are all classic low serotonin symptoms: obsessive thoughts/behaviors, perfectionism, negative-self-talk, low self-esteem and depression.

This further supports the rationale for tryptophan supplementation and is another reason for this blog. I have extensive experience in the use of tryptophan and 5-HTP and believe they should be part of all eating disorder programs.

There is one big difference in that typically we see afternoon and evening sugar and carb cravings with low serotonin-type anxiety. Whereas with anorexia, the low self-esteem, obsessive thinking and body dysmorphia (feeling shame or disgust with parts of their body or appearance) may prevent someone acting on these cravings. However, if there are sugar and carb cravings (and bingeing), this is the time they will typically occur.

Here are two recent blog posts that share case studies where tryptophan was used with success:

Anorexia and other eating disorders require a multidisciplinary team

I don’t currently work with clients with anorexia as it requires a multidisciplinary team. I did, however, work with a few clients with anorexia when I worked at Recovery Systems over 10 years ago. They had a therapist, nutritionist and doctor on their team and a nutritional approach led to more improvements than they had experienced at prior in-house eating disorder clinics where they had received psychological support only or psychology and medication. Our approach included addressing low serotonin with tryptophan or 5-HTP, addressing low zinc, addressing the gut/microbiome, low B vitamins, low omega-3 fatty acids and more (based on the unique needs of the client).

I now refer eating disorder clients to Dr. James Greenbatt, MD, an eating disorder specialist and integrative psychiatrist. He has a wonderful book on the topic: Answers to Anorexia – a Breakthrough Nutritional Treatment That is Saving Lives, with the second edition coming out soon. In the first edition he does address neurotransmitter deficiencies but we differ in our approach.  He doesn’t use individual amino acids like tryptophan or 5-HTP and prefers to use a blend of amino acids based on a blood or urinary amino acid test.

In this article, New Approaches to Treating Anorexia, Dr. Greenblatt covers the multidisciplinary aspect, current treatment options, the limited medical options and the need for targeted nutrition therapy. Although this article doesn’t address tryptophan and low serotonin, he does discuss the key role of zinc, B vitamins and omega-3 fatty acids.

Resources if you are new to using the amino acids as supplements

If you are new to using the amino acids tryptophan/5-HTP, GABA or  tyrosine as supplements, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution (you can see the low serotonin symptoms here) and a brief overview here, Anxiety and targeted individual amino acid supplements: a summary.

If you suspect low serotonin or 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 so you are knowledgeable. And be sure to share it with the team you or your loved one is working with.

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 acid products that I use with my individual clients and those in my group programs.

Have you (or a loved one) been diagnosed with anorexia or another eating disorder?

Did you see the most success with an approach that included nutritional psychiatry and serotonin support with tryptophan or 5-HTP?

What else has helped?

Feel free to post any questions here too.

MegaSporeBiotic™: A spore-based probiotic for leaky gut, IBS, anxiety, depression, liver health and colitis

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megasporebiotic

MegaSporeBiotic™ is “a 100% spore-based broad-spectrum probiotic shown to maintain healthy gut barrier function” i.e. leaky gut. Research and clinical results show it is promising for irritable bowel syndrome (IBS) or SIBO (small intestinal bacterial overgrowth), recovery from liver injury caused by acetaminophen, and is protective in ulcerative colitis (an inflammatory bowel disease). Given the gut-brain connection and the fact that the majority of serotonin is produced in the gut, it’s not surprising that spore-based probiotics may also help ease anxiety and depression.

Here are some of the studies supporting this spore-based probiotic for gut issues:

The key findings of the present study is that oral spore-based probiotic supplementation reduced symptoms indicative of “leaky gut syndrome”.

The results demonstrated that patients treated with MegaSporeBiotic, compared with those treated with rifaximin followed by nutraceutical or low-FODMAP diet, had similar severity scores and rectal volume sensation test results for all parameters tested and statistically significant improvement in measurements of quality of life.

This is important because “Acetaminophen  is one of the most used analgesics [pain-reducing] and antipyretic [fever-lowering] agents in the world. Intoxication with acetaminophen is the main cause of acute liver toxicity in both the US and Europe.”

Pretreatment with probiotic spore-forming Bacillus strains and a supplement of amino acids in combination with immunoglobulins exhibited anti-inflammatory and antioxidant effects in an AA-induced rat model of ulcerative colitis.

In one study, Bacillus coagulans (one of the spore-forming strains in MegaSporeBiotic™), when used alone was shown to help ease depression and gut problems in IBS patients. It was a randomised, double-blind, placebo controlled, multi-centre, pilot clinical study and:

The improvement in depression and IBS symptoms was statistically significant and clinically meaningful. These findings support B. coagulans MTCC 5856 as an important new treatment option for major depressive disorder in IBS patients.

During The Anxiety Summit 5: Gut-Brain Axis, I interviewed Kiran Krishnan who is a microbiologist, one of the founders of Microbiome Labs and a co-creator of MegaSporeBiotic™. He reminds us about the gut-brain connection and how anxiety and mental health issues come from the gut “because the vast majority of serotonin in your body – more than ninety percent of it – is actually produced in the gut” and not in the brain.

He talks about the type of cell in the gut that produces serotonin – the enterochromaffin cell – and the fact that “spore forming bacteria are some of the best stimulators of the enterochromaffin cell to produce serotonin.”

With low levels of serotonin you’ll experience the worry-type of anxiety with ruminations, obsessing, panic attacks, insomnia (often lying awake worrying). Other low serotonin symptoms include low mood/depression, late afternoon and evening carbohydrate cravings, pain, PMS, irritability, rage and anger, TMJ, low confidence, imposter syndrome and perfectionism. This type of low-serotonin anxiety is different from the low GABA physical/tension type anxiety.

These cells also play a crucial role in gastrointestinal regulation, particularly intestinal motility. We know low serotonin also contributes to digestive/IBS-type symptoms.

You can see a list of all the low serotonin symptoms here.

Brandy’s positive feedback on digestive issues and mental health

Brandy Oto, a marriage, couple and family counselor, incorporates  an integrative nutrition approach with her clients and she shares this:

MegaSporeBiotic™ makes a HUGE difference in my body! I have used every probiotic I can think of. Megaspore has not only resolved my digestive issues and allows me regular bowel movements, I find my mental health is much better! I have decided to use it in my practice as well now. Clients consistently report better mental health!

I asked her how quickly she notices an improvement when using MegaSporeBiotic™ and what aspects of mental health improve for her and her clients. She shares this:

I personally notice physical and mental anxiety decrease usually about 4-5 days, bowel movements easy within a couple days, ability to tolerate foods I was sensitive to after 6 or so months on them.

Clients report all types of improvements from anxiety, depression, to digestive issues improving. I have even heard from one client that when she gets off the probiotic symptoms of schizophrenia return.

In Brandy’s mental health practice, she does use amino acids to address neurotransmitter deficiencies too (for example tryptophan or 5-HTP to address low serotonin symptoms like worry, fear, panic attacks). She uses this spore-based probiotic to address underlying issues that cause those deficiencies.

It’s not one or the other – the probiotics and amino acids are part of a comprehensive plan.

Not everyone raves about this probiotic and some folks report it either does nothing for them or is too strong for them. So, as with everything, it’s very individualized.

How do spore-based probiotics differ from other probiotics?

During the Anxiety Summit interview with Kiran, he explains how they differ from other probiotics and why this is important for them to get into the gut:

These are organisms that have a unique capability of covering themselves in a thick calcified protein-like coating. So it’s armor, essentially, around the bacterial cell.

This allows these bacteria to come in through the gastric system, through the oral route, and survive the gauntlet that bacteria have to go through just getting through the process of digestion.

So the first step is the stomach acid. The stomach acid is called the gastric barrier and that’s because it acts as an actual physical barrier through the function of hydrochloric acid to try to kill off as many microbes that are trying to enter the system through food and other exposure.

If something gets past the stomach acid then the second piece of the gauntlet are the bile salts. Bile salts are released into the duodenum itself. Those are very strong antimicrobials and part of their function is to act as an antimicrobial to protect the system against a lot of bacteria coming in on a regular basis.

And then the last part is the pancreatic enzymes that help you digest your food – they also act as antimicrobials.

So there’s this really difficult gauntlet that the microbes that are entering the system through the oral route have to go through in order to make it past these initial systems to get to the site of action in the deeper part of the intestines where they’re supposed to function as a probiotic.

These spores have developed this unique, natural capability of covering themselves in this armor which allows them to survive through all of that.

This study, Survival and persistence of Bacillus clausii in the human gastrointestinal tract following oral administration as spore-based probiotic formulation confirms the above for one particular strain and concludes that “Bacillus clausii spores survive transit through the human gastrointestinal tract.”

Where can I buy MegaSporeBiotic™?

megasporebiotic supplement facts

These are the spore-based bacteria contained in the MegaSporeBiotic™ product: Bacillus Licheniformis, Bacillus Indicus HU36™, Bacillus Subtilis HU58™, Bacillus Clausii and Bacillus Coagulans.

You can purchase MegaSporeBiotic™ directly from Microbiome Labs once you have set up an account with them under my name. Use this link (and make sure the Direct2Patient™ Code says tscott).

You can also read more about the product on the Microbiome Labs site here.

If you already have an account with Fullscript, my online supplement store, you can purchase from there too.

If you don’t yet have an account with Fullscript you can read more about how to set up an account here.

Let us know if you’ve used MegaSporeBiotic™ with success and how it helped you with anxiety, depression and/or gut and liver health.

Let us know if you’ve used another spore-based probiotic and which one? Or do you have a favorite probiotic that is not spore-based?

I’m going to a product review like this once a month so please let me know if you like this format with research, feedback and mechanisms.  And let me know what other products you’d like me to review.

Feel free to post your questions here too.

[The above statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure or prevent any disease.]

 

5-HTP and/or tryptophan to help with increased anxiety, panic attacks and depression caused by spring allergies

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5-htp, tryptophan, and spring allergies

Many of my clients experience increased anxiety, more severe panic attacks and worse depression when their spring allergies are flaring up. Do they feel like this simply because they feel so bad physically or could there be some underlying biochemistry that triggers their worsening mental health symptoms? I explain below how low serotonin is one possible root cause that can be addressed nutritionally with tryptophan and/or 5-HTP. Other factors to consider are the impact on the adrenals and GABA levels.

Today’s blog is inspired by Unten, who is part of my Facebook community. She asked this question:

I find that always during spring my anxiety and panic attacks get much worse when there’s lots of pollen and dust and other allergens in the air (at least here in Finland)…could this be true and not just “in my head”?

And then someone else responded saying:

I have noticed the same for me as well here in the USA.

My response to both of them is that it is not just in your head. There is plenty of research supporting this connection and we see it clinically too.

This paper, Changes in Severity of Allergy and Anxiety Symptoms Are Positively Correlated in Patients with Recurrent Mood Disorders Who Are Exposed to Seasonal Peaks of Aeroallergens, confirmed a significant positive association between allergy scores and anxiety scores and reports some possible mechanisms:

  1. The psychological effects of being ill, as well as impairments of sleep secondary to nasal obstruction or inflammation may affect mood.
  2. Cytokines may lead to a mood disturbance via the expression of the enzyme indoleamine-2,3-dioxygenase, which shifts the synthesis of tryptophan from serotonin to kynurenine. The resultant acute tryptophan depletion results in decreased brain serotonin, which may contribute to both depression and anxiety.
  3. Cytokines released during allergic inflammation may affect the brain directly, via nerves, surrounding tissue, or via regions that do not have a blood brain barrier, such as the circumventricular organs.
  4. Cytokines may also be involved in changes in the hypothalamic-pituitary-adrenal (HPA) axis… A sustained increase in activity in the HPA axis is associated with severe anxiety.
  5. Cytokines might lead to a physiological change in GABAA receptor functioning

I’ll discuss some possible solutions below.

Tryptophan and/or 5-HTP for low serotonin support if needed

The second bullet above is a good reason to consider serotonin support with tryptophan or 5-HTP.  If you have anxiety or panic attacks (and other low serotonin symptoms), we always want to figure out if low serotonin is a possible cause and address it, regardless of the circumstances/trigger (seasonal allergies in this instance).

Here are some useful blogs related to low serotonin and the amino acids:

Christine’s increased depression due to seasonal allergies improves a few days after starting 5-HTP and tryptophan

When I posted the above possible mechanisms on Facebook, Christine thanked me and shared her surprise:

I had no idea! This explains my increased depression lately. I didn’t know there was a correlation, but it makes complete sense now.  I’m in the Midwest. I’ve always had issues in March and April because of my seasonal allergies.

When I asked if she has used tryptophan or 5-HTP and bumped up the dose when she is suffering during seasonal allergies, she responded:

I just learned about both of these [amino acids]. I just bought your book and I am starting to use them. I don’t know if they take a while to start working?

I responded saying the amino acids work very quickly if they are needed and serotonin is low. It was not surprising to me that Christine shared her great results a few days later:

I’ve been using 5-HTP and tryptophan. I’m feeling so much better now. Thank you!

If your anxiety or depression is caused by low serotonin, you can expect to feel some relief right away provided you find the ideal dose for your unique needs. For some it’s a solution right away and for others it can take some adjusting up and down and trialing with 5-HTP and/or tryptophan to find the right combination.

Adrenal support and/or Seriphos if needed

The fourth bullet under the possible mechanisms above, is a good reason to also consider adrenal support: herbal adaptogens such a rhodiola and licorice, B vitamins, extra pantothenic acid and vitamin C. I also recommend using something like Seriphos to lower high cortisol if needed.  Another option is Relora®, a combination of Magnolia officinalis and Phellodendron amurense which lowers cortisol and reduces stress and anxiety.

Low GABA support if needed

The fifth bullet above is a good reason to consider GABA support with GABA or theanine if you have the low GABA type of physical tension that is made worse during your seasonal allergies. Just like with low serotonin we always want to figure out if low GABA is a possible cause of the anxiety and address it, even if it’s being made worse because of seasonal allergies.

You can see all the low GABA symptoms here and GABA products I use with my clients here on the supplements blog.

Address all root cause of anxiety/depression and the seasonal allergies

As always, it’s not only the low serotonin and/or high cortisol we need to address. We must always do a full functional workup looking at diet, nutritional deficiencies, digestion, all hormones, toxins and infections (and so on) so we can address all possible root causes.

Of course, identifying and addressing the root causes of the seasonal allergies is important too. This blog, Hay Fever: 9 Natural Ways to Treat Seasonal Allergy Symptoms by Dr. Josh Axe, outlines many dietary and lifestyle changes that can have a big impact. You’ll notice that much of this is foundational to my work.

Stress reduction is key and serotonin/GABA support help so much in this regard. So does zinc which is needed for both the production of serotonin and GABA, and enhanced immunity.

The blog also states that quercetin helps with seasonal allergies because it “stops the production and release of histamine.” Interestingly, quercetin also protects  against stress-induced anxiety and depression in animal studies (here is a link to one such study).

Thanks to these folks for asking good questions and for allowing me to share here.

My first take-away is not to ever tolerate not feeling your best (if that’s confusing – you deserve to feel your best always!) and always ask questions and look for connections.  My second take-away is to encourage you and others in my community to be empowered and take action. So kudos to Christine for jumping and purchasing my book, The Antianxiety Food Solution, reading it and being smart about using the amino acids.

Have you found that higher doses of tryptophan or 5-HTP helps with reducing the more severe anxiety, the depression/low mood and/or the increased panic attacks you experience during allergy season?

What about other low serotonin symptoms such as insomnia, cravings and PMS? Are they worse during allergy season?

Have you found addressing low GABA anxiety with higher doses of GABA helps when you have seasonal allergies?

Have you tested your cortisol levels during allergy season and found that adrenal support helps too? Keep in mind it will take longer to see results if this is the case.

Feel free to post your questions and feedback in the comments below.

5-HTP in Parkinson’s disease: benefits for depression, levodopa-induced motor complications, anxiety and sleep issues

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5-HTP and Parkinson's Disease

Research shows that the amino acid 5-HTP (5-hydroxytryptophan), the intermediate metabolite of tryptophan in the production of serotonin, offers benefits for Parkinson’s disease patients. It has been reported to ease depression and to reduce levodopa-induced motor complications. This was reported in two separate studies by the same research team at the University of Cagliari, Cagliari, Italy. They were small studies and considered preliminary. However, given what I know about the effectiveness of 5-HTP (for depression, anxiety and insomnia), I consider it a major step forward for Parkinson’s disease patients.

In this study, Efficacy and safety of 5-hydroxytryptophan on depression and apathy in Parkinson’s disease: a preliminary finding, 25 individuals with Parkinson’s disease were enrolled and “patients received placebo or 50 mg of 5-HTP daily over a period of 4 weeks”

The findings were as follows:

a significant improvement of depressive symptoms during the 50-mg 5-HTP treatment compared with placebo.

In this study 5-HTP was not shown to reduce apathy symptoms. This is not surprising to me, given that we typically see the amino acid tyrosine help with apathy symptoms associated with low catecholamines, rather than low serotonin.

In this study, Efficacy and safety of 5-Hydroxytryptophan on levodopa-induced motor complications in Parkinson’s disease: A preliminary finding, 12 Parkinson’s patients who were diagnosed with levodopa-induced dyskinesias (involuntary, erratic, writhing movements of the face, arms, legs or trunk) and motor fluctuations were included. Patients received placebo or 50 mg of 5-HTP daily over 4 weeks.

The findings were as follows:

a significant improvement of levodopa-induced dyskinesias during the 50 mg 5-HTP treatment.

The study authors make the serotonin-dyskinesias connection, stating that “Several studies have indicated that altered serotonergic neurotransmission may contribute to the motor features commonly associated with Parkinson’s disease drug treatment such as levodopa-induced dyskinesias.”

Both studies were single-center, randomized, double-blind placebo-controlled cross-over trials, and both recommend larger studies, longer treatment duration and different doses in order to corroborate these early findings.

Sleep disorders, gastrointestinal dysfunction, and anxiety in Parkinson’s disease

As reported in this paper, Spectrum of Non-Motor Symptoms in Parkinson’s Disease

Despite their significant clinical importance, the awareness of non-motor symptoms is quite negligible. Sleep disorders, gastrointestinal dysfunction, olfactory disturbances, anxiety, and depressive episodes are some of the most common non-motor presentations.

5-HTP helps with depression, anxiety, sleep issues (more here: Sleep promoting effects of combined GABA and 5-HTP)  and digestive issues.

Given what I know about the effectiveness of 5-HTP in my clients with anxiety, low mood and sleep issues, I consider this research a major step forward for Parkinson’s disease patients who may also experience anxiety, depression and sleep issues.

5-HTP also improves focus and when to switch to tryptophan

I was surprised to read that it has been hypothesized that ADHD and Parkinson’s disease share “several overlapping anatomical and neurochemical changes.”

As you can see from these blog posts, in addition to boosting mood, 5-HTP also improves focus and ADHD symptoms:

One caution with 5-HTP is that it can raise salivary cortisol and cause a “wired-tired” feeling. When this happens we switch to tryptophan, always starting with a trial in order to figure out the ideal dose.

Typical dosing of 5-HTP for low serotonin-type anxiety

I find that using 50 mg of 5-HTP 1-3 times a day is a typical starting dose for my adult clients who have the low serotonin-type of anxiety (mental anxiety, worry, panic attacks, ruminations), low mood, insomnia, sugar cravings, irritability, PMS, anger issues and TMJ.

Keep in mind that in these 2 studies, 50 mg of 5-HTP was used only once a day, and everyone was given the same dose. There is never a one-size fits all approach with the amino acids and we adjust up or down based on symptoms, using a trial approach. I’d love to see this approach used with follow-up studies.

If you are new to the concept of low serotonin and the use of tryptophan or 5-HTP you will find this blog helpful.

Parkinson’s disease and GABA, flavonoids in parsley and insecticides

Here are some other useful blogs on Parkinson’s disease:

Have you or a family member with Parkinson’s disease used 5-HTP (or tryptophan) for easing depression and improving levodopa-induced motor complications?

Have you seen reduced anxiety, improved sleep, better digestion and better focus too?

If you’re a practitioner working with Parkinson’s patients have you used 5-HTP or tryptophan with success?

Feel free to post your questions and feedback in the comments below.

Tryptophan for my teenager: she laughs and smiles, her OCD and anxiety has lessened, and she is more goal oriented and focused on school.

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tryptophan teenager

A mom posted wonderful feedback on a recent blog post on ADHD and 5-HTP, sharing how how tryptophan has helped her daughter in ways that didn’t even realize were an issue. She was shocked to see so many improvements and she called it a miracle experience. Here is the feedback Kathy shared:

We had a “miracle” experience with adding L-Tryptophan 300mg at bedtime for my teenager. I was shocked to see how much it improved my child, especially in ways that I didn’t even realize were an issue.

  • The results were like my teenager coming out of a fog, and also like my child was when she was younger.
  • She became more engaged with the family and did a lot less isolating.
  • She suddenly had interest in activities she had never pursued before. For instance, she wanted to start playing team sports after having played nothing for years. She wanted to do family game night! Before, we couldn’t force her to do it, and now it was her idea.
  • Her thoughts seemed to quiet down and were more organized.
  • Her OCD [obsessive compulsive disorder] and anxiety symptoms lessened.
  • She became more goal oriented and focused on school.
  • She laughs and smiles more!

We were most shocked because what we thought was normal teenage development was actually depression that we had no idea was there.

Tryptophan has been the most effective supplement we have ever used, and we have used a lot. We experimented with the dose until we ended up on 3 at bedtime. The brand we used was the Lidtke L-Tryptophan.

This did not cure her ADD [attention deficit disorder], but definitely improved her executive functioning. We tried GABA and saw no improvement with that. We have tinkered with L-Tyrosine, but haven’t been able to get on a steady dose of it yet to see if it will also help.

Thank you for giving us the idea to try!

I thanked Kathy for sharing the wonderful results her daughter has experienced with the Lidtke Tryptophan and how happy I was for both of them! I love all the surprise benefits she saw and appreciate this feedback: “This has been the most effective supplement we have ever used, and we have used a lot.” I hear this a lot – tryptophan and GABA are game-changers for so many of my clients.

I have these questions I posed to this mom and hope to hear back as I feel these answers may be helpful for other parents and practitioners who work with children and teens:

  • Did she use 3 x chewable 100mg tryptophan or did they open the 500mg capsule
  • What did the trial look like for them to end up with 300mg at night?
  • What made her decide to trial tryptophan instead of 5-HTP?
  • What made you decide to even trial tryptophan – was it her daughter’s anxiety and OCD?
  • Was her daughter willing to trial tryptophan initially or was there resistance?

I’ll report back once I get Kathy’s feedback.

Updated Feb 26, 2021: Kathy’s additional feedback

I read all your blog articles and listened to some of your talks. I made a chart of symptoms and then decided to try GABA Calm first.

Since that didn’t help, the next logical choice for us was Tryptophan. My daughter has a lot of anxiety, intrusive thoughts and other OCD symptoms. The reason I didn’t trial the 5HTP first was because my daughter has some PTSD like startle responses, and since you said it isn’t good if you have high cortisol, I just made the guess that she might due to her startle response.

With the Lidtke brand, we used the [500mg] capsules and I did not open them up. My teen would not have gone for that because she already takes a lot of supplements and medication because she is being treated for Lyme and Bartonella. She is cooperative with taking all the supplements/medication. We started at 1 capsule a night for probably 5 days and saw no difference, then went to two for another 5 days, and then landed on 3 when we noticed the dramatic change.

Even her LLMD [Lyme literate MD] was shocked at how differently she interacted with her in our last appointment.

Normal teenage development or really depression?

I also have to wonder how many other parents would say this after addressing low serotonin levels in their daughters and/or sons: “We were most shocked because what we thought was normal teenage development was actually depression that we had no idea was there.” I suspect the number would be high, especially given the growing incidence of anxiety and depression in teens.

Also, according to the ADAA/Anxiety and Depression Association of America “80 percent of kids with a diagnosable anxiety disorder and 60 percent of kids with diagnosable depression are not getting treatment.”

Now that Kathy has seen these wonderful changes in her daughter, I’d love to know – if she could go back in time – what questions would she have asked her anxious and depressed daughter so she could help her with solutions sooner?

And what would she suggest to other parents to be looking out for in order to identify anxiety and depression in their children (who often cannot adequately articulate that they do feel anxious and/or depressed)?

If you’re new to tryptophan and low serotonin symptoms

In case you’re new to tryptophan, it is an amino acid that is used as a supplement to support low levels of serotonin. With low serotonin we the worry-in-your-head and ruminating type of anxiety, panic attacks and phobias, lack of confidence, depression, negativity, imposter syndrome, PMS, irritability, anger issues, insomnia and afternoon/evening cravings.

My thoughts on addressing the ADD/inattention issues

Here are my thoughts for her as a starting point for helping to address her daughter’s residual ADD/inattention symptoms:

  • When someone does well with tryptophan at night, we often trial 5-HTP in the day too. As I shared in a recent blog, this mom shared how 5-HTP melts helped with ADHD symptoms one of her adopted kids was experiencing. She also called it a miracle!
  • A tyrosine trial may also be worth considering because low catecholamines lead to poor focus and feelings of calm focus are reported with tyrosine. However we also see low energy, low motivation and depression with low catecholamines which no longer seem to be an issue – so I’m not sure if tyrosine would help.
  • L-theanine may work better than the GABA they tried. Research shows it helps with cognitive function specifically improvements in verbal fluency (especially letter fluency) and improvements in executive function (planning, multi-tasking etc).
  • With inattention issues it’s also key to look at low blood sugar, gluten and sugar consumption, low iron, low zinc and low omega-3s.
  • If there was hyperactivity with the inattention then we’d look at salicylates in the diet as they can cause behaviour issues. This doesn’t seem to be the issue but a big clue would be red cheeks and ears that are not from the heat.
  • Consider the Ayurvedic herb Bacopa monnieri which has been shown to improve “visual perception, impulsivity, and attention” in children and adults.
  • Consider the herb saffron (Crocus sativus) which has “memory-enhancing and antidepressant effects” and has been shown to be as effective as Methylphenidate/Ritalin.

I love hearing heartwarming stories like this and I am sharing it here to inspire and offer hope!

Please do share your success story on the blog so we can all learn from each other, as well as inspire and offer hope.

How has tryptophan helped you or your child? What has helped with inattention?

Feel free to post your questions and feedback in the comments below.

GABA for bladder pain/interstitial cystitis and urgency, IBS pain and anxiety?

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gaba for pain

Is there a place for using the amino acid GABA as a supplement to help with bladder pain/interstitial cystitis and urgency and also help with IBS (irritable bowel syndrome) pain – at the same time as easing physical anxiety caused by low GABA levels?

I’d like to share some quotes from this commentary, GABAB receptors in the bladder and bowel: therapeutic potential for positive allosteric modulators?

The bladder pain syndrome (or interstitial cystitis/painful bladder syndrome) is a spectrum of urological symptoms characterized by frequency, urgency and pain on bladder filling.

Bladder pain syndrome is often present in those who have IBS and abdominal pain and the authors mention the role of GABA in both:

Of further note is the co-morbidity between bladder pain syndrome and other functional pain syndromes, in particular, irritable bowel syndrome, a functional gastrointestinal disorder associated with visceral abdominal pain and altered bowel habit.

… it is tempting to speculate that GABAB receptor positive allosteric modulators may display efficacy in not only functional pain disorders of the bladder, but also of the bowel, through modulation of either central and peripheral GABAB receptors, or both

Positive allosteric modulators increase the activity of the receptor so in this case they are referring to increasing the activity of the GABAB receptor, reducing both bladder pain and gut pain.

This commentary and the original paper refer to ADX71441, which has been shown in animal studies to be “a novel positive allosteric modulator (PAM) of the GABAB receptor that has shown encouraging results in pre-clinical models of anxiety, pain, overactive bladder and alcohol addiction.”

We know GABA eases anxiety and pain and is extremely beneficial when it comes to alcohol and other addictions. In a recent blog post I shared how PharmaGABA eases physical anxiety in a young man who has recently given up Adderall, alcohol and nicotine.

And given that depression, anxiety and stress is higher in women with urinary incontinence it makes sense that an amino acid such as GABA may also help ease some of the symptoms of bladder pain syndrome when low GABA is a factor.

Depending on the root cause/s it’s likely addressing low serotonin, low endorphins and low vitamin D may play a role too. Of course, a full functional medicine and nutritional work up and review of diet is key too. Bladder dysfunction is seen in up to one third of celiac patients. This can cause leaky gut and nutritional deficiencies leading to low levels of neurotransmitters such a GABA and serotonin. Dietary oxalates can often be a factor with bladder issues and pain.

Considering all of this in conjunction with learning from/working with a pelvic floor physical therapist is key.  I highly recommend someone like Isa Herrera, MSPT, CSCS who hosts online masterclass training sessions for those with pelvic health issues. Her next series airs online mid-February and you can learn more and register here.

Here are some related blog posts that you may find helpful:

In case you’re new to GABA you can read more about it here: GABA for the physical-tension and stiff-and-tense-muscles type of anxiety.

The supplements blog lists GABA products I use with clients and recommend to those in my community.

I’m proposing that there is a place for doing a trial of the amino acid GABA (as a supplement) to help with bladder pain/interstitial cystitis and urgency, especially when there are symptoms of low GABA. If GABA helps to ease the visceral pain caused by IBS/SIBO, it may also help with bladder pain.

Have you observed less bladder pain when using GABA for easing physical symptoms of low GABA anxiety (stiff and tense muscles, overwhelm, lying awake tensely at night, anxious and using alcohol to self-medicate in order to calm down)?

Have you noticed any reduction in bladder urgency when using GABA for anxiety?

Do you also have IBS pain or SIBO (small intestinal bacterial overgrowth) pain that is eased by GABA?

Have the following helped: going gluten-free, lowering oxalates and/or working with a pelvic floor physical therapist?

If you’re a practitioner have you made any of these observations?

Please do share in the comments below and let me know if you found this helpful, what else has helped you or if you have questions.