Tryptophan: Canadians Are Using It, Why Not We Americans?
That's a real question, not a come-on. I don't know the answer, frankly. But I'm beginning to wonder -- and maybe should have been wondering long ago. Here's why:
What's the difference between tryptophan and 5-HTP? The latter molecule ("5-Hydroxy-Tryptophan") is the only middle step between trytophan you eat and serotonin in your brain. There are some controls on how much serotonin you end up with for a given amount of tryptophan in your diet -- but amazingly, you can push your serotonin around rather dramatically with changes in dietary tryptophan. If I get some inquiries or comments here, indicating interest (blog just started; I know it's almost invisible so far...), I can write up a simple summary of some of the chemistry.
But in closing, consider this very remarkable finding: two weeks of daily tryptophan supplements shifted "normal" volunteers toward a "positive bias" in their interpretation of facial expressions and emotional words. They noticed positive expressions more easily, and noticed negative ones less; they paid less attention to negative words; and they startled less easily. Overall they were just a little more positive in their outlook. (Interestingly, only the women experienced this effect, not the men).
Depression, especially "bipolar depression" -- more than plain depression, but not necessarily manic-depressive; explained here -- is hard to treat sometimes. And it's common. So having a simple, cheap treatment would be great. Could tryptophan, or 5-HTP, qualify as such a treatment? If there is low risk, we would need less evidence of effectiveness to justify trying it. But the risk story is still fuzzy. See why I find myself asking: Canadians are using it, why not we Americans? Do they know something we don't, about safety? Or is our FDA properly protecting us from risk?
JP
Email this post | save in Del.icio.us
- There is some evidence, not great, not a lot, but moderately consistent, that tryptophan can treat depression like Prozac (generic: fluoxetine) and the other serotonergic antidepressants.
- Until it went off the market back in the 1990's, we were using tryptophan as a medication for sleep. It was cheap, and it seemed to work.
- The FDA pulled it from the market because of a clear association with an unusual allergic reaction ("eosinophilic myalgia" and related problems). But since then, other countries including Canada have allowed it to be used, judging the allergic reaction problem to be related to an impurity problem since solved.
- The FDA, however, continues to block the prescription of tryptophan in the U.S., saying that tryptophan itself might still carry some risk of this allergic reaction. Yet at the same time, they allow it to be used as a dietary supplement, including in powdered baby milk.
Because of a wonderful librarian, I've been able to read those last two papers listed there. The bottom line, combining the two: evidence for effectiveness is moderate; evidence for risk, due to the contaminant problem, is extremely low and not clearly a remaining risk at all, particularly using the 5-HTP approach.
- The FDA announcement (2001, no updates)
- A thorough, somewhat technical review from an alternative medicine website
- A 2006 review of using 5-HTP, the next step toward serotonin from tryptophan
- A 2004 review of the "contaminant" issues
What's the difference between tryptophan and 5-HTP? The latter molecule ("5-Hydroxy-Tryptophan") is the only middle step between trytophan you eat and serotonin in your brain. There are some controls on how much serotonin you end up with for a given amount of tryptophan in your diet -- but amazingly, you can push your serotonin around rather dramatically with changes in dietary tryptophan. If I get some inquiries or comments here, indicating interest (blog just started; I know it's almost invisible so far...), I can write up a simple summary of some of the chemistry.
But in closing, consider this very remarkable finding: two weeks of daily tryptophan supplements shifted "normal" volunteers toward a "positive bias" in their interpretation of facial expressions and emotional words. They noticed positive expressions more easily, and noticed negative ones less; they paid less attention to negative words; and they startled less easily. Overall they were just a little more positive in their outlook. (Interestingly, only the women experienced this effect, not the men).
Depression, especially "bipolar depression" -- more than plain depression, but not necessarily manic-depressive; explained here -- is hard to treat sometimes. And it's common. So having a simple, cheap treatment would be great. Could tryptophan, or 5-HTP, qualify as such a treatment? If there is low risk, we would need less evidence of effectiveness to justify trying it. But the risk story is still fuzzy. See why I find myself asking: Canadians are using it, why not we Americans? Do they know something we don't, about safety? Or is our FDA properly protecting us from risk?
JP
9 Comments:
I had no idea about the trypotphan! My psychiatrist prescribed it to me months ago to help me sleep. I stopped taking it after he increased my Klonopin dosage instead at night. Dr. I just ordered your book today. I'm hoping it will arrive in a day or so. I was just recently diagnosed with Bi Polar II at 41 years old. My biological father was diagnosed with Bi Polar I in his teens. I so look forward to your book arriving. I'm going to talk to my psychiatrist next week about your thoughts on tryptohan.
Traci
Thank you for the comment, Traci. Careful with asking your doc' about tryptophan -- you could be perceived as chasing poorly documented treatment. By comparison, there is much more firmly documented stuff to go on in my book (including the references, in the Notes section). As you may have seen, doctors can react strongly when someone is telling them what to do (not me of course), or even suggesting. Good luck with that.
Dr. P'
I just bought your book last night and am reading it like a rabid dog. So to speak. Thank you SO so much for writing it. It may possibly save my life
Hugs
Traci
p.s. I won't mention it to my dr. You are right, he's the kind the doesn' like to be told what to do
How would the "hit" of serontonin delivered by 5 HTTP be determined, modulated and regulated?
Are there any figures on over the counter 5 HTTP or Canadian trypthophan pushing in mania?
Good question. I looked for case reports of tryptophan or 5-HTTP causing mania or hypomania. In a brief search (PUB MED and Google), I'm surprised to find only two suggestive reports: one in a patient already taking an antidepressant, and one reporting only "increased sexual activity" (suggesting hypomania, perhaps).
I'm almost sure I remember something more substantial than this but did not find it. Seems like a theoretical risk all right: I still regard tryptophan as akin to an antidepressant.
JP
Interestingly, it seems that for a time l-tryptophan was actually studied as an anti-manic agent.
Here's a link to a study with a favorable result in that regard: http://tinyurl.com/yftgkj/ . This accords with some research that indicates low levels or serotonin in mania (http://tinyurl.com/ybwxrt). However, other studies (e.g. http://tinyurl.com/ylw3du/) seem to indicate more equivocal results in terms of l-tryptophan as an acute anti-manic.
Just a little more food for thought on this,
Henry
[PS: All of the tinyurl links route to PubMed abstracts. I didn't want to clutter things up with the whole long link each time.]
Thanks, Henry. Interesting comment and links. Leaves a lot of open questions for this molecule, doesn't it.
JP
I'm reading an interesting book called the "Mood Cure" by Julia Ross who discusses many of these issues in her book. She is not a physician, but a psychotherapist and nutritionist. (So some of what I am reading, I'm taking with a grain of salt...) She claims that tryptophan & 5-HTP in high doses can cause mania in some people. She says the same for fish oil. She also suggests that people need to be careful when combining SSRIs and tryptophan together because it may cause excess serontonian syndrome. She encourages clients to taper off SSRIs in favor of these more "natural" methods. She also cautions seeking help from a physician and if taking both a SSRI and 5-HTP to take them 6 hours apart.
Unfortunately while she cautions about mania and gives many research references in general, there is nothing specific about this the mania - trypthophan link that I can find in the book.
Might be interesting to follow up with her and find out what she knows based on research and/or clinical experience.
Hello,
Currently, I am taking Klonopin at night for anxiety. Would Tryptophan be a good way to taper off, perhaps adding it as I reduce the Klonopin? Also, since I haven't been responding properly to SSRIs, my doctor has suggested that I may need to go the bipolar route, perhaps starting with Lamictal. If so, would Tryptophan be OK to take with Lamictal, as it is not an SSRI?
Thanks
Post a Comment
<< Home