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Thank you for the information and helpful response on St. John’s Wort.
A related compound, 5-HTP, does seem to be a product you used in the past and may or may not still use, both as an adjunct to ssri or even on its own. I believe from reading an old post you used to use regular tryptophan at doses of 1000mg when it was available as a prescription.
But I wanted to know if you use 5HTP for “mood boosting” effects? And if you do, what doses do you typically end up at (I believe you mentioned in the past about starting at 50mg 3 times per day)? Along the dosing guidelines, do you suggest taking in sugar along with the 5-HTP?
Does the multiple times dosing per day matter compared to just say, taking one mg-equivalent dose at night?
Finally, would there be any drawback to someone using a low dose (100mg or less daily) of 5-htp even if they didn’t “need” it?
5-HTP is a supplement I sometimes prescribe to patients.
I consider 5-HTP a medicinal supplement since it is generally not present in the diet, unlike L-Tryptophan.
5-HTP is the direct product of L-Tryptophan. It is the precursor for Serotonin and Melatonin. It can enter the brain easily without requiring a transporter (unlike L-Tryptophan which requires a transporter). When ingested, about 70% is absorbed. The rest is converted into serotonin in the gut, which then increases body serotonin level. Unlike L-Tryptophan, 5-HTP can’t be used to form niacin or to be used in protein production.
It has usefulness for treating:
- depression
- anxiety
- insomnia
- fibromyalgia
- headache (migraine, tension-type)
- obesity (to reduce food cravings)
- premenstrual dysphoric disorder
- tetrahydrobiopterine deficiency (very rare illness)
- etc.
Like any medication, the effectiveness varies from person to person.
It may be used in conjunction with Serotonin Reuptake Inhibitors to improve mood, particularly in those patients more likely to be deficient in dietary L-Tryptophan. Interactions with medications, however, need to be assessed and the risks considered. With a serotonin reuptake inhibitor, there may be a small risk of developing serotonin syndrome.
The dose varies depending on use. The usual range is 33 to 300 mg a day in divided doses with meals or single dose, depending on the use.
Adverse effects (such as may occur when one already has adequate amounts) include:
anorexia- diarrhea
- flatulence
- heartburn
- nausea/vomiting
- stomach pain
- increased risk for ulcers
- increased risk for osteoporosis
- increased risk for diabetes
- edema
- eosinophilia-myalgia syndrome
- sexual dysfunction, daytime sedation
- seizures (particularly in patients with Down’s Syndrome)
- etc.
@akiravp82 6760 wrote:
Dr.mariano can one using 5htp eventually build tolerance to it and its effects stop working ?
5-HTP use can develop tolerance. Practically any treatment can lead to the development of tolerance. The reduction in effectiveness with continued use may result from the loss of receptors for the signal enhanced or downstream changes in signaling which may then change the response to the originally enhanced signal.
A sign of tolerance is a withdrawal syndrome if the treatment was suddenly stopped. With 5-HTP, this may be expressed as serotonin-withdrawal syndrome.
Generally, if a treatment’s effects stop, the question I have is What changed in that person to prevent the treatment from working? Other unaddressed problems in a person’s health may occur or worsen over time, negating the benefits of the original treatment, such as 5-HTP.
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