insomnia

DLPA (DL-Phenylalanine) eases PMDD/PMS symptoms in women who experience declining endorphin levels in the second half of their cycles

March 18, 2022 By Trudy Scott 23 Comments

Mood swings, intense sugar cravings, comfort/binge eating, sadness, anxiety, crying, cramps and increased pain, irritability, anger, fatigue, cognitive dysfunction, overwhelm, feelings of unease and dissatisfaction, aggression, heartache, and/or insomnia are common for many women during the second half of the menstrual cycle i.e. in the luteal phase. You may relate to all or some of these symptoms. And you may have been diagnosed with or may identify with PMS (premenstrual syndrome) or PMDD (premenstrual dysphoric disorder – similar to PMS but more serious).

Research shows improvements of these symptoms with the amino acids tryptophan (which provides serotonin support) and GABA (which supports GABA levels). Although there is no research that the pyroluria protocol improves symptoms it’s something I see clinically all the time. (I’ve written about this extensively and share more on this below)

A really interesting study published in 1989 identified low endorphins and low catecholamines as a probable cause for some women – Prevention of Late Luteal Phase Dysphoric Disorder Symptoms with DL-Phenylalanine in Women with Abrupt β-Endorphin Decline: A Pilot Study

I recently came across the above paper and prior to this, had not considered this as a primary root cause. Here is the excerpt from the abstract:

Twenty-two women with late luteal phase dysphoric disorder were treated with DL-phenylalanine during the 15 days prior to menses in a double-blind crossover study.

DL-Phenylalanine was shown to be more effective than placebo in attenuating many symptoms characteristic of luteal phase dysphoric disorder. This amino acid was chosen because of its hypothesized actions in attenuating the symptoms associated with the sharp decline in central β-endorphin levels during the late luteal phase in women with luteal phase dysphoric disorder.

Let’s review a few terms… Late luteal phase dysphoric disorder is a synonym for PMDD. The luteal phase is one stage of the menstrual cycle and occurs after ovulation and before your period. When you feel dysphoric you feel very unhappy, uneasy, or dissatisfied. With the downward endorphin shift at this time, period pain and other pain can be worse, and weepiness and emotional symptoms increase. The need for comfort or reward eating also increases. The study authors suggest these PMDD symptoms may “closely resemble those seen during morphine or heroin withdrawal.”

Based on my experience I do feel comfortable extrapolating these findings to PMS and even peri and post-menopausal women who experience some or all of these symptoms (other than actual periods and period issues in post-menopausal women).

Study participants, dosing and timing of DLPA and improvements

The participants in the study were white, middle-class, and between 24 and 29. Each woman took one 750 mg of DLPA at breakfast and lunch for the 15 days prior to the expected onset of their periods.

In the study groups, it was found that “initial improvement started at the end of the first month of DLPA therapy. Continued therapy brought increased relief from symptoms by the end of the second month. Interestingly, the greatest period of improvement occurred during the washout period” at the end of the third month possibly due to a delayed action of DL-phenylalanine.

The authors make the following conclusion:

DL-phenylalanine was found to be safe, well-accepted, and without significant side effects. The significant improvement it produced with many of the symptoms characteristic of Late Luteal Phase Dysphoric Disorder [PMDD] suggests that it may prove a useful addition to the therapeutic armamentarium for this syndrome.

Keep in mind that a typical starting dose of DLPA is 500mg used 2-3 x per day and it’s typically used between meals for best effects. Ideal is also to customize dosing to your unique needs. In this study, everyone received the same dose at the same time. For these reasons it’s even more impressive to see results like they did.

It makes sense but I have just not used DPLA alone and only in the second half of the cycle

It’s a very small pilot study but given my experience with the amino acids DLPA, DPA and tyrosine, and the vast number of women I have worked with who had symptoms like the above, it makes sense. Using the above three amino acids in combination with dietary changes, tryptophan, GABA and the pyroluria protocol, this approach has offered relief for many of my clients. I have just not used DPLA alone and only in the second half of the cycle.

In case you’re wondering why I mention the three amino acids DLPA, DPA and tyrosine above, it’s because:

DLPA (the amino acid used in this study) supports both endorphins and catecholamines (dopamine is one of them)
Or DPA (supports endorphins only) can be used with tyrosine (supports catecholamines only) instead of DLPA which does both

I blog about the differences between DLPA and DPA here, together with all the symptoms we look at when considering doing a trial.

In this study, they used DLPA which boosts endorphins and catecholamines. As I share in my DPA vs DLPA blog, I prefer DPA (d-phenylalanine) for endorphin support when symptoms are severe. But DPA is not always available so DLPA is a good alternative, assuming the person can handle the catecholamine support. Some people can’t and there are some contraindications too.

I’d love to see follow-on research covering the following:

A larger group of women using DLPA
Individualizing the dosing of DLPA to each person’s unique needs
Correlating results with the low endorphin and low catecholamine symptoms questionnaire
Comparing DLPA alone with a combination of DPA + tyrosine (with each individualized based on unique needs)

Serotonin and GABA support for PMS/PMDD, and the pyroluria protocol

In this paper, Premenstrual Dysphoric Disorder the authors share that PMDD

comprises emotional and physical symptoms and functional impairment that lie on the severe end of the continuum of premenstrual symptoms. Women with PMDD have a differential response to normal hormonal fluctuations.

It’s recognized that serotonin and GABA play a role:

This susceptibility may involve the serotonin system, altered sensitivity of the GABAA receptor to the neurosteroid allopregnanalone [a naturally occurring neurosteroid which is made from the hormone progesterone], and altered brain circuitry involving emotional and cognitive functions.

They share SSRIs that are considered as the first-line treatment. Second-line treatments include oral contraceptives, calcium, chasteberry, and cognitive-behavioral therapy.

However, as I share in this blog, research supports the use of tryptophan – Tryptophan for PMS: premenstrual dysphoria, mood swings, tension, and irritability

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 mention GABA in this blog and the fact that many anxious women I work with also have pyroluria or signs of low zinc and low vitamin B6 and adding these nutrients, together with evening primrose oil, provide additional hormonal and neurotransmitter support, and help with the social anxiety.

Resources if you are new to using DLPA (or other amino acids) as supplements

If you are new to using DLPA or the other amino acids as supplements, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution (you can see the low endorphin and low catecholamine symptoms.)

If you suspect low levels of endorphins and/or low levels of catecholamine and do not yet have my book, The Antianxiety Food Solution – How the Foods You Eat Can Help You Calm Your Anxious Mind, Improve Your Mood, and End Cravings, I highly recommend getting it and reading it before jumping in and using amino acids on your own so you are knowledgeable. And be sure to share it with the team you or your loved one is working with. Blog posts like this are intended to add value to the chapter on amino acids, which contains detailed information on doses and time of the day for dosing.

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.

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

Have you considered that there may be different types of PMS (premenstrual syndrome) or PMDD (premenstrual dysphoric disorder) i.e. a different combination of root causes and therefore different solutions?

And have you had success with DLPA alone (providing both endorphin and dopamine support) or by using a combination of DPA (endorphin support only) and tyrosine (catecholamine support only).

If you’re peri or post menopausal have you also seen success with any of these amino acids?

Have the other amino acids, tryptophan and GABA or the pyroluria protocol helped too?

If you’re a practitioner please share what you’ve seen with clients/patients.

Feel free to ask your questions here too.

What is the difference between DPA and DLPA (amino acids) and which one do I use for weepiness, heart-ache, pain and energy?

March 11, 2022 By Trudy Scott 75 Comments

Today we address a very common question I get: “What is the difference between DPA and DLPA?” The follow-up question is this: “And what symptoms do they help with?” These are both amino acids that help to boost certain feel-good neurotransmitters. DPA (d-phenylalanine) supports endorphins, whereas DLPA (dl-phenylalanine) supports both endorphins (to a lesser extent than DPA) and catecholamines (to a lesser extent than tyrosine).

Depending on your imbalances and symptoms, they could help with weepiness, heart-ache, comfort eating, emotional support, pain relief, better focus and energy, and even improved motivation.

I mostly recommend DPA (which I call a-hug-in-a-bottle) and share the reasons why below, but some people do really well with DLPA. It’s a matter of figuring out the best one and dose for your unique needs.

DPA for low endorphin symptoms

DPA (d-phenylalanine) is an amino acid that destroys the enzyme that breaks down endorphins. 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.

This amino acid is a favorite with so many of my clients and community because it makes them feel so lovely … a warm and fuzzy feeling. I often call it a-hug-in-a-bottle!

Here are the low endorphin symptoms I have my clients rate if they are considering a trial of DPA:

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

Tyrosine for low catecholamine symptoms

Tyrosine is the amino acid that boosts catecholamines and helps with focus, motivation, energy (especially when you crave carbs for energy) and the blah kind of depression. It’s wonderful for helping you easily quit coffee/caffeine (when you are using it to “self-medicate” due to low catecholamines). It also provides support for the thyroid.

Here are the low catecholamine symptoms I have my clients rate if they are considering a trial of the amino acid tyrosine:

Depression and apathy
Easily bored
Lack of energy
Lack of focus
Lack of drive and low motivation
Attention deficit disorder
Procrastination and indecisiveness
Craving carbs, alcohol, caffeine, or drugs for energy

DLPA for both low endorphin and low catecholamine symptoms

If someone has both low endorphin and low catecholamine symptoms, a trial of DLPA could be considered. DLPA supports both endorphins (to a lesser extent than DPA alone) and also catecholamines (to a lesser extent than tyrosine used alone). You could think of it as doing half and half of each.

Low endorphin symptoms:

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

And low catecholamine symptoms:

Depression and apathy
Easily bored
Lack of energy
Lack of focus
Lack of drive and low motivation
Attention deficit disorder
Procrastination and indecisiveness
Craving carbs, alcohol, caffeine, or drugs for energy

Why I prefer my clients use DPA and tyrosine, rather than DLPA

Many people do well with DLPA (you can read one example below) but over the years I have streamlined my amino acid recommendations and seldom suggest DLPA. Here are the reasons why I prefer DPA:

DPA is not stimulating and doesn’t affect sleep. However, DLPA can be stimulating for anxious folks (and the majority of my clients have anxiety). For this reason, DLPA can not be used later than 3pm as it can affect sleep and for some folks with really bad sleep issues it can’t be tolerated later than mid-morning (in a similar way to tyrosine).
I like to have clients use DPA alone so we can clearly identify the benefits they are experiencing for their low endorphin symptoms and then use tyrosine alone so we can clearly identify their low catecholamine benefits.
There are no precautions or contraindications with DPA. However, DLPA has the same precautions as tyrosine. This limits using it for endorphin support. These are the precautions:
- Overactive thyroid/Grave’s disease: tyrosine, DLPA (avoid)
- Phenylketonuria (PKU): tyrosine, DLPA (avoid)
- Melanoma: tyrosine, DLPA (avoid)
- High Blood pressure: tyrosine, DLPA (watch)
- Migraine headaches: tyrosine, DLPA (watch)
- Bipolar disorder: tyrosine, DLPA, glutamine (watch)
The women I work with who do have low endorphin symptoms have reported superior benefits from DPA compared to DLPA, especially for emotional pain and emotional eating.
Some folks can’t tolerate tyrosine and these same folks have a hard time with DLPA.

The one disadvantage with DPA is that it’s not as widely and readily available as DLPA. It often needs to be purchased online (I list some brands below).

Here is some feedback from folks to give you an idea how these amino acids have helped them.

As you’ll see, there are some individuals who do well with DLPA so it’s really a matter of looking at the symptoms and doing a trial.

DPA helps Missy with weepiness and a deep heart-ache (and tastes like dark chocolate)

Missy shares how DPA helped her deep heart-ache sort of feeling:

I have found I was using this product incorrectly. If you are feeling fine, you do not feel much of anything from it. But today I was weepy and felt that deep, heart-ache sort of feeling. I chewed 1000 mgs (2 capsules) and it DID help lift that awful feeling within 15 minutes.

Notice that she said if you’re feeling fine you don’t feel much at all. This is true of all the amino acids – they only make a difference when you need them.

Missy said that she chewed the capsule, however around 2019, the gelatin capsule was replaced with a cellulose capsule. It’s much more palatable when it’s opened up into the mouth. I blog more about opening the capsule here.

She also reported what about half my clients say:

Tastes like slightly bitter dark chocolate 🙂

The remainder of my clients don’t like the taste at all, although many say the taste grows on them. I’ve always been in the dark chocolate camp and find it quite pleasant tasting.

DLPA helps Toby with energy and pain relief (he has CFS and fibromyalgia)

Toby has a diagnosis of CFS (chronic fatigue syndrome) and fibromyalgia and shared how DLPA helps him:

I’ve played around with (I think) all variations of these aminos and have found unequivocally (in the sense of definite and fast observable changes as opposed to none) that DLPA is the one that works for me. I have wondered what that means. I am male, 45, diagnosed with CFS and fibromyalgia and have speculated that in lay terms the DLPA gives me a bit of energy and pain relief (endorphins). Is that a logical conclusion?

He posted an image of the DLPA product he used and said this:

After putting it on my tongue, very quickly I get an agreeable boost in energy and pain relief. I have not experienced this with DPA or tyrosine.

Based on what I’ve covered above with the symptoms you can see that Toby has made a very logical conclusion. He is getting both endorphin support (the pain relief) and catecholamine support (the energy).

Resources if you are new to using DPA or DLPA as supplements

If you are new to using the amino acids DPA or DLPA as supplements, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution (you can see the low endorphin and low catecholamine symptoms.)

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

For DPA I have used the Lidtke Endorphigen product for years and it’s a firm favorite with my clients (and I’ve used it myself).

I recently purchased a bottle of Doctor’s Best D-Phenylalanine to test and it works just as well as the Lidtke product.

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

Do you have any of the low endorphin and/or low catecholamine symptoms and have you seen benefit with DPA, DLPA and/or tyrosine? If yes, please share what benefits.

Has this blog provided clarification on DPA vs DLPA, and will you be changing how you use these amino acids going forward?

If you’re a practitioner please share what you use with clients/patients.

Feel free to ask your questions here too.

Paroxysmal laryngospasm with low GABA physical-tension-type-anxiety: Is GABA powder rubbed on the inside of the cheek a solution?

March 4, 2022 By Trudy Scott 42 Comments

One type of reactive airway obstruction is paroxysmal laryngospasm, which is a rare laryngeal disease in adults. In this condition, the throat is completely closed due to some form of hypersensitivity or a protective laryngeal reflex causing a transient, complete inability to breathe. Paroxysmal laryngospasm onset in patients is often characterized by a sudden and complete inability to breathe, along with voice loss or hoarseness and stridor. Paroxysmal laryngospasm usually lasts from several seconds to several minutes and may be accompanied by obvious causes such as upper respiratory tract infection, emotional agitation or tension, and/or severe coughing.

I shared something similar on Facebook and the fact that this had just happened to me when drinking lemon water and starting to talk too quickly after my last sip. I choked on the lemon water and my vocal cords went into a spasm. I could not breathe and I had a violent coughing fit. It was a terrifying experience! A few dabs of GABA powder inside my cheek helped relax my vocal cords – which are muscles – immediately. I could breathe right away.

I’ve been researching this condition for some time now because I figured out this same solution for a family member who has had this happen about 6 times in the last few years.

The response on Facebook was surprisingly high and I now wonder how common this condition is with those who experience low GABA physical-tension-type-anxiety and if oral GABA powder is a viable solution for more individuals.

The 2020 paper on paroxysmal laryngospasm

The above description comes from this 2020 paper – Paroxysmal Laryngospasm: A Rare Condition That Respiratory Physicians Must Distinguish from Other Diseases with a Chief Complaint of Dyspnea

Let’s review a few terms from the paper:

According to Merriam-Webster, a paroxysm is a fit or attack.
Laryngospasm “(luh-RING-go-spaz-um) is a transient and reversible spasm of the vocal cords that temporarily makes it difficult to speak or breathe”, according to Mayo Clinic
Mayo Clinic describes dyspnea as follows: “Shortness of breath – known medically as dyspnea – is often described as an intense tightening in the chest, air hunger, difficulty breathing, breathlessness or a feeling of suffocation.”
According to Medscape, stridor is “an abnormal high-pitched sound produced by turbulent airflow through a partially obstructed airway.”) It’s particularly distressing to hear.

So essentially the title of this paper could be translated to something like this: An attack of temporary spasms of the vocal cord that causes difficulty breathing (0ften with a distressing sound of suffocating). I would go as far to say: A terrifying attack ….

One of the objectives of the paper is to create more awareness on “how to identify and address paroxysmal laryngospasm from the perspective of respiratory physicians.” The authors share that otolaryngologists (head and neck surgeons) and anesthesiologists (it happens frequently when undergoing anesthesia) are experts in managing paroxysmal laryngospasm.

They also state it’s rare and generally happens when an individual has gastroesophageal reflux disease (GERD), and share how antireflux therapy i.e. PPIs (proton pump inhibitors) are frequently an effective treatment. My input on this: if it is caused by GERD, address why the GERD is happening and avoid PPIs if possible since they contribute to nutritional deficiencies and osteoporosis.

Hysterical stridor in adult females who are anxious and/or depressed

There is no mention of GABA or addressing spasms in the vocal cords and other muscles in this paper. However, the authors do discuss hysterical stridor as being different from paroxysmal laryngospasm, stating “it has a strong demographic pattern of occurring in young adult females, lasting for minutes to hours, frequently requiring sedation or anxiolytics for treatment, and persisting for years.”

They also share this about hysterical stridor:

Psychological assessment usually reveals multiple sources of life stress, compulsive personality traits, depression, anxiety, maladjustment, or a history of psychosomatic comorbidity. Other psychotherapy interventions, such as antianxiety therapy, depression therapy, sedation therapy, speech therapy, and behavioral therapy, are usually effective.

(note: I’m not thrilled by the term hysterical stridor. The diagnosis of hysteria goes back to the 1880s.)

I’m proposing oral GABA powder be researched as another viable option to address the low GABA anxiety symptoms, the hysterical stridor and the paroxysmal laryngospasm.

Is paroxysmal laryngospasm/hysterical stridor really that rare?

I do wonder if these conditions are really that rare. When I shared my experience on Facebook I had a reasonably big response from people saying it’s happened to them a few times, with some saying it has been happening all their lives. Here are a few of the many examples:

Anita shared this: “I have experienced laryngospasm. The experience is a spasmodic tightening of the airway triggered by ‘swallowing wrong’ for me. I have never experienced laryngospasm aside from that. I do have low GABA symptoms of physical tension and have had intrusive thoughts in the past, stress eating, but have never used ‘wine to relax’ as I am a ‘teetotaler.’ The episodes I’ve experienced have always resolved on their own within a minute or so. Scary feeling – that is for sure! I plan to keep GABA powder on hand now just in case of a future episode.”
Megan shared this: “I have Laryngospasm. I have total throat closure. It feels like forever but I suppose it’s up to 50 seconds. I’ve had it since I was a child and my mum has it too. Food is probably my main trigger, crumbly or syrup type things, a bad cold or even just swallowing wrong. I had a look at the list and I have quite a lot of the low GABA symptoms. I have generalized anxiety, feeling worried/fearful, panic attacks (but they are under control with Zoloft), tense stiff muscles, feeling stressed and burnt out, intrusive and unwanted thoughts and acrophobia.”

One woman felt she had experienced paroxysmal laryngospasm and she had been told it was a panic attack. A few people mentioned a similar condition called vocal cord disorder (often exercised- induced). Many said they had received no diagnosis or help from their doctor.

Interestingly, there are not many papers on “paroxysmal laryngospasm” or “hysterical stridor” so the research and presumably awareness too, seems to be lacking.

Why did I consider GABA for paroxysmal laryngospasm?

You may wonder why I considered GABA when this happened to me. I’ve personally used GABA with success over the years for spasms in my back muscles, rectal muscle spasms/proctalgia fugax, and vagus nerve and coughing/throat spasm episodes. With the additional knowledge I’ve now gained I suspect the latter was a form of laryngospasm.

I’ve also shared how GABA helps ease globus pharyngeus (a lump-in-the-throat sensation that is associated with anxiety and something I experienced in my late 30s).

I’m prone to low GABA physical-tension-type anxiety and have always done really well with oral sublingual GABA.

And of course, when you look at the low GABA symptoms all this makes perfect sense. GABA helps with muscle spasms and provides pain relief when muscles are tight. The vocal cords are muscles and the larynx itself contains many muscles.

In case you’re new to GABA, it is a calming amino acid, used as a supplement, to ease low GABA levels. With low GABA you’ll experience physical-tension and stiff-and-tense-muscles type of anxiety, panic attacks and insomnia. You may feel the need to self-medicate to calm down, often with alcohol but sometimes with carbs and sugary foods.

What GABA did I use and how did I use it?

I dumped some GABA powder on the palm of my hand (with the help of a family member who rushed to my aid). I wet my finger with saliva, dabbed it in the GABA powder and rubbed it on the inside of my cheek. I did this a few times.

I don’t know exactly how much I used in total but estimate it to be around 200 mg GABA. I stopped rubbing it on the inside of my cheek as soon as I felt the muscles relaxing and I was able to breathe easily again. It felt like forever but it probably only lasted 30-60 seconds. I’d assume a more intense paroxysmal laryngospasm may require more GABA.

It was really encouraging how quickly GABA relaxed the muscles and stopped the laryngospasm. It’s also taken away the fear about it happening again.

Resources if you are new to using GABA as a supplement

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

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

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

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

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

Have you experienced paroxysmal laryngospasm? And do you have the low GABA physical-tension-type-anxiety symptoms? What else is a trigger for you?

If you’ve already been using GABA with success, have you noticed a reduction in the paroxysmal laryngospasm episodes?

Have you ever used GABA in the way I did to stop an episode quickly?

Have you received a diagnosis and if yes, what diagnosis?

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

Feel free to ask your questions here too.

How much GABA should I use for my anxiety? It depends on your unique needs (and there is an extremely large variation in dosing)

February 25, 2022 By Trudy Scott 54 Comments

GABA is a calming amino acid, used as a supplement, to ease low GABA levels. With low GABA you’ll experience physical-tension and stiff-and-tense-muscles type of anxiety, panic attacks and insomnia. You may feel the need to self-medicate to calm down, often with alcohol but sometimes with carbs and sugary foods. GABA also helps with muscle spasms and provides pain relief when muscles are tight.

One of the most common questions I get from individuals who are excited to hear about the benefits of GABA but are totally new to using this amino acid is: “How much GABA should I use for my anxiety?” Even individuals who may be familiar with GABA and have even experimented with it themselves and are seeing some benefits may also have this question.

Most are not aware of the extremely large variations in dosing that may work for different individuals. Today I’ll share some examples to illustrate both the wonderful benefits and this range of dosing which can be as much as a 1000x to 2000x variation in some instances!

Syd gets sleep and body anxiety benefits with just 1.5 mg to 3 mg GABA

As you can see in this first example, Syd gets sleep and body anxiety benefits with just 1.5 mg to 3 mg GABA. She shared this on a recent blog post where I discussed how using too much GABA can cause a niacin-like flushing sensation

I think it’s useful to note that some, like me, start out with tiny doses and still get benefits with no side effects. I take around 1.5 mg to 3 mg GABA at a time and it works for me! Really helps me sleep at night.

I also take approximately 1.5mg if I feel body anxiety. I divide a melt-able 25mg tablet into 8ths or less. (Very approximate, of course. Sometimes it’s just crumbs!)

Right now, anything higher and I’m a wet noodle the next day, meaning I feel super depleted and can hardly stand up. But, no niacin flush-like symptoms.

I appreciate her sharing and I’m so glad she found her ideal dose. As you can see it’s really really low. We call folks like Syd “pixie dust” people because they do really well with tiny tiny doses. It also shows that some folks get flushed with too much GABA and some don’t. Syd just feels depleted.

In case you’re wondering which product Syd is using, it’s the Kal 25 mg GABA, which she breaks apart.

To give this perspective, a typical starting dose is 125mg GABA for adults and half that for children. I share more below on this and how to use the symptoms questionnaires and do a trial.

Christina’s agoraphobic client was able to leave the house with 3000 mg GABA

A colleague, Christina Veselak, MS, LMFT, CN shared this feedback about her client who had agoraphobia i.e. fear of outdoor spaces:

I once had a profoundly anxious, agoraphobic client who I sent home with instructions to trial GABA until she either got relief from her anxiety or an adverse reaction. She came back a few days later to say that she had arrived at 3000 mg of GABA in the morning as her ideal dose.

That dose allowed her not only to leave her bedroom but also leave her house, socialize and babysit her hyperactive grandsons!

Most of my other clients could not tolerate anything near to that dose without getting an adverse reaction but it was perfect for her.

This really adds perspective to the range of doses that folks may respond to. This dosage is 1000x higher than Syd’s maximum dose and 2000x higher than her lowest dose!

Let’s address this question: How much GABA should I use for my anxiety?

The answer is this – it depends on your unique needs and biochemistry. I know it’s not the answer you (and almost everyone else too) probably want to hear but there really is no one-size-fits-all when it comes to GABA and the other amino acids.

The best way to determine if you may have low GABA and may benefit from using GABA is to look at the low GABA symptoms, rate them on a scale of 1-10, with 10 being worst, do a trial of GABA and rate the symptoms again right afterwards (in the next 2 to 30 minutes).

Here are the symptoms.

From there you continue to adjust up (or down) over the next few weeks to find your ideal dose. If you go too high you may experience an uncomfortable tingling niacin-like flush.

I can share this: for GABA, 125mg is a typical starting dose for adults that I use with my clients. Half that or less is a good ballpark for starting a trial for children. As with all the amino acids, they are always best used sublingually and taken away from protein.

Below is an example from someone who figured out 1-3 of the 125 mg GABA Calm product was ideal for her own needs.

Melissa is much calmer, sleeps well and stopped craving sweets with 125 mg to 375 mg GABA Calm a day

Melissa started using Source Naturals GABA Calm in anticipation of holiday travel and holiday gatherings and shared how much she benefited:

I have been taking 1-3 per day for two weeks. I’m glad I bought it before traveling home for Christmas – I was cool as a cucumber at the airport and was much calmer when visiting family and friends compared to last year!

The true test of its efficacy will be in two weeks when the semester starts. For now, I notice a general calmness and am sleeping well.

An unexpected result was that I stopped craving sweets after about a week of taking it!

And how wonderful for her! And we have much appreciation for her sharing her success.

These results at this dosage are pretty typical for the majority of my clients. Of course there may need to be adjustments seasonally (possibly needing less after the holidays and closer to spring) or more around her period or more with added stresses in her life.

You can read more about the GABA Calm product she used here (you can find it in my online supplement store too).

Resources if you are new to using GABA as a supplement

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

If you are a practitioner, join us in The Balancing Neurotransmitters: the Fundamentals program. AS you’ve learned today, there are many nuances and best practices when using the amino acids. And it’s an opportunity to interact with me and other practitioners who are also using the amino acids.

What have you found to be your ideal dose of GABA? And how has it helped you?

What dose did you start with and did you go too high and then have to back down again to get to your ideal dose? (be sure to share which product worked for you too)

Are you surprised to learn about this huge variation in dosing GABA? And if yes do you feel inspired to experiment with your current dosing?

If you’re a practitioner have you seen these variations?

Feel free to ask your questions here too.

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

January 7, 2022 By Trudy Scott 33 Comments

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

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

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

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

Intuitively increased GABA without knowing about the seasonality of GABA

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

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

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

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

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

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

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

Seasonal fluctuations are also found in anxiety disorders and bulimia nervosa

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

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

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

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

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

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

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

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

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

GABA exhibits seasonal rhythms related to the pineal gland and melatonin

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

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

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

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

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

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

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

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

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

I’d also consider the following:

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

Resources if you are new to using GABA as a supplement

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

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

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

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

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

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

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

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

Feel free to ask your questions here too.

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

December 31, 2021 By Trudy Scott 30 Comments

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

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

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

About trigeminal neuralgia and the incidence

The NIH fact sheet defines trigeminal neuralgia (TN) as

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

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

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

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

When to consider GABA and serotonin support

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

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

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

St. John’s Wort for nerve pain and mood

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

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

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

Pain relief with endorphin support: acupuncture and DPA

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

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

Other research-based pain-relief approaches for trigeminal neuralgia

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

There are some less recognized approaches too:

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

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

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

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

Current approaches and emerging interventions – disappointing for a 2021 paper

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

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

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

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

I do agree with and am encouraged by these statements:

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

Complementary approaches: NIH fact sheet

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

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

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

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

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

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

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

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

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

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

Feel free to ask your questions here too.