A very common question when someone is starting amino acid therapy to reduce the urges to pull associated with trichotillomania is whether or not their pulling will get worse before it gets better. While it is possible that a person’s urges to pull may increase as we optimize their neurotransmitter function, it rarely happens in practice.

The reason why a person’s urges to pull do not normally increase with the proper use of amino acid therapy is that we are providing the body the basic building blocks that it needs to improve neurotransmitter function. Even if the balance isn’t exactly right, it is usually closer to optimal than it was prior to initiating amino acid therapy. Therefore, since it is better than it was, symptoms should also show improvement as we progress towards optimization. Once a person’s neurotransmitter function has been optimized, any urges to pull due to neurotransmitter imbalance should cease.

If an increase in a person’s urges to pull does occur, it almost always happens when we are very close to getting them optimized. In these instances, we have almost found the right combination of amino acids that they need to optimize neurotransmitter function and we are doing minor adjustments to try and get it exactly right. If the adjustment takes us further away from optimal, a person’s urges to pull can increase. However, the time a person has an increased urge to pull is usually very short, as we can make another adjustment within 7 days of a dosing change.

Thus, while increased urges to pull can happen with the use of amino acid therapy, it doesn’t happen that often. Once more, if it does happen, it usually means we are very close to optimizing neurotransmitter function and can substantially reduce the urges within a few days.