The Way Up Newsletter
Vol. 13
10/15/99

So we'll try to take on a huge topic in a wee bit of space.

WHATEVER HAPPENED TO L-TRYPTOPHAN?

L-tryptophan is an amino acid which converts to serotonin in our bodies & brains. Though safely used by millions for years, it was removed from the market when some people had severe adverse reactions to a contaminated batch from Japan. It was widely researched & even prescribed by non-holistically oriented doctors. This was a great threat to the new class of serotonin-related drugs about to be unleashed on the market place at that time.

L-tryptophan has never been restated to an over-the-counter status, but has been available by presciption from compounding pharmacies.

WHAT IS THE CONNECTION TO SEROTONIN?

L-tryptophan converts to serotonin like so:

L-tryptophan is acted upon by an enzyme tryptophan hydroxylase to become 5-Hydroxytryptophan (5-HTP). This is acted upon by the enzyme tryptophan decarboxylase, plus pyridoxal-5-phospate (the active form of vitamin B6) to become serotonin (5-HT) standing for 5-hydroxytyramine. Other vitamins & minerals also act as co-factors in this conversion.

Serotonin is related to disorders of consumption (alcoholism, bulimia, anorexia), mood, sleep, anxiety, thought(OCD), learning, memory, sexual activity, aggression, & suicidality. No wonder the race to manipulate serotonin levels with drugs!

In it's hey day L-tryptophan was extensively used to help with chronic pain, insomnia, anxiety, depression, agitation, mania, to decrease food cravings, etc. It was useful for most. About 1% of people would have a "paradoxical" reaction producing an opposite response to that desired. Then, of course, they would not continue taking it.

WHAT ABOUT 5-HYDROXY-TRYPTOPHAN? (5-HTP)

Because L-tryptophan was so effective, researchers & individuals began using 5-HTP in its place & with the same beneficial results. This was allowed over-the-counter as there had been no reported problems with it. You can be sure if there were it would quickly be removed because now it can be seen as a new competitor to the serotonin enhancing drugs.

Now along comes static & confusion about 5HTP. I find that interesting. Some warnings about 5HTP were published in a Life Extension Foundation Newsletter. While I often agreee with their opinions, I disagree with their advice to use the drug "Carbidopa"(a drug with potential serious side effects) when using 5HTP. I further disagree with their preference you avoid vitamin B6 when using 5HTP.

WHY DO THEY SUGGEST CARBIDOPA?

The Carbidopa is a drug given for Parkinson's Disease. The theory is since the Carbidopa & a B6 deficiency will interfere with the above mentioned decarboxylase enzyme, less 5HTP will convert to serotonin in the peripheral blood leaving more to go to the brain to convert to serotonin.

They suggest the danger of a body serotonin overload from the 5HTP without carbidopa & with vitamin B6. I say, show me the clinical cases, & show me the proof in the literature.

Before the serotonin enhancing drugs we did not read about problems with serotonin overload, except for unusual cases of what is called Carcinoid Syndrome (the presence of multiple serotonin producing tumors in the body).

Let's address this practically & clinically, not by theory. Thousands if not millions have by now used 5HTP(without the added Carbidopa), yet I have not seen, heard of, nor could I find in the literature any report of serotonin excess damage or "serotonin syndrome" caused by 5HTP or L-tryptophan.

This syndrome is a nasty cluster of neurological symptoms which began to appear in the literature in the late 80's. This was caused by forced artificially high levels of serotonin from drugs-rarely a single drug, usually a combination of drugs impacting the serotonin system

When using natural agent as precursors, the body has it's own regulatory pathways for conversion, metabolism, or degradation of all our food. When enough 5HTP has converted to serotonin at any one time, ther is a feedback loop to decrease the production or divert it down another pathway. The body has not has thousands of years to evolve mechanisms for clearing the high serotonin levels which may be induced by drugs.

SO WHAT IS RECOMMENDED?

In my practice I frequently order serum serotonin levels & when I do so I usually see below normal levels. Granted I am measuring this on those who are depressed, agitated, anxious, or insomniac. You can ask your Dr to order a serum serotonin, if you wish.

As you may have noted by now, it is my opinion & the opinion of other amino acid experts with whom I have consulted that there is not need to take the drug Carbidopa when using the natural product 5HTP. You rather defeat your purpose, don't you? You will know relatively soon whether it is benefiting you. In the research 5HTP has been found to have similiar results to L-tryptophan.

The dosage of L-tryptophan in the research was 500-6000 mg. 100 mg of 5HTP is equivalent to 500 mg L-tryptophan. I usually suggest starting with only 1-2 of the 100 mg size daily & adjusting as needed. It is generally best to use no more that a total of 6 daily in 2-3 divided doses, gradually increasing to this dose if needed. Usually a lower dose is effective.

It is best to take 5HTP at bedtime, unless you are using it for pain, anxiety, agitation, to decrease food or alcohol craving, or for mania. For more about 5HTP you can search for it using our Search function. Also be sure to read more about pyridoxal-5-phosphate.

I hope you are still with me after all this technical business.

Was going to also write about caffeine this month, but enough is enough, so will do another time.

WHAT'S NEW WITH BOOKS?

The most exciting concept & book on the horizon for me is called GENETIC NUTRITIONEERING. Just think, being able to modify your unwanted genetic predispostions by using certain foods & supplements. It is written by Jeffrey Bland PhD., a most respected researcher, nutritional biochemist, & functional medicine expert. If it is not yet in the bookstores, you can order by calling 1-800-228-0622.

Please let me know what you want discussed. Please forward to any you feel would be interested.

And most of all be happy & health!

Priscilla Slagle M.D.

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