Using 5-HTP to Boost Serotonin Levels in Fibromyalgia and Chronic Fatigue Syndrome

Using 5-HTP to Boost Serotonin Levels in Fibromyalgia and Chronic Fatigue Syndrome

This is from one of Dr. Murphree's newsletters. Dr. Murphree has written several books on Fibromyalgia and runs a clinic in Alabama.

From his website: Dr. Rodger Murphree is the founder and past clinic director for a large integrated medical practice located in Birmingham, Alabama. The practice was staffed with board-certified medical doctors, chiropractors, acupuncturists, and nutritionists who combined traditional and alternative medicine. The clinic provided cutting-edge treatments for acute and chronic illnesses. He has specialized in difficult-to-treat patients for the last 10 years. He is a graduate of the University of Alabama Birmingham (UAB) and is a board certified chiropractic physician.

Dr. Murphree on Serotonin, 5-HTP and Fibromyalgia

Although I've found sleep to be the essential first step in successfully treating fibromyalgia, there are several hormonal, nutritional and biochemical deficiencies that must be corrected before a patient can truly beat fibromyalgia. Unfortunately, space doesn't permit me to address these potential deficiencies at this time.

I'll spend the rest of this newsletter exploring the relationship of serotonin, deep restorative sleep and fibromyalgia. I've consistently found that many of the most troubling symptoms associated with fibromyalgia, poor sleep, fatigue, chronic pain, IBS, mood disorders, and "brain fog," are diminished (sometimes dramatically) when serotonin levels are boosted and normal circadian rhythms restored.

The Importance of a Good Night's Sleep

Studies have shown that individuals who were prevented from going into deep sleep for a period of a week develop the same symptoms associated with FMS and CFS; diffuse pain, fatigue, depression, anxiety, irritability, stomach disturbances, and headaches. 34,35.

Sleep deprivation markedly increases inflammatory cytokines (pain causing chemicals)--by a whopping 40%. 36


Serotonin helps regulate sleep, digestion, pain, mood, and mental clarity.37

Serotonin helps:

1. Raise the pain threshold (have less pain), by blocking substance P.

2. You fall asleep and stay asleep through the night.

3. Regulate moods. "The happy hormone" reduces anxiety and reduces depression.

4. Reduce sugar cravings and over-eating.

5. Increase a person's mental abilities.

6. Regulate normal gut motility (transportation of food-stuff) and reverse irritable bowel syndrome (IBS).

Surveys have shown that as many as 73% of FMS patients have irritable bowel syndrome.

You have more serotonin receptors in your intestinal tract than you do in your brain.

Emotionally stressful situations cause the body to release adrenaline, cortisol and insulin. These stress hormones stimulate the brain to secrete serotonin. Long term stress and poor dietary habits can deplete the body's serotonin stores.38

Tryptophan, 5 Hydroxytryptophan (5HTP) and Serotonin

Tryptophan is one of eight essential amino acids. Tryptophan is absorbed from the gut into the bloodstream and then dispersed throughout the body. Ninety percent of tryptophan is used for protein synthesis, one percent is converted to serotonin, and the balance is used to make niacin. In the formation of serotonin, tryptophan is hydroxylated to 5-hydroxy-tryptophan (5-HTP) by tryptophan hydroxylase.

5-HTP is converted to serotonin by the decarboxylase enzyme, which is vitamin B6 dependent. Tryptophan is transported across the blood-brain barrier via a transport molecule, which also carries leucine, isoleucine, and valine, and prefers leucine.

However, 5-HTP easily crosses the blood-brain barrier and does not utilize this transport mechanism; thus, it does not compete for passage through the blood-brain barrier with these amino acids.39

And unlike tryptophan, which is made from bacterial fermentation (and hence subject to contamination), 5HTP is derived from the West African plant Grifonia simplicifolia.

In the body, 5-HTP is converted directly in to serotonin. It is not broken down by tryptophan pyrrolase, and does not have to compete for transport across the blood-brain barrier.

Individuals with fibromyalgia have low levels of tryptophan38, serotonin39, and
5-HTP.40 Studies show that fibromyalgia patients have higher levels of metabolites in the kynurenine pathway, which diverts tryptophan away from serotonin production.41

Selective Serotonin Reuptake Inhibitor (SSRI) Medications

Prescription antidepressants can be helpful. However, antidepressant drugs have potential side effects including anxiety, depression, fatigue, decreased sex drive, and disruption of normal circadian rhythms.42

SSRI's are supposed to help a patient hang onto and use their naturally occurring stores of the brain chemical serotonin. It's like using a gasoline additive to help increase the efficiency of your cars fuel.

Most of the patients I see with fibromyalgia are running on fumes and a gasoline additive won't help.

Please keep in mind that several studies show that between 19-70% of those taking antidepressant medications do just as well by taking a placebo or sugar pill.43

I recommend my patients boost their serotonin levels by taking 5HTP.

5HTP and Depression

Studies (including double-blind) comparing SSRI and tricyclic antidepressants to 5HTP have consistently shown that 5HTP is as good if not better than prescription medications in treating mood disorders. Furthermore, 5HTP doesn't have some of the more troubling side effects associated with prescription medications.

5HTP and Sleep

5HTP has been shown to be beneficial in treating insomnia, especially in improving sleep quality by increasing REM sleep and increases the body's production of melatonin by 200%. 46,47

5HTP and Fibromyalgia
  • Double-blind placebo-controlled trials have shown that patients with FMS were able to see the following benefits from taking 5HTP: 48.
  • decreased pain.
  • improved sleep.
  • less tender points.
  • less morning stiffness.
  • less anxiety.
  • improved moods in general, including in those with clinical depression.
  • increased energy

Irritable Bowel Syndrome, 5HTP and Serotonin

There are more serotonin receptors in the intestinal tract than there are in the brain. This is one reason people get butterflies in their stomach when they get nervous.50

The brain and gut are connected through the neuroreceptors 5-hydroxytriptamine-3 (5-HT3) and 5-hydroxytriptamine-4 (5-HT4). These serotonin receptors regulate the perception of visceral pain and the gastrointestinal (GI) motility. Serotonin controls how fast or how slow food moves through the intestinal tract.51, 52

It's common for the symptoms associated with IBS, diarrhea and constipation, to disappear within 1-2 weeks once serotonin levels are normalized with 5HTP replacement therapy.

My 5HTP and Sleep Restoration Protocol

I instruct my patients to take 50mg of 5HTP 30 minutes before bed on an empty stomach (90 minutes after or 30 minutes before eating), with 4 ounces of grape juice. I know 5HTP doesn't have to compete with other amino acids to cross the blood brain barrier, but this routine seems to heighten the effect of 5HTP.

One of three things will happen when taking 5HTP.

Starting with 50 mg. of 5HTP-
1. The patient falls asleep within 30 minutes and sleeps through the night. If so, they stay on this dose until their next scheduled visit with me (typically 2 weeks).

2. Nothing happens. This is typical response to such a low dose. The patient should add an additional

50 mg. each night (up to a max of 300 mg.) until they fall asleep within 30 minutes and sleep through the night.

3. Instead of making the patient sleepy, the first dose makes them more alert. This occurs more often in CFS and chemical sensitivity patients who have a sluggish liver. If this happens, they're to discontinue taking 5HTP at bedtime and instead take 50 mg. with food for 1-2 days. Taking 5HTP with food seems to help slow down it's absorption, allowing the liver to process it more effectively. Taking 5HTP with food will not (usually) make you sleepy. After 1-2 days on 5HTP with no further problems, they should increase to 100 mg. of 5HTP with each meal (300mg a day).
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