Helping patients improve their mental health is a big part of our practice. As it’s #mentalhealth awareness month, I’d like to highlight one of the lesser known prescriptions that we write in the office - the amino acid L-tryptophan.
When you hear L-tryptophan, most people think of the protein precursor associated with eating too much Thanksgiving turkey! So while it’s true, that high amounts of tryptophan can help put you to sleep (which is why we use it for insomnia), it’s really, really useful for #depression!
#Tryptophan is a precursor to #serotonin, which plays a major role in regulating #mood. In fact, most prescribed anti-depressants impact the tryptophan-serotonin pathway. If you’ve ever been prescribed an anti-depressant, it most likely affected this very important serotonin pathway. The rate at which Tryptophan is synthesized in the brain depends on gut function (as serotonin helps regulate and move stools along).
Here’s a great clinical pearl: if your bowels are generally sluggish and you more often than not, and you have a history of recurring mild to moderate depression, it’s likely you have a serotonin deficiency. Studies where tryptophan, was actively depleted in patients, almost always results in very acute depressive episodes.
While there is no ideal L-tryptophan dose, most researchers suggest a dose of 6 grams per day or less. I have found good clinical results with about half or even a third of this dose. I will typically prescribe 1,000 mg at bedtime and then modify the dosing throughout the day accordingly. I also like to use l-tryptophan in #IV's when appropriate although the dosing is different.
While tryptophan is a safe and non-controlled natural substance, in Canada it is available at these doses only by prescription and only through compounding pharmacies. Tryptophan should generally not be taken if you’re presently taking a drug that alters serotonin such as SSRIs, amitriptyline, triptans or monoamine oxidize drugs because of the potential of serotonin excess. So exercise caution and speak with your prescribing doctor before taking any #natural substance while on medication.
In summary, if you've had sluggish bowels, trouble sleeping and history of low mood or depression -you likely suffer with low serotonin. L-tryptophan might help!