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Ask the Doctor 2018 Issue 4 (Fall)

Disclaimer: neither the BEBRF nor members of the BEBRF Medical Advisory Board has examined these patients and are not responsible for any treatment.

  • QUESTION: I've read about BEB patients who take 1000 mg of taurine twice a day, and they find that when they take it along with their botulinum toxin injections, their results are much improved. Others have said they take L-tyrosine and also have improved results. How safe is it to do that long term?

    ANSWER: This is an interesting question. The more patients I meet, the more different stories I hear about what "caused" their blepharospasm and what helps them. The problem is that there are probably many different factors involved in the development and severity of BEB, and one factor may have more impact for one person than another based upon each person's personal chemistry, genetics, immediate environment, toxin exposure, medications, diet, etc.

    I am not aware of any of my patients who are taking either Taurine or L-Tyrosine to improve their BEB, but the following may be helpful. Taurine is believed to have many actions, including stimulating the gamma-aminobutyric acid alpha (GABAa) receptors. These are the same receptors that the benzodiazepines act upon. Examples of benzodiazepines are lorazepam (Ativan), clonazepam (Klonopin), and aprazolam (Xanax). Some patients find these anti-anxiety medications helpful, while others tell me that taking these medications simply make them not care as much that they have BEB - or about much else for that matter. A dose of 1,000 mg (1 gram) of Taurine a day along with 200-400 mg normally consumed in the diet should be safe over the long run. L-Tyrosine on the other hand can be an important precursor for dopamine production. Some data suggests that BEB may be at least partly related to a diminished effect of dopamine in the brain. Note that "diminished effect" does not necessarily mean simply diminished level. Nevertheless, L-tyrosine at a dose of 500 mg/day appears to be safe. Both Taurine and L-Tyrosine are often recommended by alternative practitioners to "reduce stress and anxiety." Since both of these supplements appear safe at the doses mentioned here, I see no harm in trying them. I'm sure the BEBRF would be interested in someone keeping a log of dietary supplements that different people find helpful. The role of diet and nutrition in many diseases and disorders is becoming more and more apparent.

    Charles Soparkar, MD, PhD, Plastic Eye Surgery Associates, Houston, TX.

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