neurotransmitter

Understanding the function of the GABAergic system and its potential role in rheumatoid arthritis (for pain, anxiety, sleep issues and more)

January 3, 2025 By Trudy Scott 2 Comments

This is a great question posed by a woman in my GABA/anxiety online group program:

Can GABA be good for rheumatoid arthritis, and in its early stages? If so, in what ways would someone see signs of improvement with GABA?

When I looked into some of the recent research on GABA and rheumatoid arthritis I was fascinated. A 2023 review paper, Understanding the function of the GABAergic system and its potential role in rheumatoid arthritis, discusses the relationship between rheumatoid arthritis (RA), an autoimmune condition, and GABA (gamma-amino butyric acid), a calming neurotransmitter.

The authors discuss “a new mechanism of action in RA” and the fact that “bidirectional communication occurs between the brain and immune system…and neuroinflammatory responses in the brain.”

The paper discusses GABA and neurosignalling, immunomodulatory effects and inflammation, stating that the:

GABAergic system may modulate the abnormal pain response in RA patients.

So to answer her question, if she has low GABA levels we would expect to see some reduction in her RA pain.

As always, we look for the signs and symptoms of low GABA regardless of the diagnosis or possible diagnosis. So if someone has low GABA symptoms of physical tension, overwhelm, fears, anxiousness, stiff and tense muscles, focus issues, pain, stress eating or drinking to calm down, and poor sleep, we consider a trial of the amino acid GABA, and could expect improvements in all or some of the above symptoms.

I would also recommend that she tracks markers of inflammation (like hs CRP, IL-6, IL-1β, and TNF-α) and RA markers to see if they shift in a positive direction with her use of GABA too.

I share more below about the incidence of anxiety and sleep issues in rheumatoid arthritis and some of the mechanisms covered in the review paper. Also, there are lab tests to track and there are other nutritional approaches for supporting an autoimmune condition such as RA.

Some of the mechanisms covered in the review paper

This image from the paper and the explanation provides some insights on the mechanisms at play.

Glutamate interacts with glutamate decarboxylase (GAD65 and GAD67) to produce gamma-aminobutyric acid (GABA).
Binding of GABA to GABA-A receptors inhibits macrophage activation and decreases the release of inflammatory factors such as IL-6, IL-1β, and TNF-α. Antigen presentation by antigen-presenting cells, however, is impaired, inhibiting CD4⁺ T cell proliferation and differentiation and reducing the expression of inflammatory factors such as IL-6, IL-1β, and TNF-α.
Pain signaling activates the P38/MAPK pathway, whereas GABA binding to GABA-A receptors inhibits P38/MAPK. The P38/MAPK signaling pathway contributes to inflammation and is involved in the activation of myocardin-related transcription factor A (MRTFA), myocardin-related transcription factor B (MRTFB), and serum response factor (SRF) that played key roles in fibroblast activation.

gaba and rheumatoid arthritis — Figure 1. Understanding the function of the GABAergic system and its potential role in rheumatoid arthritis

The authors don’t mention the use of the amino acid GABA as a supplement for RA but do list a number of clinical trials (mostly diabetes patients) where GABA has been used with success. It’s a start and I look forward to future research in this area.

Anxiety, depression, insomnia, cognitive issues and stress-eating in RA

This paper, Psychiatric aspects of rheumatoid arthritis: Review of literature, reports that

Among the major psychiatric disorders found in RA, the anxiety and depressive disorders are prevalent (13 to 48% of patients), as well as suicide, insomnia and tiredness. The impairment of quality of life is markedly after age 65.

This paper, A 30-Day Adjunct Wellness Intervention for the Management of Extra-Articular Symptoms of Rheumatoid Arthritis: A Formative Study, also mentions “cognitive and physical dysfunction” and “stress-related eating” in addition to anxiety, depression and insomnia in RA patients.

Doing a trial of GABA (and other amino acids such as tryptophan and d-phenylalanine/ DPA), will confirm which symptoms are related to which neurotransmitter deficiencies. It’s exciting to consider a very possible role of GABA and other amino acids given the fact that “individuals with rheumatoid arthritis (RA) continually fall short of treatment targets using standard drug therapies alone”

Looking further than GABA and other amino acids: a gluten-free diet and other root causes

With RA we obviously want to address more than just GABA (and other amino acids). Gluten removal is recommended but I do want to mention that the research is surprisingly mixed. This paper, Efficacy of gluten-free diet in patients with rheumatoid arthritis states that

Gluten seems to be a glycoprotein with a clinically relevant inflammatory effect. Several observational studies and anecdotal cases reported a correlation between gluten and various diseases, including autoimmune diseases, such as rheumatoid arthritis. This study aimed to evaluate whether gluten-free diet could be effective in controlling inflammation and ongoing rheumatoid arthritis symptoms.

We report 4 cases of patients with long-standing rheumatoid arthritis with no response to several conventional and biotechnological drugs, treated with a gluten-free diet concurrently with the drug therapy. Our patients presented different degrees of response to the diet, in terms of disease remission and improvement of symptoms. Our cases confirm that a gluten-free diet may improve symptoms of rheumatoid arthritis, even in patients resistant to conventional drug therapies.

Many other papers dismiss the role of gluten and inflammatory diets. This one is an example of a number of similar papers.

The benefits of addressing neurotransmitter imbalances with GABA and other amino acids means the addiction is stopped and quitting bread and cookies now no longer requires willpower,

Here are some autoimmune recipe resources:

In addition to dietary changes, a full functional medicine approach is warranted as there is much research supporting the benefits of the following for RA: omega-3 fatty acids, olive oil, low vitamin B6, addressing heavy metals such as mercury and much much more.

I cover 60+ root causes of anxiety here – I’d be carefully assessing each of these root causes for RA too.

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 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.

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

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

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

Do you have rheumatoid arthritis (RA) or another autoimmune condition and has GABA helped?

Were you aware of these possible connections?

What about dietary and nutritional approaches?

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

Calming GABA, tryptophan to relinquish the evening bottle of red wine, theanine for focus and the pyroluria protocol

November 29, 2024 By Trudy Scott 5 Comments

gaba tryptophan theanine

I’m 61 years old postmenopausal. 2 GABA Calm under my tongue the second my eyes open in the morning. I keep it at the bedside. So that’s 250mg.

In the beginning I would also use two if I woke up at 2AM with a panic attack. That doesn’t happen as much anymore. I keep a bottle in my purse for panic attacks during the day. I haven’t had one of those in a couple of years. When I have a low stress week ahead, such as no social interaction scheduled, I go several days without any, but then that clutch in my chest reminds me to start back.

I also am diligent in treating my Pyroluria (diagnosed with a urine test)…it makes a difference. Daily zinc, B vitamins (especially 15mg methylfolate/day – check out the research papers on that dose being as effective as most antidepressants, I’m heterozygous not homozygous, MTHFR), Magnesium Threonate.

I am having good results with 1000 mg L-Tryptophan/day. I’ve just started adding another 1000mg/day in a bid to relinquish my evening bottle of red wine.

I keep a bottle of L-theanine on hand if I have a day ahead that I need to focus. ADHD does not improve with age!! I seriously liked it better in my day when my third-grade teacher labeled me a “dreamer”. Fortunately, I live on a farm and the cows don’t seem to mind that it takes me a bit to focus long enough to get the chores done.

I also have a regular yoga practice and I do physical work outside and in the winter use a SAD light.

I will also add that the last 8 months I have been in a very stressful family situation at home and the above regimen is holding.

If anyone has stuck with this wandering post to the end, don’t give up. Keep fighting to find what works for you.

Jennifer responded with the above in response to my question on Facebook about your starting GABA dose and if it’s changed over the years based on stress levels, hormone changes and life events.

I thanked her for sharing and for her encouraging words for others in the community and asked if I could share her feedback as a blog. She said yes saying “I have learned so very much from the stories of others on the page” – so here we are …

Stories offer hope, motivation and inspiration and we do learn so much from them.

I also told her that she is a poster child for how we want to use GABA and share more about that and her desire to relinquish her bottle of wine (and how amino acids make it easier) below.

She is a poster child for how we want to use GABA

Initially a higher dose of GABA may be needed and then as GABA levels increase and we also start to address other underlying root causes, less GABA is needed on a regular basis.

Initially Jennifer needed 4 x GABA Calm (for a total of 400mg/day) and then just 250mg GABA per day once she addressed pyroluria and B vitamin deficiencies. Yoga also supports GABA production.

On some low-stress days she doesn’t need any GABA at all, but she wisely keeps some in her purse for “panic attacks during the day” (but hasn’t had one in a couple of years).

She had struggled with perimenopause: “I must say that postmenopausal is a hell of a lot better, even with the paper thin skin and wrinkles, than the hell that was perimenopause!!!!”

And she did mention her phenyl-GABA mistake/ignorance and the fact that I helped her identify this issue 5 years ago. If you’re not aware, phenyl-GABA or phenibut can cause similar tolerance, dependence and discontinuation issues to benzodiazepines. More on phenibut here.

All of the above very likely contributed to her higher need for GABA initially.

Additional serotonin support to relinquish her evening bottle of red wine

Jennifer is already supporting her serotonin with 1000mg tryptophan per day, a SAD light in winter and physical exercise on the farm.

Afternoon and evening cravings are common when serotonin isn’t optimal – this can be carb/sugar cravings and/or also a need to self-medicate with wine. The first step is to recognize and acknowledge that a bottle of wine each evening is too much.

This amount of alcohol affects the liver, contributes to leaky gut, can cause blood sugar swings and reduces B vitamins, especially thiamine/vitamin B3. And it could also be considered an added “stress” if you have pyroluria.

Most of us are aware of these harmful effects and yet cannot easily quit. Her use of the word relinquish is a clue as to how she feels about this i.e. some common synonyms of relinquish are “abandon, resign, surrender” which “may suggest some regret, reluctance, or weakness.”

But because she understands the power of amino acids, she plans to increase her tryptophan from 1000mg to 2000mg to address this addiction without the need for willpower or with no feelings of regret or surrender.

If you are new to using this tryptophan for this purpose, this blog is worth reading: Tryptophan had the added benefit of turning me completely off alcohol when I took it to improve mood and sleep during perimenopause

Theanine for when she needs additional focus

Theanine provides a feeling of calm focus, offering support for the following neurotransmitters: GABA, serotonin and dopamine.

Jennifer also uses 400mg of theanine (Suntheanine) for her focus issues, using it only on days she needs it. She says “I rarely have a day when I would need more than 3-4 hours of paperwork concentration as my life on the farm and keeping up with grandchildren is more physical than mental focus.”

Now that she has used GABA, tryptophan and theanine with success, she has these amino acids in her toolbox whenever she needs them in the future and when she needs to increase the dose if the situation requires a change.

A few GABA product options – a sublingual and a powder

Jennifer used Source Naturals GABA Calm lozenges, a product I recommend. 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. 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%).

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

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

Wrapping up and your feedback

I appreciate Jennifer for sharing and giving me permission to share her story on the blog. Despite the wine and her very stressful family situation I am thrilled she says she is doing well. I also love that she ends with this: “… don’t give up. Keep fighting to find what works for you.”

I’d love to hear from you – has any of this worked for you?

Feel free to share about your GABA success and how much it helps you and if this has changed over time. And let us know what you feel has contributed to the need for less or more GABA i.e. which other root causes have you addressed?

Feel free to share if tryptophan (or another amino acid) has helped with quitting wine or another alcoholic beverage.

And do share if you use theanine for calm focus.

Feel free to share and ask your questions below.

GABA and theanine for sedation, anxiety, and cognition in preoperative surgical patients (a randomized controlled study)

October 18, 2024 By Trudy Scott 7 Comments

L-theanine is a unique amino acid found in green tea. It prevents stress, produces anxiolysis, modulates alpha activity, and provides beneficial effects on mental state, including sleep quality.

Gamma-aminobutyric acid (GABA) is a non-proteinogenic amino acid and a phytochemical that is the main inhibitory neurotransmitter in the mammalian brain. It is beneficial in anxiety and stress regulation.

This overview of theanine and GABA come from this paper, Comparison of the effects of two amino acids, Gamma-aminobutyric acid (GABA) and L-theanine, on sedation, anxiety, and cognition in preoperative surgical patients – A randomized controlled study, a very promising paper published in May this year.

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

The conclusion is that: “GABA and L-theanine result in effective preoperative anxiolysis with minimal sedation and improvement of cognitive skills.”

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

There are a number of reasons why I feel this study is so promising: anxiety before surgery is very common; laryngospasms (or vocal cord spasms) during surgery are potentially life threatening and clinically we see GABA to be helpful outside of the surgical setting; and any research confirming the calming benefits of GABA (and other amino acids like theanine) supports what we see clinically and furthers the field. This is especially the case when it’s a randomized controlled study such as this one. More on all this below.

The study information and benzodiazepine comparison with GABA/theanine

It was a small study with a “total of 168 patients aged between 18 and 55 years .. who were randomly divided into three groups that received either oral L-theanine, oral GABA, or oral alprazolam 0.25 mg. The anxiety score, sedation score, and psychomotor and cognitive performance scores were noted 60 minutes before and after the administration of the drugs” and amino acids.

Alprazolam is an antianxiety medication known as a benzodiazepine which impairs “psychomotor performance and cause excessive sedation.” I’ve blogged extensively about many of the known issues with benzodiazepines.

Because of this it’s worth noting that the authors share this exciting information: “To our knowledge, our study is the first comparative study that compares GABA with L-theanine and alprazolam.”

This in itself is very encouraging but more so because the outcome “showed that oral L-theanine, oral GABA, and oral alprazolam were equally effective in producing anxiolysis.”

How much GABA and theanine was used in the study? And what is optimal?

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

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

You can read the entire study here: Comparison of the effects of two amino acids, Gamma-aminobutyric acid (GABA) and L-theanine, on sedation, anxiety, and cognition in preoperative surgical patients – A randomized controlled study

Laryngospasms during anesthetic – could GABA help prevent this?

Laryngospasm is a life threatening complication during the perioperative period (time of surgery) with an incidence of 0.78-5% depending on the surgical type, patient age, pre-existing conditions and anesthetic technique.”

It is described as “the sustained closure of the vocal cords resulting in the partial or complete loss of the patient’s airway. Although described in the conscious state and associated with silent reflux, laryngospasm is a problematic reflex which occurs often under general anaesthesia.”

The authors state that “a clear management plan is required to avoid significant morbidity and even mortality.” They do discuss the use of magnesium “due to both an increased depth of anaesthetic and muscle relaxation” and the authors state that this “agent may have a role to play in the future prevention of laryngospasm, but more studies are needed.”

Clinically we see GABA to be helpful for the prevention of laryngospasms outside of a surgical setting (I blogged about this here) and it’s intriguing to consider that the use of GABA before surgery may actually help prevent or reduce the severity of this complication. I look forward to future research on this application of GABA.

Until then it may be worth discussing with your surgeon and anesthetist. I have a family member who is susceptible to laryngospasms and GABA powder rubbed on the inside of his cheek during an episode, stops the spasm and stridor (abnormal high-pitched sound) in a matter of 30 seconds. Prior to a recent surgical procedure, he discussed this with his surgeon and anesthetist. We were both pleasantly surprised that they were both interested and open to having him take GABA with him into surgery.

GABA for anxiety, stress, muscle spasms and pain too

I shared this excerpt in a recent blog but it’s worth sharing again: a number of studies have shown that “GABA is implicated in a large number of diseases including anxiety and stress disorders, pain, musculoskeletal disorders, sleep disorders, depression, addiction and withdrawal syndromes.”

Let’s consider GABA (and theanine) during the often stressful and anxiety-provoking periods leading up to surgery and on the day of surgery. It’s likely to help with muscle spasms, pain reduction and sleep too.

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

The authors had the study participants use 500 mg GABA, swallowed. As I mentioned above, using a lower dose sublingually may be as effective or possibly even more effective. Also, dosing of GABA (and other amino acids) is individualized to the unique needs of the person.

One product I use and recommend is Source Naturals GABA Calm lozenges. It’s a good low dose of 125 mg and is convenient and effective because it’s a sublingual lozenge.

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 children and those with special needs. 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%.

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.

Wrapping up and your feedback

I’d love to hear from you – does any of this resonate with you? Do you feel increasingly anxious before surgery and other medical procedures and is GABA and/or theanine part of your calming repertoire?

And have either helped you when experiencing a laryngospasm?

Have you ever discussed either of these two amino acids with your surgeon or anesthetist prior to surgery and were they open?

If you’re a practitioner do you recommend GABA and theanine to your anxious clients/patients and as a surgeon or anesthetist would you consider these amino acids in the future (especially in patients more prone to laryngospasm)?

Feel free to share and ask your questions below.

How to use GABA cream for a 9 year old boy who is anxious, has sensory issues, is a picky eater and has anger outbursts?

May 3, 2024 By Trudy Scott 8 Comments

Devon is looking for input on using a GABA cream product to help her anxious 9-year old son who has some anger and sensory issues. She’d like advice on timing too. He is a picky eater and doesn’t like GABA Calm. I share my insights about using GABA cream for raising levels of GABA (a calming neurotransmitter), some of the GABA sensory connections, the GABA anger connections and other factors to address (nutritional imbalances, diet and infections).

Here is her question and some additional background information from our online discussion:

My son has SPD/GAD (sensory processing disorder/generalized anxiety disorder). His anxiety is causing school refusal and a lot of angry outbursts. I suspect PANDAS but his primary care doctor doesn’t think he has that (I might try a different path).

He doesn’t have a problem with sleep, it is mostly anxiety/anger in the day. I am wondering if he can use this GABA cream during the day vs at night?Or would applying this at night help him through the day?

I am really hopeful that the GABA cream will help him attain a little more peace in his days.

Devon doesn’t recall if ARFID (Avoidant restrictive food intake disorder) was part of his diagnosis but he is a picky eater and

has a carb heavy diet that centers only around certain foods. He recently added corn on the cob and artichokes.

He has tried GABA here and there but can’t get past the flavor of the chewable so has never taken it consistently.

Any thoughts on this would be great. I have learned so much from your blog. Thank you for all of the info you share.

Using GABA cream for a child with these symptoms

Devon asked this question on the Somnium Nighttime GABA Cream blog where I write about using it for insomnia, anxiety, bloated belly, muscle spasms, MS (multiple sclerosis), ARFID, anorexia, Alzheimer’s and autism.

I shared that I’ve had many parents use GABA cream during the day with success to help with anxious feelings their children are experiencing. With sleep not being an issue for her son I would start really low and increase the amount and timing from there based on symptom resolution. A pea-size amount is recommended and I’d start with a 1/4 of this in the morning before school when the symptoms are causing school refusal.

Devon doesn’t mention if they noticed benefits with GABA Calm but we use sublingual /powder/liposomal GABA in a similar way. So when this has helped in the past it’s a good clue that GABA cream will help.

Sublingual /powder/ liposomal GABA is typically used morning, mid-morning, mid-afternoon, evening and during the night if needed. Similar timing can be followed with the cream, however, for some children (and adults) just once a day may be enough with additional use based on the situation, for example anger outbursts at a play date. The key to use is to start low and go slow and figure out what works for each child’s unique needs. More severe symptoms don’t necessarily mean more GABA is needed. The other key is consistency in order to increase GABA levels.

It can be applied behind the ears, inner forearm and belly but keep in mind that mom or the caregiver applying it will be getting a dose of GABA too.

A clue that too much is being used is increased sleepiness. If benefits are seen but the child is too sleepy another option is to use it at night and observe if benefits are carried through to the next day.

The GABA research: autism, social impairment and sensory issues

In this paper looking at autistic children, the authors report “increased cerebellar glutamate levels compared to neurotypical children” which means lower GABA levels. They also found that “altered excitatory/inhibitory signaling in the cerebellum was more clear-cut when analyses were restricted to male participants.” And this altered signaling of GABA/glutamate correlated with “more severe social impairment” in males.

This paper looking at adults with autism highlights the relationships “between sensory processing difficulties, loneliness, and anxiety.” And another study identifies “reduced inhibitory neurotransmission (reduced GABA) in a higher-order motor area, which modulates motor commands and integrates multiple sensory modalities” and “may underlie sensory hyper-responsiveness in ASD (autism spectrum disorder).”

Although Devon’s son hasn’t been diagnosed with autism, many of the studies have been done in this population and much can be gleaned from them.

There is also much clinical evidence supporting how GABA can help in situations like this and it’s not only in boys. This blog is just one example that highlights how GABA Calm helped a young girl improve her sleep issues, anxiety feelings and sensorimotor skills.

Picky eating, carb cravings, ARFID and the neurotransmitters

When the picky eating and carb cravings are driven by low GABA and stress/physical anxiety, GABA cream can help reduce those in the same way sublingual GABA does.

Anger is typically associated with low serotonin but can often be low GABA too. More here – GABA helps ease symptoms of anger, rage, and dark moods. I share one paper that reports “Gamma-aminobutyric acid (GABA), the primary inhibitory neurotransmitter, may be critical in the neurochemical control of aggressive behavior.”

I’d also consider low serotonin as a possible contributing factor because other signs are increased anxious feelings, and also late afternoon and evening cravings.

Devon is not sure if ARFID is part of her son’s diagnosis but addressing low serotonin can help if there is an element of fear around eating too. More on ARFID here.

Just like we track his anxious feelings and outburst of anger, tracking his eating is important too. And introducing one amino acid at a time so there is no confusion as to which one is helping which symptoms.

Pyroluria, low zinc, low vitamin B6, low magnesium and dietary factors

Zinc, vitamin B6 and magnesium are needed for neurotransmitter production i.e. to make GABA and serotonin. They are also very common deficiencies and looking at and addressing low levels are important. Zinc also affects appetite and low levels can make sensory issues more severe.

Devon shares that suspects his zinc levels a few years ago were good, based on the liquid zinc test. Levels can change and given her son’s school refusal I’d assess for the social anxiety condition called pyroluria (zinc and vitamin B6 are key). The liquid zinc is also a great way to increase zinc since it tastes like water if you are deficient.

Topical magnesium is an excellent option – as a spray, a roller (she has been using this with him) – or epsom salts baths are another option for increasing magnesium.

As always dietary factors need to be addressed as and when his sensory issues improve: real whole food, quality animal protein (especially at breakfast for blood sugar control), organic fruits and veggies, healthy fats, fermented veggies, gluten-free (and possibly grain-free), sugar-free and caffeine-free. And special diets may need to be considered too – low oxalate, low salicylate, low glutamate and/or low phenol.

PANDAS, Lyme disease and addressing the infection/s

Devon mentions that she suspects PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections) and it’s unfortunate that she is being dismissed but sadly it’s not unusual. It’s important to find a doctor who will support her in getting testing for this and either ruling it out or addressing the infection/s. You can read more about PANDAS and PANS here.

She doesn’t mention Lyme disease but I’m mentioning it because many infections can cause neuropsychiatric symptoms and should be considered.

The good news is that supporting low GABA, low serotonin and other imbalances, does provide much symptom relief. But we always want to get to the root cause as to why there are imbalances.

A topical GABA product: Somnium

Use this link to read more about Somnium and get the coupon code.

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

As a reminder, low GABA can cause physical tension, anxious feelings, feelings of panic and problems sleeping, as well as self–medicating with alcohol or carbs to relax or fit in. As always, I use the symptoms questionnaire to figure out if low GABA 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 do always appreciate questions like this so keep them coming so I can share and educate further. I will also update this blog once I hear back from Devon. She has purchased Somnium GABA Cream and plans to have her son use it.

And keep in mind, although this blog is specific for sensitive children and teens, it’s applicable to adults and folks who prefer a cream to a supplement.

Now I’d love to hear from you – does your child have low GABA levels and have you considered using a GABA cream?

If you have had success with Somnim please do share how it helps, how much you use and where you apply it?

Have you also addressed other nutritional imbalances, infections and diet?

If you’re a practitioner do you use GABA cream with your clients/patients?

And please let me know if it’s helpful that I’m now including product recommendations and where to get them.

Feel free to share and ask your questions below.

Half a crushed GABA Calm for my autistic child: sleep, anxiety and sensorimotor skills (writing, horse riding and swimming) improve

January 6, 2023 By Trudy Scott 28 Comments

The inhibitory neurotransmitter GABA (gamma-aminobutyric acid) and the main excitatory neurotransmitter glutamate released by neurons in the cerebellum play an important role in sensory processing in autism. Research shows GABA to be low and glutamate to be elevated in autism spectrum disorders. While we don’t have any research supporting the amino acid GABA (used as a supplement) to raise GABA levels (and counter high glutamate levels) in autism, we do have much clinical evidence i.e. GABA can have a major impact on sensorimotor skills, as well as improving sleep, anxiety and social interaction. Today I’m sharing feedback from a mom whose autistic child is experiencing these benefits. Here is Vic’s feedback in her own words:

I use half a GABA tablet crushed in liquid for my autistic child (the Source Naturals you recommend) and it definitely helps. A whole GABA tablet and we see increased waking in the night but half seems perfect.

I’m using GABA in combination with 5-HTP. GABA was added after 5-HTP because it didn’t feel enough on its own and sleep and anxiety definitely improved at that point. We tried L–tryptophan first without success.

Sleep and sensorimotor skills have improved since weaning off an SSRI and onto the above combination as her willingness to engage with social interaction. We are also working on OT (occupational therapy) and retained reflexes and so improvements may be from that too.

Oh also supplementing b6, but not zinc as she refused it due to taste (which from reading means she probably doesn’t need it)

On a personal note there’s no way I’d manage to get her to drink [GABA Oolong] tea with her taste sensitivities – same reason I’m crushing rather than sublingual so practically speaking Source Naturals GABA is much easier than copying what they did in the study.

Vic is referring to the GABA Oolong tea study – GABA Oolong tea in children with autism: improvements in sensorimotor skills, autism profiles, anxiety and sleep (new research).

This very small (nine children) recent study found “significant improvement in manual dexterity and some large individual improvements in balance, sensory responsivity, DSM-5 criteria and cortisol levels with GABA tea.” They ingested the equivalent of 39.2 mg GABA for the day.

Sensorimotor skills that have improved: pen and pencil use, horse riding and swimming

I was thrilled to see her wonderful feedback in the comments section of the above blog and shared my delight, asking her which sensorimotor skills have improved. Vic shared this:

Sensorimotor wise, the biggest improvement I’ve noticed is her pen and pencil use – she’s actually being able to write and draw what she wants better than she was and she’s less avoidant of it in general. Her hand/eye referencing is noticeably better and her pressure control with a writing implement.

Her balance and core strength is improving (OT feel core strength generally doesn’t come properly until those internal senses are functioning) – her horse riding instructor commented on the change in how she is able to hold herself on a horse – especially when the horse got an unexpected itch the other week and she could simply adjust her body without conscious effort. Before she would have wobbled if a horse had done that.

She’s now teaching herself to swim as she has a better sense of body awareness to coordinate her limbs to all be doing what she wants.

So yeah mostly vestibular, proprioception and interoception are all working better!

As you’ll read below, research does show that GABA plays a role in sensorimotor difficulties in autism.

Some of my feedback on the GABA product and dosing, and adding it after 5-HTP

In case you’re not familiar with the Source Naturals GABA Calm product, it’s a sublingual tablet that contains 125 mg GABA (and some other ingredients). It’s typically used as a sublingual i.e. held in the mouth and dissolved, but this mom has figured out that crushing it and mixing it in liquid works best for her daughter.

To see these results with only 62 mg GABA is impressive. But as I’ve shared before, dosage does depend on your unique needs and there can be a large variation in dosing. As mentioned above, in the GABA Oolong autism study, the equivalent of 39.2 mg GABA was used daily.

That said, I did say I’d consider exploring a GABA only product at night if there are still some low GABA symptoms that remain. This could also be mixed in water.

Given that her daughter is doing occupational therapy too and also using 5-HTP and vitamin B6 (since low serotonin and pyroluria/social anxiety is common in autism) it can be challenging to tease out how much has improved with GABA alone. Vic did add GABA after having started 5-HTP and this is the best way to know what is helping which symptoms i.e. using a layered approach.

It’s also good that she figured out 5-HTP was beneficial when tryptophan wasn’t. It’s not unusual that some folks do better on one vs the other.

GABA does play a role sensorimotor difficulties in autism – the research

As reported in this 2016 paper, The Role of Sensorimotor Difficulties in Autism Spectrum Conditions:

In addition to difficulties in social communication, current diagnostic criteria for autism spectrum conditions also incorporate sensorimotor difficulties, repetitive motor movements, and atypical reactivity to sensory input.

GABA does play a role in sensorimotor difficulties as reported in this same paper. Here are some of the highlights:

The inhibitory neurotransmitter GABA (gamma-aminobutyric acid) and the main excitatory neurotransmitter glutamate released by [neurons in the cerebellum] play an important role in sensory discrimination in autism. GABA is known to decrease the firing of neurons , thereby reducing and inhibiting sensory feedback.
GABAergic functioning has been implicated in tactile reactivity.
Reductions in GABAergic system have been discovered in brain tissue: with significant reductions in GABA_A receptors, 63% reduction in comparison to controls, and a reduction by 61% of the glutamic acid decarboxylase protein (the enzyme responsible for converting glutamate into GABA).
Increased glutamate levels (excitatory neurotransmitter) in blood and platelets have been found in autism subjects, suggesting impaired conversion of glutamate to GABA, consequently increasing the excitatory state of the brain.

In the section on future directions, the authors conclude that addressing the deficiency of the inhibitory neurotransmitter GABA in the cerebellum of those with autism, “could have a global impact on sensorimotor planning, cognitive and social development.” They recommend a non-evasive GABA substitute such as oolong tea.

Elsewhere in the paper, they mention the amino acid l-theanine which “blocks the binding of l-glutamic acid to glutamate receptors in the brain, thereby perhaps aiding the improvement in motor activity by increasing inhibition of movement.”

I’d like to propose that the amino acid GABA is the subject of future research, given what we see clinically.

Resources if you are new to using amino acids as supplements

If you are new to using GABA or any of the other 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).

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.

Another option is the budget-friendly GABA QuickStart Homestudy program.

If you also 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

I’m so happy for this young girl and she and her family must be thrilled with her results. I really do appreciate Vic for sharing this outcome – it’s so inspiring and also motivating if you are a parent.

Have you used the amino acid GABA personally or with clients/patients and observed improvements in sensorimotor skills? How much and what benefits have you seen? Which product have you used? Please do share if the diagnosis is autism spectrum disorder or something else.

Have you also seen improvements with anxiety, sleep and social skills when using the amino acid GABA?

Feel free to post your questions and feedback in the comments below.

Urinary neurotransmitter testing reports elevated GABA when it’s really low: using the low GABA symptoms and a trial of GABA is best

September 23, 2022 By Trudy Scott 4 Comments

Francoise posted this feedback and her surprise about her elevated GABA levels – as reported on a urinary neurotransmitter test. She was justifiably confused because she had looked at the low GABA symptoms and resonated with them i.e. physical anxiety/tension, stiff and tense muscles, stress eating, self-medicating with alcohol, insomnia and intrusive thoughts etc:

I previously bought Gaba Calm after reading your blog since my symptoms seemed to match your description [of low GABA].

However, I recently did an exhaustive neurotransmitter test to realize that it was the exact opposite, having a significantly high level of GABA.

Unfortunately, I’ve looked all over the internet after talking to my doctor, and it seems that no one knows how to downregulate GABA.

Not sure what to do from there, but thought I should let you know that the situation exists despite not being common.

I posted this feedback for her: I do not use urinary neurotransmitter testing as it’s not accurate. I use the low GABA symptoms questionnaire and we do a trial of GABA if low GABA symptoms are present.

She said it perfectly – “I previously bought Gaba Calm after reading your blog since my symptoms seemed to match your description” i.e. it’s very likely she does in fact have low GABA symptoms and if we were working together I’d have her do trial of GABA.

I did ask her what her doctor and the lab recommended and to share the name of the lab/test and have yet to hear back. I will share when I do.

Someone else also had the neurotransmitter report high GABA so she stopped taking her GABA supplements

When I shared Francoise’s comment and my feedback on Facebook, I had someone share a very similar outcome. Kristin had already figured out that she had low GABA levels (based on the symptoms questionnaire), was already taking GABA with good results and was then told to stop taking GABA because the urinary neurotransmitter test reported elevated GABA levels!

This is what Kristin shared on Facebook: “I just did the neurotransmitter test. It said I was high in GABA as well, so I stopped taking it.”

These were the questions I asked her: Why were you taking GABA at the time – was it because you had/have low GABA symptoms and was GABA helping to ease these symptoms? I also asked which lab did the test and what her practitioner recommended? She shared the following:

I was taking GABA for anxiety. It was helping. .

My doctor recommended that I stop the GABA and use supplements to support the areas I was low in, which were: Dopamine, Norepinephrine, Epinephrine, and Serotonin (was VERY low).

Doctor’s Data is the company. And it wasn’t a cheap test.

I was surprised that even though GABA was helping Kristin, the doctor said to stop using it. What does also concern me too is that supporting dopamine, norepinephrine and epinephrine without supporting GABA can actually increase anxiety. I’ve seen this backfire a number of times.

After seeing my post and our Facebook back and forth she decided to start back on the GABA products she had been taking: GABA Calm 1-3 tablets a day and if she is struggling terribly with morning anxiety, then 1/2 to 1 tablet as needed. In the evening she takes 2 capsules of Neurocalm which has 100 mg of GABA (and some other ingredients).

Kristin confirmed that, once again, GABA was helping to ease her intrusive thoughts, anxiety and physical tension, all low GABA symptoms.

I said to Kristin that I’d reach out to Doctor’s Data and have done so. I shared all this and I am hoping to hear back from them. I’ll keep you posted when I do.

Kristin has offered to share this blog with her integrative doctor who prescribed this test. I’m hoping she does and you do too.

I appreciate both these women sharing their experiences so I can share with you.

Urinary neurotransmitter testing falls short and other practitioners weigh in too

I find many functional tests extremely useful and Doctor’s Data is well regarded in functional medicine. However, I do find it very unfortunate that so many practitioners continue to use and recommend this test when it’s not useful, doesn’t correlate with symptoms and so often causes confusion, like in these instances (which are just two of many similar cases). By the way, they are not the only lab offering urinary neurotransmitter testing.

Be sure to read this older blog: Urinary neurotransmitter testing falls short where I share more about why I’m not in favor of this testing.

This feedback from Nora Gedgaudas, author of Primal Body Primal Mind sums up what I often hear from other practitioners:

I have considered the urinary testing approach and was even enamored of the concept at first. Once I looked into the idea more closely, though, it just didn’t add up for me. I have been using amino acids now to address issues of mood, health and cognitive functioning for over 20 years. I have never used anything other than mood/symptomatic screening to guide amino acid supplementation. Results tend to be uniformly good to excellent. The sheer overwhelming complexity of amino acid/neurotransmitter activity in the human body/brain-and the compartmentalized nature of the biochemistry of each seems to best lend itself to a more functional and symptom-related evaluation. Lab testing simply falls short of the mark here.

A colleague and good friend of mine, Dr. Josh Friedman posted this in the comments section of the above blog post (back in 2014), further supporting what practitioners are reporting about this testing:

About a year ago I got excited about urinary neurotransmitter testing. I had been using Julia Ross’ pencil and paper neurotransmitter deficiency assessment for many years with good success. Over the past year I have done the neurotransmitter testing on about 10 people with very inconsistent results. With 2-3 we hit a home run, where the recommended supplements were just the right thing to diminish the presenting symptoms. More often than not the recommended supplements seemed to give little relief or even make the symptoms worse. Additionally the testing and supplements are quite expensive.

I have since given up on the testing and as I have found the pencil and paper NT deficiency sheet to be a more effective guide to treatment. When I am unable to make progress I will often turn to serum amino acid testing and the neurotransmitter markers on the Organic acid test offered by many functional medicine labs. In addition to information about neurotransmitter functioning, the Organic Acid Test provides information about other factors involved in mental health symptoms including levels of the yeast Candida, the bacterial infection Clostridia and others.

Of course, I wholeheartedly agree with both of them.

As you can see from these two cases (and the many others in my book and on this blog), using the low GABA symptoms and a trial of GABA is best. It’s the most effective way to determine if you need GABA initially and to monitor how it’s helping. It also doesn’t cost you anything more than your time and the GABA product/s.

Resources if you are new to using 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 serotonin and low GABA).

Have you done urinary neurotransmitter testing and did any of it correlate with the neurotransmitter deficiency symptoms?

Have you been told to stop GABA that was helping to ease your symptoms – based on labs showing high GABA?

If you’re a practitioner I’d love to hear your experiences using the urinary neurotransmitter testing.

If you have questions please share them here too.