5-HTP
Source: Gale Encyclopedia of Alternative Medicine
By: Belinda Rowland
Description
5-HTP, the acronym for 5-hydroxytryptophan (or 5-hydroxy-L-tryptophan), is
a compound found primarily in the brain. 5-HTP is made from tryptophan, a
natural amino acid found in the diet. Tryptophan is an essential amino
acid, which means that it cannot be made by the body so it must be
obtained from food, particularly from proteins. In the liver and brain,
5-HTP is converted to an important monoamine neurotransmitter called
serotonin. Neurotransmitters are chemical messengers that transmit signals
between neurons (nerve cells) in the brain.
Taking 5-HTP increases the body's supply of 5-HTP, which leads to
increased levels of serotonin in the brain. Serotonin, also called
5-hydroxytryptamine or 5-HT, plays an important role in controlling
behaviour and moods. It influences many normal brain activities and also
acts as a traffic cop by regulating the activity of other
neurotransmitters. Having adequate levels of serotonin instills a feeling
of relaxation, calmness, and mild euphoria (extreme happiness). On the
contrary, low levels of serotonin, called serotonin deficiency syndrome,
leads to depression, anxiety, irritability, insomnia, and many other
problems.
Conditions associated with low levels of serotonin include:
anxiety
attention-deficit hyperactivity disorder
bulimia
depression
epilepsy
fibromyalgia
headaches
hyperactivity
insomnia
obesity
obsessive-compulsive disorder
panic attacks
premenstrual syndrome (PMS)
schizophrenia
seasonal affective disorder (SAD)
5-HTP has other effects on the body. It is an antioxidant that protects
the body from damage by substances called free radicals (unstable, toxic
molecules). In this role, 5-HTP may help slow down the aging process and
protect the body from illness. Because serotonin is used to make melatonin,
taking 5-HTP may help achieve some of the same benefits as melatonin, such
as treating jet lag, depression, and insomnia. There is some evidence that
5-HTP can replenish the supply of the pain-relieving molecules called
endorphins. Studies have shown that low levels of endorphins are
associated with chronic fatigue syndrome, fibromyalgia, stress, and
depression. In addition, 5-HTP affects other neurotransmitters, including
norepinephrine and dopamine.
General use
5-HTP has been proven effective in the treatment of carbohydrate cravings
and binge eating, chronic headaches, depression, fibromyalgia, insomnia,
anxiety, and panic disorders.
Most of the clinical research with 5-HTP focuses on treatment of
depression. In 15 separate studies, 5-HTP was tested on a total of 511
patients with different kinds of depression. Over half (56%) of these
patients had significant improvement in depression while taking 5-HTP.
5-HTP was found to be as effective as the selective serotonin reuptake
inhibitor (SSRI) fluvoxamine and the tricyclic antidepressants
chloripramine and imipramine. Most of these studies used relatively high
doses in the range of 50 mg to 3,250 mg daily.
Three clinical studies have found that 5-HTP use led to significant
improvement in the pain, anxiety, morning stiffness, and fatigue
associated with fibromyalgia. The doses ranged from 300 mg to 400 mg
daily. In one study, 5-HTP treatment was as effective as a tricyclic
antidepressant (amitriptyline) and monamine oxidase inhibitors (MAOI;
pargilyne or phenelzine).
Three clinical studies have found that 5-HTP use led to decreased intake
of food and subsequent weight loss in obese patients. The dose used in one
study was 900 mg daily, which initially caused nausea in 80% of the
patients.
A few clinical trials have found that 5-HTP can effectively prevent
chronic headaches, including migraine headache and tension headache. In
addition, 5-HTP compared favorably with propranolol and methysergide,
drugs commonly used to prevent migraines.
5-HTP is an effective treatment of insomnia. It increases the length of
rapid eye movement (REM) sleep, which improves the quality of sleep.
5-HTP was found to significantly reduce symptoms of anxiety. It instilled
a sense of "relief" in patients with panic disorders.
Other conditions that may be treated with 5-HTP, but for which no studies
yet exist, include chronic fatigue syndrome, premenstrual syndrome,
Parkinson's disease, and seizure disorders (such as epilepsy).
Preparations
The 5-HTP available commercially is isolated from the seed of an African
plant called Griffonia simplicifolia. 5-HTP is available as enteric coated
tablets, which do not break down until they reach the intestine.
The recommended starting dose for headaches, weight loss, depression, and
fibromyalgia is 50 mg three times daily. 5-HTP can be taken with food,
however, for weight loss it should be taken 20 minutes before eating. If,
after two weeks, this dose is not effective, the dose may be increased to
100 mg three times daily, but only with the recommendation of a physician.
Insomnia is treated with 25 mg (which may be increased to 100 mg after a
few days) taken 30-45 minutes before going to bed.
Precautions
The Mayo Clinic detected, and the FDA confirmed, the presence of a
contaminant ("peak X") in 5-HTP produced by six different manufacturers.
This contaminant is similar to a contaminant in L-tryptophan which, in
1989, caused the potentially fatal eosinophilia myalgia syndrome (EMS) in
some persons. The L-tryptophan supplements were subsequently banned by the
FDA. There have been 10 reports of EMS associated with 5-HTP use. The
5-HTP contaminant was not at levels high enough to cause illness; however,
taking excessive doses of 5-HTP may lead to toxic levels of peak X.
Long term studies on the safety of 5-HTP use have not been conducted. To
be safe, 5-HTP should be considered a short-term remedy.
Because there are no clinical studies on the use of 5-HTP during
pregnancy, women who are pregnant should not use 5-HTP.
Side effects
Side effects associated with 5-HTP use are rare but may include headaches,
mild stomachaches, nausea, nasal congestion, and constipation. There are
anecdotal reports that taking high doses of 5-HTP causes nightmares or
vivid dreams. Side effects may be minimized by starting with a low dose of
5-HTP and taking it with food.
Interactions
It is theorized that the effectiveness of 5-HTP may be enhanced by taking
vitamin B6 and niacinamide. The action of 5-HTP may be enhanced by
extracts of ginger, passionflower (Passiflora incarnata), St. John's wort,
and Ginkgo biloba.
There is a chance of developing serotonin syndrome when taking 5-HTP with
an antidepressant drug. Serotonin syndrome was seen in patients taking
high doses (greater than 1,200 mg daily) of L-tryptophan and MAO
inhibitors. Combining 5-HTP with a MAOI or selective serotonin reuptake
inhibitor antidepressant should be done with caution under the supervision
of a physician.
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