| 5-Hydroxytryptophan
(5-HTP) |
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| Overview |
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5-hydroxytryptophan (5-HTP) is an amino acid. The body makes
5-HTP from tryptophan (an essential amino acid) and converts it
to an important brain chemical known as serotonin. Tryptophan
and 5-HTP dietary supplements help raise serotonin levels in the
brain, which may have a positive effect on sleep, mood, anxiety,
aggression, appetite, temperature, sexual behavior, and pain
sensation.
It is important to note, however, that an outbreak of
eosinophilic myalgia syndrome (EMS; a potentially fatal disorder
that affects the skin, blood, muscles, and organs) caused by a
contaminated batch of tryptophan led to the removal of all
tryptophan supplements from the United States market in 1989.
Although the manufacturing of 5-HTP is different from that of
tryptophan, there is still concern that some 5-HTP supplements
may contain similar contaminants. It is important to obtain
dietary supplements from manufacturers that adhere to high
quality standards. At least two organizations, NSF International
and the United States Pharmacopeia (USP), offer programs that
make sure manufacturers follow high quality practices. As a
result, these manufacturers often indicate this information on
their product labels.
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| Uses |
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5-HTP may be helpful in treating a wide variety of conditions
related to low serotonin levels, including the following:
Depression
Low levels of serotonin in the brain can contribute to the
development of depression. Many drugs prescribed for depression
increase serotonin levels. Some studies indicate that 5-HTP may
be as effective as certain antidepressant drugs in treating
individuals with mild to moderate depression. Such individuals
have shown improvements in mood, anxiety, insomnia, and physical
symptoms.
Fibromyalgia
Although many factors can influence the stiffness, pain, and
fatigue associated with fibromyalgia, evidence from several
studies indicates that low serotonin levels may play a role in
the development of this condition. 5-HTP has been shown to
improve sleep quality and reduce pain, stiffness, anxiety, and
depression in individuals with fibromyalgia.
Insomnia
Medical research indicates that supplementation with
tryptophan before bedtime can induce sleepiness and delay wake
times. Studies also suggest that 5-HTP may be useful in treating
insomnia associated with depression.
Headaches
Some studies suggest that 5-HTP may be effective in children
and adults with various types of headaches including migraines.
Obesity
There is some evidence that low tryptophan levels may
contribute to excess fat and carbohydrate intake (which can
result in weight gain). A study of overweight individuals with
diabetes suggests that supplementation with 5-HTP may decrease
fat and carbohydrate intake by promoting a feeling of satiety
(fullness). Additional similar studies of obese men and women
without diabetes found that supplementation with 5-HTP resulted
in decreased food intake and weight loss.
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| Dietary Sources |
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5-HTP is not commonly available in food but the amino acid
tryptophan, from which the body makes 5-HTP, can be found in
turkey, chicken, milk, potatoes, pumpkin, sunflower seeds,
turnip and collard greens, and seaweed.
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| Available Forms |
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5-HTP can be obtained in the diet (from the conversion of
tryptophan) or in supplement form. 5-HTP supplements are made
from extracts of the seeds of the African tree Griffonia
simplicifolia. 5-HTP can also be found in a variety of
multivitamin and herbal preparations.
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| How to Take It |
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Pediatric
There are no known scientific reports on the pediatric use of
5-HTP. Therefore, it is not currently recommended for children.
Adult
50 mg of 5-HTP taken one, two, or three times per day is
generally recommended for most of the conditions discussed in
the Uses section.
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| Precautions |
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Because of the potential for side effects and interactions
with medications, dietary supplements should be taken only under
the supervision of a knowledgeable healthcare provider.
As mentioned previously, tryptophan use has been associated
with the development of serious conditions such as liver and
brain toxicity, and with eosinophilic myalgia syndrome (EMS), a
potentially fatal disorder that affects the skin, blood,
muscles, and organs. Such reports prompted the FDA to ban the
sale of all tryptophan supplements in 1989. As with tryptophan,
EMS has been reported in 10 people taking 5-HTP.
5-HTP may cause mild gastrointestinal disturbances including
nausea, heartburn, flatulence, feelings of fullness, and
rumbling sensations in some people. Pregnant or nursing women
and individuals with high blood pressure or diabetes should
consult a healthcare practitioner before taking 5-HTP.
In addition, as described in the Interactions
section below, 5-HTP should not be taken at the same time as
antidepressants.
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| Possible Interactions |
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If you are currently being treated with any of the following
medications, you should not use 5-HTP without first talking to
your healthcare provider.
Antidepressant Medications
Individuals taking the antidepressant medications known as
selective serotonin reuptake inhibitors (SSRIs) (such as
fluoxetine, paroxetine, sertraline, and citalopram) and
monoamine oxidase inhibitors (MAOIs) (such as phenelzine,
isocarboxazid, selegiline, and tranylcypromine) should not use
5-HTP as these medications enhance the action of these drugs and
may increase the risk for developing a dangerous condition known
as "serotonin syndrome." Serotonin syndrome is
characterized by mental status changes, rigidity, hot flashes,
rapidly fluctuating blood pressure and heart rate, and possibly
coma. Similarly, other drugs for depression that interfere with
the uptake of the neurotransmitter serotonin, namely trazodone
and venlafexine, may also lead to serotonin syndrome when used
along with 5-HTP.
Carbidopa
Taking 5-HTP with carbidopa, a medication used to treat
Parkinson's disease, has been associated with side effects
including scleroderma-like illnesses (a condition in which the
skin becomes hard, thick, and inflamed).
Sumatriptan
Similar to antidepressants, sumatriptan, a medication used
for migraine headaches that works by stimulating serotonin
receptors in the brain, should also not be used in combination
with 5-HTP because of the risk for serotonin syndrome.
Tramadol
Tramadol, used for pain control, may also increase serotonin
levels too much if taken in combination with 5-HTP.
Serotoninsyndrome has been reported in some people taking the
two together.
Zolpidem
Use of zolpidem, a medication for insomnia, can cause
hallucinations when used with SSRI antidepressants. Because
5-HTP may work similarly to SSRIs, the combination of 5-HTP with
zolpidem could, theoretically, lead to hallucinations as well.
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| Supporting Research |
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Angst J, Woggon B, Schoepf J. The treatment of depression
with L-5-hydroxytryptophan versus imipramine. Results of two
open and one double-blind study. Arch Psychiatr Nervenkr.
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Attele AS, Xie JT, Yuan CS. Treatment of insomnia: an
alternative approach.Altern Med Rev. 2000;5(3):249-259.
Bhatara VS, Magnus RD, Paul KL, et al. Serotonin syndrome
induced by venlafaxine and fluoxetine: a case study in
polypharmacy and potential pharmacodynamic and pharmacokinetic
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Birdsall TC. 5-Hydroxytryptophan: a clinically-effective
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Bodner RA, Lynch T, Lewis L, Kahn D. Serotonin syndrome. Neurol.
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Byerley WF, et al. 5-Hydroxytryptophan: a review of its
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Cangiano C, et al. Effects of oral 5-hydroxy-tryptophan on
energy intake and macronutrient selection in non-insulin
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Cangiano C, Ceci F, Cascino A, et al. Eating behavior and
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Caruso I, Sarzi Puttini P, Cazzola M, et al. Double-blind
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Diamond S, Pepper BJ, Diamond MI, et al. Serotonin syndrome
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Elko CJ, Burgess JL, Robertson WO. Zolpidem-associated
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Gardner DM, Lynd LD. Sumatriptan contraindications and the
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Magnussen I, Nielson-Kudsk F. Bioavailability and related
pharmacokinetics in man of orally administered
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| Review Date: April
2002 |
Reviewed By: Participants
in the review process include: Ruth DeBusk, RD, PhD, Editor,
Nutrition in Complementary Care, Tallahassee, FL; Jacqueline A.
Hart, MD, Department of Internal Medicine, Newton-Wellesley
Hospital, Harvard University and Senior Medical Editor
Integrative Medicine, Boston, MA; Gary Kracoff, RPh (Pediatric
Dosing section February 2001), Johnson Drugs, Natick, Ma; Steven
Ottariono, RPh (Pediatric Dosing section February 2001),
Veteran's Administrative Hospital, Londonderry, NH. All
interaction sections have also been reviewed by a team of
experts including Joseph Lamb, MD (July 2000), The Integrative
Medicine Works, Alexandria, VA;Enrico Liva, ND, RPh (August
2000), Vital Nutrients, Middletown, CT; Brian T Sanderoff, PD,
BS in Pharmacy (March 2000), Clinical Assistant Professor,
University of Maryland School of Pharmacy; President, Your
Prescription for Health, Owings Mills, MD; Ira Zunin, MD, MPH,
MBA (July 2000), President and Chairman, Hawaii State Consortium
for Integrative Medicine, Honolulu, HI.
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Copyright © 2004 A.D.A.M., Inc
The publisher does not accept any
responsibility for the accuracy of the information or the
consequences arising from the application, use, or misuse of any
of the information contained herein, including any injury and/or
damage to any person or property as a matter of product
liability, negligence, or otherwise. No warranty, expressed or
implied, is made in regard to the contents of this material. No
claims or endorsements are made for any drugs or compounds
currently marketed or in investigative use. This material is not
intended as a guide to self-medication. The reader is advised to
discuss the information provided here with a doctor, pharmacist,
nurse, or other authorized healthcare practitioner and to check
product information (including package inserts) regarding
dosage, precautions, warnings, interactions, and
contraindications before administering any drug, herb, or
supplement discussed herein.
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