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premenstrual dysphoric disorder

Seasonal PMDD/PMS and hormonal binge eating, wine drinking and anxiety – symptoms ramp up from October

November 17, 2023 By Trudy Scott 3 Comments

seasonal PMDD/PMS

Someone in the community asked for help for the seasonal aspect of her PMDD symptoms i.e. more severe symptoms in winter  …

My PMDD symptoms massively increase around the beginning of October right through to March. Would love some advice.

The binge eating and wine drinking is becoming habitual

She specifically mentions binge eating and wine drinking but I assume her other PMDD symptoms – such as anxiety, tension, anger, irritability, depression, sadness, hopelessness, insomnia, overwhelm, low energy, breast tenderness, headaches, pain, bloating, and/ or weight gain –  are more severe at this time too.

As you can see, her symptoms are much more severe from October through March (winter in the Northern Hemisphere). If you live in the Southern Hemisphere you could expect more severe symptoms from May through September (or thereabouts).

There is a seasonal aspect to PMDD (premenstrual dysphoric disorder) and PMS (premenstrual syndrome and other hormonal imbalances.  It’s not well recognized despite the fact that it’s documented in the research and seen clinically.

My feedback for her is to look into and address low serotonin, low GABA and/or low endorphins with the respective amino acids (adjusting up and down based on the season and symptoms), using recognized SAD (seasonal affective disorder) approaches and addressing pyroluria if needed (the nutrients are cofactors for neurotransmitter production.) I share more about each of these approaches and the research below.

The research: patients with PMDD have substantial seasonal patterns in mood and premenstrual symptoms

Premenstrual dysphoric disorder (PMDD) “accounts for the most severe form of PMS with the greatest impairment of women’s functioning and perceived quality of life, often prompting them to seek treatment.”

This older paper from 1997, Seasonality of symptoms in women with late luteal phase dysphoric disorder

  • Out of 100 patients treated in a subspecialty clinic in a university teaching hospital, “a significantly higher rate of seasonal affective disorder (38% versus 8%) as determined by Seasonal Pattern Assessment Questionnaire criteria.”
  • Also, 25% of the patients with seasonal variations in their premenstrual symptoms, consider them marked or a severe problem

The authors conclude that:

These results suggest that patients with LLPDD [or PMDD] have substantial seasonal patterns in mood and premenstrual symptoms. These seasonal patterns have implications for the clinical assessment and treatment of LLPDD [or PMDD]. For example, light therapy may be beneficial for women with seasonal worsening of LLPDD [or PMDD].

As you look at the research keep in mind the fact that late luteal dysphoric disorder (LLDD),“is now known as premenstrual dysphoric disorder (PMDD)”, as mentioned in the above paper and other older studies.

Seasonal variations in serotonin and GABA

Seasonal variations in serotonin have long been documented with much research on the winter blues. This paper, The chronobiology and neurobiology of winter seasonal affective disorder describes winter seasonal affective disorder (SAD) as “a mood disorder characterized by the predictable onset of depression in the fall/winter months, with spontaneous remissions in the spring/summer period.” They also state that “The typical patient with SAD is a premenopausal woman who experiences carbohydrate craving, hypersomnia, and prominent fatigue during winter depressive episodes.”

There is less awareness about GABA seasonality but GABA levels may also be lower in the winter months. In this animal study, Effect of the pineal gland on 5-hydroxytryptamine and γ-aminobutyric acid secretion in the hippocampus of male rats during the summer and winter, it is reported that: “GABA secretion in the hippocampus of rats had a seasonal rhythm consisting of increased secretion in summer and decreased secretion in the winter.”  I share more about this and the seasonality of GABA here.

It makes sense that supporting these lower levels in winter is going to help with the more severe PMDD symptoms that correlate with each neurotransmitter imbalance.

One solution: address low levels of neurotransmitters with amino acids

As you can see the PMDD symptoms mentioned above could fall into the categories of low GABA, low serotonin and/or low endorphins (and possibly low dopamine/catecholamines and low blood sugar too: binge eating, wine drinking, anxiety, tension, anger, irritability, depression, sadness, hopelessness, insomnia, overwhelm, low energy, breast tenderness, headaches, pain, bloating, and/ or weight gain.

(You can read this StatPearls ebook for the full description of the above symptoms: Premenstrual Dysphoric Disorder)

It’s for this reason I always have clients with PMDD (and other hormonal issues) do the Amino Acids Mood Questionnaire and trials of the respective amino acids.

Using a food mood log and tracking what time of day you binge eat and drink wine (and  all the other symptoms) is a clue as to which amino acids may help most. I would expect tryptophan, GABA and DPA would be at the top of the list, and possibly tyrosine and glutamine too.

Because of the seasonality aspect, a higher dose is likely to be needed in the winter time so if you’re just starting your amino acid trails keep this in mind. If you are already using amino acids with success in summer, then bumping up the amounts during winter is going to help further. And then be sure to reduce amounts once winter is over.

Hopefully you’ve also been working on diet, gut health, liver health, adrenal function, toxin removal and other factors to reduce or eliminate PMDD/PMS so the amino acids are not needed long term.

How targeted individual amino acids may help – some examples

As you can see from one study, tryptophan can help with premenstrual dysphoria/sadness, mood swings, tension, and irritability.

Low endorphins and low dopamine may also be a factor. I share more on this blog: DLPA (DL-Phenylalanine) eases PMDD/PMS symptoms in women who experience declining endorphin levels in the second half of their cycles

Here are some specific amino acid cases around binge eating/cravings and excessive wine drinking:

  • Would using 5-HTP or tryptophan help when you crave sugar (as a sort of antidepressant) late afternoon/evening?
  • Tryptophan had the added benefit of turning me completely off alcohol when I took it to improve mood and sleep during perimenopause
  • GABA for ending sugar cravings (and anxiety and insomnia)

None of the above are specific to seasonal changes in symptoms but illustrate the use of amino acids.

Supportive solutions: a SAD lamp when serotonin is low and addressing pyroluria

The late luteal phase dysphoric disorder paper above doesn’t mention amino acids (which is unfortunate but not surprising)  but it does mention light therapy. I do recommend the use of a SAD lamp (full spectrum light) when there are low serotonin symptoms that get more severe in the winter.

With PMDD/PMS and other hormonal imbalances, we also always consider pyroluria and the use of higher amounts of zinc, vitamin B6 and evening primrose oil. The “stress” of winter and increased sugar consumption can deplete zinc and vitamin B6 for everyone but more so if you have pyroluria. These nutrients are also key for hormonal imbalances.

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

We use the symptoms questionnaire to figure out if low GABA or low serotonin or low endorphins or low dopamine or low blood sugar may be an issue with your seasonal PMDD/PMS.

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, 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. You can find them all in my online store.

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.

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.

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.

Now I’d like to hear from you

Does any of this resonate with you? If yes, has any of the above helped with the seasonal aspect of your PMDD, PMS or other hormonal issues?

Feel free to share and ask your questions below.

Filed Under: Anxiety, Cravings, GABA, Tryptophan, Women's health Tagged With: amino acids, anger, anxiety, Balancing Neurotransmitters: the Fundamentals program for practitioners, binge eating, depression, endorphins, GABA, GABA Quickstart, hopelessness, hormonal, insomnia, irritability, PMDD, PMS, premenstrual dysphoric disorder, premenstrual syndrome, sadness, seasonal affective disorder, seasonal PMDD, seasonal PMS, serotonin, tension, wine drinking, winter, winter blues

DLPA (DL-Phenylalanine) eases PMDD/PMS symptoms in women who experience declining endorphin levels in the second half of their cycles

March 18, 2022 By Trudy Scott 23 Comments

dlpa

Mood swings, intense sugar cravings, comfort/binge eating, sadness, anxiety, crying, cramps and increased pain, irritability, anger, fatigue, cognitive dysfunction, overwhelm, feelings of unease and dissatisfaction, aggression, heartache, and/or insomnia are common for many women during the second half of the menstrual cycle i.e. in the luteal phase. You may relate to all or some of these symptoms. And you may have been diagnosed with or may identify with PMS (premenstrual syndrome) or PMDD (premenstrual dysphoric disorder – similar to PMS but more serious).

Research shows improvements of these symptoms with the amino acids tryptophan (which provides serotonin support) and GABA (which supports GABA levels). Although there is no research that the pyroluria protocol improves symptoms it’s something I see clinically all the time. (I’ve written about this extensively and share more on this below)

A really interesting study published in 1989 identified low endorphins and low catecholamines as a probable cause for some women – Prevention of Late Luteal Phase Dysphoric Disorder Symptoms with DL-Phenylalanine in Women with Abrupt β-Endorphin Decline: A Pilot Study

I recently came across the above paper and prior to this, had not considered this as a primary root cause. Here is the excerpt from the abstract:

Twenty-two women with late luteal phase dysphoric disorder were treated with DL-phenylalanine during the 15 days prior to menses in a double-blind crossover study.

DL-Phenylalanine was shown to be more effective than placebo in attenuating many symptoms characteristic of luteal phase dysphoric disorder. This amino acid was chosen because of its hypothesized actions in attenuating the symptoms associated with the sharp decline in central β-endorphin levels during the late luteal phase in women with luteal phase dysphoric disorder.

Let’s review a few terms… Late luteal phase dysphoric disorder is a synonym for PMDD. The luteal phase is one stage of the menstrual cycle and occurs after ovulation and before your period. When you feel dysphoric you feel very unhappy, uneasy, or dissatisfied. With the downward endorphin shift at this time, period pain and other pain can be worse, and weepiness and emotional symptoms increase. The need for comfort or reward eating also increases. The study authors suggest these PMDD symptoms may “closely resemble those seen during morphine or heroin withdrawal.”

Based on my experience I do feel comfortable extrapolating these findings to PMS and even peri and post-menopausal women who experience some or all of these symptoms (other than actual periods and period issues in post-menopausal women).

Study participants, dosing and timing of DLPA and improvements

The participants in the study were white, middle-class, and between 24 and 29. Each woman took one 750 mg of DLPA at breakfast and lunch for the 15 days prior to the expected onset of their periods.

In the study groups, it was found that “initial improvement started at the end of the first month of DLPA therapy. Continued therapy brought increased relief from symptoms by the end of the second month. Interestingly, the greatest period of improvement occurred during the washout period” at the end of the third month possibly due to a delayed action of DL-phenylalanine.

The authors make the following conclusion:

DL-phenylalanine was found to be safe, well-accepted, and without significant side effects. The significant improvement it produced with many of the symptoms characteristic of Late Luteal Phase Dysphoric Disorder [PMDD] suggests that it may prove a useful addition to the therapeutic armamentarium for this syndrome.

Keep in mind that a typical starting dose of DLPA is 500mg used 2-3 x per day and it’s typically used between meals for best effects. Ideal is also to customize dosing to your unique needs. In this study, everyone received the same dose at the same time. For these reasons it’s even more impressive to see results like they did.

It makes sense but I have just not used DPLA alone and only in the second half of the cycle

It’s a very small pilot study but given my experience with the amino acids DLPA, DPA and tyrosine, and the vast number of women I have worked with who had symptoms like the above, it makes sense. Using the above three amino acids in combination with dietary changes, tryptophan, GABA and the pyroluria protocol, this approach has offered relief for many of my clients. I have just not used DPLA alone and only in the second half of the cycle.

In case you’re wondering why I mention the three amino acids DLPA, DPA and tyrosine above, it’s because:

  • DLPA (the amino acid used in this study) supports both endorphins and catecholamines (dopamine is one of them)
  • Or DPA (supports endorphins only) can be used with tyrosine (supports catecholamines only) instead of DLPA which does both

I blog about the differences between DLPA and DPA here, together with all the symptoms we look at when considering doing a trial.

In this study, they used DLPA which boosts endorphins and catecholamines. As I share in my DPA vs DLPA blog, I prefer DPA (d-phenylalanine) for endorphin support when symptoms are severe. But DPA is not always available so DLPA is a good alternative, assuming the person can handle the catecholamine support. Some people can’t and there are some contraindications too.

I’d love to see follow-on research covering the following:

  • A larger group of women using DLPA
  • Individualizing the dosing of DLPA to each person’s unique needs
  • Correlating results with the low endorphin and low catecholamine symptoms questionnaire
  • Comparing DLPA alone with a combination of DPA + tyrosine (with each individualized based on unique needs)

Serotonin and GABA support for PMS/PMDD, and the pyroluria protocol

In this paper, Premenstrual Dysphoric Disorder the authors share that PMDD

comprises emotional and physical symptoms and functional impairment that lie on the severe end of the continuum of premenstrual symptoms. Women with PMDD have a differential response to normal hormonal fluctuations.

It’s recognized that serotonin and GABA play a role:

This susceptibility may involve the serotonin system, altered sensitivity of the GABAA receptor to the neurosteroid allopregnanalone [a naturally occurring neurosteroid which is made from the hormone progesterone], and altered brain circuitry involving emotional and cognitive functions.

They share SSRIs that are considered as the first-line treatment. Second-line treatments include oral contraceptives, calcium, chasteberry, and cognitive-behavioral therapy.

However, as I share in this blog, research supports the use of tryptophan – Tryptophan for PMS: premenstrual dysphoria, mood swings, tension, and irritability

A study published in 1999, A placebo-controlled clinical trial of L-tryptophan in premenstrual dysphoria, tryptophan was found to reduce symptoms of PMS when used in the luteal phase or second half of the cycle (i.e. after ovulation).

I mention GABA in this blog and the fact that many anxious women I work with also have pyroluria or signs of low zinc and low vitamin B6 and adding these nutrients, together with evening primrose oil, provide additional hormonal and neurotransmitter support, and help with the social anxiety.

Resources if you are new to using DLPA (or other amino acids) as supplements

If you are new to using DLPA or the other amino acids as supplements, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution (you can see the low endorphin and low catecholamine symptoms.)

If you suspect low levels of endorphins and/or low levels of catecholamine 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. Blog posts like this are intended to add value to the chapter on amino acids, which contains detailed information on doses and time of the day for dosing.

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

If you are a practitioner, join us in The Balancing Neurotransmitters: the Fundamentals program. It’s an opportunity to interact with me and other practitioners who are also using the amino acids.

Have you considered that there may be different types of PMS (premenstrual syndrome) or PMDD (premenstrual dysphoric disorder) i.e. a different combination of root causes and therefore different solutions?

And have you had success with DLPA alone (providing both endorphin and dopamine support) or by using a combination of DPA (endorphin support only) and tyrosine (catecholamine support only).

If you’re peri or post menopausal have you also seen success with any of these amino acids?

Have the other amino acids, tryptophan and GABA or the pyroluria protocol helped too?

If you’re a practitioner please share what you’ve seen with clients/patients.

Feel free to ask your questions here too.

Filed Under: Amino Acids, Anxiety, Hormone, PMS, Women's health Tagged With: aggression, anger, anxiety, catecholamines, Cognitive dysfunction, comfort/binge eating, cramps, crying, dissatisfaction, dl-phenylalanine, DLPA, endorphin, fatigue, feelings of unease, GABA, heartache, increased pain, insomnia, intense sugar cravings, irritability, luteal phase. premenstrual syndrome, menstrual cycle, mood swings, overwhelm, PMDD, PMS, premenstrual dysphoric disorder, pyroluria, sadness, second half of their cycles, serotonin, tryptophan

Around my period I definitely feel the need for extra tryptophan if I’ve had some extra heavy emotional stuff come up that I need to process

December 10, 2021 By Trudy Scott 6 Comments

period and extra tryptophan

Many women find that they need additional nutritional support i.e. tryptophan for serotonin support (and often GABA too) around their periods. Today’s case study highlights the hormonal shifts that may lead to a situation where it appears tryptophan doesn’t work, then it does work, and then sometimes it doesn’t work as expected. The variable results and the need to switch between lower and higher doses on an ongoing basis can occur with PMS (premenstrual syndrome) PMDD (premenstrual dysphoric disorder, a severe, sometimes disabling extension of premenstrual syndrome). The variable results can also be more pronounced while recovering from trauma.

This case study is a follow-on from a blog I recently published: Tryptophan doesn’t work, then it does and then it doesn’t: could it be hormonal shifts, dietary factors and/or parasites?

Here is Kimberley’s feedback on the Facebook post that discussed these variable results. She shared how her hormonal shifts led to a need for additional tryptophan and 5-HTP:

Around my period I definitely feel the need for extra tryptophan. My PMDD symptoms have decreased since I started using tryptophan/5-HTP, but sometimes I need a bit more if I’ve had some extra heavy emotional stuff come up that I need to process (since that always happens with my period!).

I thanked her for sharing and said how happy I was for her. I also asked what symptoms have decreased and how much? I also asked how much tryptophan and 5-HTP she uses before her period and then around her period?

I was also curious if she just experimented with different doses until she figured it out or had she heard me talk about the PMDD tryptophan study: A placebo-controlled clinical trial of L-tryptophan in premenstrual dysphoria. In this study tryptophan was found to reduce symptoms of PMS when used in the luteal phase or second half of the cycle (i.e. after ovulation).

Her low serotonin symptoms have decreased as much as 75-80 percent

Kimberley confirmed that she had read the above study and related blog post – Tryptophan for PMS: premenstrual dysphoria, mood swings, tension, and irritability – and more about her symptoms:

I had read the blog you referenced, which is one of the reasons I tried tryptophan in the first place.

I was experiencing a lot of emotional distress, feelings of downright despair that left me miserable both during my period and ovulation (half the month, every month, which was truly awful). Those have definitely decreased, sometimes as much as 75-80 percent, other times they’re worse and I feel like I need more support.

I usually take 1x Lidtke 5-HTP (50mg) mid-afternoon and 1x Lidtke Tryptophan (500mg) at bedtime, but yesterday I increased to 2x Lidtke Tryptophan and do feel an improvement in my mood this morning.

I experimented to get the right dose of both amino acids, initially increasing to the maximum you recommend, and then slowly decreasing to what I’m taking now when I found I didn’t feel well when I took too much.

I just reread the blog you linked above and realized I should be using GABA every day to support progesterone (instead of just as needed for anxiety). Thanks for the reminder!

I love that after reading the blog she was inspired and motivated to experiment with different doses when she is/was feeling so bad. I encouraged her to continue trialing different doses at various times of the month especially in the second half of the month. I also reminded her that some folks do better with tryptophan and some do better with 5-HTP when it comes to low serotonin symptoms. And to continue to look at why serotonin is low and address that. Low GABA (related to low progesterone) can cause increased anxiety at this time and is a common issue with PMS/PMDD.

(You can see the entire list of low serotonin and low GABA symptoms here.)

She plans to continue experimenting with tryptophan and 5-HTP and may also try switching over to just 5-HTP and see if that changes anything. It’s unlikely that she would benefit from much higher doses of either as she shared “I don’t seem to be able to take more than 2 caps of either one without getting uncomfortable symptoms, though.”

Exercise and yoga for her low serotonin and PMDD

She did share how much exercise helps her mood, why she isn’t able to exercise as much:

The biggest thing I know to do to address low serotonin is add more exercise into my life, but this has been hard lately because I’ve had a couple of different viruses recently that left my exercise intolerance worse than it had been. I’m trying to support my mitochondria right now and add light exercise back in slowly.

Exercise is a wonderful way to raise serotonin levels and aerobic exercise has been shown to reduce the symptoms of PMS too. Yoga may be an option while she is recovering. In one study, yoga was found to be beneficial for PMS: “Alpha-brain waves production due to regular yoga practice are directly related with state of peace, creativity, mood elevation, relaxation, and release of serotonin, thus leading yoga practitioners feel more relaxed.”

Trauma: cortisol, serotonin, dopamine and estradiol

Kimberley also shared how how trauma plays into her situation:

I think some of the reasons for my health issues, low neurotransmitters, etc., are trauma related and I’ve been working through Dr. Aimie Apigian’s programs for that. But that’s another story.

I respect Dr. Aimie Apigian’s work in trauma and somatic experiencing and acknowledge this aspect must be addressed too. I love that Dr. Aimie brings this together with a functional medicine approach, looking at biology/biochemistry too. Recent trauma research confirms that there are major biochemical mechanisms involved in PTSD (post-traumatic stress disorder). These can include impacts to cortisol, serotonin and dopamine levels. And women are more vulnerable to these effects.

A 2021 paper, Estradiol, stress reactivity, and daily affective experiences in trauma-exposed women discusses high cortisol and more severe symptoms around their periods when estradiol (one of the estrogens) is low. As I mentioned above, estrogen and serotonin are closely related. The authors state this:“For women who are cycling, it may be useful to understand how the menstrual cycle affects their symptoms. When you can explain what’s happening biologically, it often becomes less threatening.”

Yoga may provide added psychological benefits as she works through her past trauma too.

Kimberly gave me permission to share her story and this is always something I appreciate so others in my community can learn from these types of experiences. If needed, I hope this her story gives you confidence to experiment with different doses and combinations around your period.

She also benefits from the comments from others on Facebook and the comments here on the blog, our back and forth, and this blog post.

She promised to keep me posted on how she goes and I’ll be sure to share when I hear back from her.

Resources if you are new to using tryptophan, 5-HTP and GABA and the amino acids as supplements

If you are new to using the amino acids as supplements, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution (you can see the low GABA symptoms here) and a brief overview here, Anxiety and targeted individual amino acid supplements: a summary.

If you suspect low GABA or low levels of any of the neurotransmitters and do not yet have my book, The Antianxiety Food Solution – How the Foods You Eat Can Help You Calm Your Anxious Mind, Improve Your Mood, and End Cravings, I highly recommend getting it and reading it before jumping in and using amino acids so you are knowledgeable. 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 amino acid products that I use with my individual clients and those in my group programs.

Have you found you need additional tryptophan/5-HTP or GABA around your period? How have you experimented and how does it help you?

If you’re a practitioner, have you seen this with clients or patients?

Do you also feel better with exercise and/or yoga?

And are/were your variable results more pronounced while recovering from trauma?

Feel free to ask your questions here too.

Filed Under: Anxiety, GABA, PMS, PTSD/Trauma, serotonin, Women's health Tagged With: 5-HTP, anxiety, biochemical, cortisol, despair, dopamine, emotional distress, emotional stuff, estradiol, estrogen, exercise, GABA, hormonal shifts, miserable, my period, PMDD, PMS premenstrual syndrome, premenstrual dysphoric disorder, PTSD, serotonin, stress, trauma, tryptophan, yoga

Timing/combinations of tryptophan and 5-HTP for anxiety, depression and bad sleep (premenstrual dysphoric disorder/PMDD)

August 6, 2021 By Trudy Scott 28 Comments

tryptophan 5-htp timing

Naomi asked these questions about tryptophan timing, using it in the morning and her PMDD (premenstrual dysphoric disorder) symptoms of anxiety, depression and bad sleep: 

I heard your talk on the Biology of Trauma summit, thank you it was great. When’s the best time to take tryptophan? I want to try it for PMDD depression & anxiety along with accompanied bad/little sleep.

I’ve read it needs to be taken on an empty stomach. If I take it in the mornings will it make me drowsy for the day? I struggle with having an empty stomach in the evenings as I often need to eat something close to bedtime to have the energy to sleep through.

I thanked Naomi for her kind words and shared that tryptophan is best used mid-afternoon and evening when serotonin levels take a downwards dip. And tryptophan (and the other amino acids) must always be taken on an empty stomach/away from protein. I also shared how she may want to experiment with also using 5-HTP at various times in the day and in different combinations (more on that below).

Regarding the evening dose, tryptophan can be used between dinner and a bedtime snack if a snack is necessary for blood sugar stability (for improving sleep).

I shared this blog as an additional resource for her – Tryptophan for PMS: premenstrual dysphoria, mood swings, tension, and irritability

In a study published in 1999, A placebo-controlled clinical trial of L-tryptophan in premenstrual dysphoria, tryptophan was found to reduce symptoms of PMS when used in the luteal phase or second half of the cycle (i.e. after ovulation).

I’ve seen both tryptophan and 5-HTP improve symptoms in 2-3 cycles (often in conjunction with GABA) and other steps I outline in the above blog. I don’t typically have clients only use it after ovulation but this is one way a trial could be approached.

Using a combination of tryptophan and 5-HTP

Regarding Naomi’s question about taking tryptophan in the morning and her concern about it making her drowsy during the day, this is my feedback about possibly experimenting with also using 5-HTP at various times in the day and in different combinations:

  • Many folks do not need serotonin support earlier in the day since it goes down at the end of the day but there are some women who do
  • If you are someone who does need serotonin support earlier in the day, you may do very well with tryptophan i.e. it may not make you sleepy
  • If you are someone who does need serotonin support earlier in the day, you may find that tryptophan does make you sleepy and you do better with 5-HTP earlier in the day. In this case, you would use 5-HTP in the morning (as needed, possibly on waking and/or mid-morning) and tryptophan in the afternoon and evening.

And just to add to the mix of variations, keep in mind that some folks do better on 5-HTP (at any time of the day) and some folks with high cortisol find 5-HTP too stimulating.

The way to figure out which amino acid and which combination works best for you is to do a trial of the various combinations and keep a careful log of your responses.

I really do recommend my book when you are new to the amino acids

I also reminded her that when you are new to the amino acids I really do recommend my book “The Antianxiety Food Solution” so you understand exactly how to use them. There is an entire chapter on the amino acids.

I also cover other anxiety nutrition solutions like gluten/sugar/caffeine removal (all important for anxiety, depression and sleep), blood sugar control (often a factor in not being able to sleep through the night and daytime anxiety), gut health (affects mood and can also affect sleep), pyroluria (the zinc, vitamin B6 and evening primrose oil are key for hormone health). I reminded her that it’s the amino acids and diet we must work on.

If you’ve been reading my blog posts and following me for awhile, you know I speak on many summits. I see these interviews as a great introduction for folks new to the amino acids but cannot possibly cover everything in 45-60 minutes.

Additional information on PMDD and low serotonin

Here is additional information on PMDD and low serotonin – Premenstrual Dysphoric Disorder: Epidemiology and Treatment:

It is possible that women with PMDD are more sensitive to [the] effects of estrogens on serotonergic function. Women with PMDD or PMS exhibit specific serotonin abnormalities that are particularly apparent in the late luteal phase [or second half of the cycle] when estrogen levels have declined. These include a deficiency in whole blood serotonin, blunted serotonin production in response to l-tryptophan challenge and, and aggravated premenstrual symptoms during tryptophan depletion.

Be aware that the authors recommend antidepressants as the first-line treatment for PMDD and unfortunately do not mention using tryptophan, GABA or a dietary approach.

I always use this approach when serotonin is low

Keep in mind that this discussion about tryptophan and 5-HTP timing and combinations is not necessarily only applicable for PMDD or PMS but can be used across the board when serotonin support is needed.  I always use this approach when serotonin is low i.e. someone has worry-type ruminating anxiety, depression, afternoon and evening cravings, irritability, anger issues.

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

If you are new to using the amino acids tryptophan/5-HTP or GABA as supplements, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution (you can see all the low serotonin symptoms here) and a brief overview here, Anxiety and targeted individual amino acid supplements: a summary.

As I mentioned above, if you suspect low serotonin or low levels of any of the neurotransmitters and do not yet have my book, The Antianxiety Food Solution – How the Foods You Eat Can Help You Calm Your Anxious Mind, Improve Your Mood, and End Cravings, I highly recommend getting it and reading it before jumping in and using amino acids so you are knowledgeable. 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 amino acid products that I use with my individual clients and those in my group programs.

Have you (or a loved one) been diagnosed with PMDD, PMS or have low serotonin symptoms?

Has tryptophan or 5-HTP helped and what combination and what timing has worked best for you?

Feel free to post any questions here too.

Filed Under: Anxiety, Tryptophan, Women's health Tagged With: 5-HTP, anxiety, bad sleep, combinations, depression, drowsy, empty stomach, GABA, insomnia, morning, PMDD, PMS, premenstrual dysphoric disorder, serotonin, Timing, tryptophan

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