I put "5-HTP" above in bold for a good reason: My use of this supplement to treat Parkinson's disease (PD) symptoms has generated more conflicts with my family, friends, and some of my doctors than any of my other self-help endeavors.
Serotonin, 5-HTP, and Me
PD kills the brain cells that produce dopamine, the neurotransmitter that regulates movement (also behavior and emotion). PD research -- and treatments -- have focused primarily on replacing the depleted dopamine.
Serotonin, another neurotransmitter, helps regulate mood, appetite, sleep, and memory. It, too, is affected by Parkinson's, but that connection has been largely neglected until recently.
The gold standard treatment for PD is levodopa, a synthetic substance which the brain converts into dopamine. Levodopa is typically combined with carbidopa, a coupling that helps deliver the levodopa to the brain before the body metabolizes it.
5-HTP (5-Hydroxytryptophan) is a chemical by-product of the protein building block L-tryptophan. Since 5-HTP increases the synthesis of serotonin, it is used for several diseases in which serotonin likely plays an important role -- including depression, insomnia, and obesity.
Years before my 2009 Parkinson's diagnosis, I used 5-HTP to help counteract the insomnia and low mood that often accompanied jet lag. The neurologist who made the PD diagnosis told me that depression often accompanied Parkinson's, and he gave me a prescription for the antidepressant Elavil.
In addition to depression, there are two other frequent PD side effects -- insomnia and constipation -- and I was experiencing all three. I explained to my doctor the positive experience I’d had with 5-HTP as a treatment for all three conditions, and told him I’d prefer taking that single, useful supplement to taking three different pills, one for each problem.
And it worked… for a while.
I began experiencing problems with 5-HTP. Twice, I called 911 and ended up in the emergency room of my local hospital because of scary high blood pressure readings. I later learned that the same carbidopa that enhances the bioavailability of my levodopa has the same “booster” effect on 5-HTP. One estimate I saw suggested that carbidopa cranks up 5-HTP’s impact by a factor of eight. I was experiencing 5-HTP on overdrive.
Now, I regulary monitor my blood pressure and make adjustments in the timing and dosage of both my carbidopa-levodopa and my 5-HTP. It's a lot of work. Is it worth it?
Last December, I agreed to my neurologist's proposal and took a 5-HTP holiday. But constipation returned immediately. A week later, depression set in, followed soon after by insomnia.
I went back on 5-HTP.
Getting Right Dosage of 5-HTP
To achieve the ideal balance of dopamine and serotonin, I've experimented, cutting the 50mg 5-HTP pill in half -- sometimes even in quarters -- and taking the reduced dosages at different times of day. All of these experiments included a bedtime dose to combat insomnia.
I've been researching and writing about 5-HTP since my PD diagnosis, and I've learned that not many other people have found the supplement helpful as a sleeping aid. From the Google alerts I've set up on my computer, I've seen reports that the serotonin booster is used more frequently in Europe than in America, but more to deal with depression than sleeplessness.
The Trader Joe's Pill
So, the Trader Joe's "Calming Sleep Formula" and its use of 5-HTP came as a surprise. The amount of 5-HTP per pill is small, only 15mg. The label recommends taking two capsules, for 30mg.
The two other active ingredients in the "Calming Sleep Formula" are:
Here's what Drugs.com has to say about L-theanine, discovered as a constituent of green tea in 1949:
L-theanine may help relieve stress by inducing a relaxing effect without drowsiness and may also possess immunologic attributes. Theanine may also have effects on the cardiovascular system and play a preventative role in cancer; however, limited clinical information is available to support these claims.
Data supporting a clinical role for theanine are weak. Studies reporting an anti-anxiety effect used single doses of theanine 200-250mg."The Trader Joe's label shows that the "Calm Sleeping Formula" contains 200mg per serving size, 100mg from each pill.
Melatonin is a hormone produced in the brain by the pineal gland from the amino acid tryptophan. The production and release of melatonin are stimulated by darkness and decreased by light, suggesting that melatonin is involved in circadian rhythm (the internal body clock) and regulation of diverse body functions. Levels of melatonin in the blood are highest prior to bedtime.
The most common use of melatonin is to aid in sleep. The strongest evidence supporting the use of melatonin is for delayed sleep phase syndrome, insomnia in children and the elderly, jet lag, and sleep problems in people with behavioral, developmental, or mental disorders. The weakest evidence in support of melatonin is for work shift sleep disorder. Good evidence in support of melatonin for other uses is lacking.
The 3mg dosage (1.5mg per pill) shown on the label for TJ's "Calming Sleep Formula" is in the range of dosages in other sleeping aids.
My Experience with TJ's Pill
When I start a new medication, I usually take only half the recommended dosage... an especially good idea for the elderly. So, I've been taking only one of the "Calming Sleep Formula" about 30 minutes before bedtime.
I've been using the pill for over a week. I got great results the first few nights, with no trouble getting back to sleep after my middle-of-the-night bathroom visits. But I've also had a couple of problem nights.
I sense that I may be calmer during the day, but that sensation could well be the placebo effect.
Jury's still out on this supplement as far as I'm concerned. I'd love to hear from others who have tried this "Calming Sleep Formula."