5-HTP and Fibromyalgia

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5-HTP (5-hydroxytryptophan; L-5 hydroxytryptophan) is a chemical that is naturally produced in the body as a by-product of the amino acid known as L-tryptophan. It can also be produced synthetically from the seeds of the African plant known as Griffonia simplicifolia. 5-HTP works by increasing the body’s production of a chemical known as serotonin. 5-HTP is widely available as a dietary supplement and has been used to treat a number of conditions in which serotonin is thought to play a key role such as sleep disorders, depression, anxiety, migraine and tension headaches, fibromyalgia, binge eating, as well as a number of others.

Possible Risks and Drug Interactions

According to MedlinePlus, which is a service of the U.S. National Library of Medicine and the National Institutes of Health, consumers should not use 5-HTP until more is known about the substance. This warning has been put forth in light of the fact that some individuals who have taken the supplement have subsequently developed a condition called eosiniophilia-myaliga syndrome (EMS). EMS is extremely serious and is characterized by severe muscle tenderness and extremely high levels of eosinophils in the blood. Eosinophils are one of the five major types of white blood cells. Some experts think that EMS may be the result of accidental contamination of certain 5-HTP products on the market; however, there is a lack of scientific evidence to know for certain if that is the case or if 5-HTP itself can truly cause EMS.

In addition, 5-HTP has other potential side effects, including heartburn, stomach pain, vomiting, nausea, diarrhea, drowsiness, sexual problems, and muscular problems. 5-HTP may be unsafe during pregnancy and therefore should not be used by pregnant or nursing women. Furthermore, individuals with Down syndrome may be at an increased risk for seizures if they take 5-HTP.

5-HTP has been shown to have adverse interactions with a number of different medications that also affect serotonin levels. Certain antidepressant medications, such as Prozac, Paxil, Zoloft, Elavil, Anafranil, and Tofranil should not be taken while taking 5-HTP, as this may result in heart problems, shivering, and anxiety. Another group of antidepressant medications, known as monoamine-oxidase inhibitors (MAOIs) should also be avoided. The same side effects can also occur when taking the over-the-counter medication dextromethorphan (a key ingredient in Robitussin DM and other cough medicines) along with 5-HTP, or when taking the drugs Demerol and Talwin. Taking 5-HTP in conjunction with the drug Lodosyn can result in rapid speech, aggressiveness, and anxiety. Concurrent use of Ultram can result in confusion, shivering, and muscle stiffness. With regard to natural products, 5-HTP may increase both the side effects and potency of Hawaiian baby woodrose, L-tryptophan, SAMe, and St. John’s wort.

Research on 5-HTP and Fibromyalgia

Despite its controversial background, 5-HTP has been shown to improve many of the symptoms associated with fibromyalgia, including severity of pain, morning stiffness, and sleep disturbances. A 1990 study by Caruso et al. investigated the use of 5-HTP versus a placebo (“sugar pill”) to treat 50 fibromyalgia patients. Although this study found significant improvements among the patients studied, along with only mild and fleeting side effects, the authors called for additional research to better evaluate the utility of 5-HTP to treat patients with fibromyalgia. In 1992, several of the same researchers further evaluated 5-HTP in another 50 fibromyalgia patients during a 90 day study. The researchers evaluated the effects of 5-HTP on the patients’ tender point counts, anxiety, pain intensity, sleep quality, and fatigue. At the end of the study, all patients showed significant improvements in these measures, with nearly 50% reporting “good” or “fair” overall improvement throughout the course of treatment. Thirty percent of patients did report side effects, however only one patient withdrew from the study as a result. Based on their findings, the researchers concluded that 5-HTP is an effective treatment method for improving the symptoms of fibromyalgia and that effects can last for at least 90 days (Sarzi Puttini &Caruso, 1992). The most recent study to investigate the use of 5-HTP to treat fibromyalgia hails from 1996. In this study, researchers compared four separate drugs/drug combinations administered to fibromyalgia patients to determine their effects on pain intensity. The combinations studied were as follows: MAOIs with 5-HTP, 5-HTP alone, MAOIs alone, or the tricyclic antidepressant drug Amitriptyline. The researchers found that those patients treated with the combination of MAOIs and 5-HTP received the greatest benefits in pain improvement, whereas those treated with the other drugs or combination did not receive similar benefits. Some patients reported sleep disturbances and mild stomach aches, but no one withdrew from the study due to side effects.

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References

1.        Caruso I, Sarzi Puttini P, Cazzola M, Azzolini V. Double-blind study of 5-hydroxytryptophan versus placebo in the treatment of primary fibromyalgia syndrome. J Int Med Res. 1990;18:201-209.

2.        Nicolodi M, Sicuteri F. Fibromyalgia and migraine, two faces of the same mechanism. Serotonin as the common clue for pathogenesis and therapy. Adv Exp Med Biol. 1996;398:373-379.

3.        Sarzi Puttini P, Caruso I. Primary fibromyalgia syndrome and 5-hydroxy-L-tryptophan: a 90 day open study. J Int Med Res. 1992;20:182-189.

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