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GABA mixed in water and swished in his mouth before a meal prevents esophageal spasms /choking/vomiting, and allows him to swallow

By Trudy Scott 24 Comments

gaba in water

GABA mixed in water and swished in the mouth of an adult male, before a meal, prevents his esophageal spasms, and stops his frequent choking and vomiting, and allows him to swallow his food. A colleague shared her husband’s swallowing issues after she read my blog post about using GABA powder inside the check for laryngospasms. 

This is what she shared:

That [blog] made me think that [GABA] might be useful for my husband‘s esophageal spasms. He frequently can’t get food down during a meal because of them.

So he started mixing 500 mg GABA in a little water and swishing it around his mouth and then swallowing it at the beginning of each meal. Since he started doing that he has not had one spasm, or vomiting episode.

It’s wonderful to hear about her husband’s success with GABA and this unique application of swishing around GABA powder (mixed in water) in his mouth before a meal (I’ll share more on this aspect below).

I asked if they know what the causes of his esophageal spasms are but they don’t yet know:

We can’t figure it out. It appears to be all food. I would expect there to be a trigger-food, but we can’t find it.

The GABA has completely stopped it. Last night we went out to dinner and he forgot to bring GABA with him and immediately started choking. So he went to the nearest vitamin store, (of which there is only one)! Fortunately it was open. As soon as he got back to the restaurant and took his GABA, he was fine.

GABA does work so well for him and offers him some relief while they continue to search for other underlying root cause/s. Until these are found, GABA is supporting overall low GABA levels, associated with physical tension-type anxiety, intrusive thoughts, stiff and tense muscles in other areas of the body and also stress-eating and self-medicating with alcohol in order to relax. More on low GABA symptoms here.

My input on his dosing and swishing

Regarding the dosing and swishing method I have this input:

  • 500 mg GABA is the ideal dose for his needs but this is considered a high dose to start. For low GABA tension-type anxiety, I have clients start with a trial of 125 mg GABA and go up from there. I’d recommend the same approach for someone with issues like this gentleman experiences.
  • GABA is most effective when used sublingually or by opening a capsule on to the tongue or by using GABA powder on the inside of a cheek, rather than swallowing a GABA capsule. For this reason, his method of swishing GABA mixed in water is excellent for achieving the spasm-reducing and relaxing benefits quickly. For some folks doing this 30 minutes before a meal may be more effective than doing it right before eating.

The diagnosis can vary from person to person

The diagnosis can vary from person to person. But as long as there are spasms that are affecting swallowing, doing a trial of GABA is worthwhile in order to determine if it will help.

One example is eosinophilic esophagitis where

Clinical manifestations in infants and toddlers generally include vomiting, food refusal, choking with meals and, less commonly, failure to thrive. Predominant symptoms in school-aged children and adolescents include dysphagia (difficulty swallowing), food impactions, and choking/gagging with meals, particularly when comprised of foods with coarse textures. Other symptoms in this patient population include abdominal/chest pain, vomiting, and regurgitation.

The predominant symptom in adults is dysphagia [difficulty swallowing]; however, intractable heartburn and food avoidance may also be present.

One paper, Esophageal microbiome in active eosinophilic esophagitis and changes induced by different therapies discusses the role of the microbiome and how “an increase in levels of gamma-aminobutyric acid (GABA) …is known to exert a role in esophageal motor function.”

Finding the other root causes (other than low GABA)

Regarding finding the root causes, other than low GABA, this is an important aspect that does need to be pursued. Here are some of the many factors worth considering:

  • Finding food triggers. This can be challenging but an obvious one is gluten which can play a role in eosinophilic esophagitis. Dairy and environmental irritants can be issues too.
  • GERD/reflux needs to be ruled out or addressed. Food sensitivities are often a factor here too.
  • Vagus nerve issues can play a role in digestive issues like this. GABA and vagus nerve exercises helped my cough and voice issues. I recorded all my exercises on video and you can find these here. Fortunately I didn’t have any swallowing or choking episodes at that time but have had a choking episode more recently (GABA did help) so I know how scary this can be.
  • Pyroluria, a social anxiety condition needs to be ruled out or addressed too. This is because nausea, gagging and choking are common symptoms for some individuals.
  • I’d also consider a tongue tie. I just finished reading Tongue Tied: How a Tiny String Under the Tongue Impacts Nursing, Speech, Feeding, and More (my Amazon link) by Richard Baxter, DMD, MS. The focus on babies and children but adults can also benefit from addressing tongue tie issues later in life.
  • Addressing gut health and the microbiome may be one of the keys, as outlined in the paper above.

This is not a comprehensive list and a full functional workup will help to identify all possible root causes.

Related blogs: young boy with choking episodes, lump-in-the throat sensation, anxiety and globus pharyngeus

Here are some related blogs that you may find useful

Resources if you are new to using GABA as a supplement

If you are new to using the the amino acid GABA as a supplement, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution (you can see the low GABA and other low neurotransmitter symptoms).

If you suspect low levels of GABA or low serotonin 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 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.

If you don’t feel comfortable reading my book, doing the low GABA symptoms questionnaire and doing trials of GABA on your own, you can get guidance from me in the GABA Quickstart Program (online/virtual).

If you are a practitioner, join us in The Balancing Neurotransmitters: the Fundamentals program. It’s an opportunity to interact with me and other practitioners who are also using the amino acids.

Have you experienced throat or esophageal spasms and difficulty swallowing with choking and/or vomiting.

And do you have the low GABA physical-tension-type-anxiety symptoms?  What else is a trigger for you and do you have a diagnosis?

If you’ve already been using GABA with success for easing your anxiety, have you noticed a reduction in your swallowing issues?

Have you ever used GABA in this way to help your swallowing issues?

If you’re a practitioner please share what you have seen?

Feel free to ask your questions here too.

GABA helps 14-year-old with Tourette’s Syndrome (the tics and sleep), and tyrosine makes him happier and his mind sharper

By Trudy Scott 30 Comments

gaba tyrosine teenager

We typically associate low GABA, a calming neurotransmitter, with a physical-type of tension- anxiety that also often affects sleep. However there is evidence that low GABA is also a factor in other conditions. One of these conditions is Tourette’s Syndrome, which is characterized by the presence of chronic tics which can be motor/movement and vocal. In today’s blog I share some research that suggests a deficit in GABAergic transmission may contribute to symptoms in Tourette’s and a case study where a teenage boy found relief from his tics when using the amino acid GABA as a supplement. GABA also improved his sleep. He also made some dietary changes – no gluten, no sugar and no caffeine – and supplemented with magnesium and melatonin. The amino acid tyrosine, used as a supplement, also improved his low mood and focus, both of which can be issues with Tourette’s.

Kim, a mom in this community, shared this wonderful feedback about her son in response to a Facebook post a few years ago:

Because of your book, I started using GABA for my 14-year-old son with moderate to severe Tourette’s Syndrome, and the results have been significant. Highly recommended for tics, and sleep for these individuals. Thank you.

I asked her how much GABA he used and how often and she shared this:

He used 750mg GABA nightly before bed, and if tics are really active then additional 300mg. Lots of water and a balanced diet with no caffeine…. life-saver.

Keep in mind that 750mg is considered a high dose. We typically start with 125mg GABA and increase based on each person’s unique needs. There is the temptation to think “I have tics and this is a very severe condition so I need a high dose to start.” You don’t want to be thinking like this. Some people may not need this much and others may need this high dose. We always use the trial method to figure out the ideal dose.

She also shared that when he added tyrosine, he saw benefits from that amino acid supplement too:

He recently added 300mg of l-tyrosine, and it promotes happiness and a sharper mind, due to brain fog. He says he really notices a difference. He has read your book as well.

How wonderful is this? GABA helped reduce his tics and improved his sleep, and tyrosine improved his mood and focus.

I love that he’s read my book – good for him and this mom! It’s never too early to have you and your child read this information. It’s empowering for them so they understand the changes they need to make and why these amino acids, dietary changes and elimination of caffeine make such a difference.

I recently checked in to see how he is doing now and asked what other nutritional approaches helped/help other than GABA, a balanced diet and no caffeine. She shared this:

He’s gluten free, magnesium for sure for the muscle tics, and melatonin for good sleep (Touretters need a routine sleep schedule).

He’s 18 now and is doing way better as he matures, but GABA no doubt has improved his life. We promote GABA and educate others as much as possible.

All this is so great to hear and I love that they now help to educate others about GABA too.

I appreciate that she gave me permission to share, hence this post. (The image above is a stock image and not her son.)

Tourette’s Syndrome and reduced GABA function

This paper, Reduced GABAergic inhibition and abnormal sensory symptoms in children with Tourette syndrome, describes the condition and the role of reduced GABA function:

Tourette Syndrome is characterized by the presence of chronic tics. Individuals with Tourette Syndrome often report difficulty with ignoring (habituating to) tactile sensations, and some patients perceive that this contributes to a “premonitory urge” to tic. While common, the physiological basis of impaired tactile processing in Tourette Syndrome, and indeed tics themselves, remain poorly understood.

It has been well established that GABAergic processing plays an important role in shaping the neurophysiological response to tactile stimulation. Furthermore, there are multiple lines of evidence suggesting that a deficit in GABAergic transmission may contribute to symptoms found in Tourette Syndrome.

In this study, the authors used testing (magnetic resonance spectroscopy) and tasks that were vibrotactile (the perception of vibration through touch) to investigate the role of GABA and atypical sensory processing in these 8-12-year old children with Tourette Syndrome.

They found the following:

  • lower concentration of GABA in the sensorimotor cortex and “impaired performance on tactile detection and adaptation tasks, consistent with altered GABAergic function”
  • the altered/reduced GABAergic function correlated with the severity of motor tics and sensory impairments, “linking the core feature of Tourette Syndrome directly to … brain neurochemistry.”

The authors conclude that this provides a foundation for novel interventions (i.e. medications) but unfortunately do not offer the use of the amino acid GABA as one of these solutions. This is very unfortunate but not unexpected. I plan to reach out to the authors and share this case study and blog.

This research supports why GABA works so well for Kim’s son and why he needed higher amounts of GABA when his tics were more active/severe. And now I’m curious to find out if her son has/had sensory issues and how they improve/improved with GABA. I’ll report back if I hear from her about this.

It’s no surprise that GABA helps his sleep too. There is much evidence supporting this – like the the sleep promoting effects of combined GABA and 5-HTP (or GABA alone or 5-HTP alone).  I’ve also shared many GABA-sleep success stories on the blog. Here is one: Since starting GABA my child sleeps for the first time in years and really notices a difference in his carb cravings. (Use the search feature and “GABA sleep” to find additional blog posts)

Interestingly only 8% of the children in the study had generalized anxiety disorder. Given how common low GABA is in anxiety, and that low serotonin can also be a factor with tics, I would have expected anxiety to be higher.

Evidence supporting the other nutritional changes he made

There is evidence to support the other nutritional changes that Kim’s son made:

  • There are reports that “an increase in tics has been related to the consumption of caffeine and refined sugar.” The authors acknowledge that there is no one diet for Tourette’s, so as always, it’s a matter of figuring out the ideal diet for each child (or adult) with tics. Oligoantigenic diets have been identified as significantly reducing tics. This involves removing foods that can potentially cause a food sensitivity leading to tics and/or behavioral impacts and/or insomnia.
  • A gluten-free diet maintained for one year in patients with Tourette’s Syndrome was shown to markedly reduce tics and OCD in children and adults
  • Magnesium is one of the most used supplements in children with Tourette’s Syndrome. When used with probiotics, omega-3 and multivitamins “Seventy-five per cent of supplement users in the Tourette syndrome group noted improvement, mainly in motor and vocal tics, sleep quality and anxiety reduction.”
  • Melatonin is listed with a number of medications commonly prescribed for tic disorders where sleep issues are also a factor

Keep in mind that the above is not a protocol for relief from tics for everyone with Tourette’s Syndrome. It’s what worked for the unique biochemical needs of Kim’s son.

That said, this could be a framework to start with and build upon.

Tyrosine improves his mood and focus

Tyrosine helps with low catecholamines, improving the curl-up-in-bed low-energy kind of low mood and poor focus. (You can see all the symptoms here.) The typical dose is 500mg tyrosine a few times a day. Kim’s son found just 300mg to be beneficial.

Interestingly, 48% of the children in this study had attention-deficit/hyperactivity disorder (ADHD) with about half of those on stimulant medication. I wonder how many would have also benefited from tyrosine for improving their focus, as it did for Kim’s son.

You can read more about tyrosine for focus and mood, and motivation and energy here.

Resources if you are new to using GABA or tyrosine as a supplement

If you are new to using the the amino acid GABA or tyrosine as supplements, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution (you can see the low serotonin 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 or catecholamines 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. As I mentioned above, it’s empowering for your teen and also relatively easy reading too.

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

Have you seen results with GABA or any of the above approaches? Or has another approach helped you or your child?

If you’re a practitioner have you seen GABA and any of the above to help? What else has helped your clients/patients?

If you suffer from Tourette’s Syndrome, do you also experience ADHD, insomnia, low mood and/or anxiety?

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

By Trudy Scott 30 Comments

trigeminal neuralgia and anxiety

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:

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.

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

By Trudy Scott 19 Comments

tryptophan result

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.

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.

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.

Rage, anxiety, cravings & insomnia in 11-year old girl with RAD/reactive attachment disorder: chewable tryptophan turns things around

By Trudy Scott 21 Comments

rad and tryptophan

Today I’m sharing the case of an 11-year-old girl who had huge rage issues, was angry much of the time, suffered from terrible anxiety, had crazy sugar cravings (for bread and colored candies) and had dreadful insomnia. Because of the insomnia she was also very fatigued and this likely drove some of her cravings and irritability too. She was adopted and had been diagnosed with RAD (reactive attachment disorder). During our first session, chewable tryptophan turns things around quickly – she smiles and is willing to make changes and quit the sugar and gluten. We also address low iron levels and with these 4 nutritional interventions this child’s behavior improves dramatically.

This book chapter, Reactive Attachment Disorder, states how The Diagnostic and Statistical Manual 5th Edition (DSM-5) classifies reactive attachment disorder as follows:

a trauma- and stressor-related condition of early childhood caused by social neglect or maltreatment. Affected children have difficulty forming emotional attachments to others, show a decreased ability to experience positive emotion, cannot seek or accept physical or emotional closeness, and may react violently when held, cuddled, or comforted. Behaviorally, affected children are unpredictable, difficult to console, and difficult to discipline. Moods fluctuate erratically, and children may seem to live in a “flight, fight, or freeze” mode. Most have a strong desire to control their environment and make their own decisions. Spontaneous changes in the child’s routine, attempts to discipline the child, or even unsolicited invitations of comfort may elicit rage, violence, or self-injurious behavior.

Reactive attachment disorder/RAD and low serotonin

There is no research on tryptophan helping to address RAD symptoms or trauma, but based on her low serotonin symptoms, a trial of tryptophan was the first thing I considered.

There is, however, evidence to indicate the role of low serotonin in RAD, as indicated by a study where antidepressants were successfully used. The authors mention how:

The absence of responsive and consistent caretaking can subject the developing brain to an inordinate amount of physiological stress, leading to increased cortisol production and consequential inefficiencies in the serotonin and the growth-hormone releasing systems.

Although not specific to RAD, another paper looking at trauma states that:

Serotonin and dopamine levels were found to be abnormal in the presence of PTSD.

As the field of nutritional psychiatry grows, I expect to see more and more research supporting the use of tryptophan and other amino acids for those suffering from symptoms like this. Symptoms that are caused by imbalances that are triggered by the trauma in their lives.

We know that therapy, EFT, EMDR and other approaches are crucial for trauma recovery (this family had already done some of this work) but we must start to incorporate nutritional support too.

The case study

Here are the details of this case study and the nutritional interventions. As I mentioned above, because of her severe rage episodes, a trial of tryptophan was the first thing I considered:

She was referred to me by a friend. The family didn’t have much money. And so, we had to really try and figure out a few simple interventions that we could use that were going to be effective.

This young girl had been adopted. She was diagnosed with reactive attachment disorder and her anger issues were just phenomenal. The mom had to physically put her body around her and hold her down when she was having one of her fits because she was worried that she was going to hurt herself and hurt other people.

She also had anxiety, huge cravings for colored candies and insomnia. She was so fatigued because she wasn’t sleeping well.

So sitting in my office with this young girl and her mom, we started to talk about the sweets and the candies and the need to give up the candies. She was fuming with me. She was sitting in a swivel chair. She turned her back on me and didn’t want to talk about having to give up candy at all.

I said, “Look, let’s not even talk about that, but would you take this chewable tryptophan here? And we’ll talk about it in a second.” I gave her 100 mg of the chewable tryptophan and continued discussing things with her mom.  She had no idea what it was going to do or how it would make her feel.

Within five minutes she turned her chair back, looked at me and she said, smilingly, “Yes, let’s do it. I can give up the candy.” She was smiling and she was happy.

So long story short, with this young girl, we started her on [chewable] tryptophan [and it turned things around quickly].

Chewable tryptophan – when I use it and when I don’t

I typically use 500mg Lidtke tryptophan for the adult clients I work with and prefer this company’s product because it is really high quality. It really does work better than many other tryptophan products on the market.

Lidtke also makes a chewable 100mg tryptophan which is also high quality, and the product I used with this young girl. Here are some benefits of this 100mg product:

  • It’s useful for doing the initial trial in order to figure out if tryptophan is going to help with low serotonin symptoms in children – because it’s a lower dose.
  • It’s especially useful for children for ongoing use (typically midafternoon and evening) because it’s a lower dose.
  • It’s also useful for adults who are “pixie dust” folks and do better with a lower dose of supplements in general or respond more severely to medications/alcohol/chemicals. We may start with a trial of the 100mg chewable and increase from there, also typically midafternoon and evening.

I don’t use the chewable 100mg tryptophan under these circumstances:

  • When the child (or adult) finds that 5 x100mg works for them at each time they need it. In this instance it’s best to switch to a 500mg tryptophan. Using it swallowed may work or it may need to be opened onto the tongue.
  • When the child (or adult) starts to consume the chewables like candy. They are sweet and do taste good and I’ve seen this happen. Because you are continually consuming something sweet you may end up over-consuming them if sugar addiction is one of your issues. You may also end up taking too much tryptophan.

If the chewable tryptophan is not available where you live, using a small amount of a powdered tryptophan or opening a capsule of the 500mg tryptophan is an option. Since it tastes bitter it can be mixed with mashed banana or inositol. (You can find all the Lidtke products in my online supplement store. The link is in the resources section below.)

Gluten and candies were also a huge issue, and she had low iron

There was more to her issues than only low serotonin:

Gluten was also a huge issue, so we got her off gluten and the candies. The tryptophan helped with this” (i.e. it made it easy to break the addiction and not feel deprived).

Tryptophan also helped her sleep. And it helped with the severe rage issues.

Obviously the gluten was contributing to the rage issues as well.

Her iron and ferritin levels were really low (possibly as a result of her gluten issues). So we added an iron supplement, and animal protein/red meat.

So with just four interventions – the gluten, the animal protein, getting her iron levels up and the tryptophan – this kid was just a new kid.

Here are some articles that are related to the above:

Keep in mind there is not a one-size-fits-all and these 4 simple nutritional interventions – tryptophan, gluten removal, adding red meat and addressing low iron – happened to be the combination that worked for this young girl.

Resources if you are new to using tryptophan as a supplement

If you are new to using the amino acid tryptophan as a supplement, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution and a brief overview here, Anxiety and targeted individual amino acid supplements: a summary.

If you suspect low serotonin symptoms 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.

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 Lidtke chewable tryptophan 100mg, Lidtke tryptophan 500mg and other products that I use with my individual clients and those in my group programs.

We use an amino acid like tryptophan for quick relief of symptoms, like I did in this instance. Then we focus on the foundations like diet – like no gluten and red meat in this instance – and address all other imbalances, like her low iron. If cortisol was high we would have addressed that.

This case deserves it’s own blog post

In case you’re wondering, I first shared this case study in my interview, “Calming Anxiety, Aggression and OCD with Amino Acids and Food”, on the ADHD and Autism Summit in May 2021. Due to the interest in this case and the use of chewable tryptophan, I felt it deserved a deeper dive and its own blog post with links to some of the research and some practical information about the chewable tryptophan.

Have you used this chewable tryptophan product with success – personally, with your child or with a patient/client?

Have you found that addressing serotonin with tryptophan (or 5-HTP) helps resolve symptoms in a child diagnosed with RAD or a child with rage issues? What about helping with sleep problems, easing anxiety and stopping cravings too?

Have you addressed low iron levels and seen improvements with the removal of gluten too.

Feel free to post your questions here too.

 

I was called a vulture for preying on sensitive people in a social anxiety group – because I mentioned pyroluria and a nutritional solution

By Trudy Scott 74 Comments

I was called a vulture

Earlier this week I was called a vulture for preying on sensitive people in a social anxiety group because I mentioned pyroluria and a nutritional solution in response to someone asking for help. I shared much of this on Facebook and the response has been huge – supportive, understanding and encouraging, and also something many of you have also faced and can relate to. I’m publishing it as a blog post too because I feel there are many takeaways and lessons we can all learn from this.

The person asking for help posted this:

I’m seriously stuck. I’ve been battling social anxiety disorder my whole life. I feel like my social skills have gotten worse during 2020-2021. Is anyone the same way? And If possible can anyone give me some good advice?

I posted this in response to the request for advice:

Look into pyroluria and the nutrient protocol – life-changing for me (and my clients – disclaimer: I’m a nutritionist)

And this is the response from someone else in the group:

So not medicine. I think as a nutritionist you shouldn’t be advising people to avoid actual medical help. Foods can’t help but most depression and anxiety isn’t stress based. It’s a biological chemical imbalance. Food won’t help it in the long run. As someone who’s had bipolar, depression, anxiety, social anxiety, insomnia and possible schizo. I have known people to get seriously ill from people that couldn’t manage to be actual doctors. I’ve lost a friend due to them being advised to stop meds and take some herb. Please unless you are actually here because you have social anxiety and such. Could you please leave and stop acting like a vulture over the sensitive people.

I get that it can be tough to grasp that nutrition and nutrients could be a solution for social anxiety but even with a response like this I will continue to share my message.

This was my response:

Correct, not medicine … nutrition. I had social anxiety and panic attacks and diet (gluten-free, caffeine-free, sugar-free etc) and nutrients like zinc, vitamin B6, GABA, tryptophan and more solved my anxiety. I’m passionate about creating awareness because I’ve seen “nutritional psychiatry” work for 100s of thousands of folks.

Please be open-minded … and google “nutritional psychiatry”, “gut-brain”, “pyroluria social anxiety” and “gluten schizophrenia” … you will be pleasantly surprised. It’s going to take some time for all this to be part of mainstream psychiatry but it’s in the research and awareness and acceptance is growing.

I’m sorry about your loss but I would never advise anyone to stop taking their meds. For folks who want to explore this approach we always work in conjunction with their prescribing doctor.

It’s also not very nice calling someone a vulture but I understand that the idea that food and nutrients could be so powerful when it comes to anxiety and mental health can be tough when you first hear about it.

Why I’m sharing this – it’s not for sympathy or to call this person out

I’m not sharing this here for sympathy.

I’m not sharing this to call out this person who called me a vulture or to judge or shame them.

I’m sharing it to illustrate the challenge we have with getting this message out.

I’m sharing it in case you’ve tried to tell a loved one or friend or colleague about the power of anxiety nutrition solutions and have had push-back.

I’m sharing here so we remember to have empathy for someone who doesn’t yet know or understand what we have learned and experienced (no matter what they say or how they say it or even if they have even been preyed on in the past so a comment like this may be justified in their mind).

I’m sharing here because I truly believe in the power of planting seeds of knowledge.

I’m sharing here because I believe everyone deserves to feel their absolute best every single day.

I’m sharing here because everyone struggling with anxiety and social anxiety deserves to know about the growing field of “nutritional psychiatry” in mainstream medicine.

This is why I’m sharing here and why I’ll continue to share nutritional solutions in groups where folks are asking for help for social anxiety, anxiety and panic attacks (and other conditions where pyroluria and neurotransmitter imbalances are common, and there is a role for diet and nutrients).

Why the disconnect and the possible role of neurotransmitter imbalances

I’m hoping all this can help you as you reach out and offer support to someone in an online group. And also help you as you share what you have learned or experienced personally when it comes to nutritional solutions for social anxiety/anxiety – with loved ones, community members, friends and colleagues who are sometimes less than receptive.

I suspect one big disconnect is comprehending that lifestyle/diet/nutrients could help with anxiety and mental health challenges. Heart disease, diabetes, high blood pressure and cancer are more recognized as being lifestyle conditions even dietary and lifestyle changes are not always implemented.

I also often hear this: “my anxiety or social anxiety or panic attacks are so severe (or so complex) there is no way nutrients and nutrition could help! I need medications for sure.”

If someone has nutritional deficiencies or neurotransmitter imbalances, that may also be playing a role in how they respond. For example, low serotonin can make you feel hopeless, fearful, negative, overwhelmed and even angry. This is in addition to feeling anxious and not sleeping well, so you’re more likely to be cranky and irritable.

Links to resources for you to share

Here are links if you need some resources to share or in case you’re new to some of this:

Tamara’s wonderful feedback about gluten and vitamin D

This was Tamara Underwood’s response to my vulture post and her powerful feedback about gluten and vitamin D:

That was a thoughtful response Trudy. I think when people have complex health issues, they think the solution needs to be complex. I had no idea how powerful nutrients could be until it solved my own health issues. Often, it is returning to basics and using foundational support in a targeted way.

I’ve had chronic migraines (3-4 a week) since I was a toddler. Tried every medication, label and off label, to manage them for 40+ years. Removing gluten was life changing. I’ve been migraine free for 8 years now.

Also, about 10yrs ago, I experienced a very dark, unexplained depression for nearly a year. Of course drugs and therapy are the first line treatments. Not sure why I was opposed to starting there but thankful. My Vit D was 4.1. I felt so radically better within a week of starting repletion that I went back to school for my MS in Clinical Nutrition.

I think about how different life might be now, 10 yrs later, had I not pushed for testing. Psych meds wouldn’t have improved my Vit D so I would have been prescribed all the variations and combos and told how complex my case was when it didn’t help. [One study supporting an association between low vitamin D and depression]

There are just so many toxicities, deficiencies, and imbalances worth exploring if your mental wellness suffers. I’m passionate about this subject and a big fan of yours Trudy.

I’m thrilled that going gluten free and addressing low vitamin D solved her migraines and depression. It’s so wonderful to hear Tamara was inspired to go back to school to study nutrition. She now does this work helping professionals (firefighters, EMTS etc.) who shoulder a greater burden of stress and trauma. Check out Underwood Functional Wellness. I appreciate her for allowing me to share here.

I plan to update this blog with more of the wonderful insights from my community on Facebook but folks are still actively engaging and I need to get permission to share here. Stay tuned for more.  You can also join the discussion on the Facebook post here.

Until then, feel free to post your insights, thoughts, experiences (and questions if you have them) in the comments below.

Let us know how nutritional approaches have helped your anxiety and/or other health issues?

What made you open to this approach and were you initially skeptical?

And let us know if you continue to share your success and plant seeds even when you get negative feedback – and why? And do you have resources you like to share?