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swallowing issues

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

Multiple sclerosis and low GABA

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:

  • GABA is a life saver for anxiety, theanine helps at night (insomnia) and 5-HTP makes a significant difference in lessening daily pain
  • GABA is the answer after 40 years of a lump-in-the-throat sensation, nervousness and muscle tension at work

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):

  • Half a crushed GABA Calm for my autistic child: sleep, anxiety and sensorimotor skills (writing, horse riding and swimming) improve
  • GABA Calm is a game changer for husband’s sound and tactile hypersensitivity, significant coordination problems and his anxiety

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):

  • Keep GABA powder handy for choking episodes, stridor and panic (and find the ideal dose and be consistent for prevention/easing anxiety)
  • Paroxysmal laryngospasm with low GABA physical-tension-type-anxiety: Is GABA powder rubbed on the inside of the cheek a solution?
  • GABA mixed in water and swished in his mouth before a meal prevents esophageal spasms /choking/vomiting, and allows him to swallow

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).

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, sugar cravings, anxiety and mood issues.

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

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

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

Do you have 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.

Filed Under: Amino Acids, GABA, Multiple sclerosis Tagged With: amino acids, anxiety, balance issues, benzodiazepines, demyelination, GABA, GABA Quickstart online program; Balancing Neurotransmitters: the Fundamentals program for practitioners, insomnia, laryngospasms, multiple sclerosis, muscle stiffness, pain, physical anxiety, sensorimotor issues, spasticity, speaking issues, stiff and tense muscles, swallowing issues, voice issues, voice issues and sensorimotor issues

GABA mixed in water and swished in his mouth before a meal prevents esophageal spasms /choking/vomiting, and allows him to swallow

April 1, 2022 By Trudy Scott 24 Comments

gaba in water

GABA mixed in water and swished in the mouth of an adult male, before a meal, prevents his esophageal spasms, and stops his frequent choking and vomiting, and allows him to swallow his food. A colleague shared her husband’s swallowing issues after she read my blog post about using GABA powder inside the check for laryngospasms. 

This is what she shared:

That [blog] made me think that [GABA] might be useful for my husband‘s esophageal spasms. He frequently can’t get food down during a meal because of them.

So he started mixing 500 mg GABA in a little water and swishing it around his mouth and then swallowing it at the beginning of each meal. Since he started doing that he has not had one spasm, or vomiting episode.

It’s wonderful to hear about her husband’s success with GABA and this unique application of swishing around GABA powder (mixed in water) in his mouth before a meal (I’ll share more on this aspect below).

I asked if they know what the causes of his esophageal spasms are but they don’t yet know:

We can’t figure it out. It appears to be all food. I would expect there to be a trigger-food, but we can’t find it.

The GABA has completely stopped it. Last night we went out to dinner and he forgot to bring GABA with him and immediately started choking. So he went to the nearest vitamin store, (of which there is only one)! Fortunately it was open. As soon as he got back to the restaurant and took his GABA, he was fine.

GABA does work so well for him and offers him some relief while they continue to search for other underlying root cause/s. Until these are found, GABA is supporting overall low GABA levels, associated with physical tension-type anxiety, intrusive thoughts, stiff and tense muscles in other areas of the body and also stress-eating and self-medicating with alcohol in order to relax. More on low GABA symptoms here.

My input on his dosing and swishing

Regarding the dosing and swishing method I have this input:

  • 500 mg GABA is the ideal dose for his needs but this is considered a high dose to start. For low GABA tension-type anxiety, I have clients start with a trial of 125 mg GABA and go up from there. I’d recommend the same approach for someone with issues like this gentleman experiences.
  • GABA is most effective when used sublingually or by opening a capsule on to the tongue or by using GABA powder on the inside of a cheek, rather than swallowing a GABA capsule. For this reason, his method of swishing GABA mixed in water is excellent for achieving the spasm-reducing and relaxing benefits quickly. For some folks doing this 30 minutes before a meal may be more effective than doing it right before eating.

The diagnosis can vary from person to person

The diagnosis can vary from person to person. But as long as there are spasms that are affecting swallowing, doing a trial of GABA is worthwhile in order to determine if it will help.

One example is eosinophilic esophagitis where

Clinical manifestations in infants and toddlers generally include vomiting, food refusal, choking with meals and, less commonly, failure to thrive. Predominant symptoms in school-aged children and adolescents include dysphagia (difficulty swallowing), food impactions, and choking/gagging with meals, particularly when comprised of foods with coarse textures. Other symptoms in this patient population include abdominal/chest pain, vomiting, and regurgitation.

The predominant symptom in adults is dysphagia [difficulty swallowing]; however, intractable heartburn and food avoidance may also be present.

One paper, Esophageal microbiome in active eosinophilic esophagitis and changes induced by different therapies discusses the role of the microbiome and how “an increase in levels of gamma-aminobutyric acid (GABA) …is known to exert a role in esophageal motor function.”

Finding the other root causes (other than low GABA)

Regarding finding the root causes, other than low GABA, this is an important aspect that does need to be pursued. Here are some of the many factors worth considering:

  • Finding food triggers. This can be challenging but an obvious one is gluten which can play a role in eosinophilic esophagitis. Dairy and environmental irritants can be issues too.
  • GERD/reflux needs to be ruled out or addressed. Food sensitivities are often a factor here too.
  • Vagus nerve issues can play a role in digestive issues like this. GABA and vagus nerve exercises helped my cough and voice issues. I recorded all my exercises on video and you can find these here. Fortunately I didn’t have any swallowing or choking episodes at that time but have had a choking episode more recently (GABA did help) so I know how scary this can be.
  • Pyroluria, a social anxiety condition needs to be ruled out or addressed too. This is because nausea, gagging and choking are common symptoms for some individuals.
  • I’d also consider a tongue tie. I just finished reading Tongue Tied: How a Tiny String Under the Tongue Impacts Nursing, Speech, Feeding, and More (my Amazon link) by Richard Baxter, DMD, MS. The focus on babies and children but adults can also benefit from addressing tongue tie issues later in life.
  • Addressing gut health and the microbiome may be one of the keys, as outlined in the paper above.

This is not a comprehensive list and a full functional workup will help to identify all possible root causes.

Related blogs: young boy with choking episodes, lump-in-the throat sensation, anxiety and globus pharyngeus

Here are some related blogs that you may find useful

  • Paroxysmal laryngospasm with low GABA physical-tension-type-anxiety: Is GABA powder rubbed on the inside of the cheek a solution? (this is the blog that inspired my colleague to have her husband do the GABA mouth swishing)
  • GABA helps a stressed young boy with episodes of “choking” or tightening in his throat
  • GABA is the answer after 40 years of a lump-in-the-throat sensation, nervousness and muscle tension at work
  • Anxiety and globus pharyngeus (lump in the throat): GABA to the rescue?

Resources if you are new to using GABA as a supplement

If you are new to using the the amino acid GABA as a supplement, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution (you can see the low GABA and other low neurotransmitter symptoms).

If you suspect low levels of GABA or low serotonin 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 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.

If you don’t feel comfortable reading my book, doing the low GABA symptoms questionnaire and doing trials of GABA on your own, you can get guidance from me in the GABA Quickstart Program (online/virtual).

If you are a practitioner, join us in The Balancing Neurotransmitters: the Fundamentals program. It’s an opportunity to interact with me and other practitioners who are also using the amino acids.

Have you experienced throat or esophageal spasms and difficulty swallowing with choking and/or vomiting.

And do you have the low GABA physical-tension-type-anxiety symptoms?  What else is a trigger for you and do you have a diagnosis?

If you’ve already been using GABA with success for easing your anxiety, have you noticed a reduction in your swallowing issues?

Have you ever used GABA in this way to help your swallowing issues?

If you’re a practitioner please share what you have seen?

Feel free to ask your questions here too.

Filed Under: Amino Acids, Anxiety, GABA, Gluten Tagged With: anxiety, can’t get food down, choking, choking sensation, eosinophilic esophagitis, esophageal spasms, GABA, GABA Quickstart, globus pharyngeus, gluten, gut health, laryngospasms, lump in the throat, physical-tension, pyroluria, swallow, swallowing issues, swished, tongue tie, trigger-food, vomiting

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