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Serotonin
Serotonin helps regulate sleep, digestion, pain, mood, and mental clarity. Serotonin helps:
1. Raise the pain threshold (have less pain), by blocking substance P.
2. You fall asleep and stay asleep through the night.
3. Regulate moods. “The happy hormone” reduces anxiety and reduces depression.
4. Reduce sugar cravings and over-eating.
5. Increase a person’s mental abilities.
6. Regulate normal gut motility (transportation of food-stuff) and reverse irritable bowel syndrome (IBS).
Surveys have shown that as many as 73% of FMS patients have irritable bowel syndrome. You have more serotonin receptors in your intestinal tract than you do in your brain. Emotionally stressful situations cause the body to release adrenaline, cortisol and insulin. These stress hormones stimulate the brain to secrete serotonin. Long term stress and poor dietary habits can deplete the body’s serotonin stores.
Tryptophan, 5 Hydroxytryptophan (5HTP) and Serotonin
Tryptophan is one of eight essential amino acids. Tryptophan is absorbed from the gut into the bloodstream and then dispersed throughout the body. Ninety percent of tryptophan is used for protein synthesis, one percent is converted to serotonin, and the balance is used to make niacin. In the formation of serotonin, tryptophan is hydroxylated to 5-hydroxy-tryptophan (5HTP) by tryptophan hydroxylase. 5HTP is converted to serotonin by the decarboxylase enzyme, which is vitamin B6 dependent. Tryptophan is transported across the blood-brain barrier via a transport molecule, which also carries leucine, isoleucine, and valine, and prefers leucine. However, 5HTP easily crosses the blood-brain barrier and does not utilize this transport mechanism; thus, it does not compete for passage through the blood-brain barrier with these amino acids. And, unlike tryptophan, which is made from bacterial fermentation (and hence subject to contamination), 5HTP is derived from the West African plant Grifonia simplicifolia. In the body, 5HTP is converted directly in to serotonin. It is not broken down by tryptophan pyrrolase, and does not have to compete for transport across the blood-brain barrier. Individuals with fibromyalgia have low levels of tryptophan, serotonin, and 5-HTP. Studies show that fibromyalgia patients have higher levels of metabolites in the kynurenine pathway, which diverts tryptophan away from serotonin production.
Selective Serotonin Reuptake Inhibitor (SSRI) Medications
Prescription antidepressants can be helpful. However, antidepressant drugs have potential side effects including anxiety, depression, fatigue, decreased sex drive, and disruption of normal circadian rhythms. SSRI’s are supposed to help a patient hang onto and use their naturally occurring stores of the brain chemical serotonin. It’s like using a gasoline additive to help increase the efficiency of your cars fuel. Most of the patients I see with fibromyalgia are running on fumes and a gasoline additive won’t help. Please keep in mind that several studies show that between 19-70% of those taking antidepressant medications do just as well by taking a placebo or sugar pill. I recommend my patients boost their serotonin levels by taking 5HTP.
5HTP and Depression
Studies (including double-blind) comparing SSRI and tricyclic antidepressants to 5HTP have consistently shown that 5HTP is as good if not better than prescription medications in treating mood disorders. Furthermore, 5HTP doesn’t have some of the more troubling side effects associated with prescription medications.
5HTP and Sleep
5HTP has been shown to be beneficial in treating insomnia, especially in improving sleep quality by increasing REM sleep and increasing the body’s production of melatonin by 200%.
5HTP and Fibromyalgia
Double-blind, placebo-controlled trials have shown that patients with FMS were able to see the following benefits from taking 5HTP:
• decreased pain.
• improved sleep.
• less tender points.
• less morning stiffness.
• less anxiety.
• improved moods in general, including in those with clinical depression.
• increased energy.
Irritable Bowel Syndrome, 5HTP, and Serotonin
There are more serotonin receptors in the intestinal tract than there are in the brain. This is one reason people get butterflies in their stomach when they get nervous. The brain and gut are connected through the neuroreceptors 5-hydroxytriptamine-3 (5-HT3) and 5-hydroxytriptamine-4 (5-HT4). These serotonin receptors regulate the perception of visceral pain and the gastrointestinal (GI) motility. Serotonin controls how fast or how slow food moves through the intestinal tract. It’s common for the symptoms associated with IBS, diarrhea and constipation, to disappear within 1 weeks once serotonin levels are normalized with 5HTP replacement therapy.
Restoring Normal Adrenal Function
Adrenal Fatigue
The adrenals are a pair of pea-sized glands located atop each kidney. The adrenal gland consists of two sections: the medulla (inner portion) and the cortex (outer portion). The adrenal glands release certain hormones that allow us to be able to deal with immediate and long-term stress. These glands, and the hormones they release, allow us to be resilient to day-to-day stress.
Under-active adrenal glands are evident in about two-thirds of CFS patients. The majority of patients I see for chronic illnesses, including FMS and CFS, are suffering from it. They have literally burned their stress-coping organ out. Amid years of poor sleep, unrelenting fatigue, chronic pain, excessive stimulants, poor diet, and relying on a plethora of prescription medications, the adrenal glands and the hormones they release have been used up. Once adrenal exhaustion sets in, it’s not long before the body begins to break down. Getting “stressed out” and staying “stressed out” is the beginning of chronic illness for most, if not all, of the FMS and CFS patients I evaluate.
An altered or dysfunctional cortisol control system may be THE cause of FMS/CFS.
We do know that adrenal fatigue is known to cause many of the same problems associated with CFS and FMS:
• hypoglycemia (low blood sugar)
• hypo-tension(low blood pressure)
• neural mediated hypo-tension (become dizzy when stand up)
• fatigue • decreased mental acuity • low body temperature (a sign of low thyroid function)
• decreased metabolism • a compromised immune system • decreased sense of well-being (depression)
• weight loss • hyper-pigmentation (excess skin color changes)
• loss of scalp hair • excess facial or body hair • vitiligo (changes in skin color)
• auricular calcification (little calcium deposits in the ear lobe)
• GI disturbances • nausea • vomiting • constipation
• abdominal pain • diarrhea • crave salty foods • muscle or joint pains
Individuals with FMS and CFS who suffer from adrenal fatigue (99%) will find that their stress-coping abilities are shot. They don’t handle stress very well. They will try to avoid stressful situations. Stress will make their symptoms worse and cause them to have flare-ups. If they have a day when they feel good they may over do it (clean the house, paint the playroom, grocery shopping, etc.). Then, they usually crash the next day.
Therefore, restoring proper adrenal function is a crucial step in peeling away the layers of dysfunction associated with FMS and CFS. I believe that adrenal fatigue is a major contributory factor to the symptoms associated with FMS and CFS.
The Cortex
The adrenal cortex is primarily associated with response to chronic stress (infections, prolonged exertion, prolonged mental, emotional, chemical, or physical stress). The hormones of the cortex are steroids. The main steroid is cortisol. Chronic over secretion of cortisol leads to adrenal exhaustion, which accelerates the downward spiral towards chronic poor health. Once in adrenal exhaustion your body can’t release enough cortisol to keep up with the daily demands. Eventually you become deficient in cortisol and then DHEA.
Chronic headaches, nausea, allergies, nagging injuries, fatigue, dizziness, hypo-tension, low body temperature, depression, low sex drive, chronic infections, and cold hands and feet are just some of the symptoms that occur with adrenal cortex exhaustion.
Not Enough DHEA
The adrenal cortex, when healthy, produces adequate levels of dehydroepiandrosterone (DHEA). DHEA boosts:
• energy
• sex drive
• resistance to stress
• self-defense mechanisms (immune system)
• general well-being, and helps to raise:
• cortisol levels
• overall adrenal function
• mood
• cellular energy
• mental acuity
• muscle strength
• stamina
DHEA and immune function
The decrease in DHEA levels correlates with the general decline of cell-mediated immunity and increased incidence of cancer. DHEA protects the thymus gland, a major player in immune function. My fibromyalgia patient's usually take a special adrenal cortex glandular supplement
DHEA
is notoriously low in FMS and CFS patients. Chronic stress initially causes the adrenals to release extra cortisol. Continuous stress raises cortisol to abnormally high levels. Then, the adrenal glands get to where they can’t keep up with the demand for more cortisol. As the cortisol levels continue to become depleted from on-going stress, the body attempts to counter this by releasing more DHEA. Eventually they can’t produce enough cortisol or DHEA. Aging makes holding on to DHEA even tougher. Even in healthy individuals, DHEA levels begin to drop after the age of 30. By age 70, they are at about 20% of their peak levels.
Stress and DHEA
DHEA helps prevent the destruction of tryptophan (5HTP), which increases the production of serotonin. This helps provide added protection from chronic stress. Studies continue to show low DHEA to be a biological indicator of stress, aging, and age-related diseases including neurosis, depression, peptic ulcer, IBS, and others.
Digestive Enzymes
Most individuals with fibromyalgia will complain of bloating, gas, and indigestion. Many of these folks will be placed on acid blocking prescription drugs for heartburn or reflux. However, these drugs can cause nutritional deficiencies since they prevent the absorption of certain essential vitamins and minerals. This may lead to symptoms of fatigue, increased pain, anxiety, and depression.
Most digestion and absorption takes place in the small intestine and is regulated by pancreatic enzymes and bile. The pancreas aids in digestion by releasing proteolytic enzymes, which help break down proteins into amino acids. It’s these amino acids which make the brain chemicals including serotonin, dopamine, and epinephrine.
These enzymes break down food-stuff and allow the smaller molecules and nutrients to be absorbed into the bloodstream. The enzymes may become deficient for a variety of reasons, including advancing age, excess sugar, deficient essential fatty acids, excessive trans-fatty acids, and overeating. Eating processed food also depletes normal pancreatic enzymes.
I also recommend that all of my fibromyalgia patients take a digestive enzyme with each meal.
Vitamin and Mineral Supplements
Dr. Janet Travell, White House physician for Presidents John F. Kennedy and Lyndon B. Johnson, and Professor Emeritus of Internal Medicine at George Washington University cowrote Myofascial Pain and Dysfunction: The Trigger Point Manual, which is acknowledged as the authoritative work on muscle pain.
In one chapter alone, Dr. Travell and co-author, Dr. David Simons, referenced 317 studies showing that problems such as hormonal, vitamin, and mineral deficiencies can contribute to muscle pain and soreness.
There are numerous studies which show that individuals with fibromyalgia benefit from taking certain vitamins, minerals and fatty acids. The mineral magnesium, which acts as a natural muscle relaxant, is especially helpful in relieving many of the symptoms associated with fibromyalgia. Malic acid, derived from apples, has been shown to reduce the chronic pain associated with fibromyalgia. Vitamins B6, B3, and B2 are needed to make the brain chemicals, including serotonin. Essential fatty acids (EFAs) help reduce inflammation, boost mood, and optimize the immune system. I’ve developed a special vitamin/mineral formula for my fibromyalgia patients. I have a special "jumpstart" package which contains the Fibromyalgia/Chronic Fatigue Formula, the Adrenal Cortex Formula, the Digestive Enzymes, and the 5HTP formula. These are the nutritional supplements that I recommend for 98% of the patients I see with FMS and CFS, all in one money saving package.
Traditional Drug Therapy for Fibromyalgia & Side Effects
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