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lump in the throat

How to alleviate the fear and anxiety associated with choking and vomiting in Avoidant Restrictive Food Intake Disorder (ARFID)

May 27, 2022 By Trudy Scott 14 Comments

arfid and anxiety

According to The National Eating Disorders Association /NEDA, “Avoidant Restrictive Food Intake Disorder (ARFID) is a new diagnosis in the DSM-5, and was previously referred to as “Selective Eating Disorder.” ARFID is similar to anorexia in that both disorders involve limitations in the amount and/or types of food consumed, but unlike anorexia, ARFID does not involve any distress about body shape or size, or fears of fatness.”

As you can read on this page:

  • “Many children with ARFID also have a co-occurring anxiety disorder, and they are also at high risk for other psychiatric disorders”
  • There are also “fears of choking or vomiting” and
  • There is a “dramatic restriction in types or amount of food eaten” and they will often “only eat certain textures of food”

What we seldom see addressed is the biochemical causes of anxiety and fears which can show up as phobias and ongoing worrying and obsessing about ingesting certain foods. These are all typical low serotonin symptoms.

With low serotonin (you can see all the symptoms here) we use the amino acids tryptophan or 5-HTP to raise serotonin and alleviate these symptoms (often within a few minutes).

However, what do we do when a child (or adult) with ARFID has low serotonin and is too terrified to even consider a trial of tryptophan or 5-HTP? This may be because of fear of choking or vomiting and/or because of an aversion to the taste/texture and/or the fact that they are being offered something new that is not on their “safe foods” list.

There is a similar issue with low GABA which can show up as physical anxiety and tummy issues like “constipation, abdominal pain, upset stomach.” Intrusive thoughts are a common sign of low GABA too and this can manifest as a debilitating fear of choking and dying.

There is the same issue with not being able to have the individual use sublingual GABA as a supplement in order to alleviate these symptoms.

It’s for this reason, we have to be creative and find other ways to support serotonin and GABA.

Other ways to boost serotonin and GABA

The traditional ways that tryptophan/5-HTP and GABA are used is opened onto the tongue or swallowed or chewed. However, there are other ways to boost serotonin and GABA in these kids with ARFID, without further adding to their distress:

  • Experiment with using tryptophan or 5-HTP topically. I’m not aware of a commercial topical product but I recently mixed 500mg tryptophan powder (only tryptophan with no fillers) into a base cream (I used Primal Derma beef tallow) and used it topically with success.
  • Experiment in a similar way with using GABA topically. It could be made at home too (with a GABA only powder) or a product such as Somnium GABA cream is an excellent option (I have used this product with success). I suspect the liposomal GABA/theanine products may also work topically (but have yet to experiment with this option).
  • If tolerated, GABA powder swished in the mouth but not swallowed, may be an option once some of the anxiety and fears have been reduced. GABA powder doesn’t taste bad (it’s slightly sweet) and mixes well in water. By swishing some in the mouth it can help reduce the fear of choking and esophageal spasms (if they are present). It may also help with the sensation of a lump-in-the-throat (called globus pharyngeus) that some kids with ARFID describe.
  • Liquid zinc (zinc sulfate) tastes like water when zinc levels are low and may be tolerated. This 2021 paper, Macro- and Micronutrient Intake in Children with Avoidant/Restrictive Food Intake Disorder, lists low vitamin B1, vitamin B2, vitamin C, vitamin K, zinc, iron, and potassium in kids with ARFID. Zinc, iron and the B vitamins are all needed to make serotonin and GABA, and low zinc can reduce appetite. It’s also possible these children had low levels of some of these nutrients beforehand and that this contributed to their fears and restrictive eating.
  • Magnesium spray or other forms of topical magnesium creams can be used. Magnesium itself is calming and is a cofactor for making serotonin and GABA. An Epsom salts bath also provides magnesium and a warm bath with Epsom salts and an essential oil such as lavender is very calming.

Other less direct but equally effective approaches to include are:

  • gentle yoga (it supports GABA production and is calming)
  • swinging on an outdoor swing (reduces stress, cortisol and anxiety)
  • full spectrum light therapy (boosts serotonin)
  • vagus nerve support “This modern world can lead to overstimulation of the nervous system and you can become desensitized to chronic stress. Over time, this can lead to low vagal tone, which has been linked to a variety of mental and physical health issues.”
  • full spectrum infrared sauna (low heat and of short duration to simulate light exercise)
  • a weighted blanket is calming and improves mood and sleep and
  • essential oils such as orange (topically or diffused) can help with fear and anxiety.

Once serotonin and GABA levels have improved with some of the above measures, and more and more of the fear of choking and vomiting dissipates and food texture and taste aversion is reduced, the amino acids can then hopefully be introduced in the ways they are typically used (more on that below). This will further speed up the anxiety and fear reduction, allowing more and more foods to be slowly introduced.

If you are new to Avoidant Restrictive Food Intake Disorder (ARFID)

Be sure to read more about ARFID on The National Eating Disorders Association /NEDA site: diagnostic criteria, risk factors, warning signs and symptoms (behavioral and psychological, and physical).

As with all eating disorders, the risk factors for ARFID involve a range of biological, psychological, and sociocultural issues. These factors may interact differently in different people, which means two people with the same eating disorder can have very diverse perspectives, experiences, and symptoms.

Resources if you are new to using tryptophan/5-HTP and GABA as  supplements

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

If you suspect low levels of GABA or 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 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, 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.

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. This is a paid online/virtual group program where you get my guidance and community support. There are many moms in the program who are having much success with their kids.

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.

If you feel comfortable doing so, please share more about the ARFID struggles of your son or daughter in order to help more parents understand this disorder  – their age, how long they have struggled, their fears and their safe food list.

Do let us know if you have found success with any of these approaches with your loved one with ARFID (or yourself)? And what other approaches have also helped?

If you are a practitioner are you seeing results with approaches like these with your ARFID clients/patients?

If you have questions please share them here too.

Filed Under: 5-HTP, Anxiety, GABA, serotonin, Tryptophan Tagged With: anxiety, ARFID, Avoidant Restrictive Food Intake Disorder, choking, cream, Epsom salts, esophageal spasms, fear, GABA, globus pharyngeus, intrusive thoughts, liposomal, liquid zinc, lump in the throat, magnesium spray, NEDA, obsessing, phobias, serotonin, textures, The National Eating Disorders Association, topical, tryptophan/5-HTP, types of food eaten, vomiting, worrying

GABA mixed in water and swished in his mouth before a meal prevents esophageal spasms /choking/vomiting, and allows him to swallow

April 1, 2022 By Trudy Scott 24 Comments

gaba in water

GABA mixed in water and swished in the mouth of an adult male, before a meal, prevents his esophageal spasms, and stops his frequent choking and vomiting, and allows him to swallow his food. A colleague shared her husband’s swallowing issues after she read my blog post about using GABA powder inside the check for laryngospasms. 

This is what she shared:

That [blog] made me think that [GABA] might be useful for my husband‘s esophageal spasms. He frequently can’t get food down during a meal because of them.

So he started mixing 500 mg GABA in a little water and swishing it around his mouth and then swallowing it at the beginning of each meal. Since he started doing that he has not had one spasm, or vomiting episode.

It’s wonderful to hear about her husband’s success with GABA and this unique application of swishing around GABA powder (mixed in water) in his mouth before a meal (I’ll share more on this aspect below).

I asked if they know what the causes of his esophageal spasms are but they don’t yet know:

We can’t figure it out. It appears to be all food. I would expect there to be a trigger-food, but we can’t find it.

The GABA has completely stopped it. Last night we went out to dinner and he forgot to bring GABA with him and immediately started choking. So he went to the nearest vitamin store, (of which there is only one)! Fortunately it was open. As soon as he got back to the restaurant and took his GABA, he was fine.

GABA does work so well for him and offers him some relief while they continue to search for other underlying root cause/s. Until these are found, GABA is supporting overall low GABA levels, associated with physical tension-type anxiety, intrusive thoughts, stiff and tense muscles in other areas of the body and also stress-eating and self-medicating with alcohol in order to relax. More on low GABA symptoms here.

My input on his dosing and swishing

Regarding the dosing and swishing method I have this input:

  • 500 mg GABA is the ideal dose for his needs but this is considered a high dose to start. For low GABA tension-type anxiety, I have clients start with a trial of 125 mg GABA and go up from there. I’d recommend the same approach for someone with issues like this gentleman experiences.
  • GABA is most effective when used sublingually or by opening a capsule on to the tongue or by using GABA powder on the inside of a cheek, rather than swallowing a GABA capsule. For this reason, his method of swishing GABA mixed in water is excellent for achieving the spasm-reducing and relaxing benefits quickly. For some folks doing this 30 minutes before a meal may be more effective than doing it right before eating.

The diagnosis can vary from person to person

The diagnosis can vary from person to person. But as long as there are spasms that are affecting swallowing, doing a trial of GABA is worthwhile in order to determine if it will help.

One example is eosinophilic esophagitis where

Clinical manifestations in infants and toddlers generally include vomiting, food refusal, choking with meals and, less commonly, failure to thrive. Predominant symptoms in school-aged children and adolescents include dysphagia (difficulty swallowing), food impactions, and choking/gagging with meals, particularly when comprised of foods with coarse textures. Other symptoms in this patient population include abdominal/chest pain, vomiting, and regurgitation.

The predominant symptom in adults is dysphagia [difficulty swallowing]; however, intractable heartburn and food avoidance may also be present.

One paper, Esophageal microbiome in active eosinophilic esophagitis and changes induced by different therapies discusses the role of the microbiome and how “an increase in levels of gamma-aminobutyric acid (GABA) …is known to exert a role in esophageal motor function.”

Finding the other root causes (other than low GABA)

Regarding finding the root causes, other than low GABA, this is an important aspect that does need to be pursued. Here are some of the many factors worth considering:

  • Finding food triggers. This can be challenging but an obvious one is gluten which can play a role in eosinophilic esophagitis. Dairy and environmental irritants can be issues too.
  • GERD/reflux needs to be ruled out or addressed. Food sensitivities are often a factor here too.
  • Vagus nerve issues can play a role in digestive issues like this. GABA and vagus nerve exercises helped my cough and voice issues. I recorded all my exercises on video and you can find these here. Fortunately I didn’t have any swallowing or choking episodes at that time but have had a choking episode more recently (GABA did help) so I know how scary this can be.
  • Pyroluria, a social anxiety condition needs to be ruled out or addressed too. This is because nausea, gagging and choking are common symptoms for some individuals.
  • I’d also consider a tongue tie. I just finished reading Tongue Tied: How a Tiny String Under the Tongue Impacts Nursing, Speech, Feeding, and More (my Amazon link) by Richard Baxter, DMD, MS. The focus on babies and children but adults can also benefit from addressing tongue tie issues later in life.
  • Addressing gut health and the microbiome may be one of the keys, as outlined in the paper above.

This is not a comprehensive list and a full functional workup will help to identify all possible root causes.

Related blogs: young boy with choking episodes, lump-in-the throat sensation, anxiety and globus pharyngeus

Here are some related blogs that you may find useful

  • Paroxysmal laryngospasm with low GABA physical-tension-type-anxiety: Is GABA powder rubbed on the inside of the cheek a solution? (this is the blog that inspired my colleague to have her husband do the GABA mouth swishing)
  • GABA helps a stressed young boy with episodes of “choking” or tightening in his throat
  • GABA is the answer after 40 years of a lump-in-the-throat sensation, nervousness and muscle tension at work
  • Anxiety and globus pharyngeus (lump in the throat): GABA to the rescue?

Resources if you are new to using GABA as a supplement

If you are new to using the the amino acid GABA as a supplement, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution (you can see the low GABA and other low neurotransmitter symptoms).

If you suspect low levels of GABA or low serotonin 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 team you or your loved one is working with.

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 GABA products that I use with my individual clients and those in my group programs.

If you don’t feel comfortable reading my book, doing the low GABA symptoms questionnaire and doing trials of GABA on your own, you can get guidance from me in the GABA Quickstart Program (online/virtual).

If you are a practitioner, join us in The Balancing Neurotransmitters: the Fundamentals program. It’s an opportunity to interact with me and other practitioners who are also using the amino acids.

Have you experienced throat or esophageal spasms and difficulty swallowing with choking and/or vomiting.

And do you have the low GABA physical-tension-type-anxiety symptoms?  What else is a trigger for you and do you have a diagnosis?

If you’ve already been using GABA with success for easing your anxiety, have you noticed a reduction in your swallowing issues?

Have you ever used GABA in this way to help your swallowing issues?

If you’re a practitioner please share what you have seen?

Feel free to ask your questions here too.

Filed Under: Amino Acids, Anxiety, GABA, Gluten Tagged With: anxiety, can’t get food down, choking, choking sensation, eosinophilic esophagitis, esophageal spasms, GABA, GABA Quickstart, globus pharyngeus, gluten, gut health, laryngospasms, lump in the throat, physical-tension, pyroluria, swallow, swallowing issues, swished, tongue tie, trigger-food, vomiting

GABA helps a stressed young boy with episodes of “choking” or tightening in his throat

December 25, 2020 By Trudy Scott 34 Comments

gaba throat relief

Earlier this year I blogged about how the calming amino acid GABA is often a solution for both anxiety and globus pharyngeus (lump in the throat) and a mom shared this about her son’s episodes of “choking” or tightening in his throat (to the point that he cannot swallow), especially when school stress gets high:

My son, (8 y.o.) has a history of public school use of physical aversion intervention for behaviors that result from a significant language impairment often reports “choking” or tightening in his throat to the point that he cannot swallow. When school stress gets high, he ceases to swallow his saliva which creates a long period of “spitting” out substances including food and natural spit as he is fearful of “choking” to death. During panic attacks he immediately reports “choking” which furthers his panic. You are the first practitioner I have come across that has explained the relationship between globus pharyngeus, stress reaction and low GABA levels. I always felt his throat tightening (involuntary muscle response) was a stress response but was not aware of it’s connection to GABA levels. Thank you for this informative piece!

I voiced my concern for what her son was going through and how I can’t imagine how scary it must be for someone his age, asking her to keep us updated on his progress.

And just over a month later she reported the success her son was having with GABA:

We started a GABA supplement which has positively impacted my son. While he still struggles with hypersalivation when in distress or anxious, his self-reports of feeling like he is “choking” or his throat is closing, has not been present since GABA has been started. We are about a month in and I am inspired that we will continue to have progress. I have been referring to your work as a source to everyone I know that struggles with anxiety. Thank you for all that you do from a very grateful parent.

What wonderful results for her son! Getting feedback like this warms my heart and I appreciate her for sharing so I can share here.

I did ask what GABA product he was using, how much/how often he uses it and how quickly he noticed an improvement but did not hear back. My recommendation is 125mg to start for adults and less for children and I like the GABA Calm product as it’s a sublingual form and easy to use for kids.

I also commented on the fact that he still has “hypersalivation when in distress or anxious.” I would focus on trying to reduce the anxiety with higher doses of GABA and also consider addressing low serotonin because of the anxiety, panic attacks and being “fearful of “choking” to death”.

The anxiety could trigger hypersalivation but the hypersalivation could also be as a result of a food sensitivity like gluten or dairy. Both these and other food sensitivities could also contribute to low GABA/low serotonin and be a trigger for anxiety.

Of course, bullying at school should always be considered and so should the social anxiety condition pyroluria, speech therapy, gut health and vagus nerve support.

Could this be a case of laryngopharyngeal reflux (LPR)?

I always like to try and connect the dots and wonder if this could be a case of laryngopharyngeal reflux (LPR)?  I don’t know but it’s possible. This paper, Laryngopharyngeal reflux: A confounding cause of aerodigestive dysfunction, states that LPR is “defined by the retrograde passage of gastric contents beyond the upper oesophageal sphincter, with contamination of the larynx, pharynx and lungs” and states that “half of the laryngeal complaints referred to ear, nose and throat (ENT) services are ultimately diagnosed as LPR.

It also mentions globus pharyngeus and dysphagia (which is difficulty swallowing), sharing that changes in pH suggest reflux occurs in “50% of patients with hoarseness, 64% with globus, 55% with chronic cough and 35% with dysphagia.”

This same paper reports that “30% of patients with LPR-like symptoms report anxiety, compared with 6% of healthy controls.”

Prevalence of reflux disease in children and LPR symptoms by age

This paper, Laryngopharyngeal Reflux Disease in Children, reports that “Although the exact prevalence is unknown, it is estimated that nearly 1 in 5 children likely suffers from reflux disease.” This 1 in 5 number is for both GERD (gastroesophageal reflux disease) and LPR.

The authors also share that it usually presents with a different set of symptoms depending on age:

  • Infants typically present with regurgitation, vomiting, dysphagia [difficulty swallowing], anorexia, failure to thrive, apnea, recurrent croup, laryngomalacia [softening of the laryngeal structure], subglottic stenosis [narrowing of the airway], or chronic respiratory issues.
  • School-age children tend to demonstrate chronic cough, dyspnea [shortness of breath], dysphonia [hoarseness], persistent sore throat, halitosis [bad breath], and globus sensation.
  • Older children may also complain of regurgitation, heartburn, vomiting, nausea, or have chronic respiratory issues.

Low levels of GABA, a calming neurotransmitter

In case you’re new to GABA: low levels of GABA, a calming neurotransmitter can lead to anxiety, fears and panic attacks. With low GABA, the anxiety is a physical kind of anxiety with muscle tension or muscle spasms. Low GABA may be one possible root cause of globus pharyngeus, which leads to a rather scary golf-ball-like lump or constriction in the throat – or as this young boy describes, episodes of “choking” or tightening in his throat.

The amino acid GABA raises GABA levels and in this instance helps ease this tightening, choking or throat muscle spasms.

To be clear, there is no research (yet) on the use of the amino acid GABA for these types of symptoms, however in one study gabapentin was compared to baclofen for the treatment of gastro-oesophageal reflux-induced chronic cough and in another study there were improvements with both proton pump inhibitors and gabapentin for globus pharyngeus. If GABA works I’m all for it, rather than these  medications, which do have a long list of side-effects.

Has your child been diagnosed with globus pharyngeus or laryngopharyngeal reflux disease?

Have you observed episodes like this in your child, personally or with clients/patients and has GABA helped?

Have you found other contributing factors like low serotonin, food sensitivities, gut issues, vagus nerve issues or pyroluria?

Feel free to post your questions here on the blog too.

Filed Under: Anxiety, Children/Teens, GABA Tagged With: anxiety, anxious, calming, choking, episodes of choking, GABA, GERD, globus pharyngeus, hypersalivation, laryngopharyngeal reflux, LPR, lump in the throat, reflux, serotonin, stress, stressed, throat tightening, tightening in his throat

GABA is the answer after 40 years of a lump-in-the-throat sensation, nervousness and muscle tension at work

November 20, 2020 By Trudy Scott 18 Comments

gaba answer to muscle tension

Earlier this year, I published a blog post on the sensation of having a lump in the throat when you feel anxious. It’s called globus pharyngeus which is defined as “the painless sensation of a lump in the throat and may be described as a foreign body sensation, a tightening or choking feeling.”

Globus means globe/sphere and it can actually feel like you have a golf-ball sized object in your throat. It’s very uncomfortable and quite terrifying outside of the anxiety that is often the trigger. I share my lump-in-the-throat story and my success with GABA in this blog: Anxiety and globus pharyngeus (lump in the throat): GABA to the rescue?

Pam recently shared her wonderful success with GABA on the above blog, after having dealt with what she calls “her throat thing” for 40 years!

I have dealt with this throat thing since I was a teenager. I’m now 57. It was only when I saw what you wrote about how yours came back after a scary airplane incident that I made the connection that GABA could help me. I saw that in the summer of 2019, so I spent about 40 years dealing with this until I found the GABA answer!

Mine comes up when speaking in front of others, such as work meetings, or even just one-on-one work discussions, and it was getting consistently worse. I would be swallowing constantly and trying to talk. Absolutely awful. Of course everyone could see it happening.

GABA solved this for me, and I can’t even describe how grateful I am!

How wonderful are these results! I am so happy for her and thanked her for coming back and sharing in the comments.  I also asked some follow-up questions so I can continue to learn and so I can share so you get to learn too:

  • How much GABA helps and how do you take it (when you know you’ll be in this situation or a few times a day to get your levels up)?
  • Did you ever use a prescribed medication or were recommended something?
  • Have you seen any other benefits from using GABA – improved sleep, reduced anxiety in other situations, reduced cravings?
  • Have you made other changes too – like dietary changes such as gluten/sugar/caffeine/alcohol removal?

She shared this about timing and how GABA helps with anxiety-related physical/muscle tension and nervousness:

I take GABA Calm … one upon waking, 1 mid-morning, and 1 mid- afternoon. I take an extra one right at the time of a meeting.

That is the only change I made. I’ve never been on any prescription medication.

Other than the specific throat issue, I notice I’m generally less physically tense, with muscles not getting so knotted up in my face, scalp, neck, shoulders, and back, which is wonderful.

I work at a computer job, which causes lots of muscle tension, but I feel that anxiety-related muscle tension has reduced.

I notice that my muscles have less of that “immediate tightness” upon seeing someone whom I’m nervous to interact with.

This timing and dosage of GABA Calm is typically what I use with clients and what works so it was great to hear that it’s working for her. I was also so pleased to hear the anxiety-related muscle tension and nervousness has reduced too. This is also to be expected.

I did remind her to keep in mind that the amino acids are intended for short-term use. This could be a few weeks up to 6-12 months depending on each person. While using the GABA, I have my clients start to address all the dietary changes, gut health, nutritional deficiencies (zinc and B6 are needed to make neurotransmitters and key with pyroluria), toxin exposure (like BPA, phthalates, pesticides, fluoride etc), infections (like Lyme and co-infections, parasites, PANDAS/PANS) etc. and everything else that may be causing low GABA levels (as we covered in The Anxiety Summit 6).

Vagus nerve support is also key. I cover what I did for my vagus nerve in this blog that Pam referred to: Vagus nerve rehab with GABA, breathing, humming, gargling and key nutrients

Globus pharyngeus or this sensation of the-lump-in-the throat is way more common than most people realize and mainstream medicine seldom has a solution. Medications that are commonly prescribed for globus pharyngeus are benzodiazepines, antidepressants/SSRIs and sometimes PPIs/proton pump inhibitors. Cognitive behavior therapy has some success in some instances but it’s always best to get to the root cause of low GABA and address that with the amino acid GABA. And then figure out why GABA is low and address that too.

If you’re new to the amino acids here is a quick summary about GABA: low levels of GABA, a calming neurotransmitter can lead to anxiety, fears and panic attacks. With low GABA, the anxiety is a physical kind of anxiety with muscle tension or muscle spasms.  I propose that low GABA may be one possible root cause of globus pharyngeus.

I appreciate Pam for sharing her story and I’m sharing it here in order to give you practical solutions and hope. If she can find a solution to her 40-year the-lump-in-the throat and physical tension issues then anything is possible.

Please also share your lump-in-the-throat story and what has helped you.  Or if you’re a practitioner, do share how you have helped your clients/patients who experienced this sensation.

Feel free to post your questions here too.

Filed Under: Anxiety Tagged With: anxiety, choking, foreign body sensation, GABA, GABA Calm, globus pharyngeus, lump in the throat, lump-in-the-throat sensation, muscle tension, nervousness, tension, tightening, vagus nerve

Anxiety and globus pharyngeus (lump in the throat): GABA to the rescue?

July 3, 2020 By Trudy Scott 69 Comments

globus pharyngeus and gaba

Low levels of GABA, a calming neurotransmitter can lead to anxiety, fears and panic attacks. With low GABA, the anxiety is a physical kind of anxiety with muscle tension or muscle spasms.  Today you’ll read how low GABA may be one possible root cause of globus pharyngeus, which you may have experienced as a rather scary golf-ball-like lump or constriction in the throat.

Let me describe globus pharyngeus and then I’ll share my story with globus pharyngeus, why low GABA may be a factor (and supplemental sublingual GABA to the rescue) and other possible root causes that should be considered.

This 2015 paper, Globus pharyngeus: an update for general practice, defines it as follows:

Globus pharyngeus or globus sensation is the painless sensation of a lump in the throat and may be described as a foreign body sensation, a tightening or choking feeling.

Globus means globe or sphere and it can actually feel like you have a golf-ball sized object in your throat.

You may have experienced it without even knowing the medical name. Only a few of my clients and those in my community have ever heard the term. I also only learned about the name many years after my episode.

What is very surprising is that, according to the above paper, up to 45% of the population have experienced it.

My story with globus pharyngeus

I’m one of the 45% and for me it was a terrifying experience.  As you may know, I experienced anxiety, PMS, fears and panic attacks in my late 30s and early 40s (it’s why I do this work).

Fortunately I only had one episode. It truly felt like I had a golf-ball in my throat and was horrifying. I knew I needed to swallow so I could get rid of this obstruction but at the same time I was terrified to swallow in case it got stuck and choked and killed me.

I remember going to the mirror to try and see this golf-ball sized object in my throat. I was so surprised that I couldn’t see anything.

Looking back, I suspect the addition of GABA Calm to my protocol prevented further episodes. I was also using progesterone cream at the time and this promotes GABA production too.

I’ve had many clients report that looking back they also realized their episodes stopped once they addressed their low GABA levels.

I was also under a great deal of stress at the time: work stress (long hours and my adrenals were a mess) and physical stress (due to amalgam removal, gluten issues, perimenopausal changes and much more).

Globus pharyngeus and GABA

The fact that the throat or pharynx “is a muscular tube that runs from the back of your nose down into your neck” is one reason for considering a muscle spasm and low GABA as a root cause.

The amino acid GABA, when used sublingually, eases muscle spasms within 15 seconds to 2 minutes. Some examples where we see this:

  • Physical tension with anxiety
  • Rectal spasms or proctalgia fugax
  • Throat spasms caused by vagus nerve issues

If you’re in the midst of an episode it’s impossible to open a capsule of GABA into your mouth. Until a client knows how much they can tolerate we start with 100-125 mg and increased based on the trial.  Taking the powder and dabbing it with a wet finger and putting the finger to the inside cheek a few times is the best way for quick relief.

A product that is GABA-only in a capsule such as Enzymatic Therapy GABA or ProThera 500mg GABA are my choices for in-the moment relief (more on these in my supplement store here).

Source Naturals GABA Calm is my most popular GABA product and is my choice for everyday use.

Of course, I recommend this approach to doing nothing. The authors state: “simple reassurance may be all that is required” or “Advise patients to resist the urge to dry swallow.” We can do better.

Once your GABA levels are sufficient, it’s less likely to happen unless you’re under a great deal of stress and/or there are psychological factors at play:

There is increased reporting of stressful life events prior to development of symptoms and research suggests that as many as 96% of patients with globus sensation report an exacerbation of symptoms during times of emotional intensity.

During times of added stress, folks may experience other “physical symptoms such as palpitations, poor sleep, and feelings of panic.”

Other root causes and possible solutions

The above paper does also list other root causes and solutions that would need to be investigated if GABA doesn’t help or possibly in conjunction with GABA support: tonsil issues, hiatus hernia, reflux in 23 -68% of individuals (I would look for the root cause rather than using a proton pump inhibitor/PPI), sinusitis, post-nasal drip, goitre, an actual foreign body, high consumption of alcohol/caffeine/tobacco and cancer (which they state is rare).

Interestingly, speech and language therapy has been shown to improve globus pharyngeus in two studies, possibly due to the reassurance experienced.

The paper concludes as follows:

Finally the link between anxiety and globus sensation must be considered. Evidence supports the use of cognitive behavioural therapy, but very little evidence exists for the use of anxiolytics or antidepressants.

I’ll add to this: the link between low GABA and globus sensation must also be considered, especially if you experience the physical type of low GABA anxiety. GABA to the rescue!

Based on the research, low serotonin, vagus nerve function, thyroid health and h/pylori may also be factors. I suspect food sensitivities play a role. And pyroluria too, because of the additional loss of zinc and vitamin B6 which is needed for GABA production. I’ll leave all this for a follow-up blog.

Have you experienced a globus sensation episode? And what did it feel like?

Did you get a diagnosis or is the term new to you?

Has GABA helped … in the moment or if you look back on your use of GABA for anxiety?

Did you discover other root causes and solutions? Please do share.

Please share if  you have pyroluria and your episodes were triggered by a very stressful event

And feel free to post your questions.

If you’re a practitioner I’d love to hear your feedback too.

Filed Under: Amino Acids, Anxiety, GABA Tagged With: anxiety, choked, choking, constriction in the throat, GABA, GABA Calm, globus pharyngeus, golf ball, lump in the throat, panic attack, spasm, swallow, vagus nerve

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