A warning about 5-HTP v. L-Tryptophan

[Doggygirl]

To those more enlightened than I in the area of supplements, I would be interested in your take on this doctor's take on 5-HTP. This is a string of posts on a discussion forum somewhere or other, and the posts go back as far as 10 years. He may be a quack, or maybe not - I have no idea.
The cliff note version that I got from my attempt at reading this is:

Tryptophan is converted in the brain to 5-HTP which is converted to seratonin. Seratonin inside the brain = good. (generally speaking)

5-HTP taken directly is converted to some degree into Seratonin in the liver (before reaching the brain) and especially so in the presence of B-6. Higher seratonin levels in the blood, outside of the brain = bad (generally speaking) He says that elevated seratonin levels outside of the brain barrier can cause right heart valve problems.

He ends up saying that (generally) he can't find much wrong with taking pure L-Tryptophan, but has big problems with 5-HTP as a supplement.

Is this a quacking duck?

5-HTP: Doc Harris Presents Green Banana Award(Steven B. Harris, M.D.)

DG

[A Work in Progress]

A warning about 5-HTP v. L-Tryptophan

My opinion is he's not crazy. Most scientists will tell you that trying to directly manipulate your serotonin levels, either with 5-HTP or L-Tryptophan, is useless at best, and possibly harmful. And it is also generally believed that artificially manipulating one's serotonin, even if it were possible, is not necessarily a good thing.

Neurotransmitter and neurohormone and second messenger (other biochemical) functions in the brain are extremely complex... not at all like, for example, increasing insulin for a diabetic.

The brain is a very sensitive and highly homeostatic (lots of feedback functions) system and whatever we manipulate in the way of biochemical substances will result in a response by the brain to bring the level back to where it was before... which can leave us WORSE off, rather than better off.

The commonly believed idea (promoted by drug companies) that SSRI (antidepressant meds) safely enhance serotonin functioning is at least partially (and likely to be mostly) false. What does appear to be happening, and for unknown reasons, is that those meds actually somehow increase neurogenesis (growth of new nerve cells) which is exactly the same thing that happens when we begin an exercise program! Either way, our mood improves. Strange and very interesting, but true.

There are good reasons why our doctors do NOT recommend using these serotonin precursors... there really is no good evidence (in peer reviewed journals) of their effectiveness.... same is true for the amino acid supplementation... I am very much a skeptic about these matters...

[nancy]

A warning about 5-HTP v. L-Tryptophan

Wow WIP. Merry XMAS! Thanks for posting that. I think it's great to get a critical point of view on this, it's really needed.

So you are really skeptical of the prescribed meds too (SSRIs)? They are backed by trials.Why would doctors be reluctant to directly supplement tryptophan but open to giving meds that don't allow the serotonin to escape (reuptake inhibitors)?

You mention amino acid supplementation. I knew that was controversial partly because they are given indivividually whereas they function all together. How is amino acid supplementation like giving tryptophan apart from lack of evidence?

And just to challenge you a bit, aren't there meds established in use that don't necessarily have trials backing them up? Like everyone knows they work so they were never thoroughly tested? And isn't tryptophan/5HTP used a lot in other countries?

Doggygirl, as for your original question, I brought this up myself before and Roberta Jewell wrote a response. I will try to find the thread.

[Doggygirl]

A warning about 5-HTP v. L-Tryptophan

WIP thanks for your reply - and a practical sounding one it is!

And Nancy thanks for the offer to find something RJ said directly about it - that should be interesting.

This is just a very, broad and general comment not specific to 5-HTP or L-Tryp. I get very frustrated on the topic of clinical trials and research because I think very little of it is truly objective. The drug companies have a vested interest in "proving" the pharmaceutical stuff to be good, so there is funding. I also wonder what must happen to studies that turn south - that don't necessarily prove the hypotheses to be true.

By the same token, I think lots of studying does NOT get done regarding supplements because there is no benefit to the big money pham companies to conduct such studies, and why would very many others be interested when these things cannot be patented...etc. etc.? So I don't believe that in general, the "studies" environment is fair or balanced.

Which leaves us poor consumers...... Not always sure where that leaves us.

Back to the linked article - WIP since this doctor is so adamantly opposed to the 5-HTP supplements, why do you think he would be more neutral (not opposed) to L-Tryptophan? Just wondering what the motive might be if they are equally bad. (or just both bad)

This subject of supplements can be so confusing!!

OK - off to do my hair LOL!

DG

[A Work in Progress]

A warning about 5-HTP v. L-Tryptophan

Nancy, DG, yes it is VERY confusing, and for many of the reasons that each of you mention.

Probably the fundamental reason is this: nobody really understands the specific biochemical mechanisms and neural pathways that contribute to mood regulation, impulse regulation, delay of gratification, regulation of anxiety, and all the other systems that contribute to problems in the areas of mood, anxiety, and alcohol/drug dependence. The stuff we read is ALL THEORY, and various of the theories that MIGHT explain the apparent (but quite limited) effectiveness of some drugs, such as SSRI's, are still being tested. Nobody knows the answers, yet. I think that is the real answer to your last question, DG, about this particular writer; he has an idea about how all this might be working in human bodies... and he might be right... but nobody knows.

Another majorly important and fundamental problem, to which you both refer, esp. with respect to non-pharmaceutically created medications (enzyme supplements, "natural" remedies, stuff like aspirin) has to do with (a) lack of funding to run legitimate trials on these substances; and (b) lack of transparency, or even just plain dishonesty, about the results of trials that have actually BEEN run. The science is sketchy, it is hard to interpret, some of it is deliberately obscured BUT that doesn't mean that anything goes, and we should just put anything into our bodies that someone thinks might be a good idea...

Nancy, I think the biggest problem (other than the point you make, about critical balances that exist only within our own biochemical systems) about amino acid supplementation is that, like serotonin, these substances work WHEN they are manufactured in our own bodies... they do not necessarily work the same way when we take them in the form of supplements... again, unlike some substances (such as insulin), not everything necessarily works when artificially supplied.

And finally... there are huge psychological factors involved in what "works" and what doesn't "work" ... the so-called "placebo effect" is very real. Our expectations about the substances we consume create REAL biochemical changes in our bodies... but not in a reliable manner. Many people here on MWO will swear up and down that putting powdered L-Glutamine under their tongue reduces their cravings. I believe that when they do that, they experienced reduced cravings... but I am not convinced, at all, that the reason has anything to do with the chemical properties of the substance under their tongues...

[A Work in Progress]

A warning about 5-HTP v. L-Tryptophan

p.s. Nancy, as to "trials" of SSRI's, the results are VERY MUCH equivocal. These medications appear to help some people, to some degree. A few people benefit quit a bit. Many people are not helped at all. Recently we've learned that one or more of the drug companies published only their "good" results, and essentially hid their not-so-good findings...

When I think about all my friends, and all the people I have seen clinically, who have been or are on antidepressants, my personal and professional conclusions (just from my own observations, no "scientific" study involved), are that I am not at all sold on their effectiveness. I do routinely refer people to psychiatrists, and I do recommend that people try them... and hope that they are helpful. Sometimes they are.

[francophone]

A warning about 5-HTP v. L-Tryptophan

Re: A warning about 5-HTP v. L-Tryptophan

A Work in Progress;502792 wrote: Nancy, DG, yes it is VERY confusing, and for many of the reasons that each of you mention.

Probably the fundamental reason is this: nobody really understands the specific biochemical mechanisms and neural pathways that contribute to mood regulation, impulse regulation, delay of gratification, regulation of anxiety, and all the other systems that contribute to problems in the areas of mood, anxiety, and alcohol/drug dependence. The stuff we read is ALL THEORY, and various of the theories that MIGHT explain the apparent (but quite limited) effectiveness of some drugs, such as SSRI's, are still being tested. Nobody knows the answers, yet. I think that is the real answer to your last question, DG, about this particular writer; he has an idea about how all this might be working in human bodies... and he might be right... but nobody knows.

Another majorly important and fundamental problem, to which you both refer, esp. with respect to non-pharmaceutically created medications (enzyme supplements, "natural" remedies, stuff like aspirin) has to do with (a) lack of funding to run legitimate trials on these substances; and (b) lack of transparency, or even just plain dishonesty, about the results of trials that have actually BEEN run. The science is sketchy, it is hard to interpret, some of it is deliberately obscured BUT that doesn't mean that anything goes, and we should just put anything into our bodies that someone thinks might be a good idea...

Nancy, I think the biggest problem (other than the point you make, about critical balances that exist only within our own biochemical systems) about amino acid supplementation is that, like serotonin, these substances work WHEN they are manufactured in our own bodies... they do not necessarily work the same way when we take them in the form of supplements... again, unlike some substances (such as insulin), not everything necessarily works when artificially supplied.

And finally... there are huge psychological factors involved in what "works" and what doesn't "work" ... the so-called "placebo effect" is very real. Our expectations about the substances we consume create REAL biochemical changes in our bodies... but not in a reliable manner. Many people here on MWO will swear up and down that putting powdered L-Glutamine under their tongue reduces their cravings. I believe that when they do that, they experienced reduced cravings... but I am not convinced, at all, that the reason has anything to do with the chemical properties of the substance under their tongues...

Hello, WIP

I was just wondering if you had used L-Glutamine in your recovery plan, or any supplement for that matter. I remember reading, several months ago, that Determinator was taking over 10,000 mg. of L-Glutamine on a daily basis.

Additionally, to what do you attribute your success in alcohol abstinence? With the kind of success that you have been having, I could use some of your advice - I have had very little success myself.

thankfully,

francophone

[A Work in Progress]

A warning about 5-HTP v. L-Tryptophan

Francophone, when I first started out here, I took most of the recommended supplements, including L-Glutamine. I was very frightened, and wanted to "throw the book at" my problem. I ordered the Topamax, but ended up not taking any, because by the time it arrived I was feeling stronger and I was not willing to risk the cognitive deficits. I never noticed any rapid shifts in mood, impulses, cravings, or anything else, that I could attribute to any of the supplements... but I thought that, since others reported benefits, why not give them a chance?

About 2 or 3 months into staying AF, I began to wonder if it was worth the trouble and expense to keep buying all those supplements. I stopped taking them, and could not see any changes in any aspect of my functioning. I also began ramping up my exercise, and I think it was around in that same general time frame. But it's only been in the last month or two that I have been really regular with 20+ minutes of cardio, at least 5 days a week.

I attribute my success to:

• Being determined to keep the devastation of alcohol out of my life; I am completely sick of alcohol and the impact of alcohol on my life, and on the lives of so many of my family members
• Being thoroughly convinced that it is impossible for me to control my consumption; once I have a drink or two, and the alcohol is in my brain, my frontal lobes are sufficiently disabled so that how much I drink is no longer a matter of rational decision-making
• Having spent 3 sober years in AA, years ago, which gave me a solid awareness that I am capable of living a good life without alcohol
• The support and mentoring here at MWOMeditation practiceMonitoring my thoughts, feelings, and impulses; a capacity for distress tolerance; and the ability and commitment to notice and shift out of dangerous thought patterns (meditation practice helps with all of these)Exercise

Francophone, I hope you find and commit to a plan that works for you.

[beatle]

A warning about 5-HTP v. L-Tryptophan

I've been away for a few days and can see it it is going to take a VERY long time to catch up! (and that's just keeping myself to this forum and the monthly ABs!). But this all looks very interesting. I'll jump in when I'm ready (that's a threat, not a promise!).

[A Work in Progress]

A warning about 5-HTP v. L-Tryptophan

Oh no! Here comes Beatle!!! I'd better get my ducks in a row... LOL...

How're you doing, Beatle? good to see you back.

[Doggygirl]

A warning about 5-HTP v. L-Tryptophan

BEATLE!!! So glad you are back!

Something else you might be able to help with. Nancy mentions upstream a thread or post by RJ that sounds interesting and relevant. Not sure if Nancy is having any luck finding it. I'm not the best one for getting good results with searches...so probably not surprising that I couldn't find it.

I just find this stuff interesting since at the end of the day, it seems that very little is supported by research I truly believe, and for the most part I feel I'm making decisions based on the trendsetters going before met, gut instinct, etc.

WIP this sort of reminds me of the raw dog feeding argument - not sure if you've seen any or enough of those to know how that topic usually evolves. Eventually somebody makes the astute point that they have looked high and low for scientific (studies) evidence that a raw diet is better than regular bag food i.e. Science Diet (in insert pretty much any dog food brand here) and UNTIL they see such study, will not consider it.

Well, the ones with the money (dog food companies) sure aren't going to fund such a study, and the fine growers of Purdue Chickens for People probably aren't up to fund a dog food study either. So.....all you have at the end of the day is what you see with your own two eye balls.

(I do realize that the dog food question is on some levels more simplistic than an amino acid question........)

DG

[A Work in Progress]

A warning about 5-HTP v. L-Tryptophan

DG, your canine dietary observation is right on point, in my opinion. And I don't think that the dietary question is more simplistic than the questions about amino acid supplements; in fact it is more complex, because there are so many components in the two different diets (changing 15 or 100 variables, all at once, by changing from Science Diet to raw chicken, makes it pretty much impossible to determine which variable(s) made any difference(s) that might be observed).

Of course the gold standard is the randomized double-blind study, such as is used with drugs. But even with that method, we sometimes get fraud, sloppiness, uncertainty as to results. It takes years, and many different studies done by different scientists and labs, to develop and establish a firm, mainstream opinion/conclusion about the effectiveness of a drug.

We (informed by news media, usually) become WAY too excited about the results of just a few studies. Moreover, it is very well known in science that all scientists, even those who are highly ethical, are likely to find exactly the result that they hope to find; there are ways for biases to creep in, even in the most rigorously designed study.

I've run some studies of my own, and I teach graduate students to be intelligent consumers of scientific research, and I'm not starry-eyed or stubborn about insisting on "hard science" in all areas of my life! However, it pains me to see people making claims about the effectiveness of various substances, based purely on subjective, anecdotal data. The human mind is EXTREMELY prone to finding whatever it is looking for, and regularly provides us with distorted versions of reality that we will swear up and down is the pure, unadulterated truth.

So, as to alcohol "treatment": When people recognize they have an alcohol problem, and embark on an effort to change their behavior, it is a situation (again) of many different variables all changing at once. The fluctuating variables include but are not limited to: The mind-set, attitudes, and beliefs of the individual; her always-changing environment, including the attitudes and behaviors of other people in her life, and various other stressors and supports; any supplements or medications she may be taking, and the beliefs/hopes/expectations she may have about them; her dietary practices (blood sugar levels, for example); whether she gets enough fluids; whether she exercises, meditates, uses hypnotherapy; whether she is part of a support group, and whether she feels attuned to and accepted by the people at the support group.... I could go on.

The complexity of all the changing variables is what makes scientific studies helpful; a lot of the "noise" is removed by controlling the variables as much as possible...

What I think is the bottom line, for those with alcohol problems, is this: I think people will do best by looking for a program in which a significant number of other people have been successful, and then follow the program as strictly as possible, carefully observing how things are going. If some aspects of the program are supported by solid science, so much the better. And if your friends tell you that certain things are helpful, it might be a good idea to try those aspects of the program, or other programs, too...

I hope someday there will be a much better, scientifically supported, treatment protocol for people with alcohol, drug, and other types of behavioral problems... I think we are getting there. I also think that reliance on drugs and dietary supplements is, and probably will remain, only a small part of the overall mix that is ideal for most people to genuinely change their addictive or compulsive behaviors.