GABA

The seasonality of GABA: worsening anxiety, insomnia and intrusive thoughts in winter (and the need for increased GABA supplementation)

January 7, 2022 By Trudy Scott 33 Comments

Seasonal variations in serotonin have long been documented with much research on the winter blues and SAD lamps. There is less awareness about GABA seasonality and I only recently started to look into the research when I wrote about the need to increase tryptophan or 5-HTP temporarily when a winter dip in serotonin causes more severe anxiety, OCD and/or the winter blues.

Following on from my blog post on the seasonality of serotonin, it’s important to be aware of the seasonality of GABA and that GABA levels may also be lower in the winter months. This is also due to shorter days and less light because of more overcast and cloudy/rainy/snowy days.

You may find you need to increase your GABA supplement dosing during this time, in order to get the same benefits for your low GABA physical anxiety, stiff and tense muscles, insomnia (the low GABA lying-awake-tense type), feelings of overwhelm, intrusive thoughts (the low-GABA type), and stress-eating or self-medicating with alcohol.

Read on to learn more about seasonal fluctuations in GABA, an example of how adjusting GABA could look and some of the possible mechanisms.

Intuitively increased GABA without knowing about the seasonality of GABA

A few weeks ago I shared on Facebook that GABA has a seasonal aspect and an increase may be needed in winter when it’s darker earlier and colder. Elicia offered this input:.

I use GABA Calm and usually take 1 or 2 a day. The past two days I’ve taken 4 because I suspected that I needed an increase.

I take it for physical anxiety, insomnia and intrusive thoughts. My symptoms had been worsening recently. The increased GABA seems to be helping.

She also asked what an increase in GABA would look like.

My feedback for her is (you guessed it!) that it depends on each person. If 4 x instead of 1 or 2 x GABA Calm a day helps to ease her symptoms then that’s the right amount for her unique needs at this time. It may be less or more for someone else. And it’s going to change again after the winter season.

I’m so glad to hear she intuitively increased her dose without knowing about the seasonality of GABA and that she saw her worsening symptoms improve.

Other approaches to boost GABA levels may help too: Yoga, meditation, tai chi and essential oils.

Seasonal fluctuations are also found in anxiety disorders and bulimia nervosa

As I mentioned above, SAD or seasonal affective disorder, appears to be relatively common and is well-recognized.

This review paper, An overview of epidemiological studies on seasonal affective disorder mentions anxiety and other conditions too:

Seasonal variations in mood, depressive symptoms usually peaking in winter
SAD was more prevalent at higher northern latitudes, but the prevalence varied across ethnic groups.
SAD has also been identified in children and adolescents.
Seasonal exacerbations and remissions are not limited to mood disorders, it has also been found in bulimia nervosa, anxiety disorders and other psychiatric illnesses.

Some of this may be related to low serotonin and as you’ll see below, melatonin and low GABA (and low dopamine too), and the liver, all may play a role too.

GABA is higher in summer/lower in winter and tied to liver function

In this animal study, Effect of the pineal gland on 5-hydroxytryptamine and γ-aminobutyric acid secretion in the hippocampus of male rats during the summer and winter, they report that

GABA secretion in the hippocampus of rats had a seasonal rhythm consisting of increased secretion in summer and decreased secretion in the winter.

Additionally, the liver can regulate the content of active substances, including GABA, and its function is controlled by brain centers, especially in the marginal lobe.

This paper reports similar seasonal changes with respect to serotonin, stating that both fluctuations may be related to the seasonal changes of “regulation by the liver”. The authors remind us that in Chinese Medicine the liver is closely related to emotions, and that the liver functions well in hot weather and is weak in winter.

GABA exhibits seasonal rhythms related to the pineal gland and melatonin

The introduction of this animal study (by the same authors), Molecular mechanisms of seasonal photoperiod effects of the pineal gland on the hippocampus in rats highlights a number of points related to seasonal variations in mood:

Based on the theory of “five Zang-organs corresponding to the seasons” in traditional Chinese medicine (TCM), physiological functions including emotions vary with the seasons.

The production of mood-related neurotransmitters such as 5-hydroxytryptamine [serotonin], γ-aminobutyric acid [GABA], dopamine, and norepinephrine exhibits seasonal rhythms, which are related to the regulation of the hippocampus by the pineal gland-MT [melatonin] system.

In other words, GABA (and these other neurotransmitters) exhibit seasonal rhythms related to melatonin secreted by the pineal gland, thereby impacting the hippocampus.

Be sure to read the paper for additional information on depression, seasonal affective disorder and bright light therapy; the seasonal effects of the pineal gland on the hippocampus; the role of melatonin and photoperiod/length of night; the hippocampus and melatonin receptors and more.

The authors were looking for direct evidence of the signalling mechanisms that cause this to happen:

Our findings suggest that the MTR-Gs/Gi-cAMP-PKA-CREB signaling pathway is involved in the seasonal photoperiod [length of night] effects of the pineal gland on the hippocampus and may underpin seasonal changes in emotions.

Feel free to read more about all this in the paper too as it’s beyond the topic of this blog.

Other factors to consider: sugar/alcohol, stress/pyroluria and low serotonin

I’d also consider the following:

The increased consumption of sugar at this time can lead to reduced zinc, magnesium and B vitamins (like vitamin B6 and thiamine) and this can further reduce GABA levels, which relies on these nutrients as cofactors for production. By boosting GABA levels with the amino acid GABA (and higher amounts if needed) you can actually reduce some of the cravings and stress-eating.
Overindulging in alcoholic holiday beverages can also deplete zinc and B vitamins, further affecting GABA production. Using higher amounts of the amino acid GABA (if needed) can also prevent self-medicating with alcohol. This often happens when trying to fit in and socialize.
If you have the social anxiety condition called pyroluria, the added stress of family and holiday gatherings can also contribute to zinc and vitamin B6 being dumped, and further impacting serotonin production.
The need to also increase tryptophan or 5-HTP temporarily when a winter dip in serotonin causes more severe anxiety (the low serotonin worry-type), OCD and/or the winter blues.

Resources if you are new to using GABA as a supplement

If you are new to using the the amino acid GABA as a supplements, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution (you can see the low GABA and other low neurotransmitter symptoms) and a brief overview here: Anxiety and targeted individual amino acid supplements: a summary.

If you suspect low levels of GABA 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 GABA products that I use with my individual clients and those in my group programs.

Have you noticed worsening anxiety, insomnia, intrusive thoughts or even bulimia in the winter months?

Have you noticed you need more GABA in the winter? And then you ease off at the end of winter again?

What changes in your dosing have made a difference with your symptoms?

Did you adjust intuitively or were you aware of the GABA seasonality aspect?

And do you notice something similar with serotonin support and needing additional melatonin in winter too (if you already use it)?

If you’re a practitioner, do you have your clients/patients make adjustments too?

Feel free to ask your questions here too.

Trigeminal neuralgia and anxiety: GABA, tryptophan, St. John’s Wort, acupuncture, DPA, gluten, herpes and Lyme disease

December 31, 2021 By Trudy Scott 30 Comments

I get a surprisingly high number of questions about trigeminal neuralgia asking if there is a role for the amino acids GABA or tryptophan to help ease some of the nerve and associated face pain. It’s surprising because trigeminal neuralgia is considered a rare neurological disorder.

Nerve pain is not my area of expertise (anxiety is), and because anxiety and depression is common in this population, there are very likely similar underlying causes (more on that below). The targeted individual amino acids that we use for anxiety, also help to ease pain, so I’m sharing some of what I know in case it helps you or a loved one.

Read on to learn more about this condition and GABA, tryptophan, DPA, acupuncture, St. John’s Wort, Lyme disease, herpes and B vitamins.

About trigeminal neuralgia and the incidence

The NIH fact sheet defines trigeminal neuralgia (TN) as

a chronic pain condition that affects the trigeminal or 5th cranial nerve, one of the most widely distributed nerves in the head. TN is a form of neuropathic pain (pain associated with nerve injury or nerve lesion.) The typical or “classic” form of the disorder (called “Type 1” or TN1) causes extreme, sporadic, sudden burning or shock-like facial pain that lasts anywhere from a few seconds to as long as two minutes per episode. These attacks can occur in quick succession, in volleys lasting as long as two hours. The “atypical” form of the disorder (called “Type 2” or TN2), is characterized by constant aching, burning, stabbing pain of somewhat lower intensity than Type 1. Both forms of pain may occur in the same person, sometimes at the same time. The intensity of pain can be physically and mentally incapacitating.

The incidence of new cases is approximately 12 per 100,000 people per year and women are impacted more than men.

A number of studies show anxiety, depression and insomnia are common when someone has trigeminal neuralgia. The question is this – is the pain causing the anxiety, depression and insomnia OR are there common underlying physiological causes for both. It’s likely a combination of both especially when it comes to idiopathic trigeminal neuralgia i.e. when there is no known cause. Known causes include head injury, multiple sclerosis, dental procedures, tumors and cysts.

By using some of the approaches outlined below, we may see pain relief and improved mood, less severe anxiety and better sleep.

When to consider GABA and serotonin support

There is no research on either GABA or tryptophan/5-HTP helping with symptoms of trigeminal neuralgia, however medications that work on both GABA and serotonin are typically prescribed for trigeminal nerve pain. For this reason I would consider a trial of GABA and/or tryptophan (or 5-HTP if other low GABA physical anxiety symptoms and low serotonin worry-type anxiety symptoms are also present. You can find the symptoms list here.

There is research-based and clinical evidence that GABA and serotonin support help with other types of pain:

Both help with the anxiety, low mood and insomnia that is often present with pain conditions like this.

St. John’s Wort for nerve pain and mood

In one case report, Hypericum perforatum (St. John’s Wort) as a possible therapeutic alternative for the management of trigeminal neuralgia (TN), a 53-year-old Hispanic female patient with a history of trigeminal neuralgia used an over-the-counter preparation of St. John’s Wort and found it relieved her pain completely.

St. John’s Wort is a herb that is primarily “used for depression but also is used for rheumatism, gastroenteritis, headache and neuralgias. ” This case report is one of many studies on this herb and trigeminal neuralgia and other neuralgias (nerve pain).

It has anti-inflammatory and antioxidant effects and also supports serotonin and GABA production which further supports the above recommendations to trial the amino acids. GABA and tryptophan would also be safe options if St. John’s Wort can’t be used as in the case of blood thinners, the birth control pill and other medications

Pain relief with endorphin support: acupuncture and DPA

Acupuncture offers pain relief via endorphin boosting and can be an option for the treatment of trigeminal neuralgia, also offering relief for the “secondary myofascial pain associated with it.”

DPA (d-phenylalanine) is an endorphin-boosting amino acid that may also offer some pain relief. It can also be used to wean off prescription pain medication and improve sleep.

Other research-based pain-relief approaches for trigeminal neuralgia

Physical therapy, chiropractic care, using a custom dental appliance, and addressing myofacial pain may offer relief or be part of the solution.

There are some less recognized approaches too:

Photobiomodulation on trigeminal neuralgia: systematic review “Photobiomodulation appears to be as effective as conventional therapies” that include medications and surgery and yet without the side-effects. Photobiomodulation, also known as red light therapy, is also beneficial for anxiety and mood regulation.
Palmitoylethanolamide and Its Formulations on Management of Peripheral Neuropathic Pain – Palmitoylethanolamide (shortened to PEA) “has anti-inflammatory and anti-hyperalgesic effects, due to the down-regulation of activation of mast cells”
Therapeutic potential of cannabinoids in trigeminal neuralgia – there is growing evidence that “cannabinoids may be effective in alleviating neuropathic pain and hyperalgesia [extreme pain sensitivity]” via “inhibiting neuronal transmission in pain pathways.”

All of the above can also improve mood and insomnia and reduce anxiety too.

Other factors to consider: B vitamins, Lyme disease, herpes and gluten

As with any condition, a full functional medicine work up should be done to rule out and/or address gluten issues, low vitamin B6/B1/B12, and even herpes zoster and Lyme disease as a root cause (or contributing factor).

Current approaches and emerging interventions – disappointing for a 2021 paper

I was excited to read the title of this paper, Trigeminal Neuralgia: Current Approaches and Emerging Interventions, published late this year. The authors share that it “summarizes over 150 years of collective clinical experience in the medical and surgical treatment of trigeminal neuralgia.”

What is disappointing is there is no mention of any of the approaches listed in this blog. It’s published by neurosurgeons so it is understandable that they would say: “The first-line treatment remains anticonvulsant medical therapy. Patients who fail this have a range of surgical options available to them.”

Medications and/or surgical options may work well for you but if not, you need to know there are other options. You may also be looking for a medication-free or non-invasive approach.

Keep in mind that this is what you’ll be offered unless you work with a functional medicine practitioner.

I do agree with and am encouraged by these statements:

What is increasingly clear is that there is no catch-all medical intervention that is effective for all patients with trigeminal neuralgia, likely reflective of the fact that it is likely a heterogenous group of disorders that jointly manifests in facial pain.
Ultimately, elucidation of the molecular mechanisms underlying trigeminal neuralgia will pave the way for novel, more effective and less invasive therapies.

Complementary approaches: NIH fact sheet

What is encouraging is that the NIH fact sheet I link to above, does mention low-impact exercise, yoga, creative visualization, aromatherapy and meditation.

Other than the standard medications (carbamazepine, oxcarbazepine, topiramate, gabapentin, pregabalin, clonazepam, phenytoin, lamotrigine and valproic acid and tricyclic antidepressants such as amitriptyline or nortriptyline) and surgical options they do also mention acupuncture, chiropractic, biofeedback and nutrients.

Botox is listed too but I have concerns about this approach.

This blog is not intended to be a comprehensive approach for pain relief for trigeminal neuralgia but rather some options you can consider and explore with your practitioner – especially when you also have anxiety, depression and insomnia too.

Resources if you are new to using tryptophan/5-HTP, GABA and DPA as supplements

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

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 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.

Has any of the above approaches helped you or your loved one? If not, what has helped you?

What conventional treatment have you had and did it help? Were you offered any of the above non-medication and non-surgical treatment approaches?

If you’re a practitioner, has any of this helped? Please share your treatment approaches too.

Feel free to ask your questions here too.

Around my period I definitely feel the need for extra tryptophan if I’ve had some extra heavy emotional stuff come up that I need to process

December 10, 2021 By Trudy Scott 6 Comments

Many women find that they need additional nutritional support i.e. tryptophan for serotonin support (and often GABA too) around their periods. Today’s case study highlights the hormonal shifts that may lead to a situation where it appears tryptophan doesn’t work, then it does work, and then sometimes it doesn’t work as expected. The variable results and the need to switch between lower and higher doses on an ongoing basis can occur with PMS (premenstrual syndrome) PMDD (premenstrual dysphoric disorder, a severe, sometimes disabling extension of premenstrual syndrome). The variable results can also be more pronounced while recovering from trauma.

This case study is a follow-on from a blog I recently published: Tryptophan doesn’t work, then it does and then it doesn’t: could it be hormonal shifts, dietary factors and/or parasites?

Here is Kimberley’s feedback on the Facebook post that discussed these variable results. She shared how her hormonal shifts led to a need for additional tryptophan and 5-HTP:

Around my period I definitely feel the need for extra tryptophan. My PMDD symptoms have decreased since I started using tryptophan/5-HTP, but sometimes I need a bit more if I’ve had some extra heavy emotional stuff come up that I need to process (since that always happens with my period!).

I thanked her for sharing and said how happy I was for her. I also asked what symptoms have decreased and how much? I also asked how much tryptophan and 5-HTP she uses before her period and then around her period?

I was also curious if she just experimented with different doses until she figured it out or had she heard me talk about the PMDD tryptophan study: A placebo-controlled clinical trial of L-tryptophan in premenstrual dysphoria. In this study tryptophan was found to reduce symptoms of PMS when used in the luteal phase or second half of the cycle (i.e. after ovulation).

Her low serotonin symptoms have decreased as much as 75-80 percent

Kimberley confirmed that she had read the above study and related blog post – Tryptophan for PMS: premenstrual dysphoria, mood swings, tension, and irritability – and more about her symptoms:

I had read the blog you referenced, which is one of the reasons I tried tryptophan in the first place.

I was experiencing a lot of emotional distress, feelings of downright despair that left me miserable both during my period and ovulation (half the month, every month, which was truly awful). Those have definitely decreased, sometimes as much as 75-80 percent, other times they’re worse and I feel like I need more support.

I usually take 1x Lidtke 5-HTP (50mg) mid-afternoon and 1x Lidtke Tryptophan (500mg) at bedtime, but yesterday I increased to 2x Lidtke Tryptophan and do feel an improvement in my mood this morning.

I experimented to get the right dose of both amino acids, initially increasing to the maximum you recommend, and then slowly decreasing to what I’m taking now when I found I didn’t feel well when I took too much.

I just reread the blog you linked above and realized I should be using GABA every day to support progesterone (instead of just as needed for anxiety). Thanks for the reminder!

I love that after reading the blog she was inspired and motivated to experiment with different doses when she is/was feeling so bad. I encouraged her to continue trialing different doses at various times of the month especially in the second half of the month. I also reminded her that some folks do better with tryptophan and some do better with 5-HTP when it comes to low serotonin symptoms. And to continue to look at why serotonin is low and address that. Low GABA (related to low progesterone) can cause increased anxiety at this time and is a common issue with PMS/PMDD.

(You can see the entire list of low serotonin and low GABA symptoms here.)

She plans to continue experimenting with tryptophan and 5-HTP and may also try switching over to just 5-HTP and see if that changes anything. It’s unlikely that she would benefit from much higher doses of either as she shared “I don’t seem to be able to take more than 2 caps of either one without getting uncomfortable symptoms, though.”

Exercise and yoga for her low serotonin and PMDD

She did share how much exercise helps her mood, why she isn’t able to exercise as much:

The biggest thing I know to do to address low serotonin is add more exercise into my life, but this has been hard lately because I’ve had a couple of different viruses recently that left my exercise intolerance worse than it had been. I’m trying to support my mitochondria right now and add light exercise back in slowly.

Exercise is a wonderful way to raise serotonin levels and aerobic exercise has been shown to reduce the symptoms of PMS too. Yoga may be an option while she is recovering. In one study, yoga was found to be beneficial for PMS: “Alpha-brain waves production due to regular yoga practice are directly related with state of peace, creativity, mood elevation, relaxation, and release of serotonin, thus leading yoga practitioners feel more relaxed.”

Trauma: cortisol, serotonin, dopamine and estradiol

Kimberley also shared how how trauma plays into her situation:

I think some of the reasons for my health issues, low neurotransmitters, etc., are trauma related and I’ve been working through Dr. Aimie Apigian’s programs for that. But that’s another story.

I respect Dr. Aimie Apigian’s work in trauma and somatic experiencing and acknowledge this aspect must be addressed too. I love that Dr. Aimie brings this together with a functional medicine approach, looking at biology/biochemistry too. Recent trauma research confirms that there are major biochemical mechanisms involved in PTSD (post-traumatic stress disorder). These can include impacts to cortisol, serotonin and dopamine levels. And women are more vulnerable to these effects.

A 2021 paper, Estradiol, stress reactivity, and daily affective experiences in trauma-exposed women discusses high cortisol and more severe symptoms around their periods when estradiol (one of the estrogens) is low. As I mentioned above, estrogen and serotonin are closely related. The authors state this:“For women who are cycling, it may be useful to understand how the menstrual cycle affects their symptoms. When you can explain what’s happening biologically, it often becomes less threatening.”

Yoga may provide added psychological benefits as she works through her past trauma too.

Kimberly gave me permission to share her story and this is always something I appreciate so others in my community can learn from these types of experiences. If needed, I hope this her story gives you confidence to experiment with different doses and combinations around your period.

She also benefits from the comments from others on Facebook and the comments here on the blog, our back and forth, and this blog post.

She promised to keep me posted on how she goes and I’ll be sure to share when I hear back from her.

Resources if you are new to using tryptophan, 5-HTP and GABA and the amino acids as supplements

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

If you suspect low GABA 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.

Have you found you need additional tryptophan/5-HTP or GABA around your period? How have you experimented and how does it help you?

If you’re a practitioner, have you seen this with clients or patients?

Do you also feel better with exercise and/or yoga?

And are/were your variable results more pronounced while recovering from trauma?

Feel free to ask your questions here too.

GABA lozenge relieves excruciating pelvic floor/rectal pain and spasms within 30 seconds: a solution for proctalgia fugax

December 3, 2021 By Trudy Scott 28 Comments

Have you experienced excruciating pain in the rectum as a result of spasms in your anal sphincter? You may not even know this condition is called proctalgia fugax and you may struggle with the agonizing pelvic floor pain with no quick solution. You may also not get much help from your doctor because the management of proctalgia fugax remains challenging.

The good news is that there is a simple solution that eases the spasms and stops the pain very quickly, typically in less than 2 minutes and sometimes as quickly as 30 seconds. Ashlee discovered how quickly a GABA lozenge worked to give her immediate relief from her scary and excruciatingly painful spasms.

Here is Ashlee’s wonderful feedback on the blog I wrote on this topic a few years ago after this started happening to me:

I want to personally thank you for this article and option of GABA to relieve the excruciating pain I was having.

After research I realized that my pelvic floor was having spasms. Such a new and scary feeling to have been having, and finding your advice and immediate relief of GABA changed everything!

Of course the scariest part initially is the pain and the “what is happening feeling!” But it’s quickly followed up with “when will this happen again, where will I be, and what do I do in that situation?”

I would highly recommend the GABA lozenges which I got at the vitamin store down the street. I carry them in a little baggie with me now just in case an episode happens. I did have an episode happen when I was on site of a job, and thankfully had the GABA lozenge to immediately relieve the pain, literally (within 30 seconds!! INCREDIBLE!)

The option otherwise (and what I did when it first happened) was to soak in a warm bath or with a heating pad, which obviously is not an option if you are at work or not at home.

The other options as suggested online are even scarier… resorting to electric shock up the rectum to ease the spasms! Yikes!

I thanked her for sharing how well the GABA lozenge works for her, saying how happy I am for her! I also let her know that I’d love to share it as a new blog post because it offers so much hope to others (hence this blog).

GABA Calm lozenge and other low GABA symptoms

I assume Ashlee is referring to Source Naturals GABA Calm lozenges which contains 125mg of GABA and is a sublingual lozenge. They do really work this quickly for spasms, pain and anxiety too. GABA always works best when used in a sublingual form like this or when a GABA capsule is opened onto the tongue.

I agree with her – it’s a good plan to keep GABA on hand in case she gets the spasms during the day. I also recommend having GABA next to the bed because it often seems to happen in the middle of the night.

I did ask if using GABA has also helped with easing her other low GABA symptoms. These can include:

physical anxiety and overwhelm
intrusive thoughts
stiff and tense muscles or other muscle spasms/pain
insomnia (often the type where you lie awake feeling stiff and tense)
stress eating carbs or sugary treats
self-medicating with wine or other alcoholic beverages in order to relax and fit in

You can see the entire list of low GABA symptoms here.

(I’ll share an update when I hear back from Ashlee.)

My experience, definition of proctalgia fugax, incidence and overview

I acknowledged her comment about it being very scary the first time it happens. I first blogged about this after it happened to me in 2017 and I figured out GABA worked very quickly for my excruciatingly painful spasms. It was really scary!

You can read about my experience and triggers on this blog: How GABA eases agonizing rectal pain and spasms in under 2 minutes.

The above blog also

defines this condition called proctalgia fugax which leads to rectal spasms and sharp fleeting pain in the lower rectum or anus. In some people it can be more than fleeting and is often described as excruciating and agonizing
shares how others describe the pain and how common it is (up to 18% of the population, more common in women and affects individuals between 30 and 60 years of age).
discusses heating pads as a solution (they also work but can take 20 minutes to take effect and that is simply too long when you are moaning and writhing in pain)
mentions medications that are commonly prescribed
describes using 30-60 seconds of finger pressure as one possible solution
reviews the BEST solution – sublingual GABA. Theanine and taurine can also help

Electrical stimulation of the anorectal muscles or botox – as treatment approaches

When I had first researched this a few years ago, I had not read about “electric shock up the rectum to ease the spasms” that Ashlee mentioned in her comment. I went looking and found this on Webmd:

For severe proctalgia fugax, electrical stimulation of the anorectal muscles may provide relief. This treatment option involves inserting a small, finger-sized probe into the rectum and using a low voltage current to relax spastic muscles through vibration.

This may be similar to the 30-60 seconds on finger pressure I described but I’ll take the GABA supplement thank you!

This article also mentions botox injections which I am aware is often done. But this opens up another whole can of worms with toxicity issues and the risk of increased panic attacks with botox.

I also share additional information here: How to address rectal spasms with GABA, pelvic floor work, gluten removal and squats

Management of proctalgia fugax remains challenging and treatment outcomes modest at best

A paper, Proctalgia Syndromes: Update in Diagnosis and Management, published June 2020 by gastroenterology departments in Ireland, Romania, Italy and the USA recognizes that “functional anorectal pain syndromes” are complicated and “are a neglected yet often disabling clinical entity resulting in significant economic and psychological burden to the patient.”

They acknowledge that “management of proctalgia fugax remains challenging and treatment outcomes modest at best” and conclude that “further investigation of treatment approaches in proctalgia fugax is required.”

I plan to reach out to the authors and share these wonderful results that individuals are reporting with the use of sublingual GABA. I would also love to get some case studies published so this approach becomes common knowledge.

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

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

Have you ever experienced this rectal pain and spasms/proctalgia fugax? Has GABA worked for you? What else has helped?

If GABA helped ease the spasms and pain, how quickly did it work and what product did you use? Did it help with some of the other low GABA symptoms too?

Have you been able to figure out possible triggers or root causes other than low GABA?

If you’re a practitioner, have you seen this with clients or patients and has GABA helped them?

Feel free to ask your questions here too.

Tryptophan doesn’t work, then it does and then it doesn’t: could it be hormonal shifts, dietary factors and/or parasites?

November 26, 2021 By Trudy Scott 19 Comments

Have you been in a situation where tryptophan doesn’t work, then it does work, and then sometimes it doesn’t work as expected? There is a reasonable explanation as to why it may not work initially – too much or too little was used. The variable results and the need to switch between lower and higher doses on an ongoing basis can happen but it’s not very pronounced unless there is a specific reason. In this blog I cover some of these reasons – hormone shifts, dietary factors and parasites/other digestive issues.

I’m writing this blog in response to a question that was posted on one of my speaker pages on the Anxiety Summit: Gut-Brain Axis. This is the actual question:

I tried to use tryptophan the first time (whole capsule) and got really high. Some time later I tried again, but used 1/4 of a capsule and had a good result. A few weeks later 1/4 of the capsule didn’t work at night. So I went up to half a capsule. And that’s where I am now. But some nights (very rare) I can only get good results from a whole capsule. I use it along with the same amount of GABA. Is that a normal reaction for tryptophan?

I don’t know what brand of tryptophan she was using but assume 500mg was her starting dose and she now shifts between 125 mg (¼ capsule) and 250 mg (½ capsule) with variable results.

It’s not unusual for someone to not feel great on 500 mg if that dose is too much for their unique needs. She did the right thing by lowering her dose. It’s also reasonable that someone may find 500 mg as an initial dose isn’t enough to reduce symptoms.

The variable results and the need to switch between 125 mg and 250 mg can happen but it’s not very pronounced unless there is a specific reason. Some of these reasons include hormone shifts, dietary factors, parasites/other digestive issues, thyroid issues, low lithium, product quality and environmental factors. More on all this below.

Hormone shifts/more serotonin is needed in the luteal phase

I have my clients track when the variability happens, with female clients documenting their cycles. Some women need more serotonin support in the luteal phase i.e. after ovulation and right up to before their periods. Some may even need additional tryptophan for the first few days of their periods too.

Write about tryptophan working well in the luteal phase in this blog – Tryptophan for PMS: premenstrual dysphoria, mood swings, tension, and irritability

In a study published in 1999, A placebo-controlled clinical trial of L-tryptophan in premenstrual dysphoria, tryptophan was found to reduce symptoms of PMS when used in the luteal phase or second half of the cycle (i.e. after ovulation):

37 patients with premenstrual dysphoric disorder were treated with L-tryptophan 6 g per day, and 34 were given placebo. The treatments were administered under double-blind conditions for 17 days, from the time of ovulation to the third day of menstruation, during three consecutive menstrual cycles.

They looked at dysphoria, which is defined as a state of unease or generalized dissatisfaction with life, plus mood swings, tension (and anxiety), and irritability and they found a 34.5% reduction of symptoms with tryptophan compared to 10.4% with placebo.

The paper concludes: “that these results suggest that increasing serotonin synthesis during the late luteal phase of the menstrual cycle has a beneficial effect in patients with premenstrual dysphoric disorder.”

It’s a small study but the results are powerful and it’s something I see clinically with my clients. The one big difference is that I typically have clients using tryptophan throughout the month.

But if you are seeing tryptophan work and then not work at similar times each month this is something to consider and track. And then if need be, increase and decrease tryptophan accordingly (and track again).

Dietary factors – collagen, gluten, sugar, wine and coffee

There are other factors to consider too and dietary impacts is one. For example, collagen leads to a higher need for tryptophan in susceptible individuals (due to it’s serotonin-lowering effects – I blog about this here)

Another dietary factor is accidental gluten exposure in susceptible individuals or a newly discovered gluten issue

High sugar intake, alcohol and/or caffeine consumption may also be a factor – contributing to added stress for the adrenals and depletions in zinc and the B vitamins. This can contribute to lowered serotonin and a need for a higher dose of tryptophan.

Now imagine if it’s just before her period and she adds collagen to her diet and she also eats out and gets zapped by gluten. Triple whammy for this woman!

And she goes to a party and happens to indulge in cocktails or wine, and then goes on a binge at the dessert table, followed by a few cups of coffee (or even one dessert and one cup of coffee).

A food-mood log really helps you figure things out. And then, if need be, increase and decrease tryptophan accordingly. And track again and address the dietary issues.

Parasites and other gut issues

If she has a very pronounced shift in symptoms for 4-5 days around a full moon each month – more severe insomnia, more anxious, more depressed – I would want to check for parasites.

I would also want to check for other digestion issues like dysbiosis, SIBO (small intestinal bacterial overgrowth), candida and liver health as they may all be factors. With SIBO and candida, dietary slip-ups may make symptoms worse right after the slip-up, for example increased bloating making sleep and anxiety worse.

Using tryptophan sublingually/opened on the tongue may bypass some of the digestive/liver issues until they are resolved.

As mentioned above, if need be, increase and decrease tryptophan accordingly. And track again and address the underlying issues.

Other factors to rule out – thyroid, lithium, environmental factors and the product

Two other underlying root causes we always want to rule out when we see variable results using tryptophan (and any of the amino acids) are Hashimoto’s thyroiditis (because we can have variable thyroid results – sometimes hypo/low and sometimes hyper/high) and low levels of lithium (because this can affect the results we see with all the amino acids).

And we always check environmental factors like mold, EMFs and outside stresses. And look for infections like Lyme disease or EBV. If the basics are not unearthing the solution we continue to dig deeper and do a full functional medicine workup. And adjust the tryptophan as needed.

And finally the quality of the product is key. I find Lidtke Tryptophan to be better than many other brands. I’ve also had many clients switch to Lidtke tryptophan and see better results and often need a lower dose.

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

If you are new to using the amino acids tryptophan/5-HTP and the other amino acids 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.

I always appreciate good questions like this and hope this feedback has helped her and you too if you’ve experienced something like this (or if you do in the future). In case you’re wondering, this question was posted after someone tuned into my interview, “GABA & Tryptophan: Gut-Anxiety Connections” on the Anxiety Summit 5: Gut-Brain Axis.

Have you had a variable response to tryptophan (or 5-HTP) and can you relate to any of this?

What did you figure out to be the reason?

Feel free to ask your questions here too.

GABA for anxiety, unwanted thoughts, sleep, gut pain, burning mouth (and the blood brain barrier theory and zinc-copper imbalance)

November 5, 2021 By Trudy Scott 13 Comments

In the lead up to The Anxiety Summit 5: Gut-Brain Axis, today I am going to highlight GABA (gamma-aminobutyric acid), so you can really connect the dots and understand how far-reaching an impact this calming neurotransmitter has, and how important GABA is as an amino acid supplement.

Here are a few of the many interviews on the summit that feature GABA. Some of these gems come from the experts and some are from me helping to make the connections.

The GABA challenge for a leaky blood brain barrier: a theory

In my interview with Dr. Datis Kharrazian, Fix the Brain to Fix the Gut, we take a deep dive into his GABA Challenge for a leaky blood brain barrier and he shares how it is a theory and agrees that we still have much to learn about GABA:

The GABA challenge test was based on the lactulose mannitol test which is a well-established test in gastroenterology for measuring leaky gut.
He used GABA because the S100 B and blood brain permeability tests were not readily available at the time.
The theory was that if GABA helped ease anxiety or improved sleep, the person had a leaky blood brain barrier because of the GABA particle size.

He is still always suspicious if someone takes GABA and they have a reaction and does always want to go and check the blood brain barrier too.

But Dr. Kharrazian agrees there may be other mechanisms at play: “there is actually the possibility of other pathways that can impact GABA, maybe directly to the gut itself, through the vagus, so I don’t discount those possibilities. The real answer is, we don’t know.”

I have deep respect for Dr. Kharrazian and appreciate having the opportunity to discuss this with him.

Estrogen dominance, low progesterone, zinc-copper balance, GABA and benzodiazepines

In my interview with Ann Louise Gittleman too, Bile: Key to Anxiety and Hormone Havoc, we talk about high estrogen, low progesterone, zinc-copper balance and GABA:

Part of the whole issue with estrogen dominance is that we don’t have enough zinc in our diet and we need the zinc to make progesterone. We know that when we have a copper/zinc imbalance, with high copper and low zinc, we’re going to feel more anxious.
And we need zinc in order to make GABA and other neurotransmitters like serotonin. We also need it to make progesterone.
Damage to the liver and thyroid that was caused by fluoride was reversed by using the amino acid GABA.

Ann Louise also shares how GABA was a savior for her personally. After suffering from a very bad concussion and a bout with post-traumatic stress she eventually ended up on a benzodiazepine and GABA helped her get off it. The benzo “was very very toxic for my system because I don’t have all the detox pathways functioning the way they should. GABA was my savior. So I’m a big believer in GABA. And to this day, I still take 750 mg at night and in the morning.”

Mimosa pudica seed kills parasites and the whole plant extract modulates GABA

In my interview with Dr. Jay Davidson, Parasites, Anxiety and TUDCA for Your Liver, we take a deep dive into the role of parasites in anxiety and a product he uses for doing a parasite cleanse. Dr. Jay shares these gems about mimosa pudica seed:

It is amazing for overall gut support: “So even if your goal isn’t a parasite cleanse, mimosa pudica seed is awesome to help support the digestive tract.”
It can help break up biofilm.
It’s really good against Candida
It helps to normalize microbial levels within the GI system

And I share a study where the whole plant extract of mimosa pudica was found to help modulate GABA receptors. The study reported the benefits were very similar to one of the common antianxiety medications.

I would love to know if the seed has an impact on GABA levels too and will be digging into the research. I’ll share what I find in a follow-up blog post.

Lactobacillus rhamnosus (a probiotic) increases in GABA levels

In my interview with Dr. Peter Bongiorno, Gut-Brain Axis and Mental Health, he shares a mouse study that found Lactobacillus rhamnosus (a probiotic) led to increases in the calming neurotransmitter GABA:

GABA is typically very low in people who have epilepsy and anxiety.
“This study is showing us that you can actually increase GABA by just getting a good microbiota and getting the right strains of probiotics into your body.”

I love his description of how he thinks about this: “when the brain gets over-excited it’s like a calm blanket that sort of covers the brain and makes everything feel okay.”

Everyone who has benefited from the calming effects of GABA can relate to this.

GABA for gut pain, throat spasms, burning mouth, and anxiety and sleep

And finally, in my interview, GABA & Tryptophan: Gut-Anxiety Connections, I take a deep dive into all things GABA, sharing how low GABA plays a role in poor gut health and digestion:

There is research that shows that low GABA may be a factor with the visceral pain we see with SIBO (small intestinal bacterial overgrowth) i.e. the bowels are very sensitive to the distention or stretch caused by bloating. Using a GABA supplement can help ease the pain very quickly.
GABA supplementation also helps to relax throat spasms that we see with vagus nerve issues (I share my vagus nerve story and how GABA helped me).
GABA supplementation helps with easing burning mouth syndrome which is very common in menopausal women.

I also go into how low levels of GABA cause physical anxiety and how to do a trial of GABA in order to ease anxiety quickly. I also share the following:

Hippocampal GABA enables inhibitory control over unwanted thoughts
A combination of GABA and theanine helps improve sleep problems

And I also go into the harmful effects of phenibut, which is often used instead of GABA. It can cause physical dependence and withdrawal issues similar to benzodiazepines.

Of course, I also share some of the profound benefits we see with GABA supplementation. One mom shared this about her daughter whose teachers were concerned about her ADHD and anxiety at school: “Since giving her GABA she has had amazing behavior at school and at home. She’s almost like a different child. GABA has truly changed her life.”

This is what we should expect. We want to have this wow effect!

These interviews dove-tail well with this topic and all tie back to and mention GABA, and anxiety and gut health:

Achina P. Stein, DO, DFAPA, ABIHM, IFMCP – SSRI Impact on the Microbiome and Safe SSRI Tapering
Hyla Cass, MD – Endocannabinoid System and Your Gut
Magdalena Wszelaki – Herbs to Improve Digestion and Support GABA
Chandler Marrs, PhD – Thiamine Deficiency in Anxiety and Gut Health (Part 1 & 2)

If this is the first time you’re hearing about the Anxiety Summit 5: Gut-Brain Axis, I encourage you to tune in if you have:

Anxiety & feel overwhelmed & stressed by little things
Panic attacks &/or obsessive thoughts or behaviors
Social anxiety/pyroluria
Phobias or fears (flying, spiders or even driving on a highway)

And also if you suffer from…

Food sensitivities, IBS/SIBO, parasites or gallbladder issues
Constipation, diarrhea, bloating, gas, pain & other digestive issues
Leaky gut, a leaky blood-brain barrier or vagus nerve issues

Join us if you are also an emotional eater with intense sugar cravings (and know you suffer from low blood sugar), experience insomnia, low mood, PMS, poor focus and/or low motivation.

This is THE online event to learn about the powerful individual amino acids – GABA, theanine, tryptophan, 5-HTP, glutamine, DPA and tyrosine – to quickly ease anxiety and help with gut symptoms while you are dealing with other root causes which take longer to address. (They also help with cravings as with this example, and sleep and immunity).

With research-based anxiety nutritional solutions and practical steps, you can determine your root causes, ease your anxiety and prevent it from coming back so you can feel on top of the world again!

If you are a practitioner, please join us too and find advanced solutions for your clients or patients too!

You’ve heard me say the Anxiety Summit has been called “a bouquet of hope!” My wish for you is that this summit is your bouquet of hope!

I hope you’ll join me and these incredible speakers, be enlightened and find YOUR solutions!

Learn more/purchase now

Here’s to no more anxiety and you feeling on top of the world again!