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Serotonin syndrome

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The Serotonin Deficiency Syndrome:
A Holiday Tale of Tryptophan, Serotonin and Melatonin

by Barry Keate

 

If you’re like me, you had a very enjoyable evening on Thanksgiving. After dinner and throughout the evening I was feeling very content and at ease. After a mellow evening, I slept like a baby. The next day we had leftovers for dinner and had the same great evening. I had a wonderful night’s sleep that night too. That turkey really did a number on me and was a welcome introduction to the holiday season.

Most of us know, I believe, that it’s the tryptophan in turkey that promotes the sense of well-being we associate with Thanksgiving. I began to wonder if this could have an effect on tinnitus and the anxiety and stress that often accompany it. I began to look into the effects of tryptophan. What I found out was very interesting and quite surprising. I believe there is a definite connection between tryptophan and the way many people experience tinnitus.

Tryptophan is an essential amino acid which means it is not produced by the body but rather must come strictly from the diet. There are eight essential amino acids and fourteen non-essential amino acids. The non-essential acids can be made inside the body from other components. Dietary sources of tryptophan include turkey and other meats, soy products, cottage cheese, milk, brown rice and peanuts.

In the brain, tryptophan converts to serotonin, the neuro-transmitter responsible for feelings of well-being, calmness, personal security, relaxation, confidence and concentration. Decreased serotonin levels play a key role in the development of depression. The only source for serotonin in the brain is tryptophan. It cannot be converted from any other substance. If there is not enough tryptophan in the diet, it can lead to anxiety and depression.

Depleted serotonin levels are responsible for depression and other psychological disturbances, such as anxiety, insomnia, fatigue, low concentration and low self-esteem. This is what has increasingly become known as the Serotonin Deficiency Syndrome.

Some serotonin is converted in the pineal gland to melatonin, which regulates sleep patterns. Melatonin has been shown to be helpful in getting a good night’s sleep and in some cases reducing tinnitus symptoms. A clinical study conducted at the Shea Ear Clinic in Sarasota, FL, tested 3 mg melatonin on tinnitus patients for one month. They found that those people who did not have trouble sleeping were not greatly benefited by the melatonin. However, of the people who had difficulty sleeping, 47% reported an overall improvement in their tinnitus.

My personal experience is that 3mg of melatonin will put me right to sleep, however I wake up in the middle of the night. I feel rested but I’m wide awake at 3:00 AM. I find that 3 to 6 mg of time-release melatonin will keep me asleep all night long.

There are basically two ways to rectify the Serotonin Deficiency Syndrome. One method is through the natural method of increasing tryptophan intake and the other through the use of anti-depressant medications such as Prozac. This is where the story gets very interesting.

There is a class of pharmaceutical medications called Selective Serotonin Reuptake Inhibitor (SSRI) anti-depressants. SSRI anti-depressants include Prozac, Paxil, Zoloft and others. Their method of treatment is to concentrate existing levels of tryptophan in the brain so they stay in the synapse between nerves and facilitate communication. They do not create serotonin, as many people believe, but simply collect the existing serotonin so it is used more effectively. Some studies suggest that long term use of SSRI anti-depressants actually reduce serotonin levels.

SSRI anti-depressants are in wide use today and prescribed for many people with tinnitus. In some cases they help but there are a host of side effects. Some of the more serious side effects include heart palpitations and chest pain, decreased libido, suicide (this has been in the news recently as it affects teenagers), nervous system disorders and tinnitus. The Physician’s Desk reference lists tinnitus as a frequent side effect of SSRI anti-depressants. There are no side effects to supplementation with tryptophan. So here we can have a situation where an individual who is depressed because of tinnitus is prescribed a medication that is a known cause of tinnitus.

It would make sense to go to the root of the problem and simply supplement the diet with extra tryptophan. One would think so but it’s not that easy.

Tryptophan used to be an easily obtainable and inexpensive dietary supplement in the United States. It still is in the rest of the world but since 1990 it has been banned in the US as an “untested, unapproved and hazardous drug” by the FDA. It is still regularly used in Canada, the Netherlands, the UK, Germany and France. There have been no reports of any serious or widespread health problems.

The following has been reported in many journals and media outlets. (I found some of the information on the Life Extension Foundation website in an article titled “The FDA Ban of L-Tryptophan: Politics, Profits and Prozac” by Dean Wolfe Manders, Ph.D. Dr. Manders has extensively researched and lectured on the medical politics of tryptophan.)

In 1989, there was a spontaneous outbreak of a rare and deadly disease in New Mexico called Eosinophilia-Myalgia Syndrome, or EMS. The common cause was traced back to the fact that all the people who became sick had been using tryptophan as a dietary supplement. EMS caused the deaths of 37 people and permanent disability in another 1500. The FDA immediately issued a recall of all tryptophan on the market.

Later, researchers at MIT identified the true culprit as a contaminant in the tryptophan that came from one specific company. The Japanese manufacturer, Showa Denko, was trying to speed production by using untested, genetically engineered bacteria in the fermentation process. This produced a toxin called EBT which made its way into the final product. They also cut corners in the purification process by reducing the amount of activated charcoal used to filter the final product by 50%. Showa Denko was much more interested in beating their competitors to market than in good manufacturing practices. This company is a highly unethical pharmaceutical manufacturer which once actually blew-up part of its plant to thwart a Japanese government investigation which would have proved their culpability in contaminating a river with mercury.

The MIT researchers presented their findings to the FDA showing the tryptophan was not to blame for causing EMS. In February, 1993 a US patent was awarded to use tryptophan to treat and cure EMS, the very same deadly condition which prompted the FDA to take tryptophan off the market in the first place. Nonetheless, the FDA held firm and tryptophan is banned in over-the-counter sales in the US.

But there are loopholes to this. The FDA has allowed tryptophan to be imported into the US from Ajinomoto Company in Japan. It is then distributed from the Ajinomoto USA facility in Raleigh, North Carolina through a network of compounding pharmacists across the US. It can only be purchased by individuals with a doctor’s prescription. It emerges as a new prescription medication in the serotonin marketplace. One hundred capsules of 500 mg each costs about $75.00, approximately five times more than if it were sold as a dietary supplement. It is also covered by medical insurance and adds yet another burden to our vastly overstretched medical system.

A greater irony is that tryptophan is routinely used in baby food produced and sold in the US and the Department of Agriculture still sanctions the use of tryptophan used as a nutritional and bulk feed additive in the commercial hog and chicken farming industry.

One other very curious fact arises. The FDA banned tryptophan on March 22, 1990. Within four days, March 26, 1990, Newsweek featured a lead article praising the virtues of the brand new anti-depressant drug, Prozac. Its multi-color cover displayed a floating, gigantic green and white capsule of Prozac with the caption: “Prozac: a breakthrough drug for depression.”

The fact that the FDA ban of tryptophan and the Newsweek Prozac cover story occurred within four days of each other went unnoticed by both the media and the public. Yet to those who understand the effective properties of tryptophan and Prozac, the concurrence seems unbelievably coincidental. One possible explanation for this can be found in a report by the FDA Dietary Supplement Task Force on June 15, 1993. It had been working on developing FDA policy toward nutritional supplements. On page two, the report states, “The Task Force considered various issues in its deliberations; including … what steps are necessary to ensure that the existence of dietary supplements on the market does not act as a disincentive for drug development.”

Clinical depression is a very serious condition and treatment through medication is often the right and prudent action to take. However next time a doctor wants to write a prescription for an anti-depressant, you may wish to suggest a prescription for tryptophan, and then find a compounding pharmacist who can supply it. Or you could simply … have another piece of turkey and a glass of warm milk.


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