Q. Hi Cynthia, I have had anxiety for about 10 years now with on and off depression. Recently I also started having intrusive thoughts which have increased the depression and anxiety. I do see a therapist, an MD, and ND recently. I am not having much luck with medications as a matter of fact the onset of these intrusive thoughts came on when starting an anti-depressant. I am now 2 months off anti depressants and going the alternative route. I found an ND in my area and he instantly put me on L-tryptophan 1000mg in the morning and evening. At first I felt okay but after day two I noticed that when I took it night I would wake up after about 4 hours in sheer panic. I also noticed that I had more anxiety during the day as well mostly late afternoon and night.
So I consulted my ND and he said he really didn’t think it was the tryptophan but that i could stop for a few days if I wanted to. The thing is that I have noticed a slight improvement in my mood and diminishing of the intrusive thoughts so I don’t want to stop any progress if this anxiety will eventually go away. I am on day 5 right now. He is now suggesting I take pyridoxal phosphate along with it. Now this is making me more nervous. Could it make me worse? or could it help to diminish the extra anxiety I am having? Thanks, Karyn
A. Hi Karyn,
It always baffles me as to why many natural health physicians are very similar to the mainstream physicians when someone does not respond to a treatment method in the manner in which they think the patient should or when they fail to educate the patient about their health issue thoroughly. Many people have negative responses to natural treatments, especially the ones that manipulate neurotransmitters like tryptophan, and treatment for depression, anxiety and other mental health conditions is rarely as simple as taking one nutritional supplement like tryptophan.
If you develop new symptoms in response to a nutritional supplement, or existing symptoms are exacerbated, then clearly it is the cause. Of course, before coming to that conclusion one should always examine their situation and make sure it isn’t some other unknown factor, like changes in the diet or exposure to environmental toxins. However, it is usually easy to observe a clear cause and effect, when it is a supplement.
Trust what your body tells you and don’t allow any physician to tell you that it isn’t or resort back to the old stand-by that it must be psychological, which so often happens, even with many natural health doctors. If you’re having a negative response to a nutritional supplement, there is an underlying biochemical reason that is unknown. You must search for that unknown reason.
There are a variety of reasons that people have a negative response to nutritional supplements. Some of the most common include: a poor quality supplement, a supplement with too many additives, the wrong dosage, mineral deficiencies, deficiencies in vitamin co-factors, too much toxicity in the body, malabsorption, adrenal disorders or a healing crises.
First of all make sure all your supplements are from a reputable company like, Thorne or Pure Encapuslations, and don’t have a lot of excipients. Buying from the discount vitamin store is usually not the best way to go.
Secondly, 1000 mg of tryptophan may be too high for your body. The best way to begin with tryptophan, or any amino acid, is to start with a dose of 500 mg and see how the body responds. If 500 is effective, then one does not need to move on to a higher dose. However, some very hypersensitive people need to start with a smaller dosage and work upwards.
Third, you should have been prescribed the pyridoxal 5 phosphate with the tryptophan from day one. All amino acids should be accompanied by p5p. Tryptophan is used for someone with depression because it increases serotonin levels. Serotonin is a neurotransmitter in the brain that is responsible for regulating our mood states and is often depleted in people with depression. However, tryptophan cannot be converted to serotonin without sufficient levels of p5p, and many people are deficient in p5p. So that could be another reason you had the response you had. So, adding the p5p to your regimen may solve your problem.
Too much of the mineral, copper, can also inhibit the conversion of tryptophan to serotonin. However, not enough copper can result in an increase in norepinephrine. Many people have an imbalance in their minerals. Some may be deficient and some may be too high. If minerals are not sufficient in the body or if levels are too high, this can have a significant impact on how a nutritional supplement works, as well as many chronic degenerative health conditions. Minerals are co-factors to most supplements. Other crucial nutrients like fatty acids and folic acid may be deficient that result in depression and anxiety. An RBC mineral test and a hair analysis should be used to determine one’s mineral status. An organic acids test, amino acids plasma test and fatty acids test is the best way to identify nutritional deficiencies and access neurotransmitter function.
The fact that you’re depression is accompanied by anxiety tells us that you are probably having depletion or disruption in other neurotransmitters in addition to tryptophan. You may be deficient in dopamine, GABA and/or endorphins and you may have too much norepinephrine. Glutamine can increase GABA, dl-phenenlalaine can increase endorphins, SAMe and magnesium or methionine and magnesium can reduce norepinephrine and dopamine can be increased with tyrosine. However tyrosine can also increase norepinephrine, which would increase anxiety, so it should be used last after some balance is restored or accompanied by SAMe or methionine and magnesium. An organic acids test and an amino acid plasma test is the best way to asses your neurotransmitter levels and functioning.
If an amino acid like tryptophan, glutamine or SAMe is going to be effective, you should notice something quickly. Some people feel results immediately or within hours. At a minimum, you should be seeing results within a few days. If you don’t see results within that time frame, then you aren’t going to and should discontinue. That is not the case with vitamins and minerals, as it can take a while for them to make it into the cell, and may take up to a few months. Therefore, if aminos are ineffective you may want to try them again later, after other deficiencies have been corrected.
Additionally, if there is a lot of toxicity in the body from heavy metals, common everyday environmental toxins, poor diet etc., this can interfere with how a nutritional supplement is received by the body. Heavy metal toxicity also disrupts the synthesis of neurotransmitters. Having minerals in balance is the first step in the process of detoxification, but one may need to engage in some other forms of detoxification like saunas, colonics or enemas, Epsom salt baths, clay baths, chelators, skin brushing etc. A hair analysis is one of the most effective ways to measure heavy metals in the body. Read this page from last week on heavy metal testing.
Malabsorption is a common problem in our society which hinders the ability of the body to absorb the nutrients it needs, even when it is taken in the supplement form. The gastrointestinal tract gets damaged from a poor diet, unhealthy organisms like candida yeast, bacteria or parasites or lack of sufficient enzymes. Helping the GI tract heal by eating a Paleolithic diet, taking digestive enzymes, probiotics and other nutrients may be necessary. The diet you eat also has a profound impact on neurotransmitters. The Paleolithic diet is the best diet to restore balance to the neurotransmitters as well.
Many people with advanced stage adrenal fatigue don’t always respond well to nutritional supplements. It often results in high levels of anxiety, fear and insomnia because their autonomic nervous system is in a hypersensitive state and any change in the body is seen as a threat that the body is not capable of dealing with effectively. These people must go very slow and start with small doses. You may have adrenal fatigue and/or autonomic nervous system dysfunction.So I encourage you to read those pages. A saliva adrenal stress test is the best way to measure the health of the adrenal glands.
On those pages, I mention deep breathing exercises, and I want to point to out that breathwork is one of the most effective, easiest and quickest methods to address depression and anxiety. Deep breathing reduces norepinephrine and increases serotonin, dopamine and endorphins. It provides instant relief for stress and anxiety and with continued use can provide significant improvement in all neurotransmitter functioning. Not only that, it doesn’t cost anything. So this is something you could practice to try and find some relief while you sort this all out.The deep breathing should be practiced several times a day.
However, the most important point to be aware of is that there are many other factors that contribute to depression, anxiety and intrusive thoughts besides deficiencies in the minerals, aminos and vitamins, like the presence of sugar, caffeine, alcohol, junk food and whole grains in the diet, nicotine, environmental toxins, food allergies or sensitivity,hypoglycemia heavy metal toxicity, adrenal fatigue, hypothyroidism, mold mycotoxins and candida overgrowth. Each of these factors disrupt the neurotransmitters in the brain that result in depression, anxiety and intrusive thoughts and must be addressed. If you take a nutritional supplement to increase your serotonin levels or decrease your norepinephrine, but continue to engage in activities or have other underlying issues that disrupt the neurotransmitters, then the results you want to achieve are not likely to happen. I encourage you to read my causes of depression page and my causes of anxiety page.
Last, but not least, I cover all the topics we have discussed above in great depth in my book, What Your Psychologist Hasn’t Told You About Anxiety and Depression.You may want to take a look at that. Tryptophan and p5p may indeed be an important and effective component of the recovery plan, but unfortunately they are not a magic bullet the majority of the time. Depression, anxiety and other mental health conditions are complex conditions and require a comprehensive approach for long-term results.
All the best