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Metabolism and absorption of 5-HTP

JoAnn Guest

Jan 29, 2005 23:03 PST

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Metabolism and absorption of 5-HTP

 

5-HTP (5-hydroxytryptophan) is formed by the addition of a hydroxyl

group (-OH) to the 5 carbon of the indole ring of tryptophan. Conversion

of tryptophan to 5-hydroxytryptophan is catalyzed by the enzyme

tryptophan hydroxylase.

 

5-HTP functions as the precursor for serotonin, and is converted to

serotonin in a pyridoxal phosphate (vitamin B6) dependent reaction

catalyzed by the enzyme L-amino acid decarboxylase.2

 

Synthesis of serotonin in the brain requires an adequate supply of

either tryptophan or 5-HTP as precursors. The supply of tryptophan

available for conversion to 5-HTP depends on a number of factors,

including nutritional status and competition between tryptophan and

other amino acids for transport across the blood brain barrier.

 

Disturbances in the serotonin metabolic pathway may disrupt central

nervous system functions which utilize serotonin as a neurotransmitter.

 

Administration of 5-HTP bypasses the conversion of tryptophan to 5-HTP.

5-HTP readily crosses the blood brain barrier and becomes available for

serotonin synthesis.

 

Serotonergic neurons (nerve cells stimulated by serotonin) regulate

sleep, appetite, nociception (the perception of pain), and aggressive

behavior.

 

Serotonin is metabolized to 5-HIAA (5-hydroxyindolacetic acid) which is

its primary breakdown product.

 

The concentration of 5-HIAA in cerebrospinal fluid is used as an

indicator of serotonin turnover in the CNS serotonin level.

 

Psychiatric patients have been found to have low levels of 5-HIAA in the

CNS fluid, suggesting serotonin deficiency.3

 

5-HTP is readily absorbed by the mucosal cells of the

gastrointestinal tract. The delivery of 5-HTP into general circulation

is enhanced by the concomitant administration of an L-amino acid

decarboxylase inhibitor such as carbidopa, which reduces the conversion

of 5-HTP to serotonin in the gut and in liver.

 

In one study using five subjects, systemic absorption of 5-HTP in

combination with carbidopa averaged 69.2 percent.4 Another absorption

study found that carbidopa enhanced the increase in serum 5-HTP

concentration 5 to 15 fold.

 

In this study, a single dose of 5-HTP increased the plasma level of

5-HTP only slightly, whereas 5-HIAA increased 9-20 fold. This suggests

that the gut mucosa has a storage capacity for 5-HTP, and that plasma

increases occur after maximum capacity is reached.5

 

Observed Effects of 5-HTP Administration

 

Improves Well-Being in Depressed Persons

 

Serotonin in the central nervous system is recognized as a causative

factor in some depressed persons.6,7 A comprehensive review of seven

open and seven controlled clinical studies found that oral consumption

of 5-HTP improved mental and emotional status in 60 to 70 percent of

depressed people. The results varied from " modest " to " marked. " 8 Dosages

ranged from 50 to 300 mg daily.

 

The accumulated evidence is inconclusive as to whether 5-HTP is more

effective combined with decarboxylase inhibitors than when taken alone.

Many of the early trials used the combination, and this has been a

frequently used therapeutic strategy for reducing conversion of 5-HTP to

serotonin outside the CNS.

 

It is generally accepted that a large portion of absorbed 5-HTP is

metabolized to serotonin in peripheral tissues before it can enter the

brain.

 

Peripheral conversion of 5-HTP to serotonin would theoretically limit

the usefulness of oral 5-HTP for improving CNS functions and mental

health. However, trials in which 5-HTP was given alone do show benefits.

A small open trial in which 25 people were given 5-HTP either alone or

with a decarboxylase inhibitor found no difference in effectiveness.

 

Thirteen of the patients had " very good " or " good " improvement, 8 had

" moderate, " and in 4 out of the twenty-five the results were judged to

be " poor. "

 

A more recent randomized double-blind study compared the efficacy of

oral 5-HTP (100 mg T.I.D., without a decarboxylase inhibitor) to that of

fluvoxamine, a selective serotonin reuptake inhibitor.10 (SSRIs block

the reabsorption of serotonin by postsynaptic receptors, thus increasing

the available supply of serotonin in the synaptic cleft.)

 

The two were found to be equally effective, and 5-HTP was better

tolerated.

 

It should be noted that 5-HTP was given in the form of enteric-coated

pH-sensitive capsules which dissolve in the small intestine, thus

preventing

conversion of 5-HTP to serotonin in the stomach.

 

In contrast to MAO inhibitors and SSRIs, medications which act by

blocking normal physiologic functions, 5-HTP supports normal function in

its role as a serotonin precursor.

 

Correcting serotonin deficiency has been called a

" functional-dimensional approach " in the treatment of depression.

(continued on reverse)

 

Improves Sleep Quality

 

Studies have shown that 5-HTP influences the quality of sleep by

increasing REM (rapid eye movement) sleep. Administration of 5-HTP in

the evening prior to bedtime has been shown to increase the duration of

REM sleep and decrease the amount of non-REM sleep.11,12

 

Helps Prevent Migraine Headaches

 

Serotonin is known to play an important role in the pathophysiology of

migraine headaches.13 Serotonin regulates a key pain control system

which is activated during a migraine attack.

 

In a placebo-controlled, double-blind cross-over study 31 people with

migraine took 400 mg of 5-HTP per day. By the second month, 5-HTP

reduced the frequency and severity of attacks by more than 50 percent in

52 percent of the subjects, although the results were not statistically

significant.

 

In a larger study using 124 migraine sufferers, 5-HTP for migraine

prevention was compared to methysergide.14 Seventy-one percent of the

subjects taking 5-HTP (600 mg per day) experienced significant reduction

of intensity and duration of attacks, compared to seventy-five percent

of those taking the drug. Side effects were less frequent in the 5-HTP

group.

 

Improves Clinical Parameters in Fibromyalgia

 

Disturbances in serotonin-controlled nervous system function are

believed to be a factor in fibromyalgia.15 In a 90 day open trial, 50

people with primary fibromyalgia received 100 mg of 5-HTP three times

daily.

 

Nearly 50 percent showed " good " or " fair improvements in clinical

parameters such as the number of tender points, anxiety, fatigue and

sleep quality. A placebo controlled, double-blind study on 50 patients

produced similar significant improvements.17

 

5-HTP–A Free-radical Scavenger

 

The OH group which is added to tryptophan in the formation of 5-HTP

gives 5-HTP antioxidant properties.18 (Compounds such as vitamin E and

flavonoids derive their free-radical quenching ability from OH groups,

which donate electrons to oxidants.)

 

5-HTP quenches a variety of free-radicals. This is in contrast to

tryptophan, which is " sensitive " to oxidation.

 

Adverse effects of 5-HTP

 

Oral administration of 5-HTP in clinical studies has resulted in

gastrointestinal disturbances such as nausea, vomiting and diarrhea.

According to a review by Byerley, et. al. these effects are tolerated by

most patients and tend to lessen over time.

 

Side effects are more marked with higher doses, and may be reduced by

the use of enteric-coated, pH sensitive capsules or tablets.

 

 

 

Scientific References:

 

1. Pike, R.L., Brown, M.L. Nutrition: An Integrated Approach. NY:

Macmillan Pub. Co.; 1986:626-28.

 

2. Peters, J.C. Tryptophan nutrition and metabolism: An overview.

Advances in Experimental Medicine and Biology 1991;294:345-349.

 

3. van Pragg, H.M. Central monoamine metabolism in depressions. I.

Serotonin and related compounds. Comprehensive Psychiatry

1980;21(1):30-43.

 

4. Magnussen, I., Neilsen-Kudsk, F. Bioavailability and related

pharmacokinetics in man of orally administered L-5-hydroxytryptophan in

steady state. Acta pharmacol. et toxicol. 1980;46:257-62.

 

5. Magnussen, I., Jensen, T.S., Rand, J.H., Van Woert, M.H. Plasma

accumulation and metabolism of orally administered single dose

L-5-hydroxytryptophan in man. Acta pharmacol. et toxicol.

1981;49:184-89.

 

6. van Pragg, H.M. Korf, J. 5-hydroxytryptophan as an antidepressant.

Journal of Nervous and Mental Disease 1974;158(5):331-37.

 

7. van Pragg, H.M. Management of depression with serotonin precursors.

Biological Psychiatry 1981;16(3):291-310.

 

8. Byerley, W.F. et. al. 5-Hydroxytryptophan: A review of its

antidepressant efficacy and adverse effects. Journal of Clinical

Psychopharmacology 1987;7(3):127-37.

 

9. Zmilacher, K. Battegay, R., Gastpar, M. L-5-hydroxytryptophan alone

and in combination with a peripheral decarboxylase inhibitor in the

treatment of depression. Neuropsychobiology 1988;20:28-35.

 

10. Pšldinger, W., Calanchini, B., Schwarz, W. A functional-dimensional

approach to depression: Serotonin deficiency as a target syndrome in a

comparison of 5-hydroxytryptophan and fluvoxamine. Psychopathology

1991;24:53-81.

 

11. Zarcone, V.P. Hoddes, E., Smythe, H. Oral 5-hydroxytryptophan

effects on sleep. in Serotonin and Behavior, edited by Barchas, J.,

Usidin, E., NY: Academic Press; 1973:499-505.

 

12. Wyatt, R.J., et. al. Effects of 5-hydroxytryptophan on the sleep of

normal human subjects. Electroencephalography and Clinical

Neurophysiology 1971;30:505-09.

 

13. De Benedittis, G., Massei, R. 5-HT precursors in migraine

prophylaxis: A double-blind cross-over study with L-5-hydroxytryptophan

versus placebo. The Clinical Journal of Pain 1986;2:123-129.

 

14. Titus, F., D‡valos, A., Alom, J., Codina, A. 5-hydroxytryptophan

versus methysergide in the prophylaxis of migraine. Eur. Neurol.

1986;25:327-29.

 

15. Nicolodi, M., Sicuteri, F. Fibromyalgia and migraine, two faces of

the same mechanism. Recent Advances in Tryptophan Research, Vol. 398,

edited by Filippini, G.A., et. al., NY: Plenum Press; 1996:373-79.

 

16. Puttini, P.S., Caruso, I. Primary fibromyalgia syndrome and

5-hydroxy-L-tryptophan: a 90 day open study. The Journal of

International Medical Research 1992;20:182-89.

 

17. Caruso, I., Puttini, P.S., Cazzola, M., Azzolini, V. Double-blind

study of 5-hydroxytryptophan versus placebo in the treatment of primary

fibromyalgia syndrome. The Journal of International Medical Research

1990;18:201-09.

 

18. Simic, M.G. Al-Sheikhly, M. Jovanovic, S.V. Inhibition of free

radical processes by antioxidantsÐtryptophan and 5-hydroxytrytophan.

Bibl Nutra Dieta 1989;43:288-96.

http://www.willner.com/References/webref58.html

 

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5-HTP Honest Information

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5-HTP Honest Information

by Ray Sahelian, M.D.,

http://www.raysahelian.com/5-htp.html

 

best selling author of

5-HTP: Nature's Serotonin Solution

 

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 also involved in impulse control. For instance, low

serotonin levels may lead to addictive behavior such as gambling or

other habits with weak will power.

 

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 is best absorbed on an empty stomach.

 

5-HTP Properties -- Appetite, Sleep, Mood, Stress

 

Some people who take 5-HTP notice better mood balance, decrease in

appetite, reduced anxiety, better impulse control, and better sleep.

 

I have come across some individuals who find themselves more alert

rather than in a relaxed, sleepy state of mind with 5-HTP.

 

Some find that 5-HTP helps curb appetite with better weight control.

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. A study in rodents indicates that 5-HTP

may be useful in controlling the excessive food intake sometimes

generated by stress.

 

5-HTP may be temporarily helpful in conditions that normally require

prescription antidepressants, anti-anxiety 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 partly be due to low serotonin levels.

Amount Per Capsule:

5-HTP - 50 mg

Vitamin C - 30 mg

Vitamin E - 10 iu

 

Vitamin C and Vitamin E added as antioxidants

 

Laboratory tested. The certificate of analysis says this product

actually has 113% of its actual content which means it has 56 mg of

5-HTP.

 

There is no Peak X or any unwanted substances, only pure 5-HTP.

 

Plus: Subscribe to our free Supplement Research Update newsletter.

 

Once or twice a month we email a brief abstract of several studies on

supplements and natural medicine topics and their practical

interpretation by Ray Sahelian, M.D. We occasionally discuss 5-HTP.

 

A message regarding the safe use of 5-HTP

 

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 fuzzy. We

don't know as much as we should 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.

 

I tell my patients who use 5-HTP to take frequent breaks (the frequency

and length of breaks varies since each person is unique).

 

During these breaks, other forms of therapy could be substituted.

 

As of now, and after years of 5-HTP sold to the public, I am not aware

of any reports in the medical literature of anyone who has encountered

life threatening or other serious side effects from the use of 5-HTP.

 

5-HTP Dosage

 

Some studies have used dosages of 300 mg a day for depression, but I

consider any 5-HTP dose above 50 mg a high dose.

 

Most 5-HTP products on the market are sold in 50 and 100 mg capsules.

Some people do well with 20 to 50 mg, while others may temporarily

require 100 mg or more.

 

I'm not aware of 5-HTP products on the market that are less than 50 mg.

Those who do well with small doses can open a capsule and take a portion

mixed with water.

 

5-HTP is best absorbed on an empty stomach.

 

Medical supervision is recommended if high doses of 5-HTP are required

to treat a particular condition.

 

I don't recommend the routine use of daily intake doses greater than 100

mg since there's the possibility of nausea or nightmares.

Also, we still don't know if there are any long term side effects if

people take high doses for many years. 5-HTP enhances dreams and makes

them more vivid.

 

Safety of 5-HTP-- as discussed in the April 2004 issue of Toxicology

Letters

 

5-Hydroxy-L-tryptophan (5-HTP) is the immediate precursor in the

biosynthesis of 5-hydroxy-tryptamine (5-HT; serotonin) from the

essential amino acid L-tryptophan.

 

The use of L-Tryptophan as a dietary supplement was discontinued in 1989

due to an outbreak of eosinophilia-myalgia syndrome (EMS) that was

traced to a contaminated synthetic L-Tryptophan from a single

manufacturer.

 

5-HTP has since become a popular dietary supplement in lieu of the

removal of L-Tryptophan from the market. Because of its chemical and

biochemical relationship to L-Tryptophan, 5-HTP has been under vigilance

by consumers, industry, academia and government for its safety.

 

However, no definitive cases of toxicity have emerged despite the

worldwide usage of 5-HTP for last 20 years, with the possible exception

of one unresolved case of a Canadian woman.

 

Extensive analyses of several sources of 5-HTP have shown no toxic

contaminants similar to those associated with L-Tryptophan, nor the

presence of any other significant impurities.

 

A minor chromatographic peak (peak X) reported in some 5-HTP samples

lacks credibility due to chromatographic artifacts and infinitesimal

concentrations, and has raised undue speculations concerning its

chemistry and toxicity.

 

Das YT, Bagchi M, Bagchi D, Preuss HG. Safety of 5-hydroxy-L-tryptophan.

Toxicol Lett. 2004 Apr 15;150(1):111-22. ISSI Laboratories Inc., 515

Blue Ridge Avenue, Piscataway, NJ 08854, USA.

 

Biochemistry of 5-HTP

The figure below shows tryptophan converting into 5-HTP, which then

readily converts into serotonin.

 

Once serotonin is made, the pineal gland is able to convert it at night

into melatonin, the sleep-inducing hormone.

Vitamin B6 is involved in the process of serotonin formation.

 

Tryptophan, 5-HTP, and melatonin are available for sale as supplements.

 

Tryptophan*

â

5-HTP

â

Serotonin

â

N-Acetyl-serotonin

â

Melatonin

 

*Note: Tryptophan is also metabolized on a different pathway, not all of

it is converted into 5-HTP.

 

Figure 13.2 from the book Mind Boosters: Conversion of Tryptophan into

5-HTP, Serotonin and Melatonin.

 

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Drug Interactions: 5-HTP (5-Hydroxytryptophan)

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5-Hydroxytryptophan

Also indexed as: 5-HTP

 

Drug Interactions

 

Certain medicines interact with 5-hydroxytryptophan:

Some interactions may increase the need for 5-hydroxytryptophan (),

other interactions may be negative () and indicate 5-hydroxytryptophan

should not be taken without first speaking with your physician or

pharmacist, others may require further explanation (). Refer to the

individual drug article for specific details about an interaction.

 

Note: the following list only includes the generic or class name of a

medicine—to find a specific brand name, use the Safetychecker index.

 

Carbidopa

 

Carbidopa/Levodopa

 

Fluoxetine

 

Fluvoxamine

 

Paroxetine

 

Selegiline

 

Sertraline

 

Sibutramine

 

Sumatriptan

 

Tramadol

 

Venlafaxine

 

Zolmitriptan

 

Zolpidem

 

 

www.healthnotes.com

 

---

 

 

JoAnn Guest

mrsjo-

DietaryTi-

www.geocities.com/mrsjoguest/Genes

 

 

 

 

 

 

AIM Barleygreen

" Wisdom of the Past, Food of the Future "

 

http://www.geocities.com/mrsjoguest/Diets.html

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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