tryptophan

Intrusive thoughts are a thing with anxiety: low GABA, low serotonin, pyroluria (low zinc & vitamin B6) and hormone imbalances as possible causes

February 4, 2022 By Trudy Scott 56 Comments

Intrusive thoughts are a thing with anxiety even though they are not often talked about. It’s for this reason I shared a link to an article on Facebook recently – “The Debilitating Anxiety Symptom No One Ever Talks About” – and the response was overwhelming. I promised to do a blog to do a deeper dive into this topic and share actual real-life examples of uncomfortable and unwanted intrusive thoughts that seemingly appear out of no-where when you have anxiety. And of course, I’m using these real-life examples to highlight some of the many biochemical root causes and nutritional solutions: low GABA, low serotonin, low zinc, low vitamin B6 (and pyroluria) and hormone imbalances. These root cause solutions are all backed by research and clinical results.

You’ll also discover that intrusive thoughts are more common than you’d expect and it’s not just you who experiences them.

Katelyn, author of the above article, shared this about her intrusive thoughts (and this is part of what I shared on Facebook):

As I gained more life experiences, my intrusive thoughts developed into other fears. Now that I was older, these thoughts turned into new scenarios, ones that felt more real. For example, when I started driving, I’d see myself veering off the road, hitting a side rail, flying off a ledge, or running head-on into a semi. I didn’t really want to do any of these things. I just wanted to get to my destination, but these thoughts would keep running through my mind, and I couldn’t stop them.

I did not realize intrusive thoughts were a ‘thing,’ and I thought this was just me

The Facebook post and article quickly resonated with many women with someone saying “I have never identified with an article more…wow.”

One woman said “I did not realize intrusive thoughts were a ‘thing,’ a symptom of something” and someone else said “I thought this was just me.”

Someone else responded: “I thought it was only me as well. I’ve had thoughts like this nearly my entire life.”

(You can read the entire article here: The Debilitating Anxiety Symptom No One Ever Talks About)

The purpose of this blog is to share actual feedback so you can see how varied these intrusive thoughts can be. And recognize that they are a thing and that you are not alone if you experience them.

And then use these cases to illustrate the variety of root causes (and solutions) and show how some of them are very interconnected: like zinc and vitamin B6 for pyroluria, for making GABA and serotonin, and also for hormone balance (more on that below).

A definition from The Anxiety and Depression Association of America

In case you need a definition: “Unwanted intrusive thoughts are stuck thoughts that cause great distress. They seem to come from out of nowhere, arrive with a whoosh, and cause a great deal of anxiety.

The content of unwanted intrusive thoughts often focuses on sexual or violent or socially unacceptable images. People who experience unwanted intrusive thoughts are afraid that they might commit the acts they picture in their mind. They also fear that the thoughts mean something terrible about them….

Unwanted intrusive thoughts can be very explicit, and many people are ashamed and worried about them, and therefore keep them secret.” ~ The Anxiety and Depression Association of America (ADAA).

The ADAA offers an excellent overview that is worth reading, but unfortunately they do not offer any of the nutritional solutions that we know can eliminate these uncomfortable intrusive thoughts.

GABA support with the amino acid GABA

Assessing for and addressing low GABA levels is the first place I start because you get results so quickly if low GABA is one of the root causes.

Jacqueline shared this on the Facebook post about intrusive thoughts: “GABA definitely helped me with this! Also meditation has helped me to learn to stay present. The two combined are helpful.”

Tiffany shares how Source Naturals GABA Calm helps her: “I have definitely noticed that sublingual GABA Calm that you suggest helps calm my overactive brain.”

Elicia offered this input about GABA on the seasonality of GABA blog and needing more in winter:

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.

Intrusive thoughts is one of the symptoms on the low GABA section of the Amino Acids Mood Questionnaire: “Have intrusive thoughts, perseverate or have an overactive brain or have unwanted thoughts – thoughts about unpleasant memories, images or worries.”

This is not in my book or on the original questionnaire but was added in 2017 based on new GABA research on intrusive thoughts. I blogged about this here: GABA helps with inhibition of unwanted thoughts (and have added more recent supporting research on the glutamate/GABA balance i.e. increased glutamatergic excitation and reduced GABAergic inhibition.)

Serotonin support with the amino acid 5-HTP (or tryptophan)

Assessing for and addressing low serotonin levels would be the next step for the same reason – you get results so quickly if low serotonin is one of the root causes.

Yosef shared this about his anxiety, panic and intrusive thoughts on the GABA blog on intrusive thoughts hoping low GABA might be his root cause, with GABA as a solution:

I have issues with intrusive thoughts that present daily challenges. On top of that, I have been living with anxiety and panic issues for so long that I have adjusted to the limitations (I work from home, order pretty much everything online and have a very tolerant wife). I’ve been trying mindfulness for the intrusive thoughts, but if GABA might help with that and the panic (and perhaps help me unlearn the agoraphobia) that would be awesome. Imagine being able to go on vacations with my wife!! I’m ordering some and will give it a shot.

About 6 weeks later he shared that he didn’t notice a drastic difference with GABA but that serotonin support did help. He used 5-HTP and shared these wonderful results after using it for only a week:

What did make a difference is 5-HTP (Now – 100mg). I’ve been using it for a week so far. It was recommended by Dr. Amen (the brain doctor) who says it is helpful with OCD, intrusive thoughts, and the like. You take it before going to sleep. It used to be that I had trouble falling asleep because of the “noise” in my head – random anxious thoughts, jumpiness. I would usually need to have something playing (podcast, music, anything) to help me fall asleep. So far, on 5-HTP I find it easier to fall asleep, I don’t have to search for the right podcast, etc. I just feel really tired and fall asleep.

He did a trial of GABA and then a trial of 5-HTP when GABA didn’t help. This is exactly what I would have done. Tryptophan is also an option when 5-HTP is not tolerated.

You’ll see intrusive thoughts listed as “Obsessive thoughts or behaviors” on the low serotonin section of the Amino Acids Mood Questionnaire

5-HTP and tryptophan are listed in this paper: Nutraceuticals in the treatment of obsessive compulsive disorder (OCD): a review of mechanistic and clinical evidence.

Low zinc and low vitamin B6 (and pyroluria)

Low zinc and low vitamin B6 is common with the social anxiety condition called pyroluria. Kez shared how addressing pyroluria/pyrrole disorder resolved her intrusive or ruminating thoughts:

I noticed after being diagnosed with pyrolle disorder that when I had been taking zinc and vitamin B6 supps for a couple of years, the ruminating thoughts left me and my head was peaceful.

Before starting on the zinc and vitamin B6, she described her intrusive thoughts as follows:

Everything would go around and around in my head, it never stopped. And if my son was a few minutes late home, I would picture him in an accident dead on the side of the road. All really negative stuff. When I realised it had stopped it was such a relief.

She confirmed that she didn’t use 5-HTP/tryptophan or GABA. However the pyroluria protocol helps with the production of GABA and serotonin, and also helps to balance sex hormones (more on that below).

You’ll see “Neurotransmitter imbalances, especially low serotonin” on the Pyroluria Questionnnaire.

In one study, Alterations of serum zinc, copper, manganese, iron, calcium, and magnesium concentrations and the complexity of interelement relations in patients with obsessive-compulsive disorder, patients with obsessive-compulsive disorder had low zinc, iron and magnesium.

In another study, Depressive Symptoms in Middle-Aged and Elderly Women Are Associated with a Low Intake of Vitamin B6: A Cross-Sectional Study, they looked at anxiety symptoms like “feeling tense, restless, or panicky; feeling something awful will happen; having worrying thoughts” and low vitamin B6.

Hormonal imbalances: more than 3 x the intrusive thoughts

In this study summary, Hormone levels may provide key to understanding psychological disorders in women, the authors share that “a common symptom of mood and anxiety problems is the tendency to experience repetitive and unwanted thoughts. These ‘intrusive thoughts’ often occur in the days and weeks after a stressful experience.” In this particular study the women watched a 14-minute stressful film containing death or injury and then salivary hormone levels were measured.

In this study “women in the ‘early luteal’ phase… had more than three times as many intrusive thoughts.” The luteal phase happens after ovulation i.e. about 16 to 20 days after the start of their period.

The authors conclude that “Women at a particular stage in their monthly menstrual cycle may be more vulnerable to some of the psychological side-effects associated with stressful experiences.”

If your intrusive thoughts ramp up in the luteal phase it’s important to consider the role of hormone imbalances.

But keep in mind that the pyroluria protocol also helps to balance sex hormones. And that tryptophan and GABA help to balance hormones too: Tryptophan for PMS: premenstrual dysphoria, mood swings, tension, and irritability.

As I mentioned above, I typically like to start with addressing low serotonin and/or low GABA because the amino acids offer quick relief, and they give you time to dig deeper into other causes like hormonal imbalances. I also always consider pyroluria with anyone who is anxious so that’s high on the list too. We can see results in a week when we figure out the correct doses.

In part 2, I share one woman’s story of how a lifetime of horrible and bizarre intrusive thoughts were eliminated by a low carb/high fat diet (not as strict as keto).

Stay tuned for part 3 of this blog where I’ll address other possible root causes of intrusive thoughts: low magnesium, low iron, gluten issues, discontinuation syndrome, Lyme disease, mold toxicity, heavy metals, toxins, infections, TBI and trauma.

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

If you are new to using the the amino acids GABA or 5-HTP/tryptophan as 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 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 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, 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. Here is the budget-friendly GABA QuicksStart Homestudy version.

If you also need serotonin support, the Serotonin QuickStart Program is a good place to get help. This is also a paid online/virtual group program where you get my guidance on using tryptophan and 5-HTP safely, and community support during 5 LIVE Q&A calls. You can sign up to be notified when the next live launch of this program is happening.

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.

We appreciate Katelyn for writing the article I shared and everyone for being willing to share their stories so we can all learn and feel better.

Let’s change this and talk about intrusive thoughts so we don’t have to feel alone and so we can find solutions. As Katelyn says: “If you struggle with intrusive thoughts, share them. The more we share these experiences, the better we can understand ourselves and others and the more we can help one another. Know you are not alone.”

I’ll add this: and share your success with nutritional solutions when something works for you. Share it with your friends and your health practitioner.

Now I’d love to hear from you …

Did you know intrusive thoughts are a ‘thing,’ or did you think it was just you?

Has any of the above helped you: GABA, 5-HTP or tryptophan, zinc and/or vitamin B6?

And have you observed more intrusive thoughts after ovulation and before your next period?

Feel free to ask your questions here too.

Does 5-HTP make you “wired-tired” and affect your sleep when cortisol is high? (“yes” and “not sure” and “no, 5-HTP was miraculous!”)

January 14, 2022 By Trudy Scott 38 Comments

Both 5-HTP and tryptophan are amino acid supplements that are known to help to boost serotonin levels so you can feel happy, calm, sleep well and not crave carbs in the afternoon/evening. They also help with panic attacks and phobias, lack of confidence, depression, negativity, imposter syndrome, PMS, irritability, anger issues, pain/fibromyalgia, TMJ and anger. I typically have my clients with low serotonin symptoms start with a trial of tryptophan because I see such excellent results with this amino acid. That being said, some people simply do better on one versus the other and you may do better with 5-HTP.

There is one big caveat with 5-HTP. I don’t recommend 5-HTP when a client has elevated cortisol levels because we know that it can raise cortisol levels in certain individuals. This can leave you feeling agitated, cranky, as well as “wired and tired” at the same time. You may be able to relate to this if you’ve ever used 5-HTP to help with anxiety and insomnia and ended up feeling more anxious and more wide-awake despite your exhaustion and need for sleep.

Today you’ll hear actual feedback from members of my community who responded to a past blog post: 5-HTP can raise salivary cortisol: does this cause a “wired-tired” feeling?.

Read on to hear how one woman found that 5-HTP did lead to her feeling wired and tired and how 5-HTP made sleep worse and worse in another; how one woman wasn’t sure if 5-HTP caused her disturbed sleep and waking in the night; and how one man found that 5-HTP was miraculous for his wife. In each instance I offer input and next steps if necessary. As you can see their responses were very different and my hope is that you may see yourself in some of these “cases” and learn more about using the amino acids.

And be sure to read the original blog post if you’d like to check out the study and some of my feedback on it and using 5-HTP.

5-HTP did lead to feeling wired and tired and made sleep worse and worse

Gloria shared how 5-HTP did not help her sleep and made her feel wired and tired. She figured out the tryptophan did work for her:

I so appreciate your blog and have learned so much that is helpful. I tried 5-HTP and it did not help me sleep. I do much better on Lidtke tryptophan. The 5-HTP did make me feel wired and tired. I also have that reaction to GABA Calm because of the taurine and do much better on GABA-T SAP. Thank you for all your research.

I appreciate her sharing and am so pleased she has good results with tryptophan. The Lidtke brand is the one I have the most success with. The GABA-T SAP is a combination of GABA and theanine and is another product I recommend and see good results with.

Alexandra knew she had high night time cortisol and yet has been taking 5-HTP at the recommendation of her psychiatrist and her sleep was getting worse and worse. She shared this on the above blog post:

Your posts do not stop amazing me! I have been diagnosed with HPA axis dysfunction with high cortisol at night, my psychiatrist had me on 200 mg of 5-HTP and my sleep was getting worse and worse! I had to stop taking it because I was going to get the DUTCH test done by Geneva and noticed I slept much better without it…. I am so grateful for your posts!

I appreciate her for sharing and glad she made the connection. Hopefully she shared this information with her doctor too.

The 200mg 5-HTP dose is considered relatively high, certainly as a starting dose. I start clients on 50mg and increase based on symptoms so I assume she worked up to taking 200mg.

When 5-HTP is making things worse we switch to tryptophan, also starting low and increasing based on need. Keep in mind that 50mg 5-HTP is equivalent to 500mg tryptophan but I like to have clients start low when making a switch and increase based on results.

It’s always important to address the high cortisol levels (with Seriphos and other adrenal support). And to consider checking for parasites, changes in sex hormones, SIBO (small intestinal bacterial overgrowth), gluten issues and other food intolerances, toxin exposure, new EMF exposure, medication side-effects, mold toxicity and infections – all of which can affect sleep and may impact cortisol levels.

Not sure if 5-HTP caused disturbed sleep and waking in the night

Merrily experienced some really good results using 5-HTP, starting low and working up to her ideal dose of 200mg. And then she started experiencing disturbed sleep and wasn’t sure if it was the 5-HTP:

Because of mood issues – dysthymia [low mood], irritability, negative thoughts, and low energy, my doctor recommended 5-HTP. I started on 50mg 5-HTP and have worked up to 200mg daily (which I’ve been taking at bedtime for over 2 years now). On the occasions when I cut back, mood issues returned which does suggest to me it’s working.

Lately I am experiencing problems with disturbed sleep, waking during the night which I had not associated with the 5-HTP. Shall I switch to tryptophan?

Thank you so much for your blogs, your book and lectures. You really make a difference Trudy!

She has a few options. One is to cut back the 5-HTP again and see if her mood issues return. If they don’t return and sleep improves she can stay on the lower dose but may need to increase it temporarily during the winter time

Another option is to space out her dosing and take less at night and some mid-afternoon.

Finally she could switch to tryptophan. As I mentioned above, 50mg 5-HTP is equivalent to 500mg tryptophan but I like to have clients start low when making a switch and increase based on results.

If these approaches don’t work it would be useful to test salivary cortisol levels to see if her cortisol levels are now high and if yes, address this with Seriphos and other adrenal support as I mentioned for Alexandra above. And to consider checking the same root causes that can affect sleep and cause high cortisol levels.

No, 5-HTP was miraculous for his wife!

When serotonin levels are low and cortisol is not high, results with 5-HTP can be miraculous for some individuals. Russell shared how much his wife benefitted from just 50mg 5-HTP twice a day:

I treated my wife with 5-HTP when she suffered from work burn out, depression and menopause. This all hit at once.

I spent hours researching what I could to relieve the night sweats, mood swings etc. and came upon 5-HTP. I used 50 mg 5-HTP, one before bedtime and the other on waking up and it basically fixed everything that was associated with the problems mentioned above.It was miraculous to say the least and my wife was also very happy.

I’m thrilled for his wife and thanked him for sharing the wonderful results she has experienced with 5-HTP.

If her results were not sustained, I’d suggest taking her doses mid-afternoon and before bed as this is when serotonin is lowest. Otherwise, I’d say continue as above.

Keep in mind that 50mg 5-HTP twice a day is a typical starting dose and we increase from there. In her case, this was sufficient and she did not need to increase her dose or take additional doses during the day.

Positive research and positive case studies

My intention is not to scare you away from doing a trial of 5-HTP if you have low serotonin symptoms, but rather to educate. As with all nutritional approaches, there is no one-size-fits-all so we just need to be smart with using amino acids.

There are also many studies supporting the serotonin-boosting effects of 5-HTP:

These blog posts illustrate other positive case studies where 5-HTP was extremely beneficial:

I see wonderful results like this all the time, but always keep the high cortisol and “wired and tired” potential issues in the back of my mind.

Unfortunately many practitioners only ever recommend 5-HTP due to their concerns about tryptophan.

Resources if you are new to using 5-HTP (or tryptophan) as a supplement

If you are new to using the the amino acid 5-HTP (or tryptophan) as a 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 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 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 5-HTP and tryptophan products that I use with my individual clients and those in my group programs.

Have you used 5-HTP with success? Or have you used it and felt “wired-tired” with an impact on your sleep? Have you correlated the success or failure of your 5-HTP use with your salivary cortisol levels?

What approaches have you used to lower your cortisol levels?

If you switched from 5-HTP to tryptophan did you have success with that?

If you’re a practitioner is this something you see with your clients/patients and take into consideration?

Feel free to ask your questions here too.

Trigeminal neuralgia and anxiety: GABA, tryptophan, St. John’s Wort, acupuncture, DPA, gluten, herpes and Lyme disease

December 31, 2021 By Trudy Scott 30 Comments

I get a surprisingly high number of questions about trigeminal neuralgia asking if there is a role for the amino acids GABA or tryptophan to help ease some of the nerve and associated face pain. It’s surprising because trigeminal neuralgia is considered a rare neurological disorder.

Nerve pain is not my area of expertise (anxiety is), and because anxiety and depression is common in this population, there are very likely similar underlying causes (more on that below). The targeted individual amino acids that we use for anxiety, also help to ease pain, so I’m sharing some of what I know in case it helps you or a loved one.

Read on to learn more about this condition and GABA, tryptophan, DPA, acupuncture, St. John’s Wort, Lyme disease, herpes and B vitamins.

About trigeminal neuralgia and the incidence

The NIH fact sheet defines trigeminal neuralgia (TN) as

a chronic pain condition that affects the trigeminal or 5th cranial nerve, one of the most widely distributed nerves in the head. TN is a form of neuropathic pain (pain associated with nerve injury or nerve lesion.) The typical or “classic” form of the disorder (called “Type 1” or TN1) causes extreme, sporadic, sudden burning or shock-like facial pain that lasts anywhere from a few seconds to as long as two minutes per episode. These attacks can occur in quick succession, in volleys lasting as long as two hours. The “atypical” form of the disorder (called “Type 2” or TN2), is characterized by constant aching, burning, stabbing pain of somewhat lower intensity than Type 1. Both forms of pain may occur in the same person, sometimes at the same time. The intensity of pain can be physically and mentally incapacitating.

The incidence of new cases is approximately 12 per 100,000 people per year and women are impacted more than men.

A number of studies show anxiety, depression and insomnia are common when someone has trigeminal neuralgia. The question is this – is the pain causing the anxiety, depression and insomnia OR are there common underlying physiological causes for both. It’s likely a combination of both especially when it comes to idiopathic trigeminal neuralgia i.e. when there is no known cause. Known causes include head injury, multiple sclerosis, dental procedures, tumors and cysts.

By using some of the approaches outlined below, we may see pain relief and improved mood, less severe anxiety and better sleep.

When to consider GABA and serotonin support

There is no research on either GABA or tryptophan/5-HTP helping with symptoms of trigeminal neuralgia, however medications that work on both GABA and serotonin are typically prescribed for trigeminal nerve pain. For this reason I would consider a trial of GABA and/or tryptophan (or 5-HTP if other low GABA physical anxiety symptoms and low serotonin worry-type anxiety symptoms are also present. You can find the symptoms list here.

There is research-based and clinical evidence that GABA and serotonin support help with other types of pain:

Both help with the anxiety, low mood and insomnia that is often present with pain conditions like this.

St. John’s Wort for nerve pain and mood

In one case report, Hypericum perforatum (St. John’s Wort) as a possible therapeutic alternative for the management of trigeminal neuralgia (TN), a 53-year-old Hispanic female patient with a history of trigeminal neuralgia used an over-the-counter preparation of St. John’s Wort and found it relieved her pain completely.

St. John’s Wort is a herb that is primarily “used for depression but also is used for rheumatism, gastroenteritis, headache and neuralgias. ” This case report is one of many studies on this herb and trigeminal neuralgia and other neuralgias (nerve pain).

It has anti-inflammatory and antioxidant effects and also supports serotonin and GABA production which further supports the above recommendations to trial the amino acids. GABA and tryptophan would also be safe options if St. John’s Wort can’t be used as in the case of blood thinners, the birth control pill and other medications

Pain relief with endorphin support: acupuncture and DPA

Acupuncture offers pain relief via endorphin boosting and can be an option for the treatment of trigeminal neuralgia, also offering relief for the “secondary myofascial pain associated with it.”

DPA (d-phenylalanine) is an endorphin-boosting amino acid that may also offer some pain relief. It can also be used to wean off prescription pain medication and improve sleep.

Other research-based pain-relief approaches for trigeminal neuralgia

Physical therapy, chiropractic care, using a custom dental appliance, and addressing myofacial pain may offer relief or be part of the solution.

There are some less recognized approaches too:

Photobiomodulation on trigeminal neuralgia: systematic review “Photobiomodulation appears to be as effective as conventional therapies” that include medications and surgery and yet without the side-effects. Photobiomodulation, also known as red light therapy, is also beneficial for anxiety and mood regulation.
Palmitoylethanolamide and Its Formulations on Management of Peripheral Neuropathic Pain – Palmitoylethanolamide (shortened to PEA) “has anti-inflammatory and anti-hyperalgesic effects, due to the down-regulation of activation of mast cells”
Therapeutic potential of cannabinoids in trigeminal neuralgia – there is growing evidence that “cannabinoids may be effective in alleviating neuropathic pain and hyperalgesia [extreme pain sensitivity]” via “inhibiting neuronal transmission in pain pathways.”

All of the above can also improve mood and insomnia and reduce anxiety too.

Other factors to consider: B vitamins, Lyme disease, herpes and gluten

As with any condition, a full functional medicine work up should be done to rule out and/or address gluten issues, low vitamin B6/B1/B12, and even herpes zoster and Lyme disease as a root cause (or contributing factor).

Current approaches and emerging interventions – disappointing for a 2021 paper

I was excited to read the title of this paper, Trigeminal Neuralgia: Current Approaches and Emerging Interventions, published late this year. The authors share that it “summarizes over 150 years of collective clinical experience in the medical and surgical treatment of trigeminal neuralgia.”

What is disappointing is there is no mention of any of the approaches listed in this blog. It’s published by neurosurgeons so it is understandable that they would say: “The first-line treatment remains anticonvulsant medical therapy. Patients who fail this have a range of surgical options available to them.”

Medications and/or surgical options may work well for you but if not, you need to know there are other options. You may also be looking for a medication-free or non-invasive approach.

Keep in mind that this is what you’ll be offered unless you work with a functional medicine practitioner.

I do agree with and am encouraged by these statements:

What is increasingly clear is that there is no catch-all medical intervention that is effective for all patients with trigeminal neuralgia, likely reflective of the fact that it is likely a heterogenous group of disorders that jointly manifests in facial pain.
Ultimately, elucidation of the molecular mechanisms underlying trigeminal neuralgia will pave the way for novel, more effective and less invasive therapies.

Complementary approaches: NIH fact sheet

What is encouraging is that the NIH fact sheet I link to above, does mention low-impact exercise, yoga, creative visualization, aromatherapy and meditation.

Other than the standard medications (carbamazepine, oxcarbazepine, topiramate, gabapentin, pregabalin, clonazepam, phenytoin, lamotrigine and valproic acid and tricyclic antidepressants such as amitriptyline or nortriptyline) and surgical options they do also mention acupuncture, chiropractic, biofeedback and nutrients.

Botox is listed too but I have concerns about this approach.

This blog is not intended to be a comprehensive approach for pain relief for trigeminal neuralgia but rather some options you can consider and explore with your practitioner – especially when you also have anxiety, depression and insomnia too.

Resources if you are new to using tryptophan/5-HTP, GABA and DPA 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, low GABA and low endorphin symptoms) and a brief overview here: Anxiety and targeted individual amino acid supplements: a summary.

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. 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.

Has any of the above approaches helped you or your loved one? If not, what has helped you?

What conventional treatment have you had and did it help? Were you offered any of the above non-medication and non-surgical treatment approaches?

If you’re a practitioner, has any of this helped? Please share your treatment approaches 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 30 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.

Another option is the budget-friendly GABA QuickStart Homestudy program.

Wrapping up and your feedback

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.

Around my period I definitely feel the need for extra tryptophan if I’ve had some extra heavy emotional stuff come up that I need to process

December 10, 2021 By Trudy Scott 6 Comments

Many women find that they need additional nutritional support i.e. tryptophan for serotonin support (and often GABA too) around their periods. Today’s case study highlights the hormonal shifts that may lead to a situation where it appears tryptophan doesn’t work, then it does work, and then sometimes it doesn’t work as expected. The variable results and the need to switch between lower and higher doses on an ongoing basis can occur with PMS (premenstrual syndrome) PMDD (premenstrual dysphoric disorder, a severe, sometimes disabling extension of premenstrual syndrome). The variable results can also be more pronounced while recovering from trauma.

This case study is a follow-on from a blog I recently published: Tryptophan doesn’t work, then it does and then it doesn’t: could it be hormonal shifts, dietary factors and/or parasites?

Here is Kimberley’s feedback on the Facebook post that discussed these variable results. She shared how her hormonal shifts led to a need for additional tryptophan and 5-HTP:

Around my period I definitely feel the need for extra tryptophan. My PMDD symptoms have decreased since I started using tryptophan/5-HTP, but sometimes I need a bit more if I’ve had some extra heavy emotional stuff come up that I need to process (since that always happens with my period!).

I thanked her for sharing and said how happy I was for her. I also asked what symptoms have decreased and how much? I also asked how much tryptophan and 5-HTP she uses before her period and then around her period?

I was also curious if she just experimented with different doses until she figured it out or had she heard me talk about the PMDD tryptophan study: A placebo-controlled clinical trial of L-tryptophan in premenstrual dysphoria. In this study tryptophan was found to reduce symptoms of PMS when used in the luteal phase or second half of the cycle (i.e. after ovulation).

Her low serotonin symptoms have decreased as much as 75-80 percent

Kimberley confirmed that she had read the above study and related blog post – Tryptophan for PMS: premenstrual dysphoria, mood swings, tension, and irritability – and more about her symptoms:

I had read the blog you referenced, which is one of the reasons I tried tryptophan in the first place.

I was experiencing a lot of emotional distress, feelings of downright despair that left me miserable both during my period and ovulation (half the month, every month, which was truly awful). Those have definitely decreased, sometimes as much as 75-80 percent, other times they’re worse and I feel like I need more support.

I usually take 1x Lidtke 5-HTP (50mg) mid-afternoon and 1x Lidtke Tryptophan (500mg) at bedtime, but yesterday I increased to 2x Lidtke Tryptophan and do feel an improvement in my mood this morning.

I experimented to get the right dose of both amino acids, initially increasing to the maximum you recommend, and then slowly decreasing to what I’m taking now when I found I didn’t feel well when I took too much.

I just reread the blog you linked above and realized I should be using GABA every day to support progesterone (instead of just as needed for anxiety). Thanks for the reminder!

I love that after reading the blog she was inspired and motivated to experiment with different doses when she is/was feeling so bad. I encouraged her to continue trialing different doses at various times of the month especially in the second half of the month. I also reminded her that some folks do better with tryptophan and some do better with 5-HTP when it comes to low serotonin symptoms. And to continue to look at why serotonin is low and address that. Low GABA (related to low progesterone) can cause increased anxiety at this time and is a common issue with PMS/PMDD.

(You can see the entire list of low serotonin and low GABA symptoms here.)

She plans to continue experimenting with tryptophan and 5-HTP and may also try switching over to just 5-HTP and see if that changes anything. It’s unlikely that she would benefit from much higher doses of either as she shared “I don’t seem to be able to take more than 2 caps of either one without getting uncomfortable symptoms, though.”

Exercise and yoga for her low serotonin and PMDD

She did share how much exercise helps her mood, why she isn’t able to exercise as much:

The biggest thing I know to do to address low serotonin is add more exercise into my life, but this has been hard lately because I’ve had a couple of different viruses recently that left my exercise intolerance worse than it had been. I’m trying to support my mitochondria right now and add light exercise back in slowly.

Exercise is a wonderful way to raise serotonin levels and aerobic exercise has been shown to reduce the symptoms of PMS too. Yoga may be an option while she is recovering. In one study, yoga was found to be beneficial for PMS: “Alpha-brain waves production due to regular yoga practice are directly related with state of peace, creativity, mood elevation, relaxation, and release of serotonin, thus leading yoga practitioners feel more relaxed.”

Trauma: cortisol, serotonin, dopamine and estradiol

Kimberley also shared how how trauma plays into her situation:

I think some of the reasons for my health issues, low neurotransmitters, etc., are trauma related and I’ve been working through Dr. Aimie Apigian’s programs for that. But that’s another story.

I respect Dr. Aimie Apigian’s work in trauma and somatic experiencing and acknowledge this aspect must be addressed too. I love that Dr. Aimie brings this together with a functional medicine approach, looking at biology/biochemistry too. Recent trauma research confirms that there are major biochemical mechanisms involved in PTSD (post-traumatic stress disorder). These can include impacts to cortisol, serotonin and dopamine levels. And women are more vulnerable to these effects.

A 2021 paper, Estradiol, stress reactivity, and daily affective experiences in trauma-exposed women discusses high cortisol and more severe symptoms around their periods when estradiol (one of the estrogens) is low. As I mentioned above, estrogen and serotonin are closely related. The authors state this:“For women who are cycling, it may be useful to understand how the menstrual cycle affects their symptoms. When you can explain what’s happening biologically, it often becomes less threatening.”

Yoga may provide added psychological benefits as she works through her past trauma too.

Kimberly gave me permission to share her story and this is always something I appreciate so others in my community can learn from these types of experiences. If needed, I hope this her story gives you confidence to experiment with different doses and combinations around your period.

She also benefits from the comments from others on Facebook and the comments here on the blog, our back and forth, and this blog post.

She promised to keep me posted on how she goes and I’ll be sure to share when I hear back from her.

Resources if you are new to using tryptophan, 5-HTP and GABA and the amino acids 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 GABA symptoms here) and a brief overview here, Anxiety and targeted individual amino acid supplements: a summary.

If you suspect low GABA 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.

Have you found you need additional tryptophan/5-HTP or GABA around your period? How have you experimented and how does it help you?

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

Do you also feel better with exercise and/or yoga?

And are/were your variable results more pronounced while recovering from trauma?

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 19 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.