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GABA mixed in water and swished in his mouth before a meal prevents esophageal spasms /choking/vomiting, and allows him to swallow

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gaba in water

GABA mixed in water and swished in the mouth of an adult male, before a meal, prevents his esophageal spasms, and stops his frequent choking and vomiting, and allows him to swallow his food. A colleague shared her husband’s swallowing issues after she read my blog post about using GABA powder inside the check for laryngospasms. 

This is what she shared:

That [blog] made me think that [GABA] might be useful for my husband‘s esophageal spasms. He frequently can’t get food down during a meal because of them.

So he started mixing 500 mg GABA in a little water and swishing it around his mouth and then swallowing it at the beginning of each meal. Since he started doing that he has not had one spasm, or vomiting episode.

It’s wonderful to hear about her husband’s success with GABA and this unique application of swishing around GABA powder (mixed in water) in his mouth before a meal (I’ll share more on this aspect below).

I asked if they know what the causes of his esophageal spasms are but they don’t yet know:

We can’t figure it out. It appears to be all food. I would expect there to be a trigger-food, but we can’t find it.

The GABA has completely stopped it. Last night we went out to dinner and he forgot to bring GABA with him and immediately started choking. So he went to the nearest vitamin store, (of which there is only one)! Fortunately it was open. As soon as he got back to the restaurant and took his GABA, he was fine.

GABA does work so well for him and offers him some relief while they continue to search for other underlying root cause/s. Until these are found, GABA is supporting overall low GABA levels, associated with physical tension-type anxiety, intrusive thoughts, stiff and tense muscles in other areas of the body and also stress-eating and self-medicating with alcohol in order to relax. More on low GABA symptoms here.

My input on his dosing and swishing

Regarding the dosing and swishing method I have this input:

  • 500 mg GABA is the ideal dose for his needs but this is considered a high dose to start. For low GABA tension-type anxiety, I have clients start with a trial of 125 mg GABA and go up from there. I’d recommend the same approach for someone with issues like this gentleman experiences.
  • GABA is most effective when used sublingually or by opening a capsule on to the tongue or by using GABA powder on the inside of a cheek, rather than swallowing a GABA capsule. For this reason, his method of swishing GABA mixed in water is excellent for achieving the spasm-reducing and relaxing benefits quickly. For some folks doing this 30 minutes before a meal may be more effective than doing it right before eating.

The diagnosis can vary from person to person

The diagnosis can vary from person to person. But as long as there are spasms that are affecting swallowing, doing a trial of GABA is worthwhile in order to determine if it will help.

One example is eosinophilic esophagitis where

Clinical manifestations in infants and toddlers generally include vomiting, food refusal, choking with meals and, less commonly, failure to thrive. Predominant symptoms in school-aged children and adolescents include dysphagia (difficulty swallowing), food impactions, and choking/gagging with meals, particularly when comprised of foods with coarse textures. Other symptoms in this patient population include abdominal/chest pain, vomiting, and regurgitation.

The predominant symptom in adults is dysphagia [difficulty swallowing]; however, intractable heartburn and food avoidance may also be present.

One paper, Esophageal microbiome in active eosinophilic esophagitis and changes induced by different therapies discusses the role of the microbiome and how “an increase in levels of gamma-aminobutyric acid (GABA) …is known to exert a role in esophageal motor function.”

Finding the other root causes (other than low GABA)

Regarding finding the root causes, other than low GABA, this is an important aspect that does need to be pursued. Here are some of the many factors worth considering:

  • Finding food triggers. This can be challenging but an obvious one is gluten which can play a role in eosinophilic esophagitis. Dairy and environmental irritants can be issues too.
  • GERD/reflux needs to be ruled out or addressed. Food sensitivities are often a factor here too.
  • Vagus nerve issues can play a role in digestive issues like this. GABA and vagus nerve exercises helped my cough and voice issues. I recorded all my exercises on video and you can find these here. Fortunately I didn’t have any swallowing or choking episodes at that time but have had a choking episode more recently (GABA did help) so I know how scary this can be.
  • Pyroluria, a social anxiety condition needs to be ruled out or addressed too. This is because nausea, gagging and choking are common symptoms for some individuals.
  • I’d also consider a tongue tie. I just finished reading Tongue Tied: How a Tiny String Under the Tongue Impacts Nursing, Speech, Feeding, and More (my Amazon link) by Richard Baxter, DMD, MS. The focus on babies and children but adults can also benefit from addressing tongue tie issues later in life.
  • Addressing gut health and the microbiome may be one of the keys, as outlined in the paper above.

This is not a comprehensive list and a full functional workup will help to identify all possible root causes.

Related blogs: young boy with choking episodes, lump-in-the throat sensation, anxiety and globus pharyngeus

Here are some related blogs that you may find useful

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 (online/virtual).

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 experienced throat or esophageal spasms and difficulty swallowing with choking and/or vomiting.

And do you have the low GABA physical-tension-type-anxiety symptoms?  What else is a trigger for you and do you have a diagnosis?

If you’ve already been using GABA with success for easing your anxiety, have you noticed a reduction in your swallowing issues?

Have you ever used GABA in this way to help your swallowing issues?

If you’re a practitioner please share what you have seen?

Feel free to ask your questions here too.

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

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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.

Intrusive thoughts are a thing with anxiety: low GABA, low serotonin, pyroluria (low zinc & vitamin B6) and hormone imbalances as possible causes

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intrusive thoughts and anxiety

Intrusive thoughts are a thing with anxiety even though they are not often talked about. It’s for this reason I shared a link to an article on Facebook recently – “The Debilitating Anxiety Symptom No One Ever Talks About” – and the response was overwhelming. I promised to do a blog to do a deeper dive into this topic and share actual real-life examples of uncomfortable and unwanted intrusive thoughts that seemingly appear out of no-where when you have anxiety. And of course, I’m using these real-life examples to highlight some of the many biochemical root causes and nutritional solutions: low GABA, low serotonin, low zinc, low vitamin B6 (and pyroluria) and hormone imbalances. These root cause solutions are all backed by research and clinical results.

You’ll also discover that intrusive thoughts are more common than you’d expect and it’s not just you who experiences them.

Katelyn, author of the above article, shared this about her intrusive thoughts (and this is part of what I shared on Facebook):

As I gained more life experiences, my intrusive thoughts developed into other fears. Now that I was older, these thoughts turned into new scenarios, ones that felt more real. For example, when I started driving, I’d see myself veering off the road, hitting a side rail, flying off a ledge, or running head-on into a semi. I didn’t really want to do any of these things. I just wanted to get to my destination, but these thoughts would keep running through my mind, and I couldn’t stop them.

I did not realize intrusive thoughts were a ‘thing,’ and I thought this was just me

The Facebook post and article quickly resonated with many women with someone saying “I have never identified with an article more…wow.”

One woman said “I did not realize intrusive thoughts were a ‘thing,’ a symptom of something” and someone else said “I thought this was just me.”

Someone else responded: “I thought it was only me as well. I’ve had thoughts like this nearly my entire life.”

(You can read the entire article here: The Debilitating Anxiety Symptom No One Ever Talks About)

The purpose of this blog is to share actual feedback so you can see how varied these intrusive thoughts can be. And recognize that they are a thing and that you are not alone if you experience them.

And then use these cases to illustrate the variety of root causes (and solutions) and show how some of them are very interconnected: like zinc and vitamin B6 for pyroluria, for making GABA and serotonin, and also for hormone balance (more on that below).

A definition from The Anxiety and Depression Association of America

In case you need a definition: “Unwanted intrusive thoughts are stuck thoughts that cause great distress. They seem to come from out of nowhere, arrive with a whoosh, and cause a great deal of anxiety.

The content of unwanted intrusive thoughts often focuses on sexual or violent or socially unacceptable images. People who experience unwanted intrusive thoughts are afraid that they might commit the acts they picture in their mind. They also fear that the thoughts mean something terrible about them….

Unwanted intrusive thoughts can be very explicit, and many people are ashamed and worried about them, and therefore keep them secret.” ~ The Anxiety and Depression Association of America (ADAA).

The ADAA offers an excellent overview that is worth reading, but unfortunately they do not offer any of the nutritional solutions that we know can eliminate these uncomfortable intrusive thoughts.

GABA support with the amino acid GABA

Assessing for and addressing low GABA levels is the first place I start because you get results so quickly if low GABA is one of the root causes.

Jacqueline shared this on the Facebook post about intrusive thoughts: “GABA definitely helped me with this! Also meditation has helped me to learn to stay present. The two combined are helpful.”

Tiffany shares how Source Naturals GABA Calm helps her: “I have definitely noticed that sublingual GABA Calm that you suggest helps calm my overactive brain.”

Elicia offered this input about GABA on the seasonality of GABA blog and needing more in winter:

I use GABA Calm and usually take 1 or 2 a day. The past two days I’ve taken 4 because I suspected that I needed an increase.

I take it for physical anxiety, insomnia and intrusive thoughts. My symptoms had been worsening recently. The increased GABA seems to be helping.

Intrusive thoughts is one of the symptoms on the low GABA section of the Amino Acids Mood Questionnaire: “Have intrusive thoughts, perseverate or have an overactive brain or have unwanted thoughts – thoughts about unpleasant memories, images or worries.”

This is not in my book or on the original questionnaire but was added in 2017 based on new GABA research on intrusive thoughts. I blogged about this here: GABA helps with inhibition of unwanted thoughts (and have added more recent supporting research on the glutamate/GABA balance i.e. increased glutamatergic excitation and reduced GABAergic inhibition.)

Serotonin support with the amino acid 5-HTP (or tryptophan)

Assessing for and addressing low serotonin levels would be the next step for the same reason – you get results so quickly if low serotonin is one of the root causes.

Yosef shared this about his anxiety, panic and intrusive thoughts on the GABA blog on intrusive thoughts hoping low GABA might be his root cause, with GABA as a solution:

I have issues with intrusive thoughts that present daily challenges. On top of that, I have been living with anxiety and panic issues for so long that I have adjusted to the limitations (I work from home, order pretty much everything online and have a very tolerant wife). I’ve been trying mindfulness for the intrusive thoughts, but if GABA might help with that and the panic (and perhaps help me unlearn the agoraphobia) that would be awesome. Imagine being able to go on vacations with my wife!! I’m ordering some and will give it a shot.

About 6 weeks later he shared that he didn’t notice a drastic difference with GABA but that serotonin support did help. He used 5-HTP and shared these wonderful results after using it for only a week:

What did make a difference is 5-HTP (Now – 100mg). I’ve been using it for a week so far. It was recommended by Dr. Amen (the brain doctor) who says it is helpful with OCD, intrusive thoughts, and the like. You take it before going to sleep. It used to be that I had trouble falling asleep because of the “noise” in my head – random anxious thoughts, jumpiness. I would usually need to have something playing (podcast, music, anything) to help me fall asleep. So far, on 5-HTP I find it easier to fall asleep, I don’t have to search for the right podcast, etc. I just feel really tired and fall asleep.

He did a trial of GABA and then a trial of 5-HTP when GABA didn’t help. This is exactly what I would have done. Tryptophan is also an option when 5-HTP is not tolerated.

You’ll see intrusive thoughts listed as “Obsessive thoughts or behaviors” on the low serotonin section of the Amino Acids Mood Questionnaire

5-HTP and tryptophan are listed in this paper: Nutraceuticals in the treatment of obsessive compulsive disorder (OCD): a review of mechanistic and clinical evidence.

Low zinc and low vitamin B6 (and pyroluria)

Low zinc and low vitamin B6 is common with the social anxiety condition called pyroluria. Kez shared how addressing pyroluria/pyrrole disorder resolved her intrusive or ruminating thoughts:

I noticed after being diagnosed with pyrolle disorder that when I had been taking zinc and vitamin B6 supps for a couple of years, the ruminating thoughts left me and my head was peaceful.

Before starting on the zinc and vitamin B6, she described her intrusive thoughts as follows:

Everything would go around and around in my head, it never stopped. And if my son was a few minutes late home, I would picture him in an accident dead on the side of the road. All really negative stuff. When I realised it had stopped it was such a relief.

She confirmed that she didn’t use 5-HTP/tryptophan or GABA. However the pyroluria protocol helps with the production of GABA and serotonin, and also helps to balance sex hormones (more on that below).

You’ll see “Neurotransmitter imbalances, especially low serotonin” on the Pyroluria Questionnnaire.

In one study, Alterations of serum zinc, copper, manganese, iron, calcium, and magnesium concentrations and the complexity of interelement relations in patients with obsessive-compulsive disorder, patients with obsessive-compulsive disorder had low zinc, iron and magnesium.

In another study, Depressive Symptoms in Middle-Aged and Elderly Women Are Associated with a Low Intake of Vitamin B6: A Cross-Sectional Study, they looked at anxiety symptoms like “feeling tense, restless, or panicky; feeling something awful will happen; having worrying thoughts” and low vitamin B6.

Hormonal imbalances: more than 3 x the intrusive thoughts

In this study summary, Hormone levels may provide key to understanding psychological disorders in women, the authors share that  “a common symptom of mood and anxiety problems is the tendency to experience repetitive and unwanted thoughts. These ‘intrusive thoughts’ often occur in the days and weeks after a stressful experience.” In this particular study the women watched a 14-minute stressful film containing death or injury and then salivary hormone levels were measured.

In this study “women in the ‘early luteal’ phase… had more than three times as many intrusive thoughts.”  The luteal phase happens after ovulation i.e. about 16 to 20 days after the start of their period.

The authors conclude that “Women at a particular stage in their monthly menstrual cycle may be more vulnerable to some of the psychological side-effects associated with stressful experiences.”

If your intrusive thoughts ramp up in the luteal phase it’s important to consider the role of hormone imbalances.

But keep in mind that the pyroluria protocol also helps to balance sex hormones. And that tryptophan and GABA help to balance hormones too: Tryptophan for PMS: premenstrual dysphoria, mood swings, tension, and irritability.

As I mentioned above, I typically like to start with addressing low serotonin and/or low GABA because the amino acids offer quick relief, and they give you time to dig deeper into other causes like hormonal imbalances. I also always consider pyroluria with anyone who is anxious so that’s high on the list too. We can see results in a week when we figure out the correct doses.

In part 2, I share one woman’s story of how a lifetime of horrible and bizarre intrusive thoughts were eliminated by a low carb/high fat diet (not as strict as keto).

Stay tuned for part 3 of this blog where I’ll address other possible root causes of intrusive thoughts: low magnesium, low iron, gluten issues, discontinuation syndrome, Lyme disease, mold toxicity, heavy metals, toxins, infections, TBI and trauma.

Resources if you are new to using GABA and 5-HTP/tryptophan as supplements

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

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 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.

We appreciate Katelyn for writing the article I shared and everyone for being willing to share their stories so we can all learn and feel better.

Let’s change this and talk about intrusive thoughts so we don’t have to feel alone and so we can find solutions. As Katelyn says: “If you struggle with intrusive thoughts, share them. The more we share these experiences, the better we can understand ourselves and others and the more we can help one another. Know you are not alone.”

I’ll add this: and share your success with nutritional solutions when something works for you. Share it with your friends and your health practitioner.

Did you know intrusive thoughts are a ‘thing,’ or did you think it was just you?

Has any of the above helped you: GABA, 5-HTP or tryptophan, zinc and/or vitamin B6?

And have you observed more intrusive thoughts after ovulation and before your next period?

Feel free to ask your questions here too.

The seasonality of GABA: worsening anxiety, insomnia and intrusive thoughts in winter (and the need for increased GABA supplementation)

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seasonability of gaba

Seasonal variations in serotonin have long been documented with much research on the winter blues and SAD lamps. There is less awareness about GABA seasonality and I only recently started to look into the research when I wrote about the need to increase tryptophan or 5-HTP temporarily when a winter dip in serotonin causes more severe anxiety, OCD and/or the winter blues.

Following on from my blog post on the seasonality of serotonin, it’s important to be aware of the seasonality of GABA and that GABA levels may also be lower in the winter months. This is also due to shorter days and less light because of more overcast and cloudy/rainy/snowy days.

You may find you need to increase your GABA supplement dosing during this time, in order to get the same benefits for your low GABA physical anxiety, stiff and tense muscles, insomnia (the low GABA lying-awake-tense type), feelings of overwhelm, intrusive thoughts (the low-GABA type), and stress-eating or self-medicating with alcohol.

Read on to learn more about seasonal fluctuations in GABA, an example of how adjusting GABA could look and some of the possible mechanisms.

Intuitively increased GABA without knowing about the seasonality of GABA

A few weeks ago I shared on Facebook that GABA has a seasonal aspect and an increase may be needed in winter when it’s darker earlier and colder. Elicia offered this input:.

I use GABA Calm and usually take 1 or 2 a day. The past two days I’ve taken 4 because I suspected that I needed an increase.

I take it for physical anxiety, insomnia and intrusive thoughts. My symptoms had been worsening recently. The increased GABA seems to be helping.

She also asked what an increase in GABA would look like.

My feedback for her is (you guessed it!) that it depends on each person. If 4 x instead of 1 or 2 x GABA Calm a day helps to ease her symptoms then that’s the right amount for her unique needs at this time. It may be less or more for someone else. And it’s going to change again after the winter season.

I’m so glad to hear she intuitively increased her dose without knowing about the seasonality of GABA and that she saw her worsening symptoms improve.

Other approaches to boost GABA levels may help too: Yoga, meditation, tai chi and essential oils.

Seasonal fluctuations are also found in anxiety disorders and bulimia nervosa

As I mentioned above, SAD or seasonal affective disorder, appears to be relatively common and is well-recognized.

This review paper, An overview of epidemiological studies on seasonal affective disorder mentions anxiety and other conditions too:

  • Seasonal variations in mood, depressive symptoms usually peaking in winter
  • SAD was more prevalent at higher northern latitudes, but the prevalence varied across ethnic groups.
  • SAD has also been identified in children and adolescents.
  • Seasonal exacerbations and remissions are not limited to mood disorders, it has also been found in bulimia nervosa, anxiety disorders and other psychiatric illnesses.

Some of this may be related to low serotonin and as you’ll see below, melatonin and low GABA (and low dopamine too), and the liver, all may play a role too.

GABA is higher in summer/lower in winter and tied to liver function

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, they report that

GABA secretion in the hippocampus of rats had a seasonal rhythm consisting of increased secretion in summer and decreased secretion in the winter.

Additionally, the liver can regulate the content of active substances, including GABA, and its function is controlled by brain centers, especially in the marginal lobe.

This paper reports similar seasonal changes with respect to serotonin, stating that both fluctuations may be related to the seasonal changes of “regulation by the liver”. The authors remind us that in Chinese Medicine the liver is closely related to emotions, and that the liver functions well in hot weather and is weak in winter.

GABA exhibits seasonal rhythms related to the pineal gland and melatonin

The introduction of this animal study (by the same authors), Molecular mechanisms of seasonal photoperiod effects of the pineal gland on the hippocampus in rats highlights a number of points related to seasonal variations in mood:

Based on the theory of “five Zang-organs corresponding to the seasons” in traditional Chinese medicine (TCM), physiological functions including emotions vary with the seasons.

The production of mood-related neurotransmitters such as 5-hydroxytryptamine [serotonin], γ-aminobutyric acid [GABA], dopamine, and norepinephrine exhibits seasonal rhythms, which are related to the regulation of the hippocampus by the pineal gland-MT [melatonin] system.

In other words, GABA (and these other neurotransmitters) exhibit seasonal rhythms related to melatonin secreted by the pineal gland, thereby impacting the hippocampus.

Be sure to read the paper for additional information on depression, seasonal affective disorder and bright light therapy; the seasonal effects of the pineal gland on the hippocampus; the role of melatonin and photoperiod/length of night; the hippocampus and melatonin receptors and more.

The authors were looking for direct evidence of the signalling mechanisms that cause this to happen:

Our findings suggest that the MTR-Gs/Gi-cAMP-PKA-CREB signaling pathway is involved in the seasonal photoperiod [length of night] effects of the pineal gland on the hippocampus and may underpin seasonal changes in emotions.

Feel free to read more about all this in the paper too as it’s beyond the topic of this blog.

Other factors to consider: sugar/alcohol, stress/pyroluria and low serotonin

I’d also consider the following:

  • The increased consumption of sugar at this time can lead to reduced zinc, magnesium and B vitamins (like vitamin B6 and thiamine) and this can further reduce GABA levels, which relies on these nutrients as cofactors for production. By boosting GABA levels with the amino acid GABA (and higher amounts if needed) you can actually reduce some of the cravings and stress-eating.
  • Overindulging in alcoholic holiday beverages can also deplete zinc and B vitamins, further affecting GABA production. Using higher amounts of the amino acid GABA (if needed) can also prevent self-medicating with alcohol. This often happens when trying to fit in and socialize.
  • If you have the social anxiety condition called pyroluria, the added stress of family and holiday gatherings can also contribute to zinc and vitamin B6 being dumped, and further impacting serotonin production.
  • The need to also increase tryptophan or 5-HTP temporarily when a winter dip in serotonin causes more severe anxiety (the low serotonin worry-type), OCD and/or the winter blues.

Resources if you are new to using GABA as a supplement

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

If you suspect low levels of GABA 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 GABA products that I use with my individual clients and those in my group programs.

Have you noticed worsening anxiety, insomnia, intrusive thoughts or even bulimia in the winter months?

Have you noticed you need more GABA in the winter? And then you ease off at the end of winter again?

What changes in your dosing have made a difference with your symptoms?

Did you adjust intuitively or were you aware of the GABA seasonality aspect?

And do you notice something similar with serotonin support and needing additional melatonin in winter too (if you already use it)?

If you’re a practitioner, do you have your clients/patients make adjustments too?

Feel free to ask your questions here too.

Increasing tryptophan or 5-HTP temporarily when a winter dip in serotonin causes more severe anxiety, OCD and/or the winter blues

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tryptophan and 5htp during winter

Don’t forget that serotonin takes a dip in winter when the days are shorter and there is less light. If you’re currently using tryptophan or 5-HTP to boost low serotonin and ease low serotonin symptoms – worry-type anxiety, panic attacks, insomnia, ruminations, PMS, irritability, negativity, perfectionism, obsessiveness, lack of confidence, anger/rage, afternoon/evening cravings – you may find you need to increase your dose for a few months.

This will especially be the case if you check off winter blues or more severe winter anxiety (yes it’s a thing and published in the research) on the low serotonin symptoms list.

I shared this on Facebook last week and the feedback ranged from surprised to curious to confirmatory.

In this blog I’m sharing some of the feedback and some of the supporting evidence, as well as other factors to consider.

The addition of 5-HTP in the morning and a light box

Kathy thanked me for the reminder and shared the changes she makes in the winter months:

Thanks for the reminder! I need to increase my dose this time of year… I can feel myself feeling “down”. I take 500 mg Tryptophan before bed and 100 mg 5-HTP in the morning before breakfast. I also use a light box in the morning while eating breakfast, which helps.

This is an increase from her typical dosing in the spring and summer when she only takes tryptophan at night before bed.

She also only uses her light box or SAD (seasonal affective disorder) lamp in winter. You can read more about SAD/full spectrum lamps here. They are also a wonderful way to boost serotonin and mood in the winter.

My daughter’s anxiety and OCD goes through the roof

Mark shared about his daughter’s anxiety and OCD (obsessive compulsive disorder):

Every year from October – March, my daughter’s anxiety and OCD goes through the roof. At first we thought it was the transition from summer to school, then the craziness of the winter holidays and suspected mold allergy. Now, based on this information, a winter/less light induced dip in serotonin may be an additional factor we hadn’t considered. We’ll try adjusting her 5-HTP dose and see if we gain some improvement. Thanks for the tip.

It’s really common for families to attribute the more severe anxiety and OCD to the stress and craziness of the winter holidays. And of course suspected mold issues do need to be looked into and addressed. But even then, the dip in serotonin can compound all these factors.

Planned tryptophan bump for Christmas sugar cravings and holiday family stress

Carol shared this about her plans to temporarily boost serotonin:

I am one of those light weights that was able to do one 500 mg pill a day of tryptophan. But I do think that it would help to bump it up to two a day to get me through the Christmas sugar cravings AND holiday family stressful get togethers! I’m all about taking the minimum effective dose but this is helpful to know that there could be a temporary boost just to get you through this time!

It’s wonderful that 500mg tryptophan is enough for her and I’m all for a minimum effective dose! However the winter dip in serotonin – and increased sugar cravings and family stress – is a common reason many folks bump up the dose for a month or more.

You may also find you made the change intuitively. Linda shared this: “I had made the adjustment. I just did not realize the reason why.”

A question about timing of 5-HTP and what to do in Spring

Suzanne shared that she uses a SAD light (also called a light box) and finds that it helps. She asks:

Can I just take the 5-HTP on days with no sun or is it better to have it build up in my system? When spring rolls around, do I taper off or can I just stop taking it?

This is my feedback: I haven’t had anyone just use 5-HTP on cloudy days but it’s worth a trial.  If you are noticing increased anxiety and mood changes only on cloudy days and using the SAD lamp on those days helps, then using 5-HTP on those days may be enough. If not, use 5-HTP consistently/daily through the winter months.

Amino acids do not need to be tapered but I find my clients do better when they are reduced over a few weeks. Some folks also choose to just stop taking them and do fine.

I appreciate all the feedback and the great questions. I’ll report back when I hear how Mark’s daughter does with the adjusted 5-HTP and how Carol does with the bump in tryptophan (and any other feedback I get from these folks).

Some of the research and possible mechanisms

There are many studies that support serotonin changes and seasonal variations in mood. Here are just two of them:

  • Effect of sunlight and season on serotonin turnover in the brain “Alterations in monoaminergic neurotransmission in the brain are thought to underlie seasonal variations in mood, behaviour, and affective disorders… turnover of serotonin by the brain was lowest in winter. Moreover, the rate of production of serotonin by the brain was directly related to the prevailing duration of bright sunlight… Our findings are further evidence for the notion that changes in release of serotonin by the brain underlie mood seasonality and seasonal affective disorder.”
  • Sunshine, Serotonin, and Skin: A Partial Explanation for Seasonal Patterns in Psychopathology? “one contributory facet may be the role of sunshine on human skin. Human skin has an inherent serotonergic system that appears capable of generating serotonin.”

Other factors to consider: low vitamin D, sugar, pyroluria and phenols

There are other low-serotonin related factors to consider too:

  • Low vitamin D is common in the winter and sufficient levels are needed for making serotonin. This paper, Vitamin D and the omega-3 fatty acids control serotonin synthesis and action, part 2: relevance for ADHD, bipolar disorder, schizophrenia, and impulsive behavior describes how“Brain serotonin is synthesized from tryptophan by tryptophan hydroxylase 2, which is transcriptionally activated by vitamin D hormone. Inadequate levels of vitamin D (∼70% of the population) and omega-3 fatty acids are common, suggesting that brain serotonin synthesis is not optimal.”
  • The increased consumption of sugar at this time can lead to reduced zinc, magnesium and B vitamins (like vitamin B6 and thiamine) and this can further reduce serotonin levels, which relies on these nutrients as cofactors for production. By boosting serotonin with additional tryptophan or 5-HTP you can actually reduce some of the cravings.
  • If you have the social anxiety condition called pyroluria, the added stress of family and holiday gatherings can also contribute to zinc and vitamin B6 being dumped, and further impacting serotonin production.
  • Christmas tree phenols can be a trigger for anger, meltdowns, anxiety, hyperactivity, insomnia, aggression, self-injury and autistic symptoms in susceptible individuals

Resources if you are new to using tryptophan and 5-HTP 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 serotonin symptoms here) and a brief overview here, Anxiety and targeted individual amino acid supplements: a summary.

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 noticed this winter dip in serotonin and made adjustments to your 5-HTP or tryptophan? And do you feel less anxious, less obsessive, not as low and with fewer sugar cravings?

Do you find that using a SAD lamp/full spectrum light at this time helps even further?

Were you aware that serotonin dipped in winter and could be playing a role for you? Or did you think it was just the stress and overwhelm of the holidays (and /or some of the emotional upheaval some of us face at this time)?

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

Have you also noticed you need to adjust your GABA and other amino acids at this time too (both GABA and dopamine show seasonality)?

Feel free to ask your questions here too.

Alice in Wonderland Syndrome – is there a pyroluria connection?

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alice in wonderland syndrome

I first learned about Alice in Wonderland Syndrome (AIWS) during one of the Anxiety Summits. I’m surprised at how many queries I get about this syndrome and the fact that everyone who has reached out also has the social anxiety condition called pyroluria or suspects they have it.

This 2017 paper, Alice in Wonderland Syndrome: A real life version of Lewis Carroll’s novel, describes it as follows:

Alice in Wonderland Syndrome was originally coined by Dr. John Todd in 1955. The syndrome is named after the sensations experienced by the character Alice in Lewis Carroll’s novel Alice’s Adventures in Wonderland. Alice in Wonderland Syndrome consists of metamorphopsia (seeing something in a distorted fashion), bizarre distortions of their body image, and bizarre perceptual distortions of form, size, movement or color. Additionally, patients with Alice in Wonderland Syndrome can experience auditory hallucinations and changes in their perception of time. Currently, there is no known specific cause of Alice in Wonderland Syndrome. However, theories point to infections such as the Epstein-Barr virus, medications such as topiramate and associated migraines.

You can read about all the types of visual and non-visual distortions in this paper: Alice in Wonderland syndrome – A systematic review. This paper also includes a list of conditions in which Alice in Wonderland syndrome has been described in the literature, with infections and migraines being very common. The authors also feel that what we see in the published literature may only be the tip of the iceberg:

Since 1955, no more than 169 case descriptions of AIWS have been published. The literature indicates that this may be only the tip of the iceberg, with many individual symptoms of AIWS being experienced (albeit occasionally and only fleetingly) by up to 30% of adolescents in the general population.

The published case numbers have increased slightly (this paper was published in 2016) and it’s reported that many of the 30% of adolescents with AIWS experience non-clinical symptoms i.e. they are not severe enough to need treatment.

I still find “up to 30% of adolescents in the general population” to be very surprising for a syndrome which was once considered very rare and is frequently misdiagnosed.

Read on to hear from some folks in my community who have reached out and described their AIWS episodes. They all have pyroluria and I’d love to know if there is a possible connection.

Everything either looks really far away but massive or really close up but tiny

Sallie, a mom in my community, shared about her son and what he experienced in the comments section of the pyroluria prevalence and associated conditions blog. During his episodes, everything either looks really far away but massive or really close up but tiny:

I believe he has Alice in Wonderland syndrome. I have taken him to GP’s, pediatricians, optometrists, opthamologists and no one knew what was wrong. I spent about 6 months researching the possibilities myself and came across AIWS. When I showed him some of the journal articles, he was so relieved to finally have an answer. Since then, I have had a gut feeling that pyroluria and AIWS may be linked somehow.

She believes his AIWS may have been triggered by an infection when he was around 6 years of age. He developed sudden onset of vomiting, fever and delirium:

Still to this day, he distinctly remembers this night and recalls (like it was yesterday) not being able to stop looking at his hands because they were changing size and how far away/close up they were.

Once he was old enough to articulate what he was experiencing, he was able to tell me he feels weird, like he needs to go to a pitch-black room and lie down. Sometimes it coincides with a headache.

Everything suddenly appears as if far away then everything either looks really far away but massive or really close up but tiny. He feels dizzy while this happens also. Stress definitely increases the number of AIWS episodes.

Infections are reported as one (of possibly many) root causes of AIWS: “Reported causes include infection (especially with Epstein Barr virus), migraine, epilepsy, depression, and toxic and febrile delirium.”

Infections are common mental health triggers. Strep as a trigger for PANDAS/PANS is a classic example. I blog about Bartonella and sudden-onset adolescent schizophrenia here.

He has pyroluria and stress increases the number of episodes he experiences. My question is this: is there a link between the dumping of zinc and vitamin B6 during these times of stress and episodes of AIWS?

The feeling of being extremely small somatically (or physically), like how you feel when in a football stadium

Mike is a 21 year old male and thinks he may very well have pyroluria based on the questions. He also shares this in the blog comments about his AIWS experiences:

I have experienced sensations similar to Alice in Wonderland Syndrome throughout my life, more so during periods of stress. The feeling of being extremely small somatically (or physically), like how you feel when in a football stadium.

Again, he has pyroluria and his symptoms are worse during periods of stress. Keep in mind that stress makes pyroluria symptoms more intense too.

She usually experiences objects/people smaller than what they are but her more pronounced symptoms are sound distortions

Brenda, another mom in the community, shared this about her daughter’s dreams and PMS on the pyroluria questionnaire blog:

I’m quite certain that my 17 year old daughter has pyroluria. I counted 23 symptoms that she definitely exhibits. Her dream recall is so poor that she insists she doesn’t dream at all. I’m going to start her on zinc, B6 and evening primrose oil right away. Her PMS/premenstrual syndrome is so severe that I had decided to see a gyno to discuss birth control pills. Of course I won’t after listening to your interview with Karla Maree (on the Anxiety Summit).

She also asked if I was familiar with Alice in Wonderland Syndrome and if so do I think it may be connected to pyroluria?  She shares this about her daughter’s AIWS experiences:

My daughter has experienced occasional Lilliputian (trivial or small) hallucinations since childhood.  She usually experiences objects/people smaller than what they are but her more pronounced symptoms are sound distortions. She hears voices/noises (real, not imagined) much louder than they are in reality.

She does not have migraines, has never had mononucleosis or any of the other conditions listed as possible causes of Alice in Wonderland Syndrome. That’s why I’m thinking it may be caused by nutritional deficiencies.

This was my introduction to this syndrome and I appreciate her for asking the question. I did some reading of the research and the word “hallucination” got me thinking that a pyroluria connection was possible. The original work by Dr. Carl Pfeiffer with pyroluria was with individuals with schizophrenia.

However, the second paper mentioned above does state that “AIWS is characterized by perceptual distortions rather than hallucinations or illusions and therefore needs to be distinguished from schizophrenia spectrum and other psychotic disorders.”

We clearly have much to learn and I’m still curious to find out how often these two conditions do overlap – pyroluria/social anxiety and Alice in Wonderland Syndrome.

Resources if you are new to pyroluria

Pyroluria is a social anxiety condition and the physical and emotional symptoms are caused by deficiencies of vitamin B6 and zinc. When you experience high levels of stress, vitamin B6 and zinc will be further depleted, so you may notice worsening symptoms and more anxiety. Here is the symptoms questionnaire and additional resources if you are new to pyroluria:

Have you (or a family member) had episodes of Alice in Wonderland Syndrome? And do episodes coincide with times of added stress?

Do you also suspect pyroluria and has the pyroluria protocol or other nutritional interventions helped to reduce or stop the episodes?

I’d love to also hear anything else you’re willing to share: age at onset, age AIWS stopped, do you suspect an infection as the trigger (or a medication or toxins or something else?), do others in the family have AIWS episodes and how would you describe your AIWS episodes?

Feel free to post any questions here too.