Tag Archives: depression

NAC for Trichotillomania

Research shows that nutritional supplements may help mental health including trichotillomania. Lately I have focused on inositol and NAC as I have heard about these supplements in many trichotillomania communities with varied success.

I started taking NAC (N-acetylcysteine) about two years ago and have noticed a decrease in my urge to pull when I take it 5-6 days per week. I take2-600mg capsules in the morning and 2-600mg capsules in the evening, giving me a total of 2400mg of NAC. Doses between 1200-3600mg may be helpful according to this article,  N-Acetylcysteine, a Glutamate Modulator, in the Treatment of Trichotillomania

I recently added inositol to increase the benefits of NAC.  It is generally agreed that a large dose is needed for inositol to be effective with trich. I worked my way up to 18g per day. I do this by mixing 3 teaspoons or 1 tablespoon of inositol in water 3 times a day. I have found the Jarrow brand powder dissolves best. It is available on amazon for a reasonable price. I mix it with warm water as it dissolves better that way. You can add it to fruit juice or other sweetened drinks.  I simply mix the powder with ~3 oz. of warm water and drink it plain as it has a mild sweet taste that I actually like.

 

NAC and Trichotillomania

By Fred Penzel, Ph.D.

**Please note the following: This advice is purely informational, and not in any way meant to be a substitute for treatment by a licensed physician. Do not try this, or anything else, without first consulting your physician. If your M.D. has not heard about it, refer them to the following article and let them decide:

Jon E. Grant, JD, MD, MPH; Brian L. Odlaug, BA; Suck Won Kim, MD, N-Acetylcysteine, a Glutamate Modulator, in the Treatment of Trichotillomania: A Double-blind, Placebo-Controlled Study. Arch Gen Psychiatry/ VOL 66 (NO. 7), JULY 2009.

 

Over the years, it has become apparent that prescription medications, as remedies for trichotillomania (TTM), have proved to be somewhat of a disappointment. These meds have been employed since the early 1990’s, and although they may be seen to work occasionally for some individuals, research indicates that their overall effectiveness is not great for the majority of sufferers. When they do appear to work, it is most likely that they are actually helping with coexisting problems such as depression and anxiety that are impacting the pulling, but not directly causing it. The discovery of a new compound with a greater level of direct effectiveness would be considered a blessing to sufferers. If this compound were also an over-the-counter remedy, it would be even better.

This very thing was confirmed in 2009 with the publication of an article by Grant, Odlaug, and Kim in The Archives of General Psychiatry, titled “N-acetylcysteine, A Glutamate Modulator, In the Treatment of Trichotillomania.”This study, which lasted 12 weeks, investigated the use of the amino acid N-acetylcysteine (NAC) in 50 patients with TTM, and found that 56% of them were rated as improved or very much improved. A much smaller previous pilot study had also found positive results.

So what is this compound? NAC is a both a pharmaceutical drug and a nutritional supplement used primarily to treat Cystic Fibrosis, and also to treat individuals suffering from acetaminophen overdoses. In the former case, it thins mucus, making it easier for patients to cough it up, and in the latter case, has liver detoxifying effects. It has also been said to aid in the treatment of cocaine addiction. Some practitioners out there are also exploring the use of NAC in the treatment of OCD, although whether it is effective or not, is still unproven.

What exactly is NAC? NAC is a natural sulfur-containing amino acid that is a breakdown product of the amino acid L-cysteine, and is in turn broken down by the body and converted to a powerful antioxidant known as glutathione.Antioxidants can repair oxidative stress in the body. Oxidative stress occurs when cell metabolism produces an increased level of oxidants known as free radicals that tip the balance between themselves and antioxidants in the body.These free radicals can cause the breakdown of cells, damaging proteins, genes, and cell membranes. Substances known as antioxidants act by neutralizing free radicals, and some are produced naturally by the body. Some have theorized that hair-pulling may be the result of the effects of oxidative stress within the brain, and that NAC can help reverse this.

NAC is also what is known as a chelating agent. That is, it hastens the excretion of heavy metals such as lead, mercury and arsenic from the body by binding to them. While this is of course, a positive benefit of taking it, it also causes the body to excrete copper, zinc and other essential minerals when used over time. Some research says this effect may be minimal, but others have suggested that it is necessary to take supplements containing copper, zinc, and other vital minerals when using NAC. Until this is settled, it is advisable to take a daily multivitamin plus minerals along with the NAC. It is often recommended to take extra vitamin C, itself an antioxidant, along with NAC, as it can also assist in raising glutathione levels. The amount of vitamin C one should take has been said to be in the range of 500 mg. per day.

As far as taking NAC itself for a BFRB, we have been using the following approach:

1. Start by taking one, 600 mg. capsule of NAC daily for the first two weeks along with a daily multivitamin plus minerals, in addition to 500 mg. of vitamin C. You will most likely not see any changes on this dosage.

2. If the NAC appears to be well tolerated, increase it to 1, 600 mg. capsule, 2x per day. Again, wait two to three weeks to see if there is any reduction in pulling activity.

3. If there are no changes, or only minimal changes in pulling, increase to 1 capsule, 3x per day, and again wait two to three weeks to see if there is any noticeable result.

4. If there is only little or no change, you can then increase to 4, 600 mg. capsules per day, and wait another two to three weeks. Take 2 capsules for one of the three daily doses, to make a daily total of four.

5. If there is still little or no change, you can increase up to what is the maximum of 5, 600 mg. capsules per day. A total of 3,000 mg. is the maximum you should take as a daily dose. Take 2 capsules for two of the three daily doses, to make a daily total of five.

6. If after 4 weeks at the maximum dosage there is still no result, then it is likely that it is not working, and can then be discontinued.

As with all medications and supplements, there are no sure things. It is ultimately all trial-and-error. We hope that NAC will help, but just keep in mind that it will not necessarily work for everyone. Remember that it was shown to be effective for about 56 percent of the subjects in the original research study.

NOTE: There are some very important precautions that should be observed when taking NAC.

1. It should be noted that there are some individuals who suffer from cystinuria, a genetic disorder that causes cysteine to build up in their urine. If levels of cysteine molecules become high enough, they clump together to form kidney stones. It is therefore recommended that those with this problem not take NAC.

 

2. In addition, NAC supplementation might increase the side effects associated with nitroglycerin and isosorbide, two medications commonly used to treat angina.

 

3. Using NAC at the same time as the hypertension drugs ACE-inhibitors might cause blood pressure to drop too low. It might also excessively strengthen the actions of immunosuppressant drugs.

 

How N-Acetylcysteine (N-A-C) Cured My Depression and Anxiety

The maternal side of my family contains a history of severe mental illness. My maternal grandmother suffered from schizophrenia and died in a mental ward. My mother has been institutionalized repeatedly, suffering from a decades long battle with bipolar disorder.

My younger brother is a legitimate sociopath. He is not merely “dark triad.” He has actual antisocial personality disorder. He has no feelings of empathy or kindness or decency. Lacking the vision to rob banks or become a drug kingpin, he is currently free after spending 10 years in prison for shooting his one-armed drug dealer.

In other words, there’s some funny business in my DNA.

I used to get depressed and feel anxious. I never had full-on panic attacks, but I would have severe anxiety that would leave my brain spinning. My skin would break out in rashes.

I conquered this anxiety through two means, as anxiety and other mental illnesses have two components – physical and psychological.

The psychological components of anxiety come from society and the brain washing. That is where state controlreframing techniques, and other Mindset Training comes into play.

The physical components of anxiety and depression come from a variety of sources – poor nutrition, lack of sunlight, excessive oxidative stress, high cortisol, and heavy metal poisoning.

glutathione

N-Acetylcysteine (N-A-C) has been clinically proven to help treat symptoms of anxiety and depression.

N-Acetylcysteine is a powerful nootropic with still many unstudied benefits. N-A-C has been used by visionary doctors to help treat intractable depression and anxiety.

Why haven’t you heard about the magical effects of N-A-C? Simple. Go on Amazon and see how much a bottle of N-A-C costs.

My mom was on a $1,500 a month cocktail of drugs. No one would listen when I suggested they buy a $15 bottle of N-A-C. But the science is there.

See, N-acetyl cysteine for depressive symptoms in bipolar disorder–a double-blind randomized placebo-controlled trial(“NAC appears a safe and effective augmentation strategy for depressive symptoms in bipolar disorder.”) (PubMed.)

See also, N-acetyl cysteine as a glutathione precursor for schizophrenia–a double-blind, randomized, placebo-controlled trial. (“These data suggest that adjunctive NAC has potential as a safe and moderately effective augmentation strategy for chronic schizophrenia.”) (PubMed.)

N-A-C depression anxiety

Why does N-A-C help treat depression?

Acetylcysteine is a glutathione precursor. That is, acetylcysteine is converted into glutathione.

Glutathione is an antioxidant that used by your liver to detox your body. Emergency rooms give high doses of NAC to patients that have overdosed with Tylenol.

Resources:

  • The Wahls Protocol: How I Beat Progressive MS Using Paleo Principles and Functional Medicine (Amazon).
  • Smash Chronic Fatigue: A Concise, Science-Based Guide to Help Your Body Heal, and Banish Fatigue Forever (Amazon).

Could mental illness be caused by toxins that your liver is unable to clear from your body, due to a glutathione deficiency?

That is not so far fetched, and in fact the cutting-edge of mental health research is on the role toxins and oxidative stress play in mental illness.

See, The efficacy of adjunctive N-acetylcysteine in major depressive disorder: a double-blind, randomized, placebo-controlled trial (“These data implicate the pathways influenced by NAC in depression pathogenesis, principally oxidative and inflammatory stress and glutamate, although definitive confirmation remains necessary.”) (PubMed.)

See also, The Glutathione System: A New Drug Target in Neuroimmune Disorders (“Glutathione depletion and concomitant increase in oxidative and neurological stress and mitochondrial dysfunctions play a role in the pathophysiology of diverse neuroimmune disorders, including depression, myalgic encephalomyelitis/chronic fatigue syndrome and Parkinson’s disease, suggesting that depleted GSH is an integral part of these diseases.” (PudMed.)

Do you know what else boosts glutathione?

Carrot orange pomegranate juice

How much N-A-C should you take?

That would be medical advice, which I don’t give. However, participants in the studies usually used between 1 and 2 grams daily.

Why take N-A-C instead of glutathione?

If N-A-C is a precursor, wouldn’t it make more sense to take glutathione directly? That seems intuitively correct. There is some evidence to suggest that N-A-C is more bioavailable than glutathione.

I personally use N-A-C because that was the compound studied. How much glutathione would one need to take to get the same benefits that one can obtain from 1 to 2 grams of N-A-C? As I don’t know, I went with N-A-C.

You are of course free to try both for yourself to see what works best.

What brand of N-A-C is best?

As the supplement industry is unregulated, I generally prefer to use use two brands of supplements – Life Extension Foundation and Jarrow.

I personally use Jarrow’s form of N-A-C Sustain, which is time released. (Amazon).

For more information on oxidative stress, nutrition, and various maladies, watch this video.

Minding Your Mitochondria

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High Doses of EPA for Depression, Anxiety, and Bipolar Disorder

I have been researching the use of omega 3’s in the treatment of depression, anxiety, and bipolar disorder.  The current studies agree that high doses of EPA work well to treat mood disorders.  DHA is another omega 3 and works better for cognition and fetal/infant development.  Studies show that supplementing with only EPA or higher doses of EPA than DHA work best for mood disorder.

I just had a baby and have been taking 1 gram of DHA throughout my pregnancy. I will continue this dose until I am done breatfeeding.  I have also been taking 500 mg of EPA.   Now I am increasing my EPA dose to 2 grams.  I am hoping this will help with postpartum depression, which I had badly with my 3 previous children. I will keep you posted as to my progress with this increase.  Here is some helpful information about EPA for depression, suggested doses, and relevant studies.

High Doses of Omega 3 EPA and Depresion

Omega 3 Fatty Acids

Omega 3 and Depression

I started taking omega 3’s (specifically DHA and EPA) when pregnant with my first daughter. I remember thinking how good my mood was as I was not taking any of my prescription medications for anxiety and depression. I stopped the supplement shortly after having my daughter and did not begin taking it again until I was pregnant with my second daughter. Again, I was surprised by my stable mood. I continued taking the supplement after some research showing the many benefits of omega-3 fatty acids.

I found a more potent form of DHA and EPA in a coated capsule from NOW vitamins. It did not give off the fishy aftertaste of fish oil and was more potent than flaxseed oil. One tablet contains 500mg of DHA and 250 of EPA. I take 2 a day. Studies suggest benefits from even higher doses.  I have found a lot of research supporting the claim that omega 3’s are very helpful in treating depression.  The following article does a nice job of summing up these benefits.

Omega-3 fatty acids banish depression: Research

Increasing your intake of omega-3 fatty acids may be one of the safest, easiest ways to battle depression, research suggests.

Omega-3 fatty acids can be found in fish and canola oil, flax seeds, chia seeds, kiwifruit and purslane.

Interest in a relationship between omega-3s and depression began with a number of correlational studies. Many epidemiological studies have found that populations with higher fish consumption report lower rates of depression, postpartum depression, bipolar disorder and seasonal affective disorder than nations with lower fish consumption. Similar effects have been seen within nations, with lower rates of depression and suicidal thoughts among people who eat more fish. A study in New Zealand found that people who ate more fish rated their mental health status more highly than people who ate less fish.

Studies have also shown that people with low levels of omega-3s in their bodies are significantly more likely to suffer from depression and other psychological disorders.

Clinical research confirms the link

A number of clinical trials have supported the effectiveness omega-3 supplementation as a way to alleviate depression symptoms, particularly in patients who have not responded to treatment with antidepressant drugs.

One such study was conducted by researchers from the University of Pavia, Italy, and published in the Journal of Nutrition Health and Aging in 2011. In a double-blind experiment, researchers randomly assigned 46 depressed women between the ages of 66 and 95 to take a supplement consisting of either omega-3 long-chain polyunsaturated fatty acids or a placebo. The omega-3 supplement consisted of 1.67 g per day of eicosapentaenoic acid (EPA) and 0.83 g per day of docosahexaenoic acid (DHA).

After two months, women who had been taking omega-3s showed significant improvements on measures of depression and mental and physical health status; no such improvement was seen in the placebo group.

“The supplementation of omega-3 LCPUFA in elderly female patients reduces the occurrence of depressive symptoms, improves phospholipids fatty acids profile and health-related quality of life,” the researchers wrote.

Effective across a broad spectrum

One of the most comprehensive investigations of omega-3s’ effects on depression was published in the Journal of Clinical Psychiatry in 2010. More than 400 men and women participated in the randomized, double-blind study, and were assigned to take three capsules a day of either a placebo or a fish oil supplement with high concentrations of EPA. Unlike many clinical trials of antidepressant drugs, the study included large numbers of patients with hard-to-treat conditions, including people suffering from both depression and anxiety and people whose depression had not responded to drugs. This was meant to gain a sense of how omega-3s would function in a more real-world setting.

The researchers found that after eight weeks, depression symptoms had significantly decreased among those who took the omega-3 supplement, but only among patients who also suffered from anxiety. The improvement was comparable to the improvement seen in studies performed on the effectiveness of antidepressants among an easier-to-treat population.

Sources for this article include:

http://www.vitasearch.com/get-clp-summary/39553

http://www.sciencedaily.com/releases/2010/06/100621111238.htm

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC533861/

Omega 3 Benefits

Omega 3 Benefits (from omega-3.us)

1. Freedom from pain and inflammation. The National Institute of Health’s website, Medline Plus says, “Omega-3 fatty acids reduce pain and swelling.” How? Omega 3 fish oil fatty acids, particularly EPA, are involved in your body’s inflammatory response and inflammation cycle. Relieving the inflammation (swelling) will help reduce the pain.

2. Better brain function and higher intelligence. Pregnant and nursing mothers who include omega 3 fatty acids in their diets, may have a positive impact on their babies intelligence. For adults, fish oil is also being researched in association with improved memory, recall, reasoning and focus.

3. Feeling better with much less depression. Making you smarter is not all that fish oil may do for your brain. Psychiatry department researchers at the University of Sheffield UK, along with other research studies, have seen the possibility that the omega 3 fatty acids in fish oil supplements “alleviated” the symptoms of depression, bipolar and psychosis. [Journal of Affective Disorder Vol. 48(2-3);149-55]  **for more info see: Omega 3 and Depression**

4. Lower incidence of childhood disorders. Just to show how omega 3 fatty acids leave nobody out, studies suggest that children (and adults) with ADD and ADHD may experience a greatly improved quality of life. From Medline Plus, “Taking fish oil seems to improve thinking skills and behavior in 8 to 12 year-old children with ADHD.”

5. Superior cardiovascular health. Research has suggested that the DHA, EPA and DPA in fish oil may have a positive effect on heart disease. According to Medline Plus, “Fish oil may be effective in keeping people with healthy hearts free of heart disease. People who already have heart disease may be able to lower their risk of dying from heart disease by taking fish oil. Though not all researchers agree, some investigators believe that fish oil may be even more effective in reducing death from heart attacks than a group of commonly used cholesterol-lowering drugs called “statins.”

6. Protection from heart attack and stroke. When plaque builds up on arterial walls and then breaks loose, it causes what’s known as a thrombosis, which is a fancy way of saying clot. If a clot gets stuck in the brain, it causes a stroke and when it plugs an artery, it causes a heart attack. From Medline Plus: “Moderate fish consumption (once or twice a week) seems to lower the risk of having a stroke by as much as 27%.”

DHA/EPA and the Omega-3 Recommended Intakes

Life Stages

Age

Males (g/day)

Females (g/day)

Infants 0-6 mos

0.5

0.5

Infants 7-12 mos

0.5

0.5

Children 1-3 yrs

0.7

0.7

Children 4-8 yrs

0.9

0.9

Children 9-13 yrs

1.2

1.2

Children 14-18 yrs

1.6

1.1

Adults 19 yrs and older

1.6

1.1

Pregnancy All ages

1.4

Breastfeeding All ages

1.3

Magnesium Benefits

Magnesium and Depression: The Best Natural Depression Treatment

Did you know that depression, anxiety, forgetfulness, and fatigue are all symptoms of a magnesium deficiency?  Magnesium is one of the four major ions in the human body.  Magnesium along with sodium, potassium and calcium work to regulate hundreds of bodily functions.  Magnesium alone is a key element in more than 300 biochemical reactions that take place in our body.  Magnesium is extremely important.  Lack of the mineral is believed to be a contributing factor in neurotransmitter malfunction that leads to depression and bipolar disorder.

As far back as the 1920s magnesium has been used to successfully (a 90% success rate) treat depression.  As an added bonus for us women, a double blind study in 1991 suggest that magnesium may be one of the major factors associated with PMS symptoms.  95% of women taking a magnesium supplement reported less breast pain and less weight gain.  Not to mention magnesium is proven to fight cramps.  While it is extremely argumentative, less PMS may mean fewer feelings of depression…right?

How Does Magnesium Treat Depression?

One of the many chemical reactions in your body is the release of serotonin.  Serotonin acts as a neurotransmitter by relaying messages from one area of the brain to another.  Of the approximately 40 million brain cells, most are influenced by serotonin either directly or indirectly.  This includes brain cells related to mood, depression, sexual desire and function, sleep, memory, appetite and some social behavior.

Serotonin is dependent on magnesium.  The biochemical reactions necessary for serotonin, which is the brains natural feel good drug, cannot function properly if you are suffering from low magnesium.  To control depression, you must regulate magnesium.

How Can I Increase My Magnesium Levels?

There are three ways you can increase your daily magnesium intake.  The first is by changing what you eat.  You must structure your diet to include as many magnesium rich foods as possible.

The second is by taking a daily magnesium supplement.  Doctors often recommend a daily supplement because most patients are not successful in obtaining the 400 mg of magnesium needed every day through diet alone.

BAD formulas of magnesium include:
Glutamate
Asparate
Oxide
Carbonate
Hydroxide
Stearate

GOOD formulas:
Magnesium Taurate (Taurinate)
Citrate (can be laxatative, so take with food)
Glycinate

The third way is to soak in an Epsom salt bath.  Use two cups of Epsom salts in a traditional size bath tub and soak for a least 12 minutes 2-3 times per week.

As always you should consult your doctor before beginning any vitamin supplement program.  Once cleared, I encourage you to research the pros and cons of various magnesium supplements on the market before moving forward.  There are hundreds of magnesium supplements available and the key to successfully controlling depression is choosing the supplement that is right for you.

Typical blood work usually won’t pick up the deficiency:

This following is from an article by an RN:
“If you ever get a serum Mg level drawn and it comes back normal, your physician will happily assure your problems are NOT magnesium deficiency symptoms and that is the end of the investigation into your magnesium status. But magnesium is not IN your blood, it is inside your CELLS! In fact – only 1% of your body’s magnesium is in your bloodstream, making serum magnesium levels near worthless tests that detect only the most severe and dangerous magnesium deficiencies.”
http://ezinearticles.com/?Hospital-Magnesium-Testing-Catches-Only-a-Fraction-of-Magnesium-Deficiencies&id=3020787

For more information on magnesium check out these links:

George Eby’s research on Magnesium deficiency:
“Depression Treatment: A Cure for Depression using Magnesium?”

Test results showing that 89.7% of people with depression tested were found to be Magnesium deficient:
http://www.oasisadvancedwellness.com/learning/magnesium-deficiency-depression.html

Magnesium Deficiency can cause:
http://drcarolyndean.com/magnesium_miracle/

Magnesium and depression: a systematic review

5-HTP vs Tryptophan

5-HTP vs Tryptophan

Both tryptophan and 5 HTP are amino acids and precursors of serotonin. They are also both available as over-the-counter dietary supplements for treating depression, obesity, sleep disorders etc. Find out which of the 2 is the better supplement for increasing serotonin levels in the brain.

What is Tryptophan?

Tryptophan is one of the essential amino acids commonly found in human diet. It is available in 2 forms: D- and L- isomers.

The L- isomer is more common and it is the form of tryptophan found in proteins in the body.

Tryptophan is found in most dietary proteins but it is especially abundantly found in meat, poultry, milk, yogurt, egg, fish, banana and peanut.

While some believe that turkey is the richest source of tryptophan and plants are poor in the amino acid, both beliefs are untrue: turkey contains no more tryptophan than other poultry and meat, and excellent plant sources of tryptophan are abundant.

Even though there are several dietary sources of L-tryptophan, different studies have found that these food sources cannot dramatically increase the blood levels of the amino acid. Therefore, tryptophan is widely sold as a dietary supplement and even drug.

As a drug/supplement, L-tryptophan is used because it is a precursor of serotonin, an important neurotransmitter in the brain. L-tryptophan is first converted to 5-hydroxytryptophan or 5 HTP (another dietary supplement) which is then converted to serotonin or 5 HT in the brain.

However, these biochemical reactions happen in the brain, therefore, tryptophan has to cross the blood-brain barrier.

L-tryptophan only represent about 1% of the amino acids available in dietary proteins. Since the other amino acids also want to get into the brain, there is a competition for the transport mechanisms that carry them across this blood-brain barrier.

For example, L-tryptophan shares the same transport mechanism with valine, leucine and isoleucine.

Therefore, the extent of absorption of this amino acid is much reduced especially from protein-rich foods. To improve the uptake of tryptophan into the brain, carbohydrates are required.

After the ingestion of carbohydrates, the body releases insulin in response. Fortunately, insulin drives valine, leucine and isoleucine (but not tryptophan) into the cells of the body. Therefore, the proportion of tryptophan among the amino acids left in the blood is increased and this increases the chances of tryptophan crossing into the brain.

The use of tryptophan as a dietary supplement was banned for most of the 1990s. This is because of cases of eosinophilia-myalgia syndrome (EMS) associated with the amino acid.

This syndrome was blamed on bacterial contaminants left in the final product by one major supplier of the amino acid. This was never conclusively proven and some other experts believe that the large doses of tryptophan taken are responsible (tryptophan metabolites block the breakdown of histamine and the symptoms of EMS resembles the effect of prolonged action of histamine).

However, tryptophan is now commonly sold as dietary supplement and drug. It is obtained from high-quality sources and regarded as safe.

What is 5 HTP?

5 HTP is a naturally occurring amino acid produced from L-tryptophan. There are no dietary sources of 5 HTP although the 5 HTP used in supplements is obtained from the seeds of Griffonia simplicifolia, a plant native to Africa.

5 HTP is a direct precursor of serotonin and an intermediate in the synthesis of melatonin, a neurohormone.

The conversion of 5 HTP to serotonin is catalyzed by 5 HTP decarboxylase, an enzyme whose cofactor is vitamin B6. All the effects of 5 HTP are solely due to its ability to increase serotonin levels in the brain.

However, 5 HTP is also converted to serotonin in the liver. In fact, more serotonin is produced outside the brain than inside. But since serotonin cannot cross the blood-brain barrier, only the amount of 5 HTP crossing into the brain can increase the level of serotonin in the central nervous system and also the psychoactive effect of the neurotransmitter.

The serotonin produced outside the brain is released from the enterochromaffin cells found in the gastrointestinal tract. In the gut, serotonin promotes intestinal motility.

The excess serotonin released from these cells are removed by the veins draining the gut. While in the blood, serotonin is carried through the circulatory system and stored in platelets. Therefore, the serotonin produced from 5 HTP can reach the cardiovascular and musculoskeletal systems.

5 HTP is commonly sold as a dietary supplement and marketed as a sleeping aid, antidepressant and appetite suppressant. It is usually prepared in 50 mg and 100 mg capsules.

Besides the uses listed above, 5 HTP is also taken to treat fibromyalgia and anxiety disorders.

Although 5 HTP supplementation has not been extensively studied in large clinical trials but in the 60 years that it has been used, there are only very few reports of serious side effects.

Moderate doses of 5 HTP is safe and well tolerated but it may cause vomiting and diarrhea. These gastrointestinal side effects are due to the increased production of serotonin outside the body. When released from the enterochromaffin cells, the increased serotonin levels increase gastrointestinal movement.

5 HTP supplements were also believed to cause EMS due to contamination during production. However, such cases have not been reported since FDA’s GMP (Good Manufacturing Practice) regulations came into place.

The Differences Between 5 HTP and Tryptophan

Although tryptophan and 5 HTP are both amino acids and used as dietary supplements for the same indications, they do differ. The major differences between these 2 precursors of serotonin are discussed in the table below.

5 HTP vs Tryptophan

Precursor: 5 HTP is the direct precursor of serotonin and an intermediate in the synthesis of melatonin while tryptophan is the direct precursor of 5 HTP. In addition, tryptophan is also used in the syntheses of other biochemicals including niacin, proteins and enzymes.

Source: The L-tryptophan used in dietary supplements is obtained from the bacterial fermentation of serine and indole. 5 HTP is extracted from the seeds of Griffonia simplicifolia, a wild plant native to Ghana and Ivory Coast.

Uses: Both 5 HTP and tryptophan are used to treat diseases arising from serotonin deficiency including depression, anxiety disorders, sleep disorders and obesity. However, L-tryptophan is also used to treat tryptophan deficiency since it is the one among other essential amino acids that is most commonly deficient in diet.

Administration: Because nausea is a common symptom of 5 HTP supplementation, it should be taken with food. Tryptophan, on the other hand, can be taken with or without food. However, since tryptophan competes with other aromatic and branched chain amino acids such as itself, it is best to take the supplement with low or no protein diet but with carbohydrates to help reduce the competition.

5 HTP is a better supplement than L-tryptophan for increasing serotonin levels in the central nervous system because of the following reasons.

Why 5 HTP is better than L-tryptophan5
  • It does not compete with other amino acids to cross the blood-brain barrier
  • The conversion of tryptophan to 5 HTP is the rate-limiting step in the synthesis of serotonin; this means that this conversion is the weakest link in the production of serotonin. Therefore, 5 HTP supplementation represents a bypass of this step in the synthesis of the neurotransmitter
  • Tryptophan is an amino acid that is also utilized in the production of other biochemicals while 5 HTP is solely committed to the synthesis of serotonin
  • Tryptophan is more likely to be converted to serotonin in the liver than 5 HTP. This happens because 5 HTP faces no competition to cross into the brain, therefore, it is easily taken up. Tryptophan, on the hand, is easily converted to serotonin in the liver while it waits to cross the blood-brain barrier
  • 5 HTP is obtained from plant sources while L-tryptophan is produced from bacterial fermentation; therefore, there is a lower chance of contamination in 5 HTP supplements (and thus, lower risk of EMS) than tryptophan supplement

“L-tryptophan works better with people who suffer from insomnia and depression. “Julia Ross author of The Mood Cure

Combining 5 HTP and Tryptophan

Because 5 HTP and tryptophan increase the level of serotonin in the body, some people may be tempted to use both supplements at the same time. This practice should be discouraged especially since it can dramatically increase the side effects of both drugs and cause serotonin toxicity.

Mild gastrointestinal side effects such as nausea, vomiting and diarrhea are immediately triggered.

Taking 5 HTP and tryptophan concurrently will increase the synthesis of serotonin in the liver and in the central nervous system. This may cause serotonin syndrome in the nervous system and cardiac fibrosis in the cardiovascular system

Of the two, serotonin syndrome appears first. It is characterized by the mild and serious symptoms. Mild symptoms include shivering, sweating, tremor, restless limbs and headache while serious symptoms include hypertension, hyperthermia, mania, hallucination and ataxia.

These symptoms will subside 24 hours after stopping both supplements but the more serious symptoms may need urgent medical attention.

Cardiac fibrosis is caused by high doses and prolonged use of drug combinations that increase serotonin levels.

In the circulatory and cardiovascular systems, serotonin acts as a vasoconstrictor and healing factor. It repairs damaged tissue by promoting the production of fibrins to cover the site of damage.

However, the kind of connective tissue caused by serotonin action is thicker and less flexible than normal connective tissue. This causes cardiac fibrosis and heart failure from thickened right heart valve.

Although these serious side effects of 5 HTP and tryptophan combination are rarely in medical literature that is mainly due to lack of large-scale and thorough clinical studies on the use of this dietary supplements.

Therefore, the potential for these side effects should be considered when 5 HTP is combined with tryptophan.

My Battle

In the 20 years I have battled trich, I have tried so many strategies, treatments, and therapies. Nothing has worked as I am still here pulling out my hair. I think I had sort of given up hope of ever truly being free from this. I had come to a level of acceptance. Now after years of passivity, my will is renewed. I have promised myself to fight the urges with all that I have and use every resource I can get my hands on. I have a tool box filled with ever strategy that has ever helped, knowledge of new treatments I plan to try, a positive outlook, and this blog. I am going to try to write about my battle, to share my story with anyone who wants to listen. I’m going to be honest. I’m going to force myself to address the reality of this situation for probably the first time. Maybe this time I can beat it.

I remember exactly where I was the first time I started pulling out my hair. I was 6 years old and in first grade. I woke up in the morning with my long eyelashes stuck together so I began to pick at the goo. As I cleaned my lashes, I accidentally pulled one out. The sensation was surprisingly pleasant. This became a morning ritual, I would wake up and clean my eyes, allowing myself to pull out just a few lashes that were stuck together.  Before long, I found myself sitting in class pulling on my lashes without knowing when I had started. I hoped no one had noticed and vowed to stop this habit. Well that was 20 years ago, and I am still here pulling. These days I pull out my eyelashes, my eyebrows, and hair from my head. I’ve become an expert in makeup, as I started using eyeliner in third grade. I’ve mastered the art of not letting anyone get to close to me because I’m so ashamed of what I do and am embarrassed by what they will see.

I commit to an honest expression of my battle with trich. If I can help even one person in doing so, then this page is worth it. We must accept that trich does not define us and we can choose how much control it has over our lives. Yes it may affect our hair and appearance, but we can still lead full happy lives. For years I thought trich ruled my life, but I have come to see there is more. Anyone who truly cares about you will look past it and see you. They will love you and support your battle. If you are not ready to tell anyone else, let me be your partner because we are in this together.

Undermethylation & Trich – what it means for you

Trichotillomania sufferers are believed to be undermethylated.

Undermethylated people tend to be depleted in these 3 neurotransmitters- serotonin, dopamine, and norepinephrine, which all greatly affects one’s mental health.

Most people with depression, oppositional defiant disorder, OCD, bipolar disorder, trichotillomania, or schizophrenia exhibit a genetic abnormality in methylation….. which appears to be central to their illness.

Trichotillomania treatment includes(1) aggressive doses of l-methionine, calcium, magnesium, along with augmenting nutrients zinc, B-6, Inositol, Vitamin A & C and (2) strict avoidance of folic acid, choline, DMAE, and copper supplements.

Aggressive methylation therapy can be very successful, but usually involves a very slow response. Typically, treatment requires about 2 months before the patient before any progress is evident and 6-12 months are required for all of the benefits to be attained.

One way to speed up the process of recovery is to use SAMe supplements in the beginning. Undermethylated patients usually report nice progress after the first week or two. SAMe is quite expensive, and can be gradually replaced by methionine after a couple of months.

Adults typically require 2,000 – 3,000 mg/day of methionine for several months to see good results. Also, augmenting nutrients such as calcium, magnesium, B-6, and zinc are essential.

Undermethylation

Most undermethylated persons in the general population tend to be high-achievers and have good mental health.  These people tend to be our doctors, lawyers, corporate executives, professional athletes and scientists who strive for high career accomplishment.  Undermethylation is also more prevalent in college populations and in affluent neighborhoods.

Many individuals diagnosed with mental illnesses have severe undermethylation which is associated with low serotonin activity.  They have a genetic tendency to be very depressed in calcium, magnesium, methionine, and Vitamin B-6 and may have excessive levels of folic acid in nuclei of brain cells.  Undermethylated persons benefit from biomedical therapy to directly correct the underlying problem using methionine, calcium, magnesium, amongst others.

Decide for yourself if you fit into this chemical biotype.  Here is a list of factors associated with undermethylation – 

•  obsessive/compulsive tendencies

•  history of perfectionism

•  seasonal inhalant allergies

•  low tolerance for pain

•  prior diagnosis of OCD or ODD

•  ritualistic behaviors

•  very strong willed

•  slenderness

•  history of competitiveness in sports

•  calm demeanor, but high inner tension

•  frequent headaches

•  family history of high accomplishment

•  delusions (thought disorder)

•  self-motivated during school years

•  poor concentration endurance

•  social isolation

•  addictiveness

•  phobias

•  good response to antihistamines

•  high fluidity (tears, saliva, etc.)

•  good response to SSRI’s

•  very high libido

•  diagnosis of delusional disorder

http://www.mensahmedical.com/resourcecenter/undermethylation.html