|
 If
you're one of the 14 million people who previously took
L-tryptophan to obtain relief from sleeping difficulties,
premenstrual syndrome, obsessive/compulsive behavior, stress
and depression, a newly available nutritional supplement,
5-HTP (5-hydroxy-L-tryptophan), may be of special interest
to you.
Tryptophan is a naturally occurring amino acid required by
the human body for the production of melatonin and
serotonin, two vital brain chemicals necessary for sleep and
mood regulation. Once readily available as a nutritional
supplement, tryptophan has been one of the most difficult
substances to obtain in the U.S. since being banned by the
FDA in November of 1990. The FDA's decision to remove all
tryptophan-containing supplements from store shelves was in
response to an outbreak of Eosinophilia-Myalgia Syndrome
(EMS) that was linked to the use of tryptophan. EMS is a
dangerous and potentially deadly blood disease that is
usually associated with parasitic infections or severe
allergy. From July of 1989 to December of 1990, more than
1500 cases of EMS and 27 deaths were associated with the
outbreak in the United States.
In a report released by the Centers for Disease Control (CDC)
in August of 1992, researchers revealed that tryptophan was
not the cause of the of EMS outbreak. The CDC, working with
scientists from the Mayo Clinic, the Oregon State Health
Division and the Minnesota Department of Health, traced the
cause of the EMS crisis to a contaminant found only in
batches of tryptophan manufactured by a single Japanese
company, Showa Denko. Showa Denko, the source for up to 60%
of all the tryptophan sold in the United States, had
produced the tainted tryptophan after introducing an
untested manufacturing process that reduced the amount of
activated charcoal used to filter fermented raw tryptophan.
After tryptophan was cleared of any role in the EMS outbreak
it was natural to expect that tryptophan supplements would
soon reappear in health food stores. In reality, tryptophan
has been kept off of the market by the FDA, which currently
has no plans for lifting the ban on sales of this
supplement. This position is ironic, since the FDA feels
that tryptophan is safe enough to use in infant formulas and
parenteral (IV feedings) solutions. Still, it is doubtful
that this unique supplement will ever be found on store
shelves again.
In the absence of access to tryptophan, several new
prescription drugs designed to regulate brain serotonin
levels (Selective Serotonin Reuptake Inhibitors or SSRIs)
have been introduced. Drugs such as Prozac work through the
selective enhancement of serotonin levels, and
Dexfenfluramine, used in Europe to reduce
carbohydrate-cravings and suppress appetite, works by
mimicking serotonin activity in the brain.
Unfortunately Prozac can present unwanted and potentially
dangerous side effects, and the safety of dexfenfluramine is
in question after a study found it may cause brain damage in
monkeys.
5-hydroxy-L-tryptophan (5-HTP) is considered by many
researchers to be the safest tryptophan alternative
available. 5-HTP is normally converted in the body from
L-tryptophan, and as an intermediate metabolite, is further
converted into melatonin, a neurohormone, and serotonin
(5-hydroxytryptamine or 5-HT), a neurotransmitter. While
5-HTP is more expensive than tryptophan prior to the 1990
ban, it is also ten times as effective (a 50 mg. capsule of
5-HPT is generally regarded as the equivalent of 500 mg. of
tryptophan).
5HTP and You
Should
just any person who suspects that low serotonin levels are
the cause of their depression, overeating, substance abuse
or insomnia consume 5-HTP? What are the contraindications of
5-HTP and is it safe for all persons? Who should not take
5-HTP? Lastly, what is the safe and appropriate daily dose
of 5-HTP in persons who are otherwise healthy? These are
important questions.
It is advisable that professional advice should be solicited
by persons having (or suspected of having) emotional or
physical conditions such as those mentioned above. Listed at
the end of this article are the pre-existing conditions that
contraindicate (that is, advise against) the use of 5-HTP or
strongly indicate that its use should be under the guidance
of a physician.
Obviously, individuals who are already under medical
treatment using drugs which alter serotonin metabolism
should not take 5-HTP unless under the supervision of the
prescribing physician. Anti-depressants, weight-loss drugs
and L-dopa (used in the treatment of Parkinson's disease)
are examples of types of drugs that might contraindicate
unsupervised use at the same time as 5-HTP. An expanded list
of possibly contraindicated drugs is also included at the
end of this article.
As a nutritional supplement in most individuals 5-HTP can
safely be consumed at a dosage of up to 100 milligrams (mg)
per day. Recall that 100 mg of 5-HTP produces, in the body,
a rise in the blood (plasma) concentration of serotonin
equivalent to the amount that is produced from the
consumption of about 10 bananas. Much higher doses of
several hundred to nearly 3000 mg per day of 5-HTP have been
used in the treatment of severe muscular (myoclonic)
contractions. As will be described, a particular side effect
can occur in certain susceptible individuals.
It
is important to note that in persons experiencing certain
underlying medical conditions (mentioned below), long-term
elevations of serotonin have been associated with the
deposition of connective tissue (fibrosis) in the heart,
muscles, skin, and blood vessels. A predisposition to a
heart disease called endomyocardial fibrosis (EMP) exists
among chronically malnourished populations who consume low
protein/high carbohydrate diets rich in serotonin-containing
foods (such as bananas, plantain or cassavas). This
indicates that persons on a weight loss program who use
5-HTP should be on a high protein/low carbohydrate diet.
Another factor in the development of fibrosis is the
simultaneous presence of both high levels of serotonin and
another tryptophan metabolite that is not derived from
5-HTP, but that is toxic. The level of this toxic metabolite
was highly elevated in 1 out of 8 people who developed
fibrosis of the skin (scleroderma) after long-term treatment
with 5-HTP for myoclonic contractions. Conditions such as
AIDS, cancer, aging and autoimmune diseases frequently cause
an elevation in the level of this toxic tryptophan
metabolite. Persons with these conditions (and those listed
at the end of this article) should, therefore, not consume
5-HTP unless under the guidance of a physician.
Vitamin B-6 is a cofactor for the enzyme that degrades toxic
tryptophan metabolites. Since the enzyme that converts 5-HTP
into serotonin also needs B-6, this vitamin should regularly
be taken on the same day as 5-HTP, but at least 6 hours
before 5-HTP consumption. This preliminary use of B-6 before
5-HTP both helps to prevent the accumulation of toxic
tryptophan metabolites and delays somewhat the rise in
plasma levels of serotonin (from 5-HTP). No additional B-6
is needed beyond that obtained in a typical B-vitamin pill
or a minimum of 10 mg per day
Alcohol
effects the metabolism of 5-HTP. Therefore, persons who have
taken 5-HTP should not drink alcohol within six (6) hours of
its use. Persons with liver damage should not use 5-HTP. For
example, those who are chronic alcoholics, or intravenous
drug users, or who have cirrhosis, hepatitis or parasitic
infections should not use 5- HTP. Experimental 5-HTP use in
animals -- at the same time that liver toxic drugs were
administered -- produced heart fibrosis. 5-HTP
administration alone did not produce this effect.
Malnourished African persons who consume serotonin-rich
foods and have heart fibrosis also probably have liver
damage induced by chronic viral hepatitis and parasites like
malaria. Therefore, drugs that damage the liver -- and
probably effect tryptophan metabolism -- such as cancer
chemotherapies and powerful antibiotics, should not be used
at the same time as 5-HTP.
Since serotonin is involved in the constriction of blood
vessels and the clotting of blood by platelets, it should
not be used in persons at risk of heart disease or strokes
or who have high blood pressure. Its use in elderly persons
should be under the supervision of a physician, especially
those individuals receiving L-dopa for Parkinson's disease.
Persons with severe allergies should not use 5-HTP. Persons
who have previously experienced either flushing of the skin
should not take it or diarrhea with it use. If 5-HTP induces
nausea, the dosage should be reduced or, if symptoms
persist, its use discontinued entirely.
The effect of 5-HTP on fetuses and in pregnant women has not
been investigated clinically; therefore its use during
pregnancy is contraindicated. Lastly, persons driving an
automobile or operating machinery should not consume 5-HTP
within six hours prior to that activity. 5-HTP can potentate
the effects of certain tranquilizing drugs and alcohol.
One
of the titles of this article "Listening to 5-HTP"
is a parody of the title of the book "Listening to
Prozac". The author of "Listening to Prozac"
generally extols the virtues of selective serotonin reuptake
inhibitor drugs, like Prozac, especially underscoring their
marked improvement over previously developed types of anti-
depressants. Yet ironically, one six-week study of 69
subjects that compared another SSRI to 5-HTP found that both
compounds have equal antidepressant capabilities. Moreover,
5-HTP had one-half as many moderate-to-severe side effects
as the SSRI. One article, which reviewed the results of 17
clinical trials that used 5-HTP - mostly for depression -
concluded, "Oral administration of 5-HTP is associated
with few adverse effects". Two other facts surrounding
5- HTP are ironic vis-à-vis Prozac. For one, the efficacy
of Prozac and other SSR's are still dependent upon the
brains availability or serotonin precursors like tryptophan
or its derivative, 5-HTP. When patients receiving SSR's were
fed a special diet devoid of tryptophan, a relapse into
depression was experienced, despite the continued presence
of the SSRI. Tryptophan supplementation restored the
antidepressant effects of the SSRI. Finally, 5-HTP is an
amino acid and is available without a prescription
Contraindications
to 5-HTP use or
conditions
under
which 5-HTP Should Be Monitored
Cardiovascular Diseases (high blood pressure, post-stroke,
post-heart attack); Extremely Elderly Persons; those with
Parkinson's Disease, Cancer or Autoimmune Diseases (Scleroderma,
Rheumatoid Arthritis, Multiple Sclerosis, Lupus); Lung
Diseases; Chronic Alcoholism; Liver diseases (hepatitis or
cirrhosis); parasitic infection; AIDS; Anorexia Nervosa; Low
protein Diets; Allergies (severe); Myalgia (persistent pain
and weakness of the muscles); Peripheral Neuropathy (pain
weakness of the muscles); Rash or Flushing; Edema; Nausea;
Diarrhea; Sickle cell anemia; hemophilia; Pregnancy
Concurrent drug use: 5-HTP should not be used if
taking: Anti-depressant drugs; Monoamine oxidase inhibitors;
Selective Serotonin Reuptake Inhibitors (SSRI's e.g.,
Prozac); Tricyclic medications; Weight Loss medications
(i.e., dextenfluramine); Anti-parkinson medications (e.g.,
L-dopa); Barbiturates and other tranquilizing drugs;
Antihistamines and cold medications; Alcoholic beverages;
Intravenous (illegal I.V.) drugs; Cancer chemotherapy or
antibiotic medications.
Warning: Dosages
of 5-hydroxy L-tryptophan (5-HTP) greater than 100
milligrams per day should be taken only under the guidance
of a physician. 5-HTP use at doses greater than 100 mg per
day should be taken with the prescription drug carbadopa to
prevent excessive levels of serotonin production in the
peripheral blood circulation. 5-HTP can increase the effect
of tranquilizing drugs and can impair the ability to drive
an automobile.
Suggested
use:
2 capsules in the morning or at bedtime to assist with mood,
energy, and appetite control. For maximum effects, 2
capsules may be taken three times daily one half hour before
meal times, whether eating or not. It is suggested to begin
taking the GemBalance with 5HTP in the evenings at first as
it may cause drowsiness. To provide DL-phenylalanine at
levels found to relieve chronic pain, the recommended intake
is 2 capsules 3 times/ day before meals.
Ingredients:
DL-Phenylalanine, L-Tyrosine, L-Glutamine, L-5
Hydroxytryrtophan (5HTP), Ascorbic Acid (Vit.C),
L-Methionine, Magnesium Chelate (Mg), Zinc Chelate, Niacin
(B3), Pyridoxine (B6), Aloe Vera 200:1, Thiamine Monohydrate
(B1). 
Please
click below for Product
Information on
Gem
Balance with 5HTP
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