Category Archives: Amino Acid Therapy

NAC for Trichotillomania

Research shows that nutritional supplements may help mental health including trichotillomania. Lately I have focused on inositol and NAC as I have heard about these supplements in many trichotillomania communities with varied success.

I started taking NAC (N-acetylcysteine) about two years ago and have noticed a decrease in my urge to pull when I take it 5-6 days per week. I take2-600mg capsules in the morning and 2-600mg capsules in the evening, giving me a total of 2400mg of NAC. Doses between 1200-3600mg may be helpful according to this article,  N-Acetylcysteine, a Glutamate Modulator, in the Treatment of Trichotillomania

I recently added inositol to increase the benefits of NAC.  It is generally agreed that a large dose is needed for inositol to be effective with trich. I worked my way up to 18g per day. I do this by mixing 3 teaspoons or 1 tablespoon of inositol in water 3 times a day. I have found the Jarrow brand powder dissolves best. It is available on amazon for a reasonable price. I mix it with warm water as it dissolves better that way. You can add it to fruit juice or other sweetened drinks.  I simply mix the powder with ~3 oz. of warm water and drink it plain as it has a mild sweet taste that I actually like.

 

NAC and Trichotillomania

By Fred Penzel, Ph.D.

**Please note the following: This advice is purely informational, and not in any way meant to be a substitute for treatment by a licensed physician. Do not try this, or anything else, without first consulting your physician. If your M.D. has not heard about it, refer them to the following article and let them decide:

Jon E. Grant, JD, MD, MPH; Brian L. Odlaug, BA; Suck Won Kim, MD, N-Acetylcysteine, a Glutamate Modulator, in the Treatment of Trichotillomania: A Double-blind, Placebo-Controlled Study. Arch Gen Psychiatry/ VOL 66 (NO. 7), JULY 2009.

 

Over the years, it has become apparent that prescription medications, as remedies for trichotillomania (TTM), have proved to be somewhat of a disappointment. These meds have been employed since the early 1990’s, and although they may be seen to work occasionally for some individuals, research indicates that their overall effectiveness is not great for the majority of sufferers. When they do appear to work, it is most likely that they are actually helping with coexisting problems such as depression and anxiety that are impacting the pulling, but not directly causing it. The discovery of a new compound with a greater level of direct effectiveness would be considered a blessing to sufferers. If this compound were also an over-the-counter remedy, it would be even better.

This very thing was confirmed in 2009 with the publication of an article by Grant, Odlaug, and Kim in The Archives of General Psychiatry, titled “N-acetylcysteine, A Glutamate Modulator, In the Treatment of Trichotillomania.”This study, which lasted 12 weeks, investigated the use of the amino acid N-acetylcysteine (NAC) in 50 patients with TTM, and found that 56% of them were rated as improved or very much improved. A much smaller previous pilot study had also found positive results.

So what is this compound? NAC is a both a pharmaceutical drug and a nutritional supplement used primarily to treat Cystic Fibrosis, and also to treat individuals suffering from acetaminophen overdoses. In the former case, it thins mucus, making it easier for patients to cough it up, and in the latter case, has liver detoxifying effects. It has also been said to aid in the treatment of cocaine addiction. Some practitioners out there are also exploring the use of NAC in the treatment of OCD, although whether it is effective or not, is still unproven.

What exactly is NAC? NAC is a natural sulfur-containing amino acid that is a breakdown product of the amino acid L-cysteine, and is in turn broken down by the body and converted to a powerful antioxidant known as glutathione.Antioxidants can repair oxidative stress in the body. Oxidative stress occurs when cell metabolism produces an increased level of oxidants known as free radicals that tip the balance between themselves and antioxidants in the body.These free radicals can cause the breakdown of cells, damaging proteins, genes, and cell membranes. Substances known as antioxidants act by neutralizing free radicals, and some are produced naturally by the body. Some have theorized that hair-pulling may be the result of the effects of oxidative stress within the brain, and that NAC can help reverse this.

NAC is also what is known as a chelating agent. That is, it hastens the excretion of heavy metals such as lead, mercury and arsenic from the body by binding to them. While this is of course, a positive benefit of taking it, it also causes the body to excrete copper, zinc and other essential minerals when used over time. Some research says this effect may be minimal, but others have suggested that it is necessary to take supplements containing copper, zinc, and other vital minerals when using NAC. Until this is settled, it is advisable to take a daily multivitamin plus minerals along with the NAC. It is often recommended to take extra vitamin C, itself an antioxidant, along with NAC, as it can also assist in raising glutathione levels. The amount of vitamin C one should take has been said to be in the range of 500 mg. per day.

As far as taking NAC itself for a BFRB, we have been using the following approach:

1. Start by taking one, 600 mg. capsule of NAC daily for the first two weeks along with a daily multivitamin plus minerals, in addition to 500 mg. of vitamin C. You will most likely not see any changes on this dosage.

2. If the NAC appears to be well tolerated, increase it to 1, 600 mg. capsule, 2x per day. Again, wait two to three weeks to see if there is any reduction in pulling activity.

3. If there are no changes, or only minimal changes in pulling, increase to 1 capsule, 3x per day, and again wait two to three weeks to see if there is any noticeable result.

4. If there is only little or no change, you can then increase to 4, 600 mg. capsules per day, and wait another two to three weeks. Take 2 capsules for one of the three daily doses, to make a daily total of four.

5. If there is still little or no change, you can increase up to what is the maximum of 5, 600 mg. capsules per day. A total of 3,000 mg. is the maximum you should take as a daily dose. Take 2 capsules for two of the three daily doses, to make a daily total of five.

6. If after 4 weeks at the maximum dosage there is still no result, then it is likely that it is not working, and can then be discontinued.

As with all medications and supplements, there are no sure things. It is ultimately all trial-and-error. We hope that NAC will help, but just keep in mind that it will not necessarily work for everyone. Remember that it was shown to be effective for about 56 percent of the subjects in the original research study.

NOTE: There are some very important precautions that should be observed when taking NAC.

1. It should be noted that there are some individuals who suffer from cystinuria, a genetic disorder that causes cysteine to build up in their urine. If levels of cysteine molecules become high enough, they clump together to form kidney stones. It is therefore recommended that those with this problem not take NAC.

 

2. In addition, NAC supplementation might increase the side effects associated with nitroglycerin and isosorbide, two medications commonly used to treat angina.

 

3. Using NAC at the same time as the hypertension drugs ACE-inhibitors might cause blood pressure to drop too low. It might also excessively strengthen the actions of immunosuppressant drugs.

 

How N-Acetylcysteine (N-A-C) Cured My Depression and Anxiety

The maternal side of my family contains a history of severe mental illness. My maternal grandmother suffered from schizophrenia and died in a mental ward. My mother has been institutionalized repeatedly, suffering from a decades long battle with bipolar disorder.

My younger brother is a legitimate sociopath. He is not merely “dark triad.” He has actual antisocial personality disorder. He has no feelings of empathy or kindness or decency. Lacking the vision to rob banks or become a drug kingpin, he is currently free after spending 10 years in prison for shooting his one-armed drug dealer.

In other words, there’s some funny business in my DNA.

I used to get depressed and feel anxious. I never had full-on panic attacks, but I would have severe anxiety that would leave my brain spinning. My skin would break out in rashes.

I conquered this anxiety through two means, as anxiety and other mental illnesses have two components – physical and psychological.

The psychological components of anxiety come from society and the brain washing. That is where state controlreframing techniques, and other Mindset Training comes into play.

The physical components of anxiety and depression come from a variety of sources – poor nutrition, lack of sunlight, excessive oxidative stress, high cortisol, and heavy metal poisoning.

glutathione

N-Acetylcysteine (N-A-C) has been clinically proven to help treat symptoms of anxiety and depression.

N-Acetylcysteine is a powerful nootropic with still many unstudied benefits. N-A-C has been used by visionary doctors to help treat intractable depression and anxiety.

Why haven’t you heard about the magical effects of N-A-C? Simple. Go on Amazon and see how much a bottle of N-A-C costs.

My mom was on a $1,500 a month cocktail of drugs. No one would listen when I suggested they buy a $15 bottle of N-A-C. But the science is there.

See, N-acetyl cysteine for depressive symptoms in bipolar disorder–a double-blind randomized placebo-controlled trial(“NAC appears a safe and effective augmentation strategy for depressive symptoms in bipolar disorder.”) (PubMed.)

See also, N-acetyl cysteine as a glutathione precursor for schizophrenia–a double-blind, randomized, placebo-controlled trial. (“These data suggest that adjunctive NAC has potential as a safe and moderately effective augmentation strategy for chronic schizophrenia.”) (PubMed.)

N-A-C depression anxiety

Why does N-A-C help treat depression?

Acetylcysteine is a glutathione precursor. That is, acetylcysteine is converted into glutathione.

Glutathione is an antioxidant that used by your liver to detox your body. Emergency rooms give high doses of NAC to patients that have overdosed with Tylenol.

Resources:

  • The Wahls Protocol: How I Beat Progressive MS Using Paleo Principles and Functional Medicine (Amazon).
  • Smash Chronic Fatigue: A Concise, Science-Based Guide to Help Your Body Heal, and Banish Fatigue Forever (Amazon).

Could mental illness be caused by toxins that your liver is unable to clear from your body, due to a glutathione deficiency?

That is not so far fetched, and in fact the cutting-edge of mental health research is on the role toxins and oxidative stress play in mental illness.

See, The efficacy of adjunctive N-acetylcysteine in major depressive disorder: a double-blind, randomized, placebo-controlled trial (“These data implicate the pathways influenced by NAC in depression pathogenesis, principally oxidative and inflammatory stress and glutamate, although definitive confirmation remains necessary.”) (PubMed.)

See also, The Glutathione System: A New Drug Target in Neuroimmune Disorders (“Glutathione depletion and concomitant increase in oxidative and neurological stress and mitochondrial dysfunctions play a role in the pathophysiology of diverse neuroimmune disorders, including depression, myalgic encephalomyelitis/chronic fatigue syndrome and Parkinson’s disease, suggesting that depleted GSH is an integral part of these diseases.” (PudMed.)

Do you know what else boosts glutathione?

Carrot orange pomegranate juice

How much N-A-C should you take?

That would be medical advice, which I don’t give. However, participants in the studies usually used between 1 and 2 grams daily.

Why take N-A-C instead of glutathione?

If N-A-C is a precursor, wouldn’t it make more sense to take glutathione directly? That seems intuitively correct. There is some evidence to suggest that N-A-C is more bioavailable than glutathione.

I personally use N-A-C because that was the compound studied. How much glutathione would one need to take to get the same benefits that one can obtain from 1 to 2 grams of N-A-C? As I don’t know, I went with N-A-C.

You are of course free to try both for yourself to see what works best.

What brand of N-A-C is best?

As the supplement industry is unregulated, I generally prefer to use use two brands of supplements – Life Extension Foundation and Jarrow.

I personally use Jarrow’s form of N-A-C Sustain, which is time released. (Amazon).

For more information on oxidative stress, nutrition, and various maladies, watch this video.

Minding Your Mitochondria

GABA and Anxiety

In Julia Ross’ book, The Mood Cure, she discusses many amino acids and how that can benefit your mood.  As someone who suffers from anxiety, I was interested in her prescription of GABA for anxiety.  After reading her book I started taking GABA when my anxiety is extra high or before a situation I know will stress me out.  I take 500mg capsules. I notice decreased anxiety about 15 minutes after taking the supplement.  It makes me so calm I feel sleepy and therefore usually only take it in the evening.

GABA For Anxiety – Does It Work

Most of the substances used to relieve anxiety – alcohol, cannabis, tranquilisers – get their effect through boosting GABA in your brain. So could GABA itself be a useful supplement to stop anxiety?

In fact, many people find that a GABA supplement is the perfect natural remedy for anxiety – though like any other remedy, it does not work for everyone.

Before you decide to take a GABA supplement, you might want to learn more about GABA and even more, how different types of anxiety might respond differently to a GABA supplement.

What is GABA?

GABA – it’s full scientific name is gamma-aminobutyric acid – occurs naturally in your brain, where it functions as a neurotransmitter and helps regulate brain activity. It is also needed in other parts of your body, where its most important function is regulating muscle tone.

Unlike other neurotransmitters, GABA has an inhibitory function – it tends to slow down neuron firing. Other neurotransmitters – adrenaline, nor-adrenaline, dopamine, serotonin, glutamate – have an excitatory function, i.e. they stimulate neuron firing. It’s important to remember this difference when you are deciding which is the best supplement to take for anxiety or depression.

Without enough GABA, neurons fire too easily and too often.

Too much, and you can’t get moving….

GABA is technically an amino acid, though it’s not part of any protein either in the food you eat, or in your body. You can get small amounts from food, but most of it in synthesized in your body from glutamate – something you most likely have plenty of.

Many of the medications and remedies for anxiety that are used today affect the levels of GABA and how it works in your brain.

Benzodiazepines (medications such as valium and xanax) reduce anxiety through the way they interact with the GABA receptors. (On the other hand, coffee inhibits GABA, and so can make you more anxious or buzzed up.)

How can I boost GABA naturally?

Whether or not you decide to try a GABA supplement (see below for more information about GABA supplements), you need to enhance the way GABA works in your brain.

One way to do this is by taking extra Vitamin B6, which is needed for GABA synthesis. Many GABA supplements include B6 – if not, make sure you take a separate B6 supplement.

Magnesium is also essential for GABA activity, enhancing GABA sensitivity on nerve receptors (just one of the many essential functions of magnesium In your body). Magnesium is great as a muscle relaxant, and also has a calming effect – and it’s is one of the many minerals that is generally deficient in our modern diet, which goes a long way to explaining the increased levels of anxiety we see today. Low levels of magnesium are associated with a whole range of disorders, including high blood pressure, diabetes and thyroid imbalances as well as anxiety, so a magnesium supplement makes sense if you have any of these conditions.

There are other natural supplements, such as Theanine, which can be highly effective in boosting GABA activity in your brain … read more about Theanine for Anxiety here.

Will a GABA supplement help anxiety?

We know that low levels of GABA are associated with anxiety. There are many people who find that boosting GABA with a supplement definitely helps relieve anxiety, even though current medical belief is that GABA does not cross the blood-brain barrier, i.e. the GABA you take in a supplement might not be the most effective way to boost brain GABA levels. For example, this is one comment about the effectiveness of GABA:

As a pharmacist I know that in theory this stuff shouldn’t cross the blood brain barrier and have an effect. But from my personal experience, it DEFINITELY does something after I take it. I feel more calm and relaxed.

GABA side-effects and cautions

GABA is designated GRAS (Generally Recognized As Safe) by the FDA, and there are no reports of any toxic effects from taking GABA. But there are some cautions in using it:

Keep to the recommended dose of GABA

It’s been reported that high doses can have unexpected effects – some people have found that a high dose actually increases anxiety. High doses can also result in skin flushing, or skin tingling (you probably won’t notice this at doses under 1 gm, which is what we recommend).

If your main problem is depression, try a serotonin booster instead

If you are susceptible to serious depression, be careful with GABA as it can trigger a depressive episode.

And if you’ve been diagnosed with a cyclic disorder (such as Bipolar Affective Disorder – BPAD), or you are prone to seizures (Dr Amen’s types 5 or 6) you should be especially careful about what you take (only take supplements on the advice of a qualified health professional who knows your history).

Dr Amen recommends GABA supplementation for those suffering from his Type 1 – “Pure Anxiety”. Refer to the summary on the Natural Anxiety Remedies page, to get an idea of what type of anxiety you might have.

It makes sense that if you are low in energy, mood and concentration (common issues in clinical depression) you should not be trying to boost GABA, but instead, your serotonin, dopamine and nor-adrenaline.

While GABA does tend to enhance serotonin in your brain (mostly a good thing), it also tends to reduce some other neurotransmitters (adrenaline, nor-adrenaline, dopamine).

That is helpful if the levels are too high (as is likely with anxiety), but not if you are depressed!

Denver Naturopathic Clinic has an article with more information about GABA for anxiety.

Recommendations for GABA

If you think you are low in GABA, try a GABA supplement for yourself – it’s the only way to find out if it works for you!

In his book, Dr Amen recommends a dose of 100-250 mg, 2-3 times per day. Start with a lower dose and work up – but don’t go above his recommended maximum (750 mg per day).

You can buy pure GABA on Amazon or in your local health shop. But I recommend a supplement that combines GABA with other enhancing factors such as L-Theanine, magnesium and B6 – that way you will avoid the plateau effect and get a better overall brain balancing effect.

Amino Acid Therapy and Trichotillomania

Amino Acid Therapy and Trichotillomania

Amino acid therapy can be very effective at restoring proper neurotransmitter function and alleviating the insatiable urge to pull that some many people with trichotillomania experience. There are really two ways in which amino acids are used for people with trichotillomania. The first is to use n-acetyl cysteine, or NAC, which has been shown in clinical trials to reduce the urge to pull in about 56% of people that use NAC (see our post entitled N-acetylcysteine and Treatment of Trichotillomania for more information). NAC is thought to work by increasing the concentration of glutamate (an excitatory neurotransmitter) in a part of the brain that reduces compulsive behavior and hair pulling. Glutamate works in conjunction with GABA (an inhibitory neurotransmitter) to control many functions in the body. Thus, NAC provides a safe and moderately effective strategy to use amino acid therapy to decrease the urge to pull associated with trichotillomania.

However, we have found that a more effective way to implement amino acid therapy in regards to trichotillomania is to address the serotonin/dopamine system. By providing the brain the proper proportion of the necessary amino acid precursors and cofactors necessary to achieve optimal serotonin and dopamine function we have had an 86% success rate with eliminating the urge to pull, as opposed to just reducing the urge to pull.

This increased success rate is attributed to the fact that dopamine exhibits control over the release of glutamate and GABA in certain parts of the brain. Therefore, the imbalance between glutamate and GABA that leads to trichotillomania in most people is likely to be caused by an imbalance with dopamine and serotonin (as they are farther upstream). By optimizing serotonin and dopamine function, all the systems downstream, including glutamate and GABA normalize as well. When this happens, the urge to pull disappears.

Another key distinction between using NAC or this balanced amino acid approach is the ability to remain symptom free once the amino acid(s) have been discontinued. With NAC, the urge to pull often returns once the supplement is discontinued (this provides further evidence that NAC may not be addressing the root cause of the imbalance). However, with balanced amino acid therapy we have found that once optimized neurotransmitter function is established and maintained for a period of time, most people can reduce or eliminate the amino acids and remain symptom free utilizing dietary and lifestyle factors to maintain optimal neurotransmitter status. This means that it is very likely you won’t have to take these supplements forever and you can remain trichotillomania-free. This occurs because we are addressing the underlying root imbalance that seems to lead to the urge to pull for most people with trichotillomania. By correctly the underlying neurotransmitter imbalance with balanced amino acid therapy you effectively eliminate the problem, which allows you to stop pulling your hair out.

Source:

http://stoppullinghairout.com/blog/2011/12/15/amino-acid-therapy-and-trichotillomania/