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

By Trudy Scott 54 Comments

gaba dosage and needs

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Here are the symptoms.

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

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

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

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

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

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

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

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

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

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

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

Resources if you are new to using GABA as a supplement

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

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

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

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

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

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

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

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

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

Feel free to ask your questions here too.

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

By Trudy Scott 19 Comments

dpa

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

Here is the question that was posted:

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

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

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

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

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

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

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

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

If you are new to DPA and endorphin support

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

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

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

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

In summary, these are the signs of low endorphins:

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

DPA and endorphin support for pain: the research

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

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

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

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

Is DPA the same as DLPA?

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

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

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

The brand of DPA that I recommend for my clients

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

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

lidtke endorphigen

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

Benefits include reduction of emotional/comfort eating too

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

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

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

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

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

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

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

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

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

A comprehensive approach is key

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

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

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

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

If you are new to using the amino acids, DPA, tryptophan or GABA, as supplements and want to know more, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution and a brief overview here, Anxiety and targeted individual amino acid supplements: a summary.

If you suspect low endorphins, low serotonin or low GABA levels and do not yet have my book, The Antianxiety Food Solution – How the Foods You Eat Can Help You Calm Your Anxious Mind, Improve Your Mood, and End Cravings, I highly recommend getting it and reading it before jumping in and using amino acids so you are knowledgeable.

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

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

What about less emotional eating when using DPA/Endorphigen?

Feel free to post your questions too.

Swings are fun for teens, college students and adults! And they reduce stress/anxiety, and improve mood, memory and PMS symptoms

By Trudy Scott 21 Comments

swings for anxiety

Earlier this month I met up with a dear childhood friend for a walk and catch-up and we both rediscovered the joy of swings. I always suggest a walk or hike or swim when meeting with friends and colleagues, and this time was no different except that I really wanted to go somewhere with a swing!

The reason that I wanted to find a swing set was because I had just read an article about swings and teen girls needing a better place to hang out. I love the outdoors and love to play, laugh and have fun, and I couldn’t resist it once I started looking at the research. I discovered all the wonderful benefits of improved mood, reduced anxiety and stress, improved cognition and memory, reduced PMS symptoms, improved social relationships and reduced pain.

These pictures are us swinging and catching up – we laughed and laughed and had such fun!  It’s hard to believe we’ve been friends for close to 50 years and it always feels like we were never apart when we do get together.

swings

Our swing experience made it extra special this time! You can see the pure joy on our faces!

Teen girls needing a better public space to hang out

The recent Bloomberg article I had read, Teen Girls Need Better Public Spaces to Hang Out shares this:

Making space for girls means rethinking which age groups need to swing and climb, how to encourage physical activity (and not just playing a sport), and how to make a safe, sheltered place for outdoor conversation.

And this about movement:

While lack of activity among teens is a major public health issue, many girls are looking for more creative, less competitive ways of moving their bodies.

It features really cool images of swings called “Swing Time.” They are designed by Höweler + Yoon Architecture and deliver “the kind of fun, physical outdoor experience with room for face-to-face conversation that many teen girls are looking for.”

As I mentioned above, I was immediately intrigued because I love the idea of outdoor play and social interaction in a safe place for young girls.

Beth Jones, a Mindset and Wellness Coach who works with teen girls and their moms incorporating movement, play and nutrition, posted the Bloomberg article on Facebook saying:

I love this idea so much. I used to love going to the playground in my teens to swing, hang out, just have a space for me. There’s a reason why my business logo has a girl on a swing. That swinging and twisting are also so great for the vestibular system and can help calm anxiety (the back and forth swinging). Maybe they should bring back some swings to middle and high schools.

I’m familiar with the use of swings in occupational therapy to address sensory processing disorders in children. But I was also very interested to know if there was any research on the health benefits of swings for teens and adults. I went searching and was very pleased with what I found, hence this blog post.

Before we get into the research I’d like to extend a big thanks to Beth Jones for the inspiration for all this! Now the research …..

PMS symptoms improved: mood, stress, anxiety, social relationships, pain and memory

This small study, Vestibular stimulation for management of premenstrual syndrome found the following benefits after 2 months of using the swing in females 18-30 years of age:

  • Depression and stress scores decreased
  • Anxiety scores decreased (although it was not statistically significant)
  • Serum cortisol levels decreased.
  • Social relationships improved
  • Systolic blood pressure decreased (there was no change in diastolic blood pressure and pulse rate)
  • Pain levels decreased
  • Spatial and verbal memory improved

These are amazing benefits using something as simple as a swing. I feel we could safely extrapolate to younger teen girls and even women above 30 years of age too.

Swings for stress management in college students

Vestibular stimulation using swings is the specialty of Dr. Mukkadan, Founder and Research Director of Little Flower Medical Research Centre in India. Together with his team, he published the above PMS paper and this paper on Vestibular Stimulation for Stress Management in Students.

They recommend “placement of swings in college campuses … which may be a simple approach to alleviate stress among college students.”

This is such a simple and yet powerful (and also fun!) intervention especially given the huge rise in anxiety and mental health issues in students. It would be a perfect approach to use in conjunction with amino acid supplements and nutritional psychiatry for these students.

According to another study published by his team, college students will also see improved spatial and verbal memory.

What about swings for teen boys and all adults too?

Once I saw the images in the Bloomberg article, and after reading the research, and after playing on swings again after all these years, my thinking started expanding. I believe everyone could benefit from using a swing.

I certainly wanted to swing right away (hence the walk and swing meet up with my friend a few weeks ago) and now seek out swings when I go for walks. I would love to see an area set aside in parks for teen girls (and boys too) and as Beth says, in middle and high schools too. And how about a designated area in parks for adults who want to swing too?

There are now parks with Liberty swings for children and adults in wheelchairs. The vestibular benefits of rocking chairs are helping veterans dealing with substance abuse and mood issues. I also see an application for stress reduction in the workplace. The opportunities are endless.

Here are some of my recommendations:

  • Seek out swings in parks. Give it a try to see how you feel and how much you enjoy it!
  • Advocate for swings in your communities, middle schools, high schools, colleges and place of business.
  • Get a rocking chair for yourself and/or older family members
  • Get a swing for your backyard (suitable for teens and adults). I’m looking into options for my backyard and will share more once I find some suitable options.

When did you last go for a swing as an adult? How much fun was it!?

If it’s been some time, does this – my pictures and the research – inspire you to want to look for a swing and have a go again?

Does your teen or college student seek out outdoor play like swings and see benefits?

If you are an OT/occupational therapist or exercise physiologist or other health professional using vestibular therapy with swings please do share so we can all learn.

Feel free to post any questions here too.

Bartonella infection in mom and both sons: anxiety, panic attacks, insomnia, inconsolable crying, irritability, ADHD, rage and pain

By Trudy Scott 32 Comments

bartonella infection

A mom and both her sons experienced a variety of emotional/mood and pain symptoms between them as a result of a Bartonella infection: anxiety, panic attacks, insomnia, irritability, inconsolable crying, ADHD, rage, eye pain, joint pain and pain in the legs. This family case study was published in Parasites and Vectors in 2013. I would love to see individual amino acids being used to ease some of these symptoms while the infection is being treated (more on this below).

Here are some of the emotional and mood-related symptoms they experienced:

  • the mother and both sons developed recurrent rash-like skin lesions, disruptive sleep patterns and both boys developed anxiety accompanied by episodes of inconsolable crying, irritability, and panic attacks
  • subsequent to the spider infestation of the apartment, [the mother] developed fatigue, memory difficulties, headaches, irritability, eye pain, insomnia, chest pain, blurred vision, shortness of breath, rash and skin lesions and anxiety attacks.
  • The youngest son… awakened at night crying and complaining of pain in his legs
  • The older son experienced increased irritability and rage episodes. In addition, the boy’s teacher indicated a lack of attention during class, and suggested that the child might have an Attention Deficit Hyperactivity Disorder (ADHD).

The youngest son also developed severe neurological symptoms and was diagnosed with Guillain-Barre syndrome and Chronic Inflammatory Demyelinating Polyradiculoneuropathy.

You can read the full investigation, timing, sequence of events and all the symptoms in the paper: Bartonella henselae infection in a family experiencing neurological and neurocognitive abnormalities after woodlouse hunter spider bites

Creating awareness, motivating, inspiring and educating

I’d like to highlight some of the reasons for sharing this paper:

  • creating more awareness about the emotional/mood symptoms that can occur with a Bartonella henselae infection
  • educating about this infection in general so other families can find solutions quicker than this family did
  • motivating and inspiring you to not give up looking for answers for you and your family – this mom suspected Bartonella infection after doing internet searches (almost 3 years after all this started)
  • creating more awareness about possible hosts other than ticks (in this case woodlice and woodlice hunter spiders)
  • highlighting how family members exposed to the same infection can have different symptoms and how some family members may not be infected at all (in this case the father was not affected)
  • highlighting that some individuals (the mom in this case) do not recall being bitten and yet still get sick
  • educating on how amino acids can offer much symptom relief during the investigation and treatment of the infection (more on this below)

Treatment with antibiotics and Chinese herbs

This family was successfully treated with antibiotics and other medications once it was determined Bartonella was the cause of their symptoms:

The parents report that the [youngest] child is actively socializing with other children and now runs and plays like he had never done before.

Following this antibiotic course, the mother reported substantial overall improvement and was almost symptom free. However, she continues to experience occasional irritability, confusion, dizziness, nausea, and pain involving the shoulder, hip and the bottoms of her feet.

One of the common symptoms of Bartonella is burning feet and this article, How to Put Out the Fire in Your Burning Bartonella Feet, mentions a herb from the Zhang protocol:

In Chinese herbal medicine, an herb called “houttuynia” is classified as “Clearing Heat and Relieving Toxicity.” This herb has been successfully used to treat Bartonella by a Chinese physician in New York named Dr. Q. Zhang. This herb has antibacterial and antiviral properties in addition to clearing heat and toxins. Fortunately this herb can be combined with other herbs to help relieve Bartonella symptoms.

I mention this because I am personally familiar with the Zhang protocol, having used it when working with Dr. Darin Ingels to address my Lyme disease (Borrelia). Dr. Ingels is the author of  The Lyme Solution and writes about the Zhang protocol in this excellent book.

Using amino acids to address anxiety, panic attacks, sleep problems, crying and pain

Individual amino acids, used as supplements, can offer much symptom relief during the investigation and treatment of the Bartonella infection, however they are seldom recommended. I would love to see this change and become the norm.

In this blog post, GABA helps with Lyme anxiety (while addressing the underlying disease), Tricia shares that “Lyme, Bartonella and Babesia are all known to cause anxiety and other psychological disorders ranging from mild to very severe.” She also shares that her daughter used GABA:

We’ve used Source Naturals GABA Calm sublinguals with good results. I learned about GABA helping anxiety and because I was treating my young daughter I purchased this because it was easy for her to take.

Looking at some of the emotional symptoms this family experienced, and how the amino acids could have helped:

I feel for this poor family. It certainly was a very complex family case and reflects the need to dig deep to find the root cause. And I appreciate the case being written up so more awareness can be created.

Have you or your family experienced something like this? And has your practitioner introduced you to the amino acids for some symptom relief while they are addressing the infection/s?

If you’re a practitioner working with Lyme disease and coinfections such as Bartonella, have you seen cases similar to this one? Do you use amino acids for some symptom relief while addressing the infection/s?

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

Outsmart Endometriosis by Dr. Jessica Drummond

By Trudy Scott Leave a Comment

outsmart endometriosis

Dr. Jessica Drummond, DCN, CNS, PT, is a good friend and colleague whose work in women’s health I highly respect. Her book, Outsmart Endometriosis (now available in paperback), is integrative, evidence-based, practical and empowering!

She is a leader in the field and her vast experience and compassion makes this a must-read. As a nutritionist working with women with anxiety, I am thrilled to have this comprehensive evidence-based book as a resource for those in my community who are on their endometriosis healing journey, and for practitioners who work with women with endometriosis.

Here is the official book blurb:

Endometriosis does not have to ruin your career.

Wouldn’t it be nice to stop worrying about how your endometriosis symptoms are going to hold you back from hitting your career goals? Or to have tools that you can use to reduce your pain and manage your energy so you don’t have to miss out on important opportunities? Sometimes, it can feel like endometriosis is controlling your life.

Sought-after endometriosis, pelvic pain, and nutrition expert Dr. Jessica Drummond, DCN, CNS, PT, has helped thousands of women relieve their pelvic pain in over twenty years of practice. In Outsmart Endometriosis, she offers not another “one-size-fits-none endo diet,” but a comprehensive approach to managing your symptoms using simple, repeatable strategies, and without having to wait for an appointment with your doctor.

In Outsmart Endometriosis, Dr. Drummond can help you to:

  • Stop missing important work meetings or deadlines because of your endometriosis pain, fatigue, anxiety, and/or digestive symptoms
  • Let go of your worries about your fertility
  • Clear your brain fog so you can do your best work
  • Get control over your symptoms so you can feel more comfortable, and no longer just power through or be forced to quit
  • Build a team of the right professionals to support you along the way

Read Outsmart Endometriosis and become the boss of your symptoms and your career.

Get your copy on Amazon here (my Amazon link) or from Target, Barnes and Noble or independent bookstores.  You can also download book bonuses here.

Vitamin C causes oxalate formation resulting in pain, anxiety, and insomnia (when there is a defect in ascorbic acid or oxalate metabolism)?

By Trudy Scott 50 Comments

vitamin c and oxalate

Supplemental vitamin C has many exceptional health benefits and causes no issues for a large majority of individuals. However if you have dietary oxalate issues, doses of vitamin C above 100mg to 250mg per day may be problematic and trigger pain, anxiety, insomnia, bladder issues and more. This blog, Coronavirus and vitamin C for immune support: new pain or more severe pain due to oxalate issues?, is part 1 of the series  which sets the scene and is a fact-finding article. Part 2, Oxalate crystal disease, dietary oxalates and pain: the research & questions (part 2), covers the research behind oxalate crystal disease.

Today we look at some of the research on vitamin C/ascorbic acid being a possible trigger for the formation of oxalates in certain instances. This paper, No contribution of ascorbic acid to renal calcium oxalate stones, has a good summary:

Even though a certain part of oxalate in the urine derives from metabolized ascorbic acid, the intake of high doses of vitamin C does not increase the risk of calcium oxalate kidney stones due to physiological regulatory factor: gastrointestinal absorption as well as renal tubular reabsorption of ascorbic acid are saturable processes, and the metabolic transformation of ascorbic acid to oxalate is limited as well.

But in the large-scale Harvard Prospective Health Professional Follow-Up Study, those groups in the highest quintile of vitamin C intake (> 1,500 mg/day) had a lower risk of kidney stones than the groups in the lowest quintiles.

This paper does however have this precaution:

Recurrent stone formers and patients with renal failure who have a defect in ascorbic acid or oxalate metabolism should restrict daily vitamin C intakes to approximately 100 mg.

My proposed interpretation of this

I’d like to propose an interpretation of this, based on what we know about oxalates. These are the individuals who should restrict daily vitamin C intakes to approximately 100 mg per day (or up to around 250mg per day – more on the range below):

1) If you are someone who is a recurrent stone former or is in renal failure with a defect in ascorbic acid or oxalate metabolism

2) If you are someone with dietary oxalate issues i.e. you have similar symptoms when consuming vitamin C as you do when consuming high oxalate foods. Could we consider that you be classified as having “a defect in ascorbic acid or oxalate metabolism?” I would say yes.

I’ve added #2 above because we need to keep in mind that many individuals who have issues with dietary oxalates are not necessarily stone formers and nor do they have renal failure.

Research is also lacking in this area as you can read in Oxalate crystal disease, dietary oxalates and pain: the research & questions (part 2).

An omission of the 100mg per day restriction

I would like to point out that the study mentioned above was referred to in an article on Dr. Andrew Saul’s site but for some reason the section about the 100mg daily restriction was omitted from the article. It may have something to do with the fact that the author firmly believes that no-one has oxalate issues with any dose of vitamin C. In fact, he even jokingly makes this comment in the article:

Is some clown still trying to tell you that vitamin C is somehow dangerous? Or that you shouldn’t take more than 200 mg/day?

If you are someone who does experience pain when consuming vitamin C (like I do), I’m pretty sure you don’t find this comment amusing.

Vitamin C intake leading to pain, anxiety, insomnia, low mood and bladder issues

Here is some additional feedback from a question I posted on Facebook. This is the question I posted:

I’ve been sharing here about vitamin C being an issue for some folks who have oxalate issues and seeing an increase in pain. I’d love to hear if you upped your vitamin C intake for immune support and saw your mood take a dive or your anxiety increase or your sleep get worse? Vitamin C typically helps because it’s a cofactor for making neurotransmitters like serotonin and GABA and tyrosine but too much of a good thing is not good! Did you also have increased or new pain (as well as anxiety, low mood and insomnia)?

Here are some of the responses from folks who shared about pain, anxiety, insomnia, low mood and bladder issues:

  • Fay shared this: “Yes increased pain, insomnia and anxiety with increased C and mouth sores to boot. Taking liposomal C and Ester C to boost antioxidants for health reasons and pain in elbows and knees. Not sleeping well at all either.”
  • Lica shared this: “Yes increased anxiety…never thought of it before…felt a bug coming on and took c for a few days…yup anxiety.”
  • Nicola shared this: “Increase in body pain, burning bladder, sleep affected and low mood ( not something I usually suffer with). I was taking liposomal C then increased the dose and also added Ester C as I had symptoms of covid. I was taking 1-2g a day of liposomal previously as a preventative and increased to 4g plus 4g of Ester. Only did it for a couple of days. Stopped three days ago and pain is starting to subside but no sleep last night. So I will continue with a break for now and add a very low dose again perhaps of Ester C and see how I go.”

I really appreciate these women sharing their experiences so we can all learn!

What is the upper limit of vitamin C for individuals with dietary oxalate issues?

I’m sure you’re wondering about the various dosages mentioned: the study mentions 100mg per day,  Dr. Andrew Saul’s clown comment says 200mg per day and Susan Owen’s TLO Facebook group recommends no more than 250mg per day. You’ll need to figure out what the upper dose of vitamin C you can tolerate – by trial and error.

The big disconnect is always the mention of kidney stones

This is one of many similar studies on the topic of ascorbic acid/vitamin C and oxalates. There are also many studies and articles stating that vitamin C does NOT play a role in the formation of oxalates and cause kidney stones. The big disconnect is always the mention of kidney stones. The missing piece – in the research and in many articles – is that you can have issues with dietary oxalates AND vitamin C when there is no kidney disease/no kidney stones.

I have a number of additional oxalate blog posts planned so please let me know what else you want to hear about.

Here are the 2 previous blog posts on this topic of oxalates, vitamin C and pain:

Please also share your vitamin C oxalate story and how you figured it out (and if you react in a similar way to dietary oxalates).

Let us know what your ideal dose is (and which dose caused issues) and what form of vitamin C and product name you use/used. Feel free to share if you also have a history of kidney stones.

Feel free to post your questions here too.