5-HTP (5-hydroxytryptophan or 5-hydroxy-l-tryptophan) is a natural supplement that converts in the brain into serotonin. Serotonin is an important brain chemical involved in mood, behavior, appetite, and sleep. Serotonin is known as 5-HT, or 5-hydroxytryptamine, and is found in many places in the body particularly the brain, gastrointestinal system, and blood cells.
5-HTP was introduced to the over the counter market in 1994. Our understanding of 5-HTP's clinical role and its safety is still very early. We know very little about the effects of chronic 5-HTP use. Therefore, until we learn more, the idea is to take 5-HTP in the minimum effective dosage and to avoid its prolonged use. Tolerance may develop in some people with continual use. I tell my patients who use 5-HTP to take frequent breaks and to take the least amount that works. During these breaks, other forms of therapy could be substituted. As of now, I am not aware of any reports in the medical literature of anyone who has encountered life threatening side effects from the use of 5-HTP.
Benefits
Some people who take 5-HTP notice improved mood, decrease in appetite, reduced anxiety, and better sleep. I have come across some individuals who get wired instead of sleepy when taking 5-HTP.
Some find that 5-HTP helps curb appetite and leads to weight loss. This nutrient could be used temporarily for appetite suppression while other lifestyle and dietary changes are being incorporated regarding a life long plan for keeping weight off. Not everyone notices the appetite suppressing effect from 5-HTP.
5-HTP may be temporarily helpful in conditions that normally require prescription antidepressants, antianxiety agents, sleeping pills, and weight loss drugs. 5-HTP may also be helpful in some individuals with migraine headaches and fibromyalgia.
5-HTP reduces the severity of a panic attack which may indicate that panic attacks may be due to low serotonin levels.
A study in rodents indicates that 5-HTP may be useful in controlling the excessive food intake sometimes generated by stress, even if given without decarboxylase inhibitors or other drugs.
Dosage
I consider any dose above 50 mg a high dose. Most 5-HTP products on the market are sold in 50 and 100 mg doses. Some people do well with 20 to 50 mg. I'm not aware of products on the market sold that are less than 50 mg. Those who do well with small doses can open a capsule and take a portion mixed with water. Medical supervision is recommended for if high doses are required to treat a particular condition. 5-HTP is best absorbed on an empty stomach.
Source and manufacture
5-HTP is made in the body from the amino acid tryptophan. Most of the 5-HTP produced in the body comes from its manufacture in the intestines from tryptophan. Tryptophan is an essential amino acid; that is, the body does not have the capacity to synthesize it. All the supply of tryptophan must be gotten through foods that contain protein.
5-HTP is extracted from the Griffonia seed. The seeds come from an African tree grown mostly in Ghana and the Ivory Coast. 5-HTP can also be made synthetically in the laboratory. The final product is the same as the one made by the body. Only a small (3 to 7) percent of the griffonia seed is made of 5-HTP, therefore, consuming griffonia seeds is not an efficient way of getting 5-HTP. 5-HTP is not made from fermentation of bacteria.
Tryptophan was taken off the market in the late 1980s due to contamination with a toxic substance called Peak X during its manufacture which led to eosinophilia-myalgia syndrome (EMS), a condition which leads to muscle pain and weakness.
Short term side effects from high doses of 5-HTP include nausea and vomiting, stomach cramps, nightmares, and decreased sex drive. Serotonin has an inhibitory effect on sexual behavior. Tiredness and sleepiness can occur after several days or weeks of use which may indicate that a break should be taken from 5-HTP use. For those who experience nightmares or other side effects such as nausea or decreased libido, you may consider taking a lower dose.
Long term side effects
Long term side effects are not fully known. When hundreds of thousands of people start taking a supplement that has not had adequate long-term testing, there may be some individuals who have a biochemical abnormality in metabolizing that nutrient that was previously not known. We don't known the consequences on the immune system, skin, and other tissues of long-term 5-HTP therapy. Regular long term use is not recommended at this time.
At this point of our knowledge with 5-HTP, it would be best not to use it while trying to become pregnant or during pregnancy. The safety of 5-HTP during lactation and breast feeding is not known.
Interactions
The use of 5-HTP in combination with SSRIs such as Prozac, Paxil, Zoloft, and others has not been formally evaluated. Anecdotal reports indicate that many people tolerate small amount of 5-HTP, 50 mg or less, with small amounts of SSRIs when used under the guidance of a medical professional. The effects of taking 5-HTP along with a pharmaceutical antidepressant are sometimes difficult to predict. Since the SSRIs, like Prozac, block serotonin reuptake, and 5-HTP converts into serotonin, it is possible that dangerously high levels of serotonin could occur, a condition called serotonin syndrome.
It is difficult to predict the interaction of 5-HTP with lithium, MAO inhibitors, anti-anxiety agents, beta blockers, birth conrtrol pills, and other pharmaceutical medicines.
Some physicians are using a combination of two or more natural antidepressants such as 5-HTP, St. John's wort, SAM-e, and others. However the interactions are not fully known and caution is advised. Any such combination should be done under medical supervision.
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5-HTP or Prozac?
The choice of whether to take natural supplements for depression or pharmaceutical medicines is a personal one along with consultation with a health care professional. There are quite a number of factors, too many to list, that have to be considered. Those with mild depression may wish to try natural antidepressants first whereas those with moderate to severe depression would likely need a strong pharmaceutical medicine. Some other nutrients to consider include SAM-e and St. John's wort.
Prozac and other SSRIs have been tested more thoroughly than natural antidepressants. 5-HTP is trickier to use, tolerance may develop, long-term safety not known as well, but works well for some people in improving mood, reducing appetite, and improving sleep. It's very difficult, if not nearly impossible, to predict how each person will react or respond to a medicine or nutrient. Sometimes the best method is trial and error.
Timing and Dosage of 5-HTP
It's difficult to say what the best time to take 5-HTP since it varies among individuals. It depends whether 5-HTP is being used for sleep, in that case it is taken in the evening; for anxiety or low mood, 5-HTP can be taken any time of day; or weight loss, in which case it is taken on an empty stomach an hour or two before a meal.
If you do take 5-HTP during the day, it's best to take no more than 25 mg since it could cause sleepiness. 5-HTP is absorbed better taken on an empty stomach.
There is has not been enough research done with 5-HTP to know the ideal dosages and timing. Also, there is significant individual variability to the response to 5-HTP. Hence, each person may need to find out for themselves the lowest dose that works well, and the ideal timing, whether early in the day, midday or evening.
A small amount of alcohol usually does not interfere with 5-HTP, but larger amounts may.
To B6 or not to B6?
The potential benefit from taking vitamin B6 along with 5-HTP is that B6 could help 5-HTP be converted into serotonin more efficiently. This is good when it's done in the brain where we want more serotonin, but we also want to minimize the conversion of 5-HTP to serotonin in the bloodstream. For the time being, I prefer to use a 5-HTP product without B6 added, but this issue is complicated and I don't have all the answers.
Carbidopa and 5-HTP
There's a pharmaceutical medicine called carbidopa which blocks the metabolism of 5-HTP in the blood stream allowing for more to be present in the body. The question as to whether it is preferable to take carbidopa along with 5-HTP is not clear at this time but could be considered under medical supervision. Taking carbidopa would most likely reduce the dosage required for 5-HTP since less 5-HTP would be broken down in the bloodstream and more would be available to enter the brain.
Peak X
Dr. Andrew Stoll, at Harvard Medical School in Boston reports that there may be a handful of cases of EMS worldwide from the use of 5-HTP. He recommends users contact the manufacturer of their product to make sure that the product does not contain Peak X.
I am not aware of a recent independent laboratory testing of 5-HTP products to know whether or not they contain Peak X. As a consumer, you do have the option to contact a company that sells 5-HTP and ask them if they have tested for Peak X.