L-5-hydroxytriptophan

An amino acid supplement with DLPA, glutamine and 5-HTP (and a few other nutrients) eases alcohol withdrawal symptoms at an inpatient detoxification program. Other than anxiety (I’ll share more on this below), there was also a significant decrease in psychiatric symptoms. Here is an excerpt from the study, The use of a food supplementation with D-phenylalanine, L-glutamine and L-5-hydroxytriptophan in the alleviation of alcohol withdrawal symptoms:

We described the use of a food supplementation with D-phenylalanine, L-glutamine and L-5-hydroxytryptophan in the alleviation of alcohol withdrawal symptoms in patients starting a detoxification therapy.

Since abstinence from ethanol causes a hypodopaminergic and a hypoopioidergic environment in the reward system circuits, manifesting with withdrawal symptoms, food supplements that contains D-phenylalanine, a peptidase inhibitor (of opioid inactivation) and L-amino-acids (for dopamine synthesis) were used to replenish a lack in neurotransmitters and alleviate the symptoms of alcohol withdrawal.

First I cover some translation issues and then more about the actual product and study results. I also share my commentary on the amino acids and dosing used in the study (and the fact that anxiety did not resolve). I include how to apply this information if you have a loved one in an alcohol treatment/rehab program or if you recognize social drinking is an issue for you. And I wrap up with additional resources if you are new to using GABA as a supplement, the GABA Quickstart online program and the practitioner training.

The study was completed and published in Slovenia and there are a few translation issues I’d like to clarify:

• The study title states D-phenylalanine (DPA) was in the amino acid product, however DL-phenylalanine (DLPA) was actually used. You can read about the difference between DPA and DLPA here. In summary, DPLA works on both dopamine and endorphin support and DPA works on endorphin support only.
• As you can see from the excerpt above, hypodopaminergic refers to low dopamine and hypoopioidergic refers to low endorphins. During withdrawal from ethanol/alcohol, both low dopamine and low endorphins cause withdrawal symptoms.
• L-5-hydroxytryptophan is incorrectly spelled as L-5-hydroxytriptophan and reward system is incorrectly spelled as reword system. (Clarifications are provided for facilitating online searches in the research literature.)

More about the product, the study and the conclusion

It was a small randomized, double blind study with just 20 patients and the amino acid product was used for 40 days of the inpatient alcohol detox or rehab program.

This is the actual combination product used:

Psychiatric symptoms were measured using the SCL- 90R and included assessing for “somatization, obsessive-compulsive, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid, and psychoticism.” During their rehab there was a significant decrease in these categories of psychiatric symptoms in the study group, except for their anxiety symptoms.

The authors conclude that “abstinence causes a major stress for the patients. The use of a food supplement containing D-phenylalanine [it was actually DL-phenylalanine], L-glutamine and L-5-hydroxytryptophan alleviates the withdrawal symptoms.”

As expected, once alcohol consumption was stopped, cortisol levels, liver enzymes and total bilirubin all decreased in the study group and the control group.

My commentary on the amino acids and dosing used in the study (and the fact that anxiety did not resolve)

Keep in mind the same dosing was used for all study participants. What I use clinically with folks with low levels of these neurotransmitters, is an individualized approach based on each person’s needs, for endorphin and dopamine support (from the DLPA), blood sugar support (from glutamine) and serotonin support (from 5-HTP). This means identifying symptoms in each category and doing a trial of each respective amino acid, starting low and increasing based on symptom resolution.

Given that anxiety symptoms didn’t resolve in the study group, I would have loved to see the amino acid GABA included, also dosed according to individual needs. GABA helps ease the physical tension-type anxiety and low GABA tension often drives the need to self-medicate with alcohol in order to relax and fit in socially.

The authors do mention GABA too: “the physiological craving for alcohol may be the result of a deficiency of the naturally occurring opiate like substances as well as other neurochemical deficits (i.e., dopaminergic, GABAergic, and serotonergic).

Also, an animal study shows that GABA helps with gut damage caused by alcohol consumption, so there is this additional benefit.

A higher dose of glutamine and/or 5-HTP may have also helped ease anxiety. They used 150 mg glutamine whereas a typical starting dose for glutamine is 500 mg (and we increase from there). Going up to 1000 mg to 1500 mg three or 4 times a day is not unusual and is typically very beneficial for alcoholics – for blood sugar stability, an additional calming effect and for healing the leaky gut which has been damaged by the alcohol consumption.

With regards to 5-HTP, they used 5 mg 5-HTP which is considered extremely low. I wonder if it was in fact 50 mg, which is a typical starting dose? Going up to 150 mg 5-HTP use 2 or 3 times a day is not unusual. Serotonin support with 5-HTP (or tryptophan) is very beneficial for the worry-type of ruminating anxiety.

For some individuals DLPA may have been too stimulating and contributing to anxiety via a dopamine boost. For these individuals, DPA may have been a better option for endorphin support.

I am not in favor of folic acid and prefer methylfolate, and although magnesium is an important cofactor for neurotransmitter production, magnesium oxide does not provide much usable magnesium.

Outside of the amino acids and other nutrients used, a vitamin B1 (thiamine) deficiency would need to be addressed and any other deficiencies (such as all the B vitamins, zinc, vitamin D, magnesium etc.) caused by chronic alcohol consumption. This is not a comprehensive list and a full functional workup will help to identify all possible deficiencies.

Despite my quibbles, the outcome of the study is very encouraging, I appreciate the researchers and I hope to see it replicated and refined in other settings.

How to apply this information if you have a loved one in an alcohol treatment/rehab program

Unfortunately the amino acids are seldom incorporated at in-patient detox and rehab centers but they should be. Your options are to:

• Share this study and my blog with the treatment center
• Educate yourself (on using the questionnaire and doing the amino acid trials) so you can use them with your loved one once rehab is over. This is key for preventing a relapse and for swapping alcohol addiction for sugar or caffeine or nicotine addiction.
• Introduce one amino acid at a time so you can figure out which one/s they need and how much
• Read my book, The Antianxiety Food Solution – How the Foods You Eat Can Help You Calm Your Anxious Mind, Improve Your Mood, and End Cravings, and share a copy with the treatment center (and your loved one and their treatment team)
• Address diet, nutritional deficiencies and gut health

Keep in mind that the amino acids are used with success for cocaine, heroin and other drug addictions.

How to apply this information if you recognize social drinking is an issue for you

New research shares that “low-level alcohol consumption is commonly perceived as being inconsequential or even beneficial for overall health, with some reports suggesting that it may protect against dementia or cardiovascular risks”, however, as the authors suggest “even low-level alcohol consumption is associated with premature brain aging.”

Social drinking is the norm and is way too prevalent. And it’s often used as a calming measure in order to relax and fit in socially.  If this sounds like you:

• Educate yourself (on using the questionnaire and doing the amino acid trials) so you can use them to quit drinking easily with no willpower and no feelings of being deprived. This is key for preventing the swapping out the need for alcohol (to relax or fit in socially) with a sugar or caffeine or nicotine addiction. In this case, GABA helps a young man who has recently given up alcohol, Adderall and nicotine.
• Introduce one amino acid at a time so you can figure out which one/s you need and how much
• Read my book, The Antianxiety Food Solution – How the Foods You Eat Can Help You Calm Your Anxious Mind, Improve Your Mood, and End Cravings, and share a copy with your loved one/spouse/partner and practitioners/therapists.
• Address diet, nutritional deficiencies and gut health

Resources if you are new to using the amino acids as supplement

If you are new to using the amino acids as supplements, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution (you can see all the low neurotransmitter symptoms).

If you suspect low levels of any of the neurotransmitters and do not yet have my book, The Antianxiety Food Solution – How the Foods You Eat Can Help You Calm Your Anxious Mind, Improve Your Mood, and End Cravings, I highly recommend getting it and reading it before jumping in and using amino acids on your own so you are knowledgeable. And be sure to share it with the team you or your loved one is working with.

There is a section on alcohol but keep in mind that all the sections on sugar craving/addiction apply to alcohol addiction and self-medicating with alcohol too. Some individuals use alcohol to numb out and some use sugar. Many use both and once alcohol addiction is addressed, it’s often replaced with sugar and caffeine addiction. This is why addressing neurotransmitter imbalances is key.

The book doesn’t include product names (per the publisher’s request) so this blog, The Antianxiety Food Solution Amino Acid and Pyroluria Supplements, lists the amino acids that I use with my individual clients and those in my group programs.

If you don’t feel comfortable reading my book and figuring things out on your own (doing the symptoms questionnaire and doing respective trials), you can get guidance from me in the GABA Quickstart Program (online/virtual).

If you are a practitioner, join us in The Balancing Neurotransmitters: the Fundamentals program. It’s an opportunity to interact with me and other practitioners who are also using the amino acids.

Have you used amino acids with success as part of an alcohol detox program (for yourself or for a loved one)? Or to help stop social drinking of alcohol?

Which neurotransmitter imbalances were driving your need to self-medicate with alcohol and which amino acids helped?

If you’re a practitioner do you use the amino acids (via an individualized approach) to help with alcohol withdrawal and cessation with your patients and/or clients?

Feel free to ask your questions here too.