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5-HTP / Tryptophan
5-HTP (5-hydroxytryptophan) is the breakdown product of tryptophan, an essential amino acid present in most protein foods. It is a precursor to serotonin (5-HT), so people with a serotonin deficiency, or too-rapid uptake of serotonin can probably benefit from 5-HTP. I use it for sleep in place of a tricyclic antidepressant. It has the delightful side effect of reducing carbohydrate cravings. (I believe this is because people with sufficient serotonin don't have to load up on tryptophan-containing carbohydrates.)
5-HTP works best if taken 3 or more hours after your last protein-containing meal or snack. Washing it down with fruit juice also gives it a boost.
People who are taking SSRIs Prozac, Wellbutrin and Zoloft should exercise caution in taking 5-HTP. The result is may be an overdose of serotonin; the effects are not pleasant. I know of one person who experienced severe nausea on taking her first 100mg dose. This does not happen to everyone, and I have not heard of it happening to people on Prozac, but it might, and you should weigh the risk of an episode of severe nausea against the benefit of obtaining restful sleep in making your decision. I have no personal knowledge of any other adverse effects, although the papers abstracted below mention that some exist.
Usual dose for sleep is 100-600mg at bedtime. For people who had success with L-tryptophan in years past, the ratio of tryptophan to 5-HTP seems to be about 5:1. Thus, if you used to take 1500 mg of L-tryptophan, you'd probably take 300 mg of 5-HTP.
The difference between L-tryptophan and 5-HTP is this: L-tryptophan breaks down into 5-HTP and kynurenin. I have so far been unable to determine the purpose of kynurenin, but there is no suggestion that it is useful for sleep or pain relief. There is some evidence to suggest that people with FM may be deficient in serotonin because the tryptophan they obtain from food metabolizes into kynurenin rather than both it and 5-HTP. Therefore, 5-HTP seems likely to be more efficient than L-tryptophan in boosting serotonin.
Here are two abstracts that you and your doctor may find of interest:
Puttini PS; Caruso I Primary fibromyalgia syndrome and 5-hydroxy-L-tryptophan: a 90-day open study.
Rheumatology Unit, L Sacco Hospital, Milan, Italy.
J Int Med Res 1992 Apr;20(2):182-9
Unique Identifier: MEDLINE 92394366ABSTRACT:
The efficacy and tolerability of 5-hydroxy-L-tryptophan (5-HTP) were studied in an open 90-day study in 50 patients affected by primary fibromyalgia syndrome. When all the clinical variables studied throughout the trial (number of tender points, anxiety, pain intensity, quality of sleep, fatigue) were compared with baseline results, they all showed a significant improvement (P less than 0.001). The overall evaluation of the patient condition assessed by the patient and the investigator indicated a 'good' or 'fair' clinical improvement in nearly 50% of the patients during the treatment period. A total of 15 (30%) patients reported side-effects but only one patient was withdrawn from the treatment for this reason. No abnormality in the laboratory evaluation was observed. It is concluded that 5-HTP is effective in improving the symptoms of primary fibromyalgia syndrome and that it maintains its efficacy throughout the 90-day period of treatment.
Byerley WF; Judd LL; Reimherr FW; Grosser BI
5-Hydroxytryptophan: a review of its antidepressant efficacy and adverse effects.
J Clin Psychopharmacol (HUD), 1987 Jun; 7 (3): 127-37ABSTRACT:
Alterations in serotonin metabolism may be an important factor in the etiology and treatment of depression. In this regard, 5-hydroxytryptophan (5-HTP), a serotonin precursor, has been given to patients with depression. Although a review of these studies suggests that 5-HTP possesses antidepressant properties, additional trials are clearly indicated. Following a discussion of the pharmacology of 5-HTP, the authors highlight adverse effects associated with its administration to depressed patients, neurologic subjects, and normal individuals. Relatively few adverse effects are associated with its use in the treatment of depressed patients. [Contains 59 references.]
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