Balancing Neurotransmitters: the Fundamentals program for practitioners

Urinary neurotransmitter testing reports elevated GABA when it’s really low: using the low GABA symptoms and a trial of GABA is best

September 23, 2022 By Trudy Scott 4 Comments

Francoise posted this feedback and her surprise about her elevated GABA levels – as reported on a urinary neurotransmitter test. She was justifiably confused because she had looked at the low GABA symptoms and resonated with them i.e. physical anxiety/tension, stiff and tense muscles, stress eating, self-medicating with alcohol, insomnia and intrusive thoughts etc:

I previously bought Gaba Calm after reading your blog since my symptoms seemed to match your description [of low GABA].

However, I recently did an exhaustive neurotransmitter test to realize that it was the exact opposite, having a significantly high level of GABA.

Unfortunately, I’ve looked all over the internet after talking to my doctor, and it seems that no one knows how to downregulate GABA.

Not sure what to do from there, but thought I should let you know that the situation exists despite not being common.

I posted this feedback for her: I do not use urinary neurotransmitter testing as it’s not accurate. I use the low GABA symptoms questionnaire and we do a trial of GABA if low GABA symptoms are present.

She said it perfectly – “I previously bought Gaba Calm after reading your blog since my symptoms seemed to match your description” i.e. it’s very likely she does in fact have low GABA symptoms and if we were working together I’d have her do trial of GABA.

I did ask her what her doctor and the lab recommended and to share the name of the lab/test and have yet to hear back. I will share when I do.

Someone else also had the neurotransmitter report high GABA so she stopped taking her GABA supplements

When I shared Francoise’s comment and my feedback on Facebook, I had someone share a very similar outcome. Kristin had already figured out that she had low GABA levels (based on the symptoms questionnaire), was already taking GABA with good results and was then told to stop taking GABA because the urinary neurotransmitter test reported elevated GABA levels!

This is what Kristin shared on Facebook: “I just did the neurotransmitter test. It said I was high in GABA as well, so I stopped taking it.”

These were the questions I asked her: Why were you taking GABA at the time – was it because you had/have low GABA symptoms and was GABA helping to ease these symptoms? I also asked which lab did the test and what her practitioner recommended? She shared the following:

I was taking GABA for anxiety. It was helping. .

My doctor recommended that I stop the GABA and use supplements to support the areas I was low in, which were: Dopamine, Norepinephrine, Epinephrine, and Serotonin (was VERY low).

Doctor’s Data is the company. And it wasn’t a cheap test.

I was surprised that even though GABA was helping Kristin, the doctor said to stop using it. What does also concern me too is that supporting dopamine, norepinephrine and epinephrine without supporting GABA can actually increase anxiety. I’ve seen this backfire a number of times.

After seeing my post and our Facebook back and forth she decided to start back on the GABA products she had been taking: GABA Calm 1-3 tablets a day and if she is struggling terribly with morning anxiety, then 1/2 to 1 tablet as needed. In the evening she takes 2 capsules of Neurocalm which has 100 mg of GABA (and some other ingredients).

Kristin confirmed that, once again, GABA was helping to ease her intrusive thoughts, anxiety and physical tension, all low GABA symptoms.

I said to Kristin that I’d reach out to Doctor’s Data and have done so. I shared all this and I am hoping to hear back from them. I’ll keep you posted when I do.

Kristin has offered to share this blog with her integrative doctor who prescribed this test. I’m hoping she does and you do too.

I appreciate both these women sharing their experiences so I can share with you.

Urinary neurotransmitter testing falls short and other practitioners weigh in too

I find many functional tests extremely useful and Doctor’s Data is well regarded in functional medicine. However, I do find it very unfortunate that so many practitioners continue to use and recommend this test when it’s not useful, doesn’t correlate with symptoms and so often causes confusion, like in these instances (which are just two of many similar cases). By the way, they are not the only lab offering urinary neurotransmitter testing.

Be sure to read this older blog: Urinary neurotransmitter testing falls short where I share more about why I’m not in favor of this testing.

This feedback from Nora Gedgaudas, author of Primal Body Primal Mind sums up what I often hear from other practitioners:

I have considered the urinary testing approach and was even enamored of the concept at first. Once I looked into the idea more closely, though, it just didn’t add up for me. I have been using amino acids now to address issues of mood, health and cognitive functioning for over 20 years. I have never used anything other than mood/symptomatic screening to guide amino acid supplementation. Results tend to be uniformly good to excellent. The sheer overwhelming complexity of amino acid/neurotransmitter activity in the human body/brain-and the compartmentalized nature of the biochemistry of each seems to best lend itself to a more functional and symptom-related evaluation. Lab testing simply falls short of the mark here.

A colleague and good friend of mine, Dr. Josh Friedman posted this in the comments section of the above blog post (back in 2014), further supporting what practitioners are reporting about this testing:

About a year ago I got excited about urinary neurotransmitter testing. I had been using Julia Ross’ pencil and paper neurotransmitter deficiency assessment for many years with good success. Over the past year I have done the neurotransmitter testing on about 10 people with very inconsistent results. With 2-3 we hit a home run, where the recommended supplements were just the right thing to diminish the presenting symptoms. More often than not the recommended supplements seemed to give little relief or even make the symptoms worse. Additionally the testing and supplements are quite expensive.

I have since given up on the testing and as I have found the pencil and paper NT deficiency sheet to be a more effective guide to treatment. When I am unable to make progress I will often turn to serum amino acid testing and the neurotransmitter markers on the Organic acid test offered by many functional medicine labs. In addition to information about neurotransmitter functioning, the Organic Acid Test provides information about other factors involved in mental health symptoms including levels of the yeast Candida, the bacterial infection Clostridia and others.

Of course, I wholeheartedly agree with both of them.

As you can see from these two cases (and the many others in my book and on this blog), using the low GABA symptoms and a trial of GABA is best. It’s the most effective way to determine if you need GABA initially and to monitor how it’s helping. It also doesn’t cost you anything more than your time and the GABA product/s.

Resources if you are new to using amino acids as supplements

If you are new to using any of the 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 serotonin and low GABA).

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, sugar cravings, self-medicating with alcohol and more.

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 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). 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.

Have you done urinary neurotransmitter testing and did any of it correlate with the neurotransmitter deficiency symptoms?

Have you been told to stop GABA that was helping to ease your symptoms – based on labs showing high GABA?

If you’re a practitioner I’d love to hear your experiences using the urinary neurotransmitter testing.

If you have questions please share them here too.

GABA is a life saver for anxiety, theanine helps at night (insomnia) and 5-HTP makes a significant difference in lessening daily pain

September 16, 2022 By Trudy Scott 16 Comments

Joie has Sjogren’s, Hashimoto’s, fibromyalgia & collagenous colitis (all diagnosed after severe mold exposure) and shared how GABA is a life saver for her anxiety, how theanine helps at night with her insomnia and how 5-HTP makes a significant difference in lessening her daily pain. Here is her wonderful feedback in her own words (my feedback for her follows):

I was diagnosed with Sjogrens several years ago. I also have Hashimoto’s, Fibromyalgia & Collagenous Colitis. All of these happened after a severe mold exposure which destroyed my pituitary, and caused Exocrine Pancreatic Insufficiency (EPI). I have to take human growth hormone injections daily, as my pituitary isn’t working, digestive enzymes for the EPI, and have experienced the anxiety and depression you’ve written about.

The GABA has been a life saver for me (for my anxiety), and I share this with all I know who experience anxiety. I also use L-theanine at night because of insomnia. The 5-HTP has helped somewhat for sleep. L-tryptophan didn’t seem to make a difference. However the 5-HTP has made a significant difference in lessening my daily pain levels, which I am most grateful for.

Unfortunately, I am also taking Klonopin and Gabapentin, both of which I have tried to get off of but keep finding myself back on both in order to have greater than 5 hours of sleep at night. Even with these, I often awaken after 4-6 hours and take 1-2 chewable GABA which allows me to go back to sleep and get 2-4 more hours of sleep.

She shared this on the blog, Sjogren’s syndrome: tryptophan and GABA for anxiety, and moisturizing for dry skin and inflammation?, where I write about the prevalence of anxiety and depression in this autoimmune condition, and the fact that serotonin and GABA are often low.

I shared how sorry I was to hear how mold has impacted her but that it was wonderful to hear the GABA has been a lifesaver for you in terms of anxiety (and when waking in the night) and that theanine helps her sleep. It’s wonderful that 5-HTP helps ease her daily pain (here is fibromyalgia research on 5-HTP) and helps somewhat with her sleep issues.

Has she increased the amino acids to the optimal doses for her unique needs?

My question for her was this: “how much of each of these amino acids are you using and have you increased them to the optimal doses for your unique needs?” I asked this because many folks don’t do this and we always want to capitalize on what is working.

Here are some examples that relate to Joie:

When 5-HTP helps with pain relief we also do afternoon and bedtime trials to see if it can improve sleep further. And we always explore some of the reasons why serotonin may be low and address those too. You can read more on that here: what causes low serotonin

I shared that tryptophan doesn’t work for everyone and some do better with 5-HTP, but I do also consider melatonin when sleep is an issue, especially timed release to prevent waking in the night.

Since GABA is a lifesaver for her in terms of her anxiety and also helps when she wakes, trialing higher doses at bedtime may prevent the early morning waking. The same could be said for trialing a higher dose of theanine and using both GABA and theanine together at night (a 2019 study shows the combination decreases sleep latency and improves NREM sleep).

High cortisol, rebound sleep issues with meds and/or poor fat digestion?

If she has already done the above, I’d explore high cortisol and do a 5-collection an adrenal saliva test). When cortisol is high during the night, the use of Seriphos can be a game-changer for many.

Unfortunately both Klonopin and Gabapentin (especially the former) can cause rebound insomnia even when they seem to be helping in the short-term.

I also mentioned that my recent blog post many be helpful since she mentions exocrine pancreatic insufficiency, which could affect sleep by impacting her fat digestion – Waking in the night due to environmental toxins: impacts on the liver, gallbladder and fat digestion (making oxalate issues worse). This has relevance whether or not oxalates are an issue.

Autoimmune-Paleo (AIP) diet, pyroluria and moisturizing for reducing inflammation

It goes without saying that since Sjogren’s, Hashimoto’s and even Collagenous Colitis are autoimmune conditions, following an Autoimmune-Paleo (AIP) diet is key too. I have links to some AIP resources on the above Sjogren’s blog post.

In this blog I also mention pyroluria which may be relevant for someone with Collagenous Colitis and is crucial to address when there has been toxic mold exposure or other chronic issues like Lyme disease or MCAS. More on this here.

And you can also read about the value of moisturizing for reducing inflammation.

I thanked her and said I plan to share her results and my response as a new blog as I feel it will help others and give hope!

Resources if you are new to using amino acids as supplements

Has GABA helped with your anxiety and insomnia? What about theanine? And 5-HTP for your pain? Or melatonin for sleep?

Have you used taurine with success for fat digestion? Or Seriphos for high cortisol?

What else has helped you with symptoms like these ones?

If you have questions please share them here too.

Waking in the night due to environmental toxins: impacts on the liver, gallbladder and fat digestion (making oxalate issues worse)

September 9, 2022 By Trudy Scott 37 Comments

Today I’m sharing how waking in the night may be caused by oxalate issues that are made more severe because of home cleaning products, environmental toxins and fragrances/phthalates. It can happen because of the additional detoxification work required and adverse impacts on your liver and gallbladder. This can impact bile production so fat digestion is impaired. And when you have impaired fat digestion this can contribute to more severe oxalate issues because more oxalates are absorbed in the gut. This can lead to increased pain, worsening sleep and/or waking in the night, increased anxiety, fatigue, depression, more severe bladder symptoms, eye problems etc.

Using extra calcium citrate in the night can help in the short term. But improving fat digestion (with lipase, ox bile, taurine, a lipotropic formula, digestive bitters etc.) and supporting the liver/gallbladder is key because it gets to the root of the problem. And of course, avoid the chemical exposure. Sometimes this can’t be done – which is the case when you are traveling – so you have to do your best to reduce exposure.

This is actually my story. I’m traveling in South Africa at the moment and had a flare of my old oxalate issues, with increased foot pain at night, so much so that it was waking me at 3am in the morning. I’d be awake from 3-5am feeling agitated and restless and waiting for the extra calcium citrate to work. I’m a hot mess when I don’t get a solid 8-9 hours sleep so I had to figure out what the issue was and fix it quickly. It was a somewhat convoluted journey (more on that below) but eventually I landed on taurine as the solution and it’s been wonderful to get my solid sleep with no waking in the night!

I do eat a fair amount of fat – plenty of butter on my steamed veggies, olive oil, coconut oil, avocados, the fat from grass-fed meat, chicken skin, full fat cheese and eggs – and didn’t want to cut back.

So when taurine came to the rescue I was thrilled and still am!

I took 500mg before bed the first day and woke briefly twice but went right back to sleep. The second day I took 500mg taurine mid-morning, 500mg taurine mid-afternoon and 500mg before bed (all away from food). That night I woke briefly once and went right back to sleep. The third day I did the same and slept solidly through the night. My goal had been to increase to 3000mg per day but I’ll stick with 1500mg as long as this continues.

There were a few clues that indicated a need for liver-gallbladder support: the 3am waking is classic for liver issues; and my stool had become pale despite nothing else changing.

Impaired fat digestion leads to an increase in oxalate absorption

As mentioned above, when you have impaired fat digestion this can contribute to more severe oxalate issues because more oxalates are absorbed in the gut. This paper, Fat malabsorption induced by gastrointestinal lipase inhibitor leads to an increase in urinary oxalate excretion, summarizes the mechanism well:

Unabsorbed bile acids and fatty acids may react with calcium in the intestinal lumen, forming “soaps” that limit the amount of free calcium binding with oxalate, with a consequent increase in intestinal oxalate absorption leading to hyperoxaluria

In the above study, it’s orlistat (Xenical®), a gastrointestinal lipase inhibitor rather than environmental toxins and bile issues, that causes the increase in oxalates. I share it because it has a helpful explanation of the mechanism.

I share more about my issues with dietary oxalates here – Oxalate crystal disease, dietary oxalates and pain: the research & questions. My main issues in the past have been foot pain and eye pain, with downstream impacts on sleep. This blog has links to a number of other dietary oxalate blogs if this topic is new to you.

Bile production and detoxification

You may recall my wonderful interview with Ann Louise Gittleman on The Anxiety Summit 5: Gut-Brain Axis. The topic was: Why Bile is the Key to Anxiety & Hormone Havoc. I’ll add sleep to that too.

She covered the role of bile in PMS, estrogen imbalance and thyroid health; and importantly, how it’s involved in the removal of toxins from the body:

Bile is the dumping ground for hormones like estrogen. It’s the dumping ground for heavy metals that create anxiety like mercury, as well as too much aluminum and lead. And it’s the dumping ground, also, for a bunch of chemicals. So you got to keep the bile flowing. You have to keep it decongested. You have to thin it out.

She mentions simple tools to improve bile production: bitters (already part of my routine), lemon and water in the morning (also part of my daily routine), coffee (I can’t drink coffee as it makes me anxious), grapefruit and watercress. She also discusses key nutrients for bile production and quality: choline, inositol, methionine and taurine.

I could not find any lipotropic formula with choline, inositol, methionine (they all had rice flour). And I could not find any products that contained only lipase or ox bile.

While I was looking for something to improve my bile production, I did try a milk thistle extract (for overall liver support) and a liver-gallbladder herbal tincture but both made things worse. So I did some reading on taurine, found a nice taurine only 500mg product and haven’t looked back. Read on for some of the mechanisms.

Taurine and bile acid conjugation and detoxification

Metabolic actions of the amino acid taurine include: “bile acid conjugation, detoxification, membrane stabilization, osmoregulation, and modulation of cellular calcium levels.”

This paper, The Continuing Importance of Bile Acids in Liver and Intestinal Disease, explains the significance of bile acid conjugation with taurine:

After biosynthesis from cholesterol and before excretion from the hepatocyte, bile acid molecules are conjugated with glycine or taurine, which converts a weak acid to a strong acid. As a result, conjugated bile acids are fully ionized at the range of pH values present in the small intestine.

Taurine works on GABA receptors and is a GABA alternative

What is really interesting is that taurine works on GABA receptors and has a synergistic effect with GABA. I suspect this played a role for me too.

In this editorial, Taurine and GABA neurotransmitter receptors, a relationship with therapeutic potential?, the authors share the following::

“Taurine exerts its neuronal inhibitory effect through the activation of GABAA receptors (GABAAR) but with less affinity than the specific agonists of each receptor.
GABA and taurine act synergistically in extra-synaptic GABA receptors.
Some experiments suggest that taurine activates GABAB receptors with high affinity”

In countries where over-the-counter GABA is not available (like the UK, Australia and New Zealand), I will recommend taurine as an option. I don’t find it to be as effective as GABA but it is slightly calming.

You may need to course-correct from time to time

I share this story to illustrate that things can be going well in terms of sleep, pain, anxiety, depression and so on, and then something can happen and you have to course-correct.

I also often hear from folks in my community saying: “GABA and/or tryptophan was working perfectly to help me sleep and all of a sudden it’s no longer working. What is going on?” A situation like this shows how something else can change and it has nothing to do with the amino acids no longer working.

I do already use GABA, tryptophan (more on these below), melatonin and magnesium at bedtime and continued taking these supplements but I had to fix the root cause – the fat digestion issue.

I will add this: even if you don’t have dietary oxalate issues, this approach may be worth considering if you have no gallbladder, have fat digestion issues, are exposed to environmental toxins, have liver issues and wake in the night.

Resources if you are new to using amino acids as supplements

Have you experienced any adverse symptoms when exposed to environmental toxins? And has this made your oxalate issues worse or affected your fat digestion?

Have you used taurine with success? How much helps you?

Have other liver or gallbladder approaches also helped?

If you have questions please share them here too.

Read all posts in this series:

Collagen causes increased anxiety, low mood, irritability, insomnia, gut issues and an itchy skin: some questions and my answers

September 2, 2022 By Trudy Scott 37 Comments

Today we have some feedback from folks on some of the negative impacts they experienced when consuming collagen. I’m sharing their questions and the feedback I gave them in the hope this will help you too. Not everyone experiences unpleasant symptoms when consuming collagen but those who are susceptible may experience the following: increased anxiety or new anxiety, feeling low, inability to sleep or worsening sleep, tension, irritability, gut issues, itchy skin, frequent urination, a bad mood, worsening psoriasis, blepharitis, panic attacks and a disrupted menstrual cycle.

The causes of these symptoms can be due to the serotonin-lowering effects of collagen, the dietary oxalate impact, a histamine reaction and/or a glutamate reaction to collagen.

Beth shares how she feels low and anxious after using marine collagen for five days:

Have just recently begun receiving your emails. I read the above article and wanted to let you know of my experience. I started taking Vital Proteins marine collagen to see if it would improve sun damage to my skin. I took one scoop for about five days. On the fifth day I felt very low. So low that it made me somewhat anxious. As I have trouble with anxiety I stopped it immediately. Felt better the next day. The container lists 19 amino acids including tryptophan but the amount of it is zero mg. I hadn’t noticed that when I started taking it. After reading your article I’m fairly sure that that is why I felt depressed.

I shared this: for individuals who have observed a mood dip or increase in anxiety since using collagen or gelatin, I suggest they stop using collagen/gelatin and see how they feel, then add it back and see how they feel (sometimes more than once if they are not certain).

If they do see a correlation, look at the low serotonin symptoms and do a trial of tryptophan or 5-HTP (after checking the precautions) to see if this improves their low mood and reduces their anxiety when using collagen/gelatin. This confirms if their symptoms are due to the serotonin-lowering effects and allows them to continue using it for the benefits it provides.

Be sure to read the above collagen/serotonin blog for some of the research on what makes some folks more susceptible to the serotonin-lowering effects: a current depression/anxiety or history of depression/anxiety (even a family history), prior use of antidepressants, OCD / obsessive compulsive disorder, MAOA and/or 5-HTTLPR (the serotonin transporter gene) polymorphisms, smokers or former smokers, and women polydrug ecstasy users. This is not a conclusive list.

It’s interesting that she mentions her product has tryptophan listed with zero mg. When I looked online I didn’t see it listed on the product at all. Maybe it’s a change they have made to the label.

I also shared that when 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.

The above question and the following questions come from the popular blog, Collagen and gelatin lower serotonin: does this increase your anxiety and depression?

How long after stopping bone broth does it take for this anxious feeling to leave?

Diane asks about bone broth and collagen and how it causes extreme anxiety and sleep problems:

I just finished your book and have to say how awesome it is ! A wealth of information. As I am struggling with many of the issues, I do have a question on bone broth and collagen. I have definitely noticed extreme anxiety and inability to sleep with bone broth and collagen supplement.(plus spring allergies are at play as well) I even tried a piece of Turkey with my bone broth this week to see if that helped. I have such gut issues I was really hoping to use bone broth. Anyway, my question is how long after stopping bone broth does it take for this anxious feeling to leave? Days or weeks? I want it cleared out before I try adding tryptophan with the broth.

I thanked her for the great feedback on my book. It’s wonderful to have the foundational stuff in place and she’s getting that from my book.

I don’t have an answer on how long symptoms can last as it’s very individualized. Typically if the effects are caused by serotonin being lowered, using either tryptophan or 5-HTP can result in significantly less anxiety and better sleep in a few days, provided the optimal dose is used.

Keep in mind that spring allergies can often make things worse and more tryptophan or 5-HTP may be needed during the allergy period. The dose would then need to be reduced once allergy season has passed. I blog about spring allergies and increased anxiety here.

My advice would be to use the tryptophan or 5-HTP to resolve the anxiety and insomnia and then once resolved, consider adding back the collagen and monitoring how she is doing. At this time she may need to bump up her tryptophan or 5-HTP yet again.

Is it a histamine reaction rather than low serotonin? (or an oxalate or glutamate reaction?)

Kelly believes her symptoms may be a histamine reaction and not caused by low serotonin:

If you become anxious, tense, irritable, can’t sleep AND have some issues with itchy skin, frequent urination, worsened gut issues, etc., then it’s a histamine problem from the collagen/glycine, and not serotonin at all.

I shared that these symptoms could actually be both since low serotonin can also cause anxiety, tension, irritability and insomnia. But I agree the itchy skin, frequent urination, worsened gut issues are a big clue it’s a histamine issue too or perhaps only a histamine issue. Gut issues would happen with both low serotonin and histamine.

I’d start with a trial of tryptophan or 5-HTP because if it is low serotonin you will know very quickly. You can see what symptoms resolve and by how much.

Challenges with dietary oxalates could cause all the symptoms she experiences. So it’s a matter of figuring it out for each person. If you already know you have histamine or oxalate issues it’s also relatively easy to figure out by simply stopping the collagen and/or adding the counter-measures you typically use – like quercetin for histamine reactions and calcium citrate for oxalate issues.

It’s possible that some of these symptoms are a glutamate reaction too – like anxiety, tension, irritability and insomnia – and the amino acid GABA may help in this instance.

A bad mood, insomnia, psoriasis, blepharitis, panic attacks, hormone imbalance – oxalates or serotonin-lowering effects?

Em shares how she had a really bad mood, full blown insomnia, worsening psoriasis, blepharitis, panic attacks and disrupted menstrual cycle:

I am soooo glad I found this article. I started taking Oslo Skin Labs collagen (Verisol, so it is considered good quality) half way through December 2021. Looking back, that is when the problems started. I started sleeping restlessly and it got really bad in January. Full blown insomnia. My psoriasis got much worse, the blepharitis too. I have severe Endometriosis and was worried that if these other inflammation issues (psoriasis causes skin inflammation and blepharitis causes eye inflammation) were worse then maybe my endo was worse also since that can’t be checked on the outside.

Besides the inflammation symptoms I was experiencing extremely bad moods, feeling tense to the point of bordering on panic attacks and also a disrupted menstrual cycle.

I have been on Amitriptyline for 1,5 years and it worked wonders on my mood and sleep and I just couldn’t figure out why it wasn’t working any more. Then I realized that the only thing I changed was adding collagen to my diet in my fruit/vegetable smoothie ( I don’t drink coffee). So I started Googeling and found your article and stopped the collagen immediately. Have stopped for 2 days now and already my eyes are less red and inflamed. Pfew! It’s crazy and also scary how serious the side effects of collagen have been.

Do you think that besides the tryptophan lowering side effect that also the histamine might have played a part in my case? I don’t dare try the collagen with tryptophan supplement as the potential side effects are too serious to play around with. But I’m very bummed out about missing out on the skin and hair benefits.

Would love to hear your thoughts. I follow a vegetarian diet by the way and eat super healthy.

With Em I’d suspect an oxalate issue first because of the worsening psoriasis, blepharitis and endometriosis. She is also a vegetarian and this diet is often high in dietary oxalates. I write about oxalates and pain here.

However, with the “bad moods, feeling tense to the point of bordering on panic attacks and also a disrupted menstrual cycle”, I’d also suspect a serotonin-lowering impact. As mentioned above, a history of mood issues and antidepressant use can be a predisposing factor. She would need to work with her prescribing doctor if she wanted to use tryptophan or 5-HTP because Amitriptyline has the potential to cause serotonin syndrome.

It’s also possible that her symptoms are caused in part by a histamine or glutamate reaction too.

With appreciation for helping to create awareness about these issues with collagen

I have much appreciation for each of these women for asking these questions and sharing their symptoms so we can all learn. There is not much awareness about collagen being problematic for some susceptible folks and it’s a very rude awakening when you start using something for the health benefits and have a bad reaction. Hopefully their stories and others like this will help create more awareness.

The good news is that once you identify your cause/s and address them as above, you can often continue to consume collagen.

Resources if you are new to using tryptophan/5-HTP and other amino acids as supplements

Have you experienced any adverse symptoms when using collagen? Please share the symptoms so we can all learn from each other .

And were you able to figure out if it was due to low serotonin, a histamine or glutamate reaction or because of dietary oxalates?

If it was low serotonin, has tryptophan or 5-HTP helped so you can continue to use collagen?

If you have questions please share them here too.

Rebound insomnia after tapering a benzodiazepine: will taking GABA or any other natural supplement interfere with healing?

August 26, 2022 By Trudy Scott 14 Comments

This question was posted on one of the GABA blog posts by Fran, asking about about using GABA for insomnia shortly after having tapered a benzodiazepine she had used for 15 years:

I am a senior who took benzodiazepines (clonazepam) on advice of my doctor for sleep because of chronic fatigue for 15 years. Last year I weaned myself off the medication and it has been just over 10 months. No one tells you that when you stop taking them you go into a rebound insomnia phase and it can last a long time. The doctor still won’t admit that!

I joined benzo buddies, a group I found out about on your site and found much encouragement from the posts of many brave and determined people. One post mentioned that the drug actually overrides your GABA receptors so when you stop taking it they have to heal to become active again. My question is: Will taking GABA or any other natural supplement interfere with that healing. The writer of the post feels taking nothing is best for the brain to return to normal and that only time will do that.

I said I was sorry to hear about her struggles with her benzodiazepine prescription. Sadly it’s all too common and it’s seldom that folks are cautioned about the rebound insomnia and other issues seen with benzodiazepines.

I love benzo buddies and other benzo support groups and often recommend that clients join one of these groups for the community support aspect. I am really happy that Fran found encouragement.

However, I respectfully disagree with their message that GABA supplements or other supplements should not be used and that you should just wait for time to heal. We want to use everything at our disposal in order to heal as quickly as possible. And quality sleep is imperative for healing.

Also many of the most severely affected folks are part of these support groups, so it may well be all that they know, hence the advice they dispense.

Many do get relief with GABA during and post benzo taper and it won’t affect long-term healing (with a very low dose)

It is true that GABA receptors can be affected by benzodiazepines but despite this, many of my clients and others in my community do get relief from GABA during this period. Since we are all unique, some folks may have an issue, so we always do a trial with GABA if someone has rebound insomnia (and other low GABA symptoms of physical tension/anxiety, stiff and tense muscles, stress eating etc).

When someone can’t tolerate GABA they will know very quickly – typically in 1-2 days. If you can’t tolerate GABA it may feel the same as someone who takes GABA and doesn’t need it (i.e. GABA isn’t low) or when someone takes too much. This could make you feel light-headed, dizzy, feel a flush and/or feel too tired. You may even feel more anxious. Vitamin C is a wonderful antidote to all this and these short-term adverse reactions won’t interfere with long-term healing.

We also start with a very small dose – I typically have someone start with 25mg GABA and go up from there – and only use sublingual GABA. For some very sensitive folks we will start even lower as in this example where Syd gets sleep and body anxiety benefits with just 1.5 mg to 3 mg GABA.

Other nutrients that may also help with insomnia

We may also use other nutrients to help with sleep support and rebound anxiety (which is also common) and other symptoms, all based on each person’s unique needs. These may include tryptophan or 5-HTP if serotonin is also low (this can affect sleep and cause worry/ruminating type anxiety), melatonin if that is low (either sublingual or timed-release) and Seriphos if cortisol is high too. We may also combine GABA with theanine (research shows the combination may help some folks).

A full functional medicine and nutritional workup is recommended in order to be as nutritionally stable as possible. Ideally this happens before tapering starts but even if it’s done after the fact it can help with healing and symptom relief. Addressing histamine imbalances is one factor to consider as this can impact sleep (more on that below).

This is an important question that many folks ask so I appreciate her asking so I could share it as a blog post for others in a similar situation.

I am waiting to hear back about what happened when she did use GABA and how much she used. She mentioned that she did take GABA for a time at first but it only worked for a while. I find that during the taper and post taper, GABA needs can fluctuate as healing starts to take place. I have clients adjust up and down as needed.

More on benzodiazepine withdrawal and histamine issues

These medications have the most debilitating withdrawal reactions in all of medicine and Valium blocks DAO/impacts histamine levels:

World Benzodiazepine Awareness Day 2017: Awareness and Anxiety Nutrition Solutions

Benzodiazepines (Xanax, Klonopin, Ativan, Valium, Librium, and others) as well as Z-drugs (Ambien, Lunesta and others), which are similar, have the most debilitating withdrawal reactions in all of medicine.

This happens in regular, everyday people who are taking the medications exactly as their doctor prescribed. It also happens to people on what they think are “low doses” and is not just a “high dose” problem.

The benzodiazepine valium blocks DAO and impacts histamine levels: wisdom from Yasmina Ykelenstam and a tribute to her brilliance

Many people doing a benzodiazepine taper are often switched to Valium which is a DAO [diamine oxidase blocker (or histamine liberator)] and this further prevents histamine from being removed from the body [and can lead to increased anxiety].

Dyes are also triggers…the pink Xanax can be problematic.

GABA is as effective as benzodiazepines (which should only be prescribed for short-term use)

Many folks who have used benzos in the past, find GABA to be as effective. Another woman in my community, Dee, shared that she had taken Xanax in the past for panic attacks and her functional medicine doctor suggested GABA Calm as she wanted a natural product. This is her encouraging feedback: “I was amazed how it works just like the Xanax did – instant calm feeling within 10 mins of taking 2 capsules. I use them as needed when I am having heightened stress and anxiety.”

Ideally we want to use GABA instead of one of the benzodiazepines – which are all too commonly prescribed for anxiety, insomnia and pain – in order to avoid tolerance issues, dependence and withdrawal/tapering issues. The fact that they are used long term – like 15 years for Fran – further compounds the issues. Even a few months can be problematic for some folks. It’s important to be aware that this class of medication is intended for short-term use i.e. 2-4 weeks only.

Resources if you are new to using the GABA and other amino acids as supplements

If you are new to using GABA and any of other the 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).

Have you used GABA with success while tapering a benzodiazepine or shortly after tapering is complete?

Have you used other nutrients to help while tapering or post taper? If yes, which ones?

Did you find that GABA was not helpful? (which product and how much did you use?)

If you have questions please share them here too.

The importance of addressing pyroluria with chronic Lyme disease (and co-infections), MCAS (Mast Cell Activation Syndrome) and other chronic illnesses

August 5, 2022 By Trudy Scott 25 Comments

Pyroluria is a social anxiety condition that responds well to zinc, vitamin B6, evening primrose oil and a few other key nutrients, typically resulting in resolution of social anxiety symptoms within a few weeks with the correct combination and dosing. However there is much more to pyroluria than meets the eye. Addressing this biochemical imbalance is crucial for recovery from chronic Lyme disease (and co-infections), MCAS (Mast Cell Activation Syndrome) and other chronic illnesses caused by heavy metal toxicity, mold toxicity, multiple chemical sensitivities and Ehlers Danlos syndrome (amongst others).

Dr. Neil Nathan, MD, author of Toxic: Heal Your Body from Mold Toxicity, Lyme Disease, Multiple Chemical Sensitivities, and Chronic Environmental Illness (2018), shares this about pyroluria and chronic illness:

This biochemical imbalance is surprisingly common in chronically ill patients, and missing this diagnosis (by neglecting to test for and treat it) also denies us the opportunity to provide a simple, benign treatment that can help quiet down patients’ already overstimulated nervous systems.

(Here is my Amazon link to his book, which is excellent)

For over 15 years Dr. Dietrich Klinghardt has been saying you won’t see success with Lyme disease without also addressing pyroluria. He has seen a correlation with all his patients with chronic illness and pyroluria.

Let me quote from an article by Scott Forsgren, FDN-P and Dr. Dietrich Klinghardt, MD PhD: Kryptopyrroluria (aka Hemopyrrollactamuria): A Major Piece of the Puzzle in Overcoming Chronic Lyme Disease (a Townsend letter article published in 2017):

Based on testing with a lab in Holland, Klinghardt has found the incidence of KPU [Kryptopyrroluria or pyroluria] in Lyme disease to be 80% or higher; incidence of KPU over 75% in patients with heavy metal toxicity (lead, mercury, aluminum, cadmium, and others) and in children with autism over 80%.

These are very significant percentages of the patient population with chronic illness that may benefit from a treatment program that addresses KPU.

They also state what has long been known when it comes to pyroluria: symptoms are made worse by stress and “chronic infections, such as Lyme disease, may themselves serve as a trigger for the condition (of pyroluria).”

When it comes to MCAS, an updated version of this same article states that:

Klinghardt has worked with biochemists in Germany that are beginning to link KPU with mastocytosis or mast cell activation syndrome (MCAS).

They have observed that KPU treatment repairs the heme molecule, which notably stabilizes the mast cells and lowers the response to these relative rises in histamine.

I use the term pyroluria in this article, throughout my blog and in my book. It was coined by Carl Pfeiffer, MD PhD in the 1970s (after its discovery by Abram Hoffer in 1958). You’ll see these other terms used in various articles and in some of the older research: kryptopyrroluria (KPU), hemopyrrollactamuria (HPU), pyrrole disorder, mauve factor and sometimes malvaria.

As I shared in my interview with Dr. Kelly MCann on the summit, The Many Manifestations of Mast Cell Activation, it would be wonderful to get the terminology standardized and to get some case studies published. This would allow it to gain more acceptance in the mainstream and in functional medicine.

These papers, Discerning the Mauve Factor, Part 1 and 2, highlight some of the mechanisms as to why addressing pyroluria is so important:

“Treatment with nutrients – particularly vitamin B6 and zinc – reduces urinary excretion of HPL and improves diverse neurobehavioral symptoms in subjects with elevated urinary HPL.
Heightened HPL excretion classically associates with emotional stress, which in turn is known to associate with oxidative stress.
HPL correlated inversely with plasma glutathione
HPL is a promising biomarker for oxidative stress. HPL is known to cause non-erythroid heme depression, which lowers zinc, increases nitric oxide, and increases oxidative stress.”

The Forsgren/Klinghardt article above, covers additional mechanisms. With regards to MCAS specifically, the pyroluria supplements – zinc, vitamin B and evening primrose oil – all play a role in reducing histamine, providing immune support and reducing inflammation. And they provide nutritional support for the anxiety and mental health aspects of the condition – directly for pyroluria and indirectly via neurotransmitter support (since they are necessary cofactors for making serotonin and GABA).

Here is some of the research I gathered on some of the ways zinc, vitamin B6 and evening primrose oil (EPO) may help when it comes to MCAS:

This paper, Role of Zinc Signaling in the Regulation of Mast Cell-, Basophil-, and T Cell-Mediated Allergic Responses, states that “zinc signaling dysregulation is a leading health problem in inflammatory disease and allergy…. These findings may lead to future therapeutic applications for suppressing inflammatory or allergic responses.”
In this paper, Effect of pyridoxine on histamine liberation and degranulation of rat mast cells, the authors share that vitamin B6 “significantly inhibited rat mast cell degranulation and histamine release induced by egg albumin allergen.” This paper also discusses the lack of toxicity of vitamin B6 and “the possibility that other mechanisms of action may be involved, such as the improvement in tryptophan metabolism.”
This paper, Alterations of mast cell mediator production and release by gamma-linolenic and docosahexaenoic acid/DHA, was looking at mastocytoma (a type of mastocytosis) using a cell line as a model for canine atopic dermatitis (cells were incubated with the wasp venom peptide.) They found that “GLA decreased histamine release …and DHA diminished prostaglandin production.” Evening primrose oil is a source of GLA and fish oil is a source of DHA.

If you’re new to MCAS, Dr. Jill Carnahan has an excellent overview here: Mast Cell Activation Syndrome: Here’s What You Need to Know When Histamine Goes Haywire and I’ve blogged about PharmaGABA often being an issue and making anxiety worse when you have MCAS or histamine issues.

The ramifications of this biochemical imbalance are far-reaching

Here is the pyroluria questionnaire / symptoms list (from my book, The Antianxiety Food Solution). It has been updated with recently with additional conditions. You can read about pyroluria prevalence and associated conditions here.

Here are some of my pyroluria blog posts you may find useful (click each of the linked articles to read further). As you will see the ramifications of this biochemical imbalance are far-reaching:

Feel free to use the search feature on the blog to find additional information about pyroluria. I have written about it extensively. I have it myself and it’s really common – I see it in about 80% of my community – so I am pretty passionate about the topic.

Resources if you are new to pyroluria

If you are new to pyroluria, there is an entire chapter on the topic in 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 the pyroluria supplements on your own. And be sure to share it with the practitioner/health team you or your loved one is working with. We need the wider practitioner community to be aware of this condition and the importance of addressing it.

I use individual amino acids such as GABA and tryptophan with all my anxious clients and we always layer in the pyroluria protocol. There is also 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, self-medicating with alcohol and more.

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 and pyroluria supplements that I use with my individual clients and those in my group programs.

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

Have you used the pyroluria protocol as part of your recovery from chronic Lyme disease or MCAS (or another chronic illness)?

Did you learn about this from your practitioner or elsewhere? (please share where)

If you’re a practitioner, is the pyroluria protocol part of your plan for clients and patients? And has it been a game-changer for them?

If you have questions please share them here too.