May 9, 2014

5-HTP and Parkinson's: Am I the Only One Experiencing this "Miracle"?

I recently watched a webinar that featured leading neurologists and scientists discussing the latest Parkinson's developments. One panelist -- after extolling levadopa's efficacy in treating PD's motor symptoms -- bemoaned the the lack of a similar drug to treat the disease's non-motor symptoms.

For me, the OTC supplement 5-HTP has proved a more effective therapy for my non-motor symptoms than levadopa has been for my motor symptoms.

What is 5-HTP?
It's basically a serotonin booster. Serotonin is one of the neurotransmitters that light up the brain. It is allied with another neurotransmitter, dopamine. Parkinson's results from the depletion of dopamine-generating cells in the brain.

Dopamine regulates muscle movement, motivation and reward seeking, sociability, and pain processing. Serotonin primarily affects mood, impulsiveness, appetite, intestinal motility, sex drive, and the sleep/awake cycle.

5-HTP and me
Here’s a quick rundown on PD's major non-motor symptoms, and my experience with 5-HTP as a therapy for them.

Symptom 1)  Depression
Before my 2009 PD diagnosis, I’d experienced only one bout of depression. That unpleasantness occurred about 10 years ago during my "Summer from Hell," when I over-used Tylenol PM and Ambien in an effort to remedy bad jet lag after a trip to Nepal. Popping  meds prescribed by doctors and sleep specialists only made things worse. What finally worked were holistic remedies, including meditation and 5-HTP.

Depression returned with the arrival of Parkinson’s. When it did, I almost sold my house and moved into a senior residence. The neurologist who diagnosed the Parkinson’s prescribed Elavil for the depression. Then, my present neurologist expressed concern about that drug's possible adverse effect on cognition. I told him about my earlier, positive experience with 5-HTP. He approved my suggestion that I try it again, and I've been depression-free for four and a half years now.

Symptom 2)  Insomnia 
I have a much longer history battling insomnia. Until March 23, 1978, my drug of choice for dealing with insomnia was alcohol. Most nights, I went to bed half drunk. Toward the end of my active alcoholism, I kept a small glass of vermouth by the bed, to help me get back to sleep after my middle-of-the-night bathroom visits. After I quit drinking, I began using Tylenol PM or Ambien for fairly frequent spells of insomnia. Sometimes, particularly when traveling, I’d take half an Ambien pill along with the Tylenol PM.

Thanks to 5-HTP, I’m now insomnia free for the first time in my life. For nearly five years now, I log at least seven hours of sleep each night. I can easily get back to sleep after my 3-4am hour of meditation and exercise. This quality of sleep is the best I’ve ever had.

Symptom 3)  Constipation 
My experience here goes as far back as my struggles with insomnia. In fact, I thought the two were somehow connected, since they seemed to occur in tandem. 5-HTP put an end to the constipation.

Symptom 4)  Cognition and Executive Function 
For years, I’ve focused my cognitive concerns on memory and Alzheimer’s. Instead, I should have been paying more attention to executive function and Parkinson’s. Alzheimer’s tends to begin in the part of the brain that affects memory, while Parkinson’s starts in a region that controls "executive function."

That function includes decision making, problem solving, and planning. Parkinson’s impact on executive function was a key theme in Michael Kinsley's article in The New Yorker last month, which I discussed in a blog post.

This is where it gets weird: Instead of experiencing problems with executive function, I’m encountering just the opposite. It's clear to me that 5-HTP is the reason.

I take my 5-HTP pill at bedtime. More often than not, when I open my eyes in the morning, my first thought brings a solution to some problem that had been bothering me. My middle-of-the-night “quiet hour” also produces those solutions, or creative new ideas.

When I increase my nighttime 5-HTP dose, even a little, the next morning can bring ideas -- some crazy -- that explode like fireworks on the Fourth of July. With those ideas comes a euphoric mood that borders on mania. I admit; it's very pleasant. Unfortunately, those mornings are usually accompanied by big spikes in my blood pressure.

A New Development 
Over the past months, I’ve been experimenting -- varying the timing and dosage of my 5-HTP pill. Sometimes I’ll take only a half pill at bedtime and then a quarter pill at various times during the day. A few times recently, I’ve noticed that my gait was practically normally, not my usual old-man shuffle. As I'd enter the observation in my journal, I'd see great improvements in my handwriting, too. My usual Parkinson’s-induced micrographia -- cramped, tiny, illegible script -- was now large and smooth and almost normal! Unfortunately, I didn’t properly track my pill intake, so I don’t know what combination of levadopa and serotonin produced these pleasant results.

What the hell is going on?
Here's my theory: As Parkinson’s destroys my dopamine-producing cells, using 5-HTP to boost my serotonin offsets the damage, particularly with respect to non-motor functions. My five years of experience with PD and 5-HTP makes this theory seem credible to me.

But is it just a quirk applicable only to me and a few others? Or might it have wider applicability?

I’ve been hypercritical of Dr. Mary Newport for turning her anecdotal experience feeding coconut oil to her Alzheimer’s-afflicted husband into a profitable enterprise. Other people -- including Pat Robertson and Dr. Oz -- have also benefited by jumping on the coconut-oil-for-Alzheimer’s bandwagon. But they have cruelly raised the hopes of AD patients and their families by touting the coconut oil miracle without cautioning about the lack of scientific evidence to support that miracle. Thousands have tried it; very few have seen results similar to the Newport's. To date, no proper, longitudinal, double-blind (to guard against both experimenter bias and placebo effect), peer-reviewed scientific studies exist to corroborate her conclusions. One is underway now, however.

I don’t want to go down that road. So I’ll start by saying there have been no clinical trials involving 5-HTP and Parkinson’s. It’s also unlikely that Big Pharma, which funds much of our drug research, will have any interest investigating a cheap, OTC supplement.

I can't provide reports of other people with Parkinson’s who had experienced 5-HTP benefits like mine. A few friends with PD tried it. One reported some positive effects with constipation. But that's about it. 

Increasingly, however, I see reports that suggest my experience isn't a fluke. For example:
  • Most of us with PD take levadopa, designed to replace the dopamine our disease destroys. But the levadopa is mixed with carbidopa, since that addition helps the levadopa pass the blood-brain barrier. As it turns out, carbidopa works the same way with serotonin, helping it enter the brain where it can have an impact. So when we take 5-HTP when we're already taking carbidopa, the positive effects (on issues like mood and insomnia, for example) are enhanced. 
  • A 2011 NIH study concluded that serotonin plays a significant role in the brain's executive function. So carbidopa-enhanced 5-HTP could be kick-starting my executive function.
  • A 2012 article in Scientific American reported on the use of stem cell grafts on patients with PD. Those grafts, when they "took" properly, helped restore dopamine function. As a result, patients scored very well on all measures of motor function. But those same patients -- with normal dopamine levels -- had serotonin levels even lower than untreated patients, and were having issues with bowel and sexual function, mood, and sleep -- all problems linked to serotonin. The authors proposed multiple grafts of dopamine and serotonin cells. But then, significantly, they suggested that for those with less severe PD symptoms, it might be enough to combine levodopa with "something else to increase serotonin function while possible."
I see more and more reports like this one, that suggest the medical community has been focused too exclusively on dopamine as a Parkinson's therapy. More attention should be paid to serotonin.

I’m increasingly persuaded I’m not the only person with Parkinson’s who could benefit from 5-HTP.

How safe is 5-HTP?
That's a very important question, which I'll address in the next post.


Anonymous said...

Thank you john for the references to 5htp. I'm working on theses lines now and seeing some benefit.

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