Today I’m sharing the case of an 11-year-old girl who had huge rage issues, was angry much of the time, suffered from terrible anxiety, had crazy sugar cravings (for bread and colored candies) and had dreadful insomnia. Because of the insomnia she was also very fatigued and this likely drove some of her cravings and irritability too. She was adopted and had been diagnosed with RAD (reactive attachment disorder). During our first session, chewable tryptophan turns things around quickly – she smiles and is willing to make changes and quit the sugar and gluten. We also address low iron levels and with these 4 nutritional interventions this child’s behavior improves dramatically.
This book chapter, Reactive Attachment Disorder, states how The Diagnostic and Statistical Manual 5th Edition (DSM-5) classifies reactive attachment disorder as follows:
a trauma- and stressor-related condition of early childhood caused by social neglect or maltreatment. Affected children have difficulty forming emotional attachments to others, show a decreased ability to experience positive emotion, cannot seek or accept physical or emotional closeness, and may react violently when held, cuddled, or comforted. Behaviorally, affected children are unpredictable, difficult to console, and difficult to discipline. Moods fluctuate erratically, and children may seem to live in a “flight, fight, or freeze” mode. Most have a strong desire to control their environment and make their own decisions. Spontaneous changes in the child’s routine, attempts to discipline the child, or even unsolicited invitations of comfort may elicit rage, violence, or self-injurious behavior.
Reactive attachment disorder/RAD and low serotonin
There is no research on tryptophan helping to address RAD symptoms or trauma, but based on her low serotonin symptoms, a trial of tryptophan was the first thing I considered.
There is, however, evidence to indicate the role of low serotonin in RAD, as indicated by a study where antidepressants were successfully used. The authors mention how:
The absence of responsive and consistent caretaking can subject the developing brain to an inordinate amount of physiological stress, leading to increased cortisol production and consequential inefficiencies in the serotonin and the growth-hormone releasing systems.
Although not specific to RAD, another paper looking at trauma states that:
Serotonin and dopamine levels were found to be abnormal in the presence of PTSD.
As the field of nutritional psychiatry grows, I expect to see more and more research supporting the use of tryptophan and other amino acids for those suffering from symptoms like this. Symptoms that are caused by imbalances that are triggered by the trauma in their lives.
We know that therapy, EFT, EMDR and other approaches are crucial for trauma recovery (this family had already done some of this work) but we must start to incorporate nutritional support too.
The case study
Here are the details of this case study and the nutritional interventions. As I mentioned above, because of her severe rage episodes, a trial of tryptophan was the first thing I considered:
She was referred to me by a friend. The family didn’t have much money. And so, we had to really try and figure out a few simple interventions that we could use that were going to be effective.
This young girl had been adopted. She was diagnosed with reactive attachment disorder and her anger issues were just phenomenal. The mom had to physically put her body around her and hold her down when she was having one of her fits because she was worried that she was going to hurt herself and hurt other people.
She also had anxiety, huge cravings for colored candies and insomnia. She was so fatigued because she wasn’t sleeping well.
So sitting in my office with this young girl and her mom, we started to talk about the sweets and the candies and the need to give up the candies. She was fuming with me. She was sitting in a swivel chair. She turned her back on me and didn’t want to talk about having to give up candy at all.
I said, “Look, let’s not even talk about that, but would you take this chewable tryptophan here? And we’ll talk about it in a second.” I gave her 100 mg of the chewable tryptophan and continued discussing things with her mom. She had no idea what it was going to do or how it would make her feel.
Within five minutes she turned her chair back, looked at me and she said, smilingly, “Yes, let’s do it. I can give up the candy.” She was smiling and she was happy.
So long story short, with this young girl, we started her on [chewable] tryptophan [and it turned things around quickly].
Chewable tryptophan – when I use it and when I don’t
I typically use 500mg Lidtke tryptophan for the adult clients I work with and prefer this company’s product because it is really high quality. It really does work better than many other tryptophan products on the market.
Lidtke also makes a chewable 100mg tryptophan which is also high quality, and the product I used with this young girl. Here are some benefits of this 100mg product:
- It’s useful for doing the initial trial in order to figure out if tryptophan is going to help with low serotonin symptoms in children – because it’s a lower dose.
- It’s especially useful for children for ongoing use (typically midafternoon and evening) because it’s a lower dose.
- It’s also useful for adults who are “pixie dust” folks and do better with a lower dose of supplements in general or respond more severely to medications/alcohol/chemicals. We may start with a trial of the 100mg chewable and increase from there, also typically midafternoon and evening.
I don’t use the chewable 100mg tryptophan under these circumstances:
- When the child (or adult) finds that 5 x100mg works for them at each time they need it. In this instance it’s best to switch to a 500mg tryptophan. Using it swallowed may work or it may need to be opened onto the tongue.
- When the child (or adult) starts to consume the chewables like candy. They are sweet and do taste good and I’ve seen this happen. Because you are continually consuming something sweet you may end up over-consuming them if sugar addiction is one of your issues. You may also end up taking too much tryptophan.
If the chewable tryptophan is not available where you live, using a small amount of a powdered tryptophan or opening a capsule of the 500mg tryptophan is an option. Since it tastes bitter it can be mixed with mashed banana or inositol. (You can find all the Lidtke products in my online supplement store. The link is in the resources section below.)
Gluten and candies were also a huge issue, and she had low iron
There was more to her issues than only low serotonin:
Gluten was also a huge issue, so we got her off gluten and the candies. The tryptophan helped with this” (i.e. it made it easy to break the addiction and not feel deprived).
Tryptophan also helped her sleep. And it helped with the severe rage issues.
Obviously the gluten was contributing to the rage issues as well.
Her iron and ferritin levels were really low (possibly as a result of her gluten issues). So we added an iron supplement, and animal protein/red meat.
So with just four interventions – the gluten, the animal protein, getting her iron levels up and the tryptophan – this kid was just a new kid.
Here are some articles that are related to the above:
- The role of low serotonin, low vitamin B6 and low iron in anxiety and panic attacks
- Integrative Medicine Approach to Pediatric Obsessive-Compulsive Disorder and Anxiety I write about a study where gluten was found to be the cause of a childhood case of obsessive-compulsive disorder (OCD)
- Tryptophan for my teenager: she laughs and smiles, her OCD and anxiety has lessened, and she is more goal oriented and focused on school.
Keep in mind there is not a one-size-fits-all and these 4 simple nutritional interventions – tryptophan, gluten removal, adding red meat and addressing low iron – happened to be the combination that worked for this young girl.
Resources if you are new to using tryptophan as a supplement
If you are new to using the amino acid tryptophan as a supplement, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution and a brief overview here, Anxiety and targeted individual amino acid supplements: a summary.
If you suspect low serotonin symptoms and do not yet have my book, The Antianxiety Food Solution – How the Foods You Eat Can Help You Calm Your Anxious Mind, Improve Your Mood, and End Cravings, I highly recommend getting it and reading it before jumping in and using amino acids so you are knowledgeable.
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 Lidtke chewable tryptophan 100mg, Lidtke tryptophan 500mg and other products that I use with my individual clients and those in my group programs.
We use an amino acid like tryptophan for quick relief of symptoms, like I did in this instance. Then we focus on the foundations like diet – like no gluten and red meat in this instance – and address all other imbalances, like her low iron. If cortisol was high we would have addressed that.
This case deserves it’s own blog post
In case you’re wondering, I first shared this case study in my interview, “Calming Anxiety, Aggression and OCD with Amino Acids and Food”, on the ADHD and Autism Summit in May 2021. Due to the interest in this case and the use of chewable tryptophan, I felt it deserved a deeper dive and its own blog post with links to some of the research and some practical information about the chewable tryptophan.
Have you used this chewable tryptophan product with success – personally, with your child or with a patient/client?
Have you found that addressing serotonin with tryptophan (or 5-HTP) helps resolve symptoms in a child diagnosed with RAD or a child with rage issues? What about helping with sleep problems, easing anxiety and stopping cravings too?
Have you addressed low iron levels and seen improvements with the removal of gluten too.
Feel free to post your questions here too.
I’m recovering from years of toxic mold exposure and have added tryptophan to my night time supplements with amazing success. I had a lot of insomnia and sleep disturbances for years, and the tryptophan has really helped. I plan to read your book, thank you from the bottom of my heart for all that you do Trudy!
Rachel
Thanks for sharing and you’re welcome! I’m so happy to hear tryptophan is helping your sleep. If you need additional support as you navigate toxic mold exposure you may find this recent blog helpful too https://www.everywomanover29.com/blog/gaba-heartmath-and-eft-ease-mickis-mold-induced-anxiety-and-panic-attacks/
And yes do read my book – it’s a comprehensive approach to healing – the amino acids and a dietary approach.
Trudy- I truly appreciate your willingness to share your well researched wisdom with us. This particular blog post is really encouraging and inspiring. Your blog posts always seem to be applicable to areas we are working on- either myself or one of our 4 kids. We have an adopted 4 year old daughter with a history of trauma as well. And our 8 year old son is a sensitive child with food sensitivities to gluten and dairy. We see a holistic Physician Assistant who guides us through labs and recommendations. But many of my questions or inquiries to her, stem from your knowledge of amino acids and supplements. Our son’s lab results show low iron. Do you have an iron supplement that you recommend?
Beth
Thanks for your kind words. I like Designs for Health Ferrochel. It’s iron bisglycinate and non-constipating. It’s also more bioavailable that ferrous sulfate which is commonly used in iron products. I also look at diet and recommend including iron rich foods like grass-fed red meat as I did with this young girl. And ideally make sure digestive enzymes are good enough, and figure out why iron is low eg. none in the diet or low because of gluten and leaky gut (this is common). It could also just be caused by growth spurts. Looking for the presence of inhibitors and promoters of iron absorption in the diet is also important.
It’s wonderful you have a holistic Physician Assistant to work with. Please feel free to share with her the fact that I offer practitioner training on how to use the amino acids. I will be expanding it to incorporate a wide range of topics on nutritional psychiatry.
Hi Trudy
I read your case study with interest and just wondering how gluten can contribute to rage?
Thankyou for your work
Jill
Sydney Australia
Jill
Gluten issues can cause leaky gut which can cause low iron, low zinc, low B6 (all needed to make serotonin). And anger/rage is a sign of low serotonin in some folks.
Also, low zinc means higher copper and this can also trigger anger/rage/violence.
And inflammation an/or pain may be a trigger too.
Hi Trudy !!
Thank you for this blog ! It has been a life saver for me ..
But today I inquire about my 3 year old grandson .. He has trouble sleeping and sugar is his go to for comfort, huge activity during the day and fights to nap and wakes up several times during the night ( not always but often )
Could Tryptophan help? Sometimes after nap he wakes up and is angry . He hits and kicks !
He is growing up without a father . He left when he was born..
Any advice would be greatly appreciated .
Thanking you in advance !
Paz Bingham
Pazi
I’m sorry your grandson is struggling. I would start with diet first. Real whole food, no gluten, no sugar, no sodas/fruit juice, protein at breakfast for blood sugar control – for starters. Then work with your practitioner to trial 25mg of the chewable to start.
If you are new to the amino acids (and other anxiety nutrition solutions like gluten/sugar/caffeine removal, blood sugar control, gut health, pyroluria etc) my book “The Antianxiety Food Solution” is a great place to start. More here https://www.everywomanover29.com/blog/the-antianxiety-food-solution-by-trudy-scott/
It’s a comprehensive approach – amino acids AND diet. What is his diet like right now – gluten-free, sugar-free, caffeine-free, eating protein at breakfast for blood sugar control, real whole foods, grass-fed red meat, wild fish, fermented foods etc?
Also look at EMFs as this can have a big impact on sleep. So no wifi in the house ideally.
Glad to hear my blog has been a life-saver for you – please do share more so others ca be inspired and have hope
Would this help with Misophonia?
Jeannie
Serotonin support with either tryptophan or 5-HTP often helps resolve many misophonia symptoms – anger, irritability, verbal/physical aggression (all low serotonin signs). We also always address low GABA (physical tension, rapid heartbeat, anxiety etc) and high cortisol levels with misophonia (if needed).
Just like this case I share we look at all factors – possible gluten issues, low iron, low zinc, low B6, gut issues etc – all of which can contribute to low levels of neurotransmitters.
If you are new to the amino acids (and other anxiety nutrition solutions like gluten/sugar/caffeine removal, blood sugar control, gut health, pyroluria etc) my book “The Antianxiety Food Solution” is a great place to start. More here https://www.everywomanover29.com/blog/the-antianxiety-food-solution-by-trudy-scott/
It’s a comprehensive approach – amino acids AND diet. What is your diet like right now – gluten-free, sugar-free, caffeine-free, eating protein at breakfast for blood sugar control, real whole foods, grass-fed red meat, wild fish, fermented foods etc?
I have a question please Miss Trudy. I have purchased some chewable tryptophan and I did sleep well.
Is the tryptophan safe to take with other prescriptions for anxiety and depression. Such as Prozac, Trazadone, Wellbrution,
Andrea
There is the risk of serotonin syndrome with these these medications and also using tryptophan and 5-HTP. It’s not advised.
Hello! I’m in desperate need of finding help for my daughter who is 14 and on the autism spectrum. We’ve been having the most challenging times the past few years and no one or nothing is helping with the rage, anxiety, self injurious, OCD, impulsivity, tics, etc. could you recommend a do it or to see? We are in South Jersey and are really struggling. We had a meeting at school the other day and they said she’s the most complex child that they’d ever worked with. I’be taken her to every specialist and have done numerous tests to figure out what could be the problem but every doctor says m, well that’s autism. It’s so frustrating!!! Please help!!
I am wondering if you use 5-HTP like tryptophan (opened capsule on tongue) and empty stomach?
Panagiotis
It can be used like this and depends on each person’s response. 5-HTP also doesn’t have to be taken away from protein, unlike tryptophan
Dear Trudy,
I am giving it a try with chewable tryptophan 100 mg for my daughter (11yo) with anxiety, sleep issues, tics, adhd, sensory issues, etc. – how do I know it’s working? and how many is the right amount? how would I be able to tell if I need to give her more or less? once certain that it’s working, is there a period to keep her on it and then off, and if just “on” for how long?
She’s taking 1 in the morning and 1 before bed.
Many thanks for your great work and input!
Marika
You will know it’s working when you see improvements or she tells you she feels less anxious and feels better.
The best way to determine if someone may have low serotonin is to look at the low serotonin symptoms, rate them on a scale of 1-10 with 10 being worst, do a trial of tryptophan or 5-HTP and rate the symptoms again right afterwards (in the next 2 to 30 minutes). Here are the symptoms https://www.everywomanover29.com/blog/amino-acids-mood-questionnaire-from-the-antianxiety-food-solution/
We increase from there based on the response and continue with the ideal dose for as long as needed. Ideal timing is afternoon and evening. If you are new to the amino acids (and other anxiety nutrition solutions like gluten/sugar/caffeine removal, blood sugar control, gut health, pyroluria etc) my book “The Antianxiety Food Solution” is a great place to start. More here https://www.everywomanover29.com/blog/the-antianxiety-food-solution-by-trudy-scott/
Can you use tryptophan if the patient is on an a low dose 10mg antidepressant? Such as lexapro.
Sarah
I have clients take tryptophan 6 hours away from the SSRI (all with the prescribing doctor’s approval and monitoring). It’s advised to use these aminos when someone is on only 1 prescription psych medication.
Best is to read this blog and work with and discuss with the prescribing doctor /pharmacist as there is the potential risk of serotonin syndrome with SSRIs and tryptophan/5-HTP https://www.everywomanover29.com/blog/taper-from-antidepressant-tryptophan-amino-acids/
If you are new to the amino acids (and other anxiety nutrition solutions like real whole food, quality animal protein, fermented foods, organic produce, health fats, gluten/sugar/caffeine removal, blood sugar control, gut health, pyroluria etc) my book “The Antianxiety Food Solution” is a great place to start. It’s heavily referenced and practitioners use it as a resource and recommend it to their clients/patients. More here https://www.everywomanover29.com/blog/the-antianxiety-food-solution-by-trudy-scott/
I do also offer amino acid training for practitioners. As well as the valuable content, it’s an opportunity to interact with me and other practitioners who are also using the amino acids. More here https://www.anxietynutritioninstitute.com/balancingneurotransmitters/