insomnia

How did you come up with the idea of using GABA on the tongue? (GABA is a calming amino acid supplement used to ease physical anxiety symptoms)

May 5, 2023 By Trudy Scott 23 Comments

Today I’m answering this question that has been asked of me a number of times: How did you come up with the idea of using GABA on the tongue? Since there is so much controversy about GABA and the blood brain barrier and whether GABA actually works, it’s time to address this question via a blog post. Using GABA on the tongue, under the tongue and/or on the inside cheek approach is also the most effective way to use GABA and when it’s not used in one of these ways many individuals end up saying GABA didn’t help ease their anxiety and other low GABA symptoms. I also define sublingual – the term I use when discussing this approach – and how this method is broader than just being sublingual. And I share a case study. More on all this below.

So how did I come up with the idea of using GABA on the tongue?

I’ve always had clients use a GABA capsule opened on to their tongue for the initial trial, based on them having low GABA symptoms of physical anxiety, stiff and tense muscles, tension, stress eating, insomnia, laryngospasms, intrusive thoughts and self-medicating with alcohol. Doing it this way means we get results right away (for example within 5 minutes they can say their physical anxiety has improved from 9/10 to say 6/10) and we know how to proceed in terms of dosing.

Then I’d have clients go home and swallow the GABA capsules. However not everyone continued to get the same benefits they experienced in the one-off trial so I’d suggest a higher dose, also swallowed.

Then I decided to have clients just continue to use GABA capsules opened or as powder or a liposomal product (more on these below) after the initial one-off trial. Having clients use GABA this way resulted in consistent and superior results and it’s what I continue to recommend.

The many benefits of this approach

There are many benefits to using this approach of using GABA on the tongue:

Seeing better results and in some cases getting results (fullstop!)when you were not seeing any benefits swallowing a GABA capsule
Better results when you have digestive and/or liver issues because GABA bypasses the liver and digestive system.
Quicker/almost immediate results (in 5-10 minutes and often quicker) which is more encouraging and gives you hope right away.
You need less GABA so it’s money-saving too.

I now have folks use all the amino acids this way and it’s working very well.

Defining sublingual, buccal and roof of the mouth and which is best

I use the term sublingual very broadly – under the tongue, in the cheek or on the tongue – for at least 2 minutes and not washed down with water or food right away.

It’s easier but technically sublingual means using GABA under the tongue. This way it is absorbed directly into the bloodstream for immediate use, bypassing the liver and digestive system.

When I talk and write about using GABA on the tongue or sublingually, I’m often asked: How is on tongue vs under tongue different or is it?

This paper, Sublingual Mucosa as a Route for Systemic Drug Delivery summarizes the benefits of sublingual delivery and which area of the mouth provides better results (for drug delivery)

Drug delivery via the oral mucous membrane is considered to be a promising alternative to the oral route. Sublingual route is useful when rapid onset of action is desired with better patient compliance than orally ingested tablets.

In terms of permeability, the sublingual area of the oral cavity (i.e. the floor of the mouth) is more permeable than the buccal (cheek) area, which in turn is more permeable than the palatal (roof of the mouth) area.

The portion of drug absorbed through the sublingual blood vessels bypasses the hepatic first‐pass metabolic processes giving acceptable bioavailability.

I find that either way works (under and on the tongue) and so does using it rubbed on the inside of the cheek/buccal area. I share more on that here – Paroxysmal laryngospasm with low GABA physical-tension-type-anxiety: Is GABA powder rubbed on the inside of the cheek a solution?

One way you could hedge your bets is to use a GABA powder (with some water) or lozenge or liposomal and swish it in the mouth, making sure it gets under the tongue, onto the cheek areas and on top of the tongue. Swish it for about 2 minutes before swallowing. And don’t wash it down with water or food right away.

Amanda’s feedback on GABA calm vs GABA capsules

When I shared some of this on Facebook, Amanda shared her positive feedback:

Sublingual is more effective and faster. I’ve been taking capsules at night and noticed improvement with sleep. Last week we decided to sell our house and I was soooo stressed with prepping and dealing with people.

I had a bottle of GABA Calm I ordered from your recommendation (I didn’t mean to order because I had lots of gaba capsules). I was so thankful because I took two of those and about 15 minutes later I was much more relaxed. They are so helpful!!

A common question I get is this: is GABA Calm better than plain GABA powder? Some folks prefer GABA Calm and others the powder. Either way we do increase to find the ideal dose and using powder allows us to go higher more easily.

But we are all unique and it’s a matter of finding what works best for your needs. Amanda also shared why she feels GABA Calm is so helpful:

GABA Calm also has tyrosine, magnesium, and taurine. It seems for me the combination of the magnesium and taurine with the GABA takes it from helpful to stellar. I know I have a history of low taurine so perhaps that’s why for me.

All this and the fact that it’s a lozenge that is dissolved in your mouth and absorbed quickly makes it so effective for her and so many of my clients.

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 and low endorphins).

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, 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 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.

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.

What have you found, is GABA opened/sublingual more effective than a GABA capsule swallowed?

What works best for your unique needs – a powder, a chewable or a liposomal product?

And do you find it more effective under the tongue/sublingual, in the cheek/buccal or on the tongue? Or have you not noticed or perhaps find similar benefits with all three ways?

If you have questions and other feedback please share it here too.

Multiple sclerosis: low GABA research and the amino acid GABA for anxiety, muscle stiffness, swallowing/voice issues and pain

April 14, 2023 By Trudy Scott 12 Comments

I’m excited about the GABA research – an older paper and some new studies – on multiple sclerosis (MS). This means there is the potential for using GABA supplementation in similar ways it’s used with other conditions where anxiety, insomnia and pain are issues. This can include the typical low GABA-type physical anxiety, stiff and tense muscles, insomnia and pain, and also MS-specific issues such as spasticity, laryngospasms, balance issues, swallowing and speaking/voice issues and sensorimotor problems.

Anxiety is common in MS and benzodiazepines are commonly prescribed. The ideal is to use the amino acid that supports GABA, instead of needing to use benzodiazepines. I share some of the GABA/MS research and specific applications for using GABA below.

Prevalence of anxiety/depression in MS and the use of benzodiazepines

Anxiety and depression is common in multiple sclerosis. This paper, The incidence and prevalence of psychiatric disorders in multiple sclerosis: A systematic Review, included 118 studies and found that:

Among population-based studies, the prevalence of anxiety was 21.9% (and up to 35.0% in some papers), 23.7% for depression, 14.8% for alcohol abuse, 5.83% for bipolar disorder, 4.3% for psychosis and 2.5% for substance abuse.

psychiatric comorbidity remains understudied.

What is concerning is that benzodiazepines such as Ativan, Valium and Xanax are commonly prescribed for MS patients for their anxiety, insomnia, spasticity and pain. Recent research, Use of Benzodiazepines and Z-Drugs in Multiple Sclerosis found that benzodiazepine use is more “more common in people with MS than in general population controls, and use of these agents is in persons with MS is often chronic” i.e. for longer than 6 months.

This is problematic given that anything over 2 weeks can cause dependence, tolerance and withdrawal. They can cause balance issues and can actually cause anxiety and insomnia. Someone in my community was totally disabled for over 3 years with “locked shoulder muscles, neck, jaw …internal vibrations… bad headaches, jelly legs, distorted vision like floaters and squiggles and fireworks …cortisol rushes through the body.. And tortured every day.” Read more about her horror story and benzos here.

The ideal is to use the amino acid that supports GABA, instead of needing to use benzodiazepines.

Low GABA plays a role in multiple sclerosis: the research

Low GABA (gamma-aminobutyric acid) plays a role in multiple sclerosis. This paper, Reduced gamma-aminobutyric acid concentration is associated with physical disability in progressive multiple sclerosis states that there are

reduced GABA levels in the hippocampus and sensorimotor cortex of patients, and show that reduced GABA in the sensorimotor cortex is associated with increased motor impairment. Changes in GABA may be a marker of neurodegeneration.

This study supports the idea that modulation of gamma-aminobutyric acid neurotransmission may be an important target for neuroprotection in multiple sclerosis.

Of course, the authors don’t mention using the calming amino acid GABA, but we extrapolate and use what we see clinically in other conditions like autism (more on that below).

Two other papers support the GABA connections. This 2021 paper, Altered Plasma Metabolic Profiles in Chinese Patients With Multiple Sclerosis, observed “a great increase in the levels of L-glutamic acid” in patients with MS. Increased glutamate typically means low GABA levels.

Guanidinoacetic acid (GAA) is an experimental nutrient that is new to me, but the GABA effects and mechanisms are encouraging. In this 2022 paper, Guanidinoacetic Acid as a Nutritional Adjuvant to Multiple Sclerosis Therapy the author states that GAA may benefit MS patients via “modulation of gamma-aminobutyric acid (GABA)ergic neurotransmission and brain oxidant-antioxidant status, or a reduction of glutamate neurotoxicity.’

The author also shares that “demyelination is often characterized by various neurochemical abnormalities in GABA-glutamate metabolism.”

In case you’re new to MS and demyelination, this Mayo Clinic article describes them as follows:

A demyelinating disease is any condition that causes damage to the protective covering (myelin sheath) that surrounds nerve fibers in your brain, the nerves leading to the eyes (optic nerves) and spinal cord. When the myelin sheath is damaged, nerve impulses slow or even stop, causing neurological problems.

Multiple sclerosis is the most common demyelinating disease of the central nervous system. In this disorder, your immune system attacks the myelin sheath or the cells that produce and maintain it.

This attack causes inflammation and injury to the nerve sheath and ultimately to the nerve fibers that it surrounds. The process can result in multiple areas of scarring (sclerosis).

I gathered some of this research while preparing for an interview with the wonderful Dr. Terry Wahls, MD and author of “The Wahls Protocol.” We were both pleasantly surprised to see these GABA/MS connections.

Using GABA for easing anxiety, overwhelm and insomnia in multiple sclerosis

There is no research that I am aware of that has studied the use of GABA supplementation in MS. We can, however, extrapolate from other conditions and use GABA for easing various MS symptoms based on what we see clinically.

As mentioned above, anxiety is common in MS and if you have the low GABA type of physical anxiety, GABA is worth a trial for easing typical low GABA symptoms of physical anxiety, feelings of overwhelm and intrusive thoughts, stress eating, using alcohol to relax or fit in socially and insomnia. You can read more about GABA for physical anxiety here and see all the low GABA symptoms here.

And here are a few examples/case studies:

Using GABA to help with balance, and sensorimotor and coordination issues in multiple sclerosis

These case studies illustrate an application for GABA being used for balance, sensorimotor and coordination issues that are common in MS (they are not folks with MS):

Much of the research in this area has been done with autism, as illustrated by this GABA Oolong tea study tea in children with autism. They saw improvements in sensorimotor skills, autism profiles, anxiety and sleep.

Using GABA to help with stiff and tense muscles, spasticity, voice issues, laryngospasms and difficulty swallowing in multiple sclerosis

GABA helps to ease stiff and tense muscles in those with physical anxiety. In a similar way we see GABA help with these common MS symptoms: muscle spasms, spasticity, voice issues, laryngospasms and swallowing difficulties (dysphagia affects about a third of folks with MS).

These case studies illustrate an application for GABA being used for some of above issues that are common in MS (they are not folks with MS):

Again, there is no research that I am aware of specifically with MS, but clinically I see GABA helping all of the above symptoms related to spasms and muscle tension, often with anxiety and pain as an underlying factor too.

Other MS symptoms that may also be supported by addressing low GABA levels: bowel issues and rectal spasms, bladder issues/spasms, tremor and problems with memory/thinking, and possibly even vision issues.

I really look forward to seeing future research on the use of the amino acid GABA in MS. And I’d love to be involved in some studies if you are associated with a research facility or do research.

Low serotonin and low endorphins are common in multiple sclerosis too

Low GABA is just the tip of the iceberg when it comes to the underlying neurotransmitter imbalances in MS.

The amino acid DPA/d-phenylalanine may help ease some of the low endorphin pain symptoms, weepy kind of depression, and alcohol addiction. You can read about this here.

Tryptophan and/or 5-HTP may help ease some of the low serotonin worry-type of anxiety, fear, panic attacks, obsessing, low mood and MS-specific pain issues and insomnia. I’ll write more about this and the supporting research in a follow-up blog.

If you do have more than one imbalance (which is not unusual), you need to figure out which imbalance you have and address that with the relevant amino acids, one at a time. I have clients pick the area that is more problematic for them and start there.

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

If you are new to using GABA and the other 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 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). This is a paid online/virtual group program where you get my guidance and community support.

Do you have multiple sclerosis and has the amino acid GABA helped with your anxiety and fears; muscle stiffness and spasticity; swallowing, laryngospasms and voice problems; balance and sensorimotor issues, insomnia and pain?)

How much has helped and which product do you use?

Do you find sublingual, powder or an opened capsule helps more than swallowing the GABA capsule?

Were you surprised that GABA would help so much?

What else has helped your multiple sclerosis symptoms? And have you also addressed low serotonin and low endorphins with amino acids tryptophan and DPA?

If you have questions and other feedback please share it here too.

A case of enterobiasis presenting as post-traumatic-stress-disorder / PTSD (i.e. a common and parasitic pinworm infection)

February 3, 2023 By Trudy Scott 11 Comments

Enterobiasis (oxyuriasis) is a common infection in humans caused by Enterobius vermicularis (E. vermicularis), a human intestinal helminth. Because of the easy way of its transmission among people, it has an extremely high prevalence in overcrowded conditions, such as nurseries and primary schools. Oxyuriasis’s symptoms are extremely diverse in children, ranging from nausea, diarrhea, insomnia, irritability, recurrent cellulitis, loss of appetite, nightmares and endometritis.

Here we report a curious case of oxyuriasis in the settings of a refugee camp in Greece. The patient was a 10-year old Syrian female, who presented with unusual and vague symptoms like insomnia and irritability. Given the violent background of the Syrian warzone that the patient had escaped, she was firstly diagnosed with post traumatic stress disorder (PTSD) before eventually getting correctly diagnosed with enterobiasis.

This infection is the first documented case of enterobiasis in the settings of a refugee camp and can highlight the unsanitary living conditions that refugees have to endure in those camps.

The above is the abstract from a 2017 paper: A case of enterobiasis presenting as post-traumatic-stress-disorder (PTSD): a curious case of the infection with predominant mental health symptoms, presenting for the first time in the settings of a refugee camp

In addition to her symptoms of insomnia and irritability, she had a decreased appetite and mild abdominal (tummy) pain. She was also experiencing nausea and vomiting and had a slightly raised body temperature (subfebrile). She was severely malnourished and had lost 3kg/6.6lbs in 5 days.

Because of the violent nature of her situation she was initially seen by a psychologist but her symptoms worsened in a few days. When this young girl complained about itching in the perianal area (around her anus), the clinic reassessed her and scars around the anal area from the scratches.

They then confirmed enterobiasis/pinworm after using a piece of clear adhesive tape “to collect a specimen from the perianal surface of the girl, for three consecutive mornings … A microscopic examination showed the presence of oval shaped eggs, which is typical for the specific helminth [parasitic worm].”

She was treated with “two doses of albendazole, with each dose two weeks apart, in order to avoid reinfection …. And after a 3 month follow-up period, the patient remains asymptomatic without any signs of recurrence.”

An overview of pinworm infections, symptoms, tape test and treatment approaches

This WebMD article offers an overview of pinworm infections, the symptoms, the tape test and treatment approaches.

As you’ll read it’s not only a problem in refugee camps – it’s “very common in elementary school-aged children” and it’s the most common kind of worm infection in the United States. “Most of the time, pinworm infections don’t cause serious problems.” However, when one child (or adult) gets a pinworm infection it can easily be spread to the entire family. The Syrian refugee paper mentions the whole family was tested.

Systemic infection: female health issues and gut health

The WebMD authors also state, “in rare cases, and especially if you have a lot of them, the pinworms can travel from the anal area up the vagina to the uterus, fallopian tubes, and around the pelvic organs. This can cause inflammation of the vagina (vulvovaginitis).”

I first learned about these serious systemic issues in women from naturopathic doctor Rachel Arthur at a conference in Australia. Contrary to the WedMD article, she believes this is not rare and more common than you’d expect, contributing to hormonal imbalances and even infertility.

The research confirms the impacts of pinworm on the gut, with reports of pinworm associated with appendicitis, pinworm in the liver, pinworms contributing to dysbiosis and pinworm being a factor in inflammatory bowel disease.

The WebMD article doesn’t mention the mental health symptoms and mechanisms but you can read more about that (and my interview with Dr. Jay Davidson) below.

Annual deworming and concerns about drug resistance?

I’m not going to get into anti-parasitic medications and herbal alternatives in this blog post – Dr. Jay talks about mimosa pudica seeds and Dr. Rachel recommends chondroitin sulfate – but do I want to mention that there are many public policy papers calling for annual deworming procedures for everyone. It’s also mentioned in the above Syrian refugee paper, as is hand-washing for prevention.

And many folks recall annual deworming concoctions as a child and did/do the same with their children.

There is, however, the concern about antiparasitic drug resistance similar to what is being seen with antibiotics and antiviral drugs.

If you are new to parasites and their impacts on mood issues, anxiety and insomnia and more

If you are new to parasites, here are some insights from an interview I did with Dr. Jay Davidson on The Anxiety Summit 5: Gut Brain Axis. The topic of our interview is – Parasites, Anxiety and TUDCA for Your Liver. He shares this:

The Greek meaning of parasite is one that sits at another’s table. So essentially think of a parasite as it’s taking things from you. It’s taking nutrients, it’s taking key things that your body needs and literally off of you, not to the point that it’s killing you because then you’re not a good host to give a good environment. So it’s basically just kind of sucking you dry.

We discussed symptoms individuals may experience: mood issues, anxiety and insomnia (especially around full moon). He shared that with insomnia “the big issue that I see is restless sleep where you toss, you turn, you wake often. You can’t just be relaxed when you sleep. Parasites get active when you go to bed. The more active they are within your body and the more you’re trying to calm down, the more your body is getting stressed out. This is where teeth grinding happens when you sleep.

This is very typical and likely the kinds of insomnia symptoms this young refugee girl experienced too. Pinworm is more active at night so the itching around her anus and the need to scratch would have affected her sleep too. This is a classic sign of pinworm.

With regards to anxiety and mood issues and possible mechanisms, Dr. Jay shares how parasites contribute to neurotransmitter imbalances:

Parasites will eat the protein you eat and not allow your body to break down that protein into amino acids. That’s why amino acid therapy can be so beneficial symptomatically and change people’s lives, because they’re getting these amino acids that they’re not getting when they have parasites.

When we digest protein, the amino acids are needed to help us make neurotransmitters. With his amino acid comments, he is making reference to my work with the amino acid tryptophan to support your low serotonin worry-type of anxiety symptoms and the amino acid GABA to support your low GABA physical-anxiety type symptoms. They are wonderful for quick relief of anxiety and mood symptoms, and even help sleep problems too. But as he says “you always want to make sure to go to the underlying cause to remove the parasitic infection.”

Other symptoms of parasitic infection that we discuss at length: restless legs and calf cramping, diarrhea, bowel urgency, SIBO (small intestinal bacterial overgrowth), vertical wrinkles above your mouth, nail-biting, food sensitivities, bed-wetting and night sweats. These are all symptoms that we need to look for and then consider stool testing and/or the sticky tape test/clear adhesive tape test for pinworm (as mentioned in the Syrian refugee paper and WebMD article above).

If you missed this interview and/or summit, you can find the purchase link on the above blog and here.

Tryptophan is not working (possibly because of parasites) and toxoplasma gondii (and GABA/anxiety)

Here is some additional reading on parasites on my site and in the literature:

Tryptophan doesn’t work, then it does and then it doesn’t: could it be hormonal shifts, dietary factors and/or parasites? As I share here, if you have a very pronounced shift in symptoms for 4-5 days around a full moon each month – more severe insomnia, more anxious, more depressed – I would want to check for parasites (as well as hormonal impacts and everything else covered on this blog).
Toxoplasma gondii: schizophrenia, bipolar disorder, OCD and unresolved anxiety? As I share in this blog, toxoplasma gondii is a microscopic parasite that infects cats and can be found in the soil – research shows it may be a factor in schizophrenia, bipolar disorder and OCD in susceptible individuals. Could toxoplasma gondii could be one of the root causes of unresolved anxiety? I believe so and feel it’s under-rated.
In this study, Toxoplasma gondii Infections Alter GABAergic Synapses and Signaling in the Central Nervous System, the authors share that “toxoplasma interferes with GABA signaling in the brain …playing a role in seizures and other neurological complications seen in Toxoplasma-infected individuals.” This particular parasite disrupts the workings of the glutamic acid decarboxylase 67 enzyme (GAD67), used to make GABA from glutamate, and very likely contributes to increased anxiety symptoms too.

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

If you are new to using tryptophan, GABA or any of the other 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 and low serotonin).

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.

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 or a family member have had a pinworm infection, what symptoms did you experience and was the entire family affected?

Have you had hormonal and/or pelvic issues and/or gut issues as a result of systemic infection with pinworm?

How have other parasitic infections impacted your health?

How familiar are you with the fact that pinworm and other parasites can affect your mood, anxiety and sleep, as well as cause gut issues?

If you’re interested in learning more about testing and herbal protocols please let me know. If you’d like to share what has worked for you please do share too.

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

Coconut Macaroon Mini Muffin recipe (low oxalate)

January 20, 2023 By Trudy Scott 18 Comments

If you have dietary oxalate issues (pain, anxiety, insomnia, restless legs, hearing loss, eye issues, unresolved thyroid issues, bladder issues and more) and yet really miss the occasional muffin this Coconut Macaroon Mini Muffin recipe is a delicious low oxalate option. I see way too many so-called healthy gluten-free recipes that use almond flour and it’s concerning given that almonds are high oxalate foods. If you’re new to the dietary oxalate issues you can read more about this below. I’m finding it to be underappreciated as an issue especially in menopausal women when symptoms seem to be more severe in susceptible individuals. I have also found that using almond flour in baking affects your zinc/copper balance, increasing copper and hence causing more anxiety and even panic attacks.

If you don’t have dietary oxalate issues, you can certainly enjoy this recipe too. The addition of flaked coconut does make it similar to macaroons.

Coconut Macaroon Mini Muffin recipe (a low oxalate option)

Ingredients

1/2 cup melted butter
1/2 cup coconut sugar
4 eggs
1/2 teaspoon vanilla
1/2 cup sifted coconut flour
2 cups coconut flakes

Method

Melt the butter over low heat and add the coconut sugar. Once it’s cooled add the eggs and vanilla. Stir in the coconut flour and coconut flakes.

Spoon the mixture into a greased mini muffin pan. Bake at 375 degrees F/ 190 degrees C for 18 – 20 minutes. The muffins don’t rise at all but will start to turn golden brown. Remove and cool on a cooking rack. Makes 12 mini muffins.

Eat warm or when cooled. Serve with butter and/or cream and/or coconut butter. For a little added sweetness a small amount of raw honey can be spread on a muffin too.

I adapted this recipe from the Coconut Butter Cookies recipe in “Cooking with Coconut Flour” by Bruce Fife ND. I pretty much always do this when I cook – adapt recipes to my needs and likes – and always reduce the sugar. In this instance, I halved the sugar and used coconut sugar.

The original recipe does have a reduced sugar option suggesting using ½ cup of sugar and adding ¼ teaspoon stevia. I’d find this too sweet.

I decided to cook them in mini muffin pans instead of making cookies on a baking tray but you could always try this option. Use the same temperature and cooking time per the original recipe.

They were a little dry (next time I’ll use a little extra butter in the recipe) but eating them with butter and/or cream made them delicious. I tried both – I always like to include some healthy fats. If dairy isn’t tolerated, coconut cream could be substituted. I suspect coconut oil could be substituted for the melted butter but have not tried it.

Here is “Cooking with Coconut Flour” by Bruce Fife ND. You can find it on Amazon here (my link). I’ve baked a number of recipes from this book and I’m impressed. I really appreciate that it’s all coconut flour recipes with no almond flour or other gluten-free flours used.

It’s ideal to keep baked goods – especially the ones shown on the cover of this book – to a minimum. But for an occasional treat this recipe book is excellent.

If you’re new to dietary oxalates as a possible issue

This blog post is a helpful one to start with if you’re new to dietary oxalates and the issues they can cause: Oxalate crystal disease, dietary oxalates and pain: the research & questions

These are the common medium-oxalate and high-oxalate foods that many folks have problems with: nuts, nut-butters and nut-flour (especially baking with almond flour and something to watch when eating Paleo or GAPS), wheat, chocolate, kiwi fruit (very high – see the raphides image on the above blog), star fruit (also very high), beets, potatoes, sweet potatoes, legumes, raspberries, spinach and soy.

In the above blog post, I share an overview of oxalates, my pain issues with dietary oxalates (severe foot pain and eye pain), and deeper dive into the condition called oxalate crystal disease (with some of my insights and questions).

The big take-aways are that calcium oxalate crystals are sharp and can cause far reaching harm beyond pain – such as unresolved anxiety, thyroid issues, neurological symptoms, eye issues, hearing loss, bladder issues, headaches, fatigue, insomnia, restless legs, autism symptoms and more. You can have issues with dietary oxalates and not have kidney disease/kidney stones, although there is very little research supporting the latter.

You may find these oxalate blogs helpful too:

What dietary oxalates issues have you experienced and has a low oxalate diet helped you?

Do let us know if you make this recipe and enjoy it.

Feel free to share a favorite recipe of something you’ve adapted to be low or even medium oxalate.

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

Irukandji syndrome: severe pain, nausea, breathing difficulties and a feeling of impending doom (impact on serotonin and other neurotransmitters?)

December 30, 2022 By Trudy Scott 14 Comments

Irukandji syndrome is in the news again. In addition to the jellyfish sting causing severe pain, nausea and breathing difficulties, the research states there is a feeling of impending doom after you’re stung. I’m sharing this current news from Australia and a recent study because I’m curious about the mechanisms and short- and long-term impacts on serotonin and other neurotransmitters, likely affecting anxiety, depression, pain and insomnia. And I’d like to help create awareness since there is not 100% consensus on what to do right away after a sting and less awareness in the medical community than I feel comfortable with.

From the ABC article published this week in Australia: “Another child has been flown to Hervey Bay Hospital with a suspected Irukandji sting after swimming in a creek off Wathumba Road on K’gari (Fraser Island) in Queensland, Australia on Wednesday afternoon.

The key points of the article:

“Three young girls and a boy have been flown to hospital with suspected Irukandji stings in the past two days
The jellyfish stings can cause severe pain, nausea and breathing difficulties
A Toxicologist is calling for more research into their movements and physiology”

The yahoo news article expanded on the symptoms: “They have this severe body pain, often low back pain, nausea, vomiting, and this feeling of impending doom that sort of lays over the top of this whole thing.”

I found the latter interesting as impending doom is a classic sign of low serotonin. So I went digging into the research. I was enlightened and surprised by what I found.

Raising awareness on this worldwide increasing threat

This 2022 paper, Raising Awareness on the Clinical and Forensic Aspects of Jellyfish Stings: A Worldwide Increasing Threat is eye-opening and concerning and also mentions the impending doom symptom.

Irukandji syndrome is a severe illness produced by the envenomation i.e. injection of venom, of some species of small jellyfish from the Cubozoa class, known as box jellyfish.

It consists of a clinical picture dominated by systemic symptoms similar to a catecholamine surge, including hypertension, tachycardia, intense pain, and muscle cramping, eventually leading to pulmonary edema, shock and cerebral hemorrhage.

Also listed are symptoms of anxiety, restlessness, headache, localized sweating and impending doom. A feeling of impending doom is a classic symptom of low serotonin.

With regards to Irukandji syndrome it’s becoming a worldwide problem: “The first cases described happened in the northern Australian territories. However, similar disorders have been observed all over the tropical waters, including Thailand, the Caribbean, Florida, and Hawaii.”

The good news is that the authors state “Irukandji syndrome is typically not deadly, especially if supportive care is given early” and “not all encounters with species capable of producing Irukandji syndrome result in this clinical state.” They also share that typically the severe pain only lasts a few hours but do mention one case where “pain recurred up to a year later.” I discuss possible longer term effects below.

As you read the paper, be aware there are many types of jellyfish with many different mechanisms. Cubozoa includes the deadliest jellyfish species and includes Carukia barnesi and Chironex fleckeri. (commonly known as the Australian box jelly). It’s the Carukia barnesi that causes Irukandji syndrome.

The images in the above paper are graphic so be warned.

There is not 100% consensus on what to do right away

What is also really concerning is that there is not 100% consensus on what to do right away. This 2017 paper, Cubozoan Sting-Site Seawater Rinse, Scraping, and Ice Can Increase Venom Load: Upending Current First Aid Recommendations, published by Hawaiian researchers, found the “best outcomes occurred with the use of venom-inhibiting technologies (Sting No More® products)” and they state not to use a sea water rinse. They also found vinegar and heat treatment were less effective with certain types of jellyfish.

And yet the tentative recommendation from the above 2022 paper is to use vinegar, heat, sea water, and careful removal of remaining tentacles with tweezers quickly because only “about 1% of nematocysts (stinging cells) discharge upon initial contact.” They do suggest using Sting No More® before removing tentacles in order to deactivate the nematocysts.

I’m not sharing any of the above as conclusive in all situations but more to illustrate what both papers state: further research is needed in different places of the world, as different jellyfish species seem to react differently to the treatments.

There is also less awareness in the medical community than I feel comfortable with hence my desire to share this so you are more aware if you or a family member is stung by a jellyfish.

Are there possible long-term impacts on anxiety, depression, pain and insomnia? (and the potential role of amino acids)

Just like we have long-term impacts on anxiety, depression, pain and insomnia with Lyme disease and other infections like Bartonella – due to effects on serotonin, GABA and other neurotransmitters – do we need to consider these long term impacts after a jellyfish sting too?

I have to wonder if there are also longer term impacts given the trauma of the situation and the many medications that are needed to save your life: nitroglycerin, opioids, benzodiazepines and others.

If mood, anxiety, pain and sleep issues persist after the acute recovery phase (which can take up to 3 months and more) and there are other signs of low serotonin, GABA, dopamine and endorphins, it’s important to consider the use of targeted amino acids. I recommend tryptophan or 5-HTP for low serotonin symptoms (worry type of anxiety, insomnia and low mood), GABA for low GABA symptoms (physical anxiety and tension), tyrosine for low dopamine symptoms (depressed with low energy and poor focus) and DPA for low endorphin symptoms (pain and weepiness).

It would be wonderful to see research in this area.

Is there a possible role for GABA right after the sting too?

Given there is “hypertension, tachycardia, intense pain, and muscle cramping”, would the amino acid GABA help?

With Irukandji syndrome, “there have been reports of blood pressures as high as 300/180 mmHg” (normal is 120/80 mmHg). In one study, 80mg GABA was found to reduce mild hypertension and it’s possible that a higher dose of GABA may help right after the sting. It may also help to alleviate pain and muscle tension/muscle cramping too.

It would be wonderful to see research on GABA use right after the sting too.

Resources if you are new to using amino acids as supplements

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

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.

I do hope these 4 young Australian children are doing well after having been stung.

Have you or a family member been stung by a jellyfish? Where did it happen and what type of jellyfish? What symptoms did you experience? What was the treatment and what was recovery like?

Have you or your family member had any long-term lingering symptoms of anxiety, depression, pain and insomnia? Have the amino acids or other solutions helped?

If you’re a practitioner have you seen long-term lingering symptoms of anxiety, depression, pain and insomnia in your clients/patients who have had a jellyfish sting?

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

GABA supplementation may offer a new approach for the prevention and treatment of asthma (and it helps anxiety, ADHD and insomnia)

December 16, 2022 By Trudy Scott 12 Comments

If you’re already taking the amino acid GABA for physical anxiety, have you noticed if it’s also helping to ease your asthma symptoms too? This may sound surprising but research shows GABA may reduce inflammation and spasms and help with asthma symptoms via these mechanisms. What’s encouraging is the fact that GABA supplementation also helps with anxiety, obesity, ADHD and insomnia which commonly occur with asthma and can be associated with inflammation too. It’s so important to be addressing the root causes of asthma because of the many neuropsychiatric side-effects of asthma medications. This blog addresses all of these topics.

We’ll start with the research first. In this study, Effect of gamma-aminobutyric acid treatment on plasma substance P and calcitonin gene-related peptide levels in children with asthma, of 75 children with asthma, 36 children were in the GABA treatment group and received oral GABA (25-30 mg/kg per day) in addition to standard asthma medications.

The authors propose that airway inflammation may be a factor in asthma and GABA helps because it reduces SP (substance P) and CGRP (calcitonin gene-related peptide), easing neurogenic inflammation and tracheal spasms.

The conclusion of the study is that oral GABA:

can significantly decrease plasma levels of SP and CGRP in children suffering from acute asthma.

It may offer a new approach for the prevention and treatment of asthma.

(this is my best translation from the Chinese paper).

Dosing of GABA for asthma

The children in the study group received oral GABA of 25-30 mg/kg per day. For a 100 lb /45 kg child this would equate to 1125 mg -1350 mg of GABA per day.

As I always share, I don’t recommend using GABA based on the weight of the person and I consider this a high dose. For adults, 125 mg GABA is a good starting dose with 125 mg often used 2-4 times a day. For a child, ¼ to ⅓ this dose is typically good to start with. All that said, many adults and children with asthma and anxiety need higher doses than what they initially start with.

It’s also worth noting that the oral dose of GABA was swallowed so it’s possible (and very likely) that more was needed than if it was used sublingually or with the capsule opened or a powder or a liposomal form.

GABA is seldom recommended for asthma – more recent research supports this approach

This is not new research – the paper was published in 2013 – but I seldom see it discussed or hear about practitioners recommending GABA for asthma.

A more recent paper, Neuroimmune Pathophysiology in Asthma (published in 2021) supports this and discusses the role of neurotransmitters (including GABA and serotonin) and neuropeptides (including SP, CGRP and others) in asthma. The authors suggest “that regulating the effects of neurotransmitters and neuropeptides represents a potential novel approach for the treatment of asthma.”

Why we need to consider GABA – the neuropsychiatric side effects of asthma medications

Exploring the use of GABA and these approaches is especially important given the neuropsychiatric side effects of asthma medications. In this study (published in March this year), Neuropsychiatric adverse drug reactions induced by montelukast impair the quality of life in children with asthma

Neuropsychiatric ADRs (adverse drug reactions) were reported in 78 (62.4%) of 125 patients, who recovered when the drug was discontinued.

These were children of 3-18 years taking montelukast for the first time. The good news is that they recovered when the drug was stopped.

The bad news is there is no information on how many kids who have been prescribed this class of medication are subsequently prescribed psychiatric medications.

This concern needs to be considered for all asthma medications: there are similar adverse effects with antihistamine and inhaled corticosteroid medications.

GABA helps with other conditions where spasms are common

The study results are very encouraging and support what I see clinically with asthma and other conditions where spasms are common. These include

GABA helps with all of the above and the non-allergic comorbidities seen with asthma.

Asthma in children and non-allergic comorbidities (obesity, depression and anxiety, ADHD and insomnia)

As stated in this paper, Paediatric asthma and non-allergic comorbidities: A review of current risk and proposed mechanisms “It is increasingly recognized that children with asthma are at a higher risk of other non-allergic concurrent diseases than the non-asthma population.” These include obesity, depression and anxiety, neurodevelopmental disorders (such as ADHD), sleep disorders and autoimmune diseases.

This paper looks at mechanisms and inflammation is a common theme except when it comes to anxiety and depression. Given that this paper was published this year and all that we now know about nutritional psychiatry and neuroinflammation and anxiety, it’s clearly lacking in this aspect.

Clinically, we see how GABA can help with obesity (and cravings or stress-eating), depression and anxiety, ADHD and insomnia, as illustrated by these case studies:

I see similar comorbidities (the occurrence of more than one disorder at the same time) in adults and GABA can be used safely with adults and children.

Asthma from a functional medicine approach

There is clearly more to asthma than only GABA. This this article on natural remedies for asthma covers diet (eat real good quality food and avoid junk food), nutrients like vitamin D, zinc and others, and allergens – and all this needs to be investigated and addressed with a functional medicine approach.

Dr. Axe does mention stress and anxiety being a trigger: “It’s well-known that stress increases the severity and frequency of asthmatic attacks because it hinders immune function and raises inflammation.” He mentions stress-reduction techniques and breathing. I say let’s add GABA to the mix too.

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

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.

Has GABA helped ease your physical anxiety and asthma symptoms too?

What about obesity/cravings, ADHD and insomnia as well?

Have you or one of your children been adversely impacted by asthma medications? If yes please share which medications and what symptoms were experienced.

What functional medicine and nutritional approaches have helped your asthma symptoms?

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