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GABA helps 14-year-old with Tourette’s Syndrome (the tics and sleep), and tyrosine makes him happier and his mind sharper

January 21, 2022 By Trudy Scott 15 Comments

We typically associate low GABA, a calming neurotransmitter, with a physical-type of tension- anxiety that also often affects sleep. However there is evidence that low GABA is also a factor in other conditions. One of these conditions is Tourette’s Syndrome, which is characterized by the presence of chronic tics which can be motor/movement and vocal. In today’s blog I share some research that suggests a deficit in GABAergic transmission may contribute to symptoms in Tourette’s and a case study where a teenage boy found relief from his tics when using the amino acid GABA as a supplement. GABA also improved his sleep. He also made some dietary changes – no gluten, no sugar and no caffeine – and supplemented with magnesium and melatonin. The amino acid tyrosine, used as a supplement, also improved his low mood and focus, both of which can be issues with Tourette’s.

Kim, a mom in this community, shared this wonderful feedback about her son in response to a Facebook post a few years ago:

Because of your book, I started using GABA for my 14-year-old son with moderate to severe Tourette’s Syndrome, and the results have been significant. Highly recommended for tics, and sleep for these individuals. Thank you.

I asked her how much GABA he used and how often and she shared this:

He used 750mg GABA nightly before bed, and if tics are really active then additional 300mg. Lots of water and a balanced diet with no caffeine…. life-saver.

Keep in mind that 750mg is considered a high dose. We typically start with 125mg GABA and increase based on each person’s unique needs. There is the temptation to think “I have tics and this is a very severe condition so I need a high dose to start.” You don’t want to be thinking like this. Some people may not need this much and others may need this high dose. We always use the trial method to figure out the ideal dose.

She also shared that when he added tyrosine, he saw benefits from that amino acid supplement too:

He recently added 300mg of l-tyrosine, and it promotes happiness and a sharper mind, due to brain fog. He says he really notices a difference. He has read your book as well.

How wonderful is this? GABA helped reduce his tics and improved his sleep, and tyrosine improved his mood and focus.

I love that he’s read my book – good for him and this mom! It’s never too early to have you and your child read this information. It’s empowering for them so they understand the changes they need to make and why these amino acids, dietary changes and elimination of caffeine make such a difference.

I recently checked in to see how he is doing now and asked what other nutritional approaches helped/help other than GABA, a balanced diet and no caffeine. She shared this:

He’s gluten free, magnesium for sure for the muscle tics, and melatonin for good sleep (Touretters need a routine sleep schedule).

He’s 18 now and is doing way better as he matures, but GABA no doubt has improved his life. We promote GABA and educate others as much as possible.

All this is so great to hear and I love that they now help to educate others about GABA too.

I appreciate that she gave me permission to share, hence this post. (The image above is a stock image and not her son.)

Tourette’s Syndrome and reduced GABA function

This paper, Reduced GABAergic inhibition and abnormal sensory symptoms in children with Tourette syndrome, describes the condition and the role of reduced GABA function:

Tourette Syndrome is characterized by the presence of chronic tics. Individuals with Tourette Syndrome often report difficulty with ignoring (habituating to) tactile sensations, and some patients perceive that this contributes to a “premonitory urge” to tic. While common, the physiological basis of impaired tactile processing in Tourette Syndrome, and indeed tics themselves, remain poorly understood.

It has been well established that GABAergic processing plays an important role in shaping the neurophysiological response to tactile stimulation. Furthermore, there are multiple lines of evidence suggesting that a deficit in GABAergic transmission may contribute to symptoms found in Tourette Syndrome.

In this study, the authors used testing (magnetic resonance spectroscopy) and tasks that were vibrotactile (the perception of vibration through touch) to investigate the role of GABA and atypical sensory processing in these 8-12-year old children with Tourette Syndrome.

They found the following:

lower concentration of GABA in the sensorimotor cortex and “impaired performance on tactile detection and adaptation tasks, consistent with altered GABAergic function”
the altered/reduced GABAergic function correlated with the severity of motor tics and sensory impairments, “linking the core feature of Tourette Syndrome directly to … brain neurochemistry.”

The authors conclude that this provides a foundation for novel interventions (i.e. medications) but unfortunately do not offer the use of the amino acid GABA as one of these solutions. This is very unfortunate but not unexpected. I plan to reach out to the authors and share this case study and blog.

This research supports why GABA works so well for Kim’s son and why he needed higher amounts of GABA when his tics were more active/severe. And now I’m curious to find out if her son has/had sensory issues and how they improve/improved with GABA. I’ll report back if I hear from her about this.

It’s no surprise that GABA helps his sleep too. There is much evidence supporting this – like the the sleep promoting effects of combined GABA and 5-HTP (or GABA alone or 5-HTP alone). I’ve also shared many GABA-sleep success stories on the blog. Here is one: Since starting GABA my child sleeps for the first time in years and really notices a difference in his carb cravings. (Use the search feature and “GABA sleep” to find additional blog posts)

Interestingly only 8% of the children in the study had generalized anxiety disorder. Given how common low GABA is in anxiety, and that low serotonin can also be a factor with tics, I would have expected anxiety to be higher.

Evidence supporting the other nutritional changes he made

There is evidence to support the other nutritional changes that Kim’s son made:

There are reports that “an increase in tics has been related to the consumption of caffeine and refined sugar.” The authors acknowledge that there is no one diet for Tourette’s, so as always, it’s a matter of figuring out the ideal diet for each child (or adult) with tics. Oligoantigenic diets have been identified as significantly reducing tics. This involves removing foods that can potentially cause a food sensitivity leading to tics and/or behavioral impacts and/or insomnia.
A gluten-free diet maintained for one year in patients with Tourette’s Syndrome was shown to markedly reduce tics and OCD in children and adults
Magnesium is one of the most used supplements in children with Tourette’s Syndrome. When used with probiotics, omega-3 and multivitamins “Seventy-five per cent of supplement users in the Tourette syndrome group noted improvement, mainly in motor and vocal tics, sleep quality and anxiety reduction.”
Melatonin is listed with a number of medications commonly prescribed for tic disorders where sleep issues are also a factor

Keep in mind that the above is not a protocol for relief from tics for everyone with Tourette’s Syndrome. It’s what worked for the unique biochemical needs of Kim’s son.

That said, this could be a framework to start with and build upon.

Tyrosine improves his mood and focus

Tyrosine helps with low catecholamines, improving the curl-up-in-bed low-energy kind of low mood and poor focus. (You can see all the symptoms here.) The typical dose is 500mg tyrosine a few times a day. Kim’s son found just 300mg to be beneficial.

Interestingly, 48% of the children in this study had attention-deficit/hyperactivity disorder (ADHD) with about half of those on stimulant medication. I wonder how many would have also benefited from tyrosine for improving their focus, as it did for Kim’s son.

Resources if you are new to using GABA or tyrosine as a supplement

If you are new to using the the amino acid GABA or tyrosine as supplements, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution (you can see the low serotonin and other low neurotransmitter symptoms) and a brief overview here: Anxiety and targeted individual amino acid supplements: a summary.

If you suspect low levels of GABA or catecholamines and do not yet have my book, The Antianxiety Food Solution – How the Foods You Eat Can Help You Calm Your Anxious Mind, Improve Your Mood, and End Cravings, I highly recommend getting it and reading it before jumping in and using amino acids so you are knowledgeable.

And be sure to share it with the team you or your loved one is working with. As I mentioned above, it’s empowering for your teen and also relatively easy reading too.

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

Have you seen results with GABA or any of the above approaches? Or has another approach helped you or your child?

If you’re a practitioner have you seen GABA and any of the above to help? What else has helped your clients/patients?

If you suffer from Tourette’s Syndrome, do you also experience ADHD, insomnia, low mood and/or anxiety?

Feel free to ask your questions here too.

The seasonality of GABA: worsening anxiety, insomnia and intrusive thoughts in winter (and the need for increased GABA supplementation)

January 7, 2022 By Trudy Scott 29 Comments

Seasonal variations in serotonin have long been documented with much research on the winter blues and SAD lamps. There is less awareness about GABA seasonality and I only recently started to look into the research when I wrote about the need to increase tryptophan or 5-HTP temporarily when a winter dip in serotonin causes more severe anxiety, OCD and/or the winter blues.

Following on from my blog post on the seasonality of serotonin, it’s important to be aware of the seasonality of GABA and that GABA levels may also be lower in the winter months. This is also due to shorter days and less light because of more overcast and cloudy/rainy/snowy days.

You may find you need to increase your GABA supplement dosing during this time, in order to get the same benefits for your low GABA physical anxiety, stiff and tense muscles, insomnia (the low GABA lying-awake-tense type), feelings of overwhelm, intrusive thoughts (the low-GABA type), and stress-eating or self-medicating with alcohol.

Read on to learn more about seasonal fluctuations in GABA, an example of how adjusting GABA could look and some of the possible mechanisms.

Intuitively increased GABA without knowing about the seasonality of GABA

A few weeks ago I shared on Facebook that GABA has a seasonal aspect and an increase may be needed in winter when it’s darker earlier and colder. Elicia offered this input:.

I use GABA Calm and usually take 1 or 2 a day. The past two days I’ve taken 4 because I suspected that I needed an increase.

I take it for physical anxiety, insomnia and intrusive thoughts. My symptoms had been worsening recently. The increased GABA seems to be helping.

She also asked what an increase in GABA would look like.

My feedback for her is (you guessed it!) that it depends on each person. If 4 x instead of 1 or 2 x GABA Calm a day helps to ease her symptoms then that’s the right amount for her unique needs at this time. It may be less or more for someone else. And it’s going to change again after the winter season.

I’m so glad to hear she intuitively increased her dose without knowing about the seasonality of GABA and that she saw her worsening symptoms improve.

Other approaches to boost GABA levels may help too: Yoga, meditation, tai chi and essential oils.

Seasonal fluctuations are also found in anxiety disorders and bulimia nervosa

As I mentioned above, SAD or seasonal affective disorder, appears to be relatively common and is well-recognized.

This review paper, An overview of epidemiological studies on seasonal affective disorder mentions anxiety and other conditions too:

Seasonal variations in mood, depressive symptoms usually peaking in winter
SAD was more prevalent at higher northern latitudes, but the prevalence varied across ethnic groups.
SAD has also been identified in children and adolescents.
Seasonal exacerbations and remissions are not limited to mood disorders, it has also been found in bulimia nervosa, anxiety disorders and other psychiatric illnesses.

Some of this may be related to low serotonin and as you’ll see below, melatonin and low GABA (and low dopamine too), and the liver, all may play a role too.

GABA is higher in summer/lower in winter and tied to liver function

In this animal study, Effect of the pineal gland on 5-hydroxytryptamine and γ-aminobutyric acid secretion in the hippocampus of male rats during the summer and winter, they report that

GABA secretion in the hippocampus of rats had a seasonal rhythm consisting of increased secretion in summer and decreased secretion in the winter.

Additionally, the liver can regulate the content of active substances, including GABA, and its function is controlled by brain centers, especially in the marginal lobe.

This paper reports similar seasonal changes with respect to serotonin, stating that both fluctuations may be related to the seasonal changes of “regulation by the liver”. The authors remind us that in Chinese Medicine the liver is closely related to emotions, and that the liver functions well in hot weather and is weak in winter.

GABA exhibits seasonal rhythms related to the pineal gland and melatonin

The introduction of this animal study (by the same authors), Molecular mechanisms of seasonal photoperiod effects of the pineal gland on the hippocampus in rats highlights a number of points related to seasonal variations in mood:

Based on the theory of “five Zang-organs corresponding to the seasons” in traditional Chinese medicine (TCM), physiological functions including emotions vary with the seasons.

The production of mood-related neurotransmitters such as 5-hydroxytryptamine [serotonin], γ-aminobutyric acid [GABA], dopamine, and norepinephrine exhibits seasonal rhythms, which are related to the regulation of the hippocampus by the pineal gland-MT [melatonin] system.

In other words, GABA (and these other neurotransmitters) exhibit seasonal rhythms related to melatonin secreted by the pineal gland, thereby impacting the hippocampus.

Be sure to read the paper for additional information on depression, seasonal affective disorder and bright light therapy; the seasonal effects of the pineal gland on the hippocampus; the role of melatonin and photoperiod/length of night; the hippocampus and melatonin receptors and more.

The authors were looking for direct evidence of the signalling mechanisms that cause this to happen:

Our findings suggest that the MTR-Gs/Gi-cAMP-PKA-CREB signaling pathway is involved in the seasonal photoperiod [length of night] effects of the pineal gland on the hippocampus and may underpin seasonal changes in emotions.

Feel free to read more about all this in the paper too as it’s beyond the topic of this blog.

Other factors to consider: sugar/alcohol, stress/pyroluria and low serotonin

I’d also consider the following:

The increased consumption of sugar at this time can lead to reduced zinc, magnesium and B vitamins (like vitamin B6 and thiamine) and this can further reduce GABA levels, which relies on these nutrients as cofactors for production. By boosting GABA levels with the amino acid GABA (and higher amounts if needed) you can actually reduce some of the cravings and stress-eating.
Overindulging in alcoholic holiday beverages can also deplete zinc and B vitamins, further affecting GABA production. Using higher amounts of the amino acid GABA (if needed) can also prevent self-medicating with alcohol. This often happens when trying to fit in and socialize.
If you have the social anxiety condition called pyroluria, the added stress of family and holiday gatherings can also contribute to zinc and vitamin B6 being dumped, and further impacting serotonin production.
The need to also increase tryptophan or 5-HTP temporarily when a winter dip in serotonin causes more severe anxiety (the low serotonin worry-type), OCD and/or the winter blues.

Resources if you are new to using GABA as a supplement

If you are new to using the the amino acid GABA as a supplements, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution (you can see the low GABA and other low neurotransmitter symptoms) and a brief overview here: Anxiety and targeted individual amino acid supplements: a summary.

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

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

Have you noticed worsening anxiety, insomnia, intrusive thoughts or even bulimia in the winter months?

Have you noticed you need more GABA in the winter? And then you ease off at the end of winter again?

What changes in your dosing have made a difference with your symptoms?

Did you adjust intuitively or were you aware of the GABA seasonality aspect?

And do you notice something similar with serotonin support and needing additional melatonin in winter too (if you already use it)?

If you’re a practitioner, do you have your clients/patients make adjustments too?

Feel free to ask your questions here too.

Increasing tryptophan or 5-HTP temporarily when a winter dip in serotonin causes more severe anxiety, OCD and/or the winter blues

December 24, 2021 By Trudy Scott 14 Comments

Don’t forget that serotonin takes a dip in winter when the days are shorter and there is less light. If you’re currently using tryptophan or 5-HTP to boost low serotonin and ease low serotonin symptoms – worry-type anxiety, panic attacks, insomnia, ruminations, PMS, irritability, negativity, perfectionism, obsessiveness, lack of confidence, anger/rage, afternoon/evening cravings – you may find you need to increase your dose for a few months.

This will especially be the case if you check off winter blues or more severe winter anxiety (yes it’s a thing and published in the research) on the low serotonin symptoms list.

I shared this on Facebook last week and the feedback ranged from surprised to curious to confirmatory.

In this blog I’m sharing some of the feedback and some of the supporting evidence, as well as other factors to consider.

The addition of 5-HTP in the morning and a light box

Kathy thanked me for the reminder and shared the changes she makes in the winter months:

Thanks for the reminder! I need to increase my dose this time of year… I can feel myself feeling “down”. I take 500 mg Tryptophan before bed and 100 mg 5-HTP in the morning before breakfast. I also use a light box in the morning while eating breakfast, which helps.

This is an increase from her typical dosing in the spring and summer when she only takes tryptophan at night before bed.

She also only uses her light box or SAD (seasonal affective disorder) lamp in winter. You can read more about SAD/full spectrum lamps here. They are also a wonderful way to boost serotonin and mood in the winter.

My daughter’s anxiety and OCD goes through the roof

Mark shared about his daughter’s anxiety and OCD (obsessive compulsive disorder):

Every year from October – March, my daughter’s anxiety and OCD goes through the roof. At first we thought it was the transition from summer to school, then the craziness of the winter holidays and suspected mold allergy. Now, based on this information, a winter/less light induced dip in serotonin may be an additional factor we hadn’t considered. We’ll try adjusting her 5-HTP dose and see if we gain some improvement. Thanks for the tip.

It’s really common for families to attribute the more severe anxiety and OCD to the stress and craziness of the winter holidays. And of course suspected mold issues do need to be looked into and addressed. But even then, the dip in serotonin can compound all these factors.

Planned tryptophan bump for Christmas sugar cravings and holiday family stress

Carol shared this about her plans to temporarily boost serotonin:

I am one of those light weights that was able to do one 500 mg pill a day of tryptophan. But I do think that it would help to bump it up to two a day to get me through the Christmas sugar cravings AND holiday family stressful get togethers! I’m all about taking the minimum effective dose but this is helpful to know that there could be a temporary boost just to get you through this time!

It’s wonderful that 500mg tryptophan is enough for her and I’m all for a minimum effective dose! However the winter dip in serotonin – and increased sugar cravings and family stress – is a common reason many folks bump up the dose for a month or more.

You may also find you made the change intuitively. Linda shared this: “I had made the adjustment. I just did not realize the reason why.”

A question about timing of 5-HTP and what to do in Spring

Suzanne shared that she uses a SAD light (also called a light box) and finds that it helps. She asks:

Can I just take the 5-HTP on days with no sun or is it better to have it build up in my system? When spring rolls around, do I taper off or can I just stop taking it?

This is my feedback: I haven’t had anyone just use 5-HTP on cloudy days but it’s worth a trial. If you are noticing increased anxiety and mood changes only on cloudy days and using the SAD lamp on those days helps, then using 5-HTP on those days may be enough. If not, use 5-HTP consistently/daily through the winter months.

Amino acids do not need to be tapered but I find my clients do better when they are reduced over a few weeks. Some folks also choose to just stop taking them and do fine.

I appreciate all the feedback and the great questions. I’ll report back when I hear how Mark’s daughter does with the adjusted 5-HTP and how Carol does with the bump in tryptophan (and any other feedback I get from these folks).

Some of the research and possible mechanisms

There are many studies that support serotonin changes and seasonal variations in mood. Here are just two of them:

Effect of sunlight and season on serotonin turnover in the brain “Alterations in monoaminergic neurotransmission in the brain are thought to underlie seasonal variations in mood, behaviour, and affective disorders… turnover of serotonin by the brain was lowest in winter. Moreover, the rate of production of serotonin by the brain was directly related to the prevailing duration of bright sunlight… Our findings are further evidence for the notion that changes in release of serotonin by the brain underlie mood seasonality and seasonal affective disorder.”
Sunshine, Serotonin, and Skin: A Partial Explanation for Seasonal Patterns in Psychopathology? “one contributory facet may be the role of sunshine on human skin. Human skin has an inherent serotonergic system that appears capable of generating serotonin.”

Other factors to consider: low vitamin D, sugar, pyroluria and phenols

There are other low-serotonin related factors to consider too:

Low vitamin D is common in the winter and sufficient levels are needed for making serotonin. This paper, Vitamin D and the omega-3 fatty acids control serotonin synthesis and action, part 2: relevance for ADHD, bipolar disorder, schizophrenia, and impulsive behavior describes how“Brain serotonin is synthesized from tryptophan by tryptophan hydroxylase 2, which is transcriptionally activated by vitamin D hormone. Inadequate levels of vitamin D (∼70% of the population) and omega-3 fatty acids are common, suggesting that brain serotonin synthesis is not optimal.”
The increased consumption of sugar at this time can lead to reduced zinc, magnesium and B vitamins (like vitamin B6 and thiamine) and this can further reduce serotonin levels, which relies on these nutrients as cofactors for production. By boosting serotonin with additional tryptophan or 5-HTP you can actually reduce some of the cravings.
If you have the social anxiety condition called pyroluria, the added stress of family and holiday gatherings can also contribute to zinc and vitamin B6 being dumped, and further impacting serotonin production.
Christmas tree phenols can be a trigger for anger, meltdowns, anxiety, hyperactivity, insomnia, aggression, self-injury and autistic symptoms in susceptible individuals

Resources if you are new to using tryptophan and 5-HTP as supplements

If you are new to using the amino acids as supplements, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution (you can see the low serotonin symptoms here) and a brief overview here, Anxiety and targeted individual amino acid supplements: a summary.

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

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

Have you noticed this winter dip in serotonin and made adjustments to your 5-HTP or tryptophan? And do you feel less anxious, less obsessive, not as low and with fewer sugar cravings?

Do you find that using a SAD lamp/full spectrum light at this time helps even further?

Were you aware that serotonin dipped in winter and could be playing a role for you? Or did you think it was just the stress and overwhelm of the holidays (and /or some of the emotional upheaval some of us face at this time)?

If you’re a practitioner, have you seen this with clients or patients?

Have you also noticed you need to adjust your GABA and other amino acids at this time too (both GABA and dopamine show seasonality)?

Feel free to ask your questions here too.

Tryptophan doesn’t work, then it does and then it doesn’t: could it be hormonal shifts, dietary factors and/or parasites?

November 26, 2021 By Trudy Scott 18 Comments

Have you been in a situation where tryptophan doesn’t work, then it does work, and then sometimes it doesn’t work as expected? There is a reasonable explanation as to why it may not work initially – too much or too little was used. The variable results and the need to switch between lower and higher doses on an ongoing basis can happen but it’s not very pronounced unless there is a specific reason. In this blog I cover some of these reasons – hormone shifts, dietary factors and parasites/other digestive issues.

I’m writing this blog in response to a question that was posted on one of my speaker pages on the Anxiety Summit: Gut-Brain Axis. This is the actual question:

I tried to use tryptophan the first time (whole capsule) and got really high. Some time later I tried again, but used 1/4 of a capsule and had a good result. A few weeks later 1/4 of the capsule didn’t work at night. So I went up to half a capsule. And that’s where I am now. But some nights (very rare) I can only get good results from a whole capsule. I use it along with the same amount of GABA. Is that a normal reaction for tryptophan?

I don’t know what brand of tryptophan she was using but assume 500mg was her starting dose and she now shifts between 125 mg (¼ capsule) and 250 mg (½ capsule) with variable results.

It’s not unusual for someone to not feel great on 500 mg if that dose is too much for their unique needs. She did the right thing by lowering her dose. It’s also reasonable that someone may find 500 mg as an initial dose isn’t enough to reduce symptoms.

The variable results and the need to switch between 125 mg and 250 mg can happen but it’s not very pronounced unless there is a specific reason. Some of these reasons include hormone shifts, dietary factors, parasites/other digestive issues, thyroid issues, low lithium, product quality and environmental factors. More on all this below.

Hormone shifts/more serotonin is needed in the luteal phase

I have my clients track when the variability happens, with female clients documenting their cycles. Some women need more serotonin support in the luteal phase i.e. after ovulation and right up to before their periods. Some may even need additional tryptophan for the first few days of their periods too.

Write about tryptophan working well in the luteal phase in this blog – Tryptophan for PMS: premenstrual dysphoria, mood swings, tension, and irritability

In a study published in 1999, A placebo-controlled clinical trial of L-tryptophan in premenstrual dysphoria, tryptophan was found to reduce symptoms of PMS when used in the luteal phase or second half of the cycle (i.e. after ovulation):

37 patients with premenstrual dysphoric disorder were treated with L-tryptophan 6 g per day, and 34 were given placebo. The treatments were administered under double-blind conditions for 17 days, from the time of ovulation to the third day of menstruation, during three consecutive menstrual cycles.

They looked at dysphoria, which is defined as a state of unease or generalized dissatisfaction with life, plus mood swings, tension (and anxiety), and irritability and they found a 34.5% reduction of symptoms with tryptophan compared to 10.4% with placebo.

The paper concludes: “that these results suggest that increasing serotonin synthesis during the late luteal phase of the menstrual cycle has a beneficial effect in patients with premenstrual dysphoric disorder.”

It’s a small study but the results are powerful and it’s something I see clinically with my clients. The one big difference is that I typically have clients using tryptophan throughout the month.

But if you are seeing tryptophan work and then not work at similar times each month this is something to consider and track. And then if need be, increase and decrease tryptophan accordingly (and track again).

Dietary factors – collagen, gluten, sugar, wine and coffee

There are other factors to consider too and dietary impacts is one. For example, collagen leads to a higher need for tryptophan in susceptible individuals (due to it’s serotonin-lowering effects – I blog about this here)

Another dietary factor is accidental gluten exposure in susceptible individuals or a newly discovered gluten issue

High sugar intake, alcohol and/or caffeine consumption may also be a factor – contributing to added stress for the adrenals and depletions in zinc and the B vitamins. This can contribute to lowered serotonin and a need for a higher dose of tryptophan.

Now imagine if it’s just before her period and she adds collagen to her diet and she also eats out and gets zapped by gluten. Triple whammy for this woman!

And she goes to a party and happens to indulge in cocktails or wine, and then goes on a binge at the dessert table, followed by a few cups of coffee (or even one dessert and one cup of coffee).

A food-mood log really helps you figure things out. And then, if need be, increase and decrease tryptophan accordingly. And track again and address the dietary issues.

Parasites and other gut issues

If she has a very pronounced shift in symptoms for 4-5 days around a full moon each month – more severe insomnia, more anxious, more depressed – I would want to check for parasites.

I would also want to check for other digestion issues like dysbiosis, SIBO (small intestinal bacterial overgrowth), candida and liver health as they may all be factors. With SIBO and candida, dietary slip-ups may make symptoms worse right after the slip-up, for example increased bloating making sleep and anxiety worse.

Using tryptophan sublingually/opened on the tongue may bypass some of the digestive/liver issues until they are resolved.

As mentioned above, if need be, increase and decrease tryptophan accordingly. And track again and address the underlying issues.

Other factors to rule out – thyroid, lithium, environmental factors and the product

Two other underlying root causes we always want to rule out when we see variable results using tryptophan (and any of the amino acids) are Hashimoto’s thyroiditis (because we can have variable thyroid results – sometimes hypo/low and sometimes hyper/high) and low levels of lithium (because this can affect the results we see with all the amino acids).

And we always check environmental factors like mold, EMFs and outside stresses. And look for infections like Lyme disease or EBV. If the basics are not unearthing the solution we continue to dig deeper and do a full functional medicine workup. And adjust the tryptophan as needed.

And finally the quality of the product is key. I find Lidtke Tryptophan to be better than many other brands. I’ve also had many clients switch to Lidtke tryptophan and see better results and often need a lower dose.

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

If you are new to using the amino acids tryptophan/5-HTP and the other amino acids as supplements, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution (you can see the low serotonin symptoms here) and a brief overview here, Anxiety and targeted individual amino acid supplements: a summary.

I always appreciate good questions like this and hope this feedback has helped her and you too if you’ve experienced something like this (or if you do in the future). In case you’re wondering, this question was posted after someone tuned into my interview, “GABA & Tryptophan: Gut-Anxiety Connections” on the Anxiety Summit 5: Gut-Brain Axis.

Have you had a variable response to tryptophan (or 5-HTP) and can you relate to any of this?

What did you figure out to be the reason?

Feel free to ask your questions here too.

Fatigue, sleep disorders, depression, anxiety, fibromyalgia and cardiac troubles as the expression of a classic mild thiamine deficiency

October 8, 2021 By Trudy Scott 6 Comments

Fatigue, sleep disorders, depression, anxiety, fibromyalgia and cardiac troubles are some of the symptoms we see as the expression of a classic mild thiamine deficiency. Thiamine deficiency is very under-rated and under-recognized, and can have far reaching ramifications. And a magnesium deficiency and high dose magnesium can actually cause a thiamine deficiency. There are also many other causes of thiamine deficiency that may not be on your radar: a high carb/processed food/sugar diet, coffee, tea, alcohol, genetics, environmental toxins, medications, celiac disease, leaky gut, bariatric surgery and malabsorption.

It’s for this reason that I invited Chandler Marrs, PhD to speak on the Anxiety Summit 5: Gut-Brain Axis. We had so much to cover and it ended up being so long, that we split it into part 1 and part 2.

This is what we cover in Thiamine Deficiency in Anxiety and Gut Health (Part 1)

Excessive carbs, alcohol, medications and genetics as causes of low B1/thiamine
Dysbiosis, dysmotility, constipation, anxiety, depression, panic attacks, low energy
Psychiatric and digestive effects: research, history and other symptoms

This is what we cover in Thiamine Deficiency in Anxiety and Gut Health (Part 2)

The mitochondria, dysautonomia and POTS
Other symptoms: hyperemesis, exercise intolerance, muscle pain, neuropathy
Thiamine supplementation – forms, dosing and paradoxical reactions

Thiamine deficiency is under-rated and under-recognized

We start with why it’s an under-rated and under-recognized deficiency and Dr. Marrs shares that the assumption is that deficiency is not common and even when you test it looks like you are not deficient:

“The assumption is that there is no such thing [as a thiamine deficiency] and that it’s rare unless you are a chronic alcoholic. And even then, it’s missed 80% of the time. Or you have a severe injury or illness that depletes thiamine rapidly.
The presumption is that we’ve solved it, and it’s rare, and it only happens in countries where food availability is problematic.
The reality is that the chemistry of our foods, the chemistry of our environment, the medications that we take all combine and accrue to not only deplete the available thiamine on the basis of intake but to increase the need and to damage a lot of the enzymes involved in the processing of thiamine.
So a lot of folks are functionally deficient in that even though by definition they meet the daily requirement and they may, based upon lab testing, show up as being sufficient and not frankly deficient.
And so, I think that we just have taken our eye off of the ball with regard to this particular nutrient.”

Magnesium deficiency (and high dose magnesium) can actually cause a thiamine deficiency

Dr. Marrs also shares how a magnesium deficiency (which is very common) can actually cause a thiamine deficiency:

“One of the things that’s interesting is it requires magnesium to activate thiamine into its active form.
If someone is thiamine sufficient and magnesium deficient, then they are actually functionally deficient in thiamine because you cannot take the free thiamine and activate it into thiamine pyrophosphate.
So magnesium deficiency itself can cause thiamine deficiency. And there’s a good percentage of the population that doesn’t get enough magnesium.”

And she also shares how when taking high dose magnesium it’s so crucial to also be addressing low thiamine in order to prevent them becoming more thiamine deficient:

“Now, the flip side of that is really interesting. And I think this is important for your audience, in particular, is that magnesium supplementation, when someone has a problem with thiamine, will actually shut down thiamine processing and mitochondrial processing at one of the enzymes. Because if you don’t have thiamine with magnesium, then the enzyme α-ketoglutarate dehydrogenase kind of shuts the whole sequence down.
So if you are giving someone high dose magnesium, which is common to supplement, and not tackling the thiamine as well, you risk them becoming more thiamine deficient and reducing ATP output, energy output even further. So everything has to be in balance to some extent or another.”

I can think of one situation where this could be common. You use high dose magnesium due to constipation. Low thiamine may be one of the underlying causes of your constipation and now high dose magnesium is going to make the low thiamine situation worse.

Up to 30% of psychiatric patients have a thiamine deficiency

We talk about how up to 30% of psychiatric patients have a thiamine deficiency but that there hasn’t been enough work on psychiatric disorders which Dr. Marrs says “is strange given the fact that some of the strongest symptoms involve brain function and the most dangerous or some of the more dangerous damage is relative to areas of the brain.”

I share some quotes from a 2019 paper that does actually look at the psychiatric aspects – Neurological, Psychiatric, and Biochemical Aspects of Thiamine Deficiency in Children and Adults:

“The brain is highly vulnerable to thiamine deficiency due to its heavy reliance on mitochondrial ATP production. This is more evident during rapid growth, i.e., perinatal and children.
Thiamine deficiency contributes to a number of conditions spanning from mild neurological and psychiatric symptoms, confusion, reduced memory, sleep disturbances, and severe encephalopathy, ataxia, congestive heart failure, muscle atrophy, and even death.”

This paper also looks at the beneficial effect of thiamine supplementation in autism spectrum disorder (ASD) and other neurological conditions.

Below, I share some additional studies that we didn’t talk about in the interview but add value to the topic.

Fatigue, sleep disorders, depression, anxiety, fibromyalgia and cardiac troubles as the expression of a classic mild thiamine deficiency

This paper, High-dose thiamine improves the symptoms of fibromyalgia, states that “It is our opinion that fatigue, sleep disorders, depression, anxiety and cardiac troubles are the expressions of a classic mild thiamine deficiency.”

The authors share 3 cases where thiamine/vitamin B1 improved symptoms in all areas for all these women:

Patient 1: Female, 58 years old, weight 59 kg. From 1998, the patient began to have widespread pain accompanied by severe fatigue, depression, anxiety, irritability, sleep disorders, trouble concentrating, dry skin, general sickness, continuous headache, intolerance to low temperatures and, more recently, episodes of tachycardia and extrasystolia [alteration in heart rhythm].
Patient 2: Female, 37 years old, weight 74 kg. From 1999, the patient has had widespread pain and all the symptoms described for patient 1, with the only exception being that of cardiac symptoms.
Patient 3: Female, 60 years old, weight 65 kg. From 2006, the patient began to have widespread pain, fatigue, depression, anxiety, sleep disorders. Trouble concentrating.

As you can see the symptoms can be very varied and this is what makes it challenging to identify low thiamine as being the issue.

Thiamine deficiency after bariatric surgery

Here one case study where thiamine deficiency occurred after bariatric surgery: Wernicke’s encephalopathy mimicking multiple sclerosis in a young female patient post-bariatric gastric sleeve surgery:

We describe a case of Wernicke’s encephalopathy secondary to thiamine (B1) deficiency in a patient status post-bariatric sleeve gastrectomy.

The presenting symptoms of new-onset weakness, diplopia [double-vision], and confusion in a young female patient raised suspicion for multiple sclerosis (MS), but given a history of bariatric surgery, thiamine levels were checked, revealing significant Vitamin B1 (thiamine) deficiency.

This case highlights the importance of thorough history taking, as a misdiagnosis of MS in this case could have resulted in irreversible neurological deterioration and hematological and infectious consequences associated with the inappropriate administration of disease-modifying therapies.

Bariatric surgery is one of many causes of thiamine deficiency.

Some of the other many causes of thiamine deficiency

Other causes of thiamine deficiency include factors that may not be on your radar: a high carb/processed food/sugar diet (and even consistent smaller amounts of “healthy” sweeteners), coffee and tea consumption, alcohol consumption (excessive consumption and even moderate consumption i.e. social drinking), genetics (we talk about specific genes in the interview), environmental toxins, certain medications, celiac disease, leaky gut and malabsorption etc.

We do a deep dive into all this in the two interviews (and much more).

chandler marrs interview — (As you can see, when I do interviews I take notes throughout for a few reasons: writing consolidates the information into my brain and it allows me to make notes for follow-up questions. It also helps the video editing process later.)

Interviews that dove-tail well with this topic are these ones:

Michael Collins – Sugar/Fructose Addiction: Anxiety, ADHD and Aggression (because sugar and carbs lead to low thiamine)
My interviews, Glutamine, DPA and Tyrosine for Anxiety and Sugar Cravings and GABA & Tryptophan: Gut-Anxiety Connections (because the amino acids help you quit sugar/carbs, coffee and alcohol easily)
Tara Hunkin, NTP, CGP, RWP – Mitochondrial Dysfunction in Anxiety (because low thiamine adversely affects the mitochondria)

I encourage you to register and tune in if you have:

Anxiety & feel overwhelmed & stressed by little things
Panic attacks &/or obsessive thoughts or behaviors
Social anxiety/pyroluria
Phobias or fears (flying, spiders or even driving on a highway)

And also if you suffer from…

Food sensitivities, IBS/SIBO, parasites or gallbladder issues
Constipation, diarrhea, bloating, gas, pain & other digestive issues
Leaky gut, a leaky blood-brain barrier or vagus nerve issues

Join us if you are also an emotional eater with intense sugar cravings (and know you suffer from low blood sugar), experience insomnia, low mood, PMS, poor focus and/or low motivation.

This is THE online event to learn about the powerful individual amino acids – GABA, theanine, tryptophan, 5-HTP, glutamine, DPA and tyrosine – to quickly ease anxiety and help with gut symptoms while you are dealing with other root causes which take longer to address. (They also help with cravings as with this example, and sleep and immunity).

With research-based anxiety nutritional solutions and practical steps, you can determine your root causes, ease your anxiety and prevent it from coming back so you can feel on top of the world again!

If you are a practitioner, please join us too and find advanced solutions for your clients or patients too!

You’ve heard me say the Anxiety Summit has been called “a bouquet of hope!” My wish for you is that this summit is your bouquet of hope!

I hope you’ll join me and these incredible speakers, be enlightened and find YOUR solutions!

Here’s to no more anxiety and you feeling on top of the world again!

Please share if these thiamine deficiency symptoms are new to you.

Also let us know if you’ve benefited from thiamine in the past or are currently using some form of thiamine – and how helped/is helping.

Have you seen this correlation between low magnesium and low thiamine OR taking high doses of magnesium and low thiamine symptoms?

Feel free to post your questions here too.

“A demonic urge to eat sugar and all things sweet”: glutamine opened onto the tongue stops the urge every time!

October 1, 2021 By Trudy Scott 9 Comments

In my interview, Glutamine, DPA & Tyrosine for Anxiety & Sugar Cravings, on the Anxiety Summit 5: Gut-Brain Axis, I share the story of a client of mine who described her sugar cravings as an “almost demonic urge to eat sugar and all things sweet.”

Before working with me she had been trying to control her blood sugar levels by eating the right foods at the right times i.e. healthy fats and quality protein (especially at breakfast). But this wasn’t enough to eliminate her sweet cravings. She would make and eat sweet treats all day long, using “healthier” sweeteners like monk fruit and maple syrup.

The solution was using 500mg of glutamine opened onto her tongue. I had the same conversation that I have with all my clients who would obviously rather eat something sweet than open a glutamine capsule onto their tongue: “If you have an intense craving for something sweet, tell yourself that you’re going to indulge, but also humor your nutritionist and take the glutamine anyway. You may be surprised to find your urge completely disappears.”

She did that and it worked – it stopped her demonic urge to eat something sweet every time and very quickly!

As a reminder here are the signs of low blood sugar –

Anxiety and mood:

Nervous, anxious, panic attacks
Irritable, shaky, headachey – especially if you go too long between meals
Lightheaded if meals are missed
Agitated, easily upset
Eating relieves fatigue

Sugar cravings:

Crave sugar, starch or alcohol any time during the day
Very intense cravings for sweets/sugar

I also share an excerpt from this March 2021 paper, The role of glutamine in supporting gut health and neuropsychiatric factors, highlighting the role of glutamine in gut health and depression/anxiety, and the gut-brain connection:

Glutamine can positively affect gut health by supporting the gut microbiome, gut mucosal wall integrity, and by modulating inflammatory responses.

As modulated by the vagus nerve, via the enteric nervous system, the gut-brain connection can impact the brain’s neurochemical environment.

Poor gut health can disrupt the balance of neurotransmitters, which can result in neuropsychiatric based conditions such as depression [and anxiety].

Glutamine supplementation may provide significant adjunctive nutritional support in cases of depression [and anxiety] by promoting proper gut health.

Here are all the topics I cover in my interview:

Sugar addiction: impacts on the microbiome, tryptophan metabolism, zinc & B vitamins
Glutamine for intense sugar cravings, anxiety & support of the microbiome/mucosa
DPA for comfort/reward cravings, pain & acute stress
Tyrosine for focus & calm energy

Dr. Aimie Apigian, MD, kindly interviewed me. She is also a guest expert on the summit so be sure to tune into her excellent interview too: The Biology of Trauma and the Freeze Response.

I encourage you to register and tune in if you have:

Anxiety & feel overwhelmed & stressed by little things
Panic attacks &/or obsessive thoughts or behaviors
Social anxiety/pyroluria
Phobias or fears (flying, spiders or even driving on a highway)

And also if you suffer from…

Food sensitivities, IBS/SIBO, parasites or gallbladder issues
Constipation, diarrhea, bloating, gas, pain & other digestive issues
Leaky gut, a leaky blood-brain barrier or vagus nerve issues

Join us if you are also an emotional eater with intense sugar cravings (and know you suffer from low blood sugar), experience insomnia, low mood, PMS, poor focus and/or low motivation.

With research-based anxiety nutritional solutions and practical steps, you can determine your root causes, ease your anxiety and prevent it from coming back so you can feel on top of the world again!

If you are a practitioner, please join us too and find advanced solutions for your clients or patients too!

You’ve heard me say the Anxiety Summit has been called “a bouquet of hope!” My wish for you is that this summit is your bouquet of hope!

I hope you’ll join me and these incredible speakers, be enlightened and find YOUR solutions!

Here’s to no more anxiety and you feeling on top of the world again!

Please share if glutamine has helped you with low blood sugar symptoms such as an intense desire for something sweet.

Feel free to post your questions here too.