melatonin

I feel so dependent on my nightly “cocktail” of GABA, 5-HTP, melatonin and Ambien for insomnia – how do I reduce them?

May 2, 2025 By Trudy Scott 3 Comments

I have had insomnia for years. I have used GABA Calm with good results and also 5-HTP, melatonin and Ambien. Recently I discovered I have mild sleep apnea and have made huge progress in modifying my night awakening.

With my sleep apnea issues addressed, I would like to try to reduce my supplements and the Ambien… but the thought of this causes more anxiety. I feel so dependent on my nightly “cocktail”.

What is the best way to reduce the fear of withdrawal and my nagging brain that tells me I “need” these things?

Many thanks for all the wonderful information you share!

Lynn asked this on one of the blogs and since it’s a common question I’m sharing my feedback in this new blog post. I’m pleased to hear she has discovered sleep apnea is a factor as it’s not always checked and it definitely can cause disrupted sleep and waking in the night.

There is no need to taper amino acids and melatonin but I typically have clients gradually reduce them, one at a time, especially when they are concerned and are not sure how much they may still be helping.

She has a nagging feeling she still needs these supplements, feels dependent on them and feels anxious about stopping. All of this, in conjunction with the fact that stopping a sleep medication such as Ambien can also cause rebound insomnia has me advising a go-slow approach in a situation like this. Also, Ambien does need to be tapered very slowly and under medical supervision, so she would need to keep this in mind too.

A go-slow approach and one amino acid at a time

Lynn may still need one or more of the GABA, 5-HTP and/or melatonin and we don’t want to lose any gains.

As mentioned above, there is no need to taper amino acids and melatonin but I typically have clients gradually reduce them, one at a time, especially when they are concerned and are not sure how much they may still be helping.

I would start with assessing other low GABA symptoms and other low serotonin symptoms and if there are none, start with reducing either GABA or 5-HTP over a few weeks, watching for worsening sleep or other symptoms showing up. She could then do the same with melatonin.

As a reminder, other than sleep issues (with physical tension at night), these are low GABA symptoms: feeling anxious with physical-tension and stiff-and-tense-muscles, overwhelm, feelings of panic, and the need to self-medicate to calm down, often with alcohol but sometimes with carbs and sugary foods. You can also experience anger, rage and agitation, poor focus, intrusive thoughts/overactive brain, spasms, visceral pain/belly pain with IBS and more. You can read the entire list of low GABA signs and symptoms here.

With low serotonin, we see sleep issues with ruminating thoughts and worry (at night too), and fears, phobias, ruminations, obsessing, feelings of panic, perfectionism and lack of confidence, low mood, rage, anger and irritability.

Lynn has a nagging feeling she still needs these supplements, feels dependent on them and feels anxious about stopping. All this is a clue she may still need them or at least need one or more to some extent. Doing a reverse-trial of reducing each one, one at a time, with careful tracking is my approach.

I would tackle the above amino acid and melatonin reduction – if she decides to go ahead with it – only AFTER she has worked with her prescribing doctor on a slow taper on the Ambien. Stopping a sleep medication such as Ambien can cause rebound insomnia/discontinuation syndrome and she may find she does still need nutritional support to tide her over the Ambien taper period. This may be the same as she is currently using or she may even need to adjust upwards on one or more.

Ambien: dependence, withdrawal, rebound insomnia, slow tapering, falls and memory issues

Ambien/Zolpidem “is a non-benzodiazepine receptor modulator primarily used in the …short-term treatment of insomnia aimed at patients with difficulty falling asleep,” increasing “GABA inhibitory effects leading to sedation.”

I seldom see it used short-term i.e. 7 to 10 days. With longer-term use, “this drug has a high potential for overuse and daily dependence” and “withdrawal symptoms may occur if the zolpidem dose is tapered off rapidly or discontinued.”

Other factors to be aware of:

Complex sleep behaviors can occur after using zolpidem, such as sleep-driving, sleep-walking, and engaging in activities while not fully awake
Changes in behavior and abnormal thinking have been reported after zolpidem administration. In addition, patients have demonstrated aggressiveness and extroversion uncommon for the person’s usual behavior
Worsening of depression or suicidal ideation may occur with zolpidem therapy

I encourage you to read the article here and be fully informed.

This 2024 paper supports that “long-term use of Zolpidem may lead to drug tolerance, dependence, rebound phenomena, and withdrawal symptoms, making discontinuation difficult.” Other concerns include: dizziness, headache, falls, and cognitive decline.

Many of the papers published prior to 2023 do not report many of these issues, however awareness is growing. This 2024 paper, Case report: Additional grounds for tighter regulation? A case series of five women with zolpidem dependence from a Brazilian women-specific substance use disorder outpatient service, also reports adverse effects in women such as “memory and social impairment, falls, seizures” and “withdrawal symptoms, including rebound insomnia, social impairment, and craving.”

The authors recommend tighter regulation, stating that: “The surge in zolpidem prescriptions, driven by its perceived safety and low abuse potential compared to benzodiazepines, may lead to a global health issue of dependence.”

Because of much of this it’s important to work with the prescribing doctor on doing a very slow taper under their medical supervision. She may need to adjust her amino acids up during the taper period if her sleep gets worse in the short-term. And then do the taper approach I mentioned at the start of this blog.

With these safety, dependence and withdrawal issues, I would love to see GABA, tryptophan/5-HTP and/or melatonin (and other nutritional and functional medicine approaches), addressing sleep apnea and lifestyle factors/sleep hygiene be considered as the first approach for sleep issues – instead of Ambien/Zolipdem.

Additional resources when you are new to using GABA, 5-HTP and other amino acids as supplements

As always, I use the symptoms questionnaire to figure out if low serotonin or low GABA or other neurotransmitter imbalances may be an issue.

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

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

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

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

Wrapping up and your feedback

I appreciate Lynn for asking this question and want to acknowledge that she is wise to be cautious and have concerns about the best way to tackle this. And she may find she does have a physical dependence on the Ambien.

Have you found that GABA, 5-HTP and/or melatonin helped/helps with your sleep issues?

And is sleep apnea a factor for you too?

And have you been prescribed Ambien and had any of the issues mentioned?

And how have you adjusted your amino acids and other sleep supplements as you’ve tapered your sleep medication?

Feel free to share your feedback and ask your questions below in the comments section.

Bright light to reset circadian rhythm: a solution for jet lag (with melatonin) and for disturbed sleep caused by bile issues?

August 2, 2024 By Trudy Scott 28 Comments

The symptoms of jet lag cause distress to an increasing number of travelers. Potentially they may impair sleep,mood and cognitive performance. Critically timed exposure to bright light and melatonin administration can help to reduce symptoms.

Bright light is one of the most powerful synchronizers of human rhythms and melatonin serves as a ‘‘dark pulse’’ helping to induce nighttime behaviors. Thus, enhancing day and night signals to the brain, appropriate to the environmental light/dark cycle of the new time zone, can serve to reestablish adaptive timing relationships between the body’s internal biological rhythms and the external environment, and thereby reduce the symptoms of jet lag.

The above is from a paper published in 2002, Jet Lag: Minimizing It’s Effects with Critically Timed Bright Light and Melatonin Administration.

I came across this research just before my recent trip to Boston. I always use high dose melatonin to help with jet lag but because it was a business trip and I needed to be in top form as soon as I arrived, I was intrigued about the addition of bright light. So I purchased a light-weight 10,000 lux bright light panel and took it with me.

I was actually looking for solutions for my issues with a strange sleep pattern i.e. in waking in the early hours and not being able to get back to sleep on days when I would go to bed much earlier than usual. That pilot study found that “a brief course of morning bright light treatment had positive effects on subjective sleep quality, daytime sleepiness, and sleep timing in patients with primary biliary cholangitis.” And it led me to the jet lag research which is typical when you’re digging through the research!

The benefits for both situations – jet lag and disturbed sleep/bile issues – reinforced my decision and I’m so glad I got one. I love it! My jet lag results were better with the bright light and melatonin combined (with some caveats I share below). And I continue to use my light panel daily which means much improved sleep on those nights when I have to get to bed earlier. I am a hot mess when I don’t get a good 9 hours sleep and it’s something I continually work on.

I share more on both studies below, details on what timing is best for the bright light when traveling and at home, melatonin dosing (from the study and what I do) and how I plan to adjust things for my next long flight.

More from the jet lag study on bright light timing and melatonin

The jet lag paper talks about light being “one of the most powerful synchronizers of human circadian rhythms:

Light in the morning advances circadian rhythms and
Light in the evening delays circadian rhythms.”

And so the author shares different and very “specific recommendations using bright light and melatonin for eastward and westward travel before and after departure”and depending on “time zone changes of up to 6, 7-9 and 10 or more hours.”

These involve using the bright light either morning or night and likewise with the melatonin.

Since I was traveling eastbound from Sydney to Boston (21+ hours depending on the route) I should have followed those specific instructions.

How I used the bright light panel and melatonin

Instead, I kept it simple and 3 days before my departure I started using the bright light for 30 minutes in the morning and took 2.5 mg melatonin (and my other usual sleep solutions – see below).

When I arrived in Boston I had an afternoon nap and took 10mg of melatonin that first night – the usual increase in melatonin I use when doing long trips. For the duration of my time in Boston (a week), I used the light panel each morning for 30 minutes and 10mg of melatonin each night. And I did not experience any jet lag, other than feeling a little tired for about an hour each afternoon. I was waking earlier than usual (4am then 4:30am then 5am and then 6am) but was getting 8-9 hours of solid sleep.

I stopped in Hawaii and spent a week with my sister on the way home. I did the same even though the paper had different directions for flying westbound on a 12 hour trip. I was really tired on arriving and crashed early and still woke earlier than usual but had no jet lag.

I continue to use the light panel for 30 minutes each morning and am using 10mg melatonin (I’ll drop it down to 2.5mg soon – wild dreams are my clue I’m getting too much). My sleep has been solid since returning (other than an issue with cellulose in a new product I tried). My bedtime is earlier and I had a little less energy in the afternoons for the first 2 weeks.

We were sprayed with insecticide on the plane on arrival in Australia so I suspect that may have been a factor. (I am trying to get something done about this – I can’t actually believe this happens!)

You may wonder why I shared this study and what I did instead. Quite honestly, I was in a mad rush before I left and didn’t have time to work out the different recommendations. And I figured if I found it overwhelming others may too so let’s keep it simple.

That said, I’m impressed by the level of detail in the recommendations and may try to implement some of this on a future trip where I have some leeway if it doesn’t work. If you’ve done it per the recommendations in the above study please do let us know.

Morning bright light for disturbed sleep in primary biliary cholangitis

As I mentioned above, I had also just read the pilot study, Morning Bright Light Treatment for Sleep-Wake Disturbances in Primary Biliary Cholangitis. “Primary biliary cholangitis is a rare, immune-mediated cholestatic liver disease, mostly affecting women” where there is cholestasis or a decrease in bile flow, pruritus (itchiness) and fatigue. I don’t have this condition but do have bile issues and was experiencing a new sleep problem that my usual sleep protocol wasn’t helping.

I’ve always typically been a night owl, going to bed late and getting up late. However, I’m part of a new US-based Mastermind and with the time difference I have to get up at 5:30am two mornings a week for training sessions. I would go to bed 9 hours earlier and without fail would wake at 1am or 2am and not be able to get back to sleep.

I figured it may be liver/bile related so when I found the above paper I was very excited to give morning bright light a try. And it’s been working!

The pilot study reports these results: “a brief course of morning bright light treatment had positive effects on subjective sleep quality, daytime sleepiness, and sleep timing in patients with PBC.” This matches what I am experiencing on those early training days.

If you’re curious, I write about my current bile issues here: Ox bile as a supplement: to help counter the effects of dietary oxalates very likely caused by bile issues and poor fat digestion. I’m not suggesting it’s anything like primary biliary cholangitis other than something seems to be going on with my liver and bile production or bile quality. I will add that ox bile supplementation has reduced my daytime fatigue dramatically.

Interestingly, in other research, it was suggested that “pruritus of cholestasis is responsive to bright light in some patients” i.e, the itchiness that is experienced with chronic liver disease/bile issues.

My light panel and other sleep solutions

As I shared above, I am a hot mess when I don’t get a good 9 hours of sleep and it’s something I continually work on.

I took this photo in Boston in my hotel room. You can see the light panel and the nutrients I use at night on a regular basis. There are also 3 essential oils I use on the blue cloth (lavender, rose geranium and clary sage) and mouth tape. I always use an eye patch and only use earplugs when traveling.

I recorded a video discussing each of the above and why I use it and will share this as a separate post if there is interest.

The only change for this trip was the full spectrum light panel.

The full spectrum light panel I purchased and now recommend

This is the exact one I purchased (my Amazon link and above image from Amazon). It has 5 brightness levels but I’m only using the brightest one. It has a timer – 10, 20, 30, 40, 50 and 60 minutes. To be safe I started with 10 minutes, then went to 20 minutes the next day and then 30 minutes and have continued with this time. It also has 3 colors but I’ve only used the white so far.

I packed it in my suitcase in the original box and although it was a little bulky, it worked well to prevent it getting damaged.

If you already have a 10,000 lux full spectrum light box or lamp, it will provide similar results and also mood benefits if you experience the winter blues (more about that here). However the light-weight bright light panel is ideal for traveling.

Update Dec 2025:

If the above full spectrum light panel is not available here are some other comparable panel options and some lamp options too:

Verilux Happy Light Luxe – a light panel (my Amazon link)
Verilux Happy Light Alba – another light panel (my Amazon link)
Happy Light Therapy Lamp – a standing map for your living room, bedroom or office (my Amazon link)
Light Therapy Lamp – a desk lamp (my Amazon link)

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

As you can see I continue to use GABA and tryptophan to keep me sleeping well and anxiety-free.

For clients who may be considering using either one of these amino acids, I use the symptoms questionnaire to figure out if low low serotonin or other neurotransmitter imbalances may be an issue.

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

Wrapping up and your feedback

I’d love to hear from you – does any of this resonate with you? If yes, has full spectrum light therapy helped with jet lag? What light box or light panel do you use? And do you also travel with one?

Do you also use melatonin for jet lag and how much helps you? And what else is part of your sleep solutions?

Has bright light therapy improved your sleep if you have liver/bile issues? Has it prevented middle of the night waking?

If you’re a practitioner have you seen this research and seen bright light therapy help with jet lag and/or sleep disruption caused by liver/bile issues?

Feel free to share and ask your questions below.

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

October 20, 2023 By Trudy Scott 63 Comments

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

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

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

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

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

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

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

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

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

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

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

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

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

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

She used 1 Seriphos per day for about 3 months.

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

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

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

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

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

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

I do recommend Salivary cortisol testing before using Seriphos

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Feel free to share and ask your questions below.

GABA lessens anxiety, agitation and defiance in 98 year old mother who has been “sundowning” for a couple of years

March 17, 2023 By Trudy Scott 11 Comments

Marsha shared this feedback on one of the blogs, saying that GABA lessens anxiety in her 98 year old mother:

My mother is 98 and has been “sundowning” for a couple of years. It starts around 3pm, sometimes earlier. Some days it’s no big deal. It is on those other days when she starts and then it goes to anxiety, agitation, then she can get sort of defiant which is so not her. She is a gentle soul, friendly, and kind so this is difficult on her as well as our family.

I just started to use my pestle and mortar to crush up a 125 mg GABA CALM supplement (Source Naturals) and I mix a little into her flavored yogurt when I start to see her having difficulty. I give it to her throughout the day. She only gets the 125 mg amount so I feel safe with that.

I believe that I do notice it lessens her anxiety. I pray that this will be helpful for her because that anxiety can be really draining for her. I will keep you posted. I have not noticed any adverse reactions. Thank you Trudy for all your info.

Anxiety, fear and agitation in sundowning syndrome: circadian dysfunction and low GABA

I responded, saying how wonderful to hear that she is noticing supplemental GABA lessens her mother’s anxiety (and presumably her agitation and defiance too). And I shared that GABA may be involved in sundowning syndrome.

This paper describes “sundowning syndrome,” as “a poorly understood (and even controversial) clinical phenomenon in Alzheimer’s and dementia patients that is characterized by agitation, aggression, and delirium during the late afternoon and early evening hours.”

The authors are focusing on potential pathways for circadian rhythm – physical, mental, and behavioral changes that follow a 24-hour cycle – dysfunction in sundowning. They also mention the presence of fear and anxiety and the fact that there is a circadian aspect of these emotional processes.

What is interesting is that the “master circadian pacemaker” i.e. “the suprachiasmatic nucleus of the hypothalamus” has impacts on both GABA and serotonin, and also dopamine and orexin (involved in sleep-wake processes).

Given the circadian aspect addressed in the above paper, “properly timed light exposure” i.e. early morning sunlight, is also worth exploring.

This paper, Implications of GABAergic Neurotransmission in Alzheimer’s Disease, focuses onGABA and shares that “of the two major types of synapses in the central nervous system (CNS): glutamatergic and GABAergic, which provide excitatory and inhibitory outputs respectively, abundant data implicate an impaired glutamatergic system during disease progression.”

The amino acid GABA helps to ease anxiety symptoms and agitation and restlessness, also helping with disturbed sleep.

GABA Calm dosing in the elderly with sundowning syndrome: my observations

I also expressed how this is a smart way to use the GABA Calm. I’m going to make some assumptions and share my observations:

Marsha uses GABA Calm herself and has a good level of comfort based on personal results. She knows how she feels after using it and is observing her mother’s symptoms. I have guided many family members in doing the same type of thing – mom’s working to help a child and a granddaughter helping a grandparent – and it works well.
Marsha has also started with a low dose of 125 mg. This is a typical starting dose and is a reasonable dose that may suffice for the entire day for someone this age. She may also need more and increasing the dose and observing is the way to go when someone can’t articulate how the amino acid is helping them. For some folks, 125mg may be too much – making them too sleepy or even more agitated/anxious – the dose can be reduced in this case (after using vitamin C as an antidote).
Marsha crushes the GABA Calm chewable/sublingual and mixes it into her mother’s flavored yogurt, since having her suck on the chewable is not an option. This is a great plan but as she continues to help her, she may see better results using a non-protein source to mix it in – like apple sauce or mashed banana.
Finally, she gives it to her mother when she starts to see her having difficulty. Again, it’s wonderful she is observing and helping her at the moment, but this could be a clue that she needs more GABA to provide even better results. We also don’t want to wait for the anxiety and then address it. Instead, we want to get GABA levels up and prevent it.

You can read more about Source Naturals GABA Calm product and why I use it with clients here.

Low serotonin, tryptophan and melatonin in sundowning syndrome

I also told Marsha that when I hear symptoms like agitation and defiance, especially with the 3pm start, I also would also consider low serotonin since it starts to decline afternoon into evening.

Her mother’s anxiety may be a mix of low GABA physical-type anxiety and low serotonin worry-type anxiety. She’ll only really know once she trials the respective amino acids.

I’ve seen low serotonin worry-type anxiety, agitation and defiance symptoms improve with tryptophan and/or melatonin and share more about this in this blog post – Sundowning in Alzheimer’s and dementia: melatonin/tryptophan for the agitation, restlessness, anxiety, disturbed sleep and aggression

Dietary factors and low dose lithium

Marsha says some days it’s no big deal. I would recommend keeping a food-mood log and make sure it’s not something in her diet that may be a trigger: hidden gluten, dietary oxalates or even blood sugar swings.

These are mentioned in the above blog, together with low dose lithium orotate which can help keep moods more even.

Microdose lithium is also capable of halting signs of advanced Alzheimer’s and improving cognition. More on that here.

It’s with much appreciation that Marsha shared this feedback. I’m thrilled for her and her mother. Hopefully, my feedback on this blog means she’ll be able to fine-tune things. And you get to learn and benefit from this feedback too – for your loved one.

A few GABA product options – a sublingual, a powder and a cream

A product I use and recommend is Source Naturals GABA Calm lozenges. This is one Marsha uses for herself and is using with her mother. It’s a good low dose of 125 mg and is convenient and effective because it’s a sublingual lozenge.

Now GABA Powder is another product I use and recommend. It does need to be measured out to provide a 125 mg typical starting dose or less (as needed), and could be mixed in water in a situation like this. I have clients use a handy mini measuring spoon like this one (my Amazon link) and share more about how to measure out GABA powder on this blog).

For Source Naturals GABA Calm lozenges and Now GABA Powder:

You can purchase these from my online store (Fullscript – only available to US customers – use this link to set up an account).
If you’re not in the US, you can purchase these at iherb (use this link to save 5%).

Somnium GABA Cream is another option that could be considered especially for those with Alzheimer’s or dementia who may struggle with using a supplement. It is available in the US and elsewhere with international shipping. Read more about the product and who else may benefit from using a cream, and grab my coupon code to save 15%.

Resources if you are new to using tryptophan or GABA as supplements

If you are new to using tryptophan or GABA as supplements, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution (you can see all the symptoms of neurotransmitter imbalances, including low GABA and low serotonin).

There is an entire chapter on the amino acids and they are discussed throughout the book in the sections on gut health, gluten, blood sugar control, sugar cravings, anxiety and mood issues (which include rage/anger/irritability/self-harm).

The book doesn’t include product names (per the publisher’s request) so this blog, The Antianxiety Food Solution Amino Acid and Pyroluria Supplements, lists the amino acids that I use with my individual clients and those in my group programs. You can find them all in my online store. The above oral lavender products are available in my online store too.

Have you found GABA to help in a situation like this?

If yes, which symptoms have resolved and how much GABA/which product are you using/did you use?

What time did the symptoms start to ramp up?

And has serotonin support with tryptophan and/or melatonin also helped?

If you have questions and other feedback please share it here too.

Sundowning in Alzheimer’s and dementia: melatonin/tryptophan for the agitation, restlessness, anxiety, disturbed sleep and aggression

March 3, 2023 By Trudy Scott 8 Comments

The terms “sundown syndrome” or “sundowning” are used to describe a wide range of neuropsychiatric symptoms occurring in individuals with dementia in the late afternoon, evening, or night. These symptoms include confusion, restlessness, anxiety, agitation, aggression, pacing, wandering, screaming, yelling, and hallucinations. The treatment of sundown syndrome is challenging, and pharmacological therapies are not particularly effective.

This definition is from a very encouraging case study published as a letter to the editor of the Journal of the American Geriatrics Society – Melatonin for Sundown Syndrome and Delirium in Dementia: Is It Effective?

This case study is very typical in terms of symptoms and a pharmacological approach:

An 81-year-old man with Alzheimer’s disease diagnosed 4 years previously was admitted to the elderly department because of behavioral disturbances, sleep disorders, and wandering. His wife said that his cognitive and functional impairments had gradually worsened over the past 4 years and that, in the last 6 months, her husband had become verbally aggressive, agitated, and restless; wandered; and paced. He did not sleep for long and had difficulty falling asleep. The symptoms increased in the late afternoon and at night. He had no hallucinations or delusions. One month before admission, delirium was suspected, and his general practitioner prescribed haloperidol, but it was not effective.

During admission, sundown syndrome was diagnosed, and he received pharmacological and nonpharmacological interventions for behavioral and sleep disturbances, but none was effective, and some aggravated symptoms. The pharmacological interventions consisted of benzodiazepines, antipsychotics, cholinesterase inhibitors, mood stabilizers, and antidepressants, all given in an optimal dosing schedule.

Read on to learn how melatonin led to much improved symptoms within a few hours; more about melatonin, sleep quality and reduction of anxiety after a TBI (traumatic brain injury); sundowning and the serotonin connection (and using tryptophan or 5-HTP); Dr. Dale Bredesen’s work and tryptophan recommendations; low GABA in Alzheimer’s disease and dementia; hope for symptom relief; and additional resources if you need guidance using amino acids like GABA and tryptophan.

Melatonin led to much improved symptoms within a few hours

None of the medications were effective and some made his symptoms worse. This case study is atypical in that his doctors were open to the use of melatonin. This led to much improved symptoms within a few hours and complete resolution in 2 weeks with a second dose:

After extensive review of his history, the effect of past treatments, and the published literature, melatonin was started at a dose of 2 mg at 8:00 p.m. for sleep disorders. Not only did his sleep quality improve within a week, but there was also significant improvement in his behavior within 2 hours of initiation of melatonin. A therapeutic trial with an additional dose of 2 mg given at 3:00 p.m. was started, and his symptoms gradually improved over the subsequent 2 weeks (NPI score 20). No behavioral changes were observed in the 2-month follow-up.

These results are powerful and mirror what a number of other studies are showing, for sundowning and to also slow “down the progression of cognitive impairment”). We also see melatonin working clinically for this population.

I share this case study so if you are a carer or have a parent or loved one with Alzheimer’s or dementia, you have a resource to share with the medical team. There is growing awareness of this research and some neurologists are prescribing melatonin with success. Typically 0.5 mg to 5 mg melatonin is used once or twice a day.

My hope is that this becomes the standard of care instead of prescribing psychiatric medications which the authors acknowledge are not particularly effective. And they don’t get to the root cause that is triggering these symptoms: low melatonin and low serotonin (more on low serotonin below).

Melatonin and anxiety

Melatonin also improves sleep quality and reduces anxiety after a TBI (traumatic brain injury). I blogged about a study that used timed-release melatonin here. The study participants used 2 mg of timed-release/prolonged-release melatonin for 4 weeks. This improved sleep quality and melatonin was also associated with a small decrease in self-reported anxiety.

As outlined in this paper, Melatonin as a Potential Approach to Anxiety Treatment, “melatonin’s benefit in anxiety may reside in its sympatholytic action, interaction with the renin-angiotensin and glucocorticoid systems, modulation of interneuronal signaling and its extraordinary antioxidant and radical scavenging nature.”

The serotonin connection and using tryptophan or 5-HTP

Keep in mind the strong serotonin connection: these sundowning symptoms start late afternoon and evening (hence the name sundowning) and serotonin is a precursor to melatonin production.

I look forward to seeing research on the use of tryptophan or 5-HTP for sundowning symptoms too. Until then, based on the above, and the fact that many of these symptoms are classic signs of low serotonin, I feel comfortable recommending either of these amino acids.

As always, we start low, use afternoon and evening doses and increase based on symptom resolution. The typical adult dose of tryptophan is 500 mg and 50 mg of 5-HTP. I recommend starting with 100 mg tryptophan and 10mg of 5-HTP. The amino acid precautions are always reviewed. I would not recommend either tryptophan or 5-HTP if the individual is currently prescribed an antidepressant, unless you are working with a knowledgeable practitioner and always with the approval and monitoring of the prescribing doctor. This is because of the possibility of serotonin syndrome.

Dr. Dale Bredesen recommends tryptophan and melatonin

Dr. Dale Bredesen is the author of The End of Alzheimer’s (my Amazon link) and a number of other books on Alzheimer’s. He is an authority on Alzheimer’s and recommends both tryptophan and melatonin. In this paper, Reversal of cognitive decline: A novel therapeutic program, he reports the use of 0.5 mg melatonin and 500 mg tryptophan used (3 x week) for sleep issues.

Interestingly and surprisingly, he doesn’t mention sundowning in his books or papers. However, if you are new to his work, I encourage you to look into his functional medicine approach, which is extensive and offers results and hope for many.

Low GABA in Alzheimer’s disease and dementia

This paper, Implications of GABAergic Neurotransmission in Alzheimer’s Disease, shares that “of the two major types of synapses in the central nervous system (CNS): glutamatergic and GABAergic, which provide excitatory and inhibitory outputs respectively, abundant data implicate an impaired glutamatergic system during disease progression.”

The amino acid GABA may also help anxiety, disturbed sleep and restlessness. And it’s common to have both low serotonin and low GABA.

This case study illustrates how using the amino acid GABA can help ease the anxiety often experienced in those with Alzheimer’s disease.

It’s too entrenched in our thinking that there is nothing to be done

It saddens me that it’s too entrenched in our thinking that there is nothing to be done. Unfortunately, many family members and medical professionals consider sundowning a normal part of the disease progression and question whether it’s worth doing anything.

My feedback is this: please don’t discount the power of the amino acids, melatonin and other nutritional approaches to offer some relief and improved quality of life for the patient. And when they are calmer, less aggressive and sleeping better it’s so much easier for the caregivers too.

Resources if you are new to using tryptophan or GABA as supplements

There is an entire chapter on the amino acids and they are discussed throughout the book in the sections on gut health, gluten, blood sugar control, sugar cravings, self-medicating with alcohol and more.

If you need serotonin support, the Serotonin QuickStart Program is a good place to get help. This is also a paid online/virtual group program where you get my guidance on using tryptophan and 5-HTP safely, and community support during 5 LIVE Q&A calls. You can sign up to be notified when the next live launch of this program is happening.

Wrapping up and your feedback

Have you used melatonin to help with sundowning symptoms with your loved one and if yes how much helps?

Was melatonin prescribed or did you research it and bring the information to the doctor?

Have you used melatonin to help with sundowning symptoms in your clients/patients? What ranges have you seen to help?

Have you also found tryptophan, 5-HTP and/or GABA to help?

If you have questions and other feedback please share it here too.

A weighted blanket increases pre-sleep salivary concentrations of melatonin in young, healthy adults – a new study

October 28, 2022 By Trudy Scott 7 Comments

A new paper published earlier this month, A weighted blanket increases pre-sleep salivary concentrations of melatonin in young, healthy adults provides yet another mechanism supporting the benefits of a weighted blanket for improving sleep and also reducing anxiety – an increase in melatonin. The authors share that “Weighted blankets have emerged as a potential non-pharmacological intervention to ease conditions such as insomnia and anxiety. Despite a lack of experimental evidence, these alleged effects are frequently attributed to a reduced activity of the endogenous stress systems and an increased release of hormones such as oxytocin and melatonin.”

Here are some of the details from the study:

It was a small in-laboratory crossover study and included 26 young and healthy participants (15 men and 11 women)
The heavier weighted blanket was about 12% of their body weight
The following were measured: “salivary concentrations of the stress hormone cortisol, salivary alpha-amylase activity (as an indicative metric of sympathetic nervous system activity), subjective sleepiness, and sleep duration.”

The only difference found was a 1 hour increase of salivary melatonin from 10pm to lights off at 11pm. It was about 32% higher when using the heavier weighted blanket.

No other differences were found in terms of subjective sleepiness and total sleep duration.

The study concludes as follows:

Our study is the first to suggest that using a weighted blanket may result in a more significant release of melatonin at bedtime. Future studies should investigate whether the stimulatory effect on melatonin secretion is observed on a nightly basis when frequently using a weighted blanket over weeks to months. It remains to be determined whether the observed increase in melatonin may be therapeutically relevant for the previously described effects of the weighted blanket on insomnia and anxiety.

The authors only identified an increase in pre-sleep melatonin in this study. But keep in mind these limitations of the study: participants did not have insomnia or anxiety, and they were young (and melatonin declines as we age). The authors didn’t find an improvement in subjective feedback on better sleep and they did not measure subjective changes in anxiety levels – which I don’t find surprising.

However, as you’ll read below, many individuals in my community responded favorably when I posted this new study on Facebook, sharing how using their weighted blankets does improve their sleep and reduce their anxiety. I share some of the anecdotal feedback below.

Feedback from real people: improved sleep, calm body, soothing and less anxiety

Here is some of the feedback from folks in my Facebook community:

Krys shares this: Ever since I started using a weighted blanket my sleep has improved. I think I need a heavier one. I believe the one I have is only 12 lbs. I was born in Poland, and we always had very heavy covers. Usually feather filled comforters, which made me feel secure and helped with sleep. I have a lot of past trauma and did not notice the weighted blanket to be confining.

Christine shares this “I love my weighted blanket and sleep much better with it. I definitely sleep more soundly…less waking up. I bought it about 3 months ago and plan to use it year round. It is a faux fur glass bead filled one….it is super flexible and I can tuck it in and around all the nooks and crannies around my body. I considered a flatter, more stiff one but preferred the tucking option.” Christine’s weighted blanket is 15lbs and she plans to use an electric blanket to warm it up in winter (and switch it off /unplug it, before getting into bed).

Courtney shares this: “I started with a 12lb, then 20lb, now I have a 25lb one lol. I absolutely love my weighted blanket and can not sleep without it…I use it year round, it’s not hot but yet keeps you warm. And I feel like the weight keeps you from tossing and turning as much. It feels like a hug lol.” The hug comment makes me wonder if they provide endorphin support too.

MaryKatherine shares this: “Wow that is seriously amazing. They definitely help me. I love weighted blankets…I feel almost instant calm in my body when I use weighted blankets. It does take 10-15 min for full effect.”

Tana shares this: “I love my weighted blanket. It helps me relax. I sleep so much better.”

And then she shared this: “After this post I thought I should let my teenage daughter try my weighted blanket . She has anxiety and poor sleep habits. She loved it. I will be ordering her one.” How wonderful is this?

Brenda shares this: “Love mine… I find it helps my AM anxiety. I’m kind of a hot sleeper, so I can’t keep it on for long, but I pull it up in the early morning, and it just gives a nice feeling of safety almost. I know a guy who does this with his dog when he’s having PTSD anxiety attacks.”

Willow shares this: “I have a cooling weighted blanket that I use all year. It is completely magical. I bought it hoping to sleep better but I didn’t expect it to be so incredibly soothing. Mine is 100% organic bamboo with glass beads. I find the cooling cover perfect all year. I honestly LOVE this improvement in my life.”

Katie shares this: “I love mine! I got one for each of my kids too. For my son I got a lighter one for kids, though he prefers my heavier adult blanket. He has ADHD and anxiety and really loves the weight. We all sleep deeper and fall asleep faster. Sometimes I use mine during the day when anxiety is especially high and it helps to calm my nervous system.”

Many folks are going to need additional nutritional support for their anxiety and insomnia

One person shared this: “I love my weighted blankets but it took awhile to get used to the heaviness on me… It’s not a miracle particularly if my stress and anxiety is much higher but I’d rather have it then not. It’s more helpful if I’m calmer.”

I agree. Many folks are going to need additional nutritional support for their anxiety and insomnia. This is where my work with addressing low GABA and low serotonin comes into play. Also, we may need to consider high cortisol and always need to address gut health, diet, caffeine/sugar/gluten intake, parasites, EMFs and everything covered in my book “The Antianxiety Food Solution.”

Here are a few (of many) useful resources from the blog:

Feel free to use the search feature to find additional anxiety and sleep resources and success stories.

Resources if you are new to using GABA, tryptophan and other amino acids as supplements

If you are new to using any of the amino acids as supplements, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution (you can see all the symptoms of neurotransmitter imbalances, including low GABA and low serotonin).

Have you had success with a weighted blanket …for sleep issues and anxiety?

If you have seen these benefits with a weighted blanket:

I’m also curious if you’ve observed reductions in sugar cravings, less anger issues, less irritability, less PMS symptoms, less negativity and less worry and panic attacks? These are all symptoms of low serotonin. I suspect that if there is an increase in melatonin there may also be an increase in serotonin (which is used to make melatonin).
Have you noticed any other benefits?
Be sure to share which weighted blanket you have, what percentage of your weight it is, and how often you use it.
Have some of the nutritional approaches helped too?

If you have not seen benefits or didn’t like using one, please feel free to share your experiences.

If you’re a practitioner, do you recommend a weighted blanket to your clients/patients?

If you have questions please share them here too.