depression

My 12 year old son has ADHD, is impulsive, is a loner, craves carbs, and doesn’t do well or care about school – should he be on GABA?

July 21, 2023 By Trudy Scott 17 Comments

I’ve been reading your blogs and I’m trying to decide if my 12 year old son should be on GABA? He has ADHD, is impulsive, is a loner, craves carbs, and doesn’t do well or care about school.

Can you tell me what supplement he could be deficient and where to purchase? He is currently on ADHD medication (Focalin) during the school year.

Janice asked the above question about her 12 year old son. I wish it was as simple as just using the calming amino acid GABA but it’s seldom one amino acid that is the answer. GABA is often one of many supplements that may help and in this instance I suspect a combination of neurotransmitter imbalances (low GABA, low dopamine and low serotonin), pyroluria, other possible nutritional deficiencies and dietary factors are at play. Read on to hear my approach for working through what may help this young man improve his focus, reduce his carbs, actually care about school and doing well, reduce his impulsivity and help him fit in socially – and ultimately lead to him being a happier, calmer and healthier child.

GABA with preteens who have ADHD and spinning-type symptoms

I always start with one of the amino acids because we get quick results and immediate feedback. Since Janice asked about GABA, this is the GABA feedback I shared with her: I’ve had good results with GABA with preteens who have ADHD and spinning-type symptoms. One clue is when the craving of carbs is driven by stress i.e. stress eating. I always start with the symptoms questionnaire and have the parent rate each low GABA symptom on a scale of 1-10, with 10 being most severe, ideally in conjunction with their child.

I then have the child do a one-off trial of GABA and we observe improvements in the next 5-30 minutes. If the child reports any improvement in any of the symptoms – in this case focus and spinning driven by anxiety – the child continues with GABA and increases over the next few weeks to find the ideal dose for their needs.

Sometimes focus issues are so severe that it’s too challenging to rate symptoms before, doing a one-off trial of GABA and then rating symptoms afterwards. In cases like this, mom makes the decision to have their child use GABA before school, when they get home and possibly early evening too. Mom can observe their focus and spinning: like getting dressed and ready for school, settling down to homework in the afternoon and settling down for bed.

Relying on feedback from school is invaluable too. Stress related carb cravings are also assessed i.e. does he seek out sugar when stressed and anxious.

A mom shares how GABA helps her 11 year old daughter – GABA for children: ADHD, focus issues, irritability, anxiety and tantrums

My daughter hasn’t been diagnosed with ADHD but has a lot of ADHD qualities. We were having a huge amount of behavior problems as she is getting older (she’s 11). She has had amazing behavior at school and at home since giving it to her. She’s almost like a different child. GABA has truly changed our life.

…before the GABA she was irritable, she was fighting with her teacher and schoolmates, she couldn’t focus and was distracted by anything and everything, she was constantly disrupting the class and she was throwing major tantrums over ridiculous stuff (like her hair didn’t do what she wanted), she was mouthy and everything was a fight.

We are not seeing 99% of those behaviors at all anymore. She of course is still your typical pre-teen but if I say “no you can’t have that” our “no you can’t go there” her reaction is OK. Before it would have been a major fight or meltdown. Her teacher is reporting to me every day about her wonderful days.

Tyrosine for focus issues, low motivation and low energy type carb cravings

With focus issues I would also consider the role of low dopamine and do a trial of tyrosine. Other clues: are his carb cravings related to low energy and is there also low motivation tied to the fact that he doesn’t care about school? Are there also signs of depression or low mood?

We go back to the symptoms questionnaire and have the parent rate each low dopamine/low catecholamine symptom on a scale of 1-10, with 10 being most severe. Again, do this in conjunction with the child if possible.

We only do a trial of one amino acid at a time so we know what is working. Assuming the GABA has been helping, we’d do a trial of tyrosine next and look for improvements in focus, carb cravings (all neurotransmitter imbalances can lead to carb cravings), motivation and mood.

If the one-off trial approach is not an option, tyrosine is also used before school and right after school but no later than 3pm so as not to affect sleep. Again, the above symptoms are tracked.

In this blog both GABA and tyrosine help this teen: GABA helps 14-year-old with Tourette’s Syndrome (the tics and sleep), and tyrosine makes him happier and his mind sharper

Tryptophan or 5-HTP for ADHD/hyperactivity and afternoon cravings

Hyperactivity can also show up with low serotonin, and so can something like not caring about school i.e. a low mood. A clue here is when his carb cravings are more intense – with low serotonin it’s typically afternoon or evening.

We go back to the symptoms questionnaire and have the parent rate each low serotonin symptom on a scale of 1-10, with 10 being most severe. And again, it’s best to do this in conjunction with the child if possible and do a one-off trial of tryptophan or 5-HTP.

If that’s not possible, tryptophan or 5-HTP is used mid-afternoon and evening and symptoms are tracked. This can be layered in on top of the GABA and tyrosine if they are offering some relief.

Here is a blog post where a mom shares how 5-HTP helps her child – ADHD: 5-HTP melts have been a miracle for one of my adopted kids

5-HTP melts have been a miracle for one of my adopted kids. He had lots of trauma and off the charts ADHD. 5-HTP is better than methylphenidate (Ritalin) and we are now weaning off the non-stimulants.

Just 80 mg 5-HTP in the morning is all he needs. He was super ADHD, he had a para (teacher’s aide) in public school for years to keep him on track and this year at a school for ADHD the teachers were complaining that he was never on task. Now after a week it has changed his life.

Addressing pyroluria, low lithium, low zinc, low blood sugar and diet

Janice mentions her son is a loner so we’d look into pyroluria/social anxiety and add zinc, vitamin B6 and evening primrose oil (and other key nutrients). Keep in mind that zinc deficiency is common and is often low with ADHD.

She also mentions that he is impulsive. Impulsivity and ADHD is common with low levels of lithium. A big clue is a child having a roller-coaster of emotions. I use this low lithium questionnaire to assess for a need for low dose lithium (a nutritional supplement).

I consider low blood sugar with all my clients and with this young man low blood sugar may be contributing to his focus issues, low mood and desire for carbs. The amino acid glutamine helps as does breakfast and meals with quality animal protein and healthy fats.

And it goes without saying that dietary factors must always be addressed. My book is a great resource when are looking for a comprehensive dietary approach, which is needed with ADHD and the symptoms Janice describes – The Antianxiety Food Solution. There is also a chapter on low blood sugar, pyroluria and the amino acids.

If you are an adult and can relate to any of these symptoms and feelings, the same process applies. Just remember this: there is no one-size fits all since we all have unique biochemistry.

Side effects and longer term effects of stimulant medications

I appreciate Janice for reaching out and asking this question. Hopefully, implementing some or all of these changes, will allow her son to stop his stimulant medication, Focalin. This medication is similar to Ritalin (methylphenidate), which can cause the following side-effects: feeling sad or empty, irritability, loss of interest or pleasure, trouble concentrating, trouble sleeping (and many more).

These stimulant medications can also play a role in longer term health effects that include heart disease and the possibility of it being a gateway drug to other stimulants. The research on the latter is hotly debated but it is often seen clinically.

Resources if you are new to using amino acids as supplements

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

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.

As mentioned, 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 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. You can find them all in my online store.

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 any of the above amino acids helped your child or you with the following symptoms: ADHD and poor focus, carb cravings and low mood/low motivation (doesn’t care)?

Has the pyroluria protocol helped your child or you be less of a loner?

Has low dose lithium helped your child or you with impulsivity and focus issues?

Have dietary changes helped too?

If you are a practitioner, are you using amino acids, the pyroluria protocol, low dose lithium and dietary changes with success in cases like this?

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

Psychiatric Complications of Primary Hyperparathyroidism and Mild Hypercalcemia: anxiety, depression, anger, irritability, delusions and impaired cognition

July 7, 2023 By Trudy Scott 38 Comments

In samples of patients undergoing parathyroidectomy for primary hyperparathyroidism (PHPT), these disturbances have been identified at a rate of 43.1%–53.0% for anxiety, 33.0%–62.1% for depression, 22.0% for thoughts of death or suicide, 51.9% for anger and irritability, 5.0%–20.0% for hallucinations and delusions, and 37.3%–46.5% for impaired cognition.

In fact, it has been noted that there are more neuropsychiatric phenomena in PHPT than is often recognized and that these symptoms are easily missed, particularly in the elderly population.

This excerpt is from, Psychiatric Complications of Primary Hyperparathyroidism and Mild Hypercalcemia, published in Psychiatry Online.

I’ve recently been reading as much as I can about this condition, for personal and professional reasons. As soon as I learn about something new I go digging to see if there is an anxiety connection. And I must say I was very surprised to read these stats. It’s not something I’ve heard discussed or taught at mental health conferences.

The authors also state this about the condition:

The incidence of primary hyperparathyroidism (PHPT) is about 21 cases per 100,000 person-years, and the disorder is usually caused by a solitary parathyroid adenoma. PHPT has traditionally been recognized by its characteristic symptoms, including urolithiasis (“stones”); osteopenia and osteoporosis (“bones”); abdominal cramping, nausea, and peptic ulceration (“moans”); and depression, anxiety, cognitive dysfunction, insomnia, confusion, and personality changes (“psychiatric overtones”).

How do changes in serum calcium levels contribute to mental health and cognitive symptoms?

It’s always helpful to understand the mechanism and it was the first thought that went through my mind – how does hyperparathyroidism and changes in serum calcium levels cause these mental health and cognitive symptoms? The authors share this:

Although the pathogenesis [or cause] of psychiatric symptoms in primary hyperparathyroidism remains unclear, calcium is thought to figure prominently in determining changes in monoamine metabolism in the central nervous system(CNS), thereby modifying neurotransmission and resulting in alterations in mood and cognition.

I went digging and found this paper – Acute psychosis secondary to suspected hyperparathyroidism: A case report and literature review.

The authors also state that the mechanism isn’t known for certain. And although they are referring specifically to psychosis, the explanation could be applied to other symptoms too: “It is thought that the changes in serum calcium level slow down nerve function and neurotransmission rate, inducing psychosis (and other symptoms like anxiety, depression, anger, irritability and suicidal thoughts).

Understanding this possible mechanism helps us find a temporary solution for these symptoms until the hyperparathyroidism is addressed with surgery i.e. using amino acids as supplements.

Using amino acids to ease symptoms while you are seeking the root cause/s

If you’ve been following my work and have read my book The Antianxiety Food Solution, you’ll be familiar with using targeted amino acids as supplements to support low levels of neurotransmitters. These provide quick relief of symptoms (in a day or less) while you are seeking the root cause.

If we look at the above symptoms:

Anxiety can be a sign of low serotonin (worry type of anxiety) and/or low GABA (physical type of anxiety) – and tryptophan/5-HTP and/or GABA help ease symptoms.
Depression can be a sign of low serotonin (negativity), low dopamine (curl-up-in-bed depression) an/or low endorphins (weepy depression) – and tryptophan/5-HTP, tyrosine and/or DPA help ease symptoms.
Irritability and anger are common with low serotonin – and tryptophan/5-HTP helps to ease symptoms.
Low GABA can also be involved with anger and rage
Cognitive issues can be caused by low dopamine and low GABA – and tyrosine and/or GABA help ease symptoms

(You can find the symptoms questionnaire here. As always, amino acids are used based on symptom clusters and dosed according to your unique needs.)

If you find you have been using the amino acids long term and have explored all the possible root causes described in my book and summarized here, it may be worth investigating primary hyperthyroidism especially if you’re menopausal.

Case: “I had to have a parathyroid gland removed a few years ago… I literally felt better from the moment I came round from the surgery”

We always want to find the root cause when we have various symptoms. With this condition, it’s common to observe very quick resolution of symptoms after parathyroid surgery to remove the adenoma/s. Someone in our community shared this:

I had to have a parathyroid gland removed a few years ago … I literally felt better from the moment I came round from the surgery. It’s a miserable disease. I thought I was going to die! Lots of people get so low that they don’t feel like they can go on.

Bone pain was awful. Fatigue, depression etc.

I had had some dental issues around that time. One of my teeth crumbled. My Vitamin D went down to 9 so I am sure that was a large part of the puzzle.

I was actually diagnosed fairly quickly but was retested many times. I self-referred to a surgeon that was in-network in the end as my insurance wouldn’t cover various surgeons that my doctor wanted me to go too.

I had had breast cancer a few years ago and so had had weekly blood tests and, when I went back and looked, my calcium had been high for years. So important to read our own results.

The surgery was so easy.

What an amazing outcome for this woman and I appreciate her for sharing so we all get to learn and benefit from her journey. And yes, I agree, we need to advocate for ourselves and ask for and keep copies of all our labs. And get educated and ask questions. It’s really unfortunate that high calcium and hyperparathyroidism is so often missed.

Not everyone has all the listed symptoms of primary hyperparathyroidism. This woman did experience fatigue, depression and bone pain. She did not experience anxiety and didn’t have kidney stones. I do suspect dietary oxalate issues (without kidney stones) can be an issue for some folks because of the calcium disruption.

Some reasons why hyperparathyroidism is underdiagnosed

In the last few months I have learned that primary hyperparathyroidism is underdiagnosed. PTH (parathyroid hormone) is not routinely tested and I believe that it should be. Also, as you read above, elevated calcium levels are often ignored or brushed off as being a non-issue. And to complicate things further calcium is not always elevated. Hyperparathyroidism is also underdiagnosed and undertreated in the elderly.

For many women (and men) the discovery happens after they are diagnosed with osteoporosis and then calcium and PTH are tested, and/or past elevated calcium levels are “discovered.” If the hyperparathyroidism diagnosis happens first then osteoporosis screening is not always done and I believe it should be. And don’t get me started on when I believe osteoporosis screening should start (at 45 and not 65 or 70 years old) and issues with DEXA screening (more to come on this).

The good news is that primary hyperparathyroidism is a well-established cause of secondary osteoporosis which starts to resolve after the surgery too.

I’m still very much in learning mode

Primary hyperparathyroidism only recently appeared on my radar as a result of the 2023 osteoporosis summit, hosted by my friend and colleague, Margie Bissinger, Physical Therapist and osteoporosis coach. Dr. Deva Boone was a speaker on this condition on the summit and her site is a wealth of information. I appreciate them both.

As I mentioned above, I am also amazed it’s not something I’ve heard about at mental health or integrative health conferences and when doing continuing education.

I will admit I’m no expert and I’m still very much in learning mode – for myself and for you and this community. But, as you know, I like to share what I learn. As I continue to learn, I plan to share additional perspectives and the osteoporosis/menopause and oxalate links.

I am also in the process of creating a hyperparathyroidism questionnaire to use with my clients. Not everyone has all the above symptoms and not all the papers and resources list all the symptoms covered here today. For example, fatigue is listed on many sites but not in the above two papers and very few sites emphasize the mental health symptoms.

I’m also learning there are clues to look for – like forearm results on the DEXA scan and a good TBS/trabecular bone score has some significance. Stay tuned.

Resources if you are new to using amino acids as supplements

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

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

If you’ve been diagnosed with hyperparathyroidism (or a family member has been) you can likely relate to much of this. Please share your/their journey. I’d love to hear how long it took for a diagnosis and treatment and what symptoms resolved after surgery, and how quickly.

Did you find the amino acids helped anxiety, mood and cognition symptoms in the short term, and then were no longer needed after surgery?

If you’re new to hyperparathyroidism, feel free to ask your questions and share what you’d like to hear more about in the follow-up blog.

If you are a practitioner, is primary hyperparathyroidism on your radar and do you recommend PTH testing in addition to calcium testing? Have you found the amino acids to be a good short-term solution for your clients/patients?

And if hyperparathyroidism is your area of expertise, feel free to add to the discussion.

Feel free to post your feedback here in the comments.

Multiple sclerosis: low endorphin research and the amino acid DPA (d-phenylalanine) for pain, depression, comfort and trauma support

April 28, 2023 By Trudy Scott 8 Comments

The research on the role of low endorphins in multiple sclerosis (MS) is exciting because it creates more awareness about a powerful way to offer pain and mood support if you have been diagnosed with this condition. Typically, I ignore the diagnosis when assessing for low levels of neurotransmitters (via a symptoms questionnaire) and have clients do a trial of the amino acid DPA (d-phenylalanine) if they have physical pain symptoms, experience emotional pain symptoms with excessive weepiness/crying and seek comfort via treats/rewarding foods or the numbing effects of alcohol. However, we now know low endorphins play a role in MS (via the endogenous opioid system). By addressing low levels with DPA, you can find some relief of the above pain/depression symptoms and a need for comfort and numbing. DPA may also offer some trauma support if past trauma is a contributing factor (more on all of this below).

Low endorphins play a role in multiple sclerosis: the research

This 2021 paper, Multiple Sclerosis and the Endogenous Opioid System describes MS and the fact that current therapies have limited efficacy: “Multiple sclerosis (MS) is an autoimmune disease characterized by chronic inflammation, neuronal degeneration and demyelinating lesions within the central nervous system. The mechanisms that underlie the pathogenesis and progression of MS are not fully known and current therapies have limited efficacy.”

What is exciting is the identification of the role of the endogenous opioid system and specific opioid peptides in MS:

Preclinical investigations using the murine experimental autoimmune encephalomyelitis (EAE) model of MS, as well as clinical observations in patients with MS, provide converging lines of evidence implicating the endogenous opioid system in the pathogenesis of this disease.

In recent years, it has become increasingly clear that endogenous opioid peptides, binding μ- (MOR), κ- (KOR) and δ-opioid receptors (DOR), function as immunomodulatory molecules within both the immune and nervous systems.

The endogenous opioid system is also well known to play a role in the development of chronic pain and negative affect [i.e. depression], both of which are common comorbidities in MS. As such, dysregulation of the opioid system may be a mechanism that contributes to the pathogenesis of MS and associated symptoms.

Endogenous means internal i.e natural compounds produced by the body and involved in pain relief and mood improvement. This article, Opioid Peptides, describes peptides as compounds that “produce the same effects as the chemicals known as classic alkaloid opiates, which include morphine and heroin.”

It also mentions three major categories of opioid receptors – mu, delta, and kappa – referred to as MOR, DOR and KOR above.

D-phenylalanine for human “endorphin deficiency diseases”

Unfortunately neither of these papers mentions the amino acid DPA (d-phenylalanine) and the fact that it supports endorphin production (by inhibiting the breakdown of endorphins), reducing pain and improving mood – quickly (as in 5-10 minutes).

The use of DPA is not new information as you can read in this paper from 1982 – D-phenylalanine and other enkephalinase inhibitors as pharmacological agents: implications for some important therapeutic application

A number of compounds have been shown to inhibit the degradation of enkephalins. As expected, these compounds produce naloxone reversible analgesia and potentiate the analgesia produced by enkephalins and by acupuncture.

One of these, D-phenylalanine, is also anti-inflammatory.

D-phenylalanine has proven to be beneficial in many human patients with chronic, intractable pain. It is proposed the enkephalinase inhibitors may be effective in a number of human “endorphin deficiency diseases” such as depression, schizophrenia, convulsive disorders and arthritis.

Such compounds may alleviate other conditions associated with decreased endorphin levels such as opiate withdrawal symptoms.

Prevalence of anxiety/depression and alcohol abuse in MS

As I shared in the recent post addressing low GABA symptoms (anxiety, muscle stiffness, swallowing/voice issues and pain) in multiple sclerosis, anxiety and depression is common in this condition. Alcohol abuse is also high. I shared this paper, The incidence and prevalence of psychiatric disorders in multiple sclerosis: A systematic Review, with the following results:

Among population-based studies, the prevalence of anxiety was 21.9% (and up to 35.0% in some papers), 23.7% for depression …and 14.8% for alcohol abuse.

The above Opioid Peptides paper highlights that the endogenous opioid system may be related to excessive alcohol-drinking behavior. In the work I do with amino acids, I see alcohol used as a way to numb out.

All this supports the fact that the amino acid DPA may help ease symptoms of depression and weepiness seen in MS, and self-medicating with alcohol.

The goal is to use these amino acids instead of needing to use benzodiazepines (covered in the above GABA blog), antidepressants and pain medications.

DPA may help trauma in MS, and the freeze response

This paper, Childhood Trauma in Multiple Sclerosis: A Case-Control Study, suggests an association between childhood trauma and early-life stress and MS:

Although childhood trauma was not associated with the degree of current MS-related disability, patients with MS with histories of physical and/or sexual abuse had significantly higher relapse rates than patients without early-life stress.

DPA may also offer some trauma support if past trauma is a contributing factor. I learned about trauma and the low energy freeze state (a survival mechanism) from Dr. Aimie Apigian, MD, MS, MPH. There is the feeling of numbness and being disconnected when in the freeze state and this eventually becomes the default pattern that the nervous system has been wired into.

Individuals with low endorphins are often in the freeze state and are more emotionally sensitive to everything and because of this they experience much more stress. They also experience a feeling of numbness and feel disconnected. The encouraging news is that the amino acid DPA helps ease the low endorphin symptoms while they are addressing their trauma in other ways, like with somatic work and addressing other biological underpinnings of trauma.

DPA is comforting, helps you feel safe and is often described as feeling like someone just hugged you.

Endorphins and the amino acid DPA (d-phenylalanine) and DLPA (dl-phenylalanine)

If you’re new to endorphins and the amino acid DPA and DLPA here are some blog posts:

Low GABA and low serotonin are common in multiple sclerosis too

Low endorphins are just the tip of the iceberg when it comes to the underlying neurotransmitter imbalances in MS. Low GABA and low serotonin are common too.

As mentioned, I recently blogged about the GABA research and applications of GABA when it comes to multiple sclerosis. Here is that link.

When that blog was published I had a number of questions (see the comments in the above link) from folks asking if GABA could help with similar symptoms in Parkinson’s: swallowing and voice problems, pain and hand spasms. I said yes – if GABA is low, the amino acid GABA will help. As important as your diagnosis is, it’s always the questionnaire/symptoms that help you figure out if it’s worth trialing GABA, DPA or one of the other amino acids.

Both GABA and DPA can help pain symptoms via different mechanisms, so it’s a matter of doing a trial of each amino acid, one at a time and monitoring your response.

Tryptophan and/or 5-HTP may help ease some of the low serotonin worry-type of anxiety, fear, panic attacks, obsessing, low mood and MS-specific pain issues and insomnia.

If you do have more than one imbalance (which is not unusual), you need to figure out which imbalance you have and address that with the relevant amino acids, one at a time. I have clients pick the area that is more problematic for them and start there.

I gathered some of this research while preparing for an interview with the wonderful Dr. Terry Wahls, MD and author of “The Wahls Protocol.” We were both pleasantly surprised to see these endorphin/MS and other neurotransmitter connections.

I really look forward to seeing future research on the use of the amino acids DPA, GABA and tryptophan in MS. And I’d love to be involved in some studies if you are associated with a research facility or do research.

Resources if you are new to using amino acids as supplements

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

Do you have multiple sclerosis and has the amino acid DPA helped with your low endorphin symptoms: pain, depression, alcohol addiction, comfort and trauma support?

How much has helped and which product do you use?

Do you find opening a capsule of DPA helps more than swallowing the DPA capsule?

Were you surprised that DPA would help so much?

What else has helped your multiple sclerosis symptoms? And have you also addressed low GABA and serotonin with amino acids GABA and tryptophan?

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

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.

Her mum just passed away and although she is sad, GABA allows her to sit with a feeling of peace and calm most of the time

April 7, 2023 By Trudy Scott 33 Comments

Sandra shared this heartening feedback on how GABA helped right after the passing of her mum. She also voiced her surprise that it could have such a profound effect at a sad time like this, asking me if this was possible:

I recently started taking GABA Calm lozenges. I settled on a small dose of one lozenge at bedtime. Initially I took this for tense neck and shoulder muscles due to years of anxiety.

What I have noticed in the past month is that I seem quite calm although I do still have tense neck muscles.

Last week I experienced a profound bereavement with the passing of my mum who I have been caring for. I am genuinely surprised at how I have handled this stressful situation including the funeral. I have always been quite emotional and I have found myself, although sad, sitting in a feeling of peace and calm most of the time.

Is it possible that the GABA Calm is contributing to this? It was my understanding this product would assist with my tense muscles but I feel like it has helped me tremendously with my mindset, emotions and mood.

I look forward to your reply.

I offered my condolences for the loss of her mum and said how heartened I felt, hearing that she had a feeling of peace and calm most of the time. And the fact that GABA had helped with the stressful events of the funeral and her mindset, emotions and mood. I would expect the feeling of peace and calm, and helping reduce overall stress. The calming amino acid supplement, GABA, has long been recognized to help ease the more physical type of anxiety.

But because the amount of GABA she was taking didn’t help with her tense muscles, some of the benefits may have been as a result of GABA reducing the distressing unwanted thoughts. The emotions and mood are added benefits that we don’t always hear about with GABA but are not unheard of (more on this below).

I thanked Sandra for sharing this wonderful feedback, letting her know I’d share it as a separate blog, so we can offer support to others in similar situations. I’ll also be sharing this blog with her so she understands some of the mechanisms better too. In fact, I only made the unwanted thoughts connection after having responded to her.

GABA helps with inhibition of unwanted thoughts

In the past I’ve blogged about how Scientists identified a mechanism that helps us inhibit unwanted thoughts:

We are sometimes confronted with reminders of unwanted thoughts – thoughts about unpleasant memories, images or worries. When this happens, the thought may be retrieved, making us think about it again even though we prefer not to. While being reminded in this way may not be a problem when our thoughts are positive, if the topic was unpleasant or traumatic, our thoughts may be very negative, worrying or ruminating about what happened, taking us back to the event.

Scientists have identified a key chemical within the ‘memory’ region of the brain that allows us to suppress unwanted thoughts, helping explain why people who suffer from disorders such as anxiety, post-traumatic stress disorder (PTSD), depression, and schizophrenia often experience persistent intrusive thoughts when these circuits go awry.

Professor Anderson, Dr. Schmitz and colleagues showed that the ability to inhibit unwanted thoughts relies on a neurotransmitter – a chemical within the brain that allows messages to pass between nerve cells – known as GABA.

GABA is the main ‘inhibitory’ neurotransmitter in the brain, and its release by one nerve cell can suppress activity in other cells to which it is connected.

Anderson and colleagues discovered that GABA concentrations within the hippocampus – a key area of the brain involved in memory – predict people’s ability to block the retrieval process and prevent thoughts and memories from returning.

You can read more on the blog post here: GABA helps with inhibition of unwanted thoughts

If you are using the GABA with success already and experience the loss of a loved one, you may find you need to increase your dose for a period of time.

There is individual variability in the capacity to cope with stress during bereavement

Research supports that there is “individual variability in the capacity to cope with stress” during bereavement and there are differences in symptoms and physiological changes. This paper, Long-term immune-endocrine effects of bereavement: relationships with anxiety levels and mood, identified changes in depression, anxiety, adrenocorticotropin and cortisol plasma concentrations, beta-endorphins, and reduced “functional activity of natural killer cells.” And the two different groups of people in the study had different symptoms and physiological changes.

GABA and glutamate, and the HPA axis in depression/bereavement

The above paper doesn’t mention GABA but growing evidence indicates that glutamate and GABA, and the HPA axis/corticotropin-releasing hormone, plays a role in depression and presumably bereavement too. This may be another mechanism that led to the feelings of calm that Sandra experienced.

You’ll need to figure out your unique biochemical needs

When you experience the loss of a loved one, you’ll need to figure out your unique biochemical needs and address them one by one. You may need GABA support like Sandra and/or may find you need serotonin support (with tryptophan or 5-HTP) and/or may need endorphin support (with the amino acid DPA/d-phenylalanine).

Both GABA and serotonin support also helps to address sleep problems. DPA helps especially with the emotional pain and weepiness, and if you’re self-medicating with comfort foods while grieving.

If you have high cortisol you may benefit from Seriphos or Lactium.

Keep in mind that nutritional support is immensely helpful during caregiving too. Here is just one example: When using the amino acid DPA (d-phenylalanine) I have more resilience and more buffer in the caregiving work I do, and just the oops’s of life

Helping Sandra ease her still tense neck muscles

For her ongoing tense neck and shoulder muscles I suggested a higher amount of GABA may be needed. She reported back that taking it in the morning made her sleepy and a couple of times she noticed a headache.

When GABA in the day causes sleepiness I have clients use less GABA more frequently or to take more at night to carry over the next day. In this case probably a GABA-only product because of her headaches.

She did share that GABA was her starting point with the intention of including tryptophan for ruminating and fearful thoughts which do stop her from participating in various activities. Low serotonin does cause TMJ (temporomandibular joint) pain and it’s possible this is contributing to her ongoing tense neck and shoulder muscles, and tryptophan may be the solution.

We also address low magnesium if applicable. I’d also suggest looking into dietary oxalates too and getting checked for physical issues by a chiropractor and/or osteopath and/or physical therapist.

You can read our discussion on this blog.

Resources if you are new to using GABA or tryptophan or DPA as supplements

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

There is an entire chapter on the amino acids and they are discussed throughout the book in the sections on gut health, gluten, blood sugar control, sugar cravings, anxiety and mood issues (which include rage/anger/irritability/self-harm).

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.

Has GABA or tryptophan or DPA helped you after the loss of a loved one? How did each one help?

Were you surprised that they would help so much?

If you were using the aminos with success already did you find you needed to increase your dose for a period of time?

What else has helped you at a time of loss?

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

Irukandji syndrome: severe pain, nausea, breathing difficulties and a feeling of impending doom (impact on serotonin and other neurotransmitters?)

December 30, 2022 By Trudy Scott 14 Comments

Irukandji syndrome is in the news again. In addition to the jellyfish sting causing severe pain, nausea and breathing difficulties, the research states there is a feeling of impending doom after you’re stung. I’m sharing this current news from Australia and a recent study because I’m curious about the mechanisms and short- and long-term impacts on serotonin and other neurotransmitters, likely affecting anxiety, depression, pain and insomnia. And I’d like to help create awareness since there is not 100% consensus on what to do right away after a sting and less awareness in the medical community than I feel comfortable with.

From the ABC article published this week in Australia: “Another child has been flown to Hervey Bay Hospital with a suspected Irukandji sting after swimming in a creek off Wathumba Road on K’gari (Fraser Island) in Queensland, Australia on Wednesday afternoon.

The key points of the article:

“Three young girls and a boy have been flown to hospital with suspected Irukandji stings in the past two days
The jellyfish stings can cause severe pain, nausea and breathing difficulties
A Toxicologist is calling for more research into their movements and physiology”

The yahoo news article expanded on the symptoms: “They have this severe body pain, often low back pain, nausea, vomiting, and this feeling of impending doom that sort of lays over the top of this whole thing.”

I found the latter interesting as impending doom is a classic sign of low serotonin. So I went digging into the research. I was enlightened and surprised by what I found.

Raising awareness on this worldwide increasing threat

This 2022 paper, Raising Awareness on the Clinical and Forensic Aspects of Jellyfish Stings: A Worldwide Increasing Threat is eye-opening and concerning and also mentions the impending doom symptom.

Irukandji syndrome is a severe illness produced by the envenomation i.e. injection of venom, of some species of small jellyfish from the Cubozoa class, known as box jellyfish.

It consists of a clinical picture dominated by systemic symptoms similar to a catecholamine surge, including hypertension, tachycardia, intense pain, and muscle cramping, eventually leading to pulmonary edema, shock and cerebral hemorrhage.

Also listed are symptoms of anxiety, restlessness, headache, localized sweating and impending doom. A feeling of impending doom is a classic symptom of low serotonin.

With regards to Irukandji syndrome it’s becoming a worldwide problem: “The first cases described happened in the northern Australian territories. However, similar disorders have been observed all over the tropical waters, including Thailand, the Caribbean, Florida, and Hawaii.”

The good news is that the authors state “Irukandji syndrome is typically not deadly, especially if supportive care is given early” and “not all encounters with species capable of producing Irukandji syndrome result in this clinical state.” They also share that typically the severe pain only lasts a few hours but do mention one case where “pain recurred up to a year later.” I discuss possible longer term effects below.

As you read the paper, be aware there are many types of jellyfish with many different mechanisms. Cubozoa includes the deadliest jellyfish species and includes Carukia barnesi and Chironex fleckeri. (commonly known as the Australian box jelly). It’s the Carukia barnesi that causes Irukandji syndrome.

The images in the above paper are graphic so be warned.

There is not 100% consensus on what to do right away

What is also really concerning is that there is not 100% consensus on what to do right away. This 2017 paper, Cubozoan Sting-Site Seawater Rinse, Scraping, and Ice Can Increase Venom Load: Upending Current First Aid Recommendations, published by Hawaiian researchers, found the “best outcomes occurred with the use of venom-inhibiting technologies (Sting No More® products)” and they state not to use a sea water rinse. They also found vinegar and heat treatment were less effective with certain types of jellyfish.

And yet the tentative recommendation from the above 2022 paper is to use vinegar, heat, sea water, and careful removal of remaining tentacles with tweezers quickly because only “about 1% of nematocysts (stinging cells) discharge upon initial contact.” They do suggest using Sting No More® before removing tentacles in order to deactivate the nematocysts.

I’m not sharing any of the above as conclusive in all situations but more to illustrate what both papers state: further research is needed in different places of the world, as different jellyfish species seem to react differently to the treatments.

There is also less awareness in the medical community than I feel comfortable with hence my desire to share this so you are more aware if you or a family member is stung by a jellyfish.

Are there possible long-term impacts on anxiety, depression, pain and insomnia? (and the potential role of amino acids)

Just like we have long-term impacts on anxiety, depression, pain and insomnia with Lyme disease and other infections like Bartonella – due to effects on serotonin, GABA and other neurotransmitters – do we need to consider these long term impacts after a jellyfish sting too?

I have to wonder if there are also longer term impacts given the trauma of the situation and the many medications that are needed to save your life: nitroglycerin, opioids, benzodiazepines and others.

If mood, anxiety, pain and sleep issues persist after the acute recovery phase (which can take up to 3 months and more) and there are other signs of low serotonin, GABA, dopamine and endorphins, it’s important to consider the use of targeted amino acids. I recommend tryptophan or 5-HTP for low serotonin symptoms (worry type of anxiety, insomnia and low mood), GABA for low GABA symptoms (physical anxiety and tension), tyrosine for low dopamine symptoms (depressed with low energy and poor focus) and DPA for low endorphin symptoms (pain and weepiness).

It would be wonderful to see research in this area.

Is there a possible role for GABA right after the sting too?

Given there is “hypertension, tachycardia, intense pain, and muscle cramping”, would the amino acid GABA help?

With Irukandji syndrome, “there have been reports of blood pressures as high as 300/180 mmHg” (normal is 120/80 mmHg). In one study, 80mg GABA was found to reduce mild hypertension and it’s possible that a higher dose of GABA may help right after the sting. It may also help to alleviate pain and muscle tension/muscle cramping too.

It would be wonderful to see research on GABA use right after the sting too.

Resources if you are new to using 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.

I do hope these 4 young Australian children are doing well after having been stung.

Have you or a family member been stung by a jellyfish? Where did it happen and what type of jellyfish? What symptoms did you experience? What was the treatment and what was recovery like?

Have you or your family member had any long-term lingering symptoms of anxiety, depression, pain and insomnia? Have the amino acids or other solutions helped?

If you’re a practitioner have you seen long-term lingering symptoms of anxiety, depression, pain and insomnia in your clients/patients who have had a jellyfish sting?

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