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tryptophan » ihatedrugs

Posted by janejane on July 15, 2010, at 10:59:28

In reply to Re: PMDD and estrogen therapy? » janejane, posted by ihatedrugs on July 14, 2010, at 23:49:49

I think tryptophan (or even 5-HTP) is definitely worth trying, especially if you're an SSRI-responder and your depressive symptoms are more of the anxious type rather than the lethargic type (you'd want to look at tyrosine/phenylalanine for the latter).

Do you ever get side effects such as anxiety or headache on SSRIs? If so, I'd watch for those. (I think weight gain is a less of an issue, and in fact, you might experience less hunger and fewer carb cravings.) My problem with 5-HTP and tryptophan was that I developed anxiety and headache after a while, as well as loss of efficacy (probably because I lowered the dose to reduce the SEs). My theory is that after being on prozac for over 10 years, some of my serotonin receptors were altered enough that I now get SEs from really small doses of serotonergic substances and it's hard for me to find an effective, SE-free dosing schedule. I also think that it's possible that increasing serotonin availability in the brain globally might not always work well since there's a chance that you might unwittingly hit some receptors that are associated with SEs such as anxiety. (Again, it doesn't seem to happen to everyone, and I think mine are sort of messed up so I still encourage you to give it a go, especially if you haven't used the same SSRI for as many years as I have.)

From what I've read, it does seem that tryptophan is probably safer than 5-HTP, by the way, since it doesn't bypass the rate-limiting step that keeps serotonin out of the blood (the reason 5-HTP is given with carbidopa in Europe), and since the contaminated batch was just that -- contaminated -- and not typical of most production. It is also less likely to cause GI upset than 5-HTP. That said, I don't think the heart issues that were supposed to be a problem with 5-HTP ever really materialized and Americans have been taking it without carbidopa for a while now. Because some people seem to do better on one or the other, if tryptophan doesn't work, I wouldn't rule out 5-HTP, though I'd be more cautious with it.

You probably know this already, but remember to start modestly with tryptophan (like maybe 250 mg -- you can get tablets and a pill cutter, which is easier than opening capsules) and take it on an empty stomach. You can have a carb snack to try to increase absorption (like a small amount of fruit juice), but you want to avoid protein for at least an hour afterwards. The idea is that the insulin spike will clear competing aminos so the tryptophan can cross the blood brain barrier (it has the least affinity for the large neutral amino acid transporter). I read one article that said it doesn't help to do this, but a lot of experts recommend it, and I don't think it would hurt (especially if you've consumed other protein recently). I think competition with other aminos is less of an issue if you take it first thing in the morning, though some people like to take it at night to help with sleep. (Some take it up to three times a day, if I recall correctly.) Remember to dose any competing aminos at other times of the day. For example, if you also wanted to take tyrosine, you might do that in the morning, and tryptophan at night. (You don't have to worry about this stuff with 5-HTP which makes it a bit easier to take.)

Oh yeah, you might want to take P-5-P (active form of B-6), too. (Hopefully this will already be in your multi or b complex, but not all contain P-5-P so you'll want to check.) And make sure you're getting some B3 everyday so the tryptophan does not need to be converted into it instead of serotonin. (Something to think about... people who don't get enough B vitamins or other supporting nutrients might not have the other building blocks they need to make tryptophan work. Meaning that, for instance, Bs might be the deficiency rather than tryptophan, if the problem is low serotonin.)

Of course (and here I will bring this back on topic), you can also try to increase serotonin by using bioidentical estrogen or other supplements like SAM-e/TMG or herbs. Personally, I think that if low estrogen is the problem, it seems logical to try to take care of that first, since it's more upstream. Then again, the appeal of something like rhodiola is that it normalizes estrogen (according to some sources), balances the HPA axis, and increases depression-related neurotransmitters in different parts of the brain. (Too bad it wasn't enough for me; works for some, though.) I think the holy grail is probably different for each of us, but I'm glad that we have a place to come and compare notes.

 

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poster:janejane thread:953868
URL: http://www.dr-bob.org/babble/alter/20100703/msgs/954577.html