nervous

Flight anxiety with heightened breath, physical tension and also fearing the worst (the role of low GABA and low serotonin)

September 19, 2025 By Trudy Scott Leave a Comment

Do you have suggestions for supplements for flight anxiety, something to make flying bearable without heightened breath, etc, or is that out of the supplement realm?

I also have physical tension and fear the worst. Any kind of turbulence or warnings of turbulence makes me extremely nervous.

K asked this question on one of my blogs and I responded that this is very much in the supplement realm! And what we use depends on the type of anxiety someone is experiencing.

I would first consider serotonin support before and during flying – tryptophan or 5-HTP – because she fears the worst and feels extremely nervous. With low serotonin there may also be worry and fear leading up to the trip, as well as feelings of panic and imagining the worst during the flight.

GABA support – using the amino acid GABA or theanine – should also be considered for the more physical symptoms of heightened breath and physical tension. With low GABA there can be other physical symptoms such as excessive sweating (like the palms), a racing or pounding heart and a dry mouth. These amino acids could also be used leading up to the flight and during the trip if needed.

Read on for more on my insights on using these amino acids in a situation like this, additional information about fear of flying and a success story with GABA.

Serotonin and/or GABA support for fear of flying

In an ideal situation I would want to address both low serotonin and low GABA before flying and have her use extra during the flight, as needed. It’s very likely that many of the low serotonin and low GABA symptoms are present in some way in her day to day life too.

This means she can be methodical about doing a trial of the respective amino acids and figure out the optimal dose of each in familiar surroundings – using powder, capsule opened, sublingual, chewable or liposomal.

As always we trial one at a time so we know which one is working best. Keep in mind some folks do better with tryptophan and some do better with 5-HTP so both may need to be trialed. The same can be said for GABA and theanine.

Once the product and dose of each has been figured out, she’ll need to find a suitable option for use while traveling i.e. a sublingual or chewable tablet

It’s always a comprehensive approach

It’s a comprehensive approach – amino acids AND diet so I recommend eating real whole food, quality animal protein, eating for blood sugar stability, going gluten-free, sugar-free and caffeine-free, eating healthy fats, organic vegetables and fruit and fermented foods. My book “The Antianxiety Food Solution” is a great place to start when you are new to the amino acids and other anxiety nutrition solutions like gluten/sugar/caffeine removal, blood sugar control, gut health, pyroluria etc.

During travel it’s important to be prepared with healthy travel foods and drinks. I share some ideas here.

The definition of a specific phobia such as the fear of flying

The fear of flying is called aviophobia and it’s one of many common phobias about something specific. According to this ebook

Specific phobia is an anxiety disorder characterized by excessive and irrational fear of a particular object, situation, or activity. The anxiety response goes beyond normal apprehension and leads to avoidance behavior. The intensity of the fear is often disproportionate to the actual danger posed by the phobic stimulus.

Common examples of specific phobias include fear of heights (acrophobia), fear of spiders (arachnophobia), fear of flying (aviophobia), and fear of needles (trypanophobia). People with specific phobias may experience intense anxiety or panic attacks when exposed to the feared object or situation.

This Australian article reports that “One in six people have a significant fear that prevents them from flying, and about one in five regular flyers use alcohol or prescription drugs to “help” them through a flight, according to Victoria’s Department of Health.”

Using the amino acids to address low serotonin and/or low GABA addresses the root cause and does away with the need for alcohol and antianxiety meds (and the associated side-effects).

Cognitive behavior therapy (CBT) and exposure therapy is often recommended for aviophobia but doesn’t always help, and doesn’t address the biochemical imbalances.

A success story with GABA before and during a flight – cool as a cucumber

Melissa started using Source Naturals GABA Calm in anticipation of holiday travel and holiday gatherings and shared this:

I’m glad I saw the post about GABA on your FB page a couple weeks ago. I bought Source Naturals GABA Calm and have been taking 1-3 per day for two weeks.

I’m glad I bought it before travelling 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.

Notice that she started using it in the 2 weeks leading up to her trip and not on the flight itself.

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

We use the symptoms questionnaire to figure out if low serotonin or low GABA or other neurotransmitter imbalances may be an issue for you.

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

There is an entire chapter on the amino acids and they are discussed throughout the book in the sections on gut health, gluten, blood sugar control (this is covered in an entire chapter too), sugar cravings, anxiety and mood issues. The importance of quality animal protein and healthy fats is also covered.

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

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

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.

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.

Have you had success using serotonin and/or GABA support for your fear of flying (or other phobia/s)? If yes, which amino acids have helped you?

Did you have any success with CBT or exposure therapy or other approaches?

Feel free to share and ask your questions below.

The correlation between terrible anxiety/panic attacks and collagen

July 25, 2025 By Trudy Scott 14 Comments

Bea shared her collagen experience and insights on one of the collagen blogs:

I discovered the correlation between terrible anxiety and collagen myself several years ago! Couldn’t find any data about it then so just assumed I was a weirdo. But then my 26 yr old daughter started having terrible panic attacks. And bam! She too had started a collagen supplement! So I realized at least 2 ladies have this trouble! Got me to think about how many women seek anti-aging help with collagen and then also end up on prescriptions to help calm terrible anxiety without seeing the connection. Practitioners don’t seem to know about this. But every vitamin shop I visit hears from me on the anxiety/collagen connection. Perhaps grassroots word of mouth will help others eventually.

And yesssss… for me, bone broth is equally horrible!! Even if it is simmered for only 30 mins.

Thank you for explaining, Trudy!! How fascinating to learn it’s the drop in serotonin! I’ve never tried Tryptophan… just a bit nervous. But I think it’s time. I sure need the bone broth for my waning gut health. And I’m weary of ruminating thoughts lately! Thank you immensely for shining a needed light on how these amino acids help! I only wish I could share lunch with you and pass along my grateful hug!

God bless you, Trudy!

I’m so glad Dea found this correlation for herself and her daughter! Collagen use is on the rise and there is little awareness about these effects on serotonin levels in susceptible individuals. Read on for many of the anti-aging benefits of collagen, more information about tryptophan depletion studies, another similar story, other possible causes, and other blog resources on this topic.

Collagen use as we age: for skin, joints and bone health

Her comment about an increase in collagen use for anti-aging is so true. This 2023 paper, Collagen supplementation in skin and orthopedic diseases: A review of the literature, discusses the many age-related benefits of collagen:

hydrolyzed collagen supplementation promotes skin changes, such as decreased wrinkle formation; increased skin elasticity; increased hydration; increased collagen content, density, and synthesis, which are factors closely associated with aging-related skin damage.

Regarding orthopedic changes, collagen supplementation increases bone strength, density, and mass; improves joint stiffness/mobility, and functionality; and reduces pain. These aspects are associated with bone loss due to aging and damage caused by strenuous physical activity.

This paper mentions these aspects about collagen, that it’s low in tryptophan and that it is not a complete protein i.e. it’s a low biological value protein:

Notably, collagen is a low-tryptophan protein, an essential amino acid for humans.
Collagen is a source of conditionally essential amino acids (glycine and proline), which are important in some physiological situations.
Collagen is a low biological value protein, since its amino acid composition is poor in essential amino acids. However, it has a positive intrinsic value because its amino acid composition is equivalent to that of human connective tissue.

This supports what we have learned from acute tryptophan depletion studies causing low serotonin.

Tryptophan-depletion studies to study the relationship between low serotonin and depression

Here is my first blog explaining acute tryptophan depletion studies (published in 2017) – Collagen and gelatin lower serotonin: does this increase your anxiety and depression?.

Tryptophan-depletion studies have been done for years, as a way to study the relationship between low serotonin and depression. Often a tryptophan-deficient amino acid mixture is used for this purpose. More recently, collagen and gelatin are being used.

Collagen and gelatin are an excellent source of these amino acids: proline, glycine, glutamine and arginine, but they do not contain the amino acid tryptophan.

This paper, Pharmacokinetics of acute tryptophan depletion using a gelatin-based protein in male and female Wistar rats summarizes what we find in a number of studies that use gelatin for the purpose of lowering serotonin levels, in order to study the relationship between serotonin and behavior:

The essential amino acid tryptophan is the precursor of the neurotransmitter serotonin. By depleting the body of tryptophan, brain tryptophan and serotonin levels are temporarily reduced. In this paper, several experiments are described in which dose and treatment effects of acute tryptophan depletion (ATD) using a gelatin-based protein-carbohydrate mixture were studied in male and female Wistar rats.

I encourage you to read the above blog to learn about who may be more susceptible to these effects.

I also share my personal experience with collagen consumption and can totally relate to Bea’s story and what clients and those in my community have shared.

Toni used collagen for 8 months – anxiety and panic attacks are off the charts

Toni experienced something similar:

I’ve been using Organic collagen for about 8 months now… love the hair and skin results. My tummy felt better at first but not currently. My anxiety and panic attacks are off the charts: panic attacks, heart racing, sweating, brain fog. I want to escape – like fight or flight. Definitely obsessing and fears. Memory difficulty. I have an upcoming GI appointment to check for Candida /SIBO… but I had no idea this could add to my anxiety. I’ll be looking forward to more information, Seriously.

And a few weeks after stopping the collagen she shared this:

I stopped using collagen. Since then, my anxiety and panic have decreased by less than half. Mild in comparison. I’m definitely taking a long break.

Instead of stopping collagen altogether, my advice is to figure out if low serotonin is the cause and address this with tryptophan or 5-HTP so collagen can be used for its many anti-aging and health benefits.

Is their anxiety due to reduced serotonin or histamine, glutamate or oxalate issues

Keep in mind tryptophan will help and allow collagen, gelatin and broth to be consumed without the increase in anxiety and panic attacks (and sleep issues) only if it is due to low serotonin.

Presumably both Dea and her daughter have other low serotonin symptoms – in addition to anxiety and panic attacks – such as sleep issues, worry, fears, afternoon/evening cravings etc (here is the list of symptoms). As you can see from Toni’s feedback (above), she does have many low serotonin symptoms.

A trial of tryptophan and symptom reduction (initially until the ideal dose is found) will confirm symptoms are related to low serotonin very quickly. This will also help Dea with her nervousness and ruminating thoughts, help her daughter ease the feelings of panic and help Toni too.

It’s also often helpful to also rule out histamine, glutamate and oxalate issues from collagen, gelatin and broth intake – as all of these factors can contribute to an increase in anxiousness too.

Additional blog posts on the topic of collagen

In case you are new to these potential issues, here are additional blog posts on the topic:

If you are new to this topic and are still skeptical about all this, do read the many comments and stories on these blogs. It’s a way more common issue than you’d think!

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

As always, I use the symptoms questionnaire to figure out if low serotonin 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.

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. You can sign up to be notified when the next live launch is happening.

Wrapping up and your feedback

I appreciate Dea for sharing her story on the blog and for sharing this information at vitamin stores – we do need more awareness, hence this new blog on the topic to further help create awareness.

It’s very likely that this is one big contributing factor to the rise in anxiety and sleep issues in perimenopause and menopause. And this is probably made worse because so many practitioners are still not aware.

I thanked her for her kind words, and said I’ll take a virtual lunch and a virtual hug from her.

Have you experienced any adverse effects from collagen, gelatin or bone broth?

Have you been able to continue using them by adding tryptophan?

And why do you use collagen/how is it helping?

If you’re a practitioner are you aware of this issue for certain susceptible individuals?

Feel free to share and ask your questions below.

High dose GABA (750 mg) caused her to feel anxious and nervous with feelings of panic. She also felt agitated, flushed and hot

August 30, 2024 By Trudy Scott 15 Comments

I casually read about GABA and ordered a bottle from Walmart. It was 750mg and it said take 1x daily. Ooooooooh boy did that mess me up – anxious nervous panic. That’s how I found you though, so I guess the universe had its reasons. I read your article about GABA dosing and started doing a micro dose by opening the pill, splitting it into 4 and putting it under my tongue and it was a game changer! Immense anxiety relief and now I’m researching more to add

These game changing results are wonderful to hear and I’m very happy for Tiffany but I’m not happy with GABA product labels. Folks need to know this, and I really want to get the message out about safe ways to use GABA.

She posted this on one of my facebook threads and I asked her if she’d be willing to share what happened so this doesn’t happen to someone else. She kindly said “absolutely you can share” and proceeded to provide a very detailed description of what happened. I share all this below with some of my insights about starting with GABA 750mg (considered a high dose for most individuals), what she did really well and my takeaway lessons, plus more about GABA dosing and the antidote when too much is used.

This is what happened (in her exact words):

Day 1 (Aug 3) – 4AM – After swallowing the 750 I first noticed a heat/flush feeling. It was my neck and upper chest area. This alone had me panicking that death was imminent, then it slowed after I’d say 15-30 minutes. I felt overly anxious & agitated after that, kept checking my pulse & BP (blood pressure) reassuring myself I was not dying.

Looking at my search history my anxieties lasted hours – by 11am I was searching “can I overdose on gaba” then I finally slept

I haven’t formed a connection yet between the gaba & the flush / panic yet.

10ish pm

I again swallowed the 750. I also applied icy hot for my chronic pain condition 30ish mins later. Then the flush sensation again neck & chest like before hit me. 15-30 mins of tingling , this time I convinced myself it must just be the icy hot mixing with the gaba altering my skin sensations (I had read about how it works in the central nervous system).

Day 2 (Aug 4) – 1am (+3hrs ingested)

I was in full “health” anxiety/panic mode, panic googling & [My search “gaba cause warming sensation”] landed me on your article

This was my game changer/ life saving moment!!!!

I’m unsure how long the anxieties lingered but I had a new game plan for microdosing from now on.

Plan: open the capsule (750mg) & separate the powder into 4 equal parts. Place this 1/4 under my tongue

7am

I took my 1st 1/4 micro-dose and felt like a champ! My google searching was now about understanding how it worked in the brain and why it had unclenched my jaw muscles. (My chronic pain is from TMJD largely due to my anxiety clenching)

I’m sorry she experienced this but I’m so glad she found my dosing article and figured it out. And that the lower dose of GABA is helping so much.

She was totally new to GABA and supplements in general: “I’m just learning supplements after detoxing effexor” so it’s not totally unexpected for something like this to happen BUT it really doesn’t have to be this way when you are an informed user (I share my take-aways below).

In my article/blog, Too much GABA causes a tingling niacin-like flush sensation (in the brain and body). It’s awful and very uncomfortable! I share the issues with starting with too high a dose. If you’re new to GABA, I encourage you to click the above and read the post.

Splitting the 750 mg GABA capsule into four equal doses works for Tiffany

This is the change she made after reading my blog post i.e. she used much smaller doses

From then till now I’ve consumed 1 of the 750mg gabas each day by splitting into the 1/4’s (3-4hrs in between) and it has kept my anxiety at a consistent baseline level and helped immensely with the clenched jaw.

I also started adding l-theanine (100mg) supplement and I’m actively researching additional amino acid supplements to add in once I have some extra money to buy.

For context on Aug 7, I had an emergency dental extraction that was traumatic. I took my gaba 1/4 right before and remained relatively calm through the whole 4 hour ordeal.

Once the Walmart bottle is gone I’ll be buying a low dose sublingual.

It was fortunate that 187 mg (a quarter of 750 mg) worked well for her based on her unique needs and biochemistry. It’s possible this may have been too much for her too and in this case she would have adjusted down.

Why Tiffany considered GABA for her issues and her next steps

Her initial reason for wanting to take GABA was a desire to keep her “anxiety / panic levels regulated.” Her physical anxiety symptoms manifest as “flight or fight” response and were hitting her constantly without warning or outside triggers. She was also in “constant pain from the jaw muscle issues but couldn’t face leaving the house to find a new doctor for help.”

The good news is that after finding the proper dose of GABA she was “able to remain calm enough to find a new doctor.” Tiffany also shared this:

I am treating my brain as a delicate little flower right now. Taking copious notes trying to establish what my baseline brain chemistry is and how the individual neurotransmitters impact my mood/state in the moment.

I mentioned before I am just starting my research journey about brain chemistry and planning to start to “play” around with additional amino acid supplements.

I’m in the stage now of discovery, finding a new amino acid, researching what transmitter it is connected to, it’s role as a precursor and once I have my data compiled I’m going to take a targeted approach testing to see what the impacts are.

I’m focused on figuring out my root deficiency i.e. serotonin vs dopamine vs norepinephrine and then going from there.

Takeaway lessons for Tiffany and what she did well

I shared some of my takeaway lessons with Tiffany and here they are in case you’re also new to using the amino acid GABA:

Learn how to safely use GABA and the other aminos before you start using them i.e. read my book “The Antianxiety Food Solution” or do one of my online group programs (details below)
Use vitamin C as an antidote if you have a reaction. I write about this in my book. It negates any adverse symptoms quickly but also negates any benefits
Start with a low dose of GABA and ignore the product label. I recommend 125 mg as a safe starting dose and less for sensitive folks
Trial only one new supplement at a time so you know what is working and what is causing issues. With the GABA reaction Tiffany experienced I would not have added theanine before finding the ideal GABA dose. With her pain issues I’d be considering serotonin and endorphin support, but using one amino at a time and starting low dose with the correct timing
If you have an adverse reaction stop immediately i.e. don’t push through
Purchase professional grade supplements from Fullscript or iherb (here is the link to my products page with links to both). We want quality supplements just like we want quality food.

What Tiffany did well:

She carefully logged exactly what happened
She searched for expert advice and didn’t continue to push through the adverse effects
She split the GABA 750 mg into 4 and put the powder under her tongue
She is in the process of educating herself (and says she’ll get a copy of my book)

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

Some of the many GABA products I recommend include Source Naturals GABA Calm lozenges (a good low dose of 125 mg) and Now GABA Powder (which does need to be measured out to provide a 125 mg typical starting dose). Keep in mind, some individuals need less to start.

When using GABA powder I have clients use a handy mini measuring spoon like this one (my Amazon link) and share more about how to accurately 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 available in the US and elsewhere with international shipping. Read more about the product and who may benefit from using a cream, and grab my coupon code to save 15%.

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

As always, I use the symptoms questionnaire to figure out if low 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.

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.

Wrapping up and your feedback

I appreciate Tiffany for sharing and giving me permission to blog about this. I do hope it’s been helpful for you and her too.

Now I’d love to hear from you – does any of this resonate with you? If yes, how high a dose of GABA did you start with and what was your adverse reaction? And how much helps now and how does it help? Feel free to share which product too.

If you’re a practitioner is this how you advise your clients/patients?

Feel free to share and ask your questions below.

Twisties, nervousness and demons at the Olympics: Outpouring of love and support for Simone Biles for taking care of her mental health

July 30, 2021 By Trudy Scott 10 Comments

Simone Biles at a training session at the Rio 2016 Summer Olympic Games (Salty View / Shutterstock.com)

There has been an incredible outpouring of love and support for gymnast Simone Biles, as she withdrew from the 2020 Olympics Women’s Team final on Tuesday and All-Around Individual Final on Wednesday. This was due to the twisties, nervousness and mental demons. I’ve decided to gather some of this admiration into a blog post as a testament to Simone who I adore and respect even more than I did before today. I want this to be all about the love and support, but in order to tie it all together, I share more on the twisties (and anxiety), being vulnerable and taking care of yourself, nutritional psychiatry, using amino acids and mental health advocacy below.

Before we get into all that, here is an ET video that explains some of the backstory leading up to this:

Simone shares that she feels good physically but emotionally, her feelings vary by the day. She also talks about the stress of the Olympics and being the star gymnast and that she feels she has the weight of the world on her shoulders.

You’ll also see and hear the love and support she gets from her team members and fellow gymnasts. Two-time Olympian, Aly Raisman, says this about Simone: “She is human too and sometimes people forget that. She is doing the best she can.”

The love and support continued to show up all over social media (and is still showing up)! What follows are some of my favorite posts and mentions.

The love and support – Simone Biles already won

Women Hold Up Half The Sky, a community that empowers women to find their voice and celebrates women in their diversity, shared this powerful post when Simone withdrew:

“Simone Biles already won” and how she has “shattered records to become the world’s most decorated gymnast, has four moves named for her and fought on behalf of abuse survivors.”

Simone is one of many young female gymnasts who were sexually abused by disgraced former USA Gymnastics doctor Larry Nassar. This article in Elle covers her story and goal to be an advocate for other young girls.

We are just as proud of you today as yesterday

Jen Hatmaker, New York Times bestselling author of “Simple and Free” posts this lovely uplifting message, ending with:

I’ll tell you what, Simone Biles, the only thing withdrawing from the team competition told me is that absolutely nothing is more important than your mental health, and rather than push through until you had an utter breakdown emotionally or physically, you had the strength of character to step down. The watching, expectant eyes of the whole world are a heavy burden none of us understand.

Your IG caption on July 7th said: “Whatever is good for your soul, do that.” And you did. Well done.

Because this life is a long game, little sister. No matter what everyone is telling you, this is NOT your one moment. It sure isn’t. Most of your moments are ahead of you in fact, and you get to choose how you want to live them.

We are just as proud of you today as yesterday, and we will be proud of you for all your tomorrows. Catch your breath, girl. You are already a champion.

I wholeheartedly agree, nothing is more important than her metal health. Too often we put on a brave face and push through. Simone didn’t and for that we are super-proud of her – for her own physical and mental health, and for being a role model to girls and women around the world.

Simone Biles and Naomi Osaka are the role models I want for my girls

Diary of a Mom, mother, intersectional advocate, believer in the power of community, posted this beautiful message about strength, bravery, vulnerability and Simone and Naomi being role models for her daughters:

I have long admired Simone Biles, but I am now officially in awe of this young woman.

We knew she was strong. We knew she was brave. But, by god, the courage and resolve that she has shown in the last two days are just BEYOND.

To stand firmly in one’s own humanity and to say, from that incredibly vulnerable place, “My safety comes first,” should not have to be a radical act, but it is. Oh, how it is. In the world in which we live (and far more so in the rarified air of elite competition), it is not just radical, it’s revolutionary.

Simone Biles and Naomi Osaka are the role models I want for my girls. Women who know their worth. Who declare and own and defend their *inherent* value – not based on what they can do but on who they are. Women who achieve incredible things not despite their perfectly human limitations but precisely *because* they are willing to acknowledge and respect them.

Yes, these are the role models I want for my girls.

Bravo, Simone.

#GOAT

I applaud this strong woman and amazing athlete

Mary Kay Irving, Therapist/Care Coordinator at Boulder Community Health and Owner at Boulder Center for Health and Nutrition, shares this message.

I applaud this strong woman and amazing athlete for prioritizing her own needs….i.e.. mental health needs. #destigmatizementalhealth #mentalhealthawareness

I also applaud Simone and support her decision to take care of her mental health needs no matter how hard it must have been for her!

Simone is an absolute legend!

My friend and colleague Dr. Jessica Drummond, a functional nutrition and integrative women’s health expert, and founder of Integrative Women’s Health Institute, says Simone is an absolute legend:

Simone is an absolute legend. The fact that she landed this AT ALL is AMAZING. I was a gymnast for 13 years. You have to be able to just “feel it” in the air or you literally crash because there’s no awareness of where the floor/ apparatus is. Literally anyone else would have had a serious physical injury from this challenge to her nervous system in mid-air… especially with the amount of pure power that Simone throws around.

This is so great for people, especially our youth athletes, to see

Another friend and colleague, Beth Jones who is a Female/Teen Athlete Wellness & Mindset Coach, posts this.

I’m grateful for athletes like Simone Biles and Naomi Osaka who are coming forward (and professionals as well) to normalize mental health as a key piece of sports training and recovery.

I could not agree more.

In this post, Beth also shares Simone’s press release video where she fully advocates for her mental health and personal performance, keeping the team dynamic in mind, and also sets a wonderful example for young athletes

Sometimes you need to hear it from the GOAT’s mouth.

My understanding is that she hasn’t made a final decision regarding continuing competition in the individual event finals. She has an amazing support staff around her, including mental health specialists, who can help her make the best decision for her. I also wanted to share this video – it’s her interview explaining the decision in her own words.

She is fully advocating for her mental health and personal performance, while also keeping the team dynamic in mind. This is so great for people, especially our youth athletes, to see – there are not a lot of athletes who will speak candidly in this way.

I’m glad that athlete mental health is finally getting some of the recognition it deserves – think about how much stress and frustration not being scored on your achievements (link in comments) must have been for her on top of everything else.

The mindset that mental “injury” creates absolutely ties into, not only performance but injury prevention. The level of skill that all Olympic athletes are competing at is so high and second-guessing or not being fully focused leads to injury.

Thank you for finding your voice and staying true to yourself.

Tyler Gordon, a 14-year old artist who seeks to inspire through the stories of heroes in his work, tweeted this sweet message with his painting of Simone:

Dear Ms. @Simone_Biles Thank you for finding your voice and staying true to yourself. I know it was hard, scary, and you probably felt alone. But you powered through and are still the peoples champion!

This young man is kind-hearted and has talent! You can actually watch him painting Simone here.

Unfortunately, there have been way too many negative comments. I believe these are people who don’t understand mental health. You don’t have to have broken your back to have compassion for someone who has but there are still too many people who can’t understand mental health or have empathy until they have experienced it or see a loved one experiencing it. I’m hopeful all this media attention will help create more awareness, compassion and kindness.

The twisties and how stress and anxiety can play a role

In case you are new to this term (like I was until this week), this article explains what the twisties are – Simone Biles Mentioned Having ‘the Twisties’ – Here’s What That Means, and Why It Can Be Dangerous in Gymnastics:

The twisties is an informal term used to refer to a certain kind of mental block that a gymnast can experience as they are in the air during a twisting skill. When someone gets the twisties, there is a disconnect between the brain and body, Jamie Shapiro, PhD, a certified mental performance coach who is the co-director of the Masters in Sport and Performance Psychology program at the University of Denver

In this same article, Dr. Shapiro, a former gymnast herself, shares how this loss of control can have both physical and mental implications:

Physically, the twisties can make a gymnast unable to perform the skills as they were previously able to.

Mentally, that inability to perform the skills can cause anxiety, exacerbating the mental block.

Allie Wagener, PhD, a licensed psychologist who specializes in sport and performance psychology at Premier Sports Psychology and is also a former gymnast shares how dangerous this can be in terms of injuring yourself when “you don’t know where you are in the air and you don’t know how to land.” It’s also terrifying for the gymnast and that worry and fear about it happening again can make things worse.

I wanted to understand more about the “twisties” in gymnastics and asked Jessica Drummond how similar are they to the yips, which happen in golf or baseball, and which I know are closely tied to increased anxiety/stress. The stress/anxiety can be a trigger and then having the yips make your anxiety and fears worse. Jessica confirmed this about the twisties:

Yes, it’s sort of a loop that can get stuck – get lost in the air (cognitive, proprioceptive, vestibular) –> realize how dangerous that is/ was/ could be –> fear –> stress –> exacerbates the original brain-based issue.

I encourage you to read the entire article to see how stress and anxiety, racing/negative/distracted thoughts, fear of failure, high expectations and even focal dystonia (involuntary muscle spasms) can play a role.

The experts also mention a number of possible techniques to help (like progression, focusing on a different skill, using simple cue words to “keep you focused on the skill rather than the fear”), speaking with a sports psychologist and taking a break.

There is no mention of “nutritional psychiatry” as a possible solution (and I share more on this below).

What Simone has shared – I’m a little bit more nervous

Right now, we don’t know exactly why Simone experienced the twisties or if any of the above apply to her, but we do know some of what she has shared with the media up until now.

In this article Simone said she wasn’t physically injured but fighting some mental demons and had experienced a little injury to her pride. She said that “after the performance I did I just didn’t want to go on,” saying it was all in her head. Simone also emphasized the need to protect her body and mind, saying “I have to focus on my mental health and not jeopardize my health and well-being.”

An article in Women’s Health Magazine reports her comments at a press conference after the USA team won the Silver medal. Simone shared how she just doesn’t trust herself as much as she used to, wasn’t having as much fun as usual and admitted that “I’m a little bit more nervous when I do gymnastics.”

It was here that she announced that she had the twisties.

Around this time USA Gymnastics announced Simone had withdrawn to focus on her mental health. They also offered their support:

We wholeheartedly support Simone’s decision and applaud her bravery in prioritizing her well-being. Her courage shows, yet again, why she is a role model for so many.

A place for “nutritional psychiatry” and “anxiety nutrition solutions”

My hope is that more and more “nutritional psychiatry” and “anxiety nutrition solutions” (like the use of GABA, tryptophan and other amino acids) will make it into the world of professional (and recreational) sports. I’d like to see this embraced by athletic coaches, registered dieticians and psychologists working with athletes, and hopefully some of the athletes themselves.

Research shows that elite young athletes have high psychological demands:

Elite young athletes have to cope with multiple psychological demands such as training volume, mental and physical fatigue, spatial separation of family and friends or time management problems may lead to reduced mental and physical recovery.

The paper concludes that:

Future research should focus on sports medical and sports psychiatric interventional approaches with the goal to prevent anxiety and depression as well as teaching coping strategies to young athletes.

I recently blogged about how the amino acid tyrosine erased severe performance anxiety in a female musician – to such an extent that she had no more shaking, sweating, panic attacks or passing out. Much of this could be applied to an athletic performance where low dopamine is a factor.

This recent blog resonated with many in my community: What if overthinking, fear, anxiety and worry (caused by low serotonin) is holding you back instead of low motivation/low dopamine? Much of this could also apply to athletes with the twisties or yips with low serotonin as a root cause.

My book, The Antianxiety Food Solution, is a great place to start with the foundations of eating to reduce anxiety (real whole food, no gluten, no caffeine, no sugar, eating for blood sugar control and gut health) and more advanced interventions (like using the amino acids GABA, tryptophan, 5-HTP, tyrosine, DPA and glutamine for balancing brain chemistry, and addressing low zinc and vitamin B6 for pyroluria/social anxiety.)

All this is clearly very needed, and the research and awareness are growing in leaps and bounds, but as Beth Jones, Female/Teen Athlete Wellness & Mindset Coach, shares, what an amazing shift it would be if we could add more “nutritional psychiatry” into the sports psych training:

Coming from 20 years working in sports med with athletes, I keep coming back to wishing there was a degree that combined sports psychology & nutrition (functional & fueling). I started looking into the more mental aspects of performance and healing and then also bringing in more nutrition aligned with healing needs about 15 years ago, but it was all on my own.

What I’ve been learning from you has given me some new tools to share, but you’re right in that they are not well known. I know our US Olympic Committee has amazing health professionals in all areas that work as a team approach for our athletes, but I wonder how many of the RDs are actually having conversations with the mental health team and collaborating taking all of the athlete-specific nuances into consideration.

I know my own therapist suggested that I not pursue sports psych because of the lack of support among therapists out there, but what an amazing shift it would be if we could add more nutritional psychiatry into the sports psych training? Trying to forge a path in this area on my own, but it’s a lot of bush-whacking and little progress.

Beth raises some excellent points and as I said above, hopefully more and more of the “anxiety nutrition solutions” and “nutritional psychiatry” will make it into professional and recreational sports.

It’s ok to say you’re not ok mentally

Simone has noticed and embraced the love and support she’s been receiving. She tweeted this:

The outpouring [of] love & support I’ve received has made me realize I’m more than my accomplishments and gymnastics which, I never truly believed before

She is way more than her accomplishments and gymnastics.

Naomi Osaka penned an article in Time magazine with this title: ‘It’s O.K. Not to Be O.K.’ She wrote this shortly after she withdrew from the French Open to tend to her own mental health. Naomi’s openness has inspired Simone to speak out.

When athletes like Simone and Naomi prioritize their own mental health and are public about it, they are paving the way for it being ok to say you’re not ok mentally. Through their honesty and vulnerability, they have become role models and mental health advocates, and we applaud them for that.

But most of all we applaud them both for taking care of their mental health!

What love and support can you share for Simone and Naomi? Feel free to post in the comments.

Does this motivate and inspire you to be more open about your own anxiety and mental health challenges (if you have not been open yet)?

If you’re an athlete (professional or recreational), does any of this resonate with you and have the amino acids or diet helped you with your anxiety?

If you work with athletes (professional or recreational), I’d love to hear if this resonates with you and if you’re using nutritional psychiatry approaches with them to help ease their anxiety?

If you have connections to athletes (professional or recreational), or coaches, dieticians or psychologists who work with athletes, please share this blog and my work, so we can get nutritional psychiatry resources and anxiety nutrition solutions into their hands and help more athletes.

Tyrosine erases severe performance anxiety in a female musician: no more shaking, sweating, panic attacks and passing out

June 4, 2021 By Trudy Scott 42 Comments

Today I’m sharing the case of a female musician with severe performance anxiety. It was so severe that she would shake, sweat and actually pass out. She also had problems breathing which happens when you’re having a panic attack. Surprisingly, the amino acid supplement tyrosine eliminates – or as she says, erases – all these anxiety symptoms very quickly. It’s surprising because tyrosine is typically not used for easing anxiety symptoms and is instead used to support the low catecholamine symptoms: low motivation, low energy, poor focus, feeling flat and depressed (the curl-up-in-bed kind), cravings for sugary foods for better energy and the need for caffeine.

I share her story in her own words and explore some possible mechanisms around serotonin, cortisol, dopamine and GABA.

Pam initially shared on a Facebook thread how tyrosine erased her extreme performance anxiety and we dug deeper. This is the start of the conversation:

I’ve been performing (music) ever since I was seven, but I always hated it. For extreme performance anxiety, I found, way too late, that 1,500mg of l-tyrosine simply erased the shaking and fainting, and I was “just nervous like everybody else.”

I responded saying what a great result this was and shared that I found it so interesting that tyrosine erased the shaking and fainting that she experienced with her performance anxiety.

As I mentioned above, tyrosine is typically not used for anxiety. Instead, it’s used to improve the low catecholamine symptoms of poor focus, low energy and low motivation. (More on this here)

I also always want to understand the mechanism as to why an amino acid helps ease anxiety symptoms – or in this case erased them. I share more on that below.

When I asked what she meant by “just nervous like everybody else“, this was her response:

It means pretty much everyone gets performance nerves, but not to the point of fainting on stage. Knowing intellectually that that was ridiculous did not make any difference in the fact that it occurred.

I don’t even remember why I tried tyrosine, but I do remember the first time I took it 40 minutes before a performance. I waltzed out on stage ahead of time and sat in my chair warming up, showing off even, to a hall that was filling with people.

That was and is inconceivable without the tyrosine support, which I have to assume is putting my dopamine at a normal level. Yes, I get a little wired, which can be a good thing, but passing out, having my intestines demand to be emptied, not being able to breathe [is this a panic attack?], shaking, sweating….it fixes all of that.

It’s wonderful to hear such powerful results from 1,500mg tyrosine and how quickly it works. The latter is not surprising as this is typical with all the amino acids. They work quickly if it’s what you need and you have the ideal dose for your needs.

What is surprising is that tyrosine erased her severe performance anxiety symptoms. I immediately started trying to understand possible mechanisms.

What is the mechanism – a serotonin boost to improve confidence?

When I read “I waltzed out on stage ahead of time and sat in my chair warming up, showing off even, to a hall that was filling with people” I immediately thought of how tryptophan or 5-HTP works to give you a serotonin boost that improves your confidence.

However, Pam doesn’t feel the mechanism is related to low serotonin:

You would think, if it were serotonin, that SSRIs would be effective. They are not and cause me to have terror attacks.

She also shared that she recently gave 5-HTP a trial and it did nothing so that further supports her theory/gut feeling that her extreme performance anxiety is not related to low serotonin:

I think there is a belief system associated with serotonin that is not cognizant of the fact that the other neurotransmitters can be the culprits. I read someone’s web site sometime not that long ago, that detailed how to test all the major neurotransmitters, find out which ones were to low OR too high, and what amino acids to take to fix the imbalances. To me, this is a more comprehensive view than being stuck on serotonin.

Anxiety is not always caused by low serotonin or low GABA (although these causes are very common). I’m with Pam on finding which neurotransmitter imbalance you have. There is no one-size fits all and results can happen without us fully understanding why. It does sound like this is very much dopamine related for her but I wanted to understand how it was helping her.

What is the mechanism – lowering cortisol under extremely stressful situations?

I started looking into the research and found that one possible mechanism could be that tyrosine lowers the high cortisol that occurs after an extremely stressful situation – like going on stage to perform – and eases anxiety this way.

An animal study supports this theory: Dietary tyrosine suppresses the rise in plasma corticosterone following acute stress in rats:

Acute, uncontrollable stress increases norepinephrine (NE) turnover in the rat’s brain (depleting NE) and diminishes the animal’s subsequent tendency to explore a novel environment. Pre-treatment with tyrosine can reverse these adverse effects of stress, presumably by preventing the depletion of NE in the hypothalamus.

In the present study, we found that pre-treatment with supplemental tyrosine not only prevented the behavioral depression and hypothalamic NE depletion observed after an acute stress, but also suppressed the rise in plasma corticosterone. These results support a role for brain NE in stress-induced corticosterone secretion and demonstrate that supplemental tyrosine can protect against several adverse consequences of such stress.

Keep in mind that cortisol is the primary endogenous adrenal steroid in humans, whereas corticosterone is the primary adrenal corticosteroid in laboratory rats.

What is the mechanism – dopaminergic system influence on anxiety-like behavior?

I dug deeper into the research and found that there is evidence that dopamine plays an important role in anxiety modulation in different parts of the brain and that both dopamine D1 and D2 receptor mechanisms are important in mediating anxiety.

This paper, The Modulatory Role of Dopamine in Anxiety-like Behavior describes some of this, together with the role of GABA and glutamate:

The activity of dopaminergic system is modulated by several neurotransmitters, including glutamatergic neurons from the medial prefrontal cortex (mPFC), GABAergic fibers from the nucleus accumbens (NAc) as well as the ventral pallidum and cholinergic fibers from the pedunculopontine nucleus and the laterodorsal tegmental nucleus. Thus, changes in the glutamatergic, and GABAergic, as well as mediated transmission in the mesolimbic, mesocortical and nigrostriatal dopaminergic system may influence anxiety-like behavior.

In the past I’ve blogged about tyrosine for alleviating anxiety and panic attacks and creating a feeling of calm focus so this is not an isolated case but it is pretty unusual. As I share in the above blog, a man and a woman saw dramatic reductions in their anxiety when using tyrosine. GABA and tryptophan had not helped and both individuals were also under extreme stress. It was work stress in their cases and both of them felt that their ability to now focus in business situations eased their severe anxiety.

Regardless of the mechanism, Pam saw profound results and that is all that really matters.

My additional feedback on dosing and timing

Here is some additional feedback from me on dosing and timing. On one hand I recommend caution based on my experience with the amino acids. And on the other hand, what she did worked so I’m torn about her approach but am going to say it anyway:

A typical starting dose is 500mg tyrosine and I would never have anyone start with 1,500mg (even though it was the sweet spot for Pam). However, if she hadn’t used that dose, she would not have had the same results. I’m waiting to hear back if she started with 1,500mg tyrosine or worked up to this. (Pam also told a friend of hers about her results and the outcome was very different for her friend:“She tried 100mg of tyrosine and it caused her extreme nervousness, the opposite of me. I have to assume that 100mg put her at too *much* dopamine, and her genetic profile was significantly different from mine.” We are all unique and there is no one-size-fits-all.)
I would also be cautious about trying a new amino acid for the first time right before a major event like a musical performance. I have clients trial the amino acids at home before heading out. However, if she had done that she would likely have not experienced the desired results.

I feel it would be helpful to know if she had done a trial of GABA or tryptophan before using tyrosine but it seems she doesn’t recall this or why she decided to use 1,500mg tyrosine. If she hasn’t done I trial with both GABA and tryptophan, I would love her to consider this now in order to potentially take things up a notch further and ease her feelings of just being “nervous like everybody else”.

I appreciate Pam sharing her amazing results with tyrosine and I’m really happy for her! I’m waiting to hear back with details of what kind of musical performances she does. I’ll share this and the other information once I hear back.

I say it often and I’ll say it again – there is not a one-size-fits-all. This case illustrates this very well. Sometimes it’s methodical trial and error (my preference) and other times it’s hit and miss when nothing else seems to be helping.

Resources if you are new to using tyrosine as a supplement

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

If you suspect low 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.

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

As with all individual amino acids we use tyrosine for quick relief of symptoms, like Pam did. And we must also always focus on the foundations like diet, the gut, adrenals and stress levels.

Do you use or have you used tyrosine to help with performance anxiety – personally or with a patient/client?

And were you/are you surprised that this worked so well when tryptophan or 5-HTP or GABA had not worked as expected?

What other symptoms did/does the tyrosine help improve: focus, motivation, drive, low energy, low mood? And did/does it help reduce sugar cravings and the need for caffeine?

Feel free to post your questions here too.