5-htp
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Henry: Hello, I'm Henry Emmons and welcome to Joy Lab.
Aimee: And I'm Aimee Prasek. Here at Joy Lab, we infuse science with soul to help you build your resilience and uncover your joy. And today we are talking about 5 hydroxytryptophan or 5-HTP. ~Uh,~ 5-HTP is actually pretty commonly discussed, I'd say, as a supplement for mood. So Henry, do you want to talk more about the way you use it in practice?
Henry: Sure.~ but~ First I think it might be [00:01:00] helpful to give a little context. So, ~um,~ 5-HTP is talked about a lot because it supports serotonin. And you mentioned the name is 5-hydroxytryptophan. So tryptophan is an amino acid, which means that it is a protein. And it's called one of the essential amino acids. And what that means is that it's essential because the body can't produce it, so you have to get it through your food. And that's important. The only way to get tryptophan is to take it into the body through your mouth, so through the diet. 5-HTP is a dietary supplement that you can think of really as a concentrated form of tryptophan. When tryptophan gets turned into serotonin, in the process, there's an intermediate step where it becomes 5-HTP.
And so it's even a little easier for our bodies to use 5-HTP [00:02:00] to make serotonin because there's not as many steps to go through to get there. I think there's another important thing to know about tryptophan, and that is, it is the only means to make serotonin. It's what's called a precursor to serotonin.
In this, in this case, it is the only one. None of the other amino acids will work to build serotonin. You will get tryptophan anytime that you eat protein foods, especially foods that, ~um,~ that ~are~ include dairy or ~uh,~ chicken and Turkey and poultry. There are also a lot of good vegetarian sources though, things like nuts and seeds, legumes, even leafy greens and certain grains have quite a bit of tryptophan in them.
Pea protein, which some people use as a kind of a protein supplement, is also a really good source for 5-HTP and [00:03:00] it's even found in dark chocolate. So, If tryptophan is found in so many foods, why would we ever need to supplement with it or with 5-HTP? Surprisingly, a number of people don't actually get enough of it in their diets, at least not in a way that they can easily use.
I think that's important. So a lot of folks, for example, might have almost no protein at some meals, like, ~you know,~ say just have toast for breakfast and a salad for lunch and then they save up all their protein for ~For~ supper when they have maybe have a meat and potato kind of dinner. ~Old~ Old school.~ So ~Then in that case tryptophan has to compete with all of the other amino acids that you've just eaten. So if you have a high protein meal, you can think of tryptophan almost like the runt of the litter.
It kind of gets lost in the shuffle. It doesn't compete well to get absorbed [00:04:00] and digested. And then for a lot of other folks, they just don't digest food properly and that can be all kinds of reasons. You know, maybe they, they don't have enough stomach acid or they eat too many refined carbs, which spikes their blood sugar and messes with their insulin levels.
Or maybe they just don't have enough vitamin B6 in order to process tryptophan. And then, ~you know,~ there are all kinds of genetic quirks that can really hijack this process all along the way.
Aimee: Yeah, so you're highlighting this process of serotonin production and I believe serotonin is important ~and,~ and I think it might be helpful to put it into context as we're talking about 5-HTP. So, stepping back. We have the serotonin hypothesis for depression, or even more broadly, the monoamine depletion hypothesis, which essentially suggests that neurotransmitter deficiencies are the cause of [00:05:00] depression. And even though these are the driving frameworks for antidepressants, these hypotheses have not held up in research, right? So there's just no evidence really that one certain neurotransmitter is at fault. There's not a clear chemical imbalance or an ideal chemical balance behind depression that's been identified.
And I think that's really important. It's not like diabetes or something every case insulin deficiency is the cause. Depression is just not that simple. So I think what's interesting is that there's a lot of, uh, backward reasoning to establish causation. But it's a post hoc fallacy. Or what is it, post hoc ergo proctor hoc, I think. Which means after this, therefore...
Henry: You lost me there!
Aimee: After this, therefore because of this, I think. Which makes it a sneaky little fallacy. So for example, um, I'm no Latin scholar either, I probably said that wrong. ~Um,~ But let's [00:06:00] take SSRIs as an example, targeting serotonin, and it can help folks.
So when you reason backward, you'd assume the deficiency of serotonin was then the cause. But it's actually not a logical, ~um,~ argument, right? If your friend takes ibuprofen because they injured themselves at the trampoline park, right? slightly. Yes, I am the friend in this scenario. The problem wasn't that my body was deficient in ibuprofen, but it also doesn't mean that ibuprofen can't help, right? It also doesn't mean that I'm too old to go to the trampoline park, I'd say.
Henry: There you go, yeah.
Aimee: So, um, that's a big topic we can get into later. Key mechanisms of antidepressants, not my trampoline park habits. Because I also think there's issues to talk about with measurement, right? Our methods of measuring are not sensitive enough, possibly, or sufficient to understand [00:07:00] fully how neurotransmitter balance impacts mental health.
And then there are issues with diagnosing. Depression is overdiagnosed, which can then make the research with these participants methodologically problematic, right? We just aren't measuring quite who or what we think we are measuring. So all that to say is it is complicated. And Henry, with all that said, how do you think 5-HTP fits into this understanding of sort of this multifactorial nature of depression?
Henry: Well, I think you put your finger on it when you said that depression is just not that simple. It's really just such a much more complex thing than we typically think of it being. I was actually in my psychiatric training when Prozac came out, and it was the very first SSRI. And I'm telling you, it was a rock star at the time.
[00:08:00] It was remarkable how much hype there was about it for a long time, went on for years. And I think that was partly because it helped so many different conditions. And because, as you pointed out, because it changes how our brain cells use serotonin, it seemed as if raising serotonin levels was the key. So it,~ ~yeah, kind of a backwards way of getting to this theory that, ~um,~ folks with depression and anxiety were probably serotonin deficient and all they needed was a serotonin boost.
And this is done super powerfully by the SSRIs. Now clearly that idea was oversimplified. There are so many variables, including all the other neurotransmitters, the stress hormones, our diets, our sleep. So it is true, I [00:09:00] think, that the SSRIs really can help a lot of things, but they also did not live up to that early hype. Which is true of so many different medications if you look at the history of pharmacology. But this idea of a serotonin deficiency has really been persistent. ~ ~Now, I, I don't pretend to understand yet ~how the,~ how this all works and how the brain works, but ~I,~ the way I've come to think of it, which helps me, is that I think of the brain as a group of circuits, moving energy within these circuits.
And they work more or less in harmony with each other, unless the system gets out of balance for some reason. And there's lots of reasons for that. So I think now of the serotonin system, which is just my term for it, but rather than just thinking of pure serotonin [00:10:00] levels. And the serotonin system is impacted by a whole bunch of other systems.
And don't forget that most of the body's serotonin receptors, by far, are not in the brain. They're in the gut. Okay. And actually might be a good topic for us to take on some other time. But I still think that the brain's serotonin system is really important and it has a huge influence on how we feel emotionally and how we deal with stress too. A lot of us could use a little more support for our serotonin systems from time to time.
Aimee: Yeah. I agree. It's part of the equation. So, with that said, how do you determine that someone might need more support?
Henry: What I do is I look for patterns and they include some but not all the different kinds of depression or [00:11:00] anxiety. So, in other words, I don't think everybody with depression needs to address serotonin. In fact, sometimes it can make it quite a bit worse. But in general, ~uh,~ the serotonin system is really important for supporting our sense of wellbeing, our sense of security, our self-esteem even. Our ability to handle stress, and these are things we don't often associate with a brain chemical. And of course it's not as simple as that either, brain chemicals are involved. So, when it's not working well, folks often feel anxious, insecure, impulsive, overwhelmed really easily. Oftentimes they can't sleep very well and they tend to ruminate more at night, the middle of the night.
They might crave sweets or other comfort foods and sometimes will binge on food or even on alcohol as a way of trying [00:12:00] to ~kind of~ artificially support their mood. And then ~there~ there's also a connection with hormones and menstrual cycles with the serotonin system. People who have really strong premenstrual symptoms, I often think there's a connection there.
Or really strong symptoms around menopause. And then even migraines and chronic pain are in some way or other associated with serotonin. Now, I will also look at family history because when there's these genetic quirks that I referred to, ~um,~ so many of the things that go wrong with serotonin are genetic.
So when there's a really strong family history, I think it's even more important for way to look for ways to shore up the serotonin system. And actually, ~you know,~ our resilience quiz was designed partly ~with~ in order to look for these patterns. So I think that that folks can get a really good idea if they might benefit from taking 5-HTP [00:13:00] or some other ~ ~precursor amino acid by taking our resilience quiz.
It's a nice way to tease these patterns out while also looking to build on the strengths
that ~we~ we think go with those resilience types.
Aimee: I'll put a link to that in the show notes.
I'll note as well, this is because of my interests. Talked about this with lithium. I think 5-HTP had a PR problem a while ago. ~Um,~ I'll link to the lithium conversation in the show notes. But the FDA banned tryptophan due to contaminated supplements from a manufacturer.
I think this was in the 90s. Don't quote me on that.
Henry: I think you're right.
Okay.
Yes.
Aimee: Right, so, um, and folks died. This was bad. This was a contamination issue that also influenced, was also found in 5-HTP, much smaller amounts from the same manufacturer. So, ~um, ~it caused a lot of negative, justifiably negative PR for, [00:14:00] uh, tryptophan and 5-HTP.
And I think it also speaks to how lenient the U. S. regulations are on supplements and nutraceuticals. I mean, they're mainly just self regulated, right? Which is a whole different podcast. I don't want to go in that rabbit hole right now. But the point being, quality does matter. You want to get a good quality product that is third party tested.
You might see like an NSF or USP mark on those products and other countries, if you're listening and other countries have very different regulatory bodies, ~um,~ looking at supplements and nutraceuticals and stuff. So this is U. S. specific, um, and certainly it is extremely important to speak with your doctor about starting a new supplement.
We always say that. And 5-HTP I think is a really great example of why that's so important. Because it's usually contraindicated if you're on any antidepressant or if you're taking medication for things like Parkinson's or migraines or [00:15:00] fibromyalgia. So Henry, what do you want to add here about safety or other considerations with 5-HTP?
Henry: Well I want to agree with you completely about looking for quality in the products and checking with your doctor if you're, if you're on medications, especially. So I often, in my practice, I often do use 5-HTP together with an antidepressant in order to get the antidepressant working better again if it's pooped out or just to keep the dose low to avoid side effects.
So I often combine it, ~um,~ with medications because I, I have a lot of experience doing that. I feel comfortable with it, but it is possible to get too much serotonin and this is important. Some folks listening have probably experienced this when they go on a medication like Zoloft, Prozac, [00:16:00] Lexapro, any of the ~you know, ~the SSRIs, first starting it feeling really irritable.
Really moody. Or what I think of as being agitated. And sometimes, this can cause something called akathisia, which just simply means that your body just can't sit still. It feels like you're, it's moving internally and you might feel really restless. Like you just, you just can't sit still. To an extreme, if this goes on and it gets really bad, it can cause something called serotonin syndrome.
Which really can be serious. This was imprinted on my brain because when I was in my training, there was a case, in New York State where I trained, of a young woman dying from~ ~from being on too many serotonin medications, she developed serotonin syndrome, and it was a really big deal, really, really, uh, ~kind of~ scary.
Now, [00:17:00] I have actually never seen this condition. I've never seen anybody with serotonin syndrome. Um, and I think that it's really, a ~Uh,~ a risk primarily for people who are taking multiple medications that impact serotonin, ~uh,~ but it is still something to watch for and when, and by watching for it, I mean looking for some of those milder symptoms that I mentioned earlier, like the restlessness or agitation, because they're kind of early warning signs that this might be heading towards too much serotonin.
Now also just because I do this with almost everything, I start with very low doses. I do this with medications, other supplements, primarily to minimize those risks or the risks of just simple side effects. And I keep the dose low, probably lower than what I've seen a lot of other folks do. I rarely see the value in going higher than about 150 or [00:18:00] 200 milligrams at the most of 5-HTP. And I usually recommend taking a product that has more than just 5-HTP in it because ~it,~ you do need other things like some of the B vitamins and magnesium, they're important cofactors to help with the production of serotonin and so to me it makes more sense rather than just taking a pure 5-HTP supplement to take one that combines some of these other essentials into it.
Aimee: Yeah, magnesium. There it is. Henry's favorite supplement.
But I will, I'll link to some, ~um,~ products that we like, ~um, actually~ in the show notes. So I hope this offered some clarity on 5-HTP. It's partially, I think, because of some of that negative PR I talked about. 5-HTP has kind of this weird aura around it. So I hope this has helped ~kind of~ clarify a little bit more about it.
And we touched on some bigger topics that we can hopefully dig into ~later~ as [00:19:00] well, ~um,~ in later episodes. I'll also link to a blog that we have on 5-HTP in the show notes and that has some more information. So to close, I want to quote author Sam Miller. I think he offers a good reminder, ~kind of~ amidst all we touched on.
~Here's what he wrote. I'm going to say that last part again. ~Here's what he wrote. "We are not our trauma. We are not our brain chemistry. That's part of who we are. But we are so much more than that."
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