Irritable Bowel Syndrome Message Boards

I was interested attracted to this post as I've been researching 5-htp myself. Here is an excerpt from the website http://www.bioterrain.co.uk/IBS.html

5-HTP
Tryptophan is an essential amino acid that is metabolized by the body into 5-HTP (5-hydroxy-tryptophan) which is the direct metabolic precursor to the neurotransmitter serotonin. As a supplement 5-HTP is preferable to its amino acid because you then do not have to rely on the tryptophane - 5HTP conversion taking place. Vitamin B6 and Magnesium is necessary for the 5-HTP-serotonin conversion so IBS patients with low vitamin B/Mg levels must address that for 5-HTP to be effective. Colonic and rectal balloon distension studies have shown that IBS patients become aware of distension and perceive pain at lower pressures and volumes than healthy volunteers and subsequent findings indicate that IBS is also associated with increased sensitivity to normal intestinal conmtractions. Serotonin (5-HT) has emerged as a key chemical messenger in the pathogenesis of IBS [MD Gershon, " Review article: roles played by 5-hydroxytryptamine in the physiology of the bowel", Aliment Pharmacol Ther (1999), 13: pp. 15-30.] The gastrointestinal tract contains approximately 95% of the body's serotonin and colic mucosal serotonin metabolism has been reported to be altered in IBS patients. Serotonin mediates reflexes that control gut motility and secretion, as well as pain perception, predominantly through interactions with 5-HT1p , 5-HT3 and 5-HT4 receptors in the gastrointestinal tract. Conventional pharmacological management of IBS is often suboptimal, addressing only the most predominant symptom at any one time. According to a 2004 paper by Novartis, newer serotonergic agents that target the multiple symptoms of IBS represent a significant advance in the treatment of this disorder, and together with other measures, such as patient education, promise to improve IBS management. Here at the Integrated Medicine Practice we use the metabolic precursor 5-HTP to restore serotonin levels because this helps with pain reduction, mood enhancing including anxiety reduction. Furthermore 5-HTP helps you to go into a deeper sleep. We use 5-HTP from Nutri Ltd., a plant source precursor of seratonin which is an important neurotransmittor for brain and nerve function and is necessary to control mood, it also regulates sleep patterns. Adults may take up to a maximum of 2tbl 3x/day (600mg) - children 20mg/10kg body weight. (order from NUTRI 0800 212 742 / Ref: 187410) Pharmaceutical serotonergic agents do not come problem free. One systematic review of 5HT4 Receptor Agonists found that in women with constipation-predominant IBS, tegaserod maleate improved symptoms compared with placebo. It found insufficient evidence about the effects of tegaserod in men. Tegaserod was more likely to cause diarrhoea than placebo. One systematic review found that alosetron hydrochloride (a 5HT3 Receptor Antagonist) improved symptoms in women with diarrhoea-predominant IBS compared with placebo or mebeverine. As of November 2000, the FDA had received 70 reports of serious adverse effects of Lotronex (alosetron hydrochloride), including 49 cases of ischemic colitis and 21 cases of severe constipation resulting in severely obstructed or ruptured bowels. Of these 70 cases, 34 required hospitalization, 10 required surgery and 5 died. [JAMA, Editor's correspondence, Vol. 162 No.1, January14, 2002] Consequently Lotronex was 'voluntarily' withdrawn from the market, Dr. Richard S. Kent, Glaxo's chief medical officer and vice president estimated that ischemic colitis occurred in one of every 1,000 Lotronex patients and that "about half are managed as outpatients and half are hospitalized." Although pharmacological serotonergic agents do not come without issues, serotonin is undoubtedly a key player in the management of IBS. Using the direct precursor to serotonin allows the body to convert this precursor on an as-needed basis. Please note that interactions between 5-HTP and prescribed medication may/does occur with: sedating antihistamines, Selective Serotonin Re-uptake Inhibitors (SSRI's e.g. Prozac), codeine/morphine, L-dopa, Monoamine oxidase inhibitors, tricyclic antidepressants, barbiturates and other tranquilisers, botanical and non-botanical ephedrine or pseudoephedrine medication (Ephedra sinica is a sympathomimetic that acts directly and indirectly on the sympathetic nerves ) and ingested alcohol . If you are in any doubt at all about you using 5-HTP you should consult a well-informed, non-prejudiced physician.

One concern I have is where it says that Magnesium (along with Vitamin B6) is necessary for the 5-HTP-serotonin conversion so IBS patients with low vitamin B/Mg levels must address that for 5-HTP to be effective. I personally try to avoid Magnesium as it is not helpful for us with diarrhea only causing more in most cases.

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IBS-D. Or so a doctor says.

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