Treating GABA/Glutamate Dysregulation in Fibromyalgia and ME/CFS

A Look at Your Options

In fibromyalgia (FMS) and chronic fatigue syndrome (ME/CFS), several neurotransmitters (chemical messengers in the brain) are dysregulated. While you hear more about serotonin and norepinephrine, several others can be out of balance as well--including GABA and glutamate.

Glutamate levels or activity appears to be high, while GABA levels or activity appear to be low.

Glutamate stimulates—and can overstimulate—your brain, while GABA calms it down. Their imbalance may be responsible, at least in part, for the anxiety associated with these conditions along with other symptoms. (For more on that, see GABA & Glutamate: Part 1.) 

Altering activity of these neurotransmitters may help alleviate symptoms. 

An elderly woman standing in the woods looks calm and serene
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Diet & Supplements for GABA/Glutamate Function

Supplements for altering the function of GABA and glutamate in your brain have not been studied specifically for FMS and ME/CFS, but we do have some general knowledge about them.

A synthetic form of GABA is available as a supplement. However, current medical opinion is mixed on whether or not it crosses the blood-brain barrier (BBB), and if it can correct neurotransmitter imbalance.

Paradoxically, you may be able to increase production of GABA by increasing glutamate, since your body uses glutamate to produce GABA. To increase glutamate production, it may help to add precursors of glutamate (the things your body uses to make it) to your diet or supplement regimen.

Some precursors include:

  • 5-HTP: Your body converts 5-HTP into serotonin, and serotonin can enhance GABA activity. 5-HTP is a synthetic form of tryptophan, which is found in turkey. However, food-based sources of tryptophan are not thought to cross the BBB the way 5-HTP does.
  • Glutamine: Your body converts this amino acid into glutamate. Glutamine is available in supplement form and is present in meat, fish, eggs, dairy, wheat and some vegetables.
  • Taurine: This amino acid has been shown in rodents to alter brain levels of both GABA and glutamate. You can take it in supplement form and get it naturally in meat and seafood. Taurine is frequently added to energy drinks.
  • Theanine: This precursor of glutamate appears to lower glutamate activity in the brain by blocking receptors while also boosting GABA levels. It's found naturally in tea and also is available as a supplement.

Before you start new supplements or make significant dietary changes, talk to your healthcare provider and pharmacist about potential risks and drug interactions.

Drugs That Alter GABA

Several drugs currently on the market alter brain activity of GABA. Many have been tested and/or used as FMS treatments, but less so for ME/CFS.

These drugs are called agonists. They don't cause neurotransmitter levels to rise but instead increase activity by stimulating receptors. GABA agonists include:

  • Benzodiazepines: These drugs depress the central nervous system. Common benzodiazepines include Ativan (lorazepam), Klonopin (clonazepam), Valium (diazepam) and Xanax (alprazolam). Benzodiazepines are sometimes prescribed for FMS, especially when insomnia and anxiety are present.
  • Xyrem (sodium oxybate) & GHB (Gamma-Hydroxybutyric acid): These closely related drugs also depress the central nervous system. GHB's street name is the "date rape drug." Xyrem is approved for some symptoms of narcolepsy, and studies have shown it's effective as an FMS treatment.
  • Non-Benzodiazepine Hypnotics: This drug class includes the popular sleep medications Ambien (zolpidem), Sonata (zaleplon) and Lunesta (eszopiclone). These drugs are chemically different from benzodiazepines but work similarly. Some studies have shown that this class of drugs may improve sleep and possibly pain in FMS. None of these drugs has gone before the FDA for approval specifically for FMS.

Could Yoga Increase GABA?

Yoga is generally believed to be calming. Could it actually increase GABA in the brain? Research suggests that it might. One study shows that those suffering from depression, epilepsy, post traumatic stress disorder (PTSD), and chronic pain -- all medical conditions that involve low GABA activity -- show symptom improvement in response to yoga-based interventions. However, more research is still needed.

Neurotransmitter Dysregulation

You may want to talk with your healthcare provider about ways to try and impact your GABA/Glutamate balance. Remember that even natural treatments can have serious side effects.

Other neurotransmitters that are implicated in these conditions include: serotonin, norepinephrine, and dopamine.

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