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vitamin B6

Why is vitamin B6 toxic for some and why don’t symptoms resolve when vitamin B6 is stopped?

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In a recent blog post, Vitamin B6 improves dream recall (which can be used to monitor vitamin B6 status), I promised to address concerns about the potential for vitamin B6 toxicity. I have yet to see any signs of toxicity in my clients, but I have also not ever recommended more than 500mg/day.

However, I was recently made aware (thanks to some folks in my community) that there are some individuals who have issues with very small amounts of vitamin B6.  As of this writing I don’t know why this occurs but I’m writing about it in the hope we can start to put some of the puzzle pieces together. If you have experienced any issues with using vitamin B6 supplements please do share in the comments.

I’d like to start with what we know from the research and from experts like Dr. Carl Pfeiffer – since B6 is water soluble, excesses are documented to be excreted via the urine so that toxic levels are never reached.

It is common knowledge that amounts of 50 mg or greater are considered therapeutic and a high dose, and you should reduce your dose if you notice any tingling in your fingers and other extremities. This could be a sign of too much vitamin B6 and is called peripheral neuropathy. Because vitamin B6 is water soluble, this condition is reported to be completely reversible if you stop supplementing with vitamin B6 or reduce your dose. In one case report, some patients were using up to 5000mg/day, and once they stopped the vitamin B6 their symptoms improved.

In his book Mental and Elemental Nutrients, published in 1975, Dr. Pfeiffer stated:

excesses are excreted via the urine so that toxic levels are never reached. Pyridoxic acid occurs in the urine of patients who take any excess of vitamin B6. This is a harmless excretion product.

He had some of his patients with pyroluria use 1000mg twice a day but recommended working with a practitioner if using amounts higher than 500mg. I agree with the latter.

You’ll see varied research papers on what is considered too high a dose. In this paper, How much vitamin B6 is toxic?, the authors report that 1000mg per day or more causes neuropathy. They also share that there

have also been occasional reports of toxicity at intakes of 100-300 mg per day [and that a report of] neurotoxicity in 2 patients who had taken 24 mg and 40 mg of vitamin B6 per day respectively, may be coincidence rather than a true toxic effect of such relatively low doses.

In the USA, per this article on the NIH site, the upper limit is set at 100mg/day. This is the rationale:

several reports show sensory neuropathy occurring at doses lower than 500 mg/day, studies in patients treated with vitamin B6 (average dose of 200 mg/day) for up to 5 years found no evidence of [neurological issues].

Based on limitations in the data on potential harms from long-term use, the FNB halved the dose used in these studies to establish a UL [upper limit] of 100 mg/day for adults. ULs are lower for children and adolescents based on body size.

As I mentioned above, I have yet to see any signs of toxicity in my clients, but I have also not ever recommended more than 500mg/day.

Psychosis that resolves when vitamin B6 is stopped

A colleague shared this about 2 patients developing psychosis as a result of using too much vitamin B6:

I have had 2 patients in the past 3 years who developed psychosis as a result of taking too much vitamin B6. I think it’s a fine line between what is enough for some people, and then what becomes too much. While some may be able to handle large doses of B6, we know that at higher doses it can cause severe problems for other people. It’s a nutrient I dose and monitor carefully for sure.

There is no research on acute psychosis and vitamin B6 toxicity but she shares this:

neuropathy and psychosis (or acute mental health symptoms) often co-occur, so to me it makes sense that a person could experience both together as a result of too much vitamin B6. In both the patients the acute psychotic symptoms resolved once they stopped taking high doses of B6. They were both taking pyridoxine HCL at doses above 500mg daily (one because of information she had read online, and the other because another practitioner had recommended it). My guess is there is some genetic factor and/or mediating factor biologically that makes some people susceptible to a negative response.

Serious issues that are not resolved when vitamin B6 is stopped

Clearly there are some individuals who do have serious issues that are not resolved when they stop taking vitamin B6. In the previous blog, Vitamin B6 improves dream recall (which can be used to monitor vitamin B6 status), Ruth shared this feedback about her experience with vitamin B6 toxicity:

Trudy, I appreciate your evidence-based approach to health issues, but I think you need to be aware that there are dangers in taking too much synthetic vitamin B6. B6 toxicity is not always reversible. Individuals vary in their response to B6, and while many do well on supplementation, others experience toxicity. I was diagnosed with pyroluria, but experienced serious toxicity.

Vitamin B6 toxicity is a very unrecognized but emerging epidemic that can cause widespread neurological damage to the body. It is not commonly recognized by most of the medical community and is often misdiagnosed. B6 toxicity can cause multiple different symptoms that can vary from person to person. Peripheral neuropathy or nerve damage to the feet, legs or hands is one of the most common symptoms of vitamin B6 toxicity. Tingling, shocks/zaps, vibrations, ataxia, burning, numbness of feet, calves and/or hands, and headaches are also commonly reported. Other symptoms are: ocular, sensory, skin, gastrointestinal and psychological.

I appreciate Ruth sharing this and am very concerned that this is happening. And yes, vitamin B6 is synthetic, but I am not yet convinced that this could be the only cause as there are other synthetic/man-made supplements (such as GABA) that don’t cause issues like this.

However, we do need to know why some folks have issues and why these issues continue even when the vitamin B6 supplementation is stopped.

Possible clues as to why vitamin B6 toxicity occurs?

If you have had issues that persist I’d ask these questions which may start to give us clues as to why this occurs:

  • What were/are your symptoms and how quickly did you notice issues?
  • Have you resolved the symptoms and if yes how?
  • Did you make any other changes around the same time i.e. stopping and/or other nutritional support?
  • Was it vitamin B6/pyridoxine or P5P you were taking?
  • And how much did you take and how often?
  • If you have pyroluria were you also taking zinc and how much? (Dr. Pfeiffer recommended taking zinc together with vitamin B6).

It seems like this an emerging issue unless there is just now more awareness because of the web and more ability to share on forums, blogs and social media.

If we are to assume this is a new and emerging issue I would ask what has changed since the 1970s when Dr. Carl Pfeiffer used high doses (as I mentioned above, up to 1000mg twice a day) with no adverse effects?

These factors have wide-reaching adverse effects and may be triggering a toxic reaction in certain susceptible individuals:

  • Past history or current use of certain medications like benzodiazepines, gabapentin, Lyrica, BCP, SSRIs, fluroquinolone antibiotics, PPIs, diabetes medications, statins, blood pressure medications etc.? (If you have not used the above medications have you been exposed to them via drinking water?)
  • Our increased EMF exposure – WiFi, cell phones, cordless phone and smart meters?
  • Our increased exposure to GMOs, glyphosate, plastics/phthalates, pesticides etc.?
  • Interactions with all of the above and/or certain polymorphisms – we know cytochrome P450 polymorphisms make benzodiazepines more toxic and more difficult to taper in about 60% of those prescribed benzodiazepines

Keep in mind that for most individuals, vitamin B6 causes no issues and is an important nutrient for improving the symptoms of pyroluria/social anxiety, reducing inflammation and oxidative stress, easing PMS and hormonal issues and much more. I share links to the research on the many benefits of supplemental vitamin B6 in this blog:  Vitamin B6 improves dream recall (which can be used to monitor vitamin B6 status).

That being said, we need to know why some individuals do have issues when using vitamin B6.

Please share in the comments if you have seen adverse issues with vitamin B6 supplementation

If you have been adversely affected and feel comfortable sharing answers to the following questions in the comments this may help us try and piece the puzzle together:

  1. What were/are your symptoms and how quickly did you notice issues?
  2. Have you resolved the symptoms and if yes how?
  3. Did you make any other changes around the same time i.e. stopping and/or other nutritional support?
  4. Was it vitamin B6/pyridoxine or P5P you were taking?
  5. And how much did you take and how often?
  6. If you have pyroluria were you also taking zinc and how much? (Dr. Pfeiffer recommended taking zinc together with vitamin B6).
  7. Past history or current use of medications like benzodiazepines (such as Ativan, Xanax, valium etc.), gabapentin, Lyrica, BCP / birth control pill, SSRIs /antidepressants (such as Prozac, Celexa, Lexapro, Paxil, Zoloft etc.), fluroquinolone antibiotics (such as ciprofloxacin/Cipro, gemifloxacin/Factive, levofloxacin/Levaquin, moxifloxacin/Avelox, norfloxacin/Noroxin and ofloxacin/Floxin), PPIs (proton pump inhibitors such as Nexium for heart-burn), diabetes medications, statins, blood pressure medications etc.?
  8. What kind of EMF exposure do you have – WiFi in the home and/or at work, how much cell phone use in a day, cordless phones at home and/or work and a smart meter at home?
  9. What kind of  exposure have you had to GMOs and pesticides (i.e. do you only eat organic food), glyphosate (eg. Roundup exposure from lawns, golf courses, parks etc.), plastics/phthalates (do you avoid plastics)?
  10. What polymorphisms do you have: cytochrome P450 polymorphisms (we know some of these make benzodiazepines more toxic and more difficult to taper in about 60% of those prescribed these meds), and/or MTHFR polymorphism (may affect our detox ability if it’s expressing) and others you know about?
  11. Did you take a B complex (or a multivitamin that contains all the B vitamins) with the vitamin B6?
  12. Did you also take magnesium with the vitamin B6 and if yes how much? (Bernie Rimland reported that taking vitamin B6 together with magnesium resulted in an improved behavior of ASD (autism spectrum patients))
  13. Have you observed any correlation with intake of dietary oxalates i.e. worsening symptoms when consuming medium or high oxalate foods (such as spinach, kale, berries, nuts, kiwi fruit, eggplant etc.) or using vitamin C or milk thistle, and less severe symptoms when consuming a low oxalate diet?  (Susan Owens is founder of www.lowoxalate.info and shares that vitamin B6 is the most efficacious vitamin for reducing oxalates and that we also don’t know if the classic signs of vitamin B6 toxicity has anything to do with oxalate dumping symptoms.)
  14. Do you have a thyroid disease? “peripheral diseases frequently include polyneuropathy”
  15. Have you been diagnosed with an autoimmune condition and if yes, which one?

Is there anything else that you have discovered that you suspect may be a factor?

I plan to add to this list of questions as we get feedback and as I learn more.

To be clear, I’m not dismissing the fact that vitamin B6 toxicity is a real issue for certain individuals. I’m simply trying to figure out if there are some common factors that may be making symptoms worse in some individuals or setting someone up to be predisposed to symptoms or even preventing healing/recovery from toxicity.

Vitamin B6 improves dream recall (which can be used to monitor vitamin B6 status)

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It’s exciting to see new research confirming the connection between vitamin B6 and dream recall. In this new study, Effects of Vitamin B6 (Pyridoxine) and a B Complex Preparation on Dreaming and Sleep (which was randomized, double-blind and placebo-controlled), 100 participants from across Australia were given 240 mg vitamin B6 (pyridoxine hydrochloride) before bed for five consecutive days. Other study participants were given a B complex. This is the outcome of the study:

  • vitamin B6 significantly increased the amount of dream content participants recalled but did not significantly affect dream vividness, bizarreness, or color, nor did it significantly affect other sleep-related variables
  • participants in the B complex group showed significantly lower self-rated sleep quality and significantly higher tiredness on waking

Here are my thoughts on these results:

  • It’s wonderful to read that Vitamin B6 improves dream recall – this is what I see with my clients all the time.
  • With an optimal dose of vitamin B6, I would expect changes in “dream vividness, bizarreness, or color” and this also what I also see with my clients. If they are having horrible/vivid/bizarre dreams, the vitamin B6 changes them to pleasant dreams OR if dreams were not recalled prior to supplementation, they are now remembered and pleasant. The dose of 240 mg was used across the board but based on what we know about biochemical individuality, 240mg may be too much for some folks and not enough for others, so this could have impacted the results.
  • It’s not surprising that the B complex taken at bedtime impacted sleep. It’s known to be stimulating and it’s not something I’d advise any client to do. For this reason, I don’t feel it was the ideal control for this study.

The lead researcher is Dr. Denholm Aspy and his primary research focus is lucid dreaming. On his researcher profile on the University of Adelaide website, he describes lucid dreaming and the potential benefits:

In a lucid dream, the dreamer realizes that they are dreaming and can then explore and even control the dream. Lucid dreaming has a wide range of potential benefits and applications such as creative problem solving, treatment for recurrent nightmares and improvement of motor skills through rehearsal in the dream environment (e.g. for elite athletes or people recovering from physical trauma).

He shares that the purpose of his research is to address exploration of the potential applications of lucid dreaming and to “develop reliable ways to induce lucid dreams.” Looking for potential applications of lucid dreaming is very interesting and new to me.

Vitamin B6/dream recall research and pyroluria (a social anxiety condition)

However, this vitamin B6/dream recall research is of particular interest to me because of my work with pyroluria, a social anxiety condition which responds really well to supplementation with zinc, vitamin B6 or P5P (pyridoxal-5-phosphate) or a combination of both, and a few other key nutrients.  Here is the pyroluria questionnaire.

One of the classic signs of pyroluria is poor dream recall, stressful or bizarre dreams, or nightmares, signs which the late Carl Pfeiffer, MD attributed to low vitamin B6 status. He suggested that your dreams and dream recall serve as a good indicator of your need for vitamin B6. You should dream every night and you should remember your dreams. They should be pleasant—the kind of dreams where you wake up and want to close your eyes and continue dreaming.

Going back to the above discussion of lucid dreaming, in lucid dreams “the dreamer is aware of dreaming and often able to influence the ongoing dream content.” This is exactly how I would describe my dreams when I have good levels of vitamin B6 and my clients say the same.

Keep in mind that if you do have pyroluria, you may need to increase your dose of vitamin B6 in times of stress. Vitamin B6 can also be depleted by oral contraceptives because they cause both low vitamin B6 and zinc, reduce serotonin levels and increase anxiety. Vitamin B6 can also be depleted by antidepressants, diuretics, and cortisone, so if you start or stop taking any of these, you may need to adjust the amount you supplement.

If this intrigues you and you’re new to pyroluria, I write about dreams and vitamin B6 in the pyroluria chapter of my book, The Antianxiety Food Solution. My blog is also a wealth of information on pyroluria:

Dream recall and vitamin B6 status is important even if you don’t have pyroluria

Observing your dream recall and hence vitamin B6 status is important even if you don’t have pyroluria. This is because vitamin B6 it has been implicated as a co-factor in more than 140 biochemical reactions in the cell, playing a role making amino acids and neurotransmitters, making fatty acids, and even quenching reactive oxygen species (ROS).

This is partial list showing the importance of vitamin B6 (with both research and clinical evidence) for:

You may also wonder what the mechanism of action is? How does vitamin B6 impact your dream recall? One hypothesis is that vitamin B6 is a co-factor nutrient used in the conversion of tryptophan to serotonin which is then used to make melatonin. Vitamin B6 is also an antioxidant, is anti-inflammatory, and modulates immunity and gene expression.

If you’re looking for a quality vitamin B6 product, my supplements blog lists a range of vitamin B6 supplements that I use with clients and those in my group program.

Monitoring your dream recall is one very simple way to assess changes in your vitamin B6 status. And we now have new research supporting this. I look forward to follow-on studies by these authors, learning more from them about lucid dreaming and I hope to be able to offer some of my insights from clinical practice.

*** I address some concerns about vitamin B6 toxicity in this blog: Why is vitamin B6 toxic for some and why don’t symptoms resolve when vitamin B6 is stopped? I have yet to see any signs of toxicity in my clients, but I have also not ever recommended more than 500mg/day. However, I was recently made aware (thanks to some folks in my community) that there are some individuals who have issues with very small amounts of vitamin B6.  If you have experienced any issues with using vitamin B6 supplementation please share.

What are your dreams like and do you use your dreams to monitor your vitamin B6 status? What improvements have you noticed by addressing low vitamin B6 levels?

If you’re a practitioner do you use dream recall as an indication of vitamin B6 status?  Have you seen adverse issues with vitamin B6 supplementation and at what doses?

Help! I’m worried all the time! Soothe with supplements and tame worry with food!

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Some of my simple tips for worry were shared in the April edition of Women’s World so here they are for you to enjoy in case you didn’t see them in the magazine. I’m quite chuffed to see it’s for a piece called “Ask America’s Ultimate Experts.”

I share tips about the benefits of a B- complex vitamin (for adrenal support), vitamin B6 (especially for PMS-type anxiety and worry, the calming amino acid called GABA, plus the mood-boosting and calming benefits of a grass-fed burger (loaded with zinc, iron and omega-3s) and pumpkin seeds as a snack (because they’re rich in both tryptophan and zinc)

Here are my tips from the article:

#1 Soothe with supplements

Here are some supporting articles and research for some of the above tips. A good B- complex vitamin for adrenal support has been shown to minimize psychological stress after a natural disaster and vitamin B6 (or pyridoxine) helps with PMS-type anxiety and worry.

A paper titled Pyridoxine in the treatment of premenstrual syndrome: a retrospective survey in 630 patients, reports the following results:

The daily doses of pyridoxine hydrochloride varied from 40 to 100 mg early in the study and from 120 to 200 mg in the later period of the investigations. The response to treatment was recorded as good (no significant residual complaints) in 40 per cent or more of patients taking 100-150 mg pyridoxine daily and in 60 per cent of patients treated with 160-200 mg daily. Together with partial response (useful benefit but still some significant complaints), the positive effect of the treatment increased to 65-68 per cent and 70-88 per cent respectively. No symptoms consistent with a diagnosis of peripheral neuropathy were reported

The calming amino acid called GABA helps with the physical-tension and stiff-and-tense-muscles type of anxiety and helps with worry and inhibition of unwanted thoughts.

#2 Tame worry with foods

Professor Felice Jacka, nutritional psychiatry researcher, discusses the mood-boosting and calming benefits of grass-fed beef (loaded with zinc, iron and omega-3s) on our Anxiety Summit interview: The Research – Food to prevent and treat anxiety and depression?

Pumpkin seeds are rich in tryptophan and zinc and research shows that a functional food made from these seeds actually helps with social anxiety.

Here are a few minor discrepancies in the above sections:

  • In #1 dopamine is not a calming brain chemical but instead it’s stimulating and helps with focus and motivation. The B vitamin mentioned contain folic acid whereas methyl folate is the preferred choice.
  • In #2 the GABA product recommended is 500mg and I find starting much lower is a more effective approach with my clients.

#3 Cue calm – open a worry window

Opening a worry window is a new approach for me and I’d love to hear if it helps you now or has helped you in the past.

Anti-anxiety gummies and low serotonin

Ali Miller, RD, shares a recipe for anti-anxiety gummies (you can see it in the PDF) and I love that it includes coconut water, ginger and turmeric. I’d replace the cup of orange juice (which is high in sugar) with water and use 2 tablespoons instead. Be sure to watch that these gelatin gummies don’t make your anxiety (or depression or sleep worse). It’s a small amount of gelatin but if you’re eating a lot of them and you’re prone to low serotonin, this may be a problem for you. I write about this in a blog post here – Collagen and gelatin lower serotonin: does this increase your anxiety and depression? If it does cause an adverse reaction it doesn’t mean you can’t eat them, instead it simply means you may need to take tryptophan when eating them (if low serotonin is the issue.

If you’d like a PDF of the article you can grab a copy here.

I’d love to hear if any of these approaches have helped you or your clients/patients. Keep in mind that it’s a fun article that is by no means comprehensive in terms of addressing all the possible root causes of anxiety.

Oral contraceptives cause low vitamin B6 and zinc, reduce serotonin levels and increase anxiety

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Oral contraceptives i.e. the birth control pill, cause low vitamin B6 and zinc, thereby reducing serotonin levels and can increase anxiety and depression in susceptible women.

Dr. Daniel Amen sees the association between the birth control pill and anxiety/depression in his practice and shared this when I interviewed him during season 3 of the Anxiety Summit.

Unfortunately, they drop serotonin levels. You’ve got to ask yourself why are 23 percent of women between the ages of 20 and 60 taking antidepressants? In large part, it’s the birth-control pills that are changing the hormones in their brain, the neurotransmitters in their brain. All of a sudden they’re more anxious and they’re more depressed.

Oral contraceptives lower serotonin due to various nutrient depletions and can also impact mood due effects on the progesterone/estrogen ratio.

Drug-induced nutrient depletions, especially vitamin B6

Many medications cause drug-induced nutrient depletions and oral contraceptives do this too. In this 2013 paper, Oral contraceptives and changes in nutritional requirements, the authors report:

It has been shown that the key nutrient depletions concern folic acid, vitamins B2, B6, B12, vitamin C and E and the minerals magnesium, selenium and zinc.

Zinc, magnesium, folate, vitamin C and vitamin B6 are all needed for the conversion of tryptophan to serotonin and can therefore impact both anxiety and depression, accentuating or precipitating the development of depression (and presumably anxiety too) in susceptible women.

The World Health Organization (WHO) report, Advances in Fertility Regulation, states that:

It has been shown that about 80% of women taking oral contraceptives have abnormal tryptophan metabolism suggestive of relative B6 deficiency.

Many of these same nutrients have a major impact on how women handle stress:

Magnesium and vitamin B6 may be effective in combination in reducing premenstrual stress, and vitamin B6 alone may reduce anxiety effectively in older women. High-dose sustained-release vitamin C may reduce anxiety and mitigate increased blood pressure in response to stress.

Zinc and copper imbalances occur very quickly

In this paper published in 1980, Serum copper and zinc in hormonal contraceptive users, it is reported that

Use of combined estrogen-progestogen contraceptives resulted in a significant decrease in serum zinc levels within 3 days and an increase in serum copper levels within 10 days.

In users of combined estrogen-progestogen contraceptives the magnitude and time of occurrence of the decrease in zinc levels and the increase in copper levels was unaltered by chemical composition, dosage, route of administration, and duration of use beyond 3 months.

We know zinc plays a role in the serotonergic system, reducing depression and anxiety.

Zinc and vitamin B6 are also key nutrients for alleviating symptoms of the social anxiety condition called pyroluria.

Lowered levels of endogenous estradiol and progesterone

Other mechanisms on how oral contraceptives lower serotonin relate to lowered levels of endogenous estradiol and progesterone (i.e. the estradiol and progesterone our bodies make), as well as out of balance progesterone/estrogen ratios leading to negative moods and emotional changes. The decreased prolactin response mentioned in this paper suggests reduced serotonergic activity.

High clinical relevance

The WHO report mentioned in the 2013 paper (mentioned above), states that this topic of nutrient depletions with oral contraceptives has high clinical relevance and should be receiving the attention it deserves.

Unfortunately, the nutrient-depletion with oral contraceptives conversation is not something many of my clients have ever had with their doctors, despite this being old news. The WHO report was published over 40 years ago, in 1975!

I’m particularly concerned about teens starting on birth control at such a young age and starting down this very slippery slope with no awareness of what they are getting into.

My recommendation is to NOT use oral contraceptives because of this increased risk in depression and anxiety. I write about this and FAM as an alternative here.

However, if you (or your daughter or grand-daughter or sister or friend) chooses to use oral contraceptives we need this awareness and you/they will very likely need to address these nutrient deficiencies. 

This awareness is also needed if you are using oral contraceptives (or have used them in the recent past) and have found you’ve needed to continuing using tryptophan or 5-HTP long-term.

And finally, this awareness is needed if you know you have pyroluria and the pyroluria protocol doesn’t seem to be working for you.

Nutrition solutions for psychological stress after a natural disaster

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There is much that can be done nutritionally in support of psychological stress and PTSD (post-traumatic stress disorder) during and after a natural disaster. I’ve written this blog for you if you’ve been impacted by the recent storm and flooding due to Hurricane Harvey in the Houston area (the pictures of people returning home are so sad), and for everyone impacted by Irma and about to be impacted by Irma. This is for you if

  • you had to be rescued and had to evacuate your home, are displaced and/or saw neighbors in trouble, have lost your belongings and home – and anything else that may have happened during this natural disaster
  • you have been involved in on-the-ground rescue efforts or working online helping with rescue efforts and you have working long hours, not getting enough sleep and likely not eating well
  • you had a loved one in trouble and feared for their lives
  • and if you’re on observer feeling distressed by what you have witnessed

You may be feeling on edge and anxious about the future, fearful about losing your job, worried about expenses and the chemical soup of flood waters you were exposed to, exhausted and yet not able to sleep, feeling overly emotional and weepy, having nightmares and flashbacks and feeling frazzled.

I wasn’t even in Texas and my contribution was a very small one, helping online rescue efforts from Australia via a volunteer rescue group created by McCall McPherson, but I felt really burned out after just a few days and quite distressed by some of the rescues we were trying to facilitate. I have had to really walk my talk and implement some of what I’m sharing here even though I would consider myself resilient because my nutrient balance is good.

B-Complex for everyone

My first recommendation is a B complex and if this is all that can be managed it would be my first choice for everyone. In fact, if you live in an area prone to hurricanes, flood, fires etc. I’d recommend being on a B complex all the time.

My colleagues Bonnie Kaplin and Julia Rucklidge published this paper in 2015: A randomised trial of nutrient supplements to minimise psychological stress after a natural disaster. They share that:

After devastating flooding in southern Alberta in June 2013, we attempted to replicate a New Zealand randomised trial that showed that micronutrient (minerals, vitamins) consumption after the earthquakes of 2010-11 resulted in improved mental health. Residents of southern Alberta were invited to participate in a study on the potential benefit of nutrient supplements following a natural disaster.

Fifty-six adults aged 23-66 were randomised to receive one of the following for 6 weeks:

  1. vitamin D as a single nutrient
  2. a B-Complex formula or a
  3. broad-spectrum mineral/vitamin formula

The study participants monitored changes in depression, anxiety and stress via self-reporting. All of the above 3 groups showed substantial decreases on all measures. However, those consuming the B-Complex and the broad-spectrum mineral/vitamin formula showed significantly greater improvement in stress and anxiety compared with those consuming the vitamin D alone, with the results being similar for the group using the B-Complex and the broad-spectrum mineral/vitamin formula.

The authors report that:

The use of nutrient formulas with multiple minerals and/or vitamins to minimise stress associated with natural disasters is now supported by three studies.

Further research should be carried out to evaluate the potential population benefit that might accrue if such formulas were distributed as a post-disaster public health measure.

I would love to see either a B-Complex or broad-spectrum mineral/vitamin formula be given out to everyone as part of relief efforts for all natural disasters.

The B-Complex used in the study was made by Douglas labs but other similar B-Complex products would be fine too.  I happen to use Designs for Health B Supreme with my clients.

The broad-spectrum mineral/vitamin formula in the study was EmpowerPlus made by TrueHope.

From: A randomised trial of nutrient supplements to minimise psychological stress after a natural disaster

Vitamin D based on levels

In the above study, some participants in the vitamin D group did see benefits and it’s likely to have been those who were low in vitamin D at the time of the flooding since other research supports a connection between low vitamin D and anxiety and depression. I like to see vitamin D results before recommending supplementation.

Serotonin, GABA and endorphin support based on symptoms and a trial

As well as a B-complex and/or vitamin D, I’d also consider the following neurotransmitter support on a case by case basis, and after doing the amino acid questionnaire and a trial of each amino acid:

  • Serotonin support with Lidtke tryptophan or Lidtke Tryptophan Complete or Lidtke Combat Stress (a tryptophan product formulated for stress support) – especially if you’re feeling sad, worried, resolving to try and feel positive, imagining the worst, feeling fearful and having problem sleeping. I blogged about tryptophan products last week.
  • GABA support for physical tension and an increased need to self-medicate with alcohol in order to stay calm. New research shows that reduced plasma levels of GABA observed in PTSD could be considered as a possible biomarker for PTSD severity. This is not something I typically look at but it’s something I will be considering going forward. I blogged about some specific GABA products earlier this week.
  • Endorphin support with Lidtke DPA if you’re feeling especially emotional and weepy.

Serotonin and GABA play a role in stress resilience and when we have enhanced stress resilience mechanisms we have the ability to adapt more successfully to stressful situations like natural disasters.    

Additional adrenal support if needed

The adrenals are part of the hypothalamic-pituitary axis (HPA) and also need nutritional support after stress and trauma. I recommend a good adrenal support product with rhodiola, Vitamin C, pantothenic acid, eleuthero and ashwagandha. Designs for Health Adrenotone is a good product.

If it’s known that cortisol levels are high then the addition of Seriphos and/or a lactium product (such as Biotics Research De-Stress) helps to lower high cortisol, reduce anxiety and help with insomnia.

Additional pyroluria support if needed

It is well known that pyroluria symptoms are made worse in times of heightened stress. If you are on protocol for pyroluria, additional zinc and vitamin B6/P5P is likely going to be needed short-term too.

Essential oils

Essential oils like lavender and citrus are wonderful for the stress, anxiety and sleepless nights. An animal study reports that passively inhaling orange essential oil could potentially reduce PTSD symptoms in humans

 

Some other considerations include the following once things start to get back to some kind of normal:

I would recommend a similar approach for any natural disaster or in fact for any other traumatic event, always working individually with each person.  

If you have found some approach to be particularly useful for you please do share it.

And if you have any connections for getting this information into the hands of public health officials and non-profits offering aid please let me know. I feel that protocols similar to this one need to be made available to everyone subjected to a natural disaster.

I wish you and your families much healing and a speedy recovery.

Additional resources

I added these additional resources after September 20, 2017:

If you have links to additional useful resources please let me know and I’ll add them.

The Antianxiety Food Solution Amino Acid and Pyroluria Supplements

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antianxiety food solution and amino acids

Here are my amino acid and pyroluria supplement recommendations. These are the products I use with my one-one clients and those doing my online group programs.

You can find most of these products in my online store at Fullscript – you’ll find details here on how to set up and account (you just need to do this once) and make your purchase.

Purchase products through our Fullscript virtual dispensary.

Questionnaires and information

My publisher would not allow me to make specific product recommendations in my book so this list is a courtesy to those of you who have purchased the book.

If you do not have my book I highly recommend getting it and reading it before jumping in to taking supplements: The Antianxiety Food Solution – How the Foods You Eat Can Help You Calm Your Anxious Mind, Improve Your Mood, and End Cravings

There is a complete chapter on the amino acids and one for pyroluria, plus information on real whole food, sugar and blood sugar, gluten, digestion and much more.

Once you have read it you can use these blogs as summaries (they do contain some information that is not in my book).

Here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution and additional information on Anxiety and targeted individual amino acid supplements: a summary

Please read and follow these Amino Acid Precautions

Here is the Pyroluria Questionnaire from The Antianxiety Food Solution and additional information on Pyroluria, social anxiety, introversion: a summary

Here is a useful post: Pyroluria/social anxiety protocol: why aren’t I getting results? (trouble-shooting checklist)

Supplements for Low Blood Sugar (anxious, shaky between meals and intense sugar cravings)

Glutamine helps with low blood sugar, may help eliminate the strong desire for something sweet when opened on to the tongue, and is very healing for the digestive system

  • Pure Encapsulations L-Glutamine 500mg:  L-glutamine (free-form) 500 mg, vitamin C (as ascorbyl palmitate) 5 mg. The capsules can be swallowed or the capsule can be opened on to the tongue
  • Designs for Health Glutamine Powder: This is a powdered glutamine that you can use right on your tongue or even mixed in water. The taste is quite pleasant.

Supplements for low GABA (stiff and tense muscles, anxious, panic attacks, use sugar/wine to relax)

GABA helps to raise GABA levels.  I find GABA to be most effective when taken sublingually or opened on to the tongue. I find GABA to be more effective than pharmaGABA for most of my clients. I don’t ever use Phenibut (which the FDA recently removed from non-prescription use).  Here are some GABA products that I like and use with clients.

Source Naturals GABA Calm (lozenges): This is a pleasant-tasting sublingual product that is my most popular and the most effective form of GABA I use with my clients. It is a lozenge that contains 125mg GABA, 5mg magnesium, 50mg glycine, 25mg tyrosine and 20 mg taurine. [AS OF NOV 24, 2021 THIS PRODUCT IS IN SHORT SUPPLY AGAIN]

[Note: this product is a lozenge with 125mg GABA and is not to be confused with the Source Naturals, GABA Calm Mind, 750 mg tablets]

Nutritional Fundamentals for Health GABA-T SAP: gamma-Aminobutyric acid (GABA) 300 mg, l-Theanine 150 mg. This is pleasant-tasting when opened on to the tongue and works very well when GABA Calm can’t be used.  I find best results when it is used opened on to the tongue.

Thorne PharmaGABA-100:  the label says Gamma-Aminobutyric Acid (GABA) 100 mg but it also states that the product uses Pharma Foods International’s Gamma-Aminobutyric Acid (PharmaGABA®).  This is also pleasant-tasting when opened on to the tongue and is most effective when used this way. [AS OF NOV 24, 2021 THIS MAY BE UNAVAILABLE]

Thorne PharmaGABA-250: as above but contains 250mg of PharmaGABA®.  This is also pleasant-tasting when opened on to the tongue and is most effective when used this way. [AS OF NOV 24, 2021 THIS MAY BE UNAVAILABLE]

Designs for Health PharmaGABA Chewables: gamma-amino butyric acid (pharmaGABA) 200 mg in 2 chewable tablets.  It’s quick-acting and convenient like GABA-Calm because it’s chewable. This does contain xylitol, natural flavors, stevia and some other ingredients so taste may be a factor and xylitol can cause gas, bloating and diarrhea when too much is consumed.

Natural Factors PharmaGABA: gamma-amino butyric acid (pharmaGABA) 200 mg in 2 chewable tablets. It’s quick-acting and convenient like GABA-Calm because it’s chewable. However it also contains organic cane sugar and natural fruit flavors so it’s a little too candy-like for my preference, especially if you have low GABA-related sugar cravings. Also 2 chewable tablets – 4g of carbs which is almost 1 teaspoon of sugar!

[January 22, 2021/November 24, 2021: I’ve included this as a stand-by option for occasional use when Source Naturals GABA Calm is in short supply or if Designs for Health PharmaGABA Chewables are not available.]

 

Now Foods GABA Powder: 1/4 Level Teaspoon (500mg). This is pleasant-tasting when opened on to the tongue and is most effective when used this way.  The only challenge with powder like this is making sure you don’t use too much by mistake. And it’s especially challenging when you only need 100mg.  A mini measuring spoon set like this one (my Amazon link) is so easy and convenient to use and allows for accurate dosing.

Quicksilver Scientific Liposomal GABA with L-Theanine: 2ml (4 Pumps) provides (Gamma Amino Butyric Acid) 240mg, L-Theanine 100mg and Phosphatidylcholine 120mg (from purified sunflower seed lecithin). Spray and hold 30 seconds before swallowing. It does contain ethanol so would not be suitable for alcoholics or young children.

GABA-Pro Calming Effect Chewable: This is a chewable that contains 100 mg of pharmaGABA in 1 tablet. It is pharmaGABA even though the product says GABA-Pro on the front and the label states Gamma Amino Butyric Acid (GABA). It does contain natural flavors and xylitol. [This product is a reasonable replacement for Source Naturals GABA Calm when it’s not available (Nov 24, 2021)]

GABA-Pro Calming Effect: This contains 100 mg of pharmaGABA in 1 tablet. It is pharmaGABA even though the product says GABA-Pro on the front and the label states Gamma Amino Butyric Acid (GABA). This capsule can be opened onto the tongue.  It does contain rice flour which can be an issue if you have a rice allergy/sensitivity and/or SIBO.

Designs for Health Stress Arrest: Niacin (niacinamide) 100 mg, Vitamin B6 (pyridoxine HCL) 10 mg, Pantothenic acid (d-calcium pantothenate) 100 mg, GABA 300 mg, Glycine 200 mg

Supplements for low serotonin (worry, rumination, negativity, afternoon and evening cravings and insomnia)

Tryptophan and/or 5-HTP can help to raise low serotonin. I typically recommend starting with tryptophan and don’t recommend 5-HTP if you have high cortisol as it can raise cortisol. Some people do better on tryptophan and some do better on 5-HTP.

Lidtke l-tryptophan 500mg:  I only recommend the Lidtke brand for tryptophan as quality is a big consideration when it comes to this amino acid. This can be opened and/or chewed but doesn’t taste good. It can be mixed with inositol powder to make it more pleasant (see below) or with mashed banana. NOTE: This is not the same as the Lidtke Tryptophan Complete which has ingredients other than tryptophan making it more difficult to titrate up.

Lidtke l-Tryptophan Chewable: tablets contain 200mg L-Tryptophan per 2 tablets. This chewable form is both good and bad. It’s good because it’s a nice 100mg of tryptophan per tablet, is chewable, tastes good and is suitable for kids and “pixie dust” individuals (who need a very small amount). The bad aspect is that it does contain sugar and is quite sweet. Because you are continually consuming something sweet you may end up over-consuming them if sugar addiction is your issue.

Pure Encapsulations 5-HTP 50mg:  Some of my clients do better on 5-HTP and some find taking this during the day and tryptophan at night works well for them.

Designs for Health Inositol: is fabulous for obsessive thoughts/behaviors that the tryptophan isn’t quite enough for. It’s also been shown to be very helpful for OCD itself. The powder has a slightly sweet taste and I recommend taking it in the powdered form. You can take up to 18g a day but I suggest starting with 2g a day and building up as needed. I think it  makes a great addition for mixing into the nasty tasting tryptophan – I suggest starting with 2g inositol per 500mg tryptophan.

Douglas Labs 1mg melatonin sublingual: If the tryptophan isn’t enough for sleep issues, adding this often helps if you can’t fall asleep (and if it’s a low serotonin/low melatonin issue). Start with one and increase to 3 as needed

Douglas Labs 3mg melatonin prolonged release: If the tryptophan isn’t enough for sleep, adding this often helps if you wake in the night and if it’s a low serotonin/low melatonin issue. Start with one and increase to 2 as needed.

Supplement for low endorphins (comfort and reward eating, weepy, pain issues)

DPA or D-Phenylalanine is the amino acid that helps to raise endorphins and eliminates the comfort/reward eating and the feelings of “I deserve this” and LOVING certain foods

Lidtke Endorphigen 500mg: Riboflavin 5mg, Pyridoxal 5-phosphate 5mg (enzymatic form of vitamin B6), D-Phenylalanine 500mg. This is also one of my top products that I recommend. I used to recommend simply chewing the capsule to get the quickest and best effects and this worked well when it was produced in a gelatin capsule. Now it’s made with a cellulose capsule and chewing doesn’t work at all well so opening the capsule (or just biting off the top) and tipping the powder into your mouth works well. It does taste quite pleasant – some of my clients think it has a dark chocolate-like taste. A few people don’t like the taste at all but even then, it can be very effective when low endorphins are an issue.

Supplement for low catecholamines (tired, coffee-drinking, blahs, poor focus, low motivation)

Tyrosine is the amino acid that helps to raise low catecholamines and can often help you quit coffee if you “self-medicate” due to low catecholamines.

Progressive Labs tyrosine 500mg: 500mg l-tyrosine.  This is the last amino acid I trial with my anxious clients because it can make you more anxious (although with one client it reduced her anxiety because she was able to focus better at work).

Vitamin C for negating the effects of any amino acid

Vitamin C 1000mg is used to negate the effects of any amino acid. I used to use EmergenC but this still contains folic acid, so here are some good alternate vitamin C recommendations:

Designs for Health C + Biofizz: Vitamin C 2569 mg (as Ascorbic Acid, Calcium Ascorbate, Magnesium Ascorbate) Quercetin 20 mg Hesperidin 20 mg Rutin 10 mg. This one mixes nicely in water and can also be added to a smoothie but tastes quite sweet for many people. I personally prefer less of a sweet taste.

Designs for Health Buffered Vitamin C: Vitamin C (as ascorbic acid) 2000 mg, Calcium (as calcium ascorbate) 80 mg, Magnesium (as magnesium ascorbate) 160 mg, Potassium (as potassium bicarbonate) 200 mg. This one doesn’t mix very well in water and can also be added to a smoothie. The taste is not very pleasant.

The supplements for pyroluria

Zinc, vitamin B6, evening primrose oil and a good copper-free multivitamin are what I use for my clients with pyroluria or for those who score above 15 on the questionnaire:

Solaray OptiZinc 30mg. Zinc (as Zinc Monomethionine [OptiZinc®] 30 mg, Vitamin B6 (as Pyridoxine HCl) 20 mg. The zinc in this form seems to be well absorbed by many of my clients and is available over the counter. This also does not contain copper. Be aware as there are other OptiZinc products on the market that do contain copper (Source Naturals is one example)

Douglas Labs Opti-Zinc: Zinc (from 150 mg Zinc Monomethionine) 30 mg. The zinc in this form seems to be well absorbed by many of my clients. This also does not contain copper.

Metagenics Zinc Drink:  Zinc sulphate monohydrate in a base of distilled water. Each 2 tsp provides Zinc sulfate monohydrate 8 mg. Use this for testing your zinc status as described here: Zinc deficiency is common: using liquid zinc status test as an assessment tool

Here are a selection of 100 mg Vitamin B6/pyridoxine products. Use dream recall as a way to monitor if it’s working, plus social anxiety and mood improvements. If this doesn’t work you may need to use the activated form in conjunction with or instead of this one (see below)

Progressive Labs 100mg Vitamin B6 (contains rice flour)

NOW 100mg Vitamin B6 (contains rice flour)

Vital Nutrients 100mg Vitamin B6  (Only B6 and glycine)

Klaire Labs 250mg Vitamin B6 (Use this one if you find you do better with more i.e. 250mg)

Pure Encapsulations P5P 50 (activated B-6): pyridoxal 5 phosphate (activated B6) 50 mg, vitamin C (as ascorbyl palmitate) 3 mg. This activated form of B6 may be needed if the 100-500 mg B6/pyridoxine doesn’t work or may be needed in addition to vitamin B6/pyridoxine. Use dream recall as a way to monitor if it’s working, plus social anxiety and mood improvements.

Designs For Health P5P 50mg: another good product with pyridoxal 5 phosphate (activated B6) 50 mg

Now Foods Super Primrose 1300mg: Evening Primrose Oil (Oenothera blennis) (Seed) 1.3 g (1300 mg) – 120 count. GLA is often low in pyroluria and EPO helps with zinc absorption and PMS symptoms.

Designs for Health Twice Daily Multi: This is a good copper-free multi. It also contains Folates (NatureFolate™ blend) 400 mcg instead of folic acid (no DFH products contain folic acid).

Free form amino acids and magnesium

Pure Encapsulations Amino Replete: A free form amino acid powder blend that does contain tryptophan. It does contain fructose, flavors and luo han guo

Allergy Research Free Aminos: A free form amino acid blend in capsules. It contains 5-HTP and not tryptophan. I’d prefer it if it had tryptophan.

Designs for Health Amino Acid Supreme: A free form amino acid blend powder that does contain tryptophan. It is sweetened with stevia and contains natural flavors.

Designs for Health Magnesium Malate 360mg

Liquid and powder options for children

Here are some liquid and powder options for children (or for adults, if you have a hard time swallowing pills):

Carlson 100mg B6: Use dream recall (and no more nightmares) as a way to monitor if it’s working, plus improvements in social anxiety and mood.

Designs for Health 50mg P5P (with a little zinc and magnesium): This is the activated form of B6. Use dream recall (and no more nightmares) as a way to monitor if it’s working, plus improvements in social anxiety and mood.

Pure Encapsulations 15mg Zinc gluconate: A liquid zinc option.

Metagenics 15mg Zinc (as zinc sulfate): A liquid zinc option.

Designs for Health Zinc Challenge: Zinc sulphate monohydrate in a base of distilled water. Each 2 tsp provides Zinc sulfate monohydrate 8 mg. I use this for testing zinc status but it could be used as a supplement too.

BodyBio evening primrose oil: Gamma Linolenic Acid/GLA (omega-6) 473 mg. GLA is often low in pyroluria and EPO helps with zinc absorption, eczema and PMS symptoms.

Klaire Labs Vitaspectrum multivitamin/mineral: This is a great copper-free, iron-free powdered multi for kids. You can mix the powder directly into room temperature or cold foods or beverages just before serving.

Pure Encapsulations Amino Replete: A free form amino acid powder blend that does contain tryptophan. It does contain fructose, flavors and luo han guo.

Pure Encapsulations Magnesium Citrate 250mg powder

Designs for Health Magnesium Bisglycinate Chelate 300 mg powder: This one does have stevia and natural flavors

Also see chewable tryptophan, GABA Calm and inositol powder, plus powdered Vitamin C (all listed above).

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What about international orders?

Unfortunately, Fullscript does not ship internationally.

So we suggest folks try an intermediary shipping service like www.shipito.com (we haven’t used them as of yet, so do your own research, and if they or someone else does work out please let us know in the comments below).

An alternative is to use iHerb to get similar products, as they ship worldwide and may even have a branch in your country for free shipping.

Here is the link for iHerb and to get 5% off, and if you are interested in iHerb’s exclusive brands to get 10% off here.