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GABA, 5-HTP and melatonin isn’t working anymore for my insomnia and tryptophan gives me a migraine – what should I do?

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Today I’m addressing a great question I received on a recent tryptophan blog about insomnia and the use of the amino acids GABA and 5-HTP in a combination product together with melatonin, and what the next steps should be when you are not getting the expected results. And if continuing with tryptophan is a good idea when it seems to be causing a migraine and isn’t leading to a whole night’s sleep. Here is the question:

I have suffered from insomnia for most of my life. I just got your book and am loving it! Thank you for all that you do. My symptoms seem to be high for both low GABA and low serotonin [here is the questionnaire].

I also believe I have a blood sugar problem, so I’m starting to follow your suggestions for that.

I’ve been taking a supplement for sleep that has both GABA and 5-HTP in it, along with melatonin. It worked for a year, however it just recently stopped working.

I thought maybe I should try tryptophan. After taking only 220 mg per night, along with 5 mg of melatonin, I was able to sleep, but not through the entire night. However, the next day I woke up with a horrible headache/migraine. I know it was the tryptophan because I did a trial and tried a night without it and then again with it and the nights I took it, sure enough, the migraine would return.

I must add that I had bloodwork done and tested low for melatonin, which is why I was adding the melatonin into my protocol.

My question is: do I continue with a higher dose of GABA, 5-HTP and melatonin, since it worked for a year i.e. do I up the dosage of the supplement I’ve been taking? Or do I continue trying different doses of tryptophan?

I shared this response in my comment (with some additions for this blog post).

Always first address the nutritional foundational aspects

Firstly, I was glad to hear she is loving my book The Antianxiety Food Solution (my Amazon link) and implementing dietary changes. This is so foundational to any protocol for both anxiety and insomnia. Too often, someone hears me talking about the amazing amino acids and forgets the nutritional basics of real whole food, quality animal protein (like wild fish, pastured eggs and chicken, grass-fed red meat), organic veggies and fruit, healthy fats (like olive oil, coconut oil and butter), fermented foods and broths, and no gluten, caffeine or sugar.

I don’t ever have clients push through

With regards to her trial of tryptophan I shared that I don’t ever have clients push through on a product that is causing any adverse effects, and especially when it’s a migraine. She was smart and trialed the tryptophan twice to make sure it was the tryptophan that caused the migraine and not something else.

Capitalize on what has worked and increase one at a time

With regards to the GABA, 5-HTP and melatonin I shared that I always like to capitalize on what has worked in the past (or is currently working) and would rather increase the 5-HTP and/or melatonin and/or GABA one at a time.

Notice that I said increase these products one at a time. She is taking a combination product so it’s impossible for her to do this. Maybe her GABA levels are now good (because her progesterone levels have improved due to be on a regular zinc supplement or because she has been doing regular yoga sessions) and maybe she needs more serotonin support (because her estrogen levels are off because of recent exposure to xenoestrogens in plastics).

Even though is research showing that a combination product containing GABA and 5-HTP improved sleep and sleep duration more than the use of either of the two amino acids alone, based on her feedback, if we were working together I would have her do each of the GABA, 5-HTP and melatonin separately. This way it’s easy to mix and match and increase one and possibly lower the other, until the ideal combination is found for her unique needs at this time in her life.

She may even find she only needs GABA or only needs 5-HTP or only melatonin. She may also find she needs sublingual melatonin for helping her fall asleep and timed-release melatonin for helping her stay asleep.

She mentions the amino acid questionnaire so it sounds like she is clear on her symptoms: low GABA physical anxiety affecting her sleep and low serotonin mental worry-type of anxiety affecting her sleep. So as she trials the individual amino acids she can see how she does symptom-wise in order to find the ideal amount.

Other factors to consider with insomnia

It’s often straight-forward with the amino acids and the great thing is that one you have the correct combination you will see results in a few days to a few weeks. But There are other factors we may need to consider with insomnia:

  • Keep in mind that 5-HTP can raise cortisol and low blood sugar can indicate adrenal issues so looking at high cortisol as a factor in the sleep problems would be something to consider. A 4-collection saliva test will measure this and my favorite product for lowering high cortisol is Seriphos. Other nutrients for adrenal support may be needed too.
  • Just addressing low blood sugar can often improve insomnia. Eating to support blood sugar swings, early morning sunlight and no blue light after dark can make a world of difference.
  • Other sleep factors we always want to consider: sex hormone imbalances, parasites (they are more active at night and can keep you awake and play a role in high cortisol), accidental gluten exposure, SIBO (small intestinal bacterial overgrowth), candida, sleep apnea and mouth breathing, EMFs (WiFi in the home, commuting with the iphone on, a new cordless phone etc.) and medication side-effects (benzodiazepines are a common one).

I really appreciate questions like this being posted on the blog so others like you also get to benefit. This question also demonstrates just how our needs for certain nutrients can change over time and how we may to keep adjusting what we are doing.

In case you have questions about specific products that I use with clients, here is my supplements blog and more information on GABA for the physical type of anxiety and 5-HTP/tryptophan for the worry-type of anxiety.

Can you relate to this scenario? Feel free to ask your questions about sleep, GABA, 5-HTP, tryptophan and melatonin and share your experiences with these products and how they have helped you or if you’ve had issues with any of them.

Nutritional and lifestyle support for mercury toxicity and detoxification in general

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I’ve poured through most of the transcripts of the Heavy Metals Summit and there is so much information on nutritional and lifestyle support for mercury toxicity and the detoxification process in general:

  • sweating and using a sauna in order to detox through the skin
  • broccoli sprouts (due to a glutathione boost from sulforaphane, an organosulfur compound – in Julie Matthews’s interview)
  • reducing EMF/ELF and microwave exposure – in Dr. Mercola’s talk! He shares how all this can make matters worse and has some simple approaches like turning off power in the bedroom at night! This was new to me and a brilliant approach!
  • eating organic (to minimize GMO/glyphosate effects on a leaky gut and a leaky blood brain barrier) and never using Roundup
  • addressing low zinc and low selenium
  • supporting methylation so the body can detox on it’s own
  • supporting the liver and increasing bile production which is needed for detoxification
  • addressing low stomach acid which is needed for bile production and absorption of minerals like zinc (which is depleted by heavy metals)
  • avoiding meds like PPIs (which reduce stomach acid) and NSAIDs (which contribute to leaky gut)
  • thyroid support/iodine (as needed)
  • getting the brain’s glymphatic system working with sufficient sleep, melatonin (liposomal) and even liposomal GABA (in Dr. Christine Schaffer’s interview)
  • supporting the vagus nerve in order to improve digestion and detoxification
  • using an air filter and water filters
  • using foods/products like curcumin, ginger, probiotics, apple pectin
  • adding DPP-4 enzyme for gluten issues (mercury depletes this)
  • avoid energy-efficient bulbs (they are high mercury)
  • having Epsom salts baths
  • improving elimination from the bowels and much more

This is the support I offer as a nutritionist and it’s wonderful to hear all these doctors/practitioners discuss about all this with a tie back to mercury, lead and other metals.

Whey is not mentioned on the summit but since someone shared how it’s benefiting her (in the comments of the Boyd Haley blog) I’m sharing here too since it helps with glutathione production. In this paper “a case is made for the use of hydrolyzed whey protein to support metal detoxification and neurological function.” I recommend whey to clients if tolerated.

Many years ago I heard a presentation by a biological dentist who then became a nutritionist – he shared that he used whey with mercury toxic patients (together with other nutrients) and saw metals go up in hair analysis and then come down as their symptoms improved.

As I’ve mentioned in the past, mercury chelation is a controversial topic and you’ll see comments very divided on what the safest approach is. This is not my area of expertise and I’m very cautious with recommendations in this area as I’ve had reports of harm from individuals using all the approaches you’ll hear about on the summit (and even the Andy Cutler protocol which is not covered). My best advice is to follow all the nutritional/lifestyle recommendations and if you do decide to go the chelation root, do your homework, find a practitioner to work with and listen to your gut. If what you’re doing doesn’t feel right then stop doing it.

As with any chronic health condition, mercury detox is a comprehensive approach and very individualized.

There is also a discussion about safe removal of amalgams/mercury fillings. They do need to be done safely so as not to cause further issues. The IOMT also offers excellent guidelines.

The summit also covers other metals like copper (Ann Louise Gittleman covers this and I blog about it here), arsenic (Dr. Joseph Pizzorno covers this – reducing consumption is a big factor; and non-organic chicken is a source) and aluminum.

You can still register here to hear day 7 interviews and the encores: The Heavy Metals Summit.

Have you seen benefits with a nutritional approach?

Ashwaganda for adrenal support: a calming tonic that reduces anxiety and improves sleep

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Overactive adrenals can leave you feeling like you’re constantly in “fight or flight” mode. First, your body releases high levels of stress chemicals like adrenaline and cortisol. To ensure you’re ready to defend yourself or run, these chemicals spike your blood sugar, as well as increasing heart rate, blood pressure, and insulin levels – making you feel anxious, stressed and wide awake at night.

Nature offers plenty of wonderful herbal remedies to support the adrenals. Herbal adaptogens such as ashwaganda and rhodiola are two of my favorite herbs for the adrenals. They gently calm your overactive system helping your body damp down your fight or flight response and reduce stress and anxiety.

  • Ashwaganda is often called “Indian Ginseng” and is widely used in Ayurvedic medicine to lower stress and stabilize thyroid hormones. It is a calming tonic that reduces anxiety, improves sleep, and combats inflammation.
  • Rhodiola is a another potent herbal adaptogen that helps your body reduce anxiety and irritability. At the same time, it boosts immune function, hormonal balance, and concentration.

You can learn how to use herbs like this in your everyday routine in this no-cost online workshop “How To Use Everyday Herbs and Spices To Rebalance Your Hormones”

In this online workshop, you will learn about 20 healing herbs and spices to help support and heal your thyroid, adrenals, menopause, weight, hair loss, cellulite, PCOS, hot flashes (and more).

  • Skullcap – used to treat conditions like panic attacks, anxiety and also helps to promote better quality sleep.
  • Chamomile is well known for its calming properties. After people drink chamomile tea their levels of glycine increase. Glycine is a nerve relaxant with mild sedative properties – all things that can help you to de-stress. Chamomile also has anti-spasmodic properties that help to relieve menstrual cramps in women. It also contains a potent flavonoid called apigenin, a mild tranquilizer that can help benefit sleep onset and sleep quality.
  • Lavender made into a tea is an effective tonic for jittery nerves because it encourages a calmer state of mind. Research comparing the use of lavender to (synthetic) benzodiazepine medication for anxiety has found it provides equal benefit, minus all the side effects.

You will also learn 5 simple and delicious herbal recipes to restore and rebalance your hormones

Watch this video snippet to get a taste of some of what Magdalena will be covering in the online herbal workshop. One thing she’ll be making is the wonderful and nourishing Ashwaganda Latte for adrenal support.

And here is the recipe for the Ashwaganda Latte

Author: Magdalena Wszelaki

Ingredients

  • 1 cup of milk (almond or hazelnut works well, if using coconut milk, I would suggest ½ cup coconut milk and ½ cup water)
  • 1 teaspoon ashwagandha powder
  • ½ teaspoon cinnamon powder
  • ½ teaspoon maple syrup or honey

How To Make

  1. Warm the milk, then add the powdered spices and maple syrup or honey
  2. Stir well, using the whisk to blend, adjusting for sweetness if necessary
  3. Pour into a nice cup and drink an hour before bed

Equipment: Medium saucepan, whisk, strainer

You’ll also learn how to avoid common chemicals found in everyday skincare, personal care and house cleaning products that disrupt your hormones, and discover which herbs are best for your individual needs.

Hope to see you there! You can register for this online herbal workshop here

You may remember Magdalena from the Anxiety Summit and her wonderful interviews on eating for hormone balance! She is now taking hormone balance to the next level by teaching us how to use herbs. This wonderful workshop is a taste of what’s to come in her upcoming longer program so stay tuned for more on that!

Butyrate, oxalates, sleep and the health of the microbiome

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Butyrate, oxalates and sleep are all closely tied to the health of the microbiome. Here are a few snippets from some of my favorite interviews on the Microbiome Medicine Summit 2:

Healthy Messages from Body to Brain: Dr. David Perlmutter

Butyrate is one of the 3 very important short chain fatty acids that are made in the gut: butyrate, propionate, and acetic acid are the products of the healthy bacteria.

And it turns out that butyrate has some far reaching effects in the body. It acts as a fuel for the cells that line the gut. It acts as a modulator of our gene expression, a fancy term called histone deacetylase inhibitor, but it changes the expression of our DNA.

It regulates the leakiness of the gut lining. It regulates the leakiness of the blood brain barrier, and it also simulates specific receptors on immune cells called G protein receptors that code for things like the formation of inflammatory chemicals, so it has wide-ranging effects.

We can increase our butyrate by having healthier gut bacteria. We can eat butyrate in certain foods. It comes from the word butter; butter is probably nature’s richest source of butyrate.

Special Diets & the Microbiome: Julie Matthews

What’s interesting about oxalates is they can affect and actually damage mitochondria. Mitochondria, those little powerhouses in the cell, there are millions and millions of those going on every second that supply our entire body, every cell, every organ of our body with energy at every second.

Issues with mitochondria are very common not only on autism but variety of conditions including fibromyalgia and all sorts of pain-related condition. And we often see when people have mitochondrial issues that they have issues with three or more systems. So if they’ve got issues with their gut and maybe something in their central nervous system or their immune system.

And interestingly, there is a microbiome connection with oxalates as well. And what that is, is that oxalates have to be broken down by good bacteria, particularly there is a bacteria called Oxalobacter formigenes and its job is to break down oxalates. There are other bacteria. There are Lactobacillus bacteria that can help break down oxalates, as well. Oxalobacter is particularly sensitive to antibiotics. Even a single round of antibiotics can really damage this population, sometimes not only for the short-term but sometimes for the longer term, particularly when someone has had multiple rounds.

Cleansing the Microbiome: Donna Gates

People probably don’t have this picture of the microbiome in their mind. But it’s very dynamic. It changes all the time. If you change your diet, your microbiome is going to change. If you travel, it’s going to change because you’re eating different foods and so on.

It’s also very cyclical. So, what happens at night when we go to sleep—the microbiome changes. There are certain microbes that become dormant—become quiet. And they don’t do anything much. And other ones become very active at night when we’re sleeping.

What happens if you have sleep disorders—like sleep apnea, for example, where you’re not breathing well at night—that’s going to change the diversity of the microbes in your gut. So, you want to correct sleep disorders.

You may not realize that when you don’t sleep, you’re harming the microbes in your gut. And you’re allowing the pathogenic crypts to have a heyday down in the gut. So, sleep is very important, very much connected to the microbiome.

I hope you’ll join the host Dr. Raphael Kellman and all the great speakers on the last few days of The Microbiome Medicine Summit 2.

Tryptophan and melatonin make a big difference but why do I still wake at 4am?

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waking-up-early

I get many questions on the blog about problems with sleep: not able to fall asleep, not waking rested and waking in the early hours and not being able to go back to sleep. By far the most common question is “Why do I still wake at 4am and can’t go back to sleep?”

So let me share one of the typical questions I receive and my feedback in the hope that something you read here may help you or someone you’re working with. Here is the question:

I purchased Lidtke l-Tryptophan and time release melatonin and notice a big difference in my sleep. Instead of waking up every two hours I’m sleeping better but still wake up at 4 am and can’t get back to sleep. GABA hasn’t helped. What can I take to get back to sleep and what are your thoughts on Seriphos Phosphorylated Serine? I think my anxiety has to do with my adrenals because I wake up in a sweat and am way past menopause.

Since she is seeing a big difference with tryptophan and timed-release melatonin, low serotonin is the likely root cause of her insomnia or at least one of the root causes. We always want to capitalize on what is already working. Too many people don’t see expected results with 1 x 500mg tryptophan at bedtime and 1mg timed-release melatonin and start looking for other solutions when the answer may be right in front of them.

Here are the steps I’d follow with a client with similar sleep challenges:

  • Try more tryptophan, increasing it slowly over the course of a few weeks in the hope that it more will provide more serotonin support. This is what I call an amino acid trial where you rate and log your improvements as you incrementally increase – with the goal of finding an optimal amount for your needs. We all have different needs and post menopause it’s not uncommon for women to experience anxiety, depression and insomnia related to low serotonin and fluctuating sex hormones. We also always want to capitalize on what is already working.
  • Also, to add to what’s working, add tryptophan mid-afternoon if it’s not already in place. When someone scores high on the low serotonin questionnaire the typical timing of tryptophan is mid-afternoon and an hour before bed (always away from protein). Serotonin levels start to decline mid-afternoon hence the benefits of a mid-afternoon dose. Start low and increase slowly.
  • I would also suggest trying the tryptophan opened up (at both times) to see if this makes a difference.
  • Taking a tryptophan at the 4am waking can help you go back to sleep so this is worth trying. For some people 500mg at 4am is too much and using 125mg or 250mg works well. You determine the amount based on how you feel when you do get up. If you were able to go back to sleep easily buy wake groggy then it’s too much.
  • Some people are reporting better results with Lidtke Tryptophan Complete (which has all the co-factor nutrients) so this may be worth trialing too. I’d start by adding to what is already in place.
  • If we get benefits with any of the above by are not quite there then I would suggest additional timed-release melatonin until sleep improves.

This is always done slowly and methodically over the course of a few weeks. I always have my clients carefully log what they try and what is working and not working.

Other factors we’d make sure are addressed:

  • What GABA was used, was it trialed (starting low and increased) and was it used sublingually?
  • Is high cortisol at night a factor? Doing an adrenal saliva test will provide the answer. If it is then the Interplexus Seriphos is the best for lowering it. It’s best to take 1-3 x Seriphos about 2-3 hours before the high cortisol.  [UPDATE: INTERPLEXUS SERIPHOS WAS REFORMULATED IN 2016 – PLEASE SEE BELOW FOR MORE ON THIS]
  • Is gut health a factor? Look into SIBO, gluten sensitivity, other food sensitivities, dysbiosis and parasites (which are often active in the early hours and can cause night sweats)
  • Is there a sex hormone imbalance? Even with someone way past menopause, the night sweats mean this should be ruled out. The addition of amino acids starts to balance the hormones but more support may be needed.  
  • Is any caffeine (even decaf) still being consumed?
  • Is blood sugar stable? Make sure to have breakfast with animal protein and healthy fats and the same at each meal and for snacks. Consider a trial of glutamine during the day and just before bed for added blood sugar stability
  • Are medications a factor? Current medications or prior use of benzodiazepines or SSRIs can affect sleep even long after they have been tapered.
  • Is sleep apnea a factor?

We also address all the usual sleep hygiene factors: dark room, cool room, quiet room, no cell phone or clock radio on the bedside table, no late night computer use and getting some early morning light.

Many essential oils can provide added benefits when diffused at night or mixed with a carrier oil and used topically. One lovely combination I share on the Essential Oils Revolution 2 (happening now) is lavender, roman chamomile and neroli which helps both insomnia and anxiety.

There can be many other possible root causes of insomnia: autoimmunity, Lyme disease, pain, past trauma or grief and even genetic polymorphisms, all covered on the recent Sleep Success Summit.

Have you used tryptophan or other amino acids like GABA (for the more physical tension) and melatonin to reduce or eliminate early morning waking episodes?

If you’re a practitioner, have you helped your clients/patients with this methodical approach?

What else has helped you?

Update August 27, 2016 : INTERPLEXUS SERIPHOS HAS BEEN REFORMULATED -I am doing research to find suitable alternatives. For now, feel free to read through the comments below for discussions about this.  Once I have some useful information I’ll create a new blog post. 

Update November 18, 2016: Here are some possible alternatives to Seriphos

Update January 20, 2017: The Original Formula of Seriphos has been reintroduced you can read more about this here

 

Lavender, roman chamomile, and neroli essential oils for anxiety and sleep

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Lavender, roman chamomile, and neroli essential oils for anxiety and sleep

Lavender, roman chamomile, and neroli essential oils have been found to be beneficial for anxiety and sleep in patients going through a surgical procedure. 

The aromatherapy blend was in a ratio of 6 :  2 : 0.5  for lavender: roman chamomile: neroli.  

Participants received 10 treatments before percutaneous coronary intervention/PCI (formerly known as angioplasty with stent) and the same essential oil blend was inhaled another 10 times after the procedure.

Here are the details of the study: Effects of aromatherapy on the anxiety, vital signs, and sleep quality of percutaneous coronary intervention patients in intensive care units

The purpose of this study was to investigate the effects of aromatherapy on the anxiety, sleep, and blood pressure (BP) of percutaneous coronary intervention (PCI) patients in an intensive care unit (ICU). Fifty-six patients with PCI in ICU were evenly allocated to either the aromatherapy or conventional nursing care.

Outcome measures patients’ state anxiety, sleeping quality, and BP (blood pressure).

The aromatherapy group showed significantly low anxiety and improving sleep quality compared with conventional nursing intervention.

If these surgical patients could see these results imagine how these essential oils could help you if you suffer from anxiety and/or sleep issues.

Join us on the Essential Oils Revolution 2 to hear me cover this and  and other essential oils combinations for anxiety and insomnia.

essential-oils-revolution-banner

Here is the summit registration link:
https://qt247.isrefer.com/go/EOR16reg/trudyscottcn/

Have you found that this combination helps you with anxiety and sleep?  What ratio works for you?