An exploration of the startle reflex and its underlying conditions, the dominant role of glycine neurotransmission in hyper-eplexia, treatment options and nutritional strategies for glycine neurotransmission disorders, factors leading to glycine loss in urine and strategies to increase glycine intake, and the therapeutic use and potential risks of glycine.
An exaggerated startle reflex may indicate an underlying issue, and glycine plays a crucial role in modulating the startle reflex.
Hyper-Eplexia, a rare genetic disorder characterized by an excessive startle reflex, is caused by defects in glycine neurotransmission.
Deep dives
The Startle Reflex and Glycine
The startle reflex is a natural response that protects us from sudden threats. However, an exaggerated or easily triggered startle reflex may indicate an underlying issue. Startling too easily could be a sign of a problem. The neurobiology of the startle reflex involves visual, auditory, and tactile inputs, with most research focusing on the auditory aspect. The reflex is enhanced by fear and anxiety, while pleasure inhibits it. Loud noise, bright light, and female sex hormones can also enhance the startle reflex. Sensory inputs are integrated in the brainstem, and the motor response is coordinated in the spinal cord. Glutamate activates the startle reflex, but it is inhibited by GABA in the brainstem and glycine in the spinal cord.
Glycine and Hyper-Eplexia
Hyper-Eplexia is a rare genetic disease characterized by an excessive startle reflex in newborns. Research has found that mutations in genes involved in glycine neurotransmission are responsible for hyper-Eplexia. Glycine is overwhelmingly important in the startle reflex, and defects in glycine neurotransmission lead to an exaggerated response. Hyper-Eplexia is the only startle-specific disorder with a well-established neurobiology, and all known gene mutations related to hyper-Eplexia are involved in glycine neurotransmission. Other factors that can impact glycine status include nutritional deficiencies, genetic impairments, and excessive methionine intake, among others.
Glycine and Treatment Options
Despite glycine's importance in the startle reflex, treatment options for disorders of glycine neurotransmission often focus on increasing GABA receptor activity rather than enhancing glycine activity. Clonazepam is commonly used, but there is limited information on the effects of other substances like benzoate, ketamine, or hydroglycine. There is a lack of randomized trials on nutritional strategies to modulate neurotransmitters that impact the startle reflex. Supplementation with glycine, gelatin, collagen, or bone broth can provide additional glycine, with recommended dosages ranging from 3 to 20 grams per day depending on the purpose. However, excessive glycine intake can have adverse effects and may negatively impact respiratory chain disorders or raise oxalate levels in some individuals.
The ability to become startled is an adaptive behavior that protects us from being injured by a sudden threat, and prepares us for the fight-or-flight response when necessary.
Nevertheless, getting startled too easily can be a sign that something is wrong.
Here's what to do about it.
For the written version with links to references and links to testing, see here: