waking

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

February 28, 2025 By Trudy Scott 12 Comments

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

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

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

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

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

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

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

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

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

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

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

The conclusion is that:

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

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

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

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

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

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

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

Why you are told to stop all supplements prior to surgery

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

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

GABA lowers blood pressure which may be helpful right after surgery

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Wrapping up and your feedback

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

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

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

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

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

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

Waking with a jolt, feeling shaky and anxious: low blood sugar/hypoglycemia, glutamine and eating for blood sugar stability

February 2, 2024 By Trudy Scott 22 Comments

Low blood sugar is one of a number of causes of waking in the night or early hours, often with a jolt and feelings of anxiety or feeling like you’re having a panic attack. As shared in a recent blog post, cortisol that is high at night can cause very similar symptoms.

Because of a low blood sugar question on the high cortisol blog, today I’m explaining the very different solutions to each root cause: glutamine and eating for blood sugar stability when you have low blood sugar versus Seriphos when you have high cortisol.

Katherine shares that she has low cortisol and suspects hypoglycemia or low blood sugar, and is hesitant about using Seriphos:

My last 4 point cortisol test showed mine is low throughout the day. But I’m having episodes where I’m waking up in the mornings feeling a jolt (every time I wake up from sleeping) and sometimes also shaky and anxious.

A functional pharmacist suggested my blood sugar may be dropping during the night and hypoglycemia could cause an adrenaline surge.

I don’t know. I’m nervous to try something [such as Seriphos] to lower cortisol when it seems mine is already too low.

I agree with her functional pharmacist that hypoglycemia is likely a factor as it often is with adrenal dysfunction and low cortisol. And I am glad Katherine is being cautious about using Seriphos.

I shared that Seriphos is not the solution in this instance because she doesn’t have high cortisol based on her adrenal saliva test (4 collections). Instead, she has low cortisol throughout the day and using Seriphos would lower her cortisol even further. What many folks don’t realize is that high cortisol and low cortisol can lead to similar symptoms of anxiety, shakiness and waking in the night and early hours.

The good news is it’s relatively easy to figure out if low blood sugar is causing your symptoms. First I have clients rate their symptoms on the low blood sugar questionnaire and do a trial of glutamine. Next is figuring out the dosing and timing of glutamine, looking at a current food log and making dietary changes as needed.

If Katherine notices improvements – typically seen within a week – it’s very likely that hypoglycemia is a factor.

Finally, if additional support is needed for her anxiety I’d consider looking at low GABA and low serotonin symptoms and doing a trial of GABA and/or tryptophan.

Longer term solutions include all the dietary changes mentioned in my book – gluten-free, no sugar, no caffeine or alcohol, using nutritional support for the adrenals and addressing toxins, infections, trauma etc.

Low blood sugar symptoms

First I have clients rate their symptoms on the low blood sugar questionnaire and do a trial of glutamine if they have low blood sugar symptoms.

Here are the low blood sugar symptoms which are rated on a scale of 1 to 10, with 10 being most severe:

Crave sugar, starch or alcohol any time during the day
Irritable, shaky, headachey – especially if too long between meals
Intense cravings for sweets
Lightheaded if meals are missed
Eating relieves fatigue
Agitated, easily upset, nervous
Waking in the night or early hours with a jolt of anxiety/shakiness

If the ratings indicate the possibility of low blood sugar i.e. any cluster of the above symptoms, we do a trial of the amino acid glutamine on the tongue and record before and after ratings of a few symptoms.

Glutamine is a key amino acid for blood sugar stability and helps quickly while the adrenals heal and the dietary changes are figured out.

Glutamine for low blood sugar: dosing and timing

Typically 500 mg glutamine is a good starting dose. I see many folks start too high, like 5000 mg / 5 g and up multiple times a day, and it’s not necessary. However, we increase based on individual needs and you may find you do need to use 500 mg -1000 mg two to three times a day. Using a glutamine powder is a great way to use it especially if you find you do need more than 500 mg each time.

When you use glutamine powder directly on the tongue (rather than mixed in water), the benefits are seen almost immediately.

For someone like Katherine, using glutamine throughout the day may set her up for night time or early morning low blood sugar. She may also find she needs to use some glutamine just before bed too.

GABA and/or serotonin support too?

Depending on the causes of her anxiety and shakiness, in addition to glutamine, Katherine may need to consider GABA and/or tryptophan too. We use the low GABA and low serotonin symptoms questionnaire and do trials of GABA and/or tryptophan/5-HTP.

All three amino acids can be used before bed and during the night if needed but trials are best done one at a time.

Glutamine for low blood sugar, healing the gut, to reduce sugar cravings and for better sleep

In addition to helping with blood sugar stability and sleep issues, glutamine also helps to heal the gut and helps reduce sugar cravings. Laura shared how it’s been helping her with all of this on another blog:

I am currently struggling with gastritis (inflammation of the stomach lining) as well as a lifetime of low blood sugar and irritability. I started glutamine a few days ago (15 grams a day) and I am amazed at how it has calmed my gut as well as calmed the sugar cravings. I am also sleeping better!

I did share that 15 g is considered a high starting dose of glutamine. She may well get similar benefits with much less.

Glutamine for early morning low blood sugar and headaches

As you can see in this case, Cat finds 500 mg glutamine just once a day works well for her unique needs:

I found a powder that I mix approximately 500 mg of with water. It works within about 15 minutes and keeps me going for about 2 – 3 hours — long enough to reach a reasonable time for lunch.

I’m thrilled to have this option as anytime that I travel, low blood sugar becomes a huge issue as I suffer from ketotic hypoglycemia and end up with massive headaches and vomiting for 6-8 hours.

Dietary changes for blood sugar control and adrenal support

All my clients keep a food log and we look at what they are eating on a typical day and when. It’s key to eat in a certain way in order to control blood sugar:. breakfast on waking, healthy snacks 3 to 4 x day and some folks do well with a snack before bed. These meals and snacks should include quality animal protein and healthy fats. This is all outlined in detail in the diet and low blood sugar chapters in my book “The Antianxiety Food Solution”.

A protein smoothie in the morning is a good option too and especially helpful if you have the social anxiety condition pyroluria, where morning nausea and a low appetite is common initially. This blog highlights a research paper about breakfast smoothies helping to reduce anxiety and hypoglycemia symptoms.

Nutritional support for adrenal function includes a good B vitamin complex, extra vitamin B5/pantothenic acid, vitamin C and adaptogenic herbs such as rhodiola and ashwagandha.

Glutamine product options – capsule vs powder

Products I recommend include Pure Encapsulations 500 mg l-glutamine (capsules opened on to your tongue) and Designs for Health l-glutamine powder as you find you need higher amounts. You can purchase these from my online store (Fullscript – only available to US customers – use this link to set up an account).

If you’re not in the US, Now l-glutamine 500 mg and Doctor’s best l-glutamine powder are products I recommend on iherb (use this link to save 5%).

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

We use the symptoms questionnaire to figure out if low blood sugar and/or low serotonin and/or low GABA and other neurotransmitter imbalances may be an issue for you.

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

Have you had success with glutamine for blood sugar stability and waking with a jolt of anxiety/panic at night or in the early hours?

Have you used it for blood sugar stability, reduced cravings, leaky gut and anxiety during the day?

If yes, how much helps you? And how often do you use it?

Have dietary changes and adrenal support helped too?

If you’re a practitioner do you use glutamine and dietary approaches with clients/patients with low blood sugar?

And please let me know if it’s helpful that I’m now including product recommendations and where to get them?

Feel free to share and ask your questions below.

Seriphos to lower high cortisol: Help prevent an adrenaline-type surge and waking with anxiety and panic. Your questions answered

January 26, 2024 By Trudy Scott 16 Comments

When you have high night-time cortisol it can cause you to wake in the middle of the night with anxiety and/or feeling like you’re having a panic attack. If your cortisol is really high in the early morning (outside of the normal range), you can also wake with a jolt and feelings of anxiety and panic. Seriphos, a phosphorylated serine product, can help to lower your high cortisol and eventually prevent these symptoms.

Today I’m addressing your questions about how to use Seriphos to lower high cortisol and help prevent an adrenaline-type surge – like dosing/timing at night and in the early morning, how long you can take it for, cortisol salivary testing, interactions, brands and another option to Seriphos.

Soma shared her symptoms on Facebook when I said I’d be taking questions:

Can feel the adrenaline rush “crash” over me. I responded so so to beta blockers but still having fitful sleep and occasional “shocks” into wakefulness in the night as if tragedy struck … fight or flight upon waking. Tremendous night sweats. Generally hyper vigilant as a person.

This is her question: “What dosage and when to take (how soon before bed) is recommended?”

Addressing dosage and timing is a good place to start (and a common question) but I asked her if she has done a 4-5x cortisol salivary collection to confirm that her night time cortisol is high. She has not done this simple and very effective adrenal test and I highly recommend it before using Seriphos. The reason is that low cortisol can often have similar symptoms to high cortisol and using Seriphos is going to make things worse.

What dosage and when to take Seriphos (how soon before bed) is recommended?

Assuming Soma has done the adrenal saliva test and knows her middle of the night cortisol (5th saliva collection) is high, using 1-3 capsules a few hours before the high cortisol seems to be most effective. For example, for 2-4 am waking this typically means taking Seriphos right before bed. In some instances, taking 1 on waking in the night can help too (for a maximum of 3).

If her late evening 10 pm (4th saliva collection) is high too, the dose can be split. For example, taking 1 Seriphos at 7- 8 pm (a few hours before the high cortisol at 10 pm) and 1-2 right before bed for the 2 -4 am high cortisol.

The bottle states to use 1 capsule with water 15 minutes before a meal. I’m really not sure why they state this.

How to use Seriphos for high morning cortisol and adrenaline surge on waking?

Syd asks this question about high morning cortisol (as confirmed by saliva adrenal testing):

Opinion about using it for confirmed high MORNING cortisol? (Yup, I know cortisol is supposed to be highest in the morning, but this is off the charts, literally, high.)

“Adrenaline surge” or “catecholamine surge” is exactly how I’ve explained it to people!! No cognitive worrying, just that surge.

Because Seriphos works best taken a few hours in advance of high cortisol, I typically have clients use Lactium in this situation. It’s a hydrolyzed casein product that also lowers high cortisol. If casein is an issue then Relora is another option. I’ve blogged about both – Lactium here and Relora here.

One other option is to experiment with Seriphos – using it in the morning and also trying it at bedtime.

Should I take two Seriphos? I wake halfway through the night

Anne asks this question:

I only take one capsule? Should I take two? I wake halfway through the night, usually due to a full bladder. I fall back to sleep easily if I use a CBD gummy. Tested high for cortisol throughout the day on a DUTCH complete test, which measures at least 4 times.

Anne has done a DUTCH test which includes 4 adrenal saliva collections but doesn’t know if her cortisol is high in the middle of the night. As mentioned above, 1-3 capsules of Seriphos is ideal so I have clients start with 1 and increase to 2 and then 3. Since her cortisol is high throughout the day she may do better using Seriphos in the day and continuing with CBD at night when she wakes.

She may also want to consider low GABA and/or low serotonin as factors causing her to not sleep through the night. This applies to anyone using Seriphos to lower high cortisol. More on amino acids below.

If she does have bladder issues addressing this is key too.

For how long can Seriphos be taken?

It is recommended to take a one-month break after 3 months of Seriphos use. Ideally, once some or all the root causes of high cortisol are addressed (like gluten, stress, parasites, infections, trauma etc), you should be able to stop anyway. Or take a break, retest cortisol and then continue.

Does Seriphos have any interactions? And is there any cohort who should not use it?

Someone asked about using Seriphos with a beta blocker and someone else asked about using it with a SSRI. I’m not aware of any medication interactions but it’s best to always discuss with the prescribing physician.

What brands make Seriphos and where can I find it?

There is only one product and it’s called Interplexis Seriphos. You can purchase this from my online store (Fullscript – only available to US customers – use this link to set up an account) and you can also find it on iherb (use this link to save 5%).

Since I mentioned Lactium above, Biotics Research De-Stress contains 150mg hydrolyzed casein or lactium. You can find this in my online Fullscript too – use this link to set up an account. For non-US customers, Life Extension Bioactive Milk Peptides also contains 150mg hydrolyzed casein or lactium (you’ll see casein decapeptide and lactium on the label.) You can find this on iherb (use this link to save 5%).

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

We use the symptoms questionnaire to figure out if low serotonin or low GABA and other neurotransmitter imbalances may be an issue for you.

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 importance of quality animal protein is also covered.

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

Have you had success with Seriphos (or Lactium or Relora) to lower high cortisol and help with anxiety, panic and/or adrenaline-type surges?

Have you used Seriphos in combination with amino acids and dietary changes?

If you’re a practitioner do you use Seriphos with clients/patients?

Feel free to share and ask your questions below.

Seriphos lowers high cortisol: prevent waking in the night and nighttime anxiety

October 20, 2023 By Trudy Scott 63 Comments

Seriphos is my favorite nutrient for lowering high nighttime cortisol in order to reduce night waking and nighttime anxiety. I’ve used it with success in the past and have just needed it again:

After coming back from Hawaii (I was there for just under 2 weeks), I was still waking a few times each night. Sometimes I would be awake for 2-3 hours! I’m a hot mess when I don’t get sleep through the night. With just 1 Seriphos before bed for 9 days I was sleeping through the night again. It was glorious!

High cortisol can be a temporary issue after international travel i.e. caused by jetlag and out of balance circadian rhythm. I will admit that I have a number of confounding factors – like my loss and grief (my darling mom has just passed away), being sprayed with insecticide on landing in Australia (which I suspect caused severe vertigo the day after I got back), and high blood pressure (and likely higher cortisol too) after drinking too much licorice tea for my voice loss. Whatever the causes of my high cortisol, Seriphos really helped me sleep through the night.

I ran out of Seriphos 2 nights ago and I was awake for 3 hours last night. I’ll be adding it back to my nighttime protocol as soon as my order arrives.

Seriphos is made by Interplexus and is a phosphorylated serine product. It is similar to the more recognized phosphatidylserine which is also used and known for lowering high cortisol – clinically and in the research. However, clinically, I have found Seriphos to be more effective and work more quickly.

UPDATE Feb 2024: I did end up tweaking my Seriphos dose a few times. After a few weeks I decided to trial 2 per night – this worked well. Then a few weeks later I trialed 3 per night – but after a few days I realized that even though it worked well for sleep it made me too tired the next day. For this reason I went back down to 2 Seriphos at bedtime.

UPDATE August 2024: I’m now using just 1 Seriphos at night and have added ox bile supplementation and a bright light panel in the morning because of bile issues. More on this below.

Seriphos for high cortisol due to trauma, loss of beloved cat and more

When I posted this on Facebook, I had a number of folks share how Seriphos has also helped them.

Kathy shared this: “I take two Seriphos at night for high cortisol that causes insomnia. It works well for me and helps me to relax. I have a significant trauma background that keeps me in fight or flight, so Seriphos is a must have at night. I do take a break from time to time if I am going through a less stressful time.”

Hopefully Kathy is also working on the trauma, doing trauma work and even incorporating other nutritional approaches which help so much with recovery – like zinc, vitamin D, a B complex, GABA and tryptophan etc. Taking a break from time to time is a good plan – I share more about this below.

Kim shared this: “Seriphos is a life saver – I started it when I was having cortisol/adrenaline issues a few years ago and have continued using it. I don’t ever want to be without Seriphos. A little over a month ago I unexpectedly lost my youngest cat. She was emaciated when I rescued her over 4 years ago and we turned around health issues. I feel so sad that she was dealt such a bad hand but we got her a loving home. My animals are everything to me and the grief is so difficult. She was a character and I love her so much.”

She uses one capsule in the evening but also uses a capsule during the day if she feels off. Hopefully Kim is also doing trauma work and other nutritional support too.

Janie shared this: “I have used it, years ago when my cortisol was off the charts, morning and at night. I was awake every night until 2am, unable to sleep. Seriphos certainly helped.”

She used 1 Seriphos per day for about 3 months.

Patricia said: “Please remember that there is Original Seriphos and the next gen Seriphos. I was one of thousands of people who had used original Seriphos for sleep and then they changed their formulation without telling us and then so very many of us were wide awake at night until we realized that they had changed the formulation.”

This happened in 2016/2017 and I blogged about that whole fiasco here – Seriphos Original Formula is back: the best product for anxiety and insomnia caused by high cortisol. You can read many other success stories on the blog and in the comments.

Address the causes of your high cortisol: jetlag, grief, toxins, licorice intake

As you can see from my example there can be a number of causes of high cortisol and you always want to address these causes while using Seriphos so you can eventually stop using it:

International travel i.e. caused by jetlag and out of balance circadian rhythm. I’m home so this is no longer a contributing issue.
Loss and grief can have physiological effects and high cortisol is one of many effects: “It appears that cortisol remains elevated for at least the first 6 months of bereavement. For some, cortisol elevation may become chronic”. The loss of my darling mom is going to take time but I am making time for grieving and I’m nurturing myself. As I navigate this period in my life I’ll continue to share what has helped me. I suspect I may need Seriphos for longer than the usual 3 months.
Being sprayed with insecticide on landing in Australia (which I suspect caused severe vertigo the day after I got back). It’s well-recognized that environmental toxins are hormone disruptors and affect the hypothalamic-pituitary-adrenal (HPA) axis and cortisol. I’m addressing this with active detoxification and my portable infrared sauna.
High blood pressure and likely higher cortisol too after drinking too much licorice tea for my voice loss. I have stopped the licorice consumption and my blood pressure is back to normal.

Other possible causes of high cortisol include day to day stresses, food sensitivities such as gluten, high sugar consumption, parasites and so on. Each factor needs to be addressed.

I do recommend Salivary cortisol testing before using Seriphos

Salivary cortisol testing is something I do with all my clients anyway. And I do recommend salivary cortisol testing before using Seriphos and the other cortisol-lowering nutrients mentioned below.

I will admit that I didn’t follow my own recommendation because I’ve had high nighttime cortisol in the past and recognized the symptoms. I had also identified all the above root causes and I desperately needed to sleep. I now have an adrenal saliva test kit on hand and will report back when I get the results.

Seriphos will only work for waking in the night if cortisol is high

One woman shared “I have never slept through the night in years. It would be delightful to get to the morning without waking.” Seriphos will very likely help if her cortisol is high.

Keep in mind there are many causes of not being able to sleep through the night and Seriphos will not help if cortisol is not high. Other root causes for insomnia/waking in the night (and nighttime anxiety) we consider and investigate are:

Low GABA and low serotonin (I always start with these while waiting for salivary cortisol results to come back),
Low melatonin

The following factors need to be addressed as root causes of sleep issues, anxiety and other symptoms (like gut issues, pain etc.), and also keep in mind that they are very possibly contributing to your high cortisol too:

Gluten and other food sensitivities
Caffeine and sugar intake
Oxalate issues and/or toxins exposure affecting bile production (this affected my sleep last year)
EMFs
Parasites and other gut issues like IBS/SIBO etc.
Disrupted circadian rhythms connected to liver/gallbladder/bile issues – more on that and bright light here. (Research does support a connection between high cortisol and cholestasis i.e. “stagnation, or at least a marked reduction, in bile secretion and flow.”)

A few folks reported they had tried Seriphos without success and it may well be that they don’t have high cortisol. Or they would possibly benefit from another approach to lower their cortisol (more on this below).

What are my options if I have high cortisol at night and Seriphos has the opposite effect?

One person said it had the opposite reaction. Joanne shared this: “Seriphos had the opposite effect on me. [One Seriphos] gave me extreme anxiety, kept me awake all night. Saliva tested consistently high cortisol at night so it should have helped. Been trying to work out why it would and how it might inform how I treat my insomnia.”

I’ve had a few clients do better with less than the recommended 3 per day and one not being able to use it at all. I suspect an allergic reaction or that it’s just too high a dose for some folks. The capsule could be opened and less could be used.

If this doesn’t work, other options for lowering high cortisol include lactium/hydrolyzed casein, Relora® (which contains Magnolia officinalis and Phellodendron amurense), essential oils such as bergamot and some herbal adaptogens. You can also read about some phosphatidylserine products I looked into when the Seriphos product was changed.

Forest bathing also helps to lower high cortisol levels and I recommend it for everyone.

Where does using Seriphos fit into everything else that I’m doing to address my insomnia and/or anxiety?

I typically don’t start with Seriphos right away with clients unless we know cortisol is high. As mentioned above I always start with assessing for low GABA and low serotonin and we do trials of the respective amino acids based on the symptoms questionnaire.

I also assess for low blood sugar and dietary factors like gluten, caffeine, sugar, quality animal protein intake etc. as covered in my book “The Antianxiety Food Solution.” More about my book here. It does include a chapter on the amino acids and how to use them too.

Then we start to dig deeper and would consider Seriphos or lactium for anxiety caused by high night time or even high morning cortisol or high cortisol at other times of the day.

With many folks all of the above often applies. And we continue with assessing for each of the 60+ nutritional and biochemical root causes of anxiety/waking in the night (which does include liver/gallbladder/bile issues).

Where do I purchase Seriphos and how much do I use? What about taking a break?

You can purchase Seriphos from my online store (Fullscript – only available to USA customers – use this link to set up an account) and you can also find it on iherb (use this link to save 5%).

The bottle states to use 1 capsule with water 15 minutes before a meal. Clinically, using 1-3 capsules a few hours before the high cortisol seems to be most effective. For 2-4am waking this typically means taking Seriphos right before bed. In some instances, taking 1 on waking in the night can help too (for a maximum of 3).

With high cortisol in the night and on waking, I have clients use Seriphos before bed and lactium on waking.

It is recommended to take a one-month break after 3 months of Seriphos use. Ideally, once the root causes of high cortisol are addressed, you should be able to stop anyway. Or take a break, retest cortisol and then continue.

I’ll share some research and how Seriphos differs from phosphatidylserine in a follow-up blog if there is enough interest.

I appreciate all the feedback from these women in my community.

Have you used Seriphos (a phosphorylated serine product) to help with high cortisol and waking in the night/nighttime anxiety caused by any of the?

What do you suspect the cause(s) of your high cortisol is or was? And have you confirmed high cortisol with a saliva cortisol test?

Have any of the other products mentioned above helped to reduce high cortisol? If yes, have you compared them with Seriphos?

Let me know if you’re interested in a follow-up blog that includes some research and how Seriphos differs from phosphatidylserine.

Feel free to share and ask your questions below.

Night eating syndrome: is low serotonin a root cause and is tryptophan a solution?

April 9, 2021 By Trudy Scott 28 Comments

According to this paper, Circadian Rhythm Profiles in Women with Night Eating Syndrome, “Patients with night eating syndrome (NES) – first described in 1955 – demonstrate a phase delay in the circadian pattern of food intake, manifested by evening hyperphagia, nocturnal awakenings with food intake, and morning anorexia.”

I would start by asking this question: is low serotonin a root cause and is tryptophan a possible solution? I’ll share why below and where to start in order to find a solution.

Before I do that let me explain the terminology used in the above quote: Circadian means it happens every 24 hours, hyperphagia is obsessive food-seeking behavior, nocturnal awakenings are waking in the night and anorexia refers to restricted eating in the morning.

There is no research supporting the use of serotonin support with either tryptophan or 5-HTP for night eating syndrome but I would still start here for the following reasons:

this behavior happens in the evening and at night and it’s well recognized that serotonin levels are lower later in the day and at night
carbohydrate cravings and addictions occur with low serotonin and cravings are most intense later in the day (typically afternoon and evening)
obsessive behaviors are common with low serotonin
insomnia or night-time waking is a common symptom with low serotonin
doing a trial with either of these amino acids will very quickly confirm if low serotonin is a contributing factor or will rule it out

I would also have my client look at other low serotonin symptoms which would help confirm that low serotonin may be a factor for them: worry-type of anxiety, ruminations, PMS, irritability, rage or anger, TMJ, panic attacks, perfectionism, depression, low self-esteem and so on. You can see all the low serotonin symptoms here.

We typically start with a trial of tryptophan simply because so many of my clients do so well with it. The other reason is that 5-HTP can raise cortisol and cause a wired-tired feeling. That being said, some folks do better on one vs the other so if tryptophan doesn’t help then we trial 5-HTP. You can see the products I use with my clients here on the supplements blog.

I would love to see tryptophan or 5-HTP being more extensively – because it works so effectively and quickly, and is addressing the root cause – but also because there is research that does support the serotonin connection to night eating syndrome:

Night eating syndome has been associated with “depression, emotional eating, sleep problems, and food addiction as well as with being overweight or with having obesity (especially as people age)” – all low serotonin symptoms.
Night eating patients are “responsive to selective serotonin reuptake inhibitor treatment” (antidepressant/SSRI treatment)
Bright light therapy may help with night eating because of it’s “serotonergic antidepressant mechanisms of action.” Night eating syndrome also shares features with seasonal affective disorder (SAD) and it’s not uncommon to experience both. The winter blues or SAD is common with low serotonin. I write more about SAD and bright light here.

I’d also consider low blood sugar as a contributing factor. We would need to rule out the use of the sleep medication Ambien/Zolpidem which has been shown to cause amnesia and sleep related eating disorders which resolves when the medication is stopped.

As always, it’s not only the low serotonin we need to address. Tryptophan or 5-HTP offer quick relief but we must always do a full functional workup looking at diet, nutritional deficiencies, digestion, all hormones, toxins and infections (and so on) so we can address all possible root causes – and why serotonin is low in the first place.

I share some possible reasons for low serotonin on this blog on imposter syndrome. Imposter syndrome is another common sign of low serotonin.

Have you been diagnosed with night eating syndrome or do you feel you possibly fit the profile? Does it happen every night and what foods are you drawn to? Which low serotonin symptoms can you relate to and has tryptophan or 5-HTP helped? What about light therapy? And was an antidepressant prescribed?

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

Tryptophan and melatonin make a big difference but why do I still wake at 4am?

August 26, 2016 By Trudy Scott 113 Comments

waking-up-early

I get many questions on the blog about problems with sleep: not able to fall asleep, not waking rested and waking in the early hours and not being able to go back to sleep. By far the most common question is “Why do I still wake at 4am and can’t go back to sleep?”

So let me share one of the typical questions I receive and my feedback in the hope that something you read here may help you or someone you’re working with. Here is the question:

I purchased Lidtke l-Tryptophan and time release melatonin and notice a big difference in my sleep. Instead of waking up every two hours I’m sleeping better but still wake up at 4 am and can’t get back to sleep. GABA hasn’t helped. What can I take to get back to sleep and what are your thoughts on Seriphos Phosphorylated Serine? I think my anxiety has to do with my adrenals because I wake up in a sweat and am way past menopause.

Since she is seeing a big difference with tryptophan and timed-release melatonin, low serotonin is the likely root cause of her insomnia or at least one of the root causes. We always want to capitalize on what is already working. Too many people don’t see expected results with 1 x 500mg tryptophan at bedtime and 1mg timed-release melatonin and start looking for other solutions when the answer may be right in front of them.

Here are the steps I’d follow with a client with similar sleep challenges:

Try more tryptophan, increasing it slowly over the course of a few weeks in the hope that it more will provide more serotonin support. This is what I call an amino acid trial where you rate and log your improvements as you incrementally increase – with the goal of finding an optimal amount for your needs. We all have different needs and post menopause it’s not uncommon for women to experience anxiety, depression and insomnia related to low serotonin and fluctuating sex hormones. We also always want to capitalize on what is already working.
Also, to add to what’s working, add tryptophan mid-afternoon if it’s not already in place. When someone scores high on the low serotonin questionnaire the typical timing of tryptophan is mid-afternoon and an hour before bed (always away from protein). Serotonin levels start to decline mid-afternoon hence the benefits of a mid-afternoon dose. Start low and increase slowly.
I would also suggest trying the tryptophan opened up (at both times) to see if this makes a difference.
Taking a tryptophan at the 4am waking can help you go back to sleep so this is worth trying. For some people 500mg at 4am is too much and using 125mg or 250mg works well. You determine the amount based on how you feel when you do get up. If you were able to go back to sleep easily buy wake groggy then it’s too much.
Some people are reporting better results with Lidtke Tryptophan Complete (which has all the co-factor nutrients) so this may be worth trialing too. I’d start by adding to what is already in place.
If we get benefits with any of the above by are not quite there then I would suggest additional timed-release melatonin until sleep improves.

This is always done slowly and methodically over the course of a few weeks. I always have my clients carefully log what they try and what is working and not working.

Other factors we’d make sure are addressed:

What GABA was used, was it trialed (starting low and increased) and was it used sublingually?
Is high cortisol at night a factor? Doing an adrenal saliva test will provide the answer. If it is then the Interplexus Seriphos is the best for lowering it. It’s best to take 1-3 x Seriphos about 2-3 hours before the high cortisol. [UPDATE: INTERPLEXUS SERIPHOS WAS REFORMULATED IN 2016 – PLEASE SEE BELOW FOR MORE ON THIS]
Is gut health a factor? Look into SIBO, gluten sensitivity, other food sensitivities, dysbiosis and parasites (which are often active in the early hours and can cause night sweats)
Is there a sex hormone imbalance? Even with someone way past menopause, the night sweats mean this should be ruled out. The addition of amino acids starts to balance the hormones but more support may be needed.
Is any caffeine (even decaf) still being consumed?
Is blood sugar stable? Make sure to have breakfast with animal protein and healthy fats and the same at each meal and for snacks. Consider a trial of glutamine during the day and just before bed for added blood sugar stability
Are medications a factor? Current medications or prior use of benzodiazepines or SSRIs can affect sleep even long after they have been tapered.
Is sleep apnea a factor?

We also address all the usual sleep hygiene factors: dark room, cool room, quiet room, no cell phone or clock radio on the bedside table, no late night computer use and getting some early morning light.

Many essential oils can provide added benefits when diffused at night or mixed with a carrier oil and used topically. One lovely combination I share on the Essential Oils Revolution 2 (happening now) is lavender, roman chamomile and neroli which helps both insomnia and anxiety.

There can be many other possible root causes of insomnia: autoimmunity, Lyme disease, pain, past trauma or grief and even genetic polymorphisms, all covered on the recent Sleep Success Summit.

Have you used tryptophan or other amino acids like GABA (for the more physical tension) and melatonin to reduce or eliminate early morning waking episodes?

If you’re a practitioner, have you helped your clients/patients with this methodical approach?

What else has helped you?

Update August 27, 2016 : INTERPLEXUS SERIPHOS HAS BEEN REFORMULATED -I am doing research to find suitable alternatives. For now, feel free to read through the comments below for discussions about this. Once I have some useful information I’ll create a new blog post.

Update November 18, 2016: Here are some possible alternatives to Seriphos

Update January 20, 2017: The Original Formula of Seriphos has been reintroduced you can read more about this here