Today I’m going to share my feedback on a question I received on how to approach working with a child with anxiety, compulsive thinking and counting behaviors in the hope it can help you or someone you know (or are working with if you’re a practitioner). Here is the question:
Regarding anxiety and compulsive thinking/OCD counting behaviors in a 12 year old, have you experienced (or heard through client sharing) a correlation with certain foods or inflammatory compounds? In a younger person, I am trying figure out the triggers if there is low production of certain neurotransmitters driving the symptoms. This child in particular has had a long history of allergies and terrible asthma (requiring nebulizer treatments) so I’ve long suspected food sensitivities as a driver for systemic inflammation but am trying to connect the dots for her parent. The counting seems to be a distraction of sorts for her – I assume following a triggering thought. This parent is very new to integrative therapies so treating with an amino acid is going to *feel* like she’s not doing enough as parent. Standard talk therapy has not helped.
This is how I responded and it’s how I would start to work with a parent with a child with these types of issues.
After looking at the basics to make sure the child is eating real whole food with no additives, is not consuming any caffeine and is getting quality animal protein at breakfast (to keep blood sugar stable and reduce anxiety), I always consider gluten and even dairy and other food intolerances. I write about the success of a gluten-free diet with a 7 year old boy in this blog: Integrative Medicine Approach to Pediatric Obsessive-Compulsive Disorder and Anxiety. He saw a “marked reduction of OCD symptoms and anxiety along with marked improvement of social behavior and school work.”
OCD and counting behaviors are classic low serotonin symptoms and her anxiety could be the low-serotonin worrying type or the low GABA type which is more physical anxiety. I’d have them do the amino acid questionnaire
I’d start with a trial of tryptophan – using 100mg of Lidtke Chewable Tryptophan – to help with the OCD, counting and worry-type anxiety. If it helps, I’d have her use it twice a day mid-afternoon and evening, increasing it over the course of a few weeks to find the ideal amount for symptom relief (and keeping a food mood log to record doses and symptoms).
Some people do really well with tryptophan, others do better with 5-HTP for low serotonin symptoms, so doing a trial with 25mg of 5-HTP would be an option if the tryptophan doesn’t help as expected.
I would carefully review the precautions with the mom as tryptophan and 5-HTP can sometimes be an issue with asthma and may need to be lowered or discontinued.
Inositol can be added if additional nutritional support is needed for the OCD and counting behaviors and may even be needed to replace the tryptophan or 5-HTP if either one triggers asthma. The maximum dose in the research is 18g of inositol per day and I start at 2g once a day and increase slowly over a few weeks to find the ideal dose. Here is feedback from one mom on how inositol alone helped her son with migraines, stress, anxiety and OCD
Once we’ve figured out nutritional support for the low serotonin symptoms then we’d address low GABA if needed, using sublingual GABA. [Update Nov 17, 2017: I mentioned GABA as a possibility but with her symptoms and the new GABA research on intrusive thoughts, a GABA trial would definitely be something to pursue]
I found this comment to be rather unusual: “treating with an amino acid is going to *feel* like she’s not doing enough as parent.” The parents I work with are thrilled to discover how powerful the amino acids are and how quickly they provide amazing results.
These other factors would also be addressed: possible high cortisol, gut health and any of the other possible contributing root causes. I also always keep Lyme disease, heavy metals and PANDAS on the list as possible areas to refer out for if symptoms are not resolving with the above approaches.
Here are links to the amino acid questionnaire, the precautions and the supplements:
- I have my clients complete the Amino Acids Mood Questionnaire from The Antianxiety Food Solution and check off their symptoms in each of the sections. The rating uses scale of 1-10 with 10 being worst.
- I also have my clients review the Amino Acids Precautions and we figure out which amino acids they can and can’t use
- These are some of the supplements I use with my clients
Have you used any of the above approaches with your child or for your symptoms or for a client/patient?
Hi Trudy
What are your thoughts on using a 5htp or tryptophan with someone you has suicidal ideation on any ssri’s?
Tracy
If someone has suicidal ideation on SSRIs this needs to be discussed with the prescribing physician immediately. This is a common side-effect and very serious. I don’t work with individuals who have suicidal depression/suicidal ideation but would assume that the prescribing doctor would not approve the addition of either 5-HTP or tryptophan.
In addition to gluten, consider casein. Does the young girl drink a lot of milk and says she loves milk?
Here are a few papers which link casein to mental health problems.
Immune activation by casein dietary antigens in bipolar disorder. Bipolar Disorders 2010
Association between bovine casein antibody and new onset schizophrenia among US military personnel. Schizophrenia research 2011.
Dietary antigens, epitope recognition, and immune complex formation in recent onset psychosis and long-term schizophrenia. Schizophrenia Research 2011.
Subunit and whole molecule specificity of the anti-bovine casein immune response in recent onset psychosis and schizophrenia. Schizophrenia Research 2010
Psychiatrist, Dr James Greenblatt links both dairy and gluten to depression, anorexia and anxiety.
http://www.integrativepsychmd.com/james-greenblatt-md.html
here he explains how gluten and casein form neuropeptides which can cause mental illness
http://vimeo.com/19231456
All the best
Theresa
I do say “I always consider gluten and even dairy and other food intolerances” – so yes this would be considered as well. Thanks for sharing these papers and links.
Especially with the chronic asthma- I would make sure she isn’t living in mold! All of those symptoms can be related to mold exposure as well……
Jill
Absolutely! This would be looked at on a deeper level together with the 60+ other possible root causes I outline here https://www.everywomanover29.com/blog/60-nutritional-biochemical-causes-of-anxiety/ Even if it is mold the basic food changes and nutritional support will often go a long way to ease anxiety and OCD symptoms while the bigger issue of mold is being addressed. This is the joy of the amino acids – they so often provide relief right away.
My 11 year old son has had anxiety and depression and also a heart condition called SVT. He started having the heart racing this year and has had anxiety and depression along with it. The worry about his heart racing has caused severe anxiety. He went off gluten dairy and sugar and any grains for a month and has added back gluten as it was causing such stress about what he could eat. He is still off most dairy. He is taking 5htp at a high dose of 150 mg along with b6 and b22, methionine, probiotics, vitamin D and l theanine occasionally. Is this overkill? The dose of 5 htp seems high. He has been a lot happier, less anxiety lately. Still worries about his heart racing but is able to go to school and play with friends which is a world of a difference from several months ago.
I am just wondering how long he should be on the 5htp.
Wendy
I have had a number of clients on 150mg of 5-HTP and as long as they are happy and not anxious we know they need it. I am not familiar with SVT and any possible issues with the the amino acids so can’t comment specifically about your son.
Nutrition is super important a certified naturopatic nutritionist can change his diet and help you a lot i recomend you to get in to doctoryourself.com and find a good one…good luck and shalom!
The etiology of this young girl’s agitational and compulsive symptoms needs to be defined. The infectious causes of inflammation need to be ruled out. If infection is at the root of her encephalopthic symptoms, the earlier it is detected and treated the better her chance of recovery. Does she have a history of documented Strep throat infections? Does she have a history of tick exposure? Has she had exposure to flea bites or scratches from feral cats or outdoor pets to suggest Bartonella exposure? The list of infections capable of causing a PANS/PANDAS type encephalopathic picture in adolescents is rapidly expanding and includes Bartonella,other bacteria, Mycoplasma, various viruses, not just strep.
ASO and Anti-DNAse-B titres, a Moleculera Cunningham anti-neuronal antibody panel, Bartonella IgG titres, and mycoplasma titres, would be worth considering.
Prominent PANS/PANDAS neurologists have commented that intervention with SSRI’s (used by psychiatrists for “OCD”) more often makes PANS/PANDAS kids WORSE. which would be expected because they, like this girl, already have clinical evedence of neurotransmitter excess.
This girl is suffering, she has clear symptoms of brain inflammation, and deserves a careful address of the possible etiologies of that inflammation, including infections high on the list.
Dr John
I always start with the basic nutritional support as outlined in my blog post and much of time we see complete resolution of symptoms. It’s quite amazing what dietary changes and addressing various nutritional deficiencies can do.
I document further examples on Paleo and grain-free diets here https://www.everywomanover29.com/blog/paleo-grain-free-anxiety-depression/
I’m sure you’re familiar with the recently published SMILES trial (the first randomized controlled diet depression study where ONE THIRD of the dietary intervention group saw improvements in their depression symptoms by switching from processed/junk food to real food with no specific dietary restrictions https://www.everywomanover29.com/blog/smiles-diet-depression-trial-reduced-depression-anxiety/
When we don’t see results with nutritional support then we dig deeper and I refer out for assessment and treatment for infections, mold, heavy metals and other areas that are outside of my scope of practice as a nutritionist.
Thank you for contributing to the discussion and adding so much about infections and testing. I just recently learned about Moleculera Cunningham anti-neuronal antibody panel. I’m going to reach out to you as a referral source.
I agree with you about SSRIs often making PANS/PANDAS kids worse. It’s very unfortunate that these meds and benzodiazepines are so frequently prescribed for OCD and even autism, social anxiety, panic attacks and other mood issues that have a nutritional or infectious cause.
What child who can’t breathe which such severe asthma wouldn’t have anxiety? She’s not in control of her own life and survival which must be scary for her. From reading between the lines her mother might be hovering a bit too much for her liking. Normal in such a situation but might be stressful for the child. I wonder what kind of birth she experienced. There is not much to go on here. If talk therapy was useless (usually is), it could be something she doesn’t consciously remember that is triggering her.
In addition to what you said Trudy, and I love amino acids and have for many years, I would have the child take a teaspoon of black seed oil 2-3 times a day to support her immune system and lungs so the asthma gets under control and definitely get tested for allergies using something like Vega, SCIO, EAV or similar device. Getting tested by such a practitioner would also rule out other possibilities as suggested by Dr John. The child may just need a good colon cleansing since the colon is energetically connected to the lungs. Oddly enough as little as one colonic has eliminated asthma in some people!
Sharie
Thanks for contributing to the discussion and yes immune support and addressing gut health is always key for asthma, as are changes to an anti-inflammatory real whole-foods nutrient dense diet. Of course looking at vitamin D levels, using zinc, vitamin C and eliminating exposure to household and environmental irritants.
Not sure how helpful this will be, but this was me as a teenager. As a child I had severe asthma—was hospitalized three times and by the time I became a teen I had intense OCD counting behaviors everytime I would walk. It felt like I was losing my mind. I would do it in my head and I kept it to myself because my situation wasn’t very emotionally safe. At that time I was eating gluten/dairy and a vegetarian. (I now stay away from gluten dairy and eat healthy meats). Anyhow, I’m not advocating to just leave it, but I was tormented by the counting until I actively tried to make it stop. It was like holding my breath for to long. I felt as if I was going to die, but little by little it did lessen and then completely stop. It wasn’t a diet change, instead it was like an active mind game I did with myself. It was very scary for me and it took time. I’m glad this teen has so many people trying to figure out how to help.
Suz
Thanks for sharing – I’m really glad you were able to overcome the OCD with the mind. This can be incredibly difficult – as you’ve described – and impossible for many.
I have been on the SSRI Serzone for 20 years., and .5mg of xanax for the same . I have titrated down to only 150mg of Serzone over a period of a year. I am down to .0125 of the xanax, at bedtime. There is no one to offer guidance on going lower naturally. I have your book, and am reading it currently, Trudy. I have inositol, and GABA currently, but am looking for guidance on the other supplements,. My diagnosis has been GAD, with prior panic attacks. I’m dismayed and very discouraged to find out how hard it is to go off these completely. My worst panic attacks happen while I’m driving .its very very distressing! Can you give me encouragement and guidance , please Trudy? Thank you I find I hold much tension in my body since cutting back.
Hey everyone, Trudy wanted me to share what I mentioned on her Facebook post for this article, I mentioned how a protocol called quicksilver really finally seems to be healing my anxiety, panic, autistic symptoms, and seizures, and really put me in a wonderful normal mental state. Chris shade is the dr who was unhappy with Mercury testing and created his own test and his own supplements, that are much safer than chelation.
I followed trudys recomendations for years, I was not getting worse but, I was not getting better until starting this protocol with a quicksilver practioner. Their IMD supplement pulls Mercury, and aluminum out of the intestines first, and one should not even try this until they clear their liver and kidneys which they know what works to open these pathways and allow the IMD (intentional metal detox) to take the metals completely out of the body, i also found for me a temporary low fat whole food diet is helping to clear those pathways, my liver does much better on fruits and veggies, but I hope to return to mineral rich meats in the future.
I am so stable on this more than the high fat paleo diet and typical metal toxification supplements never could do. So I am getting my silver fillings removed and will be able to move to the next step of the protocol, which includes alpha lipoid acid and other things. Chris shades information helped me realize why I would be so mental and crazy, just Terrible when I had any chealating substances, like alpha lipid acid, spirulina, even cilantro. It was because I had no open detox pathways, at that time. Anyone who has any neurological or psychological issues should definitely check out the quicksilver Facebook page, the group gives so much ch support, there are some chris shade podcasts that are very Interesting too
My 17 year old daughter who had dysautonomia caused by Ehlers Danlos, a connective tissue disorder is having adrenaline type surges causing extreme nausea. She is also homozygous for mthfr c677t and suffers with anxiety and depression. We’re looking for something to keep her thought invoked nausea in control. She’s using guided meditation but its not helping. Would Gaba be a good first start? Thank you kindly
Kristwn
I’m sorry to hear about her nausea. I’d look into pyroluria as it seems common with EDS and nausea is often a factor. The protocol is also helpful for many EDS symptoms too – more here https://www.everywomanover29.com/blog/joint-hypermobility-ehlers-danlos-syndrome-pyroluria/
For anything “thought-invoked” I’d look into low serotonin (https://www.everywomanover29.com/blog/tryptophan-worry-head-ruminating-type-anxiety/) first but with anxiety I always look at this and the possibility of low GABA (https://www.everywomanover29.com/blog/gaba-physical-tension-stiff-tense-muscles-type-anxiety/)
Hi Trudy,
My Psycologist suggested Prozac for my OCD (obsessive thoughts, anxiety, worry, depression). I immediately said no. She then suggested Inositol as a natural option.
I’m 38 yo and I’m 6 months postpartum and currently breastfeeding. I’ve searched all over the internet to find out if Inositol is safe to take while breastfeeding but I can’t find anything confirming it. Do you know?
If you don’t have any information on Inositol, perhaps you may know about 5HTP, GABA or Tryptophan being safe while breastfeeding? Out of these 4 options, which one do you recommend most for OCD?
Thank you!!
KL
It’s wonderful to hear your psychologist recommended inositol. Unfortunately none of the nutrients have been studied during pregnancy and there is only one study on tryptophan being used during breast-feeding https://www.ncbi.nlm.nih.gov/pubmed/25823693. With the doctor’s approval some nursing moms will nurse and then use one of the amino acids or inositol right after and then not nurse for 4 hours, always watching baby for any adverse effects. For OCD I start clients on tryptophan based on the trial method and then we add inositol once we’ve reached the idea tryptophan dose.
Hi Trudy,
Thanks for all the great blogs you post. I have your book and enjoyed it! I bought the Lidtke Tryptophan but I have a tendency towards stomach pain and peptic ulcer, due to stress no doubt. In the precautions it says not to take amino acids if this is the case. Do they irritate the stomach? And what if you take them sublingually like opening the tryptophan capsule? Thank you
Marilyn
I’ve seldom had folks notice issues with tryptophan although this is a precaution. I do a trial and we see. Using them sublingually would avoid the issue if it does become and issue. I’m finding my clients do better doing it sublingually anyway
Hi Trudy,
Thankyou for your articles which have helped me to address what I suspect has been lifelong anxiety. I had thought I was knowledgeable about nutrition and lifestyle and was just a nervous person, however after following some of your suggestions from Amino Acids 101 for Anxiety and Gut Health I have found a degree of calm which I had thought was not possible.
Thankyou once again from the bottom of my heart, please keep up the amazing work that you do.
Gillian
You’re not alone – many folks just think they’re a nervous person and won’t be able to change especially when it’s been a lifelong thing. I’m thrilled to hear you’ve found a degree of calm which you had thought wasn’t possible! And so pleased you’ve taken the time to share here with me and my community (who you are inspiring and giving hope!)
I’d love to hear about some of the changes you made and what made you decide to make changes after all this time?
Hello again! Thank you again so much for all of your work. Do you go into detail anywhere about the possible strep infections causing OCD and anxiety? I have sudden onset severe anxiety (tryptophan worked ok but made me extremely groggy during the day, trying GABA now and feeling somewhat normal so hoping this works). Anyway, I also have a history of strep throat that I never considered and have even been experiencing a chronic, mild sore throat for a while. My functional medicine doc even noticed my tonsils were inflames last visit and gave me some injections in them. I would love to know how strep throat can contribute to anxiety and OCD.
Rae
Check this blog out https://www.everywomanover29.com/blog/kid-not-crazy-panspandas-awareness-day-2017/
Thank you for always replying! I’ve just tried the GABA by the way and have to say I really think I’m liking it. For some reason my anxiety seems to only happen later in the afternoon into the night. I was certain my anxiety was physical but my doctor started me on the tryptophan first anyway and while it worked at first, it never felt as “natural” as the GABA does and then eventually it gave me deja vu. I felt sedated, GABA just makes me feel even. I’ll be starting on a bioidentical progesterone cream next cycle so hopefully that’s the ticket.
Rae
Wonderful to hear! We are all different and sounds like you have found your solution!
Hi Trudy,
I’m 1 week into the program and it’s helping me. Thank you! I am sensitive so I’m careful with my dosing. My Mum (also sensitive) is 20 years into Parkinson’s Disease. Looking at the family history with anxiety I’m wanting to see if the amino acids might help her but I’m waiting to get specific instructions on how she might trial them safely and it may not be a route we can take. Then I came across some information regarding GABA and Serotonin being in the Rehydrate tincture by Physica (a high quality homeopathic preparation) and this may be a safer way for a heavily medicated suffering PD person to trial the GABA and serotonin because they could drink the tincture in water and it’s in a homeopathic form. Sorry there’s a lot here but I’d really appreciate any feedback/info you’ve got with PD patients. Sorry it’s hard for you to comment on my Mum as her health issues would need to be explained further plus her medication but with her medication it’s really hard for her to remember to take it and then swallow it and she’s on so many pharmaceutical medicines. But she really needs help with her anxiety so I’ve been thinking how this could all be approached. Then I remembered the rehydrate and thought you’d be interested in knowing about it if you don’t already! The company is Physica Energetics and the tincture is Rehydrate. However ultimately I’d like her to suck the GABA, tryptophan as per the program but I have to wait on her specialist. Best wishes, Daisy
Daisy
Really glad to hear the program is helping you and you’re being careful with your dosing! It’s wonderful you’re seeing the possibility of helping your mum too.
The product you mention is new to me but looks interesting. If the doctor was willing I would consider using it with someone with low GABA and low serotonin anxiety symptoms, both of which are common in Parkinson’s disease. I blog more about this here https://www.everywomanover29.com/blog/gaba-tryptophan-pain-anxiety-parkinsons-disease/. Perhaps you can share this with her specialist. Please do keep me posted on how things go.
Hi Trudy,
I’m struggling with intense anxiety. Used to be only in the morning and get better by early afree noon, but after an immense amount of stress, I’m in the stress response repeatedly, having panic attacks, constant tummy upset, racing thoughts, bouts of crying, body throbbing.
Mine is considered a complicated case, as it all started with an overdose of prednisone in the hospital 4 years ago. I’ve had a hysterectomy, but am perimenopausal, recently diagnosed with CIRS due to mould exposure, and very sensitive. I also have tested borderline for pyrroles, and had a copper dominance. I am taking inositol, Silexan lavender, theanine, bio identical progesterone, magnesium, Vit C, P5P, hydroxycobalamin, and Zinc. I was given lorazepam to deal with panic attacks but try not to use it. I don’t know if this is best, but I don’t want to become dependent. Lately when I’ve used it, it’s created a panic attack. My body is so sensitive I react to things and have a lot of food allergies.
I’m from Canada and working with a naturopath from Arizona who’s fantastic. She’s helping me with my CIRS and other issues, but in the past month, my anxiety has gotten out of control and I don’t know how to fix it or stop the cycle. My local MD had said she doesn’t know how to help me and only offers SSRIs or a trial of buspar as a solution, but says she hesitates given how sensitive I am. I don’t know how to get relief right now. I was in the middle of a RTW when covid hit and had a lot of stress that’s built up and taken it’s toll. I am desperate for help after suffering horribly for 4 years.
Do you have any suggestions? I desperately need help right now. Do I need to take a med to stop this immediately??
Thanks,
Angela
Angela
I’d discuss doing trials of the amino acids with your naturopath – I prefer tryptophan to 5-HTP which can be stimulating for some. Some folks have had issues with phenibut in the past but starting low on GABA and increasing slow works well for my clients. I also look at high cortisol. Keep in mind even small amounts of a benzo can trigger anxiety.
I should also add that I’ve tried 5-HTP before and with a small amount my pupils dilated and I had to run to the bathroom.
I also used GABA 4 years ago which was fine initially, then after stopping it for awhile and restarting, it gave me anxiety where I couldn’t sit still, so my naturopath told me not to use it anymore. I don’t know if my body would accept it again now as chemistry changes…???
I also take Omega 3 fish oil daily.
Wow!! I am 69 years old and totally disabled with ME/CFS/FM for 25 years. I have never heard anyone address ‘counting behaviors’!! I thought I was nuts. Whenever I had pushed my physical limits, I would find myself counting. I thought it was very strange, and it wasn’t hurting anything, so I just counted away!! Usually started around 90 and counted upwards from there! I haven’t been able to take GABA products, or anything methylated, but tryptophan has been a life saver for my sleep. I had stopped sleeping when I got sick. I learned about it from Trudy’s site. I haven’t been doing any counting for some time now.
Myoldmill
Wonderful to hear tryptophan has been a lifesaver for your sleep and it seems the counting behaviors too 🙂 It’s never too late to learn new things and also never too late to heal so keep learning
Thanks to you, Trudy Scott!!
Hi Trudy
How do you feel about the use of NAC with 5HTP or L tryptophan to help
With ocd / constant ruminations ?
John
NAC can be a very helpful addition in some cases. I blog about NAC here https://www.everywomanover29.com/blog/trichotillomania-nac-gaba-tryptophan-inositol-zinc/
This is great information thank you so so much! As parents we often feel like we aren’t doing enough to help our children or that we are failing them. I have seen an improvement in my daughter (6yo with ADHD/ODD) with gaba and L-theanine. I believe additional supplementation could be beneficial and would you recommend either 0.5 or 1mg lithium orotate or tryptophan/inositol as a starting point? We have removed gluten and dairy from the diet which did make a noticeable difference with the ODD.
Thanks!
Tara
So glad to hear gluten and dairy removal has led to some changes already. I encourage you to continue with the dietary changes and blood sugar balancing. All this often has a huge impact with children. Glad to hear GABA and theanine is also helping.
I can’t comment with specifics on the blog and it also depends on which symptoms are needing to be addressed. I can share I do use tryptophan with success with low serotonin symptoms and add inositol when that isn’t enough. I may add lithium orotate once the foundations are in place.
I also responded on the other post (https://www.everywomanover29.com/blog/the-antianxiety-food-solution-by-trudy-scott/)
THANK YOU!!! This information has been life changing for myself (anxiety and possibly pyroluria – being tested) and I am forever grateful!