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Anxiety and globus pharyngeus (lump in the throat): GABA to the rescue?

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globus pharyngeus and gaba

Low levels of GABA, a calming neurotransmitter can lead to anxiety, fears and panic attacks. With low GABA, the anxiety is a physical kind of anxiety with muscle tension or muscle spasms.  Today you’ll read how low GABA may be one possible root cause of globus pharyngeus, which you may have experienced as a rather scary golf-ball-like lump or constriction in the throat.

Let me describe globus pharyngeus and then I’ll share my story with globus pharyngeus, why low GABA may be a factor (and supplemental sublingual GABA to the rescue) and other possible root causes that should be considered.

This 2015 paper, Globus pharyngeus: an update for general practice, defines it as follows:

Globus pharyngeus or globus sensation is the painless sensation of a lump in the throat and may be described as a foreign body sensation, a tightening or choking feeling.

Globus means globe or sphere and it can actually feel like you have a golf-ball sized object in your throat.

You may have experienced it without even knowing the medical name. Only a few of my clients and those in my community have ever heard the term. I also only learned about the name many years after my episode.

What is very surprising is that, according to the above paper, up to 45% of the population have experienced it.

My story with globus pharyngeus

I’m one of the 45% and for me it was a terrifying experience.  As you may know, I experienced anxiety, PMS, fears and panic attacks in my late 30s and early 40s (it’s why I do this work).

Fortunately I only had one episode. It truly felt like I had a golf-ball in my throat and was horrifying. I knew I needed to swallow so I could get rid of this obstruction but at the same time I was terrified to swallow in case it got stuck and choked and killed me.

I remember going to the mirror to try and see this golf-ball sized object in my throat. I was so surprised that I couldn’t see anything.

Looking back, I suspect the addition of GABA Calm to my protocol prevented further episodes. I was also using progesterone cream at the time and this promotes GABA production too.

I’ve had many clients report that looking back they also realized their episodes stopped once they addressed their low GABA levels.

I was also under a great deal of stress at the time: work stress (long hours and my adrenals were a mess) and physical stress (due to amalgam removal, gluten issues, perimenopausal changes and much more).

Globus pharyngeus and GABA

The fact that the throat or pharynx “is a muscular tube that runs from the back of your nose down into your neck” is one reason for considering a muscle spasm and low GABA as a root cause.

The amino acid GABA, when used sublingually, eases muscle spasms within 15 seconds to 2 minutes. Some examples where we see this:

If you’re in the midst of an episode it’s impossible to open a capsule of GABA into your mouth. Until a client knows how much they can tolerate we start with 100-125 mg and increased based on the trial.  Taking the powder and dabbing it with a wet finger and putting the finger to the inside cheek a few times is the best way for quick relief.

A product that is GABA-only in a capsule such as Enzymatic Therapy GABA or ProThera 500mg GABA are my choices for in-the moment relief (more on these in my supplement store here).

Source Naturals GABA Calm is my most popular GABA product and is my choice for everyday use.

Of course, I recommend this approach to doing nothing. The authors state: “simple reassurance may be all that is required” or “Advise patients to resist the urge to dry swallow.” We can do better.

Once your GABA levels are sufficient, it’s less likely to happen unless you’re under a great deal of stress and/or there are psychological factors at play:

There is increased reporting of stressful life events prior to development of symptoms and research suggests that as many as 96% of patients with globus sensation report an exacerbation of symptoms during times of emotional intensity.

During times of added stress, folks may experience other “physical symptoms such as palpitations, poor sleep, and feelings of panic.”

Other root causes and possible solutions

The above paper does also list other root causes and solutions that would need to be investigated if GABA doesn’t help or possibly in conjunction with GABA support: tonsil issues, hiatus hernia, reflux in 23 -68% of individuals (I would look for the root cause rather than using a proton pump inhibitor/PPI), sinusitis, post-nasal drip, goitre, an actual foreign body, high consumption of alcohol/caffeine/tobacco and cancer (which they state is rare).

Interestingly, speech and language therapy has been shown to improve globus pharyngeus in two studies, possibly due to the reassurance experienced.

The paper concludes as follows:

Finally the link between anxiety and globus sensation must be considered. Evidence supports the use of cognitive behavioural therapy, but very little evidence exists for the use of anxiolytics or antidepressants.

I’ll add to this: the link between low GABA and globus sensation must also be considered, especially if you experience the physical type of low GABA anxiety. GABA to the rescue!

Based on the research, low serotonin, vagus nerve function, thyroid health and h/pylori may also be factors. I suspect food sensitivities play a role. And pyroluria too, because of the additional loss of zinc and vitamin B6 which is needed for GABA production. I’ll leave all this for a follow-up blog.

Have you experienced a globus sensation episode? And what did it feel like?

Did you get a diagnosis or is the term new to you?

Has GABA helped … in the moment or if you look back on your use of GABA for anxiety?

Did you discover other root causes and solutions? Please do share.

Please share if  you have pyroluria and your episodes were triggered by a very stressful event

And feel free to post your questions.

If you’re a practitioner I’d love to hear your feedback too.

Theanine for easing stress and anxiety, and improving cognition and sleep in healthy adults

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theanine for anxiety

L-Theanine is a “unique non-protein amino acid found in green tea” which according to the study below, has shown benefits when used short-term or acutely as a supplement for it’s anti-stress effects, reducing anxiety, improving sleep quality, improving cognition and even easing depression.

This 2019 study, Effects of L-Theanine Administration on Stress-Related Symptoms and Cognitive Functions in Healthy Adults: A Randomized Controlled Trial, aimed to examine the effects of four weeks use of l-theanine:

on stress-related symptoms and cognitive functions in healthy adults. Participants were 30 individuals (nine men and 21 women; aged 20-69) who had no major psychiatric illness.

The trial was randomized, placebo-controlled, crossover, and double-blind.

L-theanine (200 mg/day of Suntheanine), was used by study participants before going to bed each night and was used for four-weeks.

Study participants who used the theanine for two weeks observed the following:

  • For sleep: Reductions in sleep latency (the amount of time it takes to fall asleep), sleep disturbance and less use of sleep medication
  • For cognitive function: Improvements in verbal fluency (especially letter fluency) and improvements in executive function (planning, multi-tasking etc)

The Japanese versions of The Self-rating Depression Scale, State-Trait Anxiety Inventory-trait, and Pittsburgh Sleep Quality Index (PSQI) scores decreased and the study concludes as follows:

Our findings suggest that L-theanine has the potential to promote mental health in the general population with stress-related ailments and cognitive impairments.

The authors also note that “there were no significant adverse events, demonstrating the safety of four weeks of L-theanine administration.”

As expected, the participants saw increases in serum theanine concentrations. What is unusual and inconsistent with previous studies, is the fact that there was “no significant effect on cortisol or immunoglobulin A levels in the saliva or serum.” I’m not sure I understand  the reasoning they propose i.e. that “the reduction of salivary cortisol and immunoglobulin A levels may be short term, recoverable effect of L-theanine administration.”  I’ll be digging deeper into this to try and get a better understanding of these differences.

Some of the reported possible mechanisms of action

Here are some of the reported possible mechanisms of action of theanine from some studies referenced in his paper:

  • via glutamate receptors (improving cognitive dysfunction)
  • as a neuroprotective agent and “increases in brain serotonin, dopamine, GABA levels” (improving mood and focus and reducing anxiety)
  • enhances hippocampal activity (the hippocampus has a major role in learning and memory)
  • via a proposed increase in the expression of brain-derived neurotrophic factor (BDNF) in the hippocampus (BDNF is a protein implicated in the stress response, long-term memory, Alzheimer’s disease, and psychiatric disorders)

Theanine or GABA – which one to use when?

I typically start my clients with a trial of GABA Calm for low GABA symptoms like physical tension, stress and overwhelm, panic attacks and insomnia. If we are not getting all the expected benefits with GABA and there is a need for added cognitive benefits then we’ll consider adding theanine too. Some folks find one works better than the other and some like a combination (at the same time or theanine in the day/GABA at night or GABA in the day/theanine at night).

I recently reached out on facebook asking: “Theanine or GABA? Which do you prefer for anxiety and why? How much helps? And any other benefits (like reduced body pain, better thinking/cognition, easing IBS gut pain, reduced cravings, less negative self-talk etc)?Or do you like a combination of both?”

As you can see from these varied responses it’s a matter or trialing both to find what works for each person’s unique needs:

  • Lorraine shared this: “They are both good, but I reach for GABA Calm first.. 2 or 3 lozenges. If anxiety doesn’t leave quickly with GABA ( which works well for a panic attack), and I continue to have anxiety humming along in the background, then I’ll reach for theanine.”
  • Jackie shared this: “I take 200mg theanine in morning, then 100mg GABA around 4pm, when the kids get home from school. I had a panic attack in the middle of the night last week, took GABA 100 mg, then seemed to calm down.” I asked if theanine gives her a feeling of calm focus and she said: “yes, I think so. I noticed if I take 200mg of GABA, it makes me drowsy.”
  • Evelyn shared this: “I use both at night for sleep. If I could only use one it would be l-theanine.” Theanine is more consistently helpful for stress reduction and sleep for me. I use 200mg. When I use GABA it’s 500mg of chewables.”
  • Sara shared this: “GABA during the day, theanine at night.”
  • Karine shared this: “GABA!! The Source Naturals Theanine Serene with Holy Basil is really good. But GABA Calm (also Source Naturals which is a sublingual lozenge) is the only thing for a severe issue/episode and helps me concentrate right before an important presentation at work etc. Pure GABA from any supplier is good for long periods where you need a boost or to tone down general anxiety. I also bought a probiotic that also includes GABA (Jarrodophilus Mood) and notice it improves digestion too.”

You can find my favorite GABA/theanine combination product, a theanine-only product and my most popular GABA products on the supplements blog here (and with details for how to set up an account for my online store)

Nutritional Fundamentals for Health GABA-T SAP: 300mg GABA, 150mg theanine. This is pleasant-tasting when opened on to the tongue and works very well when GABA Calm can’t be used.

Pure Encapsulations L-Theanine: 200mg theanine. This is also pleasant-tasting when opened on to the tongue. Unlike like GABA, it can also be swallowed.

Source Naturals GABA Calm. This is a pleasant-tasting sublingual product that is my most popular and most effective form of GABA I use with my clients. It can be used in conjunction with theanine.

Enzymatic Therapy GABA: 250 mg GABA. This is also pleasant-tasting when opened on to the tongue and works very well when GABA Calm can’t be used. It can also be used in conjunction with theanine.

Please let us know … theanine or GABA: which do you prefer for anxiety and why? How much helps? And any other benefits (like reduced body pain, better thinking/cognition, easing IBS gut pain, reduced cravings, less negative self-talk etc)? Or do you like a combination of both?”

Aubrey Huff anxiety attack: could it be a food-mood issue?

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Photo by Jeffjeff08 (from Wikimedia Commons)

Do world-class athletes actually have performance anxiety and panic attacks? And could there be a food mood and nutrient connection?  Yes, food does have a big impact on our mood. And yes, anxiety can affect anyone and many athletes are affected! The most recent example is baseball player Aubrey Huff, from the San Francisco Giants. Henry Schulman wrote about Aubrey’s panic attack in SFGate in an article titled Aubrey Huff opens up about his anxiety attacks :

Aubrey Huff says his first panic attack lasted for eight hours.

Aubrey Huff was standing in his New York hotel room at 5 o’clock in the morning in the early stages of what would be an eight-hour panic attack. The Giant were to play a doubleheader against the Mets that afternoon and evening. Baseball was the last thing on Huff’s mind.

“I couldn’t breathe,” Huff recalled. “I felt I was taking short breaths. Right then and there I thought I was having a heart attack. I told myself, ‘I’ll be damned if I’m going to be sitting in this hotel room and die of a heart attack. I’ve got to get out of here.'”

I used to have social anxiety and panic attacks and it was horrible! And very scary! I really feel for Aubrey and would love to be able to help!

If I was working with Aubrey this is what I’d have him do (this is my approach for anyone who is experiencing anxiety and anxiety attacks/panic attacks):

  1. I’d have him keep a 3 day food diary and we’d look at his intake of real whole food (including grass-fed meat) compared to junk food and fast food
  2. We’d look at caffeine and sugar intake and reduce this and eventually eliminate it. Caffeine can induce anxiety and for many people it’s a tough one to eliminate so we’d have to address the underlying fatigue and reason for “self-medication”. For Aubrey, it could possibly be burned out adrenals. High sugar consumption also affects the adrenals and results in nutrient depletion of minerals like zinc and magnesium, both of which help with anxiety
  3. We’d also look at his gluten intake and assess for gluten intolerance and/or celiac disease and have him start right away on a 2 week gluten elimination trial. Whether or not gluten is a contributing factor to the anxiety, as Melissa Mclean Jory says in the Gluten-Free Edge, athletes perform better when gluten is not a part of their diets
  4. We’d have him start on the first of the 4 antianxiety diets: real whole food, good quality protein, good fats, plenty of organic veggies and fruit, and with no gluten. And make sure he eating a good breakfast that does include protein – keeping blood sugar stable is key for anxiety
  5. We must also always consider neurotransmitter imbalances. In the same SF gate interview Aubrey said this “I couldn’t control one thought in my head. There were so many thoughts going through”. Low serotonin can cause anxiety, panic attacks and ruminating thoughts, so assessing for low serotonin would be key. If low serotonin is a factor then using the amino acid supplements tryptophan or 5-HTP would be worth considering. Research supports the use of 5-HTP for panic. GABA is a calming amino acid and it’s likely that Aubrey would benefit from this too, especially if he has stiff and tense muscles
  6. I would also consider the possibility of pyroluria. In an interview on his blog, Aubrey stated: “I was very shy in high school, if you can believe it. I broke out of my shell at the University of Miami when I got around guys like Burrell. I learned how to believe in myself – and I learned how to project confidence even when I didn’t feel very confident.” As reported by Carey Vanderborg, “the Social Anxiety Institute says that social anxiety disorder, also known as performance anxiety, is a persistent fear of performance situations–such as an athletic event–in which you’re exposed to unfamiliar people or to possible judgment by others.” Zinc, vitamin B6 and evening primrose oil can completely eliminate social anxiety in someone with pyroluria. Here is the pyroluria questionnaire that I’d have Aubrey use for assessing if this is part of the issue. Raising serotonin levels also helps with boosting confidence so it doesn’t have to be learned or forced.

Each person has their own unique biochemistry and there may be other factors involved but this would be a great start. This is what I wish for Aubrey Huff with this food-mood approach: totally free of anxiety, no more panic attacks, zero performance anxiety, feeling super-confident, have no ruminating thoughts, plus playing his best baseball ever!

I would LOVE to send a copy of my book to Aubrey so if you know how to get fan-mail to him please let me know. I tried the Giants office and didn’t have any luck.

You can find out more in The Antianxiety Food Solution: How the Foods You Eat Can Help You Calm Your Anxious Mind, Improve Your Mood and End Cravings, available in major books stores, at Amazon and via www.antianxietyfoodsolution.com.