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Fibromyalgia

5-HTP can raise salivary cortisol: does this cause a “wired-tired” feeling?

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5-htp salivary

Are you aware that 5-HTP – an amino acid supplement that supports serotonin levels – can raise cortisol levels and leave you feeling “wired-tired”? You may be able to relate to this if you’ve ever used 5-HTP to help with anxiety and insomnia and ended up feeling more anxious and more wide-awake despite your exhaustion and need for sleep. You feel “wired-tired” and it’s not pleasant at all.

Both 5-HTP and tryptophan, used as supplements, help to boost serotonin levels so you can feel happy, calm, sleep well and not crave carbs in the afternoon/evening. They also help with panic attacks and phobias, lack of confidence, depression, negativity, imposter syndrome, PMS, irritability, anger issues, pain/fibromyalgia, TMJ and anger. I typically have my clients with low serotonin symptoms start with a trial of tryptophan because I see such excellent results with this amino acid. That being said, some people simply do better on one versus the other and you may do better with 5-HTP.

However there is one big caveat with 5-HTP. I don’t recommend 5-HTP when a client has elevated cortisol levels because we know that it can raise cortisol levels in certain individuals. This can leave you feeling agitated, cranky, as well as wired and yet tired at the same time.

In this 2002 study, L-5-hydroxytryptophan induced increase in salivary cortisol in panic disorder patients and healthy volunteers

Salivary cortisol levels were measured in 24 panic disorder patients and 24 healthy volunteers, following ingestion of 200 mg L-5-hydroxytryptophan or placebo.

The experiment was carried out in the afternoon, “when basal cortisol secretion is more stable.” The first saliva sample was obtained at 1pm and the subjects ingested the 200mg 5-HTP at 2pm. Additional saliva samples were obtained at 2:30pm, 3:00pm and 3:30pm.

They report the following:

A significant rise in cortisol was observed in both patients and controls following ingestion of L-5-hydroxytryptophan. No such effects were seen in the placebo condition.

Here are a few additional comments and my thoughts:

  • This study was done to find evidence for “serotonin receptor hypersensitivity in panic disorder” and not specifically to test for the effects of 5-HTP on cortisol levels but it serves this purpose rather nicely (and it’s one of many similar studies, some of which measure plasma cortisol levels)
  • Keep in mind 200mg of 5-HTP is a large starting dose. It’s typical to start with 50mg so may be a factor to consider
  • In this study they did not assess cortisol levels beyond the 1.5 hours from ingestion of the 5-HTP. It would have been useful to see when levels started to go down
  • We would want to consider the ramifications of using 5-HTP for weeks (whether it’s 50 or 200mg). What impact would that have on cortisol and the adrenals? (I am not aware of a study like this having been done)
  • I’m also not aware of a study being done with 50mg but if you feel worse and feel “wired-tired” with 5-HTP and switch to tryptophan (the equivalent starting dose is 500mg) and your anxiety and other low serotonin symptoms resolve then you have found your solution
  • You may be wondering: “could I use 5-HTP to raise my low cortisol levels”? Theoretically yes and possibly very short-term. But I would question the timing since 5-HTP and tryptophan are best dosed mid-afternoon and later. This is when we would expect our cortisol levels to be on the downward slope as we end our day. I’d also want to nourish the adrenals with B vitamins and herbal adaptogen and remove the trigger/s that are leading to low cortisol.

If you suspect low serotonin symptoms and are new to using the amino acids and do not have my book I highly recommend getting it and reading it before jumping in to taking supplements: The Antianxiety Food Solution – How the Foods You Eat Can Help You Calm Your Anxious Mind, Improve Your Mood, and End Cravings.

There is a complete chapter on the amino acids and one for pyroluria, plus information on real whole food, sugar and blood sugar, gluten, digestion and much more.  If you’re not a reader there is now also an audible version.

Here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution and additional information on Anxiety and targeted individual amino acid supplements: a summary

Please also read and follow these Amino Acid Precautions.

This lists The Antianxiety Food Solution Amino Acid and Pyroluria Supplements that I use with my individual clients and those in my group programs.

Have you used 5-HTP with success? Or have you used it and felt “wired-tired”? Have you correlated the success or failure of your 5-HTP use with your salivary cortisol levels?

If you switched from 5-HTP to tryptophan did you have success with that?

If you’re a practitioner is this something you see with your clients/patients and take into consideration?

Feel free to post your questions here too.

Low serotonin and fibromyalgia, ferritin and other testing

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Misdiagnoses of fibromyalgia is rampant–upwards of two-thirds of patients could be misdiagnosed! Tens of millions diagnosed with fibromyalgia may actually have other problems accounting for their symptoms, which leads to improper treatment. Are you one of them?

We invite you to attend this event if you are suffering from:

  • Body-wide pain
  • Persistent fatigue
  • Unrefreshed sleep and insomnia
  • Irritable Bowel Syndrome
  • Thyroid and/or adrenal dysfunction
  • Depression and/or anxiety

Naturally I discussed the fibromyalgia-anxiety connection and the use of both 5-HTP and/or tryptophan to ease the pain and the anxiety.

Here are some excerpts from one of the papers we discussed: Fibromyalgia and the serotonin pathway

Fibromyalgia syndrome is a musculoskeletal pain and fatigue disorder manifested by diffuse myalgia, localized areas of tenderness, fatigue, lowered pain thresholds, and nonrestorative sleep.

Low serotonin is often a contributing factor with fibromyalgia and we find that tryptophan and/or 5-HTP can be very beneficial for the anxiety, depression, pain and insomnia we often see in those with classic fibromyalgia:

Serotonin substrate supplementation, via L-tryptophan or 5-hydroxytryptophan (5-HTP), has been shown to improve symptoms of depression, anxiety, insomnia and somatic pains in a variety of patient cohorts.

Here is a recent blog on the topic: Fibromyalgia: tryptophan or 5-HTP for anxiety, depression, pain and insomnia

We also cover how the other aminos GABA and DPA (d-phenylalanine) can help with pain reduction too, and how to do a trial of the amino acids in order to find the optimal dose.

I also discuss how the other amino acids GABA and DPA (d-phenylalanine) can help with pain reduction too, and how to do a trial of the amino acids in order to find the optimal dose (so if you need a recap on how to do this do join us).

Other topics in our interview include:

  • Benzodiazepines
  • Joint hyperflexibility (or Ehlers–Danlos syndrome)

Dr. David M. Brady, ND is the host of the summit and is one of my favorite doctors. I learned so much from him when I first became a nutritionist!  He is an internationally recognized expert in fibromyalgia and a staunch patient advocate for those who have been struggling because of a medical system that is ill-equipped to deal with the problem.

Here is a snippet of his interview with Kara Fitzgerald on testing and ferritin:

The Fibro-fix Summit runs through June 27. You can register here.

Enjoy! And feel free to ask questions here.

 

Fibromyalgia: tryptophan or 5-HTP for anxiety, depression, pain and insomnia

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fibro and anxiety

Fibromyalgia syndrome is a musculoskeletal pain and fatigue disorder manifested by diffuse myalgia, localized areas of tenderness, fatigue, lowered pain thresholds, and nonrestorative sleep.

This description comes from a paper titled: Fibromyalgia and the serotonin pathway

The paper discusses how low serotonin is often a contributing factor with fibromyalgia and how beneficial tryptophan and/or 5-HTP can be for the anxiety, depression, pain and insomnia we often see in those with classic fibromyalgia:

Evidence from multiple sources support the concept of decreased flux through the serotonin pathway in fibromyalgia patients.

Serotonin substrate supplementation, via L-tryptophan or 5-hydroxytryptophan (5-HTP), has been shown to improve symptoms of depression, anxiety, insomnia and somatic pains in a variety of patient cohorts.

I recently blogged about the effectiveness of 5-HTP being a clinically-effective serotonin precursor and how it improves many of these same symptoms:

Therapeutic administration of 5-HTP has been shown to be effective in treating a wide variety of conditions, including depression, fibromyalgia, binge eating associated with obesity, chronic headaches, and insomnia.

An open 90-day study in 50 patients affected by fibromyalgia found benefits with the use of 5-HTP:

When all the clinical variables studied throughout the trial (number of tender points, anxiety, pain intensity, quality of sleep, fatigue) were compared with baseline results, they all showed a significant improvement.

It is concluded that 5-HTP is effective in improving the symptoms of primary fibromyalgia syndrome and that it maintains its efficacy throughout the 90-day period of treatment.

If we suspect low serotonin may be a factor, I have my clients do the following (whether or not they have a fibromyalgia diagnosis):

  • complete the Amino Acids Mood Questionnaire from The Antianxiety Food Solution and check off their symptoms on the low serotonin section.  The rating uses scale of 1-10 with 10 being worst.
  • review the Amino Acids Precautions and figure out if we can do a trial of 5-HTP or tryptophan
  • do a trial of the amino acid 5-HTP or tryptophan and observe for improvements in anxiety, depression, pain, insomnia and the other low serotonin symptoms

We are all unique and some people do better on 5-HTP and some do better on tryptophan. I typically start with a tryptophan trial since I’ve seen such great benefits with this amino acid. If that’s not working, we’ll do a 5-HTP trial, always watching for high cortisol as 5-HTP can raise cortisol if it’s already high. In this instance 5-HTP may be too stimulating.

Quality is an important issue when it comes to the amino acids and this is especially the case with tryptophan. I find that the Lidtke brand is the most superior. You can see my amino acid product recommendations here.

Do you have a diagnosis of fibromyalgia and have you found benefits with 5-HTP or tryptophan? For your pain? For your sleep? For your anxiety and/or depression?

I’d love to also hear what else has helped with your symptoms?