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Side stitch when running or exercising: the anxiety/stress connection (and the pyroluria protocol of zinc and vitamin B6 as a solution?)

By Trudy Scott 21 Comments

side stitch and anxiety

If you get a painful side stitch when running or doing other exercise or experienced a side stitch  when you were a kid, you may be as intrigued as I was to learn there is new research that points to an anxiety/stress connection. This cross-sectional observational study was done involving an anonymous survey of one hundred sixty-eight male and female adults who were running at least 10 miles/16 km per week.

The conclusion of this study, Thorn in Your Side or Thorn in Your Head? Anxiety and Stress as Correlates of Exercise-Related Transient Abdominal Pain, is as follows: “anxiety and stress are associated with the presence of ETAP.” A runner’s side stitch is referred to as ETAP i.e. exercise-related transient abdominal pain. The authors mention the fact that this is the first study to reveal this anxiety/stress connection. This is relevant given the numerous recent studies looking for a cause and no definitive solutions.

This research is also really intriguing to me given what Dr. Carl Pfeiffer MD, PhD, identified 50+ years ago in the 1970s i.e. side stitches are common in those with pyroluria/social anxiety. What’s important is the fact that the pyroluria nutrient protocol eases social anxiety and prevents side stitches in my clients. You’ll read feedback from individuals in the community who resonate with this research and the pyroluria connections. I share more about pyroluria below in case it’s new to you and a possible cause of the side stitch pain.

My feedback and feedback from others in the community

I have pyroluria and always got a left side stitch as a kid, in my teens when running and playing squash and in my 20s/30s when running. And then they stopped (and the social anxiety and related symptoms resolved) when I addressed my pyroluria with zinc, B6 and EPO, and a copper-free multi that contains manganese. I see these kinds of results with my clients all the time so a light-bulb went off when I read this new research .

I shared this research and the anxiety/stress/pyroluria connection on Facebook and asked: did you/do you get side stitches when running/exercising? Here is some of the feedback I received, where the pyroluria protocol did help.

Kameka shared this: “I had side stitches as a kid and as an adult. Running was the main exercise that caused it and it was usually the left side. Now that you mention it, I haven’t had them since I started supplementing for pyroluria. Also, my social anxiety is sooo much better as well!”

She did the symptoms questionnaire and the pyroluria urine test (which can give false negative results) and confirmed she takes vitamin B6, zinc, magnesium, and primrose oil.

Bec shared this: “I hated PE at high school for that reason. While everyone was running, I was suffering from side stitches (I think it was my right side) and having breaks. I have pyroluria with lots of symptoms. I do well with zinc and P5P.”

Not everyone reported an improvement with the protocol but many folks resonated with the side stitch/pyroluria connections:

Megan said: “Couldn’t run as a kid. A stitch every time. I can’t recall which side, never really paid too much attention. Looking at the pyroluria symptoms, I think I may have always had it.”

Janie exclaimed: “Oh, boy, did I!” (while distance running). She finds it hard to remember but thinks it may have been on her right side. She also shared that “tests for zinc come back normal, but I have many of the [pyroluria] symptoms, especially the less common ones. I scored high. I always want breakfast but all the other questions fit me like a glove, like pieces of a puzzle with my photo on the box.

My lack of dream recall is another sign. I take 25 mg of methylated B6, but still no dreams. The question regarding being seated in the middle of a restaurant…THAT IS ME!! My throat will feel like it’s closing up, so much tension.”

I explained that most zinc testing is not accurate and that we increase until we get symptom resolution. I also referred her to the pyroluria chapter in my book.

Susie shared this: “Yes I always got side stitches so I gave up running. I suspected pyroluria but not sure if I have it.”

Leah said “I’d say my daughter and I both [had side stitches] more when we were younger. Both socially anxious and pyroluria. Less exercising now too.”

Information if you’re new to pyroluria

Pyroluria is frequently associated with a type of anxiety characterized by social anxiety, avoidance of crowds, a feeling of inner tension, and bouts of depression. People with this problem experience varying degrees of anxiety or fear, often starting in childhood, but they usually manage to cover it up and push through. They tend to build their life around one person, become more of a loner over time, have difficulty handling stress or change, and have heightened anxiety symptoms when under more stress.

Also on the list of symptoms is this one: “Upper abdominal pain on your left side under the ribs or, as a child, having a stitch in your side as you ran.”

Addressing low levels of the mineral zinc and vitamin B6, together with some other nutrients and stress management, are key to addressing these symptoms.

Here is the complete symptoms questionnaire on the blog. This questionnaire can also be found in the pyroluria chapter in my book, The Antianxiety Food Solution. You’ll find the detailed supplement protocol and additional information on how to assess for low zinc and low vitamin B6 in this chapter too.

You can read more about the prevalence and associated conditions here. It’s most often considered a genetic condition but is possibly environmentally triggered too.

There are many pyroluria blog posts where I cover various aspects such as the importance of addressing pyroluria for recovery from MCAS and Lyme, pyroluria and Ehlers Danlos Syndrome, pyroluria and intrusive thoughts and many more. I encourage you to use the search feature on the blog.

A possible cause of the side stitch in pyroluria

Here is an excerpt from a paper published in 1974 by Dr. Pfeiffer and colleagues, Treatment of Pyroluric Schizophrenia Malvaria With Large Doses of Pyridoxine and zinc, describing why the side pain probably occurs:

This 15-year-old upper middle-class patient (now 19 after studying for four years) represents a case of nutrient deficiency in which vitamins (specifically B6) and the trace minerals manganese and zinc were inadequate for the development of normal knee joints and normal brain function.

The deficiency was sufficiently severe at its peak to cause prolonged psychosis, atypical seizures, arthritis, amenorrhea, constipation, and splenic pain. The pain is probably due to hemolytic crisis in which red cell fragments engorge the Kupfer cells of the spleen and liver, extend the capsule, and cause pain. The double deficiency is produced by the formation of KP [kryptopyrroles] which combines with pyridoxal and zinc.

Based on the above and other publications by Dr. Pfeiffer, when the stitch happens on the left side, my understanding is that the pain is in the spleen. And when it happens on the right side, the pain is in the liver area. Most individuals with pyroluria say they felt/feel their side stitch on the left side. Either way it appears to be caused by low zinc, low vitamin B6 and the other nutrients needed by those with pyroluria. And resolved when on the pyroluria protocol.

I would love to see these ETAP researchers take their anxiety/stress research one step further and identify how common pyroluria is in runners who get side stitches and if the pyroluria protocol prevents the side stitches.

My book as a resource and pyroluria supplements

As mentioned above, there is an entire chapter on pyroluria in 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 addressing these deficiencies. And be sure to share it with the practitioner/health team you or your loved one is working with.

Keep in mind that these nutrients are cofactors for making neurotransmitters and are a key part of my protocol when working with individual amino acids.

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 pyroluria supplements and amino acids that I use with my individual clients and those in my group programs. You can find them all in my online store.

If 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 and pyroluria protocol.

Thanks to everyone who contributed to the discussion on Facebook. Now I would love to hear from you so I can approach the authors with their feedback and yours too.

Did you get a side stitch as a kid and did it affect your ability to take part in school sports?

Do you still get a side stitch when running or doing other exercises? If yes, does it hold you back and with which exercise?

Did/does the side stitch occur on the left or right side?

And do you have pyroluria? (based on the symptoms questionnaire and/or pyroluria urine test)?

Does the pyroluria protocol prevent your painful side stitches? And had you made the connection to pyroluria/anxiety/stress?

Are you seeing a similar pattern with your kid/s? (pyroluria, side stitch and the protocol helps them too)

If you have questions and feedback please share them here too.

My 12 year old son has ADHD, is impulsive, is a loner, craves carbs, and doesn’t do well or care about school – should he be on GABA?

By Trudy Scott 17 Comments

adhd and gaba

I’ve been reading your blogs and I’m trying to decide if my 12 year old son should be on GABA? He has ADHD, is impulsive, is a loner, craves carbs, and doesn’t do well or care about school.

Can you tell me what supplement he could be deficient and where to purchase? He is currently on ADHD medication (Focalin) during the school year.

Janice asked the above question about her 12 year old son. I wish it was as simple as just using the calming amino acid GABA but it’s seldom one amino acid that is the answer. GABA is often one of many supplements that may help and in this instance I suspect a combination of neurotransmitter imbalances (low GABA, low dopamine and low serotonin), pyroluria, other possible nutritional deficiencies and dietary factors are at play.  Read on to hear my approach for working through what may help this young man improve his focus, reduce his carbs, actually care about school and doing well, reduce his impulsivity and help him fit in socially – and ultimately lead to him being a happier, calmer and healthier child.

GABA with preteens who have ADHD and spinning-type symptoms

I always start with one of the amino acids because we get quick results and immediate feedback. Since Janice asked about GABA, this is the GABA feedback I shared with her: I’ve had good results with GABA with preteens who have ADHD and spinning-type symptoms. One clue is when the craving of carbs is driven by stress i.e. stress eating.  I always start with the symptoms questionnaire and have the parent rate each low GABA symptom on a scale of 1-10, with 10 being most severe, ideally in conjunction with their child.

I then have the child do a one-off trial of GABA and we observe improvements in the next 5-30 minutes. If the child reports any improvement in any of the symptoms – in this case focus and spinning driven by anxiety – the child continues with GABA and increases over the next few weeks to find the ideal dose for their needs.

Sometimes focus issues are so severe that it’s too challenging to rate symptoms before, doing a one-off trial of GABA and then rating symptoms afterwards. In cases like this, mom makes the decision to have their child use GABA before school, when they get home and possibly early evening too. Mom can observe their focus and spinning: like getting dressed and ready for school, settling down to homework in the afternoon and settling down for bed.

Relying on feedback from school is invaluable too. Stress related carb cravings are also assessed i.e. does he seek out sugar when stressed and anxious.

A mom shares how GABA helps her 11 year old daughter – GABA for children: ADHD, focus issues, irritability, anxiety and tantrums

My daughter hasn’t been diagnosed with ADHD but has a lot of ADHD qualities. We were having a huge amount of behavior problems as she is getting older (she’s 11). She has had amazing behavior at school and at home since giving it to her. She’s almost like a different child. GABA has truly changed our life.

…before the GABA she was irritable, she was fighting with her teacher and schoolmates, she couldn’t focus and was distracted by anything and everything, she was constantly disrupting the class and she was throwing major tantrums over ridiculous stuff (like her hair didn’t do what she wanted), she was mouthy and everything was a fight.

We are not seeing 99% of those behaviors at all anymore. She of course is still your typical pre-teen but if I say “no you can’t have that” our “no you can’t go there” her reaction is OK. Before it would have been a major fight or meltdown. Her teacher is reporting to me every day about her wonderful days.

Tyrosine for focus issues, low motivation and low energy type carb cravings

With focus issues I would also consider the role of low dopamine and do a trial of tyrosine. Other clues: are his carb cravings related to low energy and is there also low motivation tied to the fact that he doesn’t care about school? Are there also signs of depression or low mood?

We go back to the symptoms questionnaire and have the parent rate each low dopamine/low catecholamine symptom on a scale of 1-10, with 10 being most severe. Again, do this in conjunction with the child if possible.

We only do a trial of one amino acid at a time so we know what is working. Assuming the GABA has been helping, we’d do a trial of tyrosine next and look for improvements in focus, carb cravings (all neurotransmitter imbalances can lead to carb cravings), motivation and mood.

If the one-off trial approach is not an option, tyrosine is also used before school and right after school but no later than 3pm so as not to affect sleep. Again, the above symptoms are tracked.

In this blog both GABA and tyrosine help this teen: GABA helps 14-year-old with Tourette’s Syndrome (the tics and sleep), and tyrosine makes him happier and his mind sharper

Tryptophan or 5-HTP for ADHD/hyperactivity and afternoon cravings

Hyperactivity can also show up with low serotonin, and so can something like not caring about school i.e. a low mood. A clue here is when his carb cravings are more intense – with low serotonin it’s typically afternoon or evening.

We go back to the symptoms questionnaire and have the parent rate each low serotonin symptom on a scale of 1-10, with 10 being most severe. And again, it’s best to do this in conjunction with the child if possible and do a one-off trial of tryptophan or 5-HTP.

If that’s not possible, tryptophan or 5-HTP is used mid-afternoon and evening and symptoms are tracked. This can be layered in on top of the GABA and tyrosine if they are offering some relief.

Here is a blog post where a mom shares how 5-HTP helps her child – ADHD: 5-HTP melts have been a miracle for one of my adopted kids

5-HTP melts have been a miracle for one of my adopted kids. He had lots of trauma and off the charts ADHD. 5-HTP is better than methylphenidate (Ritalin) and we are now weaning off the non-stimulants.

Just 80 mg 5-HTP in the morning is all he needs. He was super ADHD, he had a para (teacher’s aide) in public school for years to keep him on track and this year at a school for ADHD the teachers were complaining that he was never on task. Now after a week it has changed his life.

Addressing pyroluria, low lithium, low zinc, low blood sugar and diet

Janice mentions her son is a loner so we’d look into pyroluria/social anxiety and add zinc, vitamin B6 and evening primrose oil (and other key nutrients). Keep in mind that zinc deficiency is common and is often low with ADHD.

She also mentions that he is impulsive. Impulsivity and ADHD is common with low levels of lithium. A big clue is a child having a roller-coaster of emotions. I use this low lithium questionnaire to assess for a need for low dose lithium (a nutritional supplement).

I consider low blood sugar with all my clients and with this young man low blood sugar may be contributing to his focus issues, low mood and desire for carbs. The amino acid glutamine helps as does breakfast and meals with quality animal protein and healthy fats.

And it goes without saying that dietary factors must always be addressed. My book is a great resource when are looking for a comprehensive dietary approach, which is needed with ADHD and the symptoms Janice describes – The Antianxiety Food Solution. There is also a chapter on low blood sugar, pyroluria and the amino acids.

If you are an adult and can relate to any of these symptoms and feelings, the same process applies. Just remember this: there is no one-size fits all since we all have unique biochemistry.

Side effects and longer term effects of stimulant medications

I appreciate Janice for reaching out and asking this question. Hopefully, implementing some or all of these changes, will allow her son to stop his stimulant medication, Focalin. This medication is similar to Ritalin (methylphenidate), which can cause the following side-effects: feeling sad or empty, irritability, loss of interest or pleasure, trouble concentrating, trouble sleeping (and many more).

These stimulant medications can also play a role in longer term health effects that include heart disease and the possibility of it being a gateway drug to other stimulants. The research on the latter is hotly debated but it is often seen clinically.

Resources if you are new to using amino acids as supplements

To recap, if you are new to using amino acids as supplements, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution (you can see all the symptoms of neurotransmitter imbalances, including low GABA, low serotonin, low dopamine, low blood sugar and low endorphins).

If you suspect low levels of any of the neurotransmitters and do not yet have my book, The Antianxiety Food Solution – How the Foods You Eat Can Help You Calm Your Anxious Mind, Improve Your Mood, and End Cravings, I highly recommend getting it and reading it before jumping in and using amino acids on your own so you are knowledgeable. And be sure to share it with the practitioner/health team you or your loved one is working with.

As mentioned, there is an entire chapter on the amino acids and they are discussed throughout the book in the sections on gut health, gluten, blood sugar control, sugar cravings, anxiety and mood issues.

The book doesn’t include product names (per the publisher’s request) so this blog, The Antianxiety Food Solution Amino Acid and Pyroluria Supplements, lists the amino acids that I use with my individual clients and those in my group programs. You can find them all in my online store.

If, after reading this blog and my book, you don’t feel comfortable figuring things out on your own (i.e. doing the symptoms questionnaire and respective amino acids trials), a good place to get help is the GABA QuickStart Program (if you have low GABA symptoms too). This is a paid online/virtual group program where you get my guidance and community support.

If you are a practitioner, join us in The Balancing Neurotransmitters: the Fundamentals program. This is also a paid online/virtual program with an opportunity to interact with me and other practitioners who are also using the amino acids.

Have any of the above amino acids helped your child or you with the following symptoms: ADHD and poor focus, carb cravings and low mood/low motivation (doesn’t care)?

Has the pyroluria protocol helped your child or you be less of a loner?

Has low dose lithium helped your child or you with impulsivity and focus issues?

Have dietary changes helped too?

If you are a practitioner, are you using amino acids, the pyroluria protocol, low dose lithium and dietary changes with success in cases like this?

Feel free to post your questions and feedback here in the comments.

The importance of addressing pyroluria with chronic Lyme disease (and co-infections), MCAS (Mast Cell Activation Syndrome) and other chronic illnesses

By Trudy Scott 27 Comments

addressing pyroluria

Pyroluria is a social anxiety condition that responds well to zinc, vitamin B6, evening primrose oil and a few other key nutrients, typically resulting in resolution of social anxiety symptoms within a few weeks with the correct combination and dosing. However there is much more to pyroluria than meets the eye. Addressing this biochemical imbalance is crucial for recovery from chronic Lyme disease (and co-infections), MCAS (Mast Cell Activation Syndrome) and other chronic illnesses caused by heavy metal toxicity, mold toxicity, multiple chemical sensitivities and Ehlers Danlos syndrome (amongst others).

Dr. Neil Nathan, MD, author of Toxic: Heal Your Body from Mold Toxicity, Lyme Disease, Multiple Chemical Sensitivities, and Chronic Environmental Illness (2018), shares this about pyroluria and chronic illness:

This biochemical imbalance is surprisingly common in chronically ill patients, and missing this diagnosis (by neglecting to test for and treat it) also denies us the opportunity to provide a simple, benign treatment that can help quiet down patients’ already overstimulated nervous systems.

(Here is my Amazon link to his book, which is excellent)

For over 15 years Dr. Dietrich Klinghardt has been saying you won’t see success with Lyme disease without also addressing pyroluria. He has seen a correlation with all his patients with chronic illness and pyroluria.

Let me quote from an article by Scott Forsgren, FDN-P and Dr. Dietrich Klinghardt, MD PhD: Kryptopyrroluria (aka Hemopyrrollactamuria): A Major Piece of the Puzzle in Overcoming Chronic Lyme Disease (a Townsend letter article published in 2017):

Based on testing with a lab in Holland, Klinghardt has found the incidence of KPU [Kryptopyrroluria or pyroluria] in Lyme disease to be 80% or higher; incidence of KPU over 75% in patients with heavy metal toxicity (lead, mercury, aluminum, cadmium, and others) and in children with autism over 80%.

These are very significant percentages of the patient population with chronic illness that may benefit from a treatment program that addresses KPU.

They also state what has long been known when it comes to pyroluria: symptoms are made worse by stress and “chronic infections, such as Lyme disease, may themselves serve as a trigger for the condition (of pyroluria).”

When it comes to MCAS, an updated version of this same article states that:

Klinghardt has worked with biochemists in Germany that are beginning to link KPU with mastocytosis or mast cell activation syndrome (MCAS).

They have observed that KPU treatment repairs the heme molecule, which notably stabilizes the mast cells and lowers the response to these relative rises in histamine.

I use the term pyroluria in this article, throughout my blog and in my book. It was coined by Carl Pfeiffer, MD PhD in the 1970s (after its discovery by Abram Hoffer in 1958). You’ll see these other terms used in various articles and in some of the older research: kryptopyrroluria (KPU), hemopyrrollactamuria (HPU), pyrrole disorder, mauve factor and sometimes malvaria.

As I shared in my interview with Dr. Kelly MCann on the summit, The Many Manifestations of Mast Cell Activation, it would be wonderful to get the terminology standardized and to get some case studies published. This would allow it to gain more acceptance in the mainstream and in functional medicine.

These papers, Discerning the Mauve Factor, Part 1 and 2, highlight some of the mechanisms as to why addressing pyroluria is so important:

  • “Treatment with nutrients – particularly vitamin B6 and zinc – reduces urinary excretion of HPL and improves diverse neurobehavioral symptoms in subjects with elevated urinary HPL.
  • Heightened HPL excretion classically associates with emotional stress, which in turn is known to associate with oxidative stress.
  • HPL correlated inversely with plasma glutathione
  • HPL is a promising biomarker for oxidative stress. HPL is known to cause non-erythroid heme depression, which lowers zinc, increases nitric oxide, and increases oxidative stress.”

The Forsgren/Klinghardt article above, covers additional mechanisms. With regards to MCAS specifically, the pyroluria supplements – zinc, vitamin B and evening primrose oil – all play a role in reducing histamine, providing immune support and reducing inflammation. And they provide nutritional support for the anxiety and mental health aspects of the condition – directly for pyroluria and indirectly via neurotransmitter support (since they are necessary cofactors for making serotonin and GABA).

Here is some of the research I gathered on some of the ways zinc, vitamin B6 and evening primrose oil (EPO) may help when it comes to MCAS:

If you’re new to MCAS, Dr. Jill Carnahan has an excellent overview here: Mast Cell Activation Syndrome: Here’s What You Need to Know When Histamine Goes Haywire and I’ve blogged about PharmaGABA often being an issue and making anxiety worse when you have MCAS or histamine issues.

The ramifications of this biochemical imbalance are far-reaching

Here is the pyroluria questionnaire / symptoms list (from my book, The Antianxiety Food Solution). It has been updated with recently with additional conditions. You can read about pyroluria prevalence and associated conditions here.

Here are some of my pyroluria blog posts you may find useful (click each of the linked articles to read further). As you will see the ramifications of this biochemical imbalance are far-reaching:

Feel free to use the search feature on the blog to find additional information about pyroluria. I have written about it extensively. I have it myself and it’s really common – I see it in about 80% of my community – so I am pretty passionate about the topic.

Resources if you are new to pyroluria

If you are new to pyroluria, there is an entire chapter on the topic in 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 the pyroluria supplements on your own. And be sure to share it with the practitioner/health team you or your loved one is working with. We need the wider practitioner community to be aware of this condition and the importance of addressing it.

I use individual amino acids such as GABA and tryptophan with all my anxious clients and we always layer in the pyroluria protocol. There is also an entire chapter on the amino acids and they are discussed throughout the book in the sections on gut health, gluten, blood sugar control, sugar cravings, self-medicating with alcohol and more.

The book doesn’t include product names (per the publisher’s request) so this blog, The Antianxiety Food Solution Amino Acid and Pyroluria Supplements, lists the amino acids and pyroluria supplements that I use with my individual clients and those in my group programs.

If you are a practitioner, join us in The Balancing Neurotransmitters: the Fundamentals program. This is a paid online/virtual program with an opportunity to interact with me and other practitioners who are also using the amino acids and pyroluria protocol with success with their clients/patients.

Have you used the pyroluria protocol as part of your recovery from chronic Lyme disease or MCAS (or another chronic illness)?

Did you learn about this from your practitioner or elsewhere? (please share where)

If you’re a practitioner, is the pyroluria protocol part of your  plan for clients and patients? And has it been a game-changer for them?

If you have questions please share them here too.

I was called a vulture for preying on sensitive people in a social anxiety group – because I mentioned pyroluria and a nutritional solution

By Trudy Scott 74 Comments

I was called a vulture

Earlier this week I was called a vulture for preying on sensitive people in a social anxiety group because I mentioned pyroluria and a nutritional solution in response to someone asking for help. I shared much of this on Facebook and the response has been huge – supportive, understanding and encouraging, and also something many of you have also faced and can relate to. I’m publishing it as a blog post too because I feel there are many takeaways and lessons we can all learn from this.

The person asking for help posted this:

I’m seriously stuck. I’ve been battling social anxiety disorder my whole life. I feel like my social skills have gotten worse during 2020-2021. Is anyone the same way? And If possible can anyone give me some good advice?

I posted this in response to the request for advice:

Look into pyroluria and the nutrient protocol – life-changing for me (and my clients – disclaimer: I’m a nutritionist)

And this is the response from someone else in the group:

So not medicine. I think as a nutritionist you shouldn’t be advising people to avoid actual medical help. Foods can’t help but most depression and anxiety isn’t stress based. It’s a biological chemical imbalance. Food won’t help it in the long run. As someone who’s had bipolar, depression, anxiety, social anxiety, insomnia and possible schizo. I have known people to get seriously ill from people that couldn’t manage to be actual doctors. I’ve lost a friend due to them being advised to stop meds and take some herb. Please unless you are actually here because you have social anxiety and such. Could you please leave and stop acting like a vulture over the sensitive people.

I get that it can be tough to grasp that nutrition and nutrients could be a solution for social anxiety but even with a response like this I will continue to share my message.

This was my response:

Correct, not medicine … nutrition. I had social anxiety and panic attacks and diet (gluten-free, caffeine-free, sugar-free etc) and nutrients like zinc, vitamin B6, GABA, tryptophan and more solved my anxiety. I’m passionate about creating awareness because I’ve seen “nutritional psychiatry” work for 100s of thousands of folks.

Please be open-minded … and google “nutritional psychiatry”, “gut-brain”, “pyroluria social anxiety” and “gluten schizophrenia” … you will be pleasantly surprised. It’s going to take some time for all this to be part of mainstream psychiatry but it’s in the research and awareness and acceptance is growing.

I’m sorry about your loss but I would never advise anyone to stop taking their meds. For folks who want to explore this approach we always work in conjunction with their prescribing doctor.

It’s also not very nice calling someone a vulture but I understand that the idea that food and nutrients could be so powerful when it comes to anxiety and mental health can be tough when you first hear about it.

Why I’m sharing this – it’s not for sympathy or to call this person out

I’m not sharing this here for sympathy.

I’m not sharing this to call out this person who called me a vulture or to judge or shame them.

I’m sharing it to illustrate the challenge we have with getting this message out.

I’m sharing it in case you’ve tried to tell a loved one or friend or colleague about the power of anxiety nutrition solutions and have had push-back.

I’m sharing here so we remember to have empathy for someone who doesn’t yet know or understand what we have learned and experienced (no matter what they say or how they say it or even if they have even been preyed on in the past so a comment like this may be justified in their mind).

I’m sharing here because I truly believe in the power of planting seeds of knowledge.

I’m sharing here because I believe everyone deserves to feel their absolute best every single day.

I’m sharing here because everyone struggling with anxiety and social anxiety deserves to know about the growing field of “nutritional psychiatry” in mainstream medicine.

This is why I’m sharing here and why I’ll continue to share nutritional solutions in groups where folks are asking for help for social anxiety, anxiety and panic attacks (and other conditions where pyroluria and neurotransmitter imbalances are common, and there is a role for diet and nutrients).

Why the disconnect and the possible role of neurotransmitter imbalances

I’m hoping all this can help you as you reach out and offer support to someone in an online group. And also help you as you share what you have learned or experienced personally when it comes to nutritional solutions for social anxiety/anxiety – with loved ones, community members, friends and colleagues who are sometimes less than receptive.

I suspect one big disconnect is comprehending that lifestyle/diet/nutrients could help with anxiety and mental health challenges. Heart disease, diabetes, high blood pressure and cancer are more recognized as being lifestyle conditions even dietary and lifestyle changes are not always implemented.

I also often hear this: “my anxiety or social anxiety or panic attacks are so severe (or so complex) there is no way nutrients and nutrition could help! I need medications for sure.”

If someone has nutritional deficiencies or neurotransmitter imbalances, that may also be playing a role in how they respond. For example, low serotonin can make you feel hopeless, fearful, negative, overwhelmed and even angry. This is in addition to feeling anxious and not sleeping well, so you’re more likely to be cranky and irritable.

Links to resources for you to share

Here are links if you need some resources to share or in case you’re new to some of this:

Tamara’s wonderful feedback about gluten and vitamin D

This was Tamara Underwood’s response to my vulture post and her powerful feedback about gluten and vitamin D:

That was a thoughtful response Trudy. I think when people have complex health issues, they think the solution needs to be complex. I had no idea how powerful nutrients could be until it solved my own health issues. Often, it is returning to basics and using foundational support in a targeted way.

I’ve had chronic migraines (3-4 a week) since I was a toddler. Tried every medication, label and off label, to manage them for 40+ years. Removing gluten was life changing. I’ve been migraine free for 8 years now.

Also, about 10yrs ago, I experienced a very dark, unexplained depression for nearly a year. Of course drugs and therapy are the first line treatments. Not sure why I was opposed to starting there but thankful. My Vit D was 4.1. I felt so radically better within a week of starting repletion that I went back to school for my MS in Clinical Nutrition.

I think about how different life might be now, 10 yrs later, had I not pushed for testing. Psych meds wouldn’t have improved my Vit D so I would have been prescribed all the variations and combos and told how complex my case was when it didn’t help. [One study supporting an association between low vitamin D and depression]

There are just so many toxicities, deficiencies, and imbalances worth exploring if your mental wellness suffers. I’m passionate about this subject and a big fan of yours Trudy.

I’m thrilled that going gluten free and addressing low vitamin D solved her migraines and depression. It’s so wonderful to hear Tamara was inspired to go back to school to study nutrition. She now does this work helping professionals (firefighters, EMTS etc.) who shoulder a greater burden of stress and trauma. Check out Underwood Functional Wellness. I appreciate her for allowing me to share here.

I plan to update this blog with more of the wonderful insights from my community on Facebook but folks are still actively engaging and I need to get permission to share here. Stay tuned for more.  You can also join the discussion on the Facebook post here.

Until then, feel free to post your insights, thoughts, experiences (and questions if you have them) in the comments below.

Let us know how nutritional approaches have helped your anxiety and/or other health issues?

What made you open to this approach and were you initially skeptical?

And let us know if you continue to share your success and plant seeds even when you get negative feedback – and why? And do you have resources you like to share?

Social anxiety caused by pyroluria: oxytocin, the vagus nerve, pectus excavatum and Ehlers-Danlos Syndrome

By Trudy Scott 19 Comments

social anxiety pyroluria

Pyroluria is associated with a type of anxiety characterized by social anxiety, avoidance of crowds, a feeling of inner tension, and bouts of depression. If you have pyroluria you may experience varying degrees of anxiety or fear, often starting in childhood, and you usually manage to cover it up and push through. You may build your life around one person, become more of a loner over time, have difficulty handling stress or change, and have heightened anxiety symptoms when under more stress.

It’s not well-recognized in the medical profession and has long been considered a genetic condition. More recently some practitioners have been proposing that it may be triggered by environmental toxins and that it’s not only genetic. Either way, symptoms can start to resolve within a week when low levels of zinc and vitamin B6, together with some other nutrients are addressed. Stress management is key. This can be emotional stress and the stress of toxin exposure, infections like Lyme disease, mold toxicity and even low blood sugar and gluten issues.

We would typically not connect social anxiety/pyroluria with low oxytocin, vagus nerve function or connective tissue disorders but if you read on you’ll see there are some interesting connections.

Oxytocin, social anxiety and zinc

Research has found that oxytocin levels correlate strongly with levels of social anxiety. A paper published in the Journal of Psychiatric Research looked at how variations in the oxytocin receptor (OXTR) gene is associated with an increased risk of anxiety, stress and depression in individuals with a history of exposure to early life stress. Supporting low levels of oxytocin can ease the threats of social interactions.

What is interesting is that zinc, a key nutrient for pyroluria, is needed for binding oxytocin to its receptor. You can read more about all this here: Oxytocin, social anxiety, pyroluria and autism

Sociability improves vagus nerve function and thriving at home alone

Increased sociability helps improve vagus nerve function. It’s all good and well to recommend getting out and hanging out with more people but if you have pyroluria it’s really challenging. It’s also hard work, very stressful and the added stress makes your pyroluria symptoms worse so it becomes a vicious cycle.

You can read all about this here: Increased sociability improves vagus nerve function: the role of social anxiety, pyroluria and low zinc. There is an updated section on social isolation during coronavirus and how some people are thriving being home alone.

Pectus excavatum and Ehlers-Danlos Syndrome

Pectus excavatum is an indentation in the chest wall and is related to problems with connective tissue. When it comes to pyroluria and pectus excavatum, this is what we see in common: social anxiety and depression, low zinc and low vitamin B6, dental crowding and sometimes Ehlers-Danlos Syndrome (EDS). I write more about this here: Pectus excavatum and pyroluria: is there a connection?.

I’ve written an entire blog on Joint hypermobility / Ehlers-Danlos Syndrome and pyroluria. Anxiety, depression, attention deficit (and hyperactivity) disorder, autism spectrum disorders, and obsessive-compulsive personality disorders are all common with EDS. Many folks with EDS report better less social anxiety, improved mood and often improved physical symptoms/reduced pain on the pyroluria protocol of zinc, vitamin B6, evening primrose oil and a good copper-free multi.

Resources for you

Please do share if you have pyroluria or score high on the questionnaire and have seen improvements in your social anxiety and any physical symptoms.

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

By Trudy Scott 83 Comments

Essential tremor, dystonia, anxiety and cravings

Today I’m sharing how diet, GABA, tryptophan, zinc, vitamin B6 and other B vitamins can resolve essential tremor and sugar cravings in 2 months, and also resolve musician’s dystonia and social anxiety within 4 months.

According to Medical News Today essential tremor is a movement disorder that can cause hand tremors and “is among the most common movement disorders.” … “The tremor usually affects both sides of the body, but it may be more noticeable in the dominant hand. It tends to occur when the person is moving as well as when standing still. Genetics may be responsible for around half of the cases of essential tremor.”

Essential tremor – diet, GABA, tryptophan and B vitamins

This Croatian paper, Treatment of Essential Tremor with Multi-Modal Nutritional Therapy in a Teenage Patient, reports the “case of a 13-year-old boy with [essential tremor] causing severe functional impairment” over the previous 2 years.

“A multi-modal nutritional therapy approach” was used to target three possible areas that could be contributing to the tremors: a poor diet that was high in sugar, low GABA levels and low serotonin. These changes were implemented:

(i) diet (specifically adopting a Mediterranean diet)

(ii) GABA (through oral supplementation) and

(iii) L-tryptophan/vitamin B pathways (Triptobel oral supplement).

The papers states: “After two months of therapy, his tremor decreased significantly and he regained normal function.”

Once the essential tremor resolved, this teen was able to resume his plans to pursue a musical career as a guitar player (which had been put on hold due to the tremor and his inability to play). What wonderful results!

I’m thrilled to see tryptophan and GABA being used for this condition and am really pleased to read this case report.  Here is my commentary on the supplements and doses he used for anyone wishing to try and replicate this nutritional approach (keeping in mind there is no one-size-fits-all).

  • He used 150 mg of the Triptobel supplement three times daily at 8 am, 1 pm, and 6 pm. One capsule of  the Triptobel contains 150mg L-tryptophan and a B vitamin complex of thiamine (vitamin B1), riboflavin (vitamin B2), niacin (vitamin B3), pantothenic acid (vitamin B5), vitamin B6, folic acid (vitamin B9), and cyanocobalamin (vitamin B12).  The total tryptophan dose was 450mg per day. A typical starting dose for someone with anxiety is 500mg 2 x day so his dose was on the low-end.  The Triptobel was also used at mealtimes and according to the label “on a full stomach after a light meal, preferably without protein.” I like to use tryptophan between meals (away from protein) and a B complex with meals so I’m intrigued by this application (but wonder when protein was consumed).
  • He also used 750mg GABA twice daily at 10 am and 4 pm. This is considered a high starting dose for the majority of my clients with anxiety and I start low and build up to this amount.

Anxiety and low mood was not mentioned so I don’t know if they were factors.

It appears sugar and carb cravings were very likely a factor given that his normal daily diet contained “large amounts of refined sugars (chocolate, cake, biscuits, ice cream, etc).” The amino acids would have helped him with those cravings.

With regards to his diet, given how common movement disorders are with gluten issues, I would also consider I gluten-free diet which has been shown to have an adverse impact on neurotransmitter levels and B vitamins. Could gluten have triggered these nutritional deficiencies and the tremors?

And now to share a very similar case in an adult male … with a different and yet related approach.

Dystonia and hand tremors – and the pyroluria connection

This same Medical News Today article also describes dystonic tremor/dystonia as a movement disorder that can also cause hand tremors, stating that “the brain sends incorrect messages, resulting in overactive muscles, abnormal postures, and sustained undesired movements. Young adults and those in middle age are most likely to develop dystonic tremors, which can occur in any muscle.”

If you’ve been reading my recent articles on pyroluria (the pyroluria-vagus nerve connection and the introversion-pyroluria-loneliness connection) I’m sure you’ll be be interested to learn that there appears to be a strong link between pyroluria and focal musician’s dystonia (or musician’s cramp) in some individuals.

As you read in the blog above, Jay, also a guitar player, had to put his professional music career on hold due to musician’s dystonia. He also happened to have social anxiety and he started to notice improvements in his anxiety and tremors within the first 2 weeks. At the end of 4 months of being on the pyroluria protocol, he shared this:

I think it is, at this point, safe to say that the pyroluria treatment [120mg vitamin B6 and  60mg zinc) is, at least in my case, the cure for pyroluria and dystonia. 90%+ of my symptoms have disappeared, I am working extensively on repertoire and I am thinking about getting back into performing.

He says his experience was “akin to rebirth as a musician and also as a person.” How wonderful is that to read. Jay’s musician’s dystonia resolved and so did his social anxiety.

The outcome for the teen and Jay were similar and yet the approaches used were seemingly very different. This isn’t actually the case since zinc and vitamin B6 are co-factors that are needed to make GABA and serotonin.

Do you experience tremors, or have you been diagnosed with essential tremor or dystonia (or know someone who has)? And have you considered a nutritional approach?

Do share if you’ve seen success with either of the above approaches, and also experienced reduced anxiety or felt more social?