overwhelm

The morning after a spine surgery, I had an anxiety attack and insisted on being allowed to take my GABA, which helped

February 28, 2025 By Trudy Scott 10 Comments

I’d been taking GABA before [my spine] surgery and really didn’t want to have to discontinue it. My surgeons have always insisted on me going off supplements in the week or more leading to surgery.

I’m sure they don’t want to have to be well versed on everything a person might be taking so they only allow prescription drugs.

The morning after the spine surgery, I had an anxiety attack and insisted on being allowed to take my GABA, which helped.

GABA helps tremendously in preventing me waking in the middle of the night or early morning in a panic. I take 500mg of NOW GABA sublingually before bed. I also take tryptophan and magnesium glycinate at bedtime and believe they help a bit, but GABA is the most effective.

It would be really helpful to be able to take needed supplements right up to surgery time.

LM posted this in response to my blog: GABA and theanine for sedation, anxiety, and cognition in preoperative surgical patients (a randomized controlled study) (more on this below).

She also said “This would be really nice” if doctors knew this! I’m with her – it would be really nice if doctors were aware of this research and allowed patients to use GABA and theanine right up to surgery and right afterwards too. This is especially relevant given the fact that GABA lowers blood pressure and high blood pressure is common after surgery (more on this below too).

Hopefully this GABA/theanine surgery research and the GABA/high blood pressure research will start to shift perspectives and guidelines, especially since increased anxiety also impacts the outcome of surgery. I share more on the research and my insights below.

The study: GABA and theanine are calming before a surgical procedure and don’t cause too much drowsiness

If you missed the blog post and study I shared above, here is the overview:

This novel study was planned to study and compare the effects of L-theanine and GABA on anxiety, sedation, and cognition in preoperative patients posted for major elective surgeries under general anesthesia.

The conclusion is that:

GABA and L-theanine result in effective preoperative anxiolysis with minimal sedation and improvement of cognitive skills.

In other words, both these amino acids are calming before a surgical procedure, don’t cause too much drowsiness and improve cognition.

Study participants used 500 mg GABA and 200 mg of theanine – but dosing is unique

The authors had the study participants use 500 mg GABA and 200 mg of theanine. Both were used as capsules and swallowed. If you’ve been following my work, you’re aware that I find sublingual (or powder or liposomal or topical) use of GABA to be more effective than swallowing a capsule. For this reason it’s possible that using a lower dose sublingually may be as effective or possibly even more effective.

As always, dosing of GABA (and other amino acids such as theanine) is individualized to the unique needs of the person. Ideally, the person has figured out their optimal dose for easing anxiety in their day to day life before going in for surgery. They may find that a higher dose is needed the weeks leading up to surgery and the day of surgery.

As LM shared, she uses “500mg of NOW GABA sublingually before bed”, and presumably started with a lower dose and worked up to 500mg i.e. the optimal dose for her unique needs. It’s very individualized with no-one-size fits all i.e. someone else may get similar benefits with 125mg.

You can read the entire blog post here: GABA and theanine for sedation, anxiety, and cognition in preoperative surgical patients (a randomized controlled study).

Why you are told to stop all supplements prior to surgery

My understanding is that being told to stop all supplements prior to surgery is because of potential concerns about effects on bleeding, anesthesia and blood pressure. Unfortunately, the study didn’t address this possible issue. This article has some information on supplements (and some meds) to stop before surgery/anesthesia stating:

you may need to take a break from some supplements and medications that can interfere with anesthesia. Surgical complications could include heart or bleeding problems, prolonged anesthesia effects, or increased blood pressure.

GABA lowers blood pressure which may be helpful right after surgery

High blood pressure is common after surgery and can have far-reaching implications. According to this paper, “Postoperative hypertension often begins ~10–20 minutes after surgery and may last up to 4 hours. If left untreated, patients are at increased risk for bleeding, cerebrovascular events, and myocardial infarctions.”

This is another reason GABA may actually be helpful to use right up to surgery and right afterwards – it lowers blood pressure.

This paper, United States Pharmacopeia (USP) Safety Review of Gamma-Aminobutyric Acid (GABA), published in 2021, reports the results of a 4-week study that investigated the tolerability of GABA supplementation in mildly hypertensive but otherwise healthy adults:

The authors first established an optimum dose in mildly hypertensive subjects (SBP/systolic blood pressure between 130 and 180 mm Hg) who were randomized to receive oral doses of GABA at 0 (placebo), 20, 40, or 80 mg/day for 4 weeks.

An intake of 80 mg/day of GABA was associated with a significant reduction of the BP in adults with mild hypertension, and no adverse effects were reported.

A subsequent study evaluated long-term effects of GABA at 80 mg daily versus placebo in mildly hypertensive subjects for 8 weeks:

At the end of the 8-week study, SBP [systolic blood pressure i.e. the top number] and DBP [diastolic blood pressure i.e. the bottom number] were on average 5% lower in all the subjects who received 80 mg/day of GABA compared to participants in the placebo group whose blood pressure levels remained above normal.

This is a substantial reduction when 80 mg of GABA a day is considered a very low dose. I typically have my anxious clients start with 125mg GABA and increase from there. They may end up using 125 mg GABA 3 or 4 times a day and sometimes 250 mg a few times a day or 500 mg once a day like LM is doing.

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

As always, I use the symptoms questionnaire to figure out if low GABA may be an issue. The low GABA symptoms include: physical tension, overwhelm, fears, anxiousness, stiff and tense muscles, sleep issues, feelings of panic and stress-eating and drinking.

If you suspect low levels of any of the neurotransmitters and do not yet have my book, The Antianxiety Food Solution – How the Foods You Eat Can Help You Calm Your Anxious Mind, Improve Your Mood, and End Cravings, I highly recommend getting it and reading it before jumping in and using amino acids on your own so you are knowledgeable. And be sure to share it with the practitioner/health team you or your loved one is working with.

There is an entire chapter on the amino acids and they are discussed throughout the book in the sections on gut health, gluten, blood sugar control (this is covered in an entire chapter too), sugar cravings, anxiety and mood issues.

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 (if you have low GABA symptoms). This is a paid online/virtual group program where you get my guidance and community support.

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

Wrapping up and your feedback

I appreciate LM for sharing how GABA helps her and her post surgery experience with anxiety and using GABA. It is wonderful that she was able to take her GABA supplement for the anxiety attack after her surgery. Let’s hope this research increases awareness amongst surgeons.

I’d love to hear from you – have you been told to stop all supplements before surgery, including GABA and other amino acids.

And do you feel increasingly anxious before surgery and other medical procedures and would GABA help i.e. is GABA and/or theanine part of your calming repertoire on a day-to-fay basis?

Have you ever discussed either of these two amino acids – GABA or theanine – with your surgeon or anesthetist prior to surgery and were they open to you using them before and right after surgery?

If you’re a practitioner do you recommend GABA and theanine to your anxious clients/patients and as a surgeon or anesthetist would you consider these amino acids in the future, based on this research?

Feel free to share your experiences and ask your questions below.

Exploring the Therapeutic Potential of Gamma-Aminobutyric Acid (GABA) in Stress and Depressive Disorders through the Gut–Brain Axis

January 31, 2025 By Trudy Scott 4 Comments

Research conducted on individuals with depression reveals that major depressive disorders (MDDs) coincide with diminished levels of the inhibitory neurotransmitter γ-aminobutyric acid (GABA) in the brain, as well as modifications in the subunit composition of the primary receptors (GABA_A receptors) responsible for mediating GABAergic inhibition.

Furthermore, there is substantial evidence supporting the significant role of GABA in regulating stress within the brain, which is a pivotal vulnerability factor in mood disorders. GABA is readily available and approved as a food supplement in many countries.

Although there is substantial evidence indicating that orally ingested GABA may affect GABA receptors in peripheral tissues, there is comparatively less evidence supporting its direct action within the brain.

Emerging evidence highlights that oral GABA intake may exert beneficial effects on the brain and psyche through the gut–brain axis. While GABA enjoys wide consumer acceptance in Eastern Asian markets, with many consumers reporting favorable effects on stress regulation, mood, and sleep, rigorous independent research is still largely lacking.

Basic research, coupled with initial clinical findings, makes GABA an intriguing neuro-nutritional compound deserving of clinical studies in individuals with depression and other psychological problems.

This is the abstract from a recently published review paper: Exploring the Therapeutic Potential of Gamma-Aminobutyric Acid in Stress and Depressive Disorders through the Gut–Brain Axis

Does GABA exert calming and mood benefits via the gut-brain axis or is it really just a placebo effect? This paper discusses both possibilities. I’m excited by the former (and share more about this below) but I do not agree with the latter. Based on my clinical and personal experience, the calming effects of the amino acid GABA, used as a supplement (when you have low GABA symptoms/levels and used in a very specific way), is not a placebo effect. I also discuss this and share some cases that clearly confirm there is no placebo effect. Read on to be enlightened and encouraged about the power of GABA.

GABA and the microbiota-gut-brain axis

The authors describe the microbiome-gut-brain axis as “the bidirectional communication between the gastrointestinal tract, including its resident microbiota and the brain, linking emotional and cognitive centers of the brain with peripheral intestinal functions.”

They acknowledge that while we don’t quite understand the exact mechanisms of this bidirectional communication, “the vagus nerve, the endocrine and immune system, and the synthesis and metabolism of metabolites and neurotransmitters in the gut are critically involved.” This is exciting given what we know about the blood brain barrier.

If you are new to this concept of the gut-brain axis or want to read some of the latest updates, I encourage you to read the paper and learn about the benefits of probiotics (such as Lactobacillus and Bifidobacterium, and Lactococcus, Enterococcus, Streptococcus, and Leuconostoc) and prebiotics i.e. psychobiotics; and fermented foods – for mood improvement and stress reduction.

You’ll read this about GABA (both as a metabolite produced by the microbiome and as a supplement):

found in the enteric nervous system it contributes significantly to gut-brain axis functions and related disorders, including depression, anxiety, inflammatory, and cardiovascular disorders (they refer to GABA as a crucial ‘postbiotic’ i.e. a metabolite produced by the microbiome)
while GABA may not directly cross the blood-brain barrier in humans, an indirect influence through the enteric nervous system could potentially provide a viable pathway for the impact of GABA dietary supplements
although the connection between oral GABA administration i.e. GABA supplementation, the vagal nerve, and GABA levels in the brain has not been firmly established, considering the existing evidence, it represents a promising avenue for future research.

The last two bullets are worth emphasizing because one of the most common myths is that “GABA supplements don’t work because GABA is too big a molecule to get across the blood brain barrier.” It really doesn’t need to get through the blood brain barrier in order to be calming.

I share more about this in a blog I published in 2023 – you can read it here.

GABA is a lifesaver and helps with mycotoxin-induced anxiety

Joie has Sjogren’s, Hashimoto’s, fibromyalgia & collagenous colitis (all diagnosed after severe mold exposure) and shares how 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.

Micki Contini, MS CNC, a board-certified holistic health and nutrition consultant, is a friend and colleague whose life was hugely impacted by mold toxicity. She shares this about how GABA helped her:

As they started tearing my house apart for remediation, I started eating GABA Calm like candy. At the beginning I had to have a lot more than I do now. GABA Calm takes me down a notch and I feel my shoulder coming away from my ears and I get closer to relaxing.

Here are a few other blogs that illustrate just how calming GABA can be when used as a supplement:

If GABA works it’s a placebo effect?!

I find this statement in the conclusion of the review to be confusing given all that the authors share about the gut-brain axis, vagus nerve and bidirectional communication:

The dietary supplement form of GABA is readily accessible to consumers. While many individuals assert that they derive advantages from using these products, it remains uncertain whether these supplements provide benefits beyond what could be attributed to a placebo effect.

Their argument about conflict of interest and small sample sizes when it comes to studies doesn’t hold water with me.

As I mentioned above, based on my clinical experience, the calming effects of the amino acid GABA, used as a supplement when you have low GABA levels (and used in a very specific way), is not a placebo effect.

The following two cases clearly confirm there is no placebo effect (and these are just a few of many which I plan to share with the authors).

My 6 year old was having panic attacks getting out of the car for Kindergarten

My 6 year old son was having panic attacks getting out of the car going to Kindergarten and taking two GABA Calm has completely relieved him of his fears. He has been going for 3 straight weeks in a row.

I thought it may be low serotonin since this happened last winter as well but I gave him 5-HTP for a couple months and it didn’t seem to affect him and his anxiety. We had to have him repeat Kinder this year.

But wow, the GABA has been fabulous and Kindergarten is in full swing because of your help.

Lisa, a mom in the community, shared these wonderful results about her son. This is most definitely not a placebo effect.

You can read the entire story on the blog here. The school is actually in shock at how well carpooling is going for him.

GABA lessens anxiety, agitation and defiance in 98 year old mother who has been “sundowning” for a couple of years

My mother is 98 and has been “sundowning” for a couple of years. It starts around 3pm, sometimes earlier. Some days it’s no big deal. It is on those other days when she starts and then it goes to anxiety, agitation, then she can get sort of defiant which is so not her. She is a gentle soul, friendly, and kind so this is difficult on her as well as our family.

I just started to use my pestle and mortar to crush up a 125 mg GABA CALM supplement (Source Naturals) and I mix a little into her flavored yogurt when I start to see her having difficulty. I give it to her throughout the day. She only gets the 125 mg amount so I feel safe with that.

I believe that I do notice it lessens her anxiety. I pray that this will be helpful for her because that anxiety can be really draining for her. I have not noticed any adverse reactions.

This is another heartwarming success story shared by Marsha who used GABA Calm with her mother. It’s yet another one that is not a placebo effect either. You can read the entire blog post here.

My personal GABA results are also not a placebo effect

I can also share from first-hand experience that GABA was a life-saver for me in my late 30s when I had no idea what a panic attack was and knew very little about GABA other than the fact it calmed me down very quickly!

I still use GABA in various situations to this day: to help with back spasms after a fall, to help with rectal spasms, to help with throat spasms/pain caused by crying (after the loss of my darling mom), to help me sleep solidly and before doing an on-stage presentation, and much more.

GABA is effective and safe when used in a very specific way

Many people use GABA and report it didn’t work or that they had a strange or uncomfortable reaction to their GABA supplement (such as tingles or flush or feeling dizzy). I’m on a mission to educate folks how GABA is effective and safe when used in a very specific way:

Only if you have low GABA levels and symptoms of physical tension, overwhelm, fears, anxiousness, stiff and tense muscles, stress eating, drinking to calm down or fit in socially (you can see all the symptoms here)
Starting with a low dose of around 125mg (and less if you’re sensitive)
Only using it as a sublingual, powder or capsule opened on to the tongue, liposomal or GABA cream (to see results in 1-10 mins and to bypass the digestive system)
Titrating up (and sometimes back down) to find the ideal dose for your unique needs
Being open to trialing different products and forms and sometimes combining GABA with theanine
Understanding that there can be nuances to using GABA, making one change at a time and not giving up too soon
Tracking carefully and course-correcting as needed

I educate anxious individuals about all of the above and offer guidance and encouragement in the GABA Quickstart 2.0 online group 5 week program.

I hope this summary, the review paper and the cases leave you feeling enlightened and encouraged about the power of calming GABA.

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

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

Wrapping up and your feedback

Have you experienced the benefits of GABA for stress and/or low mood? Do you believe it’s more than a placebo effect?

And are you excited to understand the possible mechanisms and read the research? Or do you just want to know how GABA could help you and how to use it?

Have you tried GABA without success or only had limited success? Feel free to share and I’ll provide my feedback.

Feel free to ask your questions below.

Understanding the function of the GABAergic system and its potential role in rheumatoid arthritis (for pain, anxiety, sleep issues and more)

January 3, 2025 By Trudy Scott 2 Comments

This is a great question posed by a woman in my GABA/anxiety online group program:

Can GABA be good for rheumatoid arthritis, and in its early stages? If so, in what ways would someone see signs of improvement with GABA?

When I looked into some of the recent research on GABA and rheumatoid arthritis I was fascinated. A 2023 review paper, Understanding the function of the GABAergic system and its potential role in rheumatoid arthritis, discusses the relationship between rheumatoid arthritis (RA), an autoimmune condition, and GABA (gamma-amino butyric acid), a calming neurotransmitter.

The authors discuss “a new mechanism of action in RA” and the fact that “bidirectional communication occurs between the brain and immune system…and neuroinflammatory responses in the brain.”

The paper discusses GABA and neurosignalling, immunomodulatory effects and inflammation, stating that the:

GABAergic system may modulate the abnormal pain response in RA patients.

So to answer her question, if she has low GABA levels we would expect to see some reduction in her RA pain.

As always, we look for the signs and symptoms of low GABA regardless of the diagnosis or possible diagnosis. So if someone has low GABA symptoms of physical tension, overwhelm, fears, anxiousness, stiff and tense muscles, focus issues, pain, stress eating or drinking to calm down, and poor sleep, we consider a trial of the amino acid GABA, and could expect improvements in all or some of the above symptoms.

I would also recommend that she tracks markers of inflammation (like hs CRP, IL-6, IL-1β, and TNF-α) and RA markers to see if they shift in a positive direction with her use of GABA too.

I share more below about the incidence of anxiety and sleep issues in rheumatoid arthritis and some of the mechanisms covered in the review paper. Also, there are lab tests to track and there are other nutritional approaches for supporting an autoimmune condition such as RA.

Some of the mechanisms covered in the review paper

This image from the paper and the explanation provides some insights on the mechanisms at play.

Glutamate interacts with glutamate decarboxylase (GAD65 and GAD67) to produce gamma-aminobutyric acid (GABA).
Binding of GABA to GABA-A receptors inhibits macrophage activation and decreases the release of inflammatory factors such as IL-6, IL-1β, and TNF-α. Antigen presentation by antigen-presenting cells, however, is impaired, inhibiting CD4⁺ T cell proliferation and differentiation and reducing the expression of inflammatory factors such as IL-6, IL-1β, and TNF-α.
Pain signaling activates the P38/MAPK pathway, whereas GABA binding to GABA-A receptors inhibits P38/MAPK. The P38/MAPK signaling pathway contributes to inflammation and is involved in the activation of myocardin-related transcription factor A (MRTFA), myocardin-related transcription factor B (MRTFB), and serum response factor (SRF) that played key roles in fibroblast activation.

gaba and rheumatoid arthritis — Figure 1. Understanding the function of the GABAergic system and its potential role in rheumatoid arthritis

The authors don’t mention the use of the amino acid GABA as a supplement for RA but do list a number of clinical trials (mostly diabetes patients) where GABA has been used with success. It’s a start and I look forward to future research in this area.

Anxiety, depression, insomnia, cognitive issues and stress-eating in RA

This paper, Psychiatric aspects of rheumatoid arthritis: Review of literature, reports that

Among the major psychiatric disorders found in RA, the anxiety and depressive disorders are prevalent (13 to 48% of patients), as well as suicide, insomnia and tiredness. The impairment of quality of life is markedly after age 65.

This paper, A 30-Day Adjunct Wellness Intervention for the Management of Extra-Articular Symptoms of Rheumatoid Arthritis: A Formative Study, also mentions “cognitive and physical dysfunction” and “stress-related eating” in addition to anxiety, depression and insomnia in RA patients.

Doing a trial of GABA (and other amino acids such as tryptophan and d-phenylalanine/ DPA), will confirm which symptoms are related to which neurotransmitter deficiencies. It’s exciting to consider a very possible role of GABA and other amino acids given the fact that “individuals with rheumatoid arthritis (RA) continually fall short of treatment targets using standard drug therapies alone”

Looking further than GABA and other amino acids: a gluten-free diet and other root causes

With RA we obviously want to address more than just GABA (and other amino acids). Gluten removal is recommended but I do want to mention that the research is surprisingly mixed. This paper, Efficacy of gluten-free diet in patients with rheumatoid arthritis states that

Gluten seems to be a glycoprotein with a clinically relevant inflammatory effect. Several observational studies and anecdotal cases reported a correlation between gluten and various diseases, including autoimmune diseases, such as rheumatoid arthritis. This study aimed to evaluate whether gluten-free diet could be effective in controlling inflammation and ongoing rheumatoid arthritis symptoms.

We report 4 cases of patients with long-standing rheumatoid arthritis with no response to several conventional and biotechnological drugs, treated with a gluten-free diet concurrently with the drug therapy. Our patients presented different degrees of response to the diet, in terms of disease remission and improvement of symptoms. Our cases confirm that a gluten-free diet may improve symptoms of rheumatoid arthritis, even in patients resistant to conventional drug therapies.

Many other papers dismiss the role of gluten and inflammatory diets. This one is an example of a number of similar papers.

The benefits of addressing neurotransmitter imbalances with GABA and other amino acids means the addiction is stopped and quitting bread and cookies now no longer requires willpower,

Here are some autoimmune recipe resources:

In addition to dietary changes, a full functional medicine approach is warranted as there is much research supporting the benefits of the following for RA: omega-3 fatty acids, olive oil, low vitamin B6, addressing heavy metals such as mercury and much much more.

I cover 60+ root causes of anxiety here – I’d be carefully assessing each of these root causes for RA too.

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

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

Wrapping up and your feedback

Do you have rheumatoid arthritis (RA) or another autoimmune condition and has GABA helped?

Were you aware of these possible connections?

What about dietary and nutritional approaches?

Feel free to share your feedback and ask your questions below.

What causes low serotonin? Use tryptophan/5-HTP to help with the anxiety, overwhelm and worry right away and address all the root causes

May 13, 2022 By Trudy Scott 40 Comments

Low serotonin has a number of root causes which can be different for each person. If you do have low serotonin levels you always want to figure and address why it’s low. This can take time to figure out and resolve so you want to be using either tryptophan or 5-HTP (and sometimes both) to boost your serotonin levels and get symptom relief quickly. This helps with the worry, overwhelm, anxiety, insomnia, carb cravings, TMJ, irritability, PMS, anger, OCD, low mood and ruminations right away. It also helps with the worry and overwhelm triggered by sometimes complex and challenging root causes.

Here is a list of some of the many factors that may cause low serotonin for you:

stress and adrenal dysfunction (high cortisol affects your sex hormone and neurotransmitter production, inlcuding serotonin)
eating junk food and sugar (a Western diet “of processed or fried foods, refined grains, sugary products, and beer was associated with a higher odds of mood disorders”
consuming caffeine (which reduces zinc and B vitamins, needed to make serotonin)
not consuming enough quality animal protein (amino acids are the building blocks of our neurotransmitters, and grass fed red meat provides zinc, iron and omega-3s – all needed to make serotonin)
low stomach acid (meaning you can’t digest the protein you’re consuming)
gluten issues (leading to low serotonin and other nutritional deficiencies such as low iron, low vitamin D etc.)
low vitamin D (“Brain serotonin is synthesized from tryptophan by tryptophan hydroxylase 2, which is activated by vitamin D hormone”)
low iron/ferritin levels (iron is a cofactor for making serotonin)
dysbiosis and microbiome imbalances (we make so much serotonin in the gut)
candida (in one study short exposure to serotonin resulted in antifungal activity)
liver issues (affecting how you process xenoestrogens)
low bile production (affecting how you digest the healthy fats you’re eating)
sex hormone imbalances (serotonin and estrogen are very closely linked and women make less serotonin than men. In one study, tryptophan improved the low serotonin PMS symptoms)
thyroid imbalance (“it is postulated that one mechanism, among others, through which exogenous thyroid hormones may exert their modulatory effects in affective illness is via an increase in serotonergic neurotransmission”)
histamine imbalances (in one study “Acute LPS-induced inflammation increases CNS histamine and decreases CNS serotonin)”
the birth control pill (which lowers zinc and vitamin B6, both of which are needed for serotonin production)
statins (leading to cholesterol that is too low)
mold exposure/mycotoxins/mold poisoning
heavy metal toxicity such as lead (and tryptophan and ascorbic acid can help ease the anxiety)
Lyme disease and other co-infections (serotonin was found to be low in cerebrospinal fluid in patients with post-Lyme disease syndrome i.e. chronic Lyme)
collagen consumption (in susceptible folks this can lower serotonin levels)
seasonal allergies (“Cytokines may lead to a mood disturbance via the expression of the IDO enzyme, which shifts the synthesis of tryptophan from serotonin to kynurenine. The resultant acute tryptophan depletion results in decreased brain serotonin”)
genetics (one example is the MTHFR polymorphism)
low zinc, low vitamin B6 (and other B vitamins), low selenium, low magnesium etc. – all needed to make serotonin
oxalates (which can bind to zinc and deplete it)
a high copper diet (nut flours on Paleo diets can be problematic), copper IUD, copper pipes etc. (which can cause low zinc)
lack of nature (forest bathing reduces cortisol which affects serotonin production)
lack of exercise
lack of sunshine (like in the winter when serotonin declines)

When I posted some of this list on Facebook earlier this week, there was a great deal of interest, hence this blog. I’ve included one relevant link for each one so you can read further on the topic.

When I posted it I also asked this: “Have you figured out your root cause/s that are contributing to your low serotonin levels? And has tryptophan or 5-HTP helped while you’re figuring it all out?”

Leanne has mold, dysbiosis, Lyme, low vitamin D, bile issues and more

Leanne responded and gave me the go ahead to share especially if this helps someone else (I appreciate that!) She shared she has identified these root causes:

Mold. Dysbiosis. Possible Lyme/co-infections. Low vitamin D. Bile and motility issues. Liver issues. Stress. Low HCL. Those are the ones I’m aware of. And taking each and every day to work on them. It takes time to heal

I agree it takes time to heal and can be a longer journey for some folks, especially when there are a number of underlying factors. She is in a good frame of mind, saying pragmatically, it takes time to heal. This confirms her serotonin levels are robust i.e. she is not in a state of overwhelm and worry. Sure enough, when I asked if tryptophan or 5-HTP has been helping this was her response:

5-HTP and GABA calm initially helped me in my first round of going through this back in 2015. Then I discovered l-tryptophan about a year ago and that seemed to be a better help over 5-HTP.

Since I’ve just identified that histamine is an issue and started a low histamine diet this past week I noticed less of a need for l-tryptophan as I did before. My body is calming down significantly. And my digestion is working a little better.

But I still have to address mold, SIBO, candida, parasites and possibly Lyme and underlying hidden viruses.

So I know these amino acids will play a key part in supporting me as I dive deeper into addressing them all.

It’s wonderful the amino acids have helped her so much and they will most likely continue to help. A quick comment on her preference for tryptophan over 5-HTP – some folks do better on one vs the other.

Regarding the histamine issues/root cause, it’s good that she is now addressing this. Already she needs less tryptophan (for now). Things may fluctuate in the future again as she peels away the onion layers of root causes. She may find she needs tryptophan again or a higher dose or needs to get back on the GABA.

As you can see she has been working on her health for some time. This is not unusual. Slow and steady is just fine, especially when there is so much going on.

The amino acids are intended for short-term use while diet and underlying root causes are addressed. But when the list is long this is a common reason for the ongoing need for serotonin support. Keep in mind, your list may be a short one and may be quick to resolve. And not everyone has the same root causes.

Resources if you are new to using tryptophan or 5-HTP as supplements

If you are new to using tryptophan or 5-HTP as supplements, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution (you can see all the low serotonin symptoms).

If you suspect low levels of serotonin 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.

Have you figured out your root cause/s that are contributing to your low serotonin levels? And does this give you a better understanding of your own issues?

Do you have any other root causes I may have missed? (when I posted this list on Facebook, a few people pointed out I had missed a few. I’ll update the list and continue to add as we discover new connections).

Has tryptophan and/or 5-HTP helped you feel less overwhelmed and worried while you’re figuring it all out?

Have you adjusted doses of tryptophan and/or 5-HTP as things change and root causes are addressed/resolved?

If you’re a practitioner, do you have anything to add and do your clients/patients find this useful?

If you have questions please share them here too.

DLPA (DL-Phenylalanine) eases PMDD/PMS symptoms in women who experience declining endorphin levels in the second half of their cycles

March 18, 2022 By Trudy Scott 23 Comments

Mood swings, intense sugar cravings, comfort/binge eating, sadness, anxiety, crying, cramps and increased pain, irritability, anger, fatigue, cognitive dysfunction, overwhelm, feelings of unease and dissatisfaction, aggression, heartache, and/or insomnia are common for many women during the second half of the menstrual cycle i.e. in the luteal phase. You may relate to all or some of these symptoms. And you may have been diagnosed with or may identify with PMS (premenstrual syndrome) or PMDD (premenstrual dysphoric disorder – similar to PMS but more serious).

Research shows improvements of these symptoms with the amino acids tryptophan (which provides serotonin support) and GABA (which supports GABA levels). Although there is no research that the pyroluria protocol improves symptoms it’s something I see clinically all the time. (I’ve written about this extensively and share more on this below)

A really interesting study published in 1989 identified low endorphins and low catecholamines as a probable cause for some women – Prevention of Late Luteal Phase Dysphoric Disorder Symptoms with DL-Phenylalanine in Women with Abrupt β-Endorphin Decline: A Pilot Study

I recently came across the above paper and prior to this, had not considered this as a primary root cause. Here is the excerpt from the abstract:

Twenty-two women with late luteal phase dysphoric disorder were treated with DL-phenylalanine during the 15 days prior to menses in a double-blind crossover study.

DL-Phenylalanine was shown to be more effective than placebo in attenuating many symptoms characteristic of luteal phase dysphoric disorder. This amino acid was chosen because of its hypothesized actions in attenuating the symptoms associated with the sharp decline in central β-endorphin levels during the late luteal phase in women with luteal phase dysphoric disorder.

Let’s review a few terms… Late luteal phase dysphoric disorder is a synonym for PMDD. The luteal phase is one stage of the menstrual cycle and occurs after ovulation and before your period. When you feel dysphoric you feel very unhappy, uneasy, or dissatisfied. With the downward endorphin shift at this time, period pain and other pain can be worse, and weepiness and emotional symptoms increase. The need for comfort or reward eating also increases. The study authors suggest these PMDD symptoms may “closely resemble those seen during morphine or heroin withdrawal.”

Based on my experience I do feel comfortable extrapolating these findings to PMS and even peri and post-menopausal women who experience some or all of these symptoms (other than actual periods and period issues in post-menopausal women).

Study participants, dosing and timing of DLPA and improvements

The participants in the study were white, middle-class, and between 24 and 29. Each woman took one 750 mg of DLPA at breakfast and lunch for the 15 days prior to the expected onset of their periods.

In the study groups, it was found that “initial improvement started at the end of the first month of DLPA therapy. Continued therapy brought increased relief from symptoms by the end of the second month. Interestingly, the greatest period of improvement occurred during the washout period” at the end of the third month possibly due to a delayed action of DL-phenylalanine.

The authors make the following conclusion:

DL-phenylalanine was found to be safe, well-accepted, and without significant side effects. The significant improvement it produced with many of the symptoms characteristic of Late Luteal Phase Dysphoric Disorder [PMDD] suggests that it may prove a useful addition to the therapeutic armamentarium for this syndrome.

Keep in mind that a typical starting dose of DLPA is 500mg used 2-3 x per day and it’s typically used between meals for best effects. Ideal is also to customize dosing to your unique needs. In this study, everyone received the same dose at the same time. For these reasons it’s even more impressive to see results like they did.

It makes sense but I have just not used DPLA alone and only in the second half of the cycle

It’s a very small pilot study but given my experience with the amino acids DLPA, DPA and tyrosine, and the vast number of women I have worked with who had symptoms like the above, it makes sense. Using the above three amino acids in combination with dietary changes, tryptophan, GABA and the pyroluria protocol, this approach has offered relief for many of my clients. I have just not used DPLA alone and only in the second half of the cycle.

In case you’re wondering why I mention the three amino acids DLPA, DPA and tyrosine above, it’s because:

DLPA (the amino acid used in this study) supports both endorphins and catecholamines (dopamine is one of them)
Or DPA (supports endorphins only) can be used with tyrosine (supports catecholamines only) instead of DLPA which does both

I blog about the differences between DLPA and DPA here, together with all the symptoms we look at when considering doing a trial.

In this study, they used DLPA which boosts endorphins and catecholamines. As I share in my DPA vs DLPA blog, I prefer DPA (d-phenylalanine) for endorphin support when symptoms are severe. But DPA is not always available so DLPA is a good alternative, assuming the person can handle the catecholamine support. Some people can’t and there are some contraindications too.

I’d love to see follow-on research covering the following:

A larger group of women using DLPA
Individualizing the dosing of DLPA to each person’s unique needs
Correlating results with the low endorphin and low catecholamine symptoms questionnaire
Comparing DLPA alone with a combination of DPA + tyrosine (with each individualized based on unique needs)

Serotonin and GABA support for PMS/PMDD, and the pyroluria protocol

In this paper, Premenstrual Dysphoric Disorder the authors share that PMDD

comprises emotional and physical symptoms and functional impairment that lie on the severe end of the continuum of premenstrual symptoms. Women with PMDD have a differential response to normal hormonal fluctuations.

It’s recognized that serotonin and GABA play a role:

This susceptibility may involve the serotonin system, altered sensitivity of the GABAA receptor to the neurosteroid allopregnanalone [a naturally occurring neurosteroid which is made from the hormone progesterone], and altered brain circuitry involving emotional and cognitive functions.

They share SSRIs that are considered as the first-line treatment. Second-line treatments include oral contraceptives, calcium, chasteberry, and cognitive-behavioral therapy.

However, as I share in this blog, research supports the use of tryptophan – Tryptophan for PMS: premenstrual dysphoria, mood swings, tension, and irritability

A study published in 1999, A placebo-controlled clinical trial of L-tryptophan in premenstrual dysphoria, tryptophan was found to reduce symptoms of PMS when used in the luteal phase or second half of the cycle (i.e. after ovulation).

I mention GABA in this blog and the fact that many anxious women I work with also have pyroluria or signs of low zinc and low vitamin B6 and adding these nutrients, together with evening primrose oil, provide additional hormonal and neurotransmitter support, and help with the social anxiety.

Resources if you are new to using DLPA (or other amino acids) as supplements

If you are new to using DLPA or the other amino acids as supplements, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution (you can see the low endorphin and low catecholamine symptoms.)

If you suspect low levels of endorphins and/or low levels of catecholamine 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. Blog posts like this are intended to add value to the chapter on amino acids, which contains detailed information on doses and time of the day for dosing.

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 acid products 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. It’s an opportunity to interact with me and other practitioners who are also using the amino acids.

Have you considered that there may be different types of PMS (premenstrual syndrome) or PMDD (premenstrual dysphoric disorder) i.e. a different combination of root causes and therefore different solutions?

And have you had success with DLPA alone (providing both endorphin and dopamine support) or by using a combination of DPA (endorphin support only) and tyrosine (catecholamine support only).

If you’re peri or post menopausal have you also seen success with any of these amino acids?

Have the other amino acids, tryptophan and GABA or the pyroluria protocol helped too?

If you’re a practitioner please share what you’ve seen with clients/patients.

Feel free to ask your questions here too.