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Dysautonomia, Postural Orthostatic Tachycardia Syndrome, and Mast Cell Activation Syndrome – Potential Role of Therapeutic Carbohydrate Reduction
Dysautonomia, Postural Orthostatic Tachycardia Syndrome, and Mast Cell Activation Syndrome – Potential Role of Therapeutic Carbohydrate Reduction
Sarah M. Rice
Sarah M. Rice
Dysautonomia refers to conditions of autonomic nervous system dysregulation which include postural orthostatic tachycardia syndrome (POTS), the most common phenotype (1). The association of dysautonomia with covid-19 suggests the incidence of this condition is increasing (1–3). Clinical experience using an exclusion protocol ketogenic diet approach (similar to the ‘gut and physiology syndrome’ (GAPS) diet (4)) to treat dysautonomia has shown benefits (5). From the pathophysiology, there are lines of evidence that support the potential benefit of therapeutic carbohydrate reduction (TCR) or a ketogenic approach in conditions occurring as a feature of dysautonomia.
Postural orthostatic tachycardia syndrome
POTS is an autonomic dysregulation that includes features of 'volume depletion, inflammatory disorders and autoimmune diseases' (6) and may occur following various triggers, including viraemia (20-50%), trauma, or surgery (7). TCR is known to improve multiple pathways involved in inflammation and autoimmune disease (8–10). Looking at the list of symptoms (and associated conditions) (2, 7), they include those that have been reported to improve with TCR (10) – notably impaired cognitive function or brain fog (11, 12), migraine (13), gut disturbances (14), and fibromyalgia (15).
Subtypes and aetiologies fall into the following categories: neuropathic (neuropathy/sympathetic denervation); hyperadrenergic (increased sympathetic tone); hypovolemic (decreased blood volumes – low renin/aldosterone – impaired RAAS system); autoimmune (may include abnormal mast cell activation); and deconditioning and muscle wasting (cause/effect unclear) (7, 16). In addition, gastrointestinal dysfunction is common (7).
The following evidence streams, derived from the POTS pathophysiology and observed associations, can be considered:
• TCR can promote neuroprotection, especially in the ketogenic state (17) and could modulate heart rate and sympathetic activity positively (18).
• Hyperglycaemia is associated with reduced plasma sodium concentrations which may affect the RAAS system and associated haemodynamics (19–21), and increased sodium intake is recommended in POTS management (1). TCR promotes normoglycaemia (22) and has been shown to influence the RAAS system, increasing aldosterone, which is reduced in POTS (7, 23).
• Migraine (40%) and IBS (30%) are significantly comorbid with POTS (7) and can respond to TCR approaches (13, 14).
• TCR modulates the gut microbiome (24) and may help with autoimmune disorders (25), especially if an exclusion protocol is applied (26, 27). The ketogenic diet has been mentioned as an intervention in conjunction with long covid, specifically in connection with immune function, sarcopenia, and the microbiome (28).
• TCR has been shown to improve immune system function (29–31) and has been explored in the context of covid-19, showing promise in the preclinical (32) and clinical (30, 33) settings.
• Carbohydrate restriction in the form of a gluten-free diet has been shown to benefit features of POTS, notably for orthostatic intolerance, vasomotor, and gastrointestinal symptoms (34, 35).
• Deconditioning, muscle wasting (inactivity), and skeletal muscle damage may be associated with POTS (6, 7, 28). TCR, particularly in the ketogenic range, has demonstrated preservation of muscle mass and improved strength during weight loss (36, 37). Nutritional ketosis may be supported by the addition of exogenous ketones, potentially increasing the protective effect on muscle mass (38–41).
Mast cell activation syndrome
Mast cell activation syndrome (MCAS) may be a feature of POTS (7, 42) and is an immune-mediated condition causing the release of histamine, prostaglandins, and other inflammatory markers. Intestinal symptoms, which may be a feature of MCAS, can be interpreted as IBS, possibly leading to underdiagnosis (43).
Mast cell-driven inflammation, autoimmune, and hypersensitivity conditions have been shown to respond to ketones and fasting (44, 45). Dysbiosis of the microbiome and changes in gut permeability can trigger the innate immune system, leading to systemic immune responses (46), which may play a role in MCAS or other features of POTS (47).
Small intestinal bacterial overgrowth (SIBO) has been observed in association with MCAS and POTS – in one study, 41% of MCAS participants had an abnormal lactulose breath test (43). Suggested diets for SIBO include several on the carbohydrate-reduced spectrum, including a low-FODMAP, specific carbohydrate diet, and low-carbohydrate paleo diet (48, 49). SIBO has also been seen to respond to a zero-carbohydrate diet as an exclusion and reintroduction protocol (50). TCR in this context may also support recovery of the SIBO-MCAS subset (with or without POTS).
The NLRP3 inflammasome is implicated in the development of allergic disease, and NLRP3 inflammasome inhibitors are being investigated as a therapeutic target in this setting (51, 52). A ketogenic diet has been shown to suppress inflammasome activity in macrophages (53), and ketone bodies have demonstrated the same effect in preclinical studies (54), lending support to the potential benefit of a TCR approach in MCAS.
Non-pharmacological interventions and considerations
An increased intake of salt and fluid is recommended to offset the hypovolemia and raised plasma norepinephrine seen in POTS (55). A minimum of 2–3 litres of water per day (avoiding caffeine and alcohol) and one or two additional teaspoons of salt per day are recommended (a range of 3-10g sodium can be considered) (1, 7). Of interest is the role of salt in both POTS and migraine management (56, 57) and the comorbidity of migraine found in POTS. Other recommendations are compression garments and a graded exercise programme (7).
A note on bone broth
Bone broth is a popular recommendation when embarking on TCR or a ketogenic diet – it can be used as a vehicle for additional salt in the diet. Community commentary posits bone broth can have elevated glutamate, glutamine, and histamine profiles when extended cooking times are utilised (home cooked), which may be triggering for sensitive individuals (4, 58, 59). How significant this is in accounting for the quantity of amino acids in terms of mg/g compared to animal products in general and other biological effects (e.g., presence of histamine) may be difficult to predict on an individual level (60, 61). Glutamine can have healing effects on the gut (62, 63), but glutamate in the context of sensitive individuals can be detrimental – possibly driven by gut dysbiosis (64, 65). Glutamate sensitivity is associated with migraine (66), Gulf War syndrome (67), psychiatric disorders (68), and epilepsy (69) – therefore, it may be prudent to consider this in patients with POTS who may have increased sensitivity. Of note, emerging research points to modulation of the gut microbiome as a feature of therapeutic response in conditions thought to be sensitive to glutamate. These same conditions have also been shown to respond to a ketogenic diet, with modulation of the microbiome occurring as a feature of therapeutic effect (70, 71).
A prudent approach would be to consider less than 3 hours cooking time of the broth (sometimes referred to as meat stock) to reduce the risk of any hypersensitivity, as recommended on community forums (4, 59). Store-bought bone broth should be checked for added monosodium glutamate and other additives that may be potentially triggering. Progression to longer-cooked bone broths can be considered as tolerance improves.
Conclusion
Various evidence streams reflect the potential benefit of a TCR approach in POTS and associated conditions, as observed in clinical practice (5).
© 2023 Sarah M. Rice. All rights reserved.
Update
Update
A recent case study demonstrates a successful implementation of a ketogenic intervention for dysautonomia and associated conditions.
Colgan, D.D. et al. (2025) ‘Clinically Meaningful Improvements in Long COVID Symptoms Following Ketogenic Metabolic Therapy Combined with Lifestyle Interventions—A Clinical Case Report and Review of the Literature’, Case Reports in Clinical Medicine, 14(8), pp. 391–410. Available at: https://doi.org/10.4236/crcm.2025.148052.
Key points:
The patient was diagnosed with post-viral dysautonomia, specifically POTS and ME/CFS , with severe physical and cognitive fatigue and PEM and a neuroimmune disorder
In February 2024, the patient enrolled in a community-based 12-week educational program designed for dysautonomia, termed Enable Your Healing (this is the same programme developed by Ruddick, as referenced in article above [5]), which combined ketogenic metabolic therapy with lifestyle components.
Within the first two weeks of the intervention, her chronic hypotension resolved, and she discontinued IV saline therapy. She reported a notable increase in energy, which coincided with the onset of ketosis.
References
1. Carmona-Torre F, Mínguez-Olaondo A, López-Bravo A, Tijero B, Grozeva V, Walcker M, et al. Dysautonomia in COVID-19 Patients: A Narrative Review on Clinical Course, Diagnostic and Therapeutic Strategies. Front Neurol. 2022 May 27;13:886609.
2. Hassani M, Fathi Jouzdani A, Motarjem S, Ranjbar A, Khansari N. How COVID‐19 can cause autonomic dysfunctions and postural orthostatic syndrome? A Review of mechanisms and evidence. Neurol Clin Neurosci. 2021 Nov;9(6):434–42.
3. Ormiston CK, Świątkiewicz I, Taub PR. Postural orthostatic tachycardia syndrome as a sequela of COVID-19. Heart Rhythm. 2022 Nov 1;19(11):1880–9.
4. Parker A. GAPS Introduction Diet Cookbook: 100 Delicious & Nourishing Recipes for Stages 1 to 6. Stretford Publishing; 2017. 140 p.
5. Ruddick M. Presentation Low Carb USA, San Diego - 2021 [Internet]. Enable Your Healing. [cited 2023 Feb 27]. Available from: https://www.enableyourhealing.com/team
6. Olshansky B, Cannom D, Fedorowski A, Stewart J, Gibbons C, Sutton R, et al. Postural Orthostatic Tachycardia Syndrome (POTS): A critical assessment. Prog Cardiovasc Dis. 2020;63(3):263–70.
7. Vernino S, Bourne KM, Stiles LE, Grubb BP, Fedorowski A, Stewart JM, et al. Postural orthostatic tachycardia syndrome (POTS): State of the science and clinical care from a 2019 National Institutes of Health Expert Consensus Meeting - Part 1. Autonomic Neuroscience. 2021 Nov 1;235:102828.
8. Srivastava S, Pawar VA, Tyagi A, Sharma KP, Kumar V, Shukla SK. Immune Modulatory Effects of Ketogenic Diet in Different Disease Conditions. Immuno. 2023 Mar;3(1):1–15.
9. Field R, Field T, Pourkazemi F, Rooney K. Low-carbohydrate and ketogenic diets: a scoping review of neurological and inflammatory outcomes in human studies and their relevance to chronic pain. Nutr Res Rev. 2022 Apr 19;1–71.
10. Nutrition Network. Home [Internet]. Research. [cited 2023 Feb 28]. Available from: https://research.nutrition-network.org/
11. van Berkel AA, IJff DM, Verkuyl JM. Cognitive benefits of the ketogenic diet in patients with epilepsy: A systematic overview. Epilepsy & Behavior. 2018 Oct;87:69–77.
12. Altayyar M, Nasser JA, Thomopoulos D, Bruneau M. The Implication of Physiological Ketosis on The Cognitive Brain: A Narrative Review. Nutrients. 2022 Jan;14(3):513.
13. Bongiovanni D, Benedetto C, Corvisieri S, Del Favero C, Orlandi F, Allais G, et al. Effectiveness of ketogenic diet in treatment of patients with refractory chronic migraine. Neurol Sci. 2021 Feb 1;
14. Nilholm C, Roth B, Ohlsson B. A Dietary Intervention with Reduction of Starch and Sucrose Leads to Reduced Gastrointestinal and Extra-Intestinal Symptoms in IBS Patients. Nutrients. 2019 Jul;11(7):1662.
15. Ernst A, Shelley-Tremblay J. Non-Ketogenic, Low Carbohydrate Diet Predicts Lower Affective Distress, Higher Energy Levels and Decreased Fibromyalgia Symptoms in Middle-Aged Females with Fibromyalgia Syndrome as Compared to the Western Pattern Diet. Journal of Musculoskeletal Pain. 2013 Dec 1;21(4):365–70.
16. Zhao S, Tran VH. Postural Orthostatic Tachycardia Syndrome. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 [cited 2023 Feb 20]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK541074/
17. Gasior M, Rogawski MA, Hartman AL. Neuroprotective and disease-modifying effects of the ketogenic diet. Behav Pharmacol. 2006 Sep;17(5–6):431–9.
18. Polito R, Valenzano A, Monda V, Cibelli G, Monda M, Messina G, et al. Heart Rate Variability and Sympathetic Activity Is Modulated by Very Low-Calorie Ketogenic Diet. Int J Environ Res Public Health. 2022 Feb 16;19(4):2253.
19. Fountain JH, Lappin SL. Physiology, Renin Angiotensin System [Internet]. StatPearls [Internet]. StatPearls Publishing; 2022 [cited 2023 Feb 22]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470410/
20. Chuang C, Guo YW, Chen HS. Corrected sodium levels for hyperglycemia is a better predictor than measured sodium levels for clinical outcomes among patients with extreme hyperglycemia. Journal of the Chinese Medical Association. 2020 Sep;83(9):845.
21. Gronda E, Jessup M, Iacoviello M, Palazzuoli A, Napoli C. Glucose Metabolism in the Kidney: Neurohormonal Activation and Heart Failure Development. Journal of the American Heart Association. 2020 Dec;9(23):e018889.
22. Westman EC, Yancy WS, Mavropoulos JC, Marquart M, McDuffie JR. The effect of a low-carbohydrate, ketogenic diet versus a low-glycemic index diet on glycemic control in type 2 diabetes mellitus. Nutrition & Metabolism. 2008 Dec 19;5(1):36.
23. Belany P, Kackley ML, Zhao S, Kluwe B, Buga A, Crabtree C, et al. Effects of Hypocaloric Low-Fat, Ketogenic and Ketogenic & Ketone Supplement diets on Aldosterone and Renin. J Clin Endocrinol Metab. 2023 Jan 11;dgad009.
24. Olson CA, Vuong HE, Yano JM, Liang QY, Nusbaum DJ, Hsiao EY. The Gut Microbiota Mediates the Anti-Seizure Effects of the Ketogenic Diet. Cell. 2018 Jun 14;173(7):1728-1741.e13.
25. Esposito T, Lobaccaro JM, Esposito MG, Monda V, Messina A, Paolisso G, et al. Effects of low-carbohydrate diet therapy in overweight subjects with autoimmune thyroiditis: possible synergism with ChREBP. Drug Des Devel Ther. 2016 Sep 14;10:2939–46.
26. Mehrtash F. Sustained Crohn’s Disease Remission with an Exclusive Elemental and Exclusion Diet: A Case Report. Gastrointestinal Disorders. 2021 Sep;3(3):129–37.
27. Arjomand A, Suskind DL. Clinical and Histologic Remission in an Adult Crohn’s Disease Patient Following the Specific Carbohydrate Diet and Its Impact on Healthcare Costs. Cureus [Internet]. 2022 Feb 8 [cited 2022 Feb 13];14(2). Available from: https://www.cureus.com/articles/81257-clinical-and-histologic-remission-in-an-adult-crohns-disease-patient-following-the-specific-carbohydrate-diet-and-its-impact-on-healthcare-costs
28. Barrea L, Vetrani C, Caprio M, Cataldi M, Ghoch ME, Elce A, et al. From the Ketogenic Diet to the Mediterranean Diet: The Potential Dietary Therapy in Patients with Obesity after CoVID-19 Infection (Post CoVID Syndrome). Curr Obes Rep [Internet]. 2022 May 6 [cited 2022 May 8]; Available from: https://doi.org/10.1007/s13679-022-00475-z
29. Hirschberger S, Strauß G, Effinger D, Marstaller X, Ferstl A, Müller MB, et al. Very-low-carbohydrate diet enhances human T-cell immunity through immunometabolic reprogramming. EMBO Molecular Medicine. 2021 Aug 9;13(8):e14323.
30. Hirschberger S, Gellert L, Effinger D, Muenchhoff M, Herrmann M, Briegel JM, et al. Ketone Bodies Improve Human CD8+ Cytotoxic T-Cell Immune Response During COVID-19 Infection. Front Med (Lausanne). 2022;9:923502.
31. Qi J, Gan L, Fang J, Zhang J, Yu X, Guo H, et al. Beta-Hydroxybutyrate: A Dual Function Molecular and Immunological Barrier Function Regulator. Front Immunol. 2022 Jun 16;13:805881.
32. Palermo A, Li S, Hoeve J ten, Chellappa A, Morris A, Dillon B, et al. A ketogenic diet can mitigate SARS-CoV-2 induced systemic reprogramming and inflammatio [Internet]. 2022 [cited 2022 Dec 6]. Available from: https://europepmc.org/article/PPR/PPR574624
33. Sukkar SG, Cogorno L, Pisciotta L, Pasta A, Vena A, Gradaschi R, et al. Clinical efficacy of eucaloric ketogenic nutrition in the COVID-19 cytokine storm: A retrospective analysis of mortality and intensive care unit admission. Nutrition. 2021 Sep 1;89:111236.
34. Zha K, Brook J, McLaughlin A, Blitshteyn S. Gluten-free diet in postural orthostatic tachycardia syndrome (POTS). Chronic Illness. 2022 Jan 31;17423953221076984.
35. Penny HA, Aziz I, Ferrar M, Atkinson J, Hoggard N, Hadjivassiliou M, et al. Is there a relationship between gluten sensitivity and postural tachycardia syndrome? Eur J Gastroenterol Hepatol. 2016 Dec;28(12):1383–7.
36. Barrea L, de Alteriis G, Muscogiuri G, Vetrani C, Verde L, Camajani E, et al. Impact of a Very Low-Calorie Ketogenic Diet (VLCKD) on Changes in Handgrip Strength in Women with Obesity. Nutrients. 2022 Oct 10;14(19):4213.
37. Sajoux I, Lorenzo PM, Gomez-Arbelaez D, Zulet MA, Abete I, Castro AI, et al. Effect of a Very-Low-Calorie Ketogenic Diet on Circulating Myokine Levels Compared with the Effect of Bariatric Surgery or a Low-Calorie Diet in Patients with Obesity. Nutrients. 2019 Oct;11(10):2368.
38. Merra G, Miranda R, Barrucco S, Gualtieri P, Mazza M, Moriconi E, et al. Very-low-calorie ketogenic diet with aminoacid supplement versus very low restricted-calorie diet for preserving muscle mass during weight loss: a pilot double-blind study. Eur Rev Med Pharmacol Sci. 2016 Jul;20(12):2613–21.
39. Deutz NEP, Pereira SL, Hays NP, Oliver JS, Edens NK, Evans CM, et al. Effect of β-hydroxy-β-methylbutyrate (HMB) on lean body mass during 10 days of bed rest in older adults. Clinical Nutrition. 2013 Oct 1;32(5):704–12.
40. Koutnik AP, Poff AM, Ward NP, DeBlasi JM, Soliven MA, Romero MA, et al. Ketone Bodies Attenuate Wasting in Models of Atrophy. Journal of Cachexia, Sarcopenia and Muscle [Internet]. 2020 Apr 7 [cited 2020 Apr 7];n/a(n/a). Available from: https://onlinelibrary.wiley.com/doi/abs/10.1002/jcsm.12554
41. Thomsen HH, Rittig N, Johannsen M, Møller AB, Jørgensen JO, Jessen N, et al. Effects of 3-hydroxybutyrate and free fatty acids on muscle protein kinetics and signaling during LPS-induced inflammation in humans: anticatabolic impact of ketone bodies. Am J Clin Nutr. 2018 01;108(4):857–67.
42. Kohno R, Cannom DS, Olshansky B, Xi SC, Krishnappa D, Adkisson WO, et al. Mast Cell Activation Disorder and Postural Orthostatic Tachycardia Syndrome: A Clinical Association. JAHA. 2021 Sep 7;10(17):e021002.
43. Weinstock L. Small Intestinal Bacterial Overgrowth is Common in Mast Cell Activation Syndrome. J Med. 2020;
44. Thio CLP, Lai ACY, Ting YT, Chi PY, Chang YJ. The ketone body β-hydroxybutyrate mitigates ILC2-driven airway inflammation by regulating mast cell function. Cell Reports. 2022 Sep;40(13):111437.
45. Nakamura S, Hisamura R, Shimoda S, Shibuya I, Tsubota K. Fasting mitigates immediate hypersensitivity: a pivotal role of endogenous D-beta-hydroxybutyrate. Nutrition & Metabolism. 2014 Aug 28;11(1):40.
46. Jiao Y, Wu L, Huntington ND, Zhang X. Crosstalk Between Gut Microbiota and Innate Immunity and Its Implication in Autoimmune Diseases. Frontiers in Immunology [Internet]. 2020 [cited 2022 Feb 28];11. Available from: https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC7047319/
47. Traina G. Mast Cells in Gut and Brain and Their Potential Role as an Emerging Therapeutic Target for Neural Diseases. Front Cell Neurosci. 2019 Jul 30;13:345.
48. Reynolds K. Small Intestinal Bacterial Overgrowth: A Case-Based Review. Journal of Patient-Centered Research and Reviews. 2015 Nov 20;2(4):165–73.
49. O’Dwyer D. Homemade Elemental Diet to Treat Intestinal Methanogen Overgrowth: A Case Report. Integr Med (Encinitas). 2021 Apr;20(2):32–41.
50. Martin P, Johansson M, Ek A. A Zero Carbohydrate, Carnivore Diet can Normalize Hydrogen Positive Small Intestinal Bacterial Overgrowth Lactulose Breath Tests: A Case Repor [Internet]. 2021 [cited 2022 Jul 18]. Available from: https://doi.org/10.21203/rs.3.rs-148500/v1
51. Xiao Y, Xu W, Su W. NLRP3 inflammasome: A likely target for the treatment of allergic diseases. Clinical & Experimental Allergy. 2018;48(9):1080–91.
52. Ma M, Li G, Qi M, Jiang W, Zhou R. Inhibition of the Inflammasome Activity of NLRP3 Attenuates HDM-Induced Allergic Asthma. Front Immunol. 2021;12:718779.
53. Kim ER, Kim SR, Cho W, Lee SG, Kim SH, Kim JH, et al. Short Term Isocaloric Ketogenic Diet Modulates NLRP3 Inflammasome Via B-hydroxybutyrate and Fibroblast Growth Factor 21. Front Immunol. 2022 Apr 28;13:843520.
54. Youm YH, Nguyen KY, Grant RW, Goldberg EL, Bodogai M, Kim D, et al. Ketone body β-hydroxybutyrate blocks the NLRP3 inflammasome-mediated inflammatory disease. Nat Med. 2015 Mar;21(3):263–9.
55. Garland EM, Gamboa A, Nwazue VC, Celedonio JE, Paranjape SY, Black BK, et al. Effect of High Dietary Sodium Intake in Patients with Postural Tachycardia Syndrome. J Am Coll Cardiol. 2021 May 4;77(17):2174–84.
56. Pogoda JM, Gross NB, Arakaki X, Fonteh AN, Cowan RP, Harrington MG. Severe Headache or Migraine History Is Inversely Correlated With Dietary Sodium Intake: NHANES 1999–2004. Headache. 2016 Apr;56(4):688–98.
57. Stanton A. Nutrition Network Course - Neurology: Keto for Migraines, Epilepsy and Alzheimer’s Disease | Migraine [Internet]. 2021 [cited 2023 Mar 3]. Available from: https://courses.nutrition-network.org/p/neurology
58. Nichols M, Schuler N. Histamine Intolerance: Can cause a wide variety of symptoms [Internet]. 2019 [cited 2023 Feb 26]. Available from: https://medicinewithheart.com/blog/histamine-intolerance-2/
59. Schuette K. Stock vs. Broth: Are You Confused? [Internet]. Biodynamic Wellness. 2014 [cited 2023 Feb 26]. Available from: https://www.biodynamicwellness.com/stock-vs-broth-confused/
60. Schuette K. Amino Acid lab anaysis - Covance Laboratories, Madison, Wisconsin - Stock vs. Broth: Are You Confused? [Internet]. Biodynamic Wellness. 2014 [cited 2023 Mar 3]. Available from: https://www.biodynamicwellness.com/stock-vs-broth-confused/
61. Shaw MH, Flynn NE. AMINO ACID CONTENT OF BEEF, CHICKEN AND TURKEY BONE BROTH. 2019; Available from: https://www.westmont.edu/sites/default/files/users/user1231/V19No4/Nick%20Flynn_final.pdf
62. Deters BJ, Saleem M. The role of glutamine in supporting gut health and neuropsychiatric factors. Food Science and Human Wellness. 2021 Mar 1;10(2):149–54.
63. Rastgoo S, Ebrahimi-Daryani N, Agah S, Karimi S, Taher M, Rashidkhani B, et al. Glutamine Supplementation Enhances the Effects of a Low FODMAP Diet in Irritable Bowel Syndrome Management. Frontiers in Nutrition [Internet]. 2021 [cited 2023 Feb 27];8. Available from: https://www.frontiersin.org/articles/10.3389/fnut.2021.746703
64. Chang CH, Lin CH, Lane HY. d-glutamate and Gut Microbiota in Alzheimer’s Disease. International Journal of Molecular Sciences. 2020 Jan;21(8):2676.
65. Shimmura C, Suda S, Tsuchiya KJ, Hashimoto K, Ohno K, Matsuzaki H, et al. Alteration of Plasma Glutamate and Glutamine Levels in Children with High-Functioning Autism. PLOS ONE. 2011 Oct 5;6(10):e25340.
66. Hoffmann J, Charles A. Glutamate and Its Receptors as Therapeutic Targets for Migraine. Neurotherapeutics. 2018 Apr 1;15(2):361–70.
67. Holton KF, Kirkland AE, Baron M, Ramachandra SS, Langan MT, Brandley ET, et al. The Low Glutamate Diet Effectively Improves Pain and Other Symptoms of Gulf War Illness. Nutrients. 2020 Aug 26;12(9):2593.
68. Kraal AZ, Arvanitis NR, Jaeger AP, Ellingrod VL. Could Dietary Glutamate Play a Role in Psychiatric Distress? NPS. 2020;79(1–2):13–9.
69. Barker-Haliski M, White HS. Glutamatergic Mechanisms Associated with Seizures and Epilepsy. Cold Spring Harb Perspect Med [Internet]. 2015 Aug [cited 2021 Mar 14];5(8). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4526718/
70. Crawford J, Liu S, Tao F. Gut microbiota and migraine. Neurobiology of Pain. 2022 Jan 1;11:100090.
71. Olson CA, Vuong HE, Yano JM, Liang QY, Nusbaum DJ, Hsiao EY. The Gut Microbiota Mediates the Anti-Seizure Effects of the Ketogenic Diet. Cell. 2018 Jun 14;173(7):1728-1741.e13.
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