high blood pressure

The morning after a spine surgery, I had an anxiety attack and insisted on being allowed to take my GABA, which helped

February 28, 2025 By Trudy Scott 12 Comments

I’d been taking GABA before [my spine] surgery and really didn’t want to have to discontinue it. My surgeons have always insisted on me going off supplements in the week or more leading to surgery.

I’m sure they don’t want to have to be well versed on everything a person might be taking so they only allow prescription drugs.

The morning after the spine surgery, I had an anxiety attack and insisted on being allowed to take my GABA, which helped.

GABA helps tremendously in preventing me waking in the middle of the night or early morning in a panic. I take 500mg of NOW GABA sublingually before bed. I also take tryptophan and magnesium glycinate at bedtime and believe they help a bit, but GABA is the most effective.

It would be really helpful to be able to take needed supplements right up to surgery time.

LM posted this in response to my blog: GABA and theanine for sedation, anxiety, and cognition in preoperative surgical patients (a randomized controlled study) (more on this below).

She also said “This would be really nice” if doctors knew this! I’m with her – it would be really nice if doctors were aware of this research and allowed patients to use GABA and theanine right up to surgery and right afterwards too. This is especially relevant given the fact that GABA lowers blood pressure and high blood pressure is common after surgery (more on this below too).

Hopefully this GABA/theanine surgery research and the GABA/high blood pressure research will start to shift perspectives and guidelines, especially since increased anxiety also impacts the outcome of surgery. I share more on the research and my insights below.

The study: GABA and theanine are calming before a surgical procedure and don’t cause too much drowsiness

If you missed the blog post and study I shared above, here is the overview:

This novel study was planned to study and compare the effects of L-theanine and GABA on anxiety, sedation, and cognition in preoperative patients posted for major elective surgeries under general anesthesia.

The conclusion is that:

GABA and L-theanine result in effective preoperative anxiolysis with minimal sedation and improvement of cognitive skills.

In other words, both these amino acids are calming before a surgical procedure, don’t cause too much drowsiness and improve cognition.

Study participants used 500 mg GABA and 200 mg of theanine – but dosing is unique

The authors had the study participants use 500 mg GABA and 200 mg of theanine. Both were used as capsules and swallowed. If you’ve been following my work, you’re aware that I find sublingual (or powder or liposomal or topical) use of GABA to be more effective than swallowing a capsule. For this reason it’s possible that using a lower dose sublingually may be as effective or possibly even more effective.

As always, dosing of GABA (and other amino acids such as theanine) is individualized to the unique needs of the person. Ideally, the person has figured out their optimal dose for easing anxiety in their day to day life before going in for surgery. They may find that a higher dose is needed the weeks leading up to surgery and the day of surgery.

As LM shared, she uses “500mg of NOW GABA sublingually before bed”, and presumably started with a lower dose and worked up to 500mg i.e. the optimal dose for her unique needs. It’s very individualized with no-one-size fits all i.e. someone else may get similar benefits with 125mg.

You can read the entire blog post here: GABA and theanine for sedation, anxiety, and cognition in preoperative surgical patients (a randomized controlled study).

Why you are told to stop all supplements prior to surgery

My understanding is that being told to stop all supplements prior to surgery is because of potential concerns about effects on bleeding, anesthesia and blood pressure. Unfortunately, the study didn’t address this possible issue. This article has some information on supplements (and some meds) to stop before surgery/anesthesia stating:

you may need to take a break from some supplements and medications that can interfere with anesthesia. Surgical complications could include heart or bleeding problems, prolonged anesthesia effects, or increased blood pressure.

GABA lowers blood pressure which may be helpful right after surgery

High blood pressure is common after surgery and can have far-reaching implications. According to this paper, “Postoperative hypertension often begins ~10–20 minutes after surgery and may last up to 4 hours. If left untreated, patients are at increased risk for bleeding, cerebrovascular events, and myocardial infarctions.”

This is another reason GABA may actually be helpful to use right up to surgery and right afterwards – it lowers blood pressure.

This paper, United States Pharmacopeia (USP) Safety Review of Gamma-Aminobutyric Acid (GABA), published in 2021, reports the results of a 4-week study that investigated the tolerability of GABA supplementation in mildly hypertensive but otherwise healthy adults:

The authors first established an optimum dose in mildly hypertensive subjects (SBP/systolic blood pressure between 130 and 180 mm Hg) who were randomized to receive oral doses of GABA at 0 (placebo), 20, 40, or 80 mg/day for 4 weeks.

An intake of 80 mg/day of GABA was associated with a significant reduction of the BP in adults with mild hypertension, and no adverse effects were reported.

A subsequent study evaluated long-term effects of GABA at 80 mg daily versus placebo in mildly hypertensive subjects for 8 weeks:

At the end of the 8-week study, SBP [systolic blood pressure i.e. the top number] and DBP [diastolic blood pressure i.e. the bottom number] were on average 5% lower in all the subjects who received 80 mg/day of GABA compared to participants in the placebo group whose blood pressure levels remained above normal.

This is a substantial reduction when 80 mg of GABA a day is considered a very low dose. I typically have my anxious clients start with 125mg GABA and increase from there. They may end up using 125 mg GABA 3 or 4 times a day and sometimes 250 mg a few times a day or 500 mg once a day like LM is doing.

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

As always, I use the symptoms questionnaire to figure out if low GABA may be an issue. The low GABA symptoms include: physical tension, overwhelm, fears, anxiousness, stiff and tense muscles, sleep issues, feelings of panic and stress-eating and drinking.

If you suspect low levels of any of the neurotransmitters and do not yet have my book, The Antianxiety Food Solution – How the Foods You Eat Can Help You Calm Your Anxious Mind, Improve Your Mood, and End Cravings, I highly recommend getting it and reading it before jumping in and using amino acids on your own so you are knowledgeable. And be sure to share it with the practitioner/health team you or your loved one is working with.

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

The book doesn’t include product names (per the publisher’s request) so this blog, The Antianxiety Food Solution Amino Acid and Pyroluria Supplements, lists the amino acids that I use with my individual clients and those in my group programs.

If, after reading this blog and my book, you don’t feel comfortable figuring things out on your own (i.e. doing the symptoms questionnaire and respective amino acids trials), a good place to get help is the GABA QuickStart Program (if you have low GABA symptoms). This is a paid online/virtual group program where you get my guidance and community support.

If you are a practitioner, join us in The Balancing Neurotransmitters: the Fundamentals program. This is also a paid online/virtual program with an opportunity to interact with me and other practitioners who are also using the amino acids.

Wrapping up and your feedback

I appreciate LM for sharing how GABA helps her and her post surgery experience with anxiety and using GABA. It is wonderful that she was able to take her GABA supplement for the anxiety attack after her surgery. Let’s hope this research increases awareness amongst surgeons.

I’d love to hear from you – have you been told to stop all supplements before surgery, including GABA and other amino acids.

And do you feel increasingly anxious before surgery and other medical procedures and would GABA help i.e. is GABA and/or theanine part of your calming repertoire on a day-to-fay basis?

Have you ever discussed either of these two amino acids – GABA or theanine – with your surgeon or anesthetist prior to surgery and were they open to you using them before and right after surgery?

If you’re a practitioner do you recommend GABA and theanine to your anxious clients/patients and as a surgeon or anesthetist would you consider these amino acids in the future, based on this research?

Feel free to share your experiences and ask your questions below.

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

October 20, 2023 By Trudy Scott 63 Comments

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

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

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

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

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

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

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

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

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

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

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

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

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

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

She used 1 Seriphos per day for about 3 months.

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

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

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

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

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

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

I do recommend Salivary cortisol testing before using Seriphos

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Feel free to share and ask your questions below.

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

October 13, 2023 By Trudy Scott 28 Comments

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

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

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

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

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

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

Adverse effects on the heart

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

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

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

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

In addition to hypertension, the paper mentions the following:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

My cautions for consuming licorice in any form

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

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

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

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

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

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

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

How much licorice did you consume and over what period?

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

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

Feel free to share and ask your questions below.

Beware! Too much licorice tea can cause hypertension even if you have low or normal blood pressure

October 6, 2023 By Trudy Scott 38 Comments

A 45-year-old woman presented to her general practitioner with a 4-month history of hot flushes, sweating and headaches. On examination, she was found to be hypertensive, and blood tests revealed mild hypokalaemia [low potassium].

While awaiting the results of further investigation into the cause of her elevated blood pressure, the patient conducted her own research and identified liquorice tea [licorice tea] as the potential cause of her symptoms. The patient had been drinking up to six cups of liquorice tea per day as a substitute for caffeinated tea and fruit-based infusions.

The patient immediately stopped consuming the drink and within 2 weeks her symptoms, hypertension and hypokalaemia, had entirely resolved.

This case report, Hypertension induced by liquorice tea, is eye-opening because this woman had always had low blood pressure and so she ignored the small print on the box that states “not advised for people with hypertension.”

I often see this caution about avoiding licorice if you have high blood pressure (hypertension). But I have yet to see a warning on a box of tea about the fact that licorice can actually cause high blood pressure with high consumption – even when your blood pressure is low or normal. I feel the latter aspect is not as well known, which is the reason for this blog.

I’m also sharing this case report and additional information because something similar has just happened to me (more on my story below).

Here are a few more facts about this patient’s case:

She went to her doctor “with a history of hot flushes, night sweats and headaches. These symptoms had started over the preceding 4 months. The patient suspected that her symptoms were due to the onset of menopause.”
Initially her blood pressure was 162/82 and “Repeat blood pressure measurement confirmed ongoing hypertension of 150/80 mm Hg”
“Blood tests demonstrated mild hypokalaemia” (i.e. low potassium of 3.3 mmol/L).
Two weeks after she stopped drinking the licorice tea, “repeat blood pressure measurement was 128/84 mm Hg and her hypokalaemia (and other symptoms) had resolved.”

I encourage you to read the entire published case report to get an understanding of the mechanisms of licorice mediating “its effect on blood pressure via the action of glycyrrhizin on the kidney.” And the impacts on sodium, potassium, aldosterone, cortisol/cortisone and blood pressure. I will add that this is one of many such case reports in the published research.

My story with elevated blood pressure after drinking Yogi Throat Comfort tea

As I mentioned above, I’m sharing this case report because something similar has just happened to me! I had been drinking Yogi Throat Comfort tea for just over a week to soothe my throat and help after my voice loss. It contains licorice root as well as slippery elm and other herbs.

My blood pressure is typically low at 110/80 or less (sometimes as low as 102/80) and last Friday it was 130/80 which is the highest it had ever been.

I didn’t make the connection to licorice right away because I had just flown internationally from Hawaii to Australia and we were sprayed with insecticide on the plane when we landed in Australia. We all had to sit there in the toxic soup for 10 minutes. (I’ll be sharing more about all this in a future blog).

I suffered severe vertigo the next day and it was at the doctor’s office that I found out my blood pressure was 130/80. I was very surprised but he felt it could be due to the travel or vertigo or voice issues. I also know that bereavement can have major physiological impacts and increased blood pressure is one of them (I was in Hawaii for my darling mom’s memorial).

I finally made the connection when my blood pressure measured 137/84 a few days later and stopped drinking the tea immediately. Over the next few days it came down to 127/93 and then 121/90 and then 118/84. I expect it to continue to come back down to my normal low blood pressure and will update this blog when it does.

As far as symptoms, I was just not feeling myself and had a strange feeling of apprehension, spaciness and breathlessness when talking too much. These are much improved having stopped the tea. My naturopath also recommended eating a banana each day to increase my potassium levels and to have epsom salt baths to help regulate the electrolytes in my body.

I will admit there are the above confounding/contributing factors – grief, voice loss, travel, vertigo, insecticide exposure – so I can’t be sure it’s only the licorice in the tea, and I’m not willing to test it out right now.

(Update Oct 13, 2023: A week later and it’s now pretty much back to my usual low blood pressure. Over the course of this last week it measured 125/82, 118/91, 127/84, 118/85 and today it’s 112/85. I will continue to track.)

How much licorice tea is too much?

The authors of the above case report mention this about the dose of glycyrrhizin:

Experimental studies have shown that the rise in blood pressure caused by liquorice follows a linear dose–response relationship. Doses of as little as 75 mg of glycyrrhizin (equivalent to 50 g of standard liquorice confectionery) given daily for a 2-week period have been shown to cause a significant increase in systolic blood pressure (the first number).
In a survey of 33 brands of liquorice tea, the mean glycyrrhizin content was found to be 126 mg/L (range 2–450 mg/L). A cup of liquorice tea with a volume of 250 mL could therefore be expected to contain, on average, approximately 31.5 mg of glycyrrhizin.”
The European Scientific Committee on Food advises that regular glycyrrhizin doses of 100 mg/day present a risk to health, and advocate a safe average daily intake of no more than 10 mg/person/day. This is an amount equivalent to less than half a cup of liquorice tea or just 6 g of liquorice confectionery daily.

In the above published case, the patient had been “averaging around 4–6 cups per day, and had been consuming the licorice tea for about a year.” She was “unwittingly consuming daily volumes of liquorice tea containing up to 190 mg of glycyrrhizin, well in excess of the recommended limit” of 10 mg per day. It was 8 months before she started to notice the adverse effects, but I do wonder how long she had high blood pressure.

We have a home blood pressure monitor but I haven’t used it for ages and if I hadn’t gone in to the doctor for my vertigo, my elevated blood pressure may have gone unnoticed for a while too.

How much did I consume: a total of 10 Yogi Throat Comfort tea bags over the course of a week. The day before leaving I had a few cups of hot tea and was thrilled to be able to talk on my last day there. I then drank it all day on the 15+ hour flight back: I had 2 tea bags in my 2 liter / 2 quart water bottle and filled it up a few times with cold water. And I continued to do this once I was home, having it next to my bed if I woke up coughing in the night. I was probably getting 3 or 4 times more than the safe average daily intake of 10 mg/person/day.

I love licorice tea and drink it from time to time, maybe 2-4 cups a month. I’m quite surprised it affected me so quickly but have never consumed this amount and in such a concentrated time period.

Will I drink Yogi Throat Comfort tea or other herbal teas that contain licorice?

For now, I think I will – the Throat Comfort tea helped so much with my voice – but when I do I will monitor my blood pressure carefully and then make a final decision.

I also plan to dig a bit further into some of the confounding factors I mention above to see how they could possibly have made me more susceptible.

I do also have dietary oxalate issues so this could play into the effects of glycyrrhizin on the kidney. I’m finding mixed results on the oxalate content of licorice: some papers say high and some say low. But I didn’t have any of my typical oxalate reactions such as painful feet or eyes. I have, however, noticed some stiffness in my left hip the last few days so will be looking further into this aspect.

(Update Oct 13, 2023: Licorice tea is listed as low oxalate on the Trying Low Oxalates Facebook group but they will be updating their spreadsheet based on a paper I just shared with them – Oxalate in Foods: Extraction Conditions, Analytical Methods, Occurrence, and Health Implications “Licorice was the highest-oxalate food reported in this review with 3569.3 mg total oxalate/100 g FW (fresh weight).” (this is higher than spinach, sweet potatoes and rhubarb which are really high oxalate)

My takeaway messages – a warning and listen to your body

There is no licorice hypertension warning on this Yogi Throat Comfort tea box (or my Tulsi Licorice tea) and I do feel there should be 2 warnings: the usual warning about licorice if you have high blood pressure AND a general warning that licorice may also affect you if you have low or normal blood pressure.

My other takeaway message is this: listen to your body and get checked out when things don’t seem as they should be.

Has something like this happened to you? How much licorice tea did you consume, which brand and over what period?

Do you typically have low blood pressure and were you also caught by surprise?

Did you know about the caution to avoid licorice if you have high blood pressure?

And what about the fact that licorice may also affect you if you have low or normal blood pressure?

Feel free to share and ask your questions below.

GABA and taurine reduce high blood pressure: the anxiety connection and what do when on blood pressure medication or if blood pressure is already low

September 1, 2023 By Trudy Scott 18 Comments

Gamma-amino butyric acid (GABA) is an amino acid that used as a supplement to help ease physical anxiety and help with insomnia, and a host of other symptoms ranging from pain to throat spasms (you can see the most recent list of symptoms here)

Research shows that GABA lowers blood pressure too. This has implications if you have high blood pressure/hypertension and are currently taking blood pressure medication or if you happen to have low blood pressure. The latter is already a precaution I review with my clients i.e. to watch the use of GABA when blood pressure is low. But we do need to add another precaution to cover folks already on blood pressure medications. Read on to learn about these precautions and what they may mean for you, and to read about the GABA (and taurine) hypertension research. And the fact that anxiety is common when you have high blood pressure and can actually be a driving factor.

The authors first established an optimum dose in mildly hypertensive subjects (SBP/systolic blood pressure between 130 and 180 mm Hg) who were randomized to receive oral doses of GABA at 0 (placebo), 20, 40, or 80 mg/day for 4 weeks.

An intake of 80 mg/day of GABA was associated with a significant reduction of the BP in adults with mild hypertension, and no adverse effects were reported.

A subsequent study evaluated long-term effects of GABA at 80 mg daily versus placebo in mildly hypertensive subjects for 8 weeks:

At the end of the 8-week study, SBP [systolic blood pressure i.e. the top number] and DBP [diastolic blood pressure i.e. the bottom number] were on average 5% lower in all the subjects who received 80 mg/day of GABA compared to participants in the placebo group whose blood pressure levels remained above normal.

I’m not suggesting using only GABA or taurine (more on this below) when blood pressure is high as there can be many variables and root causes. I would, however, like to see GABA be given more consideration, especially when anxiety is a symptom too.

The existing GABA precautions: a new one if you are taking medication for high blood pressure

If you are currently taking blood pressure medication for high blood pressure and plan to do a trial of GABA, it’s worth monitoring your blood pressure and discussing with your prescribing doctor. GABA may lower your blood pressure enough that your medication can be reduced or possibly stopped. The above paper states this:

Because some studies showed that GABA was associated with decreases in blood pressure, it is conceivable that concurrent use of GABA with anti-hypertensive medications could increase risk of hypotension [low blood pressure].

I have now added this as a new precaution – High blood pressure and on blood pressure medications: GABA, taurine. You can see it on the Amino Acid Precautions blog.

The existing GABA precautions: watch when you have low blood pressure and don’t use when pregnant or nursing

As you can read in the amino acids chapter of my book and on the above precautions blog, there is already a precaution stating to watch the use of GABA when you have low blood pressure. It’s worth being aware of but is not something I’ve actually seen to be an issue. Occasionally folks reduce their GABA dose because they feel light-headed.

This precaution is already addressed – not to use GABA when pregnant or nursing – but it’s worth repeating here as it’s a frequent question I am asked . The above paper states:

Caution is advised for pregnant and lactating women since GABA can affect neurotransmitters and the endocrine system, i.e., increases in growth hormone and prolactin levels.

Taurine: hypertension, stroke and heart disease

You’ll notice taurine grouped with GABA on the list of precautions. Based on the research, this amino acid also helps reduce blood pressure and is cardio-protective: “Advances in extensive studies on experimental models indicate that taurine is preventive against hypertension, stroke and atherosclerotic arterial diseases.”

This is one of the proposed mechanisms of taurine for lowering blood pressure : “The preventive mechanisms of taurine were ascribed to sympathetic modulation for reducing blood pressure (BP) and anti-inflammatory action.” GABA works in a similar way.

The same precautions would apply: low blood pressure and high blood pressure with blood pressure medication.

As I mentioned above, there is more to hypertension than adding only taurine or GABA. This book by Dr. Mark Houston MD, is an excellent resource – What Your Doctor May Not Tell You About(TM): Hypertension: The Revolutionary Nutrition and Lifestyle Program to Help Fight High Blood Pressure (my Amazon link).

He does mention taurine and recommends 1 to 1.5 g of taurine twice a day for high blood pressure. He does not mention GABA supplementation but does mention how vitamin B6 is important for GABA and serotonin production and improving sympathetic function.

Stress, anxiety and fear affect blood pressure and GABA helps

Dr. Houston shares that “numerous studies have linked stress, anxiety, fear and other negative emotions to an elevation in blood pressure. Conversely, as stress decreases, so does blood pressure. ”

This supports my comments above about giving GABA more consideration when it comes to high blood pressure, especially when anxiety is a symptom too. Here are some cases studies:

When GABA is not available taurine is a viable option for anxiety and hypertension.

Resources if you are new to using amino acids as supplements

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

If, after reading this blog and my book, you don’t feel comfortable figuring things out on your own (i.e. doing the symptoms questionnaire and respective amino acids trials), a good place to get help is the GABA QuickStart Program (if you have low GABA symptoms too). This is a paid online/virtual group program where you get my guidance and community support.

If you have low blood pressure, has GABA (or taurine) been an issue for you?

Do you have high blood pressure and has GABA (or taurine) lowered it? If yes, how much did you use and how much did your blood pressure improve? And did you have to adjust your blood pressure medication (and which one)?

Has GABA (or taurine) helped ease your physical anxiety and other low GABA symptoms?

If you have questions and other feedback please share in the comments too.

Bergamot, lavender and ylangylang for anxiety and high blood pressure

August 4, 2016 By Trudy Scott 23 Comments

The wonderful combination of bergamot, lavender and ylangylang essential oils have been found to lower high blood pressure and reduce anxiety.

The study The effects of the inhalation method using essential oils on blood pressure and stress responses of clients with essential hypertension was published in 2006 and looked at 52 people who were anxious and stressed, and had high blood pressure.

The participants were placed in an essential oil group, a placebo group, and a control group by random assignment.

The essential oil group used aromatherapy inhalation by blending lavender, ylangylang, and bergamot essential oils once a day for 4 weeks.

To evaluate the effects of aromatherapy, blood pressure and pulse were measured two times a week and serum cortisol levels, catecholamine levels, subjective stress, and state anxiety were measured before and after treatment in the three groups.

Here are the results of the study:

The blood pressure, pulse, subjective stress, state anxiety, and serum cortisol levels among the three groups were significantly statistically different.

The results suggest that the inhalation method using essential oils can be considered an effective nursing intervention that reduces psychological stress responses and serum cortisol levels, as well as the blood pressure of clients with essential hypertension.

They did not see any significant differences in catecholamine levels among the three groups but keep in mind this was only a 4-week study. And to see those other results in just 4 weeks is very encouraging! A simple intervention and yet very profound.

Dietary changes and amino acids and other nutrients are my go-to approach for anxiety but I’m finding more and more of my clients benefit with the addition of essential oils.

Essential oils are also very beneficial in the following instance where amino acids and other supplements can’t be taken or are not tolerated:

Young children (inhalation aromatherapy and creams/lotions work well here)
Older adults (creams/lotions work well when there is loss of smell with dementia or Alzheimer’s disease)
Someone going through benzodiazepine withdrawal and is too sensitive for supplements or can only tolerate small amounts

I talk about this research and other essential oils for anxiety and stress in the upcoming Essential Oils Revolution 2 summit which runs August 22 to 29. I’m thrilled to be part of this event!

People all over the world are scrambling to find the answer to health problems like diabetes, pain, chronic fatigue, anxiety, estrogenic cancers and more. Millions are turning to natural solutions and many have experienced great success with essential oils. Learn if oils could be the missing ingredient for you and your family! What you will gain from this event:

Why essential oils are truly nature’s best medicine
How to use essential oils safely and effectively
Tips for regaining control of your health
Home recipes, guides, safety protocols and best practices
And so much more!

More than 165,000 people joined the 2015 Essential Oils Revolution. This year, the experts in aromatherapy, medicine and research will deliver in-depth discussion, debunk common myths and help you learn about the possibility of regaining your health using essential oils.

I can’t wait to learn more and hope you’ll tune in too. Here is the registration link:
https://qt247.isrefer.com/go/EOR16reg/trudyscottcn/

Let’s get the conversation started now. Feel free to share which essential oils you use for anxiety and stress? And how do you use them?