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Tryptophan for PMS: premenstrual dysphoria, mood swings, tension, and irritability

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pms

In a study published in 1999, A placebo-controlled clinical trial of L-tryptophan in premenstrual dysphoria, tryptophan was found to reduce symptoms of PMS when used in the luteal phase or second half of the cycle (i.e. after ovulation):

37 patients with premenstrual dysphoric disorder were treated with L-tryptophan 6 g per day, and 34 were given placebo. The treatments were administered under double-blind conditions for 17 days, from the time of ovulation to the third day of menstruation, during three consecutive menstrual cycles.

They looked at dysphoria, which is defined as a state of unease or generalized dissatisfaction with life, plus mood swings, tension (and anxiety), and irritability and they found a 34.5% reduction of symptoms with tryptophan compared to 10.4% with placebo.

The paper concludes:

that these results suggest that increasing serotonin synthesis during the late luteal phase of the menstrual cycle has a beneficial effect in patients with premenstrual dysphoric disorder.

Let me share what I see with the women with PMS that I work with:

  • This is very typical when I’m working with someone with PMS and anxiety and other mood symptoms. It typically takes 2 to 3 cycles for an amino acid like tryptophan to have an impact on PMS itself. But it does typically start to work right away on the less severe anxiety and mood symptoms that may also be a factor during the rest of the month.
  • I don’t start with 6g per day of the tryptophan but rather have each person do the amino acid questionnaire, review the precautions and do a trial of tryptophan, increasing as needed to find the optimal amount for their needs (you can read more about this here on anxiety and the amino acid overview
  • We often find that adding GABA helps too, as this supports progesterone production
  • Many anxious women I work with also have pyroluria or signs of low zinc and low vitamin B6 and adding these nutrients, together with evening primrose oil, provide additional hormonal support (and help with the social anxiety).
  • Other factors to consider with PMS: low total cholesterol (as cholesterol is needed to make hormones), gluten issues, adrenal function and blood sugar control, gut health and the microbiome, and liver support
  • And finally, we can’t forget diet and need to switch to eating a real whole foods diet free from sugar, gluten and caffeine. Coffee and chocolate in the second half of the cycle can be especially problematic for many women

Together with the tryptophan and the above approaches (if needed as we are all so different), it’s not unreasonable to get the reduction of symptoms from 34.5% (as seen with the tryptophan) down to 100%. It breaks my heart when I hear women think they have to live with PMS symptoms when they don’t have to!

Have you used tryptophan for PMS? Do you take it all month or just in the 2nd half of your cycle? What about other changes that have helped: GABA or liver support or quitting caffeine? Or something else?  Please share.

 

Reader Interactions

Comments

  1. Hi, Trudy,
    Do these protocol work for menopause as well? My symptoms sound suspiciously like some of these PMS symptoms.
    It’s time for me to pick up your book again, I think!
    Grace

    Reply

    • Grace
      This is a great question and yes all of the above works for the dysphoria, mood swings, tension/anxiety and irritability we may see with PMS, perimenopause and menopause.

      Lovley to see you here on the blog and yes read the book again and feel wonderful!

      Reply

  2. Can you send me the Amino acid profile?
    thank you. I’m dealing with adrenal fatigue and I’m up throughout the night.

    Reply

  3. Do these things help if person is on antidepressants? This question is for my daughter.

    Reply

  4. I’ve taken tryptophan on and off for the last few years with wonderful results in relation to mood, sleep and anxiety. My reasearch led me to an article on how tryptophan can aggravate asthma, and is the only amino that has the capability of causing cancer, though this can be tempered with the addition of B6. Do you agree? I notice that the study offered a list of precautions, although they weren’t mentioned. Can you offer some clarity? Thank you in advance.

    Reply

  5. What can you recommend for anxiety for a woman 83 years of age experiencing hypothroidism for 40 years plus due to radioactive iodine treatment for hyperthyroidism. Levothyroxine has negative reactions such as insomnia, loss of appetite and causes episodes of being delusional. No solution from Endocrinology.

    Trying glandulars and tyrosine. Test results show that this is not strong enough, but her temperament is much better.

    Thanks so much!
    Adrienne

    Reply

    • Adrienne

      I’d really try and find a solution for the hypothroidism – perhaps find a doctor to prescribe naturethroid. I’d also want to rule out Hashimoto’s thyroiditis and look at other nutrients for thyroid support. Zinc and iron are key.

      If low serotonin is also a factor then I’d consider tryptophan too. With everyone I have them do the questionnaire, review the precautions and do a trial to figure out what works and how much https://www.everywomanover29.com/blog/anxiety-amino-acids-overview/

      Reply

  6. really good advice here! I’ve had some fantastic results with 5-htp and GABA in treating anxiety and depression but didn’t know about the connections with PMS!
    Now that I am perimenopausal I am wondering if the above treatment would work for that as well. or what would you recommend? Thanks!

    Reply

  7. Trudy, after listening to the talks about Lidtke Tryptophan I decided to give the Tryptophan Complete a try. I’ve taken one capsule each on the last two nights instead of two of the Tryptophan 500mg caps. Both nights I slept straight through all night and had a hard time waking up in the morning. I’ve struggled with insomnia for many, many years. The 500’s were helping but I was still waking up during the night. For me to sleep all night is almost miraculous. I’ve been also taking Progesterone ( low on testing), Magnesium, L-Theanine, Melatonin. I recently added phosphatidylserine, and Holy Basil because saliva testing showed high cortisol at bedtime and off the charts high in the morning. I’m hoping to start eliminating some of those other supplements now that I’m sleeping so well.
    I want to thank you for the Anxiety Summits and your book and updates on Facebook and newsletters. I have learned so much from you!
    One quick question, I believe you say to reevaluate at the end of each bottle of supplements to see if you need to continue. Are you saying that at some point I won’t need to keep taking the amino acids? Is that true for the supplements for pyroluria as well?

    Reply

    • Lorraine
      Wonderful! very happy for you! Most people can stop the aminos provided the other underlying factors are addressed. If you have pyroluria it’s for always

      Reply

  9. Trudy, I’ve been taking 5htp supplements after going off of Zoloft. They do seem to help my serotonin levels but not to the extent that Zoloft did. I am going to buy the Optizinc and Primrose as I scored above 15 on the questionnaire. I am also thinking about trying GABA. My concern is what I have read regarding 5htp and long term use. What are your thoughts on taking it longer than 3 months? I had childhood asthma with very rare trouble now but I am unsure about trying the tryptophan.

    Thank you!

    Reply

    • Ellen
      Please share a link to your 5-HTP long-term use concerns and then I’ll comment. I am not aware of any issues with long-term use.

      As with any of the amino acids a trial is a good way to see how a client responds both positively and negatively and I’d had many clients with childhood asthma do well on tryptophan in adulthood.

      Don’t forget that vitamin B6 is part of the pyroluria protocol

      Reply

    • Ellen
      I had forgotten about this paper by Dr. Marty Hinz! I’m afraid this approach is not well-accepted in the nutrition/naturopathic world. He writes about it and so do the practitioners he teaches. Thanks for the reminder – it’s time for me to do a blog post addressing this so stay tuned.

      I’ve not seen the timeframe mentioned in the Dr. Oz article in any research paper either and don’t actually think it’s a very well written article 🙂

      I have yet to see an issue with long-term use. My bigger question would be why do you need it long-term because ideally once you address the diet, food sensitivities, the gut, stress and boost serotonin levels you should be able to stop. Some people have a harder time when they have gene polymorphisms or Lyme disease or heavy metals etc.

      But it’s always good to ask questions!

      Reply

  11. Trudy, Jess Armine, DC from the vitamin summit said one should not use Tryptophane but only 5HTP. He said: “Don’t use tryptophan itself, use 5HTP because tryptophan converts to 5 HTP but only about 10 %of it does and if the problem that is causing you to have insomnia problems is an inflammatory problem, then it will pull that tryptophan down a different pathway that ends up in a substance called quinidine ( ?spell) acid which will be excitatory.” Any comments.

    Reply

    • Mandi
      He is referring to the possibility that tryptophan converts to quinolinic acid if there is inflammation. As long as there are co-factors it’s typically not a problem. Taking enough vitamin B6 is key. Lidtke has a fomulation called Tryptophan Complete (https://www.everywomanover29.com/blog/tryptophan-500mg-or-tryptophan-complete-lidtke/) with all the necessary co-factors.

      As with all amino acids and all supplements if someone does have an adverse reaction they simply stop taking them.

      Reply

      • Thank you Trudy. So if the insomnia is caused by possible lyme disease (inflammation), you can still take tryptophane as long as it has B6 and if you have an adverse condition, then stop. Is that correct? Yes, i like the tryptophane complete.

  12. Hi Trudy, You recently had another article about tryptophan, but i can’t find it. You suggested taking tryptophan in the afternoon. My question is,won’t this make me tired?

    Reply

    • Jessie
      Serotonin takes a dip midafternoon so taking tryptophan then typically helps. I have my clients do a trial and if MA makes them tired and they don’t see any other benefits we switch to bedtime only or try 5-HTP MA and tryptophan at BT.

      Reply

  13. Hi Trudy,

    I suffer from low serotonin and low gaba. I am considering taking gaba as well as tryptophan. How do I go about taking these and during what times? Do I take them together or separately? How much should I start with.

    Thank you in advance !

    Reply

  14. Hi Trudy,

    I suffer from an over focused anxiety and depression and exhibit some OCD behaviors. I’m constantly worrying and ruminating,as well as biting my nails. My heart races and my chest gets tight and thoughts are just racing through my head. I’m angry most of the time and am rarely in a good mood these things take up so much of my day and life. And cause negative relationships with my family. All I want to is to be happy again and to find myself because I know this isn’t who I am. I’ve done much research on natural remedies and have been given so many prescription ssris but dislike all the negative side effects. I haven’t been on prescription meds in over 2 years and I’m getting worse. My research has brought me to you and all the great information and advice you have. I have recently purchased inositol and plan on taking that but not sure if that will be enough. Should I or can I incorporate inositol with something else such as tryptophan or gaba or St. John’s wort? I don’t know which one would be best to add. Or how much of I do need to add something else. I would greatly appreciate your expertise.

    Thank you

    Reply

    • Jessica
      Sorry to hear you’re feeling worse. I have my clients do the amino acid quetsionnaire, review the precautions and do a trial to determine what is best for them https://www.everywomanover29.com/blog/anxiety-amino-acids-overview/ With the symptoms you describe I’d suspect low serotonin and always start with tryptophan and then add inositol if that’s not enough for OCD. GABA will likely help too but again it’s based on the trial.

      Reply

    • Ella
      This article was shared with me last year and as I said then I’m more curious than concerned. I’m also not familiar with the work of the writer and still have plans to reach out to him.

      I skimmed the article and the acute side-effects are due to very high doses. I am familiar with the EMS concerns which is why I only ever recommend Lidtke brand because of it’s superior quality.

      Re the liver concerns it is a precaution to not use any of the aminos if you have liver issues but I’ll have to look at each paper he refers to be able to offer further commentary. It seems high doses are a factor here too. I wonder if poor quality tryptophan is a factor too?

      Re the kynurenine pathway issues, having sufficient B3 and B6 and curcumin helps with this, hence Lidtke’s Tryptophan Complete product https://www.everywomanover29.com/blog/tryptophan-500mg-or-tryptophan-complete-lidtke/. I interview Dr Bongiorno on one of the Anxiety Summits (www.theanxietysummit.com) on serotonin/tryptophan. He uses it all the time with patients and has no concerns with this kynurenine pathway issues or serotonin syndrome.

      When someone is taking a SSRI I do have them first check with their doctor before starting tryptophan and working with their doctor to monitor for the possibility of serotonin syndrome (which has never actually been documented in the research literature i.e. tryptophan use with an SSRI) and take the SSRI 6 hours away from tryptophan to be safe. Although Dr. Bongiorno isn’t concerned with this either.

      Reply

  16. Hello Trudy,
    My heart aches for teen girls of today. Among neighbors and friends, we see so many health issues – autism, anxiety, depression, PMS, PMDD, self harm, gender dysphoria, etc. So many are on prescription medicine such as antianxiety and antidepressants drugs and many are on birth control pills. So many are under the care of a psychiatrist or therapist. As a middle aged woman, I am saddened to see such a deterioration of health in just one generation and I wonder what has caused all this misery. I wish all parents, doctors and teachers knew about conditions like pyroluria as I suspect pyroluria may be one of the main root causes of all these health problems. On the matter of gender dysphoria/fluidity and the like, I believe we are going down the wrong path when we conclude it is a normal variant among humans. In the troubled teens around me, I see gender dysphoria occurring along with other health issues and wonder if conditions like pyroluria, low serotonin/GABA, methylation problems, etc. are really the root causes. I welcome your wisdom and input on this issue.
    (I have referred mothers who have confided to me their concerns about their troubled teens girls to your website and book.)
    Thanks so much.

    Reply

    • Ann
      This is so very true – thanks for sharing your feelings and for referring mothers to my site and book! The more people who know about this nutritional approach the better!

      Reply

      • Dear Trudy,
        My dear neighbor tells me that with the guidance of your book, her daughter tested positive for pyroluria per the questionnaire and she has started to give her a low dose supplement regimen of B6 and zinc. She has already observed an improvement in her teen’s stress and anxiety levels! PMS is one of the items on the pyroluria questionnaire. This dear child has severe PMS to the point of premenstrual dysphoria. The mother has observed that her daughter’s gender dysphoria matches up with her premenstrual dysphoria – that is, during the second half of the cycle she feels and acts masculine. This fluctuation between feminine and masculine along the menstrual cycle leads the mother to believe that there is an underlying biochemical imbalance.
        I suggested to the mother that she may also want to check out her child’s methylation status.
        Do you think pyroluria can be a root cause of both premenstrual and gender dysphoria?
        Do you recommend any other testing and nutrients for this teen to resolve her PMS and dysphoria issues?
        Thanks so much Trudy.
        (God bless all the mothers out there who follow their wisdom and look for root causes and natural/nutritional solutions)

      • Ann
        Wonderful to hear about this teen’s stress and anxiety levels! Well done for sharing with your neighbor!

        I’m not familiar with “gender dysphoria matching up with premenstrual dysphoria” but I’d look into increases in testosterone in the 2nd half of her cycle (which is unusual) and the need for comprehensive hormone testing and detective work to find out if something she is doing is boosting testosterone levels. PCOS needs to be ruled out and/or addressed.

  17. Dear Trudy,
    Thank you so much for your response and guidance. You are truly a wealth of knowledge and compassion. It warms my heart to have informed my good neighbor about your book and website and for this teen to have already shown improvement. Thank you for being there for all of us!! God bless.

    Reply

    • Dear Trudy,
      Will taking tryptophan and GABA for PMS / PMD have an effect on the length of the menstrual cycle? If so, is it temporary and is it a good sign?
      I have read some accounts where females report a lengthening of their menstrual cycle to 30+ days. I am wondering if the increase in the length of the cycle occurs while the is system “correcting” and “resetting”. As always, I welcome your guidance. Thanks so much.

      Reply

      • Ann
        The amino acids in conjunction with other nutritional approaches typical normalize the length of the cycle which can differ for each person.

  18. I’ve been studying Tryptophan and THEANINE (which occurs naturally in Green Tea) … to help my daughters “moderate” pms issues (mostly moderate mood swings) … and it seems to me that taking the Theanine (which boost serotonin like the tryptophan does) INSTEAD … should have the same positive impact on pms symptoms with NONE of the Side effects which tryptophan risk … am I missing something? (ive read everything I can find so far with not a single health risk for theanine and a LONG list of potential risk fromn tryptophan … is there some risk you know of?)

    thanks

    Reply

    • Jack
      Theanine works more to support GABA levels although there is some research that it may also support serotonin to some degree. If someone with PMS has low GABA then we’d expect GABA or theanine to be more helpful. If someone has PMS and low serotonin then tryptophan or 5-HTP is more helpful so it really does depend on the root causes.

      If this is helping your daughter’s PMS and moderate mood swings then it’s likely they are because of low GABA. Is the theanine helping her?

      I’d love to hear what tryptophan side-effects you’re concerned about?

      Reply

      • She has not actually tried either one yet … I’ve just been doing some research for an option to test … and these two seemed like the best options … from what I’ve read the theanine would increase serotonin & dopamine & gaba levels all three … vs the tryptophan which was likely to just increase the serotonin … are you saying that the theanine does not increase serotonin & dopamine levels in addition to the gaba? the issues with manufacturing of tryptophan was alarming … outbreak of eosinophilia-myalgia syndrome (EMS) … I read it was considered an isolated problem due to non gmo bacteria used but if it happened once maybe when your not looking it pops up again??

      • Jack
        As unfortunate as it was, the tryptophan EMS problem was one isolated outbreak. I would compare this to an outbreak of injuries/deaths from E. Coli from spinach or lettuce (https://www.washingtonpost.com/news/to-your-health/wp/2018/05/02/first-death-reported-from-e-coli-contaminated-romaine-lettuce-as-outbreak-spreads/). These are also very unfortunate but we go back to eating raw spinach and lettuce after a situation like this and take the necessary precautions to prevent it happening again.

        For prevention of a repeat tryptophan EMS outbreak we rely on quality tryptophan and the company doing the necessary safety testing. This is why I only recommend tryptophan from Lidtke. Here are the products I use with my clients https://www.everywomanover29.com/blog/amino-acids-pyroluria-supplements/

        Also, tryptophan is much more effective for raising serotonin and is my first choice. 5-HTP is another option that may work as well – some people do better on one vs the other.

    • Jack
      Based on the low GABA and low serotonin questionnaire we do trials of the respective amino acids and monitor symptoms. I may also have labs that I review (sex hormone and adrenal tests and basic blood work). I’m also looking at all the other questionnaires I have my clients complete: pyroluria, sex hormones, adrenals, digestive health etc

      Reply

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