research

GABA Oolong tea in children with autism: improvements in sensorimotor skills, autism profiles, anxiety and sleep (new research)

December 2, 2022 By Trudy Scott 14 Comments

A small feasibility study, A double-blind, placebo-controlled, randomised-designed GABA tea study in children diagnosed with autism spectrum conditions, explored the effect of drinking GABA Oolong tea on sensorimotor skills, autism profiles, anxieties and sleep of children with autism.

It was a very small study with nine children (5 male and 4 female) but the results were very promising… “significant improvement in manual dexterity and some large individual improvements in balance, sensory responsivity, DSM-5 criteria and cortisol levels with GABA tea.”

In addition to reducing anxiety (in all but one participant – more on that below), the paper lists the following additional information related to sensory issues, cortisol levels and sleep:

Results also demonstrated that sensory responsivity improved in two-thirds of the participants and autism symptomology decreased in over half, with four of these individuals being positively re-classified on the DSM-5 scale
Differences between evening and morning cortisol levels, deemed the ‘carryover’ effect and cortisol awakening levels were also decreased in over two thirds of the participants, which we attribute to a reduction in stress response which may have helped to reduce sensorimotor responsivity in individuals with autism.
Contrary to our hypotheses, GABA Oolong tea did not appear to impact sleep, with no discernible differences noted in a range of sleep parameters compared with the placebo, despite parents’ subjective reports that their children appeared to sleep more deeply.

They conclude as follows … “These results suggest that sensorimotor abilities, anxiety levels and DSM-5 symptomology of children with autism can benefit from the administration of GABA in the form of Oolong tea.”

What is GABA Oolong tea?

When I shared this study and results on Facebook, I had a few people ask if they could simply add the amino acid GABA to their Oolong tea: “Is it just brewed tea with GABA powder added? Or does someone make a specific tea? I can totally add some GABA to my daily tea.”

It’s not regular oolong tea with GABA added, instead it’s specially fermented to increase GABA levels naturally. Amber GABA Oolong tea by Meileaf is the actual tea used in the study and they share this on the product page.

The farmers achieve this by alternating the leaves between air and a nitrogen rich environment (with no air) during the oxidation phase. This is done over a matter of hours and naturally increases the GABA levels in the tea leaves.

They also share this: “In order to be called GABA tea, the leaves must contain at least 150 mg of GABA per 100g (normal oolong has about 6 mg so that is 25 times higher).”

GABA Oolong tea does also contain theanine, caffeine and epigallocatechin gallate. There is a large part of the study dedicated to theanine so feel free to read that at your leisure.

How much GABA was ingested by study participants?

It was a surprisingly low dose of GABA! They were given 4 cups a day of the GABA Oolong tea and this provided a total of 39.2mg GABA for the day. The authors share this about the amount of daily GABA the study participants received:

With the GABA Oolong tea the dose would be approximately 280 mg per 100 g tea. Based on using 3.5 g per tea portion this equates to 9.8 mg of GABA; multiplied by 4 throughout the day, being 39.2 mg of GABA.

I’ve reached out to confirm which tea was used in the study since Meileaf mentions that this tea contains 205 mg of GABA per 100 g whereas the study states there was 280 mg GABA per 100 g tea. I see consistency with assessing GABA levels accurately being a possible issue (more on that below).

One of the first questions I had was how could such a small amount – 39.2 mg GABA for the day – be so effective? I typically have clients start with 125 mg GABA and they may end up using this dose 3 or 4 x day (so 375 to 500 mg GABA total for the day.)

That said, we are all unique and as I’ve shared, there can be an extremely large variation in dosing. In this blog I share how Syd gets sleep and body anxiety benefits with just 1.5 mg to 3 mg GABA and yet Christina’s agoraphobic client was able to leave the house with 3000 mg GABA.

My other questions: the placebo, caffeine, a histamine reaction, low cortisol and B1 depletion

With new research there are always many factors to consider and I have a number of other questions I’d love to see addressed:

Why did the placebo tea also contain GABA? It had 22.2 mg per day of GABA – about half that found in the GABA Oolong tea.
GABA Oolong tea does contain small amounts of caffeine and how would this affect susceptible individuals? One child was more anxious – was it due to caffeine or was it too much GABA for his needs or a histamine reaction due to the fermentation process (or something else)?
Do we need to be concerned about long term use and depletion of vitamin B1/thiamine which happens with regular tea.
And what about the effects if someone already has low cortisol levels?
Will there be standard levels and accurate measures of GABA in the various GABA Oolong teas that we can rely on? This applies to consumers and practitioners wanting to try this approach and for ongoing research.
How much of the effect was also due to addressing dehydration and helping with dietary oxalate issues which are known to be common in autism?

Hopefully new ongoing research with more participants will shed light on some of these questions.

I’d also love to see head to head research comparing GABA Oolong tea with supplementation of the amino acid GABA, and a study where both are used for possible synergistic effects.

I do appreciate that the authors attempt to address the GABA blood brain barrier (BBB) debate and how GABA could work, focusing on a permeable blood brain barrier in epilepsy and increased epilepsy in autism. This angle is new to me. I’ve addressed the leaky BBB at length here in my interview with Dr. Kharrazian (it’s a theory) and one of my interviews on a prior Anxiety Summit (there are many possible mechanisms and the peripheral effects).

If you’re new to symptoms of low GABA (and cases highlighting the calming effects of the amino acid GABA used as as a supplement)

GABA (gamma aminobutyric acid) is a calming neurotransmitter and the calming amino acid GABA used as a supplement can raise GABA levels. With low GABA levels you’ll feel a physical-tension and stiff-and-tense-muscles type of anxiety.

The other symptoms we see with low GABA are panic attacks, physical tension in certain settings like public speaking or driving, and the need to self-medicate to calm down, often with alcohol but sometimes with carbs and sugary foods. Insomnia can also be due to low GABA and you’ll experience physical tension (rather than the ruminating thoughts which is the low serotonin type of insomnia – although it’s not uncommon to experience both). GABA also helps with muscle spasms and pain relief when muscles are tight.

Here are are some case studies where you can read about the calming effects (and other benefits) of the amino acid GABA used as as a supplement:

Resources if you are new to using GABA and other amino acids as supplements

If you are new to using GABA or any of the other amino acids as supplements, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution (you can see all the symptoms of neurotransmitter imbalances, including low GABA and low serotonin).

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, self-medicating with alcohol and more.

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). This is a paid online/virtual group program where you get my guidance and community support.

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.

Have you used GABA Oolong tea with clients/patients or personally? How much and what benefits have you seen? Which product have you used?

If you’ve also used the amino acid GABA sublingually and with success, I’d love to hear how much (and which product) and how it compares with GABA Oolong tea for anxiety, insomnia, sensorimotor skills and/or autism symptoms (as applicable to you, your child or other family member and/or your client/patient)?

If you have questions please share them here too.

Oxalate crystal disease, dietary oxalates and pain: the research & questions

June 26, 2020 By Trudy Scott 143 Comments

This blog post came out of my quest for finding a medical explanation/term for my own pain caused by dietary oxalates and a desire to gain a better understanding for my clients who experience similar pain. It’s been on my writing list for some time and I’ve been gathering articles and research but the current coronavirus pandemic and recommendations for high vitamin C intake had me concerned enough to blog about it and ask for feedback from my community.

This is the blog, Coronavirus and vitamin C for immune support: new pain or more severe pain due to oxalate issues?, where I pose the question about recent increased intake of vitamin C or the addition of large doses for immune support and increased pain: joint pain, eye pain, foot pain, vulvodynia, bladder issues, insomnia, gut pain, kidney pain, changes in thyroid health/labs, bone pain etc? The feedback on this blog and on Facebook has been huge and confirms the connection. Thank you if you’ve already contributed to the discussion!

Today I’ll share an overview of oxalates, my pain issues with dietary oxalates, a deeper dive into the condition called oxalate crystal disease (with some of my insights and questions), and the autism and atherosclerosis research. It’s by no means a comprehensive blog on all things oxalates but rather a way to try and connect some dots and pose some questions for going deeper.

The next blog will address my vitamin C/oxalate/pain story and the research on vitamin C, oxalates and pain, together with questions.

Oxalates defined and food sources

Before we review oxalate crystal disease, let’s define calcium oxalates. Julie Matthews, my good friend and colleague and an oxalate expert shares this in her blog, Oxalates: Their Influence on Chronic Disease

Oxalates present in our body as sharp crystals or crystalline structures with jagged edges that cause pain, irritation, and distress. They can bind with certain minerals; particularly calcium and magnesium, as well as iron and copper

You’ll find many different lists of low, medium and high oxalate foods. When I started eating low oxalate I found Susan Owen’s site simple and very helpful. I then joined the Trying Low Oxalates Facebook group for support and feedback.

In summary, these are the common medium-oxalate and high-oxalate foods that many folks have problems with: nuts, nut-butters and nut-flour (something to watch when eating Paleo or GAPS), wheat, chocolate, kiwi fruit (very high – see the raphides image below), star fruit (also very high), beets, potatoes, legumes, berries, spinach and soy.

You can see why these needle shaped calcium oxalate crystals found in kiwi fruit could inflict pain. This is just one example – there are many different shapes of calcium oxalate crystals.

raphides purified from kiwifruit — Raphides purified from kiwifruit. Raphides, needle shaped calcium oxalate crystals, were collected from kiwifruit homogenate through heavy media separation using a dense CsCl solution. (A) The SEM image of purified raphides (x400). Shared from: Synergistic Defensive Function of Raphides and Protease through the Needle Effect via Creative Commons.

My oxalate story: severe foot pain and eye pain

I personally had severe dietary oxalate issues in 2012 which manifested as excruciating foot pain. It was a combination of hot-burning-coals-pain and shards-of-glass-pain. It was just after my book, The Antianxiety Solution (my Amazon link), came out. Due to my book tours and events, I would be on my feet all day presenting, often for 3 full consecutive days, so I figured that must be the reason. When I travelled, I took a blender and made smoothies with berries, ate plenty of healthy nuts as my snacks and took kale chips with me to make sure I was getting my greens. Kiwi fruit was a favorite of mine!

I was eating a high oxalate diet and had no idea until I heard Julie present at an Integrative Medicine for Mental Health Conference on dietary oxalates and autism. A light-bulb went off and then I worked with her to learn about oxalates and figure out if it was in fact because of oxalates and sure enough, as soon as I removed high and medium oxalate foods the pain resolved. Note: the advice is NOT to remove all high and medium oxalate foods at once because dumping can occur. I was fortunate that this didn’t happen with me, possibly because of the vitamin B6 I was already taking as part of the pyroluria protocol.

When I eat a low oxalate diet I do really well. However, more recently dietary oxalates have been causing me eye pain when I have a treat like eggplant or carob. It starts out as a kind of scratchy discomfort and mild pain and then gets worse and worse. I also have a goopy kind of discharge from the inner part of my eye and burning/redness crystal-like teariness on the outer parts of my eyes. I recently had one very severe incident where the eye pain in my left eye was agonizing for about 2 hours. I was beside myself and tried GABA, DPA and tryptophan for an attempt at pain relief – with no success. When I took 500mg of vitamin B6 the pain eased immediately.

The theory is that oxalates cause issues where you have a weakness. I injured my left eye walking into a low tree-branch while rock-climbing 15 years ago, so I suspect this is why my left eye is more severely affected.

Oxalate crystal disease

The condition “oxalate crystal disease” is the closest explanation I’ve found that explains the pain I’ve experienced and makes the most sense, other than the fact that all the studies mention kidney disease and yet I don’t have kidney disease and have never had kidney stones. I’ve also never had a problem with my estimated Glomerular Filtration Rate (eGFR). In case eGFR is new to you it measures how well your kidneys filter the wastes from your blood and is the best overall measure of kidney function/damage.

This paper, Update on oxalate crystal disease, summarizes it:

Oxalate arthropathy is a rare cause of arthritis characterized by deposition of calcium oxalate crystals within synovial fluid. This condition typically occurs in patients with underlying primary or secondary hyperoxaluria. Primary hyperoxaluria constitutes a group of genetic disorders resulting in endogenous overproduction of oxalate, whereas secondary hyperoxaluria results from gastrointestinal disorders associated with fat malabsorption and increased absorption of dietary oxalate. In both conditions, oxalate crystals can deposit in the kidney leading to renal failure. Since oxalate is primarily renally eliminated, it accumulates throughout the body in renal failure, a state termed oxalosis. Affected organs can include bones, joints, heart, eyes, and skin. Since patients can present with renal failure and oxalosis before the underlying diagnosis of hyperoxaluria has been made, it is important to consider hyperoxaluria in patients who present with unexplained soft tissue crystal deposition. The best treatment of oxalosis is prevention. If patients present with advanced disease, treatment of oxalate arthritis consists of symptom management and control of the underlying disease process.

Let me break this down because I’ve had to look up terminology and read and re-read papers in order to get a better understanding of things:

#1 Oxalate arthropathy is a rare cause of arthritis characterized by deposition of calcium oxalate crystals within synovial fluid.

Oxalate arthropathy is a disease of the joints caused by oxalates depositing in the synovial fluid of the joints. The paper states it is a rare cause of arthritis, but I suspect it is much more common given what we’re seeing clinically.

Also, because all the research connects oxalate crystal disease with kidney disease, it may be overlooked when there is no kidney disease (more on that below).

Synovial fluid is the fluid between the joints that acts as a lubricant and nutrient source.

#2 This condition typically occurs in patients with underlying primary or secondary hyperoxaluria.

Hyperoxaluria occurs when you have “too much oxalate in your urine.”

#3 Primary hyperoxaluria constitutes a group of genetic disorders resulting in endogenous overproduction of oxalate and… secondary hyperoxaluria results from gastrointestinal disorders associated with fat malabsorption and increased absorption of dietary oxalate.

Primary hyperoxaluria is genetic and results in endogenous or internal overproduction of oxalate, causing too much oxalate in the urine.

The secondary hyperoxaluria description mentions “gastrointestinal disorders associated with fat malabsorption and increased absorption of dietary oxalate.” There are a number of other factors which I’ll address in a future blog.

According to this paper and others, secondary hyperoxaluria also results in too much oxalate in the urine.

#4 In both conditions, oxalate crystals can deposit in the kidney leading to renal failure. Since oxalate is primarily renally eliminated, it accumulates throughout the body in renal failure, a state termed oxalosis.

Affected organs can include bones, joints, heart, eyes, and skin.

Mayo clinic states oxalosis occurs if your kidneys fail. “Because your body can no longer eliminate the extra oxalate, it starts accumulating — first in your blood, then in your eyes, bones, skin, muscles, blood vessels, heart and other organs.”

My comment is that in some instances, oxalates accumulate in various parts of the body without kidney failure. I share more about this aspect and what we see clinically below, plus an autism and atherosclerosis study.

This paper, Oxalate crystal deposition disease, also mentions the following: “osteopathy, acute and chronic arthropathy with chondrocalcinosis, synovial calcification, and miliary skin calcium oxalate deposits and vascular calcifications that affect mainly the hands and feet.” The paper is focused on primary hyperoxaluria (and does also discuss the kidney involvement) but I’m including it because of the conditions listed. You may have received one of these diagnoses and not linked it back to dietary oxalates and/or vitamin C intake possibly playing a role.

The authors do report “systemic life-threatening cardiovascular, neurologic, and hematologic manifestations”, saying they are rare.

Calcium oxalates: anxiety, sleep, headaches, fatigue and other symptoms

Calcium oxalate crystals can also be found in the thyroid, and ear, leading to hearing loss under some circumstances.

Julie Matthews, in her blog, Oxalates: Their Influence on Chronic Disease, also shares that

Clinical studies and anecdotal experience indicate that oxidative stress, mitochondrial disruption and damage, and nutrient depletions, trigger widely varied symptoms including fatigue and inflammatory cascades, joint pain or pain anywhere in the body. Chronic low energy is very common because of a reduction in ATP in the mitochondria. Oxalates could be a hidden source of headaches, urinary pain, genital irritation, joint, muscle, intestinal or eye pain.

Other common oxalate-caused symptoms may include mood conditions, anxiety, sleep problems, weakness, or burning feet. Indicators can be digestive, respiratory, or even bedwetting for children.

What the researchers are saying – always kidney disease

I’ve reached out to a number of researchers, practitioners and labs and they all state that oxalate crystal disease only happens with kidney disease/kidney stones. This is what one researcher shared with me: “Plasma oxalate concentrations only elevate enough to cause systemic disease when there is significant kidney disease (typically GFR <20-30). I have never seen a significantly elevated plasma oxalate without chronic kidney disease.”

Could this be the case because they are kidney specialists and therefore only seeing patients who already have kidney disease?

The good news is that a number of them are intrigued and interested in learning more.

Oxalate crystals in autism and atherosclerosis without kidney issues

However, based on my own experience and according to many in this community and other communities like the Trying Low Oxalates Facebook group, pain issues related to dietary oxalate intake may occur without kidney issues/kidney stones, and often does.

These papers offer some support for what I suspect we are seeing clinically – systemic oxalate deposits can occur deposits without kidney stones or renal failure:

A Potential Pathogenic Role of Oxalate in Autism

Children with ASD [autism spectrum disorder] demonstrated 3-fold greater plasma oxalate levels … and 2.5-fold greater urinary oxalate concentrations. Despite significant hyperoxaluria no evidence of kidney stone disease…was observed

Atherosclerotic Oxalosis in Coronary Arteries

calcium oxalate crystals were observed within atherosclerotic plaques in the coronary arteries. Similar deposits were seen in the thyroid gland and other organs but not in the kidneys. None of the patients had chronic renal failure…. We suggest the phrase “atherosclerotic oxalosis” to describe this finding.

These are the disconnects I’m seeing in the research and questions I have:

Oxalate crystal disease is reported to be rare and it only happens with kidney disease/kidney stones – could it be more common than reported? As Julie states: “New science and clinical experience reveal concerns about oxalates that far exceed traditional kidney stone pathology.”
Should we be calling it hyperoxaluria. “too much oxalate in your urine” if the kidney is not involved? Or do we need to expand the definition of hyperoxaluria to include too much oxalate in other tissues outside the kidney and urine?
Could oxalate crystal disease with no kidney disease be a new syndrome that has yet to be widely and clearly identified in the research?

I mean no disrespect to the study authors and researchers by sharing my insights and questions here and in the section above. I appreciate the work they do and the opportunity to learn from them.

Searching through the literature on this has been extremely challenging because studies always refer to the kidney. It may well be that there is a perfectly logical explanation for much of this and someone has already gone through the research and has answers to all my questions. I am very willing to be enlightened so please do share if you’ve come across a good explanation.

Either way, please share your insights based on what I’ve shared in this blog and in relation to your experiences with pain caused by dietary oxalates and/or pain caused by vitamin C intake. I will be sharing this blog and the comments with the researchers and practitioners who are open to all this.

Read all posts in this series:

Food does improve mood: 2012 research

August 21, 2012 By Trudy Scott 19 Comments

A recent blog post on the GoodTherapy.org site featured this article: “Can Social Anxiety Be Caused by a Nutritional Deficiency?”. I was thrilled to have been quoted and to have shared my experience with pyroluria, a form of social anxiety, shyness and inner tension, that responds very well to the supplements vitamin B6, zinc and evening primrose oil. It was also a wonderful opportunity to get folks thinking about the role that food and nutrients play in mental health.

I was rather surprised by this comment from Nerina Garcia-Arcement, a licensed clinical psychologist and clinical assistant professor at the NYU School of Medicine: “Having a healthy and balanced diet is overall beneficial, but it won’t cure social anxiety or a mood disorder. I am more likely to recommend my clients get enough sun exposure to improve their moods (seasonal affective disorder) than recommend diet changes.”

I certainly support the recommendation for sun exposure and write this blog post to provide additional resources for those who may be unfamiliar with the recent food mood research. And I will address pyroluria, zinc and vitamin B6 in a separate post.

Here is just some of the 2012 food mood research:

Dias GP, Cavegn N et al. 2012. The role of dietary polyphenols on adult hippocampal neurogenesis: molecular mechanisms and behavioural effects on depression and anxiety. 2012. Oxidative Medicine and Cellular Longevity Epub 2012 Jun 28

“Studies on the effects of dietary polyphenols” (such as those found in green tea and turmeric), “on behaviour and AHN” (adult hippocampal neurogenesis), “may play an important role in the approach to use diet as part of the therapeutic interventions for mental-health-related conditions.”

Michalak J, Zhang XC et al. 2012 Vegetarian diet and mental disorders: results from a representative community survey. International Journal of Behavioral Nutrition and Physical Activity. Jun 7;9(1):67. [Epub ahead of print]

“Vegetarians displayed elevated prevalence rates for depressive disorders, anxiety disorders and somatoform disorders.” The authors also state that because “vegetarians exhibit a wide diversity of dietary practices, future research should more carefully define vegetarian diet to enable closer examination of the associations between diet and risk of mental disorders.” Since this was an epidemiological study, it shows association only. But it’s a great start.

Davison KM, Kaplan BJ. 2012. Nutrient Intakes Are Correlated With Overall Psychiatric Functioning in Adults With Mood Disorders. Canadian Journal of Psychiatry. 57:85-92

This study looked at Canadian adults with mood disorders. Intake of carbs, fiber, total fat, linoleic acid, riboflavin, niacin, folate, vitamin B6, B12, pantothenic acid, calcium, phosphorus, potassium, iron, magnesium and zinc were measured and “higher levels of nutrients equated to better mental health.” (This study was included on my poster presentation at the 2012 Anxiety Disorders Association of America conference)

One of the study authors, Dr Kaplan, PhD was quoted as saying: “Doctors should consider counseling their patients to eat unprocessed, natural, healthy foods and refer them to a nutrition professional if specialized dietary consultation is needed.”

Torres SJ, Nowson CA. 2012. A moderate-sodium DASH-type diet improves mood in postmenopausal women. Nutrition. Sep;28(9):896-900. Epub 2012 Apr 4.

“In addition to the health benefits of a moderate-sodium Dietary Approaches to Stop Hypertension diet on blood pressure and bone health, this diet had a positive effect on improving mood in postmenopausal women.” This diet did include lean red meat, which “was associated with a decrease in depression.”

Dr Felice Jacka, an Australian researcher, has a number of papers that I’ve blogged about in the past. A more recent one from 2011 looked at Norwegian adult men and women, and found that “those with better quality diets were less likely to be depressed” and that a “higher intake of processed and unhealthy foods was associated with increased anxiety.”

In a recent bipolar post, I also mention some of the research around eating a real food traditional diet and a lower risk of bipolar disorder, and the relationship between gluten and bipolar disorder.

All in all, there is much recent evidence pointing to some very real benefits for making dietary changes in order to improve mental health outcomes. Clearly, more research is needed, but we have growing evidence that the food mood connection is NOT “just a bunch of hooey” (as one of the readers stated) and we need to keep our minds open if we are to help those in need of our services!