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Pesticide warehouse fire and spill: environmental effects, detoxification and long-term impacts for anxiety and physical health

August 13, 2021 By Trudy Scott 6 Comments

pasticide warehouse and fire spill
The toxic green river/lagoon with poisoned/dead fish piling up (Credit: Drone Fundi)

One month ago, during the political riots in South Africa, a warehouse in Cornubia was burned down causing a slew of pesticides, insecticides and fungicides to be spilled into the nearby river and ocean, and burned into the atmosphere. This happened in a semi-industrial area bordering on residential areas such as Umhlanga Rocks and Sunningdale, and the informal settlement Blackburn. My sister and her family live in Umhlanga Rocks and we frantically communicated (during the riots and after the spill), trying to figure out what was going on, with me offering insights on how to help them mitigate some of the short-term toxic health effects. These included practical steps to avoid the toxic air and water, and some nutritional approaches to start supporting detoxification.

While this blog is specific to the situation in South Africa, something like this could happen near you one day. For this reason, I’m sharing what I have learned and what I already know about environmental toxins so you are aware of the short-term and long-term impacts for anxiety, mood and physical health.

Much of the nutritional support and detoxification recommendations are also applicable if you are dealing with smoke from forest fires too, like much of the western states of the US and Canada right now, and some countries like France and Greece in the EU.

The South African civil unrest and riots that led to the pesticide fire and spill

This article describes the civil unrest and explains how “South Africa suffered an insurrection attempt with two provinces, KwaZulu-Natal and Gauteng disabled, and national fuel and food supply lines disrupted.” It is thought that twelve masterminds planned and executed it on social media and then lost control after the looting started.

The pesticide warehouse in Cornubia, KwaZulu-Natal, was leased by United Phosphorus Limited (UPL) and was burned down as a direct result of this rioting and looting.

Queen Nandi Drive Durban
One of hundreds of  burning buildings: Queen Nandi Drive, Durban (Credit: Kierran Allen Photography)

The Cornubia warehouse was one of many hundreds of factories, stores and warehouses that were burned down, all contributing to a toxic soup in the atmosphere.

Wildlife photographer, Kierran Allen, captures the above scene and many other shocking images. Check them out on his Facebook page and here.

The pesticide warehouse fire and spill

The UPL product list is long and includes 124 herbicides, 43 fungicides, 52 insecticides and various other chemicals. I looked through some of the categories and found atrazine, paraquat, glyphosate, chlorpyrifos and many more.

As of today, 30 days after the initial fire, the company has not disclosed which products were part of the fire and spill (more on this below).

spilled products

As a result of the warehouse fire and spill, the Ohlanga river and Umhlanga lagoon turned a strange green-blue and thousands and thousands of fish were killed. The beaches and sea water became toxic too. Koi fish in a nearby neighborhood pond died. Surfers reported burning skin while surfing at Umdloti, 12 km north of the lagoon mouth.

Individuals in the community reported headaches, burning skin and eyes, asthma, nose and throat problems, and coughing. I also saw a report of “oily black goop floating on my pool surface” and getting on the paws of their cats and dogs.

Drone Fundi published an excellent 3-minute aerial video on their Facebook page and gave me permission to snag a screenshot of the dead fish image for this blog.

Umhlanga river

umhlanga river
The toxic green-blue river/lagoon with poisoned/dead fish piling up (Credit: Drone Fundi)

Excellent coverage by environmental journalist, Tony Carnie

Environmental journalist, Tony Carnie, has provided the most comprehensive coverage in a number of excellent articles on The Daily Maverick blog:

  • On July 20th, 2021: New health warnings issued in Durban over toxic fumes stemming from chemical blaze

    The Indian multinational pesticide company United Phosphorus Limited has belatedly advised people to double down on health and safety precautions in the wake of the arson attack and massive fire at a chemicals warehouse at Cornubia, north of Durban.

daily maverick article

  • On August 12, 2021: ‘Lift the cloud of secrecy over Durban toxic chemicals explosion,’ MPs and community leaders demand

    It has been exactly a month since a massive cloud of toxic chemical fumes engulfed residential areas over large parts of Durban for 12 days – but government officials and the Indian-owned UPL agrochemicals giant are still refusing to release a full inventory of the quantity and type of poisons to the public.

Red flags about the fire and spill that concern me

As I read the media articles, the company press releases and reached out to the company, a number of concerning red flags started showing up:

  • UPL hired a risk management company to do the press releases and respond to enquiries. I did correspond with them and although very responsive they didn’t initially provide details of what pesticides were involved and then offered a partial list
  • The first press release on July 17, 2021 mentioned a warehouse storing “plant protection products.” I had never heard this term before and had to look it up – they are pesticides and other chemicals like insecticides and fungicides. It took a good few days for this to make it into media reports
  • UPL consulted with Dr. Gerhard Verdoorn and shared this in a press releases on July 19, 2021:

    He was provided with a list of the crop solution products stored in the warehouse, and was requested to provide guidance on the possible health implications posed by the release of these products into the environment.

    In his view, there is a minimal risk of any long-term effects to the health of people exposed to smoke from the warehouse. However, exposure in the short term to some of the chemicals contained in the crop solution products may result in dermal, eye and respiratory irritation.

This does not mention that Dr. Verdoorn is an industry spokesperson and I have concerns that they continue to downplay the severity and possible long-term impacts.

This same press release did mention some of the chemicals that were in the fire:

Some of the herbicides, such as chloroacetamides (for example, acetochlor, S-metalochlor), phenoxycarboxylic acids (2,4-D, MCPA and benzoic acids, or dicamba) may not have burned out completely. Two pyrethroids – alpha-cypermethrin and lambda-cyhalothrin – which are dermal, eye and respiratory tract irritants may have been present in the smoke.

  • One of my first thoughts was why is this warehouse located so close to residential areas and why don’t they have safety measures in place
  • 30 days later there is no disclosure of what pesticides and how much (The Daily Maverick blog reports this). One article mentioned they don’t want to provoke anxiety in the community by sharing the list. Not knowing causes anxiety and concerns.
  • 30 days later there is no expert commentary on long term potential impacts (I share more on this below) and long term mitigation/cleanup and detoxification approaches for the community

After watching movies like Erin Brockovich, Dark Waters (the true story of Dupont and Teflon) and Rainmaker, red flags like this need to be documented. I’m more than happy to take all this back if and when things change.

I share all this for the residents of this area who are being impacted right now, and so you can get an idea of red flags to look out for if you encounter something like this in your neighborhood one day.

Update August 17th: The list of chemicals

According to this Daily Maverick article, Here it is: The toxic stockpile of chemicals in torched United Phosphorus Limited Durban warehouse

*More than 26 000 kilograms of Masta 900, an insecticide containing the “very potent neurotoxin” methomyl for which “contact with skin, inhalation of dust or spray, or swallowing may be fatal.”

*Another 1 800 litres of methamidophos, also a “very potent neurotoxin”.

*More than 40 000 litres of products using the herbicide paraquat which poses “high risk for all life forms”.

*Over 19 000 kilograms of Terbufos, another “very toxic” chemical presenting “high risk to all forms of life”.

*More than 600 000 kilograms of products containing tebuthiuron, a chemical classified as “very toxic to aquatic life … with long lasting effects” sold under a variety of brand names including Lava 800 and Limpopo SC.

*More than 160 000 kilograms of potassium hydroxide and 100 000 kilograms of ammonia hydroxide, both intermediate products used in manufacturing that are “extremely caustic” chemicals that burn skin on contact.

*More than 3 000 kilograms of Cyprex, a “highly active herbicide” containing halosulfuron-methyl, a product that “may damage the unborn child”, according to the European Chemicals Agency.

*More than 500 000 litres of Triclon, a product containing triclopyr butotyl and classified as “flammable, harmful and environmentally hazardous” and that “may cause lung damage if swallowed”.

*More than 30 000 litres of MSMA 720, also known as monosodium methylarsonate which has been shown to have “limited evidence of a carcinogenic effect”, and over time converts to inorganic arsenic in soil with the potential to contaminate water sources.

*More than 30 000 kilograms of oxamyl-based insecticides, including products Bandito and Oxadate, that also present “high risk for all life forms”.

*Almost 11 000 kilograms of Tenazole, containing “extremely flammable” fungicide terbuconazole.

*More than 1 000 litres of Colloso, a fungicide containing the active ingredient carbendazim which “may cause heritable genetic damage”,  “may impair fertility”, and “may cause harm to unborn child”.

Practical solutions for short-term immediate exposure

As soon as I learned what had happened I started reading everything in the local media, contacted UPL, looked up the products they carry and immediately shared Dr. Elisa Song’s 2018 blog with my sister and friends: How to Detoxify When Air Pollution is High. Dr. Song published this resource for keeping children and families safe and healthy through the tragedy of the 2018 California fire season.

I knew her advice on “Optimizing Indoor Air Quality” would be perfect for the toxic pesticide situation too:

  • keep doors and windows closed at all times
  • have separate outdoor clothes and shoes
  • vacuum daily and use a HEPA filter
  • bring plants inside to help improve air quality
  • use your air conditioner as another way to clean the air and
  • diffuse essential oils.

My additions were as follows:

  • don’t hang clothes on the washing line
  • keep your pets inside and wipe them down after they go outside
  • ideally go somewhere away from the situation
  • definitely don’t go to the source to see what is happening as exposure will likely be much higher.

I also reached out to colleagues for specific information relating to a pesticide spill and certified Toxicity and Detox Specialist, Sinclair Kennally, very kindly did a write up specially for this situation. In her blog post, Environmental Toxin Exposure: what to do when disasters hit, she shares wonderful advice on:

  • daily best practices during the disaster
  • DIY strategies to reduce toxic exposure when supplies are scarce
  • herbs that can be used for first aid in a pinch
  • most important supplements for recovery afterwards
  • using activated charcoal or zeolite on laundry loads
  • making your own air filter pet care (using apple cider vinegar and bentonite clay/activated charcoal)
  • emergency essentials (especially water).

Detoxification solutions, and respiratory and immune health

Dr. Song’s detox advice on the same blog on “Supporting Respiratory and Immune Health” is very applicable for a pesticide spill such as this and for forest fires (and other environmental pollution): “Daily epsom salt baths to support detoxification and enhance magnesium and glutathione levels,” liposomal glutathione, extra magnesium and essential oils to support detoxification, immune and respiratory health. She mentions citrus and lavender essential oils which offer the added benefit of being calming and helping with sleep too (more on that below).

On Sinclair’s blog she empahsizes “Toxin excretion is the most crucial stage of any disaster” and she discusses sauna, binders, mobilizers and support for detox pathways in great detail.

The stores were all closed because of the looting so I gathered some additional resources in case folks didn’t have certain things on hand:

  • N-Acetyl Cysteine/NAC – improves glutathione levels, is a powerful antioxidant, “acts directly as a scavenger of free radicals” and is a mucolytic (clears mucus and relieves breathing difficulties)
  • Rooibos tea – is neuroprotective and it’s “cell-protective activity …is connected with the ability of reducing glycaemia, inflammation as well as oxidative stress.” It also eases anxiety and supports healthy cortisol levels
  • Apple cider vinegar (preferably organic with the mother) – “could be promising for attenuation of liver cell damages induced by several toxins through its powerful antioxidant properties” due to its major constituents of flavonoids and polyphenols.
  • Broccoli sprouts or extract – “the sulforaphane may be exerting its protective actions by activating a signaling molecule, NRF2, that elevates the capacity of cells to adapt to and survive a broad range of environmental toxins.” The authors go on to say it’s a “frugal, simple and safe means that can be taken by individuals to possibly reduce some of the long-term health risks associated with air pollution.”  A simple way to get some of these benefits is to make your own homemade broccoli sprouts (easy and lots of fun to nurture them and watch them grow!) and to consume them daily!
  • Vitamin D3 – “vitamin D is a significant factor in detoxification and protection against environmental toxins” (used based on vitamin D levels i.e. always test first)

Sleep, stress/anxiety, pyroluria and immunity

Sinclair starts with a reminder to “be gentle and kind with yourself and others” and Dr. Song also mentions the importance of  managing stress: “Psychological stress IS a toxin and fills up our inflammation bucket as much as any physical toxin.” Dr. Song recommends some wonderful kid’s books and breathing/meditation apps.

Of course, I wholeheartedly support their sage advice. I also recommend increasing tryptophan or 5-HTP, and GABA, as needed, if you are already using these amino acid supplements. You’ll increase  tryptophan or 5-HTP for the worry-type low serotonin anxiety and/or GABA for the physical-tension low GABA anxiety.

Supporting serotonin and GABA levels also help with sleep issues and GABA also supports a good immune system.

We know these chemicals can have a direct impact on neurotransmitter levels. One example is the insecticide fipronil impacting GABA levels. In this blog I share how the main mechanism of action is by targeting the gamma-aminobutyric acid (GABA) receptor and that recent research points to increased anxiety, aggressive behavior, memory problems and even Alzheimer’s disease in animal studies.

Another example is the herbicide glyphosate, which affects gut microbiota, causing anxiety and depression-like behaviors in mice, very likely via alterations in GABA and serotonin levels.

I also recommend bumping up your pyroluria supplements because zinc and vitamin B6 are depleted by added stress and worry.

Potential long term impacts on mental and physical health

This paper, Environmental Exposures and Depression: Biological Mechanisms and Epidemiological Evidence shares that pesticides are “quickly absorbed through the skin, mucous membranes, gastrointestinal and respiratory tracts, and the placenta” and can cause depression via various mechanisms:

  • Inhibiting the enzyme acetylcholinesterase (AChE), which results in decreased degradation of the neurotransmitter acetylcholine
  • Interference with the serotonergic and dopaminergic systems

Depression may also be caused by DNA methylation in specific genes, “increased oxidative stress, astrocyte dysfunction, and impaired hippocampal neurotransmission.”  Prenatal exposure also increases the risk of depression.

This chapter, Psychiatric Effects of Organic Chemical Exposure, from the book, Effects of Persistent and Bioactive Organic Pollutants on Human Health, states that:

Clinicians should remain aware that psychiatric symptoms can arise from toxic chemicals in diverse situations including terrorist attacks with chemical agents, mass chemical disasters in industrial or community settings, individual chemical accidents, and intentional solvent inhalation. Emerging evidence also indicates that prenatal exposure to organic compounds adversely affects neurodevelopment in humans and may be associated with later risk of mental illness.

Other chapters in this book cover cancer, diabetes, heart disease, obesity, thyroid function, women’s and men’s reproductive health, bone and joint health, immunity, respiratory illnesses, cognitive function and Parkinson’s disease.

All this is why we need to know what products were part of the fire and spill.

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 and want to know more in case you need them in a future situation, 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.

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. It also covers all the basics of a healthy diet that Dr. Song recommends.

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.

With much appreciation to Dr. Song, Sinclair for their helpful resources, the journalists, advocates and photographers, and to all the researchers.

Have you (or a loved one) experienced a pesticide or other environmental spill/disaster (or excessive smoke from a forest fire) and have these detox approaches and anxiety/sleep recommendations helped (or are they helping right now)?

Do you have any additional tips to share?

Feel free to post any questions here too.

Filed Under: Anxiety, Depression, Detoxification, Environment, Women's health Tagged With: 5-HTP, anxiety, Cornubia, depression, detoxification, environmental disaster, fire, forest fires, fungicides, GABA, insecticides, long-term impacts, pesticide, pesticides, physical health, serotonin, sleep, south africa, spill, stress, toxic health effects, tryptophan, Umhlanga Rocks

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

Tryptophan supplementation for anorexia?

July 9, 2021 By Trudy Scott 27 Comments

tryptophan and anorexia

This blog post highlights the potential importance of tryptophan supplementation in improving therapeutics in anorexia (and other eating disorders) and some of my insights about the 2017 anorexia-tryptophan study. I also share the high incidence of eating disorders, overlaps with anxiety and the case for tryptophan supplementation given the many low serotonin symptoms (anxiety, obsessive thoughts/behaviors, perfectionism, negative-self-talk, low self-esteem and depression) we see with anorexia and other eating disorders. And the importance of a comprehensive nutritional approach.

I’ve updated the original blog with newer research on low zinc and iron with males with eating disorders – and how this ties in with serotonin production and also pyroluria (read on below).

According to The National Eating Disorders Association (NEDA), eating disorders are

serious but treatable mental and physical illnesses that can affect people of all genders, ages, races, religions, ethnicities, sexual orientations, body shapes, and weights. National surveys estimate that 20 million women and 10 million men in America will have an eating disorder at some point in their lives.

While no one knows for sure what causes eating disorders, a growing consensus suggests that it is a range of biological, psychological, and sociocultural factors.

While NEDA does acknowledge that some of the causative factors may be biological, unfortunately there is no mention of nutritional psychiatry or tryptophan on the site. You’ll see this to be the case in the majority of conventional treatment centers.

The 2017 paper on tryptophan potential for anorexia

The paper, Improving therapeutics in anorexia nervosa with tryptophan, does acknowledge that the “growing body of evidence suggests that our diet is an important contributing factor in the development, management and prevention of a number of psychiatric illnesses.”

It discusses what we know about tryptophan being “the sole precursor” of serotonin, a neurotransmitter and that when used as a supplement it has therapeutic benefits when serotonin is low.

The author proposes that excessive dieting and food restriction decrease brain tryptophan and serotonin and propose the “potential importance of tryptophan supplementation in improving therapeutics in anorexia patients” (together with psychotherapy).

Given that anorexia has the “highest lethality of all psychiatric illnesses” and that there are currently “no FDA approved pharmacological treatments available” for anorexia, the urgency for implementing nutritional psychiatry approaches is high. The authors also share that the antidepressants and antipsychotics which are commonly used to treat the co-occurring anxiety, depression, OCD and psychosis are not very effective.

The author mentions a paper that used 250 mg tryptophan twice a day but based on my work with individuals with anxiety, we know an individualized approach is best.  A typical starting dose of tryptophan is 500mg used once or twice a day and I use the trial approach to determine the ideal dose for each person.

Incidence of anorexia and eating disorders in general

Here are a few select anorexia and eating disorder statistics from NEDA. I find much of this alarming and in some cases surprising (like the high incidence of males who are affected):

  • 40% to 60% of elementary school girls (ages 6-12) are concerned about their weight
  • 2% to 13% of adolescent girls meet the criteria for eating disorders
  • Males represent 25% of individuals with anorexia (they are at a higher risk of dying because they are often diagnosed later since many people assume males don’t have eating disorders)
  • Male athletes, especially those competing in sports that emphasize diet, appearance, size and weight, are at risk. In weight-class sports (wrestling, rowing, horse racing) and aesthetic sports (bodybuilding, gymnastics, swimming, diving) about 33% of male athletes are affected. In female athletes in weight class and aesthetic sports, disordered eating occurs at estimates of up to 62%.
  • In one study of ultra-Orthodox and Syrian Jewish communities in Brooklyn, 1 out of 19 girls was diagnosed with an eating disorder, which is a rate about 50 percent higher than the general U.S. population.
  • Despite similar rates of eating disorders among non-Hispanic Whites, Hispanics, African-Americans, and Asians in the United States, people of color are significantly less likely to receive help for their eating issues.
  • Elevated rates of binge-eating and purging by vomiting or laxative abuse was found for both males and females who identified as gay, lesbian, bisexual, or “mostly heterosexual” in comparison to their heterosexual peers.
[You can find the actual stats and studies quoted above at the NEDA stats link.]

 

Prevalence of anxiety and making the case for low serotonin

The prevalence of anxiety is high in those with eating disorders (which is one of the reasons for this particular blog):

  • Anxiety is also diagnosed in 48-51% of people with anorexia nervosa, 54-81% of people with bulimia nervosa, and 55-65% of people with binge eating disorder
  • Two-thirds of people with anorexia also showed signs of an anxiety disorder several years before the start of their eating disorder.

In one study, after dietary treatment (called refeeding), plasma tryptophan levels normalized in patients with anorexia:

Disturbance in serotonin function has been described as central to the psychobiology of this disorder 

Plasma TRP normalizes during the course of refeeding, supporting the hypothesis that serotonin function is disturbed in patients with anorexia nervosa.

We also see a large number of low serotonin symptoms in those with eating disorders:

  • Childhood obsessive-compulsive traits, such as perfectionism, having to follow the rules, and concern about mistakes, were much more common in women who developed eating disorders than women who didn’t.
  • Binge eating disorder patients … also had significantly higher levels of negative affect, and lower self-esteem
  • In a study of women with eating disorders, 94% of the participants had a co-occurring mood disorder
[You can find the actual stats and studies quoted above at the NEDA stats link.]

There are all classic low serotonin symptoms: obsessive thoughts/behaviors, perfectionism, negative-self-talk, low self-esteem and depression.

This further supports the rationale for tryptophan supplementation and is another reason for this blog. I have extensive experience in the use of tryptophan and 5-HTP and believe they should be part of all eating disorder programs.

There is one big difference in that typically we see afternoon and evening sugar and carb cravings with low serotonin-type anxiety. Whereas with anorexia, the low self-esteem, obsessive thinking and body dysmorphia (feeling shame or disgust with parts of their body or appearance) may prevent someone acting on these cravings. However, if there are sugar and carb cravings (and bingeing), this is the time they will typically occur.

Here are two recent blog posts that share case studies where tryptophan was used with success:

  • Tryptophan calms comfort eating, eases self-doubt, reduces uncontrollable late night snacking and results in a lot more peace around food
  • Tryptophan for my teenager: she laughs and smiles, her OCD and anxiety has lessened, and she is more goal oriented and focused on school

Anorexia and other eating disorders require a multidisciplinary team and a targeted nutritional approach

I don’t currently work with clients with anorexia as it requires a multidisciplinary team. I did, however, work with a few clients with anorexia when I worked at Recovery Systems over 10 years ago. They had a therapist, nutritionist and doctor on their team and a nutritional approach led to more improvements than they had experienced at prior in-house eating disorder clinics where they had received psychological support only or psychological support and medication. Our approach included addressing low serotonin with tryptophan or 5-HTP, addressing low zinc and low iron, low vitamin D, addressing the gut/microbiome, low B vitamins, low omega-3 fatty acids and more (based on the unique needs of the client).

I now refer eating disorder clients to Dr. James Greenbatt, MD, an eating disorder specialist and integrative psychiatrist. He has a wonderful book on the topic: Answers to Anorexia – a Breakthrough Nutritional Treatment That is Saving Lives, with the second edition coming out soon. In the first edition he does address neurotransmitter deficiencies but we differ in our approach.  He doesn’t use individual amino acids like tryptophan or 5-HTP and prefers to use a blend of amino acids based on a blood or urinary amino acid test.

In this article, New Approaches to Treating Anorexia, Dr. Greenblatt covers the multidisciplinary aspect, current treatment options, the limited medical options and the need for targeted nutrition therapy. Although this article doesn’t address tryptophan and low serotonin, he does discuss the key role of zinc, B vitamins and omega-3 fatty acids.

UPDATE: October 10, 2024

Given that most of the eating disorder research is conducted primarily in females, it’s encouraging to share the results of this 2022 paper, Sex differences and associations between zinc deficiency and anemia among hospitalized adolescents and young adults with eating disorders, which reports that “zinc deficiency is equally severe and anemia is more common in hospitalized males with eating disorders compared to females.”

Liquid zinc sulfate tastes like water when zinc levels are low. I saw those with anorexia being willing to drink it when I worked in Julia Ross’ Clinic, so it’s a relatively easy way to start to increase zinc levels and improve appetite.  Zinc and iron both help increase serotonin production, and zinc is key for pyroluria/social anxiety which is common in this population.

Also, with pyroluria, morning nausea negatively affects appetite so it’s often helpful to address this in conjunction with using amino acids. Vitamin B6 is part of the pyroluria protocol and is another serotonin co-factor. Evening primrose oil, also part of the pyroluria protocol, improves zinc absorption. This is all covered in the pyroluria chapter in my book.

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

If you are new to using the amino acids tryptophan/5-HTP, GABA or  tyrosine 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 (or a loved one) been diagnosed with anorexia or another eating disorder?

Did you see the most success with an approach that included nutritional psychiatry and serotonin support with tryptophan or 5-HTP?

What else has helped?

Feel free to post any questions here too.

Filed Under: Anxiety, serotonin, Tryptophan Tagged With: 5-HTP, anorexia nervosa, binge eating, depression, diet, Dr. James Greenbatt, excessive dieting, food restriction, incidence of eating disorders, low self-esteem, mood disorder, multidisciplinary, neurotransmitter, nutritional psychiatry, obsessive-compulsive, perfectionism, prevalence of anxiety, serotonin, tryptophan, zinc

Using both tryptophan and GABA supplements together for easing anxiety: questions and answers

June 11, 2021 By Trudy Scott 71 Comments

tryptophan and gaba for anxiety

I get many questions about using both tryptophan and GABA supplements together for easing anxiety and today I’m sharing some of these questions and my answers. This will also give you the opportunity to ask questions you may have related to using both these amino acids together. You’ll also read about some reasons for the confusion about when to use GABA vs tryptophan, some success stories and some research.

Let’s start with this question since it’s one that I get asked many many times:

Should one use GABA and tryptophan together for helping with anxiety symptoms?

I have many clients who need and use both but it’s because they have low GABA and also have low serotonin, both driving different types of anxiety symptoms. It’s important to recognize that each amino acid supplement addresses a very different set of symptoms.

With low GABA levels they will have physical anxiety, tension, stiff and tense muscles and often self-medicate with alcohol in order to relax. Sleep may also be a problem with lying awake feeling tense. Because they also have low serotonin they will have the worry-in-the head type of anxiety, ruminations, and obsessions. They may also have panic attacks, negativity, anger, irritability, PMS, TMJ, lack of confidence and insomnia. (Here is a list of all the low serotonin and low GABA symptoms).

You should only use GABA and tryptophan together if you have both low GABA and low serotonin symptoms.  This will address these particular root causes.

My anxiety has improved significantly with GABA, should I also try tryptophan/5-HTP?

This is another common question I get about using tryptophan and GABA supplements together (paraphrased from one of the blog comments so I could share my feedback here):

I’m using GABA and my anxiety has improved significantly, however, the anxiety I feel in my body immediately upon waking is still bothersome. What would you recommend for the anxiety in my body on waking (that improves when I get out of bed, start moving around and as the day progresses)?

Could I try 5-HTP/tryptophan in addition to GABA?

We always want to capitalize on what is already working. GABA has improved her anxiety significantly, so I’d want to have her figure out how much it’s improved (for example from say 10/10 with 10 being worse to 5/10 with the GABA). Then we’d bump up the GABA to see if additional gains are seen. This could mean a higher dose at night and could also mean a small dose in the morning on waking. And then figure out the improvement and adjust up again if needed.

There is no reason why she shouldn’t try either tryptophan or 5-HTP too but only if she also has other low serotonin symptoms other than morning anxiety. And also, only once she has established the ideal dose for the GABA. She mentions “the anxiety in my body” so I suspect it’s the low GABA physical-tension type of anxiety. We often see low GABA and low serotonin go hand in hand so it’s very likely she’ll also benefit from serotonin support too.

Some reasons for the confusion about when to use GABA vs tryptophan

One reason for this confusion is that there are many combination products on the market that contain both GABA and tryptophan (and other nutrients). The company is trying to make a one-size-fits-all product in the hope it will help many folks. The problem is that it’s not individualized to your unique needs – which may be low GABA or low serotonin or both. Even if it is low GABA and low serotonin that you suffer from, a combination product may not work if, for example, you need a very small amount of GABA and need a much higher dose of tryptophan.

Another reason is that many well-meaning practitioners do not help their client/patients make the distinction between low serotonin and low GABA symptoms. This happens because they often don’t understand this either.

Another reason is that many folks jump in and start using these amino acids without really understanding how and why they work, how to use them and what to look out for. It’s why I highly recommend that everyone planning to use them reads my book first, The Antianxiety Food Solution.

GABA and tryptophan have helped immensely with ruminating thoughts and PTSD – can I stay on them indefinitely?

KJ posted these great results and her question on the blog:

Hi Trudy, I love your blogs and I’ve read your book, The Anti-Anxiety Food Solution – excellent! I have been taking GABA and tryptophan for about 6 months and they have helped me immensely with ruminating thoughts and PTSD. Sometimes I try to go off GABA and Tryptophan for a day or two, but the ruminating thoughts come back, so my question is, can I stay on GABA and Tryptophan indefinitely? I am 59, have no health problems and take no prescription medications.

It’s super to hear GABA and tryptophan have helped with her ruminating thoughts and symptoms of PTSD. I shared that there is no research on long-term use and we should always keep looking for the reasons serotonin and GABA are low and try to address these. Since she has my book I assume she has also implemented all the diet recommendations (no gluten, no caffeine, no sugar, eating for blood sugar control etc), addressed her gut health (candida, parasites, digestive enzymes etc) and looked at low zinc and low vitamin B6 too. There are many other factors to consider – I list 60+ nutritional and biochemical causes of anxiety here.

Jessica says GABA and tryptophan have been life-changing

Here is some feedback from Jessica about how GABA and tryptophan has been life-changing for her – and in only a matter of weeks:

I started taking Gaba and tryptophan about 3 weeks ago after reading about the benefits on this page. It’s been life changing!

I take 1000mg tryptophan at night and 100mg GABA in the morning. Ruminations and obsessive thoughts are almost non-existent now. I have less tension in the jaw and neck. I feel like I’m able to deal with everyday stressors that were overwhelming me prior to starting these supplements.

She started with the tryptophan and added the GABA after about a week.

Jessica clearly had both low serotonin and low GABA symptoms. The ruminations, obsessive thoughts and overwhelm were likely related to low serotonin. The jaw and neck tension are classic low GABA but serotonin support also helps with TMJ too.

Paula would not be able to sleep without GABA and tryptophan

Paula shared this feedback on the blog post where I write about GABA, Heartmath and EFT easing Micki’s mold-induced anxiety and panic attacks:

This was an interesting article because I use both GABA and Tryptophan and would not be able to sleep if I did not use them. I have also had chronic mold exposure. It never occurred to me that the reason I have to take these things in order to sleep is due to the mold in my system.

Toxic mold can impact neurotransmitter production and GABA and tryptophan can provide some relief while the mold is being addressed.

Some research where tryptophan and GABA have been used with success

Here is some research where tryptophan and GABA (and similar amino acids) have been used with success:

  • Essential tremor, dystonia, anxiety and cravings – diet, GABA, tryptophan, zinc and vitamin B6

This study shares the case of a 13-year-old boy with an essential tremor that caused severe functional impairment. He responded to a Mediterranean diet and supplementation with GABA and tryptophan and was able to resume his plans to pursue a musical career as a guitar player.

  • A randomized targeted amino acid therapy with behaviourally at-risk adopted children

The combination of theanine (an amino acid which also supports GABA levels) and 5-HTP (another precursor to serotonin) led to “significant decreases in parent reports of the children’s behaviour problems.”

Resources if you are new to using GABA and tryptophan as  supplements

If you are new to using the amino acid tyrosine as a supplement, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution and a brief overview here, Anxiety and targeted individual amino acid supplements: a summary.

As I mentioned above, 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 so you are knowledgeable.

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

As with all individual amino acids we use GABA and tryptophan for quick relief of symptoms. And we also always focus on the foundations like diet, the gut, adrenals and stress levels.

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.

Do you have questions about using GABA and tryptophan together?

Have you used the combination of GABA and tryptophan with success? How did they help you and what was your timing and dosing?

Feel free to post your other related questions here too.

 

Filed Under: Anxiety, GABA, Tryptophan Tagged With: anxiety, can I stay on them indefinitely, GABA, obsessions, physical anxiety, PTSD, ruminations, serotonin, sleep, stiff and tense muscles, tension, TMJ, together, tryptophan, worry

Tyrosine erases severe performance anxiety in a female musician: no more shaking, sweating, panic attacks and passing out

June 4, 2021 By Trudy Scott 42 Comments

tyrosine and musician anxiety

Today I’m sharing the case of a female musician with severe performance anxiety. It was so severe that she would shake, sweat and actually pass out. She also had problems breathing which happens when you’re having a panic attack. Surprisingly, the amino acid supplement tyrosine eliminates – or as she says, erases – all these anxiety symptoms very quickly. It’s surprising because tyrosine is typically not used for easing anxiety symptoms and is instead used to support the low catecholamine symptoms: low motivation, low energy, poor focus, feeling flat and depressed (the curl-up-in-bed kind), cravings for sugary foods for better energy and the need for caffeine.

I share her story in her own words and explore some possible mechanisms around serotonin, cortisol, dopamine and GABA.

Pam initially shared on a Facebook thread how tyrosine erased her extreme performance anxiety and we dug deeper. This is the start of the conversation:

I’ve been performing (music) ever since I was seven, but I always hated it. For extreme performance anxiety, I found, way too late, that 1,500mg of l-tyrosine simply erased the shaking and fainting, and I was “just nervous like everybody else.”

I responded saying what a great result this was and shared that I found it so interesting that tyrosine erased the shaking and fainting that she experienced with her performance anxiety.

As I mentioned above, tyrosine is typically not used for anxiety. Instead, it’s used to improve the low catecholamine symptoms of poor focus, low energy and low motivation. (More on this here)

I also always want to understand the mechanism as to why an amino acid helps ease anxiety symptoms – or in this case erased them. I share more on that below.

When I asked what she meant by “just nervous like everybody else“, this was her response:

It means pretty much everyone gets performance nerves, but not to the point of fainting on stage. Knowing intellectually that that was ridiculous did not make any difference in the fact that it occurred.

I don’t even remember why I tried tyrosine, but I do remember the first time I took it 40 minutes before a performance. I waltzed out on stage ahead of time and sat in my chair warming up, showing off even, to a hall that was filling with people.

That was and is inconceivable without the tyrosine support, which I have to assume is putting my dopamine at a normal level. Yes, I get a little wired, which can be a good thing, but passing out, having my intestines demand to be emptied, not being able to breathe [is this a panic attack?], shaking, sweating….it fixes all of that.

It’s wonderful to hear such powerful results from 1,500mg tyrosine and how quickly it works.  The latter is not surprising as this is typical with all the amino acids. They work quickly if it’s what you need and you have the ideal dose for your needs.

What is surprising is that tyrosine erased her severe performance anxiety symptoms. I immediately started trying to understand possible mechanisms.

What is the mechanism – a serotonin boost to improve confidence?

When I read “I waltzed out on stage ahead of time and sat in my chair warming up, showing off even, to a hall that was filling with people” I immediately thought of how tryptophan or 5-HTP works to give you a serotonin boost that improves your confidence.

However, Pam doesn’t feel the mechanism is related to low serotonin:

You would think, if it were serotonin, that SSRIs would be effective. They are not and cause me to have terror attacks.

She also shared that she recently gave 5-HTP a trial and it did nothing so that further supports her theory/gut feeling that her extreme performance anxiety is not related to low serotonin:

I think there is a belief system associated with serotonin that is not cognizant of the fact that the other neurotransmitters can be the culprits. I read someone’s web site sometime not that long ago, that detailed how to test all the major neurotransmitters, find out which ones were to low OR too high, and what amino acids to take to fix the imbalances. To me, this is a more comprehensive view than being stuck on serotonin.

Anxiety is not always caused by low serotonin or low GABA (although these causes are very common). I’m with Pam on finding which neurotransmitter imbalance you have. There is no one-size fits all and results can happen without us fully understanding why. It does sound like this is very much dopamine related for her but I wanted to understand how it was helping her.

What is the mechanism – lowering cortisol under extremely stressful situations?

I started looking into the research and found that one possible mechanism could be that tyrosine lowers the high cortisol that occurs after an extremely stressful situation – like going on stage to perform – and eases anxiety this way.

An animal study supports this theory: Dietary tyrosine suppresses the rise in plasma corticosterone following acute stress in rats:

Acute, uncontrollable stress increases norepinephrine (NE) turnover in the rat’s brain (depleting NE) and diminishes the animal’s subsequent tendency to explore a novel environment. Pre-treatment with tyrosine can reverse these adverse effects of stress, presumably by preventing the depletion of NE in the hypothalamus.

In the present study, we found that pre-treatment with supplemental tyrosine not only prevented the behavioral depression and hypothalamic NE depletion observed after an acute stress, but also suppressed the rise in plasma corticosterone. These results support a role for brain NE in stress-induced corticosterone secretion and demonstrate that supplemental tyrosine can protect against several adverse consequences of such stress.

Keep in mind that cortisol is the primary endogenous adrenal steroid in humans, whereas corticosterone is the primary adrenal corticosteroid in laboratory rats.

What is the mechanism – dopaminergic system influence on anxiety-like behavior?

I dug deeper into the research and found that there is evidence that dopamine plays an important role in anxiety modulation in different parts of the brain and that both dopamine D1 and D2 receptor mechanisms are important in mediating anxiety.

This paper, The Modulatory Role of Dopamine in Anxiety-like Behavior describes some of this, together with the role of GABA and glutamate:

The activity of dopaminergic system is modulated by several neurotransmitters, including glutamatergic neurons from the medial prefrontal cortex (mPFC), GABAergic fibers from the nucleus accumbens (NAc) as well as the ventral pallidum and cholinergic fibers from the pedunculopontine nucleus and the laterodorsal tegmental nucleus. Thus, changes in the glutamatergic, and GABAergic, as well as mediated transmission in the mesolimbic, mesocortical and nigrostriatal dopaminergic system may influence anxiety-like behavior.

In the past I’ve blogged about tyrosine for alleviating anxiety and panic attacks and creating a feeling of calm focus so this is not an isolated case but it is pretty unusual. As I share in the above blog, a man and a woman saw dramatic reductions in their anxiety when using tyrosine. GABA and tryptophan had not helped and both individuals were also under extreme stress. It was work stress in their cases and both of them felt that their ability to now focus in business situations eased their severe anxiety.

Regardless of the mechanism, Pam saw profound results and that is all that really matters.

My additional feedback on dosing and timing

Here is some additional feedback from me on dosing and timing. On one hand I recommend caution based on my experience with the amino acids. And on the other hand, what she did worked so I’m torn about her approach but am going to say it anyway:

  • A typical starting dose is 500mg tyrosine and I would never have anyone start with 1,500mg (even though it was the sweet spot for Pam). However, if she hadn’t used that dose, she would not have had the same results. I’m waiting to hear back if she started with 1,500mg tyrosine or worked up to this. (Pam also told a friend of hers about her results and the outcome was very different for her friend:“She tried 100mg of tyrosine and it caused her extreme nervousness, the opposite of me. I have to assume that 100mg put her at too *much* dopamine, and her genetic profile was significantly different from mine.” We are all unique and there is no one-size-fits-all.)
  • I would also be cautious about trying a new amino acid for the first time right before a major event like a musical performance. I have clients trial the amino acids at home before heading out. However, if she had done that she would likely have not experienced the desired results.

I feel it would be helpful to know if she had done a trial of GABA or tryptophan before using tyrosine but it seems she doesn’t recall this or why she decided to use 1,500mg tyrosine. If she hasn’t done I trial with both GABA and tryptophan, I would love her to consider this now in order to potentially take things up a notch further and ease her feelings of just being “nervous like everybody else”.

I appreciate Pam sharing her amazing results with tyrosine and I’m really happy for her! I’m waiting to hear back with details of what kind of musical performances she does. I’ll share this and the other information once I hear back.

I say it often and I’ll say it again – there is not a one-size-fits-all. This case illustrates this very well. Sometimes it’s methodical trial and error (my preference) and other times it’s hit and miss when nothing else seems to be helping.

Resources if you are new to using tyrosine as a supplement

If you are new to using the amino acid tyrosine as a supplement, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution and a brief overview here, Anxiety and targeted individual amino acid supplements: a summary.

If you suspect low 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.

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

As with all individual amino acids we use tyrosine for quick relief of symptoms, like Pam did. And we must also always focus on the foundations like diet, the gut, adrenals and stress levels.

Do you use or have you used tyrosine to help with performance anxiety – personally or with a patient/client?

And were you/are you surprised that this worked so well when tryptophan or 5-HTP or GABA had not worked as expected?

What other symptoms did/does the tyrosine help improve: focus, motivation, drive, low energy, low mood? And did/does it help reduce sugar cravings and the need for caffeine?

Feel free to post your questions here too.

Filed Under: Anxiety, Fear of public speaking, Music, Tyrosine Tagged With: anxiety, calm focus, catecholamine, cortisol, dopamine, fainting, GABA, musician, nervous, panic attacks, passing out, performance anxiety, serotonin, shaking, sweating, tyrosine

Rage, anxiety, cravings & insomnia in 11-year old girl with RAD/reactive attachment disorder: chewable tryptophan turns things around

May 28, 2021 By Trudy Scott 21 Comments

rad and tryptophan

Today I’m sharing the case of an 11-year-old girl who had huge rage issues, was angry much of the time, suffered from terrible anxiety, had crazy sugar cravings (for bread and colored candies) and had dreadful insomnia. Because of the insomnia she was also very fatigued and this likely drove some of her cravings and irritability too. She was adopted and had been diagnosed with RAD (reactive attachment disorder). During our first session, chewable tryptophan turns things around quickly – she smiles and is willing to make changes and quit the sugar and gluten. We also address low iron levels and with these 4 nutritional interventions this child’s behavior improves dramatically.

This book chapter, Reactive Attachment Disorder, states how The Diagnostic and Statistical Manual 5th Edition (DSM-5) classifies reactive attachment disorder as follows:

a trauma- and stressor-related condition of early childhood caused by social neglect or maltreatment. Affected children have difficulty forming emotional attachments to others, show a decreased ability to experience positive emotion, cannot seek or accept physical or emotional closeness, and may react violently when held, cuddled, or comforted. Behaviorally, affected children are unpredictable, difficult to console, and difficult to discipline. Moods fluctuate erratically, and children may seem to live in a “flight, fight, or freeze” mode. Most have a strong desire to control their environment and make their own decisions. Spontaneous changes in the child’s routine, attempts to discipline the child, or even unsolicited invitations of comfort may elicit rage, violence, or self-injurious behavior.

Reactive attachment disorder/RAD and low serotonin

There is no research on tryptophan helping to address RAD symptoms or trauma, but based on her low serotonin symptoms, a trial of tryptophan was the first thing I considered.

There is, however, evidence to indicate the role of low serotonin in RAD, as indicated by a study where antidepressants were successfully used. The authors mention how:

The absence of responsive and consistent caretaking can subject the developing brain to an inordinate amount of physiological stress, leading to increased cortisol production and consequential inefficiencies in the serotonin and the growth-hormone releasing systems.

Although not specific to RAD, another paper looking at trauma states that:

Serotonin and dopamine levels were found to be abnormal in the presence of PTSD.

As the field of nutritional psychiatry grows, I expect to see more and more research supporting the use of tryptophan and other amino acids for those suffering from symptoms like this. Symptoms that are caused by imbalances that are triggered by the trauma in their lives.

We know that therapy, EFT, EMDR and other approaches are crucial for trauma recovery (this family had already done some of this work) but we must start to incorporate nutritional support too.

The case study

Here are the details of this case study and the nutritional interventions. As I mentioned above, because of her severe rage episodes, a trial of tryptophan was the first thing I considered:

She was referred to me by a friend. The family didn’t have much money. And so, we had to really try and figure out a few simple interventions that we could use that were going to be effective.

This young girl had been adopted. She was diagnosed with reactive attachment disorder and her anger issues were just phenomenal. The mom had to physically put her body around her and hold her down when she was having one of her fits because she was worried that she was going to hurt herself and hurt other people.

She also had anxiety, huge cravings for colored candies and insomnia. She was so fatigued because she wasn’t sleeping well.

So sitting in my office with this young girl and her mom, we started to talk about the sweets and the candies and the need to give up the candies. She was fuming with me. She was sitting in a swivel chair. She turned her back on me and didn’t want to talk about having to give up candy at all.

I said, “Look, let’s not even talk about that, but would you take this chewable tryptophan here? And we’ll talk about it in a second.” I gave her 100 mg of the chewable tryptophan and continued discussing things with her mom.  She had no idea what it was going to do or how it would make her feel.

Within five minutes she turned her chair back, looked at me and she said, smilingly, “Yes, let’s do it. I can give up the candy.” She was smiling and she was happy.

So long story short, with this young girl, we started her on [chewable] tryptophan [and it turned things around quickly].

Chewable tryptophan – when I use it and when I don’t

I typically use 500mg Lidtke tryptophan for the adult clients I work with and prefer this company’s product because it is really high quality. It really does work better than many other tryptophan products on the market.

Lidtke also makes a chewable 100mg tryptophan which is also high quality, and the product I used with this young girl. Here are some benefits of this 100mg product:

  • It’s useful for doing the initial trial in order to figure out if tryptophan is going to help with low serotonin symptoms in children – because it’s a lower dose.
  • It’s especially useful for children for ongoing use (typically midafternoon and evening) because it’s a lower dose.
  • It’s also useful for adults who are “pixie dust” folks and do better with a lower dose of supplements in general or respond more severely to medications/alcohol/chemicals. We may start with a trial of the 100mg chewable and increase from there, also typically midafternoon and evening.

I don’t use the chewable 100mg tryptophan under these circumstances:

  • When the child (or adult) finds that 5 x100mg works for them at each time they need it. In this instance it’s best to switch to a 500mg tryptophan. Using it swallowed may work or it may need to be opened onto the tongue.
  • When the child (or adult) starts to consume the chewables like candy. They are sweet and do taste good and I’ve seen this happen. Because you are continually consuming something sweet you may end up over-consuming them if sugar addiction is one of your issues. You may also end up taking too much tryptophan.

If the chewable tryptophan is not available where you live, using a small amount of a powdered tryptophan or opening a capsule of the 500mg tryptophan is an option. Since it tastes bitter it can be mixed with mashed banana or inositol. (You can find all the Lidtke products in my online supplement store. The link is in the resources section below.)

Gluten and candies were also a huge issue, and she had low iron

There was more to her issues than only low serotonin:

Gluten was also a huge issue, so we got her off gluten and the candies. The tryptophan helped with this” (i.e. it made it easy to break the addiction and not feel deprived).

Tryptophan also helped her sleep. And it helped with the severe rage issues.

Obviously the gluten was contributing to the rage issues as well.

Her iron and ferritin levels were really low (possibly as a result of her gluten issues). So we added an iron supplement, and animal protein/red meat.

So with just four interventions – the gluten, the animal protein, getting her iron levels up and the tryptophan – this kid was just a new kid.

Here are some articles that are related to the above:

  • The role of low serotonin, low vitamin B6 and low iron in anxiety and panic attacks
  • Integrative Medicine Approach to Pediatric Obsessive-Compulsive Disorder and Anxiety I write about a study where gluten was found to be the cause of a childhood case of obsessive-compulsive disorder (OCD)
  • Tryptophan for my teenager: she laughs and smiles, her OCD and anxiety has lessened, and she is more goal oriented and focused on school.

Keep in mind there is not a one-size-fits-all and these 4 simple nutritional interventions – tryptophan, gluten removal, adding red meat and addressing low iron – happened to be the combination that worked for this young girl.

Resources if you are new to using tryptophan as a supplement

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

If you suspect low serotonin symptoms 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.

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 Lidtke chewable tryptophan 100mg, Lidtke tryptophan 500mg and other products that I use with my individual clients and those in my group programs.

We use an amino acid like tryptophan for quick relief of symptoms, like I did in this instance. Then we focus on the foundations like diet – like no gluten and red meat in this instance – and address all other imbalances, like her low iron. If cortisol was high we would have addressed that.

This case deserves it’s own blog post

In case you’re wondering, I first shared this case study in my interview, “Calming Anxiety, Aggression and OCD with Amino Acids and Food”, on the ADHD and Autism Summit in May 2021. Due to the interest in this case and the use of chewable tryptophan, I felt it deserved a deeper dive and its own blog post with links to some of the research and some practical information about the chewable tryptophan.

Have you used this chewable tryptophan product with success – personally, with your child or with a patient/client?

Have you found that addressing serotonin with tryptophan (or 5-HTP) helps resolve symptoms in a child diagnosed with RAD or a child with rage issues? What about helping with sleep problems, easing anxiety and stopping cravings too?

Have you addressed low iron levels and seen improvements with the removal of gluten too.

Feel free to post your questions here too.

 

Filed Under: Anxiety, Children/Teens, PTSD/Trauma, serotonin, Tryptophan Tagged With: adopted low iron, angry, anxiety, behavior, chewable tryptophan, cravings, fatigue, gluten, insomnia, irritability, nutritional interventions, nutritional psychiatry, RAD, rage, reactive attachment disorder, self-injurious behavior, serotonin, sugar, trauma, unpredictable, violence, young girl

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