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5-HTP Shows Promise, But Is It Safe?

Can one pill make you happy and thin, relieve headaches, and assure a good night's sleep? That's the promise of 5-HTP (5-hydroxytryptophan), a substance extracted from the seeds of a West African shrub (Griffonia simplicifolia) and a relative newcomer to the U.S. supplement scene. More and more Americans have taken it, and it's been getting a lot of attention lately. Unfortunately, not all the reports are positive.

First, the good news. A number of small studies, most conducted in Europe, indicate that for some people, 5-HTP may lift mood as effectively as certain prescription antidepressants. And a single dose at bedtime may promote two key sleep stages, deep sleep and dream time (REM), helping troubled sleepers wake up feeling refreshed. It may also reduce the disabling fatigue and muscle tenderness of fibromyalgia and mitigate the pain of common headaches and migraines.

The supplement has become popular as a weight loss aid as well. Taken before meals, it may curb binge eating, especially cravings for sweets and starches. Researchers at the University of Rome report that this effect may help people with diabetes stick to a healthy diet. Not surprisingly, 5-HTP has been promoted for overeaters of all types, including sufferers of wintertime blues, those quitting smoking, and adherents of the latest low-carb diets espoused in best-sellers such as The Zone, Sugar Busters, and Protein Power.

The secret's in the serotonin
How can 5-HTP do all this? The answer appears to lie in its ability to elevate levels of a key mood-enhancing chemical in the brain called serotonin. Unlike many other substances, 5-HTP is small enough to enter the brain, where it provides the raw material needed to manufacture serotonin. In addition to regulating mood, serotonin alters how well we tolerate pain and rein in aggression, how hungry we feel, and how soundly we sleep.

Serotonin levels are also raised by certain conventional drugs, including the antidepressants Prozac and Zoloft, as well as some of the newer migraine drugs.The now-banned diet drugs Redux and fenfluramine (part of the fen-phen combination that was linked to heart damage) likewise worked their magic by elevating levels of this key brain compound. Proponents of 5-HTP believe that the supplement can restore serotonin to optimal levels with far less toxicity than conventional drugs. A few days of upset stomach and queasiness are the main known side effects.

A red flag
In a letter to the journal Nature Medicine, Mayo Clinic researchers alerted doctors to the possibility of a far more serious potential danger: contaminants in the supplement that resemble those found in a once-popular but now banned sleep aid called L-tryptophan, a close chemical cousin to 5-HTP. Impurities in L-tryptophan were linked to more than 30 deaths and thousands of cases of illness in the late Eighties. Some worry that the same scenario could unfold with 5-HTP.

Investigators are looking into the case of a Canadian woman and her two young children who developed fatigue, muscle and joint aches, and abnormal blood tests while using the supplement, although whether 5-HTP played a role in their illness is unclear. There have also been a few isolated but unconfirmed reports of illness in Europeans taking the supplement.

"At present the effects of the 5-HTP contaminants are unknown," says Mayo toxicologist Stephen Naylor, Ph.D. He advises anyone considering the supplement to exercise caution and, at a minimum, to avoid the high doses (750 to 900 mg a day) advocated by some adherents.

Naturopathic physician Michael Murray of Bastyr University in Seattle and author of a book on 5-HTP has not heard of any special problems involving the supplement since the Mayo Clinic alert. He calls 5-HTP "good medicine" and has used it successfully to treat hundreds of patients. Dr. David Edelberg of American WholeHealth likewise reports that many patients are benefiting from the supplement at his Chicago clinic and adds that he sometimes combines it with St. John's wort to treat depression or fibromyalgia. In Europe, 5-HTP has been widely used to treat depression and insomnia for decades.

If you're considering 5-HTP, see your doctor first for proper evaluation of any medical problems. Don't stop taking prescription antidepressants such as Prozac on your own, or combine them with 5-HTP. And if you suspect any supplement is causing a bad reaction or is ineffective, stop taking it and see your doctor. Otherwise, 5-HTP may be worth a try.

Suggested dose:
Begin with a low dose (such as 50 mg once a day) and increase it gradually every week or so, up to 100 mg 3 times a day (if needed). For safety reasons, avoid higher doses. For weight control, take 20 minutes before meals. For insomnia, take a single 100 mg dose at bedtime.

Further reading:
Michael Murray, N.D., 5-HTP: The Natural Way to Overcome Depression, Obesity, and Insomnia (Bantam, 1998); Nature Medicine (9/98)

Date Posted: 10/30/2000

Date Published: 08/29/2004
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