stiff and tense muscles

The morning after a spine surgery, I had an anxiety attack and insisted on being allowed to take my GABA, which helped

February 28, 2025 By Trudy Scott 12 Comments

I’d been taking GABA before [my spine] surgery and really didn’t want to have to discontinue it. My surgeons have always insisted on me going off supplements in the week or more leading to surgery.

I’m sure they don’t want to have to be well versed on everything a person might be taking so they only allow prescription drugs.

The morning after the spine surgery, I had an anxiety attack and insisted on being allowed to take my GABA, which helped.

GABA helps tremendously in preventing me waking in the middle of the night or early morning in a panic. I take 500mg of NOW GABA sublingually before bed. I also take tryptophan and magnesium glycinate at bedtime and believe they help a bit, but GABA is the most effective.

It would be really helpful to be able to take needed supplements right up to surgery time.

LM posted this in response to my blog: GABA and theanine for sedation, anxiety, and cognition in preoperative surgical patients (a randomized controlled study) (more on this below).

She also said “This would be really nice” if doctors knew this! I’m with her – it would be really nice if doctors were aware of this research and allowed patients to use GABA and theanine right up to surgery and right afterwards too. This is especially relevant given the fact that GABA lowers blood pressure and high blood pressure is common after surgery (more on this below too).

Hopefully this GABA/theanine surgery research and the GABA/high blood pressure research will start to shift perspectives and guidelines, especially since increased anxiety also impacts the outcome of surgery. I share more on the research and my insights below.

The study: GABA and theanine are calming before a surgical procedure and don’t cause too much drowsiness

If you missed the blog post and study I shared above, here is the overview:

This novel study was planned to study and compare the effects of L-theanine and GABA on anxiety, sedation, and cognition in preoperative patients posted for major elective surgeries under general anesthesia.

The conclusion is that:

GABA and L-theanine result in effective preoperative anxiolysis with minimal sedation and improvement of cognitive skills.

In other words, both these amino acids are calming before a surgical procedure, don’t cause too much drowsiness and improve cognition.

Study participants used 500 mg GABA and 200 mg of theanine – but dosing is unique

The authors had the study participants use 500 mg GABA and 200 mg of theanine. Both were used as capsules and swallowed. If you’ve been following my work, you’re aware that I find sublingual (or powder or liposomal or topical) use of GABA to be more effective than swallowing a capsule. For this reason it’s possible that using a lower dose sublingually may be as effective or possibly even more effective.

As always, dosing of GABA (and other amino acids such as theanine) is individualized to the unique needs of the person. Ideally, the person has figured out their optimal dose for easing anxiety in their day to day life before going in for surgery. They may find that a higher dose is needed the weeks leading up to surgery and the day of surgery.

As LM shared, she uses “500mg of NOW GABA sublingually before bed”, and presumably started with a lower dose and worked up to 500mg i.e. the optimal dose for her unique needs. It’s very individualized with no-one-size fits all i.e. someone else may get similar benefits with 125mg.

You can read the entire blog post here: GABA and theanine for sedation, anxiety, and cognition in preoperative surgical patients (a randomized controlled study).

Why you are told to stop all supplements prior to surgery

My understanding is that being told to stop all supplements prior to surgery is because of potential concerns about effects on bleeding, anesthesia and blood pressure. Unfortunately, the study didn’t address this possible issue. This article has some information on supplements (and some meds) to stop before surgery/anesthesia stating:

you may need to take a break from some supplements and medications that can interfere with anesthesia. Surgical complications could include heart or bleeding problems, prolonged anesthesia effects, or increased blood pressure.

GABA lowers blood pressure which may be helpful right after surgery

High blood pressure is common after surgery and can have far-reaching implications. According to this paper, “Postoperative hypertension often begins ~10–20 minutes after surgery and may last up to 4 hours. If left untreated, patients are at increased risk for bleeding, cerebrovascular events, and myocardial infarctions.”

This is another reason GABA may actually be helpful to use right up to surgery and right afterwards – it lowers blood pressure.

This paper, United States Pharmacopeia (USP) Safety Review of Gamma-Aminobutyric Acid (GABA), published in 2021, reports the results of a 4-week study that investigated the tolerability of GABA supplementation in mildly hypertensive but otherwise healthy adults:

The authors first established an optimum dose in mildly hypertensive subjects (SBP/systolic blood pressure between 130 and 180 mm Hg) who were randomized to receive oral doses of GABA at 0 (placebo), 20, 40, or 80 mg/day for 4 weeks.

An intake of 80 mg/day of GABA was associated with a significant reduction of the BP in adults with mild hypertension, and no adverse effects were reported.

A subsequent study evaluated long-term effects of GABA at 80 mg daily versus placebo in mildly hypertensive subjects for 8 weeks:

At the end of the 8-week study, SBP [systolic blood pressure i.e. the top number] and DBP [diastolic blood pressure i.e. the bottom number] were on average 5% lower in all the subjects who received 80 mg/day of GABA compared to participants in the placebo group whose blood pressure levels remained above normal.

This is a substantial reduction when 80 mg of GABA a day is considered a very low dose. I typically have my anxious clients start with 125mg GABA and increase from there. They may end up using 125 mg GABA 3 or 4 times a day and sometimes 250 mg a few times a day or 500 mg once a day like LM is doing.

Additional resources when you are new to using GABA and other amino acids as supplements

As always, I use the symptoms questionnaire to figure out if low GABA may be an issue. The low GABA symptoms include: physical tension, overwhelm, fears, anxiousness, stiff and tense muscles, sleep issues, feelings of panic and stress-eating and drinking.

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

There is an entire chapter on the amino acids and they are discussed throughout the book in the sections on gut health, gluten, blood sugar control (this is covered in an entire chapter too), 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.

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.

Wrapping up and your feedback

I appreciate LM for sharing how GABA helps her and her post surgery experience with anxiety and using GABA. It is wonderful that she was able to take her GABA supplement for the anxiety attack after her surgery. Let’s hope this research increases awareness amongst surgeons.

I’d love to hear from you – have you been told to stop all supplements before surgery, including GABA and other amino acids.

And do you feel increasingly anxious before surgery and other medical procedures and would GABA help i.e. is GABA and/or theanine part of your calming repertoire on a day-to-fay basis?

Have you ever discussed either of these two amino acids – GABA or theanine – with your surgeon or anesthetist prior to surgery and were they open to you using them before and right after surgery?

If you’re a practitioner do you recommend GABA and theanine to your anxious clients/patients and as a surgeon or anesthetist would you consider these amino acids in the future, based on this research?

Feel free to share your experiences and ask your questions below.

Exploring the Therapeutic Potential of Gamma-Aminobutyric Acid (GABA) in Stress and Depressive Disorders through the Gut–Brain Axis

January 31, 2025 By Trudy Scott 4 Comments

Research conducted on individuals with depression reveals that major depressive disorders (MDDs) coincide with diminished levels of the inhibitory neurotransmitter γ-aminobutyric acid (GABA) in the brain, as well as modifications in the subunit composition of the primary receptors (GABA_A receptors) responsible for mediating GABAergic inhibition.

Furthermore, there is substantial evidence supporting the significant role of GABA in regulating stress within the brain, which is a pivotal vulnerability factor in mood disorders. GABA is readily available and approved as a food supplement in many countries.

Although there is substantial evidence indicating that orally ingested GABA may affect GABA receptors in peripheral tissues, there is comparatively less evidence supporting its direct action within the brain.

Emerging evidence highlights that oral GABA intake may exert beneficial effects on the brain and psyche through the gut–brain axis. While GABA enjoys wide consumer acceptance in Eastern Asian markets, with many consumers reporting favorable effects on stress regulation, mood, and sleep, rigorous independent research is still largely lacking.

Basic research, coupled with initial clinical findings, makes GABA an intriguing neuro-nutritional compound deserving of clinical studies in individuals with depression and other psychological problems.

This is the abstract from a recently published review paper: Exploring the Therapeutic Potential of Gamma-Aminobutyric Acid in Stress and Depressive Disorders through the Gut–Brain Axis

Does GABA exert calming and mood benefits via the gut-brain axis or is it really just a placebo effect? This paper discusses both possibilities. I’m excited by the former (and share more about this below) but I do not agree with the latter. Based on my clinical and personal experience, the calming effects of the amino acid GABA, used as a supplement (when you have low GABA symptoms/levels and used in a very specific way), is not a placebo effect. I also discuss this and share some cases that clearly confirm there is no placebo effect. Read on to be enlightened and encouraged about the power of GABA.

GABA and the microbiota-gut-brain axis

The authors describe the microbiome-gut-brain axis as “the bidirectional communication between the gastrointestinal tract, including its resident microbiota and the brain, linking emotional and cognitive centers of the brain with peripheral intestinal functions.”

They acknowledge that while we don’t quite understand the exact mechanisms of this bidirectional communication, “the vagus nerve, the endocrine and immune system, and the synthesis and metabolism of metabolites and neurotransmitters in the gut are critically involved.” This is exciting given what we know about the blood brain barrier.

If you are new to this concept of the gut-brain axis or want to read some of the latest updates, I encourage you to read the paper and learn about the benefits of probiotics (such as Lactobacillus and Bifidobacterium, and Lactococcus, Enterococcus, Streptococcus, and Leuconostoc) and prebiotics i.e. psychobiotics; and fermented foods – for mood improvement and stress reduction.

You’ll read this about GABA (both as a metabolite produced by the microbiome and as a supplement):

found in the enteric nervous system it contributes significantly to gut-brain axis functions and related disorders, including depression, anxiety, inflammatory, and cardiovascular disorders (they refer to GABA as a crucial ‘postbiotic’ i.e. a metabolite produced by the microbiome)
while GABA may not directly cross the blood-brain barrier in humans, an indirect influence through the enteric nervous system could potentially provide a viable pathway for the impact of GABA dietary supplements
although the connection between oral GABA administration i.e. GABA supplementation, the vagal nerve, and GABA levels in the brain has not been firmly established, considering the existing evidence, it represents a promising avenue for future research.

The last two bullets are worth emphasizing because one of the most common myths is that “GABA supplements don’t work because GABA is too big a molecule to get across the blood brain barrier.” It really doesn’t need to get through the blood brain barrier in order to be calming.

I share more about this in a blog I published in 2023 – you can read it here.

GABA is a lifesaver and helps with mycotoxin-induced anxiety

Joie has Sjogren’s, Hashimoto’s, fibromyalgia & collagenous colitis (all diagnosed after severe mold exposure) and shares how GABA

has been a life saver for me (for my anxiety), and I share this with all I know who experience anxiety. I also use L-theanine at night because of insomnia. The 5-HTP has helped somewhat for sleep. L-tryptophan didn’t seem to make a difference. However the 5-HTP has made a significant difference in lessening my daily pain levels, which I am most grateful for.

Micki Contini, MS CNC, a board-certified holistic health and nutrition consultant, is a friend and colleague whose life was hugely impacted by mold toxicity. She shares this about how GABA helped her:

As they started tearing my house apart for remediation, I started eating GABA Calm like candy. At the beginning I had to have a lot more than I do now. GABA Calm takes me down a notch and I feel my shoulder coming away from my ears and I get closer to relaxing.

Here are a few other blogs that illustrate just how calming GABA can be when used as a supplement:

If GABA works it’s a placebo effect?!

I find this statement in the conclusion of the review to be confusing given all that the authors share about the gut-brain axis, vagus nerve and bidirectional communication:

The dietary supplement form of GABA is readily accessible to consumers. While many individuals assert that they derive advantages from using these products, it remains uncertain whether these supplements provide benefits beyond what could be attributed to a placebo effect.

Their argument about conflict of interest and small sample sizes when it comes to studies doesn’t hold water with me.

As I mentioned above, based on my clinical experience, the calming effects of the amino acid GABA, used as a supplement when you have low GABA levels (and used in a very specific way), is not a placebo effect.

The following two cases clearly confirm there is no placebo effect (and these are just a few of many which I plan to share with the authors).

My 6 year old was having panic attacks getting out of the car for Kindergarten

My 6 year old son was having panic attacks getting out of the car going to Kindergarten and taking two GABA Calm has completely relieved him of his fears. He has been going for 3 straight weeks in a row.

I thought it may be low serotonin since this happened last winter as well but I gave him 5-HTP for a couple months and it didn’t seem to affect him and his anxiety. We had to have him repeat Kinder this year.

But wow, the GABA has been fabulous and Kindergarten is in full swing because of your help.

Lisa, a mom in the community, shared these wonderful results about her son. This is most definitely not a placebo effect.

You can read the entire story on the blog here. The school is actually in shock at how well carpooling is going for him.

GABA lessens anxiety, agitation and defiance in 98 year old mother who has been “sundowning” for a couple of years

My mother is 98 and has been “sundowning” for a couple of years. It starts around 3pm, sometimes earlier. Some days it’s no big deal. It is on those other days when she starts and then it goes to anxiety, agitation, then she can get sort of defiant which is so not her. She is a gentle soul, friendly, and kind so this is difficult on her as well as our family.

I just started to use my pestle and mortar to crush up a 125 mg GABA CALM supplement (Source Naturals) and I mix a little into her flavored yogurt when I start to see her having difficulty. I give it to her throughout the day. She only gets the 125 mg amount so I feel safe with that.

I believe that I do notice it lessens her anxiety. I pray that this will be helpful for her because that anxiety can be really draining for her. I have not noticed any adverse reactions.

This is another heartwarming success story shared by Marsha who used GABA Calm with her mother. It’s yet another one that is not a placebo effect either. You can read the entire blog post here.

My personal GABA results are also not a placebo effect

I can also share from first-hand experience that GABA was a life-saver for me in my late 30s when I had no idea what a panic attack was and knew very little about GABA other than the fact it calmed me down very quickly!

I still use GABA in various situations to this day: to help with back spasms after a fall, to help with rectal spasms, to help with throat spasms/pain caused by crying (after the loss of my darling mom), to help me sleep solidly and before doing an on-stage presentation, and much more.

GABA is effective and safe when used in a very specific way

Many people use GABA and report it didn’t work or that they had a strange or uncomfortable reaction to their GABA supplement (such as tingles or flush or feeling dizzy). I’m on a mission to educate folks how GABA is effective and safe when used in a very specific way:

Only if you have low GABA levels and symptoms of physical tension, overwhelm, fears, anxiousness, stiff and tense muscles, stress eating, drinking to calm down or fit in socially (you can see all the symptoms here)
Starting with a low dose of around 125mg (and less if you’re sensitive)
Only using it as a sublingual, powder or capsule opened on to the tongue, liposomal or GABA cream (to see results in 1-10 mins and to bypass the digestive system)
Titrating up (and sometimes back down) to find the ideal dose for your unique needs
Being open to trialing different products and forms and sometimes combining GABA with theanine
Understanding that there can be nuances to using GABA, making one change at a time and not giving up too soon
Tracking carefully and course-correcting as needed

I educate anxious individuals about all of the above and offer guidance and encouragement in the GABA Quickstart 2.0 online group 5 week program.

I hope this summary, the review paper and the cases leave you feeling enlightened and encouraged about the power of calming GABA.

Additional resources when you are new to using GABA and other amino acids as supplements

As always, I use the symptoms questionnaire to figure out if low GABA or other neurotransmitter imbalances may be an issue.

Wrapping up and your feedback

Have you experienced the benefits of GABA for stress and/or low mood? Do you believe it’s more than a placebo effect?

And are you excited to understand the possible mechanisms and read the research? Or do you just want to know how GABA could help you and how to use it?

Have you tried GABA without success or only had limited success? Feel free to share and I’ll provide my feedback.

Feel free to ask your questions below.

Understanding the function of the GABAergic system and its potential role in rheumatoid arthritis (for pain, anxiety, sleep issues and more)

January 3, 2025 By Trudy Scott 2 Comments

This is a great question posed by a woman in my GABA/anxiety online group program:

Can GABA be good for rheumatoid arthritis, and in its early stages? If so, in what ways would someone see signs of improvement with GABA?

When I looked into some of the recent research on GABA and rheumatoid arthritis I was fascinated. A 2023 review paper, Understanding the function of the GABAergic system and its potential role in rheumatoid arthritis, discusses the relationship between rheumatoid arthritis (RA), an autoimmune condition, and GABA (gamma-amino butyric acid), a calming neurotransmitter.

The authors discuss “a new mechanism of action in RA” and the fact that “bidirectional communication occurs between the brain and immune system…and neuroinflammatory responses in the brain.”

The paper discusses GABA and neurosignalling, immunomodulatory effects and inflammation, stating that the:

GABAergic system may modulate the abnormal pain response in RA patients.

So to answer her question, if she has low GABA levels we would expect to see some reduction in her RA pain.

As always, we look for the signs and symptoms of low GABA regardless of the diagnosis or possible diagnosis. So if someone has low GABA symptoms of physical tension, overwhelm, fears, anxiousness, stiff and tense muscles, focus issues, pain, stress eating or drinking to calm down, and poor sleep, we consider a trial of the amino acid GABA, and could expect improvements in all or some of the above symptoms.

I would also recommend that she tracks markers of inflammation (like hs CRP, IL-6, IL-1β, and TNF-α) and RA markers to see if they shift in a positive direction with her use of GABA too.

I share more below about the incidence of anxiety and sleep issues in rheumatoid arthritis and some of the mechanisms covered in the review paper. Also, there are lab tests to track and there are other nutritional approaches for supporting an autoimmune condition such as RA.

Some of the mechanisms covered in the review paper

This image from the paper and the explanation provides some insights on the mechanisms at play.

Glutamate interacts with glutamate decarboxylase (GAD65 and GAD67) to produce gamma-aminobutyric acid (GABA).
Binding of GABA to GABA-A receptors inhibits macrophage activation and decreases the release of inflammatory factors such as IL-6, IL-1β, and TNF-α. Antigen presentation by antigen-presenting cells, however, is impaired, inhibiting CD4⁺ T cell proliferation and differentiation and reducing the expression of inflammatory factors such as IL-6, IL-1β, and TNF-α.
Pain signaling activates the P38/MAPK pathway, whereas GABA binding to GABA-A receptors inhibits P38/MAPK. The P38/MAPK signaling pathway contributes to inflammation and is involved in the activation of myocardin-related transcription factor A (MRTFA), myocardin-related transcription factor B (MRTFB), and serum response factor (SRF) that played key roles in fibroblast activation.

gaba and rheumatoid arthritis — Figure 1. Understanding the function of the GABAergic system and its potential role in rheumatoid arthritis

The authors don’t mention the use of the amino acid GABA as a supplement for RA but do list a number of clinical trials (mostly diabetes patients) where GABA has been used with success. It’s a start and I look forward to future research in this area.

Anxiety, depression, insomnia, cognitive issues and stress-eating in RA

This paper, Psychiatric aspects of rheumatoid arthritis: Review of literature, reports that

Among the major psychiatric disorders found in RA, the anxiety and depressive disorders are prevalent (13 to 48% of patients), as well as suicide, insomnia and tiredness. The impairment of quality of life is markedly after age 65.

This paper, A 30-Day Adjunct Wellness Intervention for the Management of Extra-Articular Symptoms of Rheumatoid Arthritis: A Formative Study, also mentions “cognitive and physical dysfunction” and “stress-related eating” in addition to anxiety, depression and insomnia in RA patients.

Doing a trial of GABA (and other amino acids such as tryptophan and d-phenylalanine/ DPA), will confirm which symptoms are related to which neurotransmitter deficiencies. It’s exciting to consider a very possible role of GABA and other amino acids given the fact that “individuals with rheumatoid arthritis (RA) continually fall short of treatment targets using standard drug therapies alone”

Looking further than GABA and other amino acids: a gluten-free diet and other root causes

With RA we obviously want to address more than just GABA (and other amino acids). Gluten removal is recommended but I do want to mention that the research is surprisingly mixed. This paper, Efficacy of gluten-free diet in patients with rheumatoid arthritis states that

Gluten seems to be a glycoprotein with a clinically relevant inflammatory effect. Several observational studies and anecdotal cases reported a correlation between gluten and various diseases, including autoimmune diseases, such as rheumatoid arthritis. This study aimed to evaluate whether gluten-free diet could be effective in controlling inflammation and ongoing rheumatoid arthritis symptoms.

We report 4 cases of patients with long-standing rheumatoid arthritis with no response to several conventional and biotechnological drugs, treated with a gluten-free diet concurrently with the drug therapy. Our patients presented different degrees of response to the diet, in terms of disease remission and improvement of symptoms. Our cases confirm that a gluten-free diet may improve symptoms of rheumatoid arthritis, even in patients resistant to conventional drug therapies.

Many other papers dismiss the role of gluten and inflammatory diets. This one is an example of a number of similar papers.

The benefits of addressing neurotransmitter imbalances with GABA and other amino acids means the addiction is stopped and quitting bread and cookies now no longer requires willpower,

Here are some autoimmune recipe resources:

In addition to dietary changes, a full functional medicine approach is warranted as there is much research supporting the benefits of the following for RA: omega-3 fatty acids, olive oil, low vitamin B6, addressing heavy metals such as mercury and much much more.

I cover 60+ root causes of anxiety here – I’d be carefully assessing each of these root causes for RA too.

Additional resources when you are new to using GABA and other amino acids as supplements

As always, I use the symptoms questionnaire to figure out if low serotonin or low GABA or other neurotransmitter imbalances may be an issue.

Wrapping up and your feedback

Do you have rheumatoid arthritis (RA) or another autoimmune condition and has GABA helped?

Were you aware of these possible connections?

What about dietary and nutritional approaches?

Feel free to share your feedback and ask your questions below.

Multiple sclerosis: low GABA research and the amino acid GABA for anxiety, muscle stiffness, swallowing/voice issues and pain

April 14, 2023 By Trudy Scott 12 Comments

I’m excited about the GABA research – an older paper and some new studies – on multiple sclerosis (MS). This means there is the potential for using GABA supplementation in similar ways it’s used with other conditions where anxiety, insomnia and pain are issues. This can include the typical low GABA-type physical anxiety, stiff and tense muscles, insomnia and pain, and also MS-specific issues such as spasticity, laryngospasms, balance issues, swallowing and speaking/voice issues and sensorimotor problems.

Anxiety is common in MS and benzodiazepines are commonly prescribed. The ideal is to use the amino acid that supports GABA, instead of needing to use benzodiazepines. I share some of the GABA/MS research and specific applications for using GABA below.

Prevalence of anxiety/depression in MS and the use of benzodiazepines

Anxiety and depression is common in multiple sclerosis. This paper, The incidence and prevalence of psychiatric disorders in multiple sclerosis: A systematic Review, included 118 studies and found that:

Among population-based studies, the prevalence of anxiety was 21.9% (and up to 35.0% in some papers), 23.7% for depression, 14.8% for alcohol abuse, 5.83% for bipolar disorder, 4.3% for psychosis and 2.5% for substance abuse.

psychiatric comorbidity remains understudied.

What is concerning is that benzodiazepines such as Ativan, Valium and Xanax are commonly prescribed for MS patients for their anxiety, insomnia, spasticity and pain. Recent research, Use of Benzodiazepines and Z-Drugs in Multiple Sclerosis found that benzodiazepine use is more “more common in people with MS than in general population controls, and use of these agents is in persons with MS is often chronic” i.e. for longer than 6 months.

This is problematic given that anything over 2 weeks can cause dependence, tolerance and withdrawal. They can cause balance issues and can actually cause anxiety and insomnia. Someone in my community was totally disabled for over 3 years with “locked shoulder muscles, neck, jaw …internal vibrations… bad headaches, jelly legs, distorted vision like floaters and squiggles and fireworks …cortisol rushes through the body.. And tortured every day.” Read more about her horror story and benzos here.

The ideal is to use the amino acid that supports GABA, instead of needing to use benzodiazepines.

Low GABA plays a role in multiple sclerosis: the research

Low GABA (gamma-aminobutyric acid) plays a role in multiple sclerosis. This paper, Reduced gamma-aminobutyric acid concentration is associated with physical disability in progressive multiple sclerosis states that there are

reduced GABA levels in the hippocampus and sensorimotor cortex of patients, and show that reduced GABA in the sensorimotor cortex is associated with increased motor impairment. Changes in GABA may be a marker of neurodegeneration.

This study supports the idea that modulation of gamma-aminobutyric acid neurotransmission may be an important target for neuroprotection in multiple sclerosis.

Of course, the authors don’t mention using the calming amino acid GABA, but we extrapolate and use what we see clinically in other conditions like autism (more on that below).

Two other papers support the GABA connections. This 2021 paper, Altered Plasma Metabolic Profiles in Chinese Patients With Multiple Sclerosis, observed “a great increase in the levels of L-glutamic acid” in patients with MS. Increased glutamate typically means low GABA levels.

Guanidinoacetic acid (GAA) is an experimental nutrient that is new to me, but the GABA effects and mechanisms are encouraging. In this 2022 paper, Guanidinoacetic Acid as a Nutritional Adjuvant to Multiple Sclerosis Therapy the author states that GAA may benefit MS patients via “modulation of gamma-aminobutyric acid (GABA)ergic neurotransmission and brain oxidant-antioxidant status, or a reduction of glutamate neurotoxicity.’

The author also shares that “demyelination is often characterized by various neurochemical abnormalities in GABA-glutamate metabolism.”

In case you’re new to MS and demyelination, this Mayo Clinic article describes them as follows:

A demyelinating disease is any condition that causes damage to the protective covering (myelin sheath) that surrounds nerve fibers in your brain, the nerves leading to the eyes (optic nerves) and spinal cord. When the myelin sheath is damaged, nerve impulses slow or even stop, causing neurological problems.

Multiple sclerosis is the most common demyelinating disease of the central nervous system. In this disorder, your immune system attacks the myelin sheath or the cells that produce and maintain it.

This attack causes inflammation and injury to the nerve sheath and ultimately to the nerve fibers that it surrounds. The process can result in multiple areas of scarring (sclerosis).

I gathered some of this research while preparing for an interview with the wonderful Dr. Terry Wahls, MD and author of “The Wahls Protocol.” We were both pleasantly surprised to see these GABA/MS connections.

Using GABA for easing anxiety, overwhelm and insomnia in multiple sclerosis

There is no research that I am aware of that has studied the use of GABA supplementation in MS. We can, however, extrapolate from other conditions and use GABA for easing various MS symptoms based on what we see clinically.

As mentioned above, anxiety is common in MS and if you have the low GABA type of physical anxiety, GABA is worth a trial for easing typical low GABA symptoms of physical anxiety, feelings of overwhelm and intrusive thoughts, stress eating, using alcohol to relax or fit in socially and insomnia. You can read more about GABA for physical anxiety here and see all the low GABA symptoms here.

And here are a few examples/case studies:

Using GABA to help with balance, and sensorimotor and coordination issues in multiple sclerosis

These case studies illustrate an application for GABA being used for balance, sensorimotor and coordination issues that are common in MS (they are not folks with MS):

Much of the research in this area has been done with autism, as illustrated by this GABA Oolong tea study tea in children with autism. They saw improvements in sensorimotor skills, autism profiles, anxiety and sleep.

Using GABA to help with stiff and tense muscles, spasticity, voice issues, laryngospasms and difficulty swallowing in multiple sclerosis

GABA helps to ease stiff and tense muscles in those with physical anxiety. In a similar way we see GABA help with these common MS symptoms: muscle spasms, spasticity, voice issues, laryngospasms and swallowing difficulties (dysphagia affects about a third of folks with MS).

These case studies illustrate an application for GABA being used for some of above issues that are common in MS (they are not folks with MS):

Again, there is no research that I am aware of specifically with MS, but clinically I see GABA helping all of the above symptoms related to spasms and muscle tension, often with anxiety and pain as an underlying factor too.

Other MS symptoms that may also be supported by addressing low GABA levels: bowel issues and rectal spasms, bladder issues/spasms, tremor and problems with memory/thinking, and possibly even vision issues.

I really look forward to seeing future research on the use of the amino acid GABA in MS. And I’d love to be involved in some studies if you are associated with a research facility or do research.

Low serotonin and low endorphins are common in multiple sclerosis too

Low GABA is just the tip of the iceberg when it comes to the underlying neurotransmitter imbalances in MS.

The amino acid DPA/d-phenylalanine may help ease some of the low endorphin pain symptoms, weepy kind of depression, and alcohol addiction. You can read about this here.

Tryptophan and/or 5-HTP may help ease some of the low serotonin worry-type of anxiety, fear, panic attacks, obsessing, low mood and MS-specific pain issues and insomnia. I’ll write more about this and the supporting research in a follow-up blog.

If you do have more than one imbalance (which is not unusual), you need to figure out which imbalance you have and address that with the relevant amino acids, one at a time. I have clients pick the area that is more problematic for them and start there.

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

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

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.

Do you have multiple sclerosis and has the amino acid GABA helped with your anxiety and fears; muscle stiffness and spasticity; swallowing, laryngospasms and voice problems; balance and sensorimotor issues, insomnia and pain?)

How much has helped and which product do you use?

Do you find sublingual, powder or an opened capsule helps more than swallowing the GABA capsule?

Were you surprised that GABA would help so much?

What else has helped your multiple sclerosis symptoms? And have you also addressed low serotonin and low endorphins with amino acids tryptophan and DPA?

If you have questions and other feedback please share it here too.

Urinary neurotransmitter testing reports elevated GABA when it’s really low: using the low GABA symptoms and a trial of GABA is best

September 23, 2022 By Trudy Scott 4 Comments

Francoise posted this feedback and her surprise about her elevated GABA levels – as reported on a urinary neurotransmitter test. She was justifiably confused because she had looked at the low GABA symptoms and resonated with them i.e. physical anxiety/tension, stiff and tense muscles, stress eating, self-medicating with alcohol, insomnia and intrusive thoughts etc:

I previously bought Gaba Calm after reading your blog since my symptoms seemed to match your description [of low GABA].

However, I recently did an exhaustive neurotransmitter test to realize that it was the exact opposite, having a significantly high level of GABA.

Unfortunately, I’ve looked all over the internet after talking to my doctor, and it seems that no one knows how to downregulate GABA.

Not sure what to do from there, but thought I should let you know that the situation exists despite not being common.

I posted this feedback for her: I do not use urinary neurotransmitter testing as it’s not accurate. I use the low GABA symptoms questionnaire and we do a trial of GABA if low GABA symptoms are present.

She said it perfectly – “I previously bought Gaba Calm after reading your blog since my symptoms seemed to match your description” i.e. it’s very likely she does in fact have low GABA symptoms and if we were working together I’d have her do trial of GABA.

I did ask her what her doctor and the lab recommended and to share the name of the lab/test and have yet to hear back. I will share when I do.

Someone else also had the neurotransmitter report high GABA so she stopped taking her GABA supplements

When I shared Francoise’s comment and my feedback on Facebook, I had someone share a very similar outcome. Kristin had already figured out that she had low GABA levels (based on the symptoms questionnaire), was already taking GABA with good results and was then told to stop taking GABA because the urinary neurotransmitter test reported elevated GABA levels!

This is what Kristin shared on Facebook: “I just did the neurotransmitter test. It said I was high in GABA as well, so I stopped taking it.”

These were the questions I asked her: Why were you taking GABA at the time – was it because you had/have low GABA symptoms and was GABA helping to ease these symptoms? I also asked which lab did the test and what her practitioner recommended? She shared the following:

I was taking GABA for anxiety. It was helping. .

My doctor recommended that I stop the GABA and use supplements to support the areas I was low in, which were: Dopamine, Norepinephrine, Epinephrine, and Serotonin (was VERY low).

Doctor’s Data is the company. And it wasn’t a cheap test.

I was surprised that even though GABA was helping Kristin, the doctor said to stop using it. What does also concern me too is that supporting dopamine, norepinephrine and epinephrine without supporting GABA can actually increase anxiety. I’ve seen this backfire a number of times.

After seeing my post and our Facebook back and forth she decided to start back on the GABA products she had been taking: GABA Calm 1-3 tablets a day and if she is struggling terribly with morning anxiety, then 1/2 to 1 tablet as needed. In the evening she takes 2 capsules of Neurocalm which has 100 mg of GABA (and some other ingredients).

Kristin confirmed that, once again, GABA was helping to ease her intrusive thoughts, anxiety and physical tension, all low GABA symptoms.

I said to Kristin that I’d reach out to Doctor’s Data and have done so. I shared all this and I am hoping to hear back from them. I’ll keep you posted when I do.

Kristin has offered to share this blog with her integrative doctor who prescribed this test. I’m hoping she does and you do too.

I appreciate both these women sharing their experiences so I can share with you.

Urinary neurotransmitter testing falls short and other practitioners weigh in too

I find many functional tests extremely useful and Doctor’s Data is well regarded in functional medicine. However, I do find it very unfortunate that so many practitioners continue to use and recommend this test when it’s not useful, doesn’t correlate with symptoms and so often causes confusion, like in these instances (which are just two of many similar cases). By the way, they are not the only lab offering urinary neurotransmitter testing.

Be sure to read this older blog: Urinary neurotransmitter testing falls short where I share more about why I’m not in favor of this testing.

This feedback from Nora Gedgaudas, author of Primal Body Primal Mind sums up what I often hear from other practitioners:

I have considered the urinary testing approach and was even enamored of the concept at first. Once I looked into the idea more closely, though, it just didn’t add up for me. I have been using amino acids now to address issues of mood, health and cognitive functioning for over 20 years. I have never used anything other than mood/symptomatic screening to guide amino acid supplementation. Results tend to be uniformly good to excellent. The sheer overwhelming complexity of amino acid/neurotransmitter activity in the human body/brain-and the compartmentalized nature of the biochemistry of each seems to best lend itself to a more functional and symptom-related evaluation. Lab testing simply falls short of the mark here.

A colleague and good friend of mine, Dr. Josh Friedman posted this in the comments section of the above blog post (back in 2014), further supporting what practitioners are reporting about this testing:

About a year ago I got excited about urinary neurotransmitter testing. I had been using Julia Ross’ pencil and paper neurotransmitter deficiency assessment for many years with good success. Over the past year I have done the neurotransmitter testing on about 10 people with very inconsistent results. With 2-3 we hit a home run, where the recommended supplements were just the right thing to diminish the presenting symptoms. More often than not the recommended supplements seemed to give little relief or even make the symptoms worse. Additionally the testing and supplements are quite expensive.

I have since given up on the testing and as I have found the pencil and paper NT deficiency sheet to be a more effective guide to treatment. When I am unable to make progress I will often turn to serum amino acid testing and the neurotransmitter markers on the Organic acid test offered by many functional medicine labs. In addition to information about neurotransmitter functioning, the Organic Acid Test provides information about other factors involved in mental health symptoms including levels of the yeast Candida, the bacterial infection Clostridia and others.

Of course, I wholeheartedly agree with both of them.

As you can see from these two cases (and the many others in my book and on this blog), using the low GABA symptoms and a trial of GABA is best. It’s the most effective way to determine if you need GABA initially and to monitor how it’s helping. It also doesn’t cost you anything more than your time and the GABA product/s.

Resources if you are new to using amino acids as supplements

If you are new to using any of the 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 serotonin and low GABA).

There is an entire chapter on the amino acids and they are discussed throughout the book in the sections on gut health, gluten, blood sugar control, sugar cravings, self-medicating with alcohol and more.

Have you done urinary neurotransmitter testing and did any of it correlate with the neurotransmitter deficiency symptoms?

Have you been told to stop GABA that was helping to ease your symptoms – based on labs showing high GABA?

If you’re a practitioner I’d love to hear your experiences using the urinary neurotransmitter testing.

If you have questions please share them here too.

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

June 11, 2021 By Trudy Scott 71 Comments

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.

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.