Women's health

Fran suffered from proctalgia fugax alarmingly frequently for over 10 years: GABA is the only thing that helps and has absolutely changed her life

October 4, 2024 By Trudy Scott 4 Comments

Trudy, your information about GABA has absolutely changed my life. I was suffering from proctalgia fugax alarmingly frequently over the last 10 + years, not just during the night but also during the day, at work, while driving, anywhere… which caused so much anxiety and stress for me. I had many episodes where I had vasovagal episodes and passed out (which instantly resolved the symptoms but left me exhausted and battered.)

Now, because of your information I have a strategy that seems to work almost all the time- I take half a teaspoon of GABA powder sublingually as soon as I feel the twinge coming on. I sit on the ground in a safe place where I can either slump left or right without hitting my head (seriously! ).

I open the “breathing app” on my phone (free app) and focus on breathing in time with the inflating and deflating ball on the screen . I have more powder if the symptoms are not fading. Reducing the panic by controlling my breath is absolutely crucial, and the GABA powder short cuts the whole episode.

In the past, before GABA, I have had episodes that lasted over an hour. I have small tubs of GABA stashed in my handbag, gym bag, office, car etc. This has been the only thing that helped. Thank you

Fran posted this wonderful feedback about how the amino acid GABA, used as a supplement, is life-changing for her proctalgia fugax. If, like Fran and I, you’ve experienced these anal cramps (or butt cramps or anal sphincter spasms or “cramps in your bottom”), I know you can relate to how intense the pain can often be.

Today’s blog highlights more about this condition in case proctalgia fugax is new to you or if this application of GABA is new to you. I also discuss GABA dosing and some insights that may help Fran (and her son) get even more relief. And I share some of the latest research which unfortunately doesn’t offer much in the way of a solution.

How much GABA does Fran use?

I thanked Fran for sharing her wonderful success using GABA for proctalgia fugax. And I acknowledged how stressful it is to not know when the next episode will happen and then to be in such pain for over an hour in some instances. Like Fran, I’ve had a few clients also report passing out due to the pain.

She mentions using “half a teaspoon of GABA powder sublingually” as soon as she feels the twinge coming on. The key here is use it as soon as you feel the twinge of pain and using it sublingually like Fran does is perfect. Half a teaspoon of the powder is around 1500 mg GABA, which is a very high dose (a typical starting dose is 125 mg GABA).

I first blogged about GABA as a solution for my agonizing rectal pain and spasms in 2017. I find that 125 mg to 250 mg GABA works well for my needs and have had similar feedback from others in the community. I share this to illustrate the variability in the amount that may help.

For Fran, increasing the amount of GABA may help with prevention. But given the high dose she is already using I suspect that as time goes on and her GABA levels increase, it’s possible that her need to sit on the ground and use the breathing app may no longer be needed. She may find her GABA levels rebound with consistent GABA use throughout the day, even when she is not experiencing rectal spasms.

She does also mention feelings of panic so it’s possible that low serotonin may also be a factor. If this is the case then a trial of tryptophan or 5-HTP is worth considering.

GABA helps Fran’s son too

Fran added this PS to her comment:

Ps my 21 yo son has started experiencing these symptoms recently and he follows the process of taking GABA and using the breathing app and hasn’t had an episode last longer than a few minutes. I am so grateful that he hasn’t experienced a full blown episode of proctalgia fugax.

How wonderful that this helps her son too!

For both of them, I’d recommend trying to figure out what may be contributing to their low GABA levels and addressing those root causes. My book is a great starting point to address dietary factors, gut health, low zinc, low vitamin B6, toxins and infections that may play a role.

What is proctalgia fugax pain like and how is it treated medically?

This recent paper, Chronic anal pain: A review of causes, diagnosis, and treatment shares that “chronic anal pain is a relatively common problem affecting up to 11.6% of the US population.” Proctalgia fugax is one type of chronic anal pain and in this paper the pain is described as follows:

“Short-lasting (seconds or minutes) sharp deep rectal stabbing or cramping. No radiation. No anorectal pain between episodes.
The pain can occur night or day and vary in severity from uncomfortable to unbearable.”

It’s really disappointing to me that the solution offered is simply reassurance and an explanation:

From a treatment perspective, the problem with diagnosing proctalgia fugax is that symptoms are generally too brief or infrequent to treat. Thus, the key is patient reassurance and explanation, such as describing the condition as a “cramp in your bottom” that is harmless and not indicative of any serious bowel disease.

It may be harmless but I’ve had clients describe the pain as excruciating and agonizing, with many saying it’s worse than childbirth.

As you read above, these episodes caused Fran “so much anxiety and stress”, caused her to pass out and left her feeling “exhausted and battered.” I don’t know what her medical team told her but I believe we can do better than what these authors are proposing.

The first time I experienced a proctalgia fugax episode, I was terrified and beside myself, not knowing what it was or what to do. The pain was extremely severe and lasted about an hour. I eventually figured out the solution because I had used GABA for my own anxiety and to ease tense muscles and other kinds of pain.

GABA for anxiety, pain and muscle spasms (and more)

A number of studies have shown that “GABA is implicated in a large number of diseases including anxiety and stress disorders, pain, musculoskeletal disorders, sleep disorders, depression, addiction and withdrawal syndromes.”

It’s time that GABA supplementation is recognized and used more for pain, muscle spasms and anxiety – everything that Fran and her son experience. I’d love to get some cases like this published so we can get the message out in a bigger way and have the research catch up with what we are seeing clinically. If you know of anyone who could help in this regard please do comment below or reach out.

A few GABA product options – a sublingual, a powder and a cream

Fran used a GABA powder, possibly similar to Now GABA Powder (which does need to be measured out to provide a 125 mg typical starting dose). Keep in mind, some individuals need less to start and some like Fran may need more.

When using GABA powder I have clients use a handy mini measuring spoon like this one (my Amazon link) and share more about how to measure out GABA powder on this blog).

Source Naturals GABA Calm lozenges (a good low dose of 125 mg) is another GABA product I recommend and is helpful in cases of proctalgia fugax because of the lozenge instead of it being a powder that needed to be measured.

For Source Naturals GABA Calm lozenges and Now GABA Powder:

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, you can purchase these at iherb (use this link to save 5%).

Somnium GABA Cream used before bed may prevent an episode in the night and is less likely to stop an episode that is in full force. It is available in the US and elsewhere with international shipping. Read more about the product and who else may benefit from using a cream, and grab my coupon code to save 15%.

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 low GABA or other neurotransmitter imbalances may be an issue.

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.

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 Fran for sharing her success with GABA and the success her son has experienced too. I do hope this information has been helpful for you and for them too.

Now I’d love to hear from you – does any of this resonate with you? Have you had success like this with GABA? What solution has your medical team offered?

If you’re a practitioner is GABA one of the amino acids you use with your clients/patients?

Feel free to share and ask your questions below.

GABA works wonders for anal cramps (almost instantly) and relieves body aches in the hips and legs of a 75-year-old woman

May 17, 2024 By Trudy Scott 13 Comments

Dear Trudy, your recommendation of using GABA for anal cramps has changed my life. I don’t experience them often but when I do they are nasty. A crushed pill or open capsule on the tongue works wonders, almost instantly.

However, I want to add, after hearing your presentation on the Parkinson’s summit and your mention of relief from physical tension, that taking 500mg relieves body ache in hips and legs.

I’m 75, and have recently developed debilitating body aches. Taking one twice/day a.m. and p.m. has made a huge difference. Thank you for your brilliant blog.

Merril shared this wonderful feedback about how the amino acid GABA, used as a supplement helps her with anal cramps and also body aches. I never get tired of hearing feedback like this and as always, I like to share so I can educate further. This helps the person sharing the results and the community as a whole.

Today’s blog highlights more about the role GABA plays in muscle spasms and pain, and more about anal/rectal spasms in case this application is new to you. I also share other considerations when muscle spasms and/or pain are an issue: gluten, oxalates and low endorphins.

GABA works wonders (almost instantly) to eliminate anal cramps

I first blogged about GABA as a solution for agonizing rectal pain and spasms in 2017. I shared how I experienced the awful anal sphincter spasm and pain myself. The medical term is proctalgia fugax and is described as a condition that leads to rectal/anal spasms and sharp fleeting pain in the lower rectum or anus. In some people it can be more than fleeting and is often described as excruciating and agonizing.

The first time it happened to me I was terrified and beside myself not knowing what it was or what to do. I eventually figured out the solution because of what I knew about GABA helping to ease tense muscles and wanted to shine some light on this very painful condition.

As Merril says GABA “works wonders, almost instantly” to completely eliminate the pain. Take note that she says a “crushed pill or open capsule on the tongue.” GABA is most effective when used this way: sublingual GABA or GABA powder or liposomal GABA (and presumably GABA cream too).

GABA can also be used to prevent a full-on spasm if you catch it in advance i.e. when you first feel the twinges of a spasm coming on.

GABA relieves body aches/pain for her and in Parkinson’s patient

I love that GABA has the side benefits of also relieving her body aches in her hips and legs. It’s not unusual to use GABA or one of the other amino acids for a symptom and then discover it’s helping in another area.

And do appreciate that she picked up this tip when tuning into the Parkinson’s summit. I always share new information when I speak at summits and the amino acid and neurotransmitter information typically has varied applications.

During my summit interviews I had shared that working with a few people with Parkinson’s disease, GABA has been very helpful for the stiffness and pain, the physical anxiety, easing some of their tremors and helping with insomnia. I had one client whose husband had anxiety, insomnia, and leg pain and “thrashed around the bed at night.” GABA helped this man tremendously.

I shared this research: Molecular Imaging of the GABAergic System in Parkinson’s Disease and Atypical Parkinsonisms

A growing number of neuroimaging studies have focused on the association with different symptoms of Parkinson’s disease, thereby suggesting a GABAergic role in motor symptoms, gait disturbances, frontal cognition, somatic symptom disorder, and hallucinations.

Other ways GABA helps with pain and muscle stiffness

With regards to my comment above about GABA having many applications, when it comes to aches, pain and spasms, GABA helps with the abdominal pain of colitis, muscle stiffness and pain in those with multiple sclerosis and even bladder pain.

Gluten, sugar, gut health, and oxalates

She didn’t mention what her diet was like so just to be safe, I encouraged her to also check out my book “The Antianxiety Food Solution” to explore all the possible root causes that may be contributing to the anal spasms, pain and body aches – such as gluten (“tingling at 50%, numbness at 27%, pain at 20%, burning at 13% and “buzzing” feeling at 7%”) , gut health and SIBO (small intestinal bacterial overgrowth) and even sugar.

I mentioned that I don’t cover oxalates in my book but with body aches, spasms and pain I’d also explore this aspect. More on oxalates here and here.

Endorphin support with the amino acid DPA helps ease pain

When there is a neurotransmitter imbalance like low GABA levels it’s not uncommon to also have other neurotransmitter imbalances. With pain and aching I’d want to explore the possibility of low endorphins and do a trial with the amino acid DPA (d-phenylalanine) if low endorphin symptoms are present (you can find the symptoms questionnaire here).

DPA supports endorphin production (by inhibiting the breakdown of endorphins), reducing pain quickly, often in 2-10 minutes.

The use of DPA is not new information as you can read in this paper from 1982 – D-phenylalanine and other enkephalinase inhibitors as pharmacological agents: implications for some important therapeutic application

A number of compounds have been shown to inhibit the degradation of enkephalins. As expected, these compounds produce naloxone reversible analgesia [pain-relief] and potentiate the analgesia produced by enkephalins and by acupuncture.

One of these, D-phenylalanine, is also anti-inflammatory.

D-phenylalanine has proven to be beneficial in many human patients with chronic, intractable pain. It is proposed the enkephalinase inhibitors may be effective in a number of human “endorphin deficiency diseases” such as depression, schizophrenia, convulsive disorders and arthritis.

DPA also improves mood, especially when there is weepiness, and provides comfort when there is emotional eating. Here is one of many blogs that address DPAfor pain. Feel free to use the blog search feature to find others if you are new to this amino acid.

A few GABA product options – a sublingual, a powder and a cream

Some of the GABA products I recommend include Source Naturals GABA Calm lozenges and Now GABA Powder. 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, Source Naturals GABA Calm lozenges and Now GABA Powder are available via iherb (use this link to save 5%).

Somnium GABA Cream is available with international shipping. Read more about the product and grab my coupon code to save 15%.

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

As always, I use the symptoms questionnaire to figure out if low GABA or other neurotransmitter imbalances may be an issue.

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.

Wrapping up and your feedback

I do always appreciate feedback from the community and being able to share it on the blog. I’m thrilled Merril saw these benefits with GABA. She doesn’t mention if she has also seen benefits for sleep or feeling anxious or stress eating (all signs of low GABA too) – I’m curious to find out!

Now I’d love to hear from you – have you had success with GABA for anal/rectal spasms or other body aches, pains and muscle spasms? How much has helped and which product?

Have dietary changes or DPA also helped?

If you’re a practitioner have you seen GABA help in situations like this?

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.

Berberine in perimenopause and menopause: improving mood, calming the anxious mind, and improving heart health, blood sugar and bone health

May 10, 2024 By Trudy Scott 15 Comments

… Berberine, an isoquinoline alkaloid derived from plants of the generis Berberis, has been recognized as being capable of decreasing oxidative stress, LDL, triglycerides, and insulin resistance and of improving the mood. This review describes the cellular and clinical effects associated with the use of berberine, which suggest that this molecule could be an effective natural supplement to ensure a smooth peri- and postmenopausal transition.

The above is from a paper published in 2015, Potential benefits of berberine in the management of perimenopausal syndrome.

These are just a few of the many benefits of berberine. Other research reports impacts on the microbiome, benefits for bone density and kidney health – all very relevant in perimenopause and menopause.

I feel that berberine may be a nutrient to consider, in addition to dietary changes, stress reduction and lifestyle changes, and targeted individual amino acids. Read on to discover some of the mechanisms and the benefits of using a comprehensive approach, and feedback from folks in the community who are using berberine with success.

Impacts on oxidative stress, blood sugar/insulin resistance, lipids and heart health, and mood

I encourage you to read the full paper in order to get an overview of the impacts on oxidative stress, blood sugar/insulin resistance, lipids and heart health, and mood. Here is a very high level summary:

Estrogen deficiency, increased cardiovascular risk, an “overproduction of reactive oxygen species (ROS)” and reduced nitric oxide (NO) which are important contributing factors when it comes to “menopause-related endothelial dysfunction, atherosclerosis, hypertension, cardiovascular, and renal diseases.” Berberine counters this via various mechanisms.
Type 2 diabetes is higher amongst menopausal women, causing high blood sugar and insulin resistance. This paper shares a study that found berberine “significantly lowered fasting blood glucose (FBG), hemoglobin A1c, triglycerides, and insulin levels in patients with Type 2 diabetes as well as metformin and rosiglitazone.” One way berberine does this is via “increased insulin receptor (InsR) messenger RNA and protein expression.”
“inactivity of LDL receptor (LDLR)” in liver cells leads to higher levels of oxidized LDL, a risk factor for “endothelial dysfunction and atherosclerosis.” One mechanism is that berberine improves LDLR expression and has lipid-lowering activity.
When it comes to mood issues, the increased oxidative stress, immune dysfunction and inflammation play a role because of “interactions between neurotransmitters, neuropeptides, oxidative and nitrosative stress, and cytokines.” Higher levels of inflammatory markers such as interleukin-6 (IL-6), C-reactive protein, interleukin-1-beta (IL-1β), and TNFα “can enter the brain and may cause alterations of the metabolism of serotonin and dopamine.” Berberine helps to counter this inflammatory cascade and “inhibits the expression of MAO” , increasing norepinephrine, serotonin, and dopamine – and improving mood and presumably reducing anxiety too.

Berberine benefits menopause — From: Potential benefits of berberine in the management of perimenopausal syndrome

Feedback from folks in the community

When I shared this research on Facebook I received much in the way of positive results.

Susan shared this: “A functional medicine doctor suggested I take it with every meal. My A1C was not bad, (5.3) but my last level was 4.8. This was over the course of about 1 year.”

Becky shared this: “I used it for about 6 months along with diet changes to drop my A1C. Have been holding steady since with dietary measures alone. I didn’t realize berberine also helped lower LDL. Mine is slightly elevated. Not enough that my traditional MD has called me on it, but I’ve adjusted my diet again and hearing this about berberine I think I’ll try going back on it.”

Liz shared this: “I had gained some caregiver weight so started on berberine twice a day and it was helpful. However my Doc quickly had me switch over to [a combination product with berberine, chromium and alpha lipoic acid] and it’s fabulous! Twice a day and I feel great, my carb cravings are at bay and my bloodwork and overall health has vastly improved in just a few months.”

Marcy shared this: “Yes!! My son had been steadily gaining weight from binge eating and medications. In October 2022 his triglycerides were through the roof and I was so worried about his health. I put him on 500 mg of Berberine twice a day. Fast forward to today, he has lost approximately 50 pounds and his triglycerides are normal. There were other factors that may have contributed to the weight loss such as therapy and more structured eating times, but I absolutely believe the Berberine supported all this!” (this was also a combination product with berberine and a small amount of alpha lipoic acid and grape seed extract)

Marcia shared this: “I’ve used Berberine for appetite suppression, which it seems to help with, though not enough for me to lose any weight. But it did also actually lift my mood, which I was not expecting.”

Berberine: the microbiota, the gut-brain connection and anxiety

The number of studies on berberine is impressive and growing by the day. It’s not discussed in the above paper, but this paper, Effects of Berberine on the Gastrointestinal Microbiota states this: “The mechanism underlying the role of berberine in lipid‐lowering and insulin resistance is incompletely understood, but one of the possible mechanisms is related to its effect on the gastrointestinal microbiota.” Given what we know about the gut-brain connection, this is another likely mechanism for mood and anxiety benefits.

In another paper, Berberine ameliorates ovariectomy-induced anxiety-like behaviors by enrichment in equol generating gut microbiota, the authors propose that the use of berberine “modulates the gut microbiota, stimulates equol production, and improves anxiety-like symptoms” … “suggesting a direct link between gut microbiota modulation and estrogen deficiency-induced anxiety.”

Berberine: osteoporosis and the kidneys

An osteoporosis study shows that berberine regulates “the estrogen and thyroid hormone signaling pathways to treat osteoporosis in a multi-target, multi-pathway, and multi-system manner.”

And berberine used in conjunction with calcium carbonate and vitamin D, helps to prevent drug-induced bone loss too: “berberine inhibits bone resorption and improves bone formation to prevent glucocorticoid-induced osteoporosis.” I’d be considering vitamin K and other approaches like working towards optimal homocysteine, addressing food sensitivities, addressing possible oxalate and gallbladder issues too. The latter are more common during and after perimenopause.

Interestingly berberine also improves kidney health. One study reports that berberine “significantly ameliorated chronic kidney disease by altering the composition of the gut microbiota and inhibiting the production of gut-derived uremic toxins.”

A comprehensive approach that includes amino acids

As I mentioned above, I feel that berberine may be a nutrient to consider, in addition to dietary changes, stress reduction and lifestyle changes, and targeted individual amino acids. Berberine is relatively new to me and not covered in my book “The Antianxiety Food Solution” but it’s a great resource for the rest.

Here are are few blog posts specific to amino acids in perimenopause and menopause:

The good news is that the amino acids provide immediate relief while the berberine is slower-acting and starting to have an impact.

Product recommendation: Thorne Berberine

There are many good berberine products available. I did some reading and research and landed on Thorne Berberine.

It is available from my online store (Fullscript – only available to US customers – use this link to set up an account) and it’s available via iherb (use this link to save 5%).

If you’re new to berberine, be sure to discuss the research and if it may be something to consider with your practitioner.

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

As always, I use the symptoms questionnaire to figure out if low GABA or other neurotransmitter imbalances may be an issue.

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.

Wrapping up and your feedback

I do always appreciate feedback from the community and being able to share it on the blog.

Now I’d love to hear from you – have you used berberine with success? How much have you used, which product and how has it helped?

Were you aware of all these benefits?

Have you also used amino acids and dietary approaches as you start to see hormonal shifts?

If you’re a practitioner do you berberine with your clients/patients?

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.

Tryptophan 500 mg daily for a month: helps reduce negative thoughts, that scary wave of fear, panic attacks and anxiety

December 22, 2023 By Trudy Scott 32 Comments

Sylvie learned about my work after hearing me speak about nutritional solutions for anxiety on a summit. I discussed the use of tryptophan for low serotonin type of anxiety and panic attacks. She shared how much just 500 mg of tryptophan helps her and asks about using pharmaGABA too. In this blog I share my insights on next steps for someone in her shoes: using more tryptophan and/or more GABA and/or another GABA product. I also suggest that she reconsiders her vegetarian diet which can definitely play a role in low serotonin and some of the other neurotransmitters. Here is her wonderful feedback about tryptophan and her question in her own words:

I’ve been dealing with anxiety and panic attacks for a while. I am a vegetarian and really have no apparent reason why to have these two ghosts (anxiety and panic attacks) stealing the show in my present life. I don’t have anything causing intense stress or trauma and I take good care of myself. I went to see a Ph.D. in Psychotherapy and she couldn’t help me much, then I heard you talking about Tryptophan.

I got it the next day and I have been taking 1 x 500 mg at night daily, for about a month now. I have had almost no negative thoughts and that scary wave of fear in my body. Ok, maybe a couple of times, but really, very minimum. I was having a panic attack about once a week, ever since I took Lidtke Tryptophan so far I think I wanted to have a couple of them in the whole month, but they came very mildly and they disappeared.

May I take advantage and ask a question? When I felt I was going to have a panic attack I tried a 100mg of Pharmagaba that I found at Whole Foods, but I don’t think it did much for me. I know you recommend the GABA Calm, but I’ve suffered from migraines in the past, and I am afraid that the tyrosine will trigger one (one of my triggers for panic/anxiety are migraines), so what other brand/amount could I take that does not have tyrosine?

I don’t take any medications and am very healthy (had a yearly check up with complete lab work done in January), so the minimum dose of Tryptophan seems to be working well for me. THANK YOU SO MUCH for sharing this information. I now understand the power of nutrition in our brain’s health, thanks to your book, etc…

Use what is already working and increase to find the ideal dose

It’s wonderful to hear how just 500 mg tryptophan once a day had such an impact on her and I appreciate her for sharing this on the blog so I can share here.

When I’m working with a client we always use what is already working well – in this case it’s tryptophan – and increase it to see if we can find the ideal dose and alleviate all the low serotonin symptoms.

Her negative thoughts and the scary wave of fear have been dramatically reduced but do happen from time to time. By increasing tryptophan she may well be able to completely eliminate them.

Panic attacks are a classic sign of low serotonin and with this amount of tryptophan they have decreased from once a week to a mild version once a month. This is another clue that tryptophan is helping and that it’s worth considering an increase. I would start with this before adding in pharmaGABA or another GABA product (but more on that below).

I would also review the list of low serotonin symptoms (you can find these here) and rate what else may still be causing any issues – like insomnia, PMS, anger, afternoon sugar cravings etc.

As far as increasing tryptophan a few options could be considered:

500 mg tryptophan mid-afternoon and 500 mg tryptophan at night OR
2 x 500 mg tryptophan at night (this would be a good option if sleep is still not ideal)

Precaution about serotonin syndrome with tryptophan/5-HTP

There are precautions when using certain amino acids and I always review them with all my clients. If they have been prescribed an SSRI I have them discuss the use of tryptophan/5-HTP with their prescribing doctor so they can be monitored for serotonin syndrome. With careful monitoring and doctor approval I feel comfortable having my clients use tryptophan/5-HTP 6 hours away from their one and only SSRI.

If they are using more than one SSRI and/or a combination of psychiatric medications, the use of tryptophan/5-HTP is not advised.

None of the above applied in this situation but it’s important to be aware of.

When to consider GABA and some products to trial

Low GABA can also be a factor when it comes to anxiety and panic attacks. But it’s best to get a good baseline of serotonin support before adding a new amino acid like GABA.

I would also review the list of low GABA symptoms (you can find these here) and rate which ones may still be causing issues – like how severe her physical anxiety/tension is when she has a panic attack, if she eats more sugar/drinks more alcohol when stressed and has low GABA tension-type of insomnia.

Tyrosine is a precaution with migraines so it was wise not to use GABA Calm but the pharmaGABA dose she used may not have been high enough. It’s worth increasing the dose to see if that helps before adding a different GABA product. A GABA only product like NOW GABA powder or a liposomal GABA/theanine product would be something to consider if the pharmaGABA doesn’t help. I shared a link to many of the GABA products that I use and recommend

The role of a vegetarian diet in low serotonin

I also suggest that Sylvie reconsiders her vegetarian diet which can definitely play a role in low serotonin and some of the other neurotransmitters.

She does share that she is surprised about the anxiety and panic attacks but it’s not really surprising to me because it’s a fact that you can become nutrient depleted on a vegetarian diet: low iron, low vitamin B12, low omega-3s and low vitamin D, as well as low intake of amino acids are common. All of the above are needed to make serotonin and other neurotransmitters.

She says “I now understand the power of nutrition in our brain’s health, thanks to your book.” I do address the issue with vegetarianism in my book so hopefully she is open to considering some changes.

Here are a few blog posts to illustrate the power of eating real whole food that does include quality animal protein:

If she doesn’t make changes to her diet it’s possible she may need to use tryptophan and/or GABA long term.

Tryptophan and 5-HTP product options

Sylvie happens to respond well to tryptophan and yet some folks do better with 5-HTP so it’s a matter of doing a trial of each.

Products I recommend include Lidtke 500 mg Tryptophan, and Pure Encapsulations 50 mg 5-HTP. 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, Doctor’s Best L-Tryptophan 500mg and Source Naturals 50 mg 5-HTP are products I recommend on iherb (use this link to save 5%).

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

We use the symptoms questionnaire to figure out if low serotonin or low GABA 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 book doesn’t include product names (per the publisher’s request) so this blog, The Antianxiety Food Solution Amino Acid and Pyroluria Supplements, lists the amino acids that I use with my individual clients and those in my group programs. You can find them all – including the Lidtke Tryptophan 500 mg and some of the GABA products mentioned above – in my online store.

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

Have you had success using tryptophan and/or GABA for your anxiety, panic attacks, negative thoughts and scary waves of fear? If yes, how much helps? Did you start low and then increase?

If you’re a practitioner do you have success using tryptophan and GABA this way with your clients/patients?

Feel free to share and ask your questions below.

Seasonal PMDD/PMS and hormonal binge eating, wine drinking and anxiety – symptoms ramp up from October

November 17, 2023 By Trudy Scott 3 Comments

Someone in the community asked for help for the seasonal aspect of her PMDD symptoms i.e. more severe symptoms in winter …

My PMDD symptoms massively increase around the beginning of October right through to March. Would love some advice.

The binge eating and wine drinking is becoming habitual

She specifically mentions binge eating and wine drinking but I assume her other PMDD symptoms – such as anxiety, tension, anger, irritability, depression, sadness, hopelessness, insomnia, overwhelm, low energy, breast tenderness, headaches, pain, bloating, and/ or weight gain – are more severe at this time too.

As you can see, her symptoms are much more severe from October through March (winter in the Northern Hemisphere). If you live in the Southern Hemisphere you could expect more severe symptoms from May through September (or thereabouts).

There is a seasonal aspect to PMDD (premenstrual dysphoric disorder) and PMS (premenstrual syndrome and other hormonal imbalances. It’s not well recognized despite the fact that it’s documented in the research and seen clinically.

My feedback for her is to look into and address low serotonin, low GABA and/or low endorphins with the respective amino acids (adjusting up and down based on the season and symptoms), using recognized SAD (seasonal affective disorder) approaches and addressing pyroluria if needed (the nutrients are cofactors for neurotransmitter production.) I share more about each of these approaches and the research below.

The research: patients with PMDD have substantial seasonal patterns in mood and premenstrual symptoms

Premenstrual dysphoric disorder (PMDD) “accounts for the most severe form of PMS with the greatest impairment of women’s functioning and perceived quality of life, often prompting them to seek treatment.”

This older paper from 1997, Seasonality of symptoms in women with late luteal phase dysphoric disorder

Out of 100 patients treated in a subspecialty clinic in a university teaching hospital, “a significantly higher rate of seasonal affective disorder (38% versus 8%) as determined by Seasonal Pattern Assessment Questionnaire criteria.”
Also, 25% of the patients with seasonal variations in their premenstrual symptoms, consider them marked or a severe problem

The authors conclude that:

These results suggest that patients with LLPDD [or PMDD] have substantial seasonal patterns in mood and premenstrual symptoms. These seasonal patterns have implications for the clinical assessment and treatment of LLPDD [or PMDD]. For example, light therapy may be beneficial for women with seasonal worsening of LLPDD [or PMDD].

As you look at the research keep in mind the fact that late luteal dysphoric disorder (LLDD),“is now known as premenstrual dysphoric disorder (PMDD)”, as mentioned in the above paper and other older studies.

Seasonal variations in serotonin and GABA

Seasonal variations in serotonin have long been documented with much research on the winter blues. This paper, The chronobiology and neurobiology of winter seasonal affective disorder describes winter seasonal affective disorder (SAD) as “a mood disorder characterized by the predictable onset of depression in the fall/winter months, with spontaneous remissions in the spring/summer period.” They also state that “The typical patient with SAD is a premenopausal woman who experiences carbohydrate craving, hypersomnia, and prominent fatigue during winter depressive episodes.”

There is less awareness about GABA seasonality but GABA levels may also be lower in the winter months. In this animal study, Effect of the pineal gland on 5-hydroxytryptamine and γ-aminobutyric acid secretion in the hippocampus of male rats during the summer and winter, it is reported that: “GABA secretion in the hippocampus of rats had a seasonal rhythm consisting of increased secretion in summer and decreased secretion in the winter.” I share more about this and the seasonality of GABA here.

It makes sense that supporting these lower levels in winter is going to help with the more severe PMDD symptoms that correlate with each neurotransmitter imbalance.

One solution: address low levels of neurotransmitters with amino acids

As you can see the PMDD symptoms mentioned above could fall into the categories of low GABA, low serotonin and/or low endorphins (and possibly low dopamine/catecholamines and low blood sugar too: binge eating, wine drinking, anxiety, tension, anger, irritability, depression, sadness, hopelessness, insomnia, overwhelm, low energy, breast tenderness, headaches, pain, bloating, and/ or weight gain.

(You can read this StatPearls ebook for the full description of the above symptoms: Premenstrual Dysphoric Disorder)

It’s for this reason I always have clients with PMDD (and other hormonal issues) do the Amino Acids Mood Questionnaire and trials of the respective amino acids.

Using a food mood log and tracking what time of day you binge eat and drink wine (and all the other symptoms) is a clue as to which amino acids may help most. I would expect tryptophan, GABA and DPA would be at the top of the list, and possibly tyrosine and glutamine too.

Because of the seasonality aspect, a higher dose is likely to be needed in the winter time so if you’re just starting your amino acid trails keep this in mind. If you are already using amino acids with success in summer, then bumping up the amounts during winter is going to help further. And then be sure to reduce amounts once winter is over.

Hopefully you’ve also been working on diet, gut health, liver health, adrenal function, toxin removal and other factors to reduce or eliminate PMDD/PMS so the amino acids are not needed long term.

How targeted individual amino acids may help – some examples

As you can see from one study, tryptophan can help with premenstrual dysphoria/sadness, mood swings, tension, and irritability.

Low endorphins and low dopamine may also be a factor. I share more on this blog: DLPA (DL-Phenylalanine) eases PMDD/PMS symptoms in women who experience declining endorphin levels in the second half of their cycles

Here are some specific amino acid cases around binge eating/cravings and excessive wine drinking:

None of the above are specific to seasonal changes in symptoms but illustrate the use of amino acids.

Supportive solutions: a SAD lamp when serotonin is low and addressing pyroluria

The late luteal phase dysphoric disorder paper above doesn’t mention amino acids (which is unfortunate but not surprising) but it does mention light therapy. I do recommend the use of a SAD lamp (full spectrum light) when there are low serotonin symptoms that get more severe in the winter.

With PMDD/PMS and other hormonal imbalances, we also always consider pyroluria and the use of higher amounts of zinc, vitamin B6 and evening primrose oil. The “stress” of winter and increased sugar consumption can deplete zinc and vitamin B6 for everyone but more so if you have pyroluria. These nutrients are also key for hormonal imbalances.

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

We use the symptoms questionnaire to figure out if low GABA or low serotonin or low endorphins or low dopamine or low blood sugar may be an issue with your seasonal PMDD/PMS.

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.

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.

Does any of this resonate with you? If yes, has any of the above helped with the seasonal aspect of your PMDD, PMS or other hormonal issues?

Feel free to share and ask your questions below.

“Potion” of tyrosine, Endorphigen, GABA and tryptophan has been nothing less than a miracle for my depression and anxiety – how long can I remain on these?

August 11, 2023 By Trudy Scott 5 Comments

Amy shares how much her particular “potion” or combination of amino acids has helped her depression and anxiety and wants to know how long she can remain on them:

I currently take 500 mg of l-tyrosine in the morning, 1 Endorphigen 2xday, 1 GABA calm 2x day and 1000 mg of tryptophan before bed with some natural calm & true calm. This “potion” has been nothing less than a miracle. I feel pretty good.

The past few years have been rough, managing depression and anxiety with frequent relapse, and I finally feel ok.

I don’t want to wean off yet and am curious as to how long I can remain on these. Is it dangerous to keep on it too long? Is there a maximum time? I follow your blog and reached out to you last year. Your information has been extremely helpful. Thank you.

I’m glad to hear Amy is doing so well on this miracle combination and finally feels ok. Before stopping the amino acids, the goal is to address diet, gut health, nutritional imbalances, toxins and all the underlying factors that lead to low catecholamines, low endorphins, low GABA and low serotonin.

It’s fine to stop taking them and see how you do and add some or all of them back if you find you still need that neurotransmitter support. This is one of a few approaches I use with clients. But here are times when it’s best to wait and continue using them (like when on the pill and when affected by seasonal depression). I share my insights on this and other ways to cut back below.

How long can you remain on amino acids and when do you consider stopping them?

There is no set time frame for staying on the amino acids. As I mentioned above you can stop taking the individual amino acids and see how you do and then add some or all of them back if you find you still need that neurotransmitter support. This is one of a few approaches I use with clients.

Other approaches include: completely stopping one amino acid at a time and monitoring symptoms or reducing the amount one amino acid at a time, also monitoring symptoms. I prefer the latter especially with someone like Amy who has been “managing depression and anxiety with frequent relapse.”

I can also hear that she has some hesitation about stopping her “potion” and going with your gut is a good thing too. She also has a few confounding factors that make me feel staying on them longer may be in her best interest. One factor is her long-term use of birth control pills.

Long term use of birth control pills and the impact on mood and nutritional status

Amy also shares about her use of the birth control pill and how she suspects it’s a factor in her depression and anxiety:

I should also mention I just went off birth control pills. I have taken them since age 16 only stopping for 3 pregnancies and breastfeeding. I am 46. I’ve been on for painful periods. I made the decision to stop for fear of clots, cardiac issues and most importantly my mental well being. I truly believe they contributed to my depression. I believe I’m in perimenopause and have higher than normal anxiety. I’m extremely worried about my periods if I stop the pill and think my amino acid supplements help these worries and I cope better. That’s why I’m reluctant to stop the supplements but still worried about long term use.

Because Amy has been using the birth control pill for around 25 years I’d have her continue with the amino acids for now and address the effects on her gut health and nutritional status first.

Women taking the pill and other hormonal contraception are more likely to be depressed. A Danish study published in JAMA Psychiatry of more than 1 million women aged 15 to 34, with no prior history of depression, were included in the study and followed for 13 years. The researchers found that those women who used the pill were 23% more likely to be depressed and use antidepressants.

You can read more about the effects of the birth control pill on this blog and my book review of “Beyond the Pill” by Dr. Jolene Brighten. As you’ll read it causes vitamin, mineral, and antioxidant depletion (such as folate, B12, vitamin B6 and zinc).

She did actually come back and share that she tried and it didn’t work out going off the birth control pill. She was unable to manage the pain. She needs to address all these root causes first.

There is also no reason for her to be worried about long term use of the amino acids when they are clearly addressing her neurotransmitter imbalances.

The seasonal impact on mood and anxiety

I don’t have clients make changes to their amino acids in the Fall or Winter when there can be seasonal impacts on mood and anxiety. She had shared this too:

I’m more prone to depression this time of year. I think with these 2 factors [seasonal mood changes and the pill] I’ll stay on the regime until the spring.

This is a wise decision for Amy.

I would also hold off on making changes if someone is prone to airborne allergies. This is because there can be a higher need for neurotransmitter support when there are allergies.

Amy has already made many diet and lifestyle changes so she is heading in the right direction:

I have given my diet an overhaul. Not perfect but significantly less refined carbs and sugar. Plenty of fresh produce, healthy fats and protein ( especially animal). I also have committed to daily “body movement”: yoga, Pilates, max trainer, light weights or bike.

All of these changes are starting to support her overall nutritional status and resilience.

A recap of the amino acids Amy is using and the rationale for each one

If you’re new to using individual amino acids, here is a quick recap of the amino acids Amy is using and the rationale for each one.

She is using 500 mg of l-tyrosine in the morning. This supports low levels of dopamine/catchecolamines and improves the curl-up-in-bed kind of depression. You can read more about tyrosine here.

She is also using Endorphigen twice a day. This is a Lidtke product called Endorphigen and provides 500 mg DPA/d-phenylalanine per capsule. It raises endorphin levels, offering a mood boost, typically helping with weepiness and also emotional eating. You can read more about DPA here.

Amy is also using GABA Calm 2x day. This is a sublingual/chewable product made by Source Naturals and is a nice low dose of 125mg per chewable. You can read more about GABA here.

And finally, she is using 1000 mg of tryptophan before bed. This supports low serotonin and improves worry-kind of anxiety and depression, ruminating, obsessive tendencies and also sleep issues. You can read more about tryptophan here.

Keep in mind this is what Amy found works for her unique needs and would have done trials of the amino acids one by one to figure out which ones to use and how much of each to use. There is no one size fits all.

It’s not unusual for folks using the amino acids to describe their results as miraculous!

Resources if you are new to using amino acids as supplements

If you are new to using amino acids as supplements, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution (you can see all the symptoms of neurotransmitter imbalances, including low GABA, low serotonin, low dopamine, low blood sugar and low endorphins).

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.

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.

Thanks to Amy for sharing her results and asking this question.

Have you seen similar benefits when using individual amino acids? If yes, which ones have helped you?

What approach have you used to stop or reduce your doses?

And have you continued using the amino acids because of the effects of the pill, seasonal mood shifts or seasonal allergies (or some other reason)?

If you have questions and feedback please share them here too.