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Fatigue, sleep disorders, depression, anxiety, fibromyalgia and cardiac troubles as the expression of a classic mild thiamine deficiency

October 8, 2021 By Trudy Scott 6 Comments

Fatigue, sleep disorders, depression, anxiety, fibromyalgia and cardiac troubles are some of the symptoms we see as the expression of a classic mild thiamine deficiency. Thiamine deficiency is very under-rated and under-recognized, and can have far reaching ramifications. And a magnesium deficiency and high dose magnesium can actually cause a thiamine deficiency. There are also many other causes of thiamine deficiency that may not be on your radar: a high carb/processed food/sugar diet, coffee, tea, alcohol, genetics, environmental toxins, medications, celiac disease, leaky gut, bariatric surgery and malabsorption.

It’s for this reason that I invited Chandler Marrs, PhD to speak on the Anxiety Summit 5: Gut-Brain Axis. We had so much to cover and it ended up being so long, that we split it into part 1 and part 2.

This is what we cover in Thiamine Deficiency in Anxiety and Gut Health (Part 1)

Excessive carbs, alcohol, medications and genetics as causes of low B1/thiamine
Dysbiosis, dysmotility, constipation, anxiety, depression, panic attacks, low energy
Psychiatric and digestive effects: research, history and other symptoms

This is what we cover in Thiamine Deficiency in Anxiety and Gut Health (Part 2)

The mitochondria, dysautonomia and POTS
Other symptoms: hyperemesis, exercise intolerance, muscle pain, neuropathy
Thiamine supplementation – forms, dosing and paradoxical reactions

Thiamine deficiency is under-rated and under-recognized

We start with why it’s an under-rated and under-recognized deficiency and Dr. Marrs shares that the assumption is that deficiency is not common and even when you test it looks like you are not deficient:

“The assumption is that there is no such thing [as a thiamine deficiency] and that it’s rare unless you are a chronic alcoholic. And even then, it’s missed 80% of the time. Or you have a severe injury or illness that depletes thiamine rapidly.
The presumption is that we’ve solved it, and it’s rare, and it only happens in countries where food availability is problematic.
The reality is that the chemistry of our foods, the chemistry of our environment, the medications that we take all combine and accrue to not only deplete the available thiamine on the basis of intake but to increase the need and to damage a lot of the enzymes involved in the processing of thiamine.
So a lot of folks are functionally deficient in that even though by definition they meet the daily requirement and they may, based upon lab testing, show up as being sufficient and not frankly deficient.
And so, I think that we just have taken our eye off of the ball with regard to this particular nutrient.”

Magnesium deficiency (and high dose magnesium) can actually cause a thiamine deficiency

Dr. Marrs also shares how a magnesium deficiency (which is very common) can actually cause a thiamine deficiency:

“One of the things that’s interesting is it requires magnesium to activate thiamine into its active form.
If someone is thiamine sufficient and magnesium deficient, then they are actually functionally deficient in thiamine because you cannot take the free thiamine and activate it into thiamine pyrophosphate.
So magnesium deficiency itself can cause thiamine deficiency. And there’s a good percentage of the population that doesn’t get enough magnesium.”

And she also shares how when taking high dose magnesium it’s so crucial to also be addressing low thiamine in order to prevent them becoming more thiamine deficient:

“Now, the flip side of that is really interesting. And I think this is important for your audience, in particular, is that magnesium supplementation, when someone has a problem with thiamine, will actually shut down thiamine processing and mitochondrial processing at one of the enzymes. Because if you don’t have thiamine with magnesium, then the enzyme α-ketoglutarate dehydrogenase kind of shuts the whole sequence down.
So if you are giving someone high dose magnesium, which is common to supplement, and not tackling the thiamine as well, you risk them becoming more thiamine deficient and reducing ATP output, energy output even further. So everything has to be in balance to some extent or another.”

I can think of one situation where this could be common. You use high dose magnesium due to constipation. Low thiamine may be one of the underlying causes of your constipation and now high dose magnesium is going to make the low thiamine situation worse.

Up to 30% of psychiatric patients have a thiamine deficiency

We talk about how up to 30% of psychiatric patients have a thiamine deficiency but that there hasn’t been enough work on psychiatric disorders which Dr. Marrs says “is strange given the fact that some of the strongest symptoms involve brain function and the most dangerous or some of the more dangerous damage is relative to areas of the brain.”

I share some quotes from a 2019 paper that does actually look at the psychiatric aspects – Neurological, Psychiatric, and Biochemical Aspects of Thiamine Deficiency in Children and Adults:

“The brain is highly vulnerable to thiamine deficiency due to its heavy reliance on mitochondrial ATP production. This is more evident during rapid growth, i.e., perinatal and children.
Thiamine deficiency contributes to a number of conditions spanning from mild neurological and psychiatric symptoms, confusion, reduced memory, sleep disturbances, and severe encephalopathy, ataxia, congestive heart failure, muscle atrophy, and even death.”

This paper also looks at the beneficial effect of thiamine supplementation in autism spectrum disorder (ASD) and other neurological conditions.

Below, I share some additional studies that we didn’t talk about in the interview but add value to the topic.

Fatigue, sleep disorders, depression, anxiety, fibromyalgia and cardiac troubles as the expression of a classic mild thiamine deficiency

This paper, High-dose thiamine improves the symptoms of fibromyalgia, states that “It is our opinion that fatigue, sleep disorders, depression, anxiety and cardiac troubles are the expressions of a classic mild thiamine deficiency.”

The authors share 3 cases where thiamine/vitamin B1 improved symptoms in all areas for all these women:

Patient 1: Female, 58 years old, weight 59 kg. From 1998, the patient began to have widespread pain accompanied by severe fatigue, depression, anxiety, irritability, sleep disorders, trouble concentrating, dry skin, general sickness, continuous headache, intolerance to low temperatures and, more recently, episodes of tachycardia and extrasystolia [alteration in heart rhythm].
Patient 2: Female, 37 years old, weight 74 kg. From 1999, the patient has had widespread pain and all the symptoms described for patient 1, with the only exception being that of cardiac symptoms.
Patient 3: Female, 60 years old, weight 65 kg. From 2006, the patient began to have widespread pain, fatigue, depression, anxiety, sleep disorders. Trouble concentrating.

As you can see the symptoms can be very varied and this is what makes it challenging to identify low thiamine as being the issue.

Thiamine deficiency after bariatric surgery

Here one case study where thiamine deficiency occurred after bariatric surgery: Wernicke’s encephalopathy mimicking multiple sclerosis in a young female patient post-bariatric gastric sleeve surgery:

We describe a case of Wernicke’s encephalopathy secondary to thiamine (B1) deficiency in a patient status post-bariatric sleeve gastrectomy.

The presenting symptoms of new-onset weakness, diplopia [double-vision], and confusion in a young female patient raised suspicion for multiple sclerosis (MS), but given a history of bariatric surgery, thiamine levels were checked, revealing significant Vitamin B1 (thiamine) deficiency.

This case highlights the importance of thorough history taking, as a misdiagnosis of MS in this case could have resulted in irreversible neurological deterioration and hematological and infectious consequences associated with the inappropriate administration of disease-modifying therapies.

Bariatric surgery is one of many causes of thiamine deficiency.

Some of the other many causes of thiamine deficiency

Other causes of thiamine deficiency include factors that may not be on your radar: a high carb/processed food/sugar diet (and even consistent smaller amounts of “healthy” sweeteners), coffee and tea consumption, alcohol consumption (excessive consumption and even moderate consumption i.e. social drinking), genetics (we talk about specific genes in the interview), environmental toxins, certain medications, celiac disease, leaky gut and malabsorption etc.

We do a deep dive into all this in the two interviews (and much more).

chandler marrs interview — (As you can see, when I do interviews I take notes throughout for a few reasons: writing consolidates the information into my brain and it allows me to make notes for follow-up questions. It also helps the video editing process later.)

Interviews that dove-tail well with this topic are these ones:

Michael Collins – Sugar/Fructose Addiction: Anxiety, ADHD and Aggression (because sugar and carbs lead to low thiamine)
My interviews, Glutamine, DPA and Tyrosine for Anxiety and Sugar Cravings and GABA & Tryptophan: Gut-Anxiety Connections (because the amino acids help you quit sugar/carbs, coffee and alcohol easily)
Tara Hunkin, NTP, CGP, RWP – Mitochondrial Dysfunction in Anxiety (because low thiamine adversely affects the mitochondria)

I encourage you to register and tune in if you have:

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

And also if you suffer from…

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

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

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

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

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

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

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

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

Please share if these thiamine deficiency symptoms are new to you.

Also let us know if you’ve benefited from thiamine in the past or are currently using some form of thiamine – and how helped/is helping.

Have you seen this correlation between low magnesium and low thiamine OR taking high doses of magnesium and low thiamine symptoms?

Feel free to post your questions here too.

The Essential Oils Apothecary – Advanced Strategies and Protocols for Chronic Disease and Conditions by Eric Zielinski and Sabrina Ann Zielinski

September 10, 2021 By Trudy Scott Leave a Comment

This wonderful new book was just released this week. It covers the basics and their recipes are wonderful as always. I really appreciate that Dr. Z and Mama Z include chapters on insomnia, stress and anxiety, depression and substance abuse. Even though I already know about and use essential oils, I picked up plenty of gems. I do love that they include the research too.

Here are a few highlights that resonated with me:

A new essential oil that I learned about is Bitter Orange. I love all the citrus essential oils and learn that this one “is used in Ayurvedic medicine as an aid to meditation and can be extremely helpful in easing stress and anxiety” … and that a “study from Iranian researchers found that when patients were given bitter orange prior to a minor operation, they felt more relaxed, with much less anxiety.”
Being reminded about Thyme essential oil for stress relief and anxiety support. I found this statement worth remembering and fascinating: “Like many essential oils, thyme oil works by stimulating smell receptors in the nose, which then transmit messages through the nervous system to the emotion-controlling limbic system in the brain.”
Learning about a study where “Japanese investigators evaluated the anti-stress benefit of aromatherapeutic hand massages in healthy women in their twenties.” I see a huge application for this in children, hospitalized loved ones and elderly parents too.
I love ginger and I was intrigued to learn about Plai root essential oil, a cousin to ginger and similar to eucalyptus “with additional spicy notes.” They share that a study with healthy male volunteers found that plai improved mood “by easing the negative emotions and enhancing positive emotions, especially feelings of pleasure and contentment.” They also share that plai essential oil pairs well with rosemary, a favorite of mine for mood and anxiety support.
I was not aware that black pepper essential oil can “reduce cravings for cigarettes, alcohol, or marijuana. Black pepper oil can also help you fight withdrawal symptoms and keep you calm throughout….by elevating levels of the feel-good neurotransmitter serotonin in your brain.” They share a fun recipe for Quit Sticks to help folks quit these addictions.
The list of essential oils that are rich in linalool, “known for its calming, sedative, anticonvulsant, and anxiolytic (antianxiety) properties. Chemically, it is a monoterpenoid—a major compound found in essential oils – and is widely used as an antimicrobial agent and a fragrance.” The list includes Rosewood (82.3 to 90.3 percent), Coriander seed (59.0 to 87.5 percent), Magnolia leaf or flower (78.9 percent / 69.9 percent), Bergamot mint (24.9 to 55.2 percent), Neroli (31.4 to 54.3 percent), Lavender (25.0 to 45.0 percent) and many others.

I’ve highlighted some gems related to insomnia, stress and anxiety, depression and substance abuse but there are also sections on the following: chronic fatigue, fibromyalgia, low libido, Alzheimer’s and dementia, bone and joint disorders, cancer support, cardiovascular disease, chronic respiratory disease, diabetes and obesity, fatty liver, inflammatory bowel disease, Parkinson’s disease and epilepsy.

Here is the official blurb:

Soothing practices, healing rituals, and 100+ practical recipes for applying essential oils to the treatment and symptom management of chronic illness–by the bestselling author of The Healing Power of Essential Oils and his wife, Mama Z!

More and more people living with a chronic condition–from insomnia, hypertension, and fibromyalgia to migraines, insulin resistance, and even the effects of chemotherapy–are reaching for essential oils as a complementary therapy to treat their symptoms. Whether you apply them topically, infuse them in liquid, or diffuse them in the air, essential oils are proven to penetrate the skin and work on the body’s physiology gently and quickly.

Dr. Eric Zielinski, author of the bestselling primer on using essential oils for general health, The Healing Power of Essential Oils, and his wife, Sabrina, affectionately called Mama Z, now bring their masterful and authoritative knowledge to the complexities of chronic illness. The Essential Oil Apothecary shares more than 100 research-backed and easy-to-prepare formulations, from an Immune Boosting Blend to an Anxiety-Busting Body Oil, to help with symptoms of twenty-five common chronic conditions, including fatigue, pain, anxiety, and addiction. It also offers two life-changing tools: an essential home makeover to remove toxins that may be making you sicker, and self-care rituals (including Mama Z’s beauty rituals) that help you feel better when navigating any chronic illness.

Dr. and Mama Z’s evidence-based and holistic approach will help you experience the power of essential oils against chronic illness and build a lifetime of healthy habits and supportive lifestyle actions.

I see this as a book you’ll refer to again and again (like I refer to their first book “The Healing Power of Essential Oils”). I recommend it for essential oils beginners and for individuals (including practitioners) who are already using essential oils.

Use this link to order your copy and claim additional bonus digital content. Or purchase from your favorite local bookstore or from Amazon (my link) and then use this link to claim your bonus content.

Let us know what gems you pick up when you read it!

Wean off prescription pain medication, improve sleep and reduce emotional eating with DPA (an endorphin-boosting amino acid)

September 3, 2021 By Trudy Scott 15 Comments

A question about using the amino acid DPA (d-phenylalanine) to help wean off prescription pain medication was posted on the blog. She was also hoping it would help ease her pain while she was weaning and improve her poor sleep too. I share my feedback on DPA for weaning, timing of vitamin C, additional information for sleep support and using DPA for emotional eating too. Concerns about oxalates and pain are mentioned and the importance of a comprehensive approach.

Here is the question that was posted:

Hi Trudy, I am trying to get off prescription pain medication and have read that DPA really helps – do you have any knowledge and/or experience with this?

There is a very popular opiate withdrawal support website that recommends DPA 500mg 3x/daily. Since amino acids need to be taken away from food and other amino acids, I feel like it could be very easy to make the DPA go to waste if not taken at exactly the right time every day.

The insomnia is the worst part of opiate withdrawal for me – days can go by with only 20-45 minutes of sleep. I have a little one to care for and the stress of no sleep just makes me want to give up.

No sleep worsens my physical pain as I toss and turn for hours on end. It isn’t a surprise that then causes terrible emotional distress.

One more question…since Vitamin C does help withdrawal does it affect/break down DPA? I take a liposomal version multiple times a day.

Here is my response: Yes, DPA (d-phenylalanine) does help with withdrawal from prescription pain medication and I’ve used it for this purpose with great success with many clients. It does need to be used away from protein and the dosing can vary for each person.

A starting dose of DPA is 500mg and it can be used 3- 4 x day to start, and we increase from there based on the unique need of each person. We typically adjust the DPA up as the prescription medication is tapered very slowly, and under the guidance of the prescribing physician.

I share more about her vitamin C and insomnia questions below.

If you are new to DPA and endorphin support

DPA/d-phenylalanine is an amino acid used as a supplement.

DPA destroys the enzyme that breaks down/inhibits endorphins and in essence raises endorphin levels. Endorphins are feel-good chemicals that you experience with an endorphin rush when you go for a run or when someone gives you a big hug, when you show kindness to someone or an individual does something nice for you.

Taking the amino acid, DPA, as a supplement helps to raise your endorphins and helps when you feel weepy and overly emotional and reduces the need to self-medicate with treats as a reward or for comfort (more on that below). This amino acid is a favorite with so many of my clients and community because it makes them feel so lovely.

In addition to helping with emotional pain, DPA also helps with easing physical pain. And for this reason it can be used to help get off prescription pain medications.

In summary, these are the signs of low endorphins:

Heightened sensitivity to emotional pain
Heightened sensitivity to physical pain
Crying or tearing up easily
Eating to soothe your mood, or comfort eating
Really, really loving certain foods, behaviors, drugs, or alcohol
Craving a reward or numbing treat

DPA and endorphin support for pain: the research

Here is one paper, which discusses how DPA inhibits or breaks down enkephalins (endorphins are closely related compounds) and as a result helps with depression and pain, and acts as an anti-inflammatory: “proven to be beneficial in many human patients with chronic, intractable pain.” The authors also state that a compound such as DPA “may alleviate other conditions associated with decreased endorphin levels such as opiate withdrawal symptoms.”

This paper discusses beta-endorphins and the reward mechanism and how they can induce euphoria, reduce pain and ease addictions and distress: “Long known for its analgesic effect, the opioid beta-endorphin is now shown to induce euphoria, and to have rewarding and reinforcing properties.”

I would love to see DPA used instead of pain meds when possible or used in conjunction with prescription pain medications when they are needed.

I am also very curious to know which opiate withdrawal support website is recommending DPA. I’m so pleased to hear this because it helps so much – for physical pain relief and for weaning off pain medications.

Is DPA the same as DLPA?

DLPA (dl-phenylalanine), although similar sounding, is not the same as DPA and only offers about half as much endorphin support. It also provides dopamine/catecholamine support (i.e. focus, motivation, mood, energy) and this aspect means DLPA has the same precautions as tyrosine. It also means DLPA can affect sleep if used from midafternoon onwards.

I seldom have clients use DLPA and prefer DPA for endorphin support and tyrosine for dopamine/catecholamine support if needed.

Keep in mind, the amino acid DPA, is not the same as the omega-3 fatty acid called docosapentaenoic acid and also abbreviated as DPA.

The brand of DPA that I recommend for my clients

The brand I recommend for my clients is Lidtke Endorphigen. You can read about it and the other supplements I recommend on the supplements blog here.

My recommendation has always been to chew the DPA capsule for the best effects and to get results quickly (in 2-5 minutes). Instead of chewing the whole capsule I now recommend opening the capsule into your mouth. You can read more about using DPA and some client feedback here.

I’ve used Endorphigen personally too and it’s always with me as part of my travel first-aid kit. I write about using DPA, GABA and acupuncture for pain relief after my back injury and I had DPA, GABA and arnica on hand when I sprained my ankle while hiking in Red Rocks.

Benefits include reduction of emotional/comfort eating too

As I mentioned above, with DPA there is the bonus benefit of endorphin support to help end emotional/comfort eating where you are seeking treats as a reward i.e it helps with physical pain and emotional pain.

You may relate to this if you are someone who would say or think “I just LOVE chocolate-chip cookies!” or “PLEEEEASE don’t make me give up my treats, it’s all I have left after I gave up my coffee and wine! I deserve something nice!”

This emotional attachment to sweet treats and reward-eating is very common with low endorphins.

Using vitamin C with the amino acids and watching for oxalate pain adverse effects

She is correct, vitamin C is best used away from the amino acids so as not to reduce the beneficial effects.

I do caution clients to find the right amount of vitamin C as too much can increase pain in individuals with dietary oxalate issues. I write about oxalate crystal disease here and vitamin C and oxalates here. Both can aggravate insomnia too and increase anxiety.

Address low serotonin, low GABA and/or high cortisol for sleep too

With sleep issues we may also look into supporting low serotonin with tryptophan or 5-HTP, and/or low GABA levels with GABA and/or theanine. These amino acids can also help with reducing pain in some instances.

Opioids have an endocrine effect via impacts on the hypothalamic-pituitary-gonadal axis, affecting sex hormones levels and cortisol levels. Endocrine dysfunction can adversely impact sleep and make anxiety worse, and needs to be addressed. GABA and serotonin support can help with some of the sex hormone imbalances and Seriphos helps when cortisol is too high.

A comprehensive approach is key

Of course, a comprehensive approach is key, so it’s important to remove inflammatory foods (gluten, maybe all grains, sugar, caffeine, unhealthy fats etc), add fish oil if omega-3s are low and include anti-inflammatory nutrients such as turmeric.

And we always want to figure out the root cause of the pain and address it. Also, ruling out if dietary oxalates (and vitamin C) are an issue is important and often overlooked.

I’m a big fan of working with a physical therapist and acupuncturist too.

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

If you are new to using the amino acids, DPA, tryptophan or GABA, as supplements and want to know more, 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 endorphins, low serotonin or low GABA levels 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.

Can you relate to any of this? Has DPA helped your pain and/or helped you withdraw from prescription pain meds? And did you even know this was an option?

Did it also help you sleep and make you less anxious/worried because of the reduction in pain?

What about less emotional eating when using DPA/Endorphigen?

Feel free to post your questions too.

Teen with anxiety, low self-esteem and insomnia: how to do a one-off trial of tryptophan to figure out if she has low serotonin

August 20, 2021 By Trudy Scott 10 Comments

A mom asks for advice for her teenage daughter who has anxiety, low self-esteem issues, insomnia, experiences negativity and has phobias. She wants to know if serotonin support may help and where to start. I share my feedback confirming that these are low serotonin symptoms and that I would do a trial of tryptophan. I go deeper in this blog and also go into detail about how I would do a one-off trial (or evaluation) of tryptophan if I was working with this family. I also share why I’d look into low GABA, seasonal allergies and the birth control pill. And I discuss the importance of being proactive given the increasing suicide and self-harm in this age-group, with the pandemic compounding the increase.

Here is the question that Maria asked about her daughter:

My 13-year-old teen has always suffered from insomnia, sometimes light, sometimes a bit heavier, depending on the period. She has suffered from asthma from a young age, even if this issue has improved enormously, it is sometimes present, specially during spring time as she is allergic to different plants. She would suffer from sugar cravings in the past as we were trying to change her diet. Things are going better in this respect as well; however, negativity, phobias, low self esteem and anxiety are always present for her.

Are these signs of low serotonin? How could we help her feel better? Should serotonin pills be applied directly? Would this make the system dependent on it? If amino acids should be supplemented, how should we do this, considering her age?

I responded that yes, negativity, phobias, low self esteem and anxiety (the worry type) are signs of low serotonin. Insomnia can also be caused by low serotonin especially if her daughter is lying awake, overthinking and worrying about things.

I shared that the body does not get dependent on the amino acids and I’d consider a trial of tryptophan to address her symptoms.

Doing a one-off trial/evaluation of tryptophan based on her symptoms

If I was working with this family, I would help this mom figure out for sure if her daughter has low serotonin by reviewing the low serotonin symptom list with her, and helping her rate them on a scale of 1-10 with 10 being the worst.

This can often be challenging for a 13-year old: giving the symptoms a severity rating and being able to identify exactly how she feels. Her ratings may also be reflective of where she is in her cycle at the time and may fluctuate more in the month if her cycle is not yet regular. Working together with mom we can hopefully figure this out. If not, we do the best we can with the information we have.

The next step is picking one or two symptoms that are easy to measure the day we do the initial trial or evaluation. For this young girl I’d pick anxiety/worry and negativity and ask her some questions that would help us assess before and after results of the one-off trial /evaluation of tryptophan:

For anxiety and worry she may say it’s also a 9 and give me this example: “I’m really worried about performing in the concert – I keep thinking about it all day long and at night.”
For negativity she may say it’s a 9 and give me this example: “I really don’t think I’m good enough to be in the dance class.”

Both tryptophan and 5-HTP can raise serotonin but I like to start with tryptophan. I typically start with 100mg Lidtke chewable tryptophan in children/teens so I’d have her chew one tablet and then check back in the next 2 to 5 minutes (or maybe a little longer for some folks).

This is the kind of feedback I’m looking for:

With regards to anxiety and worry she may say: “Gosh, I completely stopped thinking about the concert. I’m not worrying about it at all. Now that you ask I’m thinking about it again but I think my worry/anxiety is about a 5 now.”
With regards to negativity she may say: “I think I feel better about being in the dance class. I think I can do it. My negativity feels like it’s a 5 or 6”

Since this teen responded so well, I’d have her start taking tryptophan midafternoon and evening (away from protein) and we’d increase if needed, each week, and based on her symptoms.

I have everyone keep a food mood and supplements log and mom could help her do this too.

GABA, seasonal allergies and the birth control pill

I also always assess low GABA when someone is anxious (especially if she also has physical anxiety, tension, stiff muscles) and has insomnia. We’d do the same one-off trial with a product like GABA Calm (or similar) once we’ve established a good dose of tryptophan for easing her symptoms.

This mom also mentioned Spring time allergies so I also shared this blog with her: 5-HTP and/or tryptophan to help with increased anxiety, panic attacks and depression caused by spring allergies. Depending on the season, her daughter may score higher on some of the low serotonin symptoms.

I’d also want to know if her daughter is on a birth control pill (often prescribed at this age for acne) because it can contribute to anxiety and depression.

Being proactive is wise given the rise in suicide and self-harm in this age group

Being proactive about addressing low serotonin symptoms quickly is wise given the rise in suicide and self-harm in this age group. This 2021 Italian study discusses the role of emotional dysregulation when it comes to and self-injurious thoughts and behaviours in high-school students:

Overall, 11.1% of adolescents reported self-harming behaviours without suicide ideation or attempts, 6.4% declared having thought to suicide without acting a suicide attempt or self-harm, 1.4% declared having attempted suicide and really thought to take away their life.

Unfortunately, the pandemic has also made things worse for many adolescents. This study reports that Canadian adolescents appear to be experiencing “higher rates of self-harm thoughts and behaviours relative to before the pandemic.”

It’s important to keep in mind that pre-teens and teens may not be willing to admit that they are engaging in self-harm like cutting or burning, or thinking about taking their lives.

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

If you are new to using the amino acids tryptophan/5-HTP or GABA as supplements and want to know more in case you need them in a future situation, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution (you can see all the low serotonin and low GABA 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.

It also covers all the basics of a healthy diet. It’s a comprehensive approach – amino acids AND diet. I’d also want to know what her diet is like right now – gluten-free, sugar-free, caffeine-free, eating protein at breakfast for blood sugar control, real whole foods, grass-fed red meat, wild fish, fermented foods etc?

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.

Thanks to this mom for asking the question and allowing me to use it as a teaching tool for my community. Let’s get her daughter and all teens feeling their best again.

Can you relate to the question this mom asked? Does it sound similar to what your daughter is experiencing right now or a client/patient?

Do you do a one-off trial /evaluation like this to find out if serotonin support is needed? Or have you done this in the past with your daughter, family member or yourself?

What are the before and after questions (and symptom ratings) and did tryptophan help?

Feel free to post any questions here too.

Timing/combinations of tryptophan and 5-HTP for anxiety, depression and bad sleep (premenstrual dysphoric disorder/PMDD)

August 6, 2021 By Trudy Scott 22 Comments

Naomi asked these questions about tryptophan timing, using it in the morning and her PMDD (premenstrual dysphoric disorder) symptoms of anxiety, depression and bad sleep:

I heard your talk on the Biology of Trauma summit, thank you it was great. When’s the best time to take tryptophan? I want to try it for PMDD depression & anxiety along with accompanied bad/little sleep.

I’ve read it needs to be taken on an empty stomach. If I take it in the mornings will it make me drowsy for the day? I struggle with having an empty stomach in the evenings as I often need to eat something close to bedtime to have the energy to sleep through.

I thanked Naomi for her kind words and shared that tryptophan is best used mid-afternoon and evening when serotonin levels take a downwards dip. And tryptophan (and the other amino acids) must always be taken on an empty stomach/away from protein. I also shared how she may want to experiment with also using 5-HTP at various times in the day and in different combinations (more on that below).

Regarding the evening dose, tryptophan can be used between dinner and a bedtime snack if a snack is necessary for blood sugar stability (for improving sleep).

I shared this blog as an additional resource for her – 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).

I’ve seen both tryptophan and 5-HTP improve symptoms in 2-3 cycles (often in conjunction with GABA) and other steps I outline in the above blog. I don’t typically have clients only use it after ovulation but this is one way a trial could be approached.

Using a combination of tryptophan and 5-HTP

Regarding Naomi’s question about taking tryptophan in the morning and her concern about it making her drowsy during the day, this is my feedback about possibly experimenting with also using 5-HTP at various times in the day and in different combinations:

Many folks do not need serotonin support earlier in the day since it goes down at the end of the day but there are some women who do
If you are someone who does need serotonin support earlier in the day, you may do very well with tryptophan i.e. it may not make you sleepy
If you are someone who does need serotonin support earlier in the day, you may find that tryptophan does make you sleepy and you do better with 5-HTP earlier in the day. In this case, you would use 5-HTP in the morning (as needed, possibly on waking and/or mid-morning) and tryptophan in the afternoon and evening.

And just to add to the mix of variations, keep in mind that some folks do better on 5-HTP (at any time of the day) and some folks with high cortisol find 5-HTP too stimulating.

The way to figure out which amino acid and which combination works best for you is to do a trial of the various combinations and keep a careful log of your responses.

I really do recommend my book when you are new to the amino acids

I also reminded her that when you are new to the amino acids I really do recommend my book “The Antianxiety Food Solution” so you understand exactly how to use them. There is an entire chapter on the amino acids.

I also cover other anxiety nutrition solutions like gluten/sugar/caffeine removal (all important for anxiety, depression and sleep), blood sugar control (often a factor in not being able to sleep through the night and daytime anxiety), gut health (affects mood and can also affect sleep), pyroluria (the zinc, vitamin B6 and evening primrose oil are key for hormone health). I reminded her that it’s the amino acids and diet we must work on.

If you’ve been reading my blog posts and following me for awhile, you know I speak on many summits. I see these interviews as a great introduction for folks new to the amino acids but cannot possibly cover everything in 45-60 minutes.

Additional information on PMDD and low serotonin

Here is additional information on PMDD and low serotonin – Premenstrual Dysphoric Disorder: Epidemiology and Treatment:

It is possible that women with PMDD are more sensitive to [the] effects of estrogens on serotonergic function. Women with PMDD or PMS exhibit specific serotonin abnormalities that are particularly apparent in the late luteal phase [or second half of the cycle] when estrogen levels have declined. These include a deficiency in whole blood serotonin, blunted serotonin production in response to l-tryptophan challenge and, and aggravated premenstrual symptoms during tryptophan depletion.

Be aware that the authors recommend antidepressants as the first-line treatment for PMDD and unfortunately do not mention using tryptophan, GABA or a dietary approach.

I always use this approach when serotonin is low

Keep in mind that this discussion about tryptophan and 5-HTP timing and combinations is not necessarily only applicable for PMDD or PMS but can be used across the board when serotonin support is needed. I always use this approach when serotonin is low i.e. someone has worry-type ruminating anxiety, depression, afternoon and evening cravings, irritability, anger issues.

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

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

As I mentioned above, 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.

Have you (or a loved one) been diagnosed with PMDD, PMS or have low serotonin symptoms?

Has tryptophan or 5-HTP helped and what combination and what timing has worked best for you?

Feel free to post any questions here too.

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

May 28, 2021 By Trudy Scott 14 Comments

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:

The role of low serotonin, low vitamin B6 and low iron in anxiety and panic attacks
Integrative Medicine Approach to Pediatric Obsessive-Compulsive Disorder and Anxiety I write about a study where gluten was found to be the cause of a childhood case of obsessive-compulsive disorder (OCD)
Tryptophan for my teenager: she laughs and smiles, her OCD and anxiety has lessened, and she is more goal oriented and focused on school.

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 Unlocking ADHD and Autism Summit (it starts next week and airs online May 31 – June 6, 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.

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