It’s easy to put two and two together. If you’re deficient in melatonin you can’t get to sleep at night. If you don’t sleep, you won’t make melatonin. It’s a viscous cycle. A deficiency of restorative sleep leads to accelerated aging, lowered immune function, and susceptibility to cancer and brain oxidation.

Melatonin Therapy

When administered in pharmacological doses (1-3mgs), melatonin acts as a powerful sleep regulating agent that controls the circadian rhythm.  A low dose of melatonin has also been shown to be effective in treating insomnia and jet lag. In a recent study, volunteers were either given a .3 mg or a 1 mg dose of melatonin or a placebo. Both levels of melatonin were effective at decreasing the time needed to fall asleep.

*This is a study by Zhdanova IV, Wurtman RJ, Linch HJ, et al. Sleep inducing effects of low doses of melatonin ingested in the evening. Clinical Pharmacological Therapeutics, 1995; 57; 552-558.

The same area of the brain that releases melatonin also regulates serotonin production. Serotonin helps to produce melatonin. If you are deficient in serotonin, you’ll also be deficient in melatonin (can’t sleep).

Melatonin is affected by a person’s exposure to light. Melatonin levels start to rise as the sun goes down and drop off as the sun comes up. The retina (eyes) are extremely sensitive to changes in light. An increase in light that strikes the retina triggers a decrease in melatonin production. Conversely, limited exposure to light increases melatonin production. This explains why some individuals suffer from Seasonal Affective Disorder. Seasonal Affective Disorder (SAD) is triggered by the onset of winter and the reduction of sunlight. As their melatonin levels increase and their serotonin levels decrease, depression sets in. One in 10 people, including children, suffer from SAD. Symptoms associated with SAD can include depression, fatigue, lethargy, anxiety, and carbohydrate cravings.

One to two hours of exposure to bright light (ultraviolet light) will usually decrease melatonin levels to a normal level. Special ultraviolet (full spectrum) bright lights can be found in various stores and catalogs. Individuals with SAD should use these lights one to hours every day during the winter months.

Magnetic Field Effects on Melatonin

Synthesis of melatonin from the amino acid Tryptophan has been shown to be decreased by exposure to magnetic fields, stress, and by the aging process.

The synthesis of melatonin has been reported to be effected by the exposure to both electric and magnetic fields.

Exposure to both static and pulsed magnetic fields has been shown to significantly decrease NAT activity in melatonin levels in the pineal gland of experimental animals.

This was reported in the Alternative Medical Journal, Volume 1, No. 2, 1996, from research cited by Welker HA, Semm P, Willig RP, et. al.  Effects of an artificial magnetic field on serotonin in acetyl transferase activity in melatonin content in the rat pineal gland.  Exp. Brain Research, 1983; 50; 426-432.  The other article cited is Lerchl A, Nonaka KO,  Stokkn KA, Reiter RJ.  Marked rapid alterations in nocturnal pineal serotonin metabolism in mice and rats exposed to wheat intermittent magnetic fields.  Metalisized Biochemical Biophys. Research Communication, 1990; 169; 102-108.

Magnesium - A natural muscle relaxant which helps regulate neurotransmitters, including serotonin. FMS and CFS patients are usually low in magnesium. I recommend a minimum 500mg of magnesium a day. An additional 100-150mg at bedtime may be helpful. It’s best to use a chelated form of magnesium; magnesium citrate, taurate, or aspartate.

My Sleep Restoring Protocol

How to take 5HTP

It’s important to take 5HTP on an empty stomach, thirty minutes before bedtime, along with 4 ounces of grape juice. The juice helps 5HTP cross the blood-brain barrier and pass into the brain, where it turns into serotonin. You should start with 50mgs. Ninety-nine percent of those taking 5HTP will notice nothing on this dose. One percent will actually become more alert. If this happens, they shouldn’t take 5HTP at night. They can, however, take 100mgs once or twice a day with food. Individuals who don’t have an adverse reaction should add an additional 50mgs each night until they fall asleep within thirty minutes and sleep through the night. So start with 50mgs. If you don’t have a negative reaction, but don’t sleep, add an additional 50mgs (total of 100mgs) the next night. If you still don’t sleep through the night, add an additional 50mgs (total of 150mgs) the next night. Keep increasing dosage up to 250mgs or until you fall asleep within 30 minutes of taking it and sleep throughout the night. This natural amino acid will never leave you hung-over, make you feel dopey, or prevent you from waking up in the middle of the night. Contrary to well-meaning warnings, I’ve found  5HTP can be taken with anti-depressants like Paxil, Celexa, Prozac, Lexapro, Trazadone, and others. These medications are usually not working anyway because there is no serotonin to work with. 5HTP may cause a hang-over if taken with Neurontin, high doses of Xanax, Ativan, Restoril, Remeron, and Klonopin. Just start with 50mgs and slowly increase your dose. 5HTP can also be taken with Ambien, Sonata, Flexeril, or other sleep medications. Remember, start with 50mg. If you have a negative reaction, stop taking 5HTP at night and take it with food during the day. I’ve recommended 5HTP for years. Less than one percent couldn’t take it (it made them more alert at night) or it didn’t help improve their poor sleep.

One of Three Things Will Happen When Taking 5HTP

Starting with 50mgs of 5HTP...

1. The person will fall asleep with in 30 minutes and sleep through the night.

If so, this is their bedtime dose until they follow up with me in 1-2 weeks.

2. The person takes 5HTP and nothing happens. This is typical response to such a low dose. They’re instructed to add 50mgs each night (up to a max of 300mgs) until they fall asleep within 30 minutes and sleep through the night. The patient should stay at the minimum dose needed for deep sleep or at 300mg.

3. The person takes 50mgs and instead of making them sleepy it makes them more alert. This may occur in 1% of my patients and is due to a sluggish liver. If this happens the patient is instructed to discontinue taking 5HTP at bedtime and instead take 50mgs with food for 1-2 days. Taking 5HTP with food will slow it down and allow the liver to process it like any other food stuff. If they have no further problems with 5HTP then they should increase to 100mgs of 5HTP at lunch and 100-200mgs at dinner. This will allow the 5HTP to build up slowly. It will work when taken with food but will take a little longer for it to produce the desired results (2-3 weeks).

Questions

Can I take 5HTP (ANY OF THER AMINO ACIDS) with Prescription Medications?

Yes. 95% of my patients are already taking anti-depressants when they come to see me. Most individuals are on selective serotonin reuptake inhibitors (SSRIs); Paxil, Prozac, Zoloft, Lexapro, Celexa, etc. These medications are gasoline additives designed to help the brain hang on to the serotonin. They don’t make serotonin.

Can Patients Take 5HTP with Sleep Medications?

Yes, I recommend patients start taking 5HTP along with their sleep medications (as recommended above). I let my patients know that 5HTP never causes a hang over. However, when taken with certain sleep medications (Flexeril, Ambien, Sonata, Elavil, Doxepin, Resteril, and especially Xanax, Klonopin, Neurontin, and Ativan) it may cause a hang-over the next day.

I don’t recommend patients discontinue taking their sleep medications. Instead I suggest they start using 5HTP and increase the bedtime dose until they sleep through the night. At some point they should be able to work with their medical doctor and slowly wean off the prescription sleep medication.

What if Someone is Using Prescription Sleep Medications and They’re Sleeping Through the Night?

If a patient is taking Elavil (or other tricyclic anti-depressent), Trazadone, Ambien, or Flexeril and they’re falling asleep within thirty minutes, dreaming, and sleeping 7-8 hours, then they should continue taking on the sleep medication. They should add 5HTP 50mgs three times a day with food. If no problems after 2-3 days, they should then increase to 100mgs with each meal. If 5HTP makes them drowsy even when taking it with food, they should take 200mgs, minimums at dinner. The optimal dose is 300mgs a day.

Remember, the reason why they are taking these prescription drugs is because they have a serotonin deficiency, not a sleep-drug deficiency. You want to help them build up their serotonin levels so that eventually they won’t need prescription sleep medications.

A person may be taking a sleep medication that allows them to go into deep sleep. This helps them to build up their serotonin stores and make deposits into their stress coping savings account. However, they will use most of their deep sleep deposits up the next day (daily stress, homeostasis, etc). The key is to build up serotonin levels with 5HTP and the vitamin, mineral cofactors (B vitamins, magnesium, Essential Fatty Acids, and vitamin C).

What if Someone Has a Serotonin Syndrome Reaction?

You always want to be aware of serotonin syndrome. Serotonin syndrome occurs when a person gets to much serotonin. It may cause rapid heart beat, increased pulse rate, elevated blood pressure, agitation, and in its worst case scenario irregular heart beats (arrythmia).

I have thousands of individuals on 5HTP and have had only one person have a serotonin syndrome reaction. This person was not a patient. She had a history of irregular heart beats and chemical sensitivities. She also had CFS. I would have never recommended she take 5HTP at bedtime. Instead I would have had her start with 50mgs with food (if I would have recommended at all). She took 50mgs at bedtime first night it made her more alert ( a sign not to take at night) and then increased to 100mgs the next night. She then began having a serotonin syndrome which caused her to be anxious and to have arrythmia for the next few hours.

I write this here not to scare you. I use 5HTP with individuals with known heart conditions. Individuals with MVP and heart disease. I always start with a low dose 50mg and warn the patient to stop taking at bedtime if they have a funny reaction.

A lot of people are on incredibly toxic heart medications that increases their risk for heart failure, stroke, and death. If I don’t get them to consistently go into deep restorative sleep each night they’ll never get well. So I don’t worry about using 5HTP. Once you start reading about the medications and combination of medications your patients are on you’ll realize just how safe 5HTP is to use.

What are Some of the Other Potential Side-effects of 5HTP?

Other than some patients becoming more alert when taking it at bed time, I have very few complaints from patients. The literature says that individuals may have headaches and nausea from taking 5HTP. I have had less than half a dozen patients who have had one of these side-effects. The headaches and any nausea go away after a couple of days.

Can 5HTP Be Taken With Any Medications?

Yes, 5HTP can be safely taken with all prescription medications. I wouldn’t recommend 5HTP be used for patients with manic depression or schizophrenia. These conditions are best referred to orthomolecular psychiatrist who specialize in these complicated disorders.

How Much 5HTP Should I Take?

Patients should be taking up to 300mgs a day. I have some who take more, but most are taking between 200�?00mgs a day.

I always ask (or have my nurse ask) how the patient is sleeping. This is the most important bench mark for how well they are doing. If they are sleeping through the night I know they are feeling much better. They’ll have less pain, less depression, less anxiety, improved energy, and increased mental clarity.

However, if they continue to have IBS symptoms, sugar cravings, low moods, or a lot of pain and they aren’t taking maximum dose of 5HTP, I’ll go ahead and ask the patent to increase their 5HTP dose up to 300mgs a day.

I have them continue to take the night dose that is putting them to sleep along with taking additional 5HTP (up to total of 300mgs a day) with food during day.

Example

The patient is taking 200mgs of 5HTP at bedtime. They’re sleeping through the night but continue to have a good deal of pain. I’ll instruct the patient to take an additional 50mgs of 5HTP twice a day with food (lunch and dinner).

Patients who can’t take at bedtime should increase their dose to up a total of 300mgs taken with food.

NOTE- IBS SYMPTOMS SHOULD GO AWAY ONCE YOUR SEROTONIN LEVELS ARE RESTORED. In my practice this usually occurs within 2-3 weeks.

If IBS continues even with 300mgs of 5HTP, then I recommend patients start taking 3 probiotics a day on an empty stomach.

What do I do When I Still Can’t Fall Asleep and Sleep Through the Night After Doing the Protocol Above?

If, after 2 weeks, someone is not falling asleep and staying asleep through the night I add melatonin.

I make sure they are taking 5HTP as they should be and at the maximum dose of 300mgs.

Melatonin is the primary hormone of the pineal gland and acts to regulate the body’s circadian rhythm, especially the sleep/wake cycle. Serotonin turns into melatonin which then promotes deep restorative sleep. But remember all the wonderful things serotonin does; increases deep restorative sleep, boosts mental clarity, elevates mood, lowers anxiety, and reduces pain. 5HTP-Serotonin-Melatonin.

When I have patients not sleeping on 5HTP and can’t fall asleep try taking 3mgs of sublingually, dissolved under the tongue, for rapid absorption right before bed, along with 300mgs of 5HTP. Individuals who can’t take 5HTP at bedtime should continue taking up to 300mgs of 5HTP with food. I have as patients to try this for a few days. If they can’t fall asleep after a few days then they should add 500mgs of niacinamide three times a day. This special form of B3 will help raise serotonin levels.

You can also take extra magnesium (especially if you are not having a bowel movement each day) at dinner or at bedtime (discontinue if you get loose bowel movements). Most patients are already taking the CFS/Fibro or other high-dose broad-spectrum multivitamin/mineral formula with a minimum of 600mgs of magnesium.

If a person isn’t having a daily bowel movement then they are still deficient in magnesium.

Magnesium is a natural muscle relaxant and a deficiency can cause low serotonin states, muscles tightness, constipation, fatigue, anxiety, and insomnia. Make sure you’re taking the CFS/Fibromyalgia Formula or a multivitamin/mineral formula with at least 600mgs of magnesium.

I Can Fall Asleep After Taking 5HTP But I can’t Stay Asleep. What Should I do?

If you’re falling asleep but can’t stay asleep, try taking 2-3mg of timed-release melatonin along with your 5HTP dose.

Patients can increase their melatonin doses up to a total of 6mgs. Again, stay on the 5HTP.

Some patients have trouble winding down and can’t turn their minds off. Some seem to catch a second wind right before going to sleep. If this sounds like you then you may need to take GABA one and a half hours after dinner (on an empty stomach) along with 5HTP and perhaps melatonin.

If GABA doesn’t work, then use L-Theonine. Both are available at your local health food store.

What If Nothing Works?

If all this fails then it is time to use prescription medications. You should continue to take 5HTP along with these medications. Hopefully you’ll build-up your serotonin levels and will be able to eventually wean off these medications with the help of your physician.

You have to consistent deep restorative sleep or you’ll never get well or feel better.

Remember you don’t have an Elavil, Ambien or Flexeril deficiency. You have a serotonin deficiency. These medications don’t make serotonin, 5HTP along with the vitamins discussed earlier make serotonin.

If you do need to take a prescription medication for sleep make sure it is one that promotes deep restorative sleep.

Medications That Promote Deep Restorative Sleep

Ambien (Zolpidem) A short-acting drug that usually lasts for 4-6 hours. Even though the literature on Ambien suggests patients don't build up a tolerance, many do. Some patients do well on Ambien and some build up a tolerance over a period of time needing higher and higher doses until the medicine no longer works.

Side-effects include Flu like symptoms, short-term memory loss, headache, dizziness, chest pain, fatigue, nervousness, anxiety, insomnia, and diarrhea. [and we now know weight gain & possible sleep walking-RM]

Sounds like some of symptoms associated with FMS and CFS�?flu-like symptoms, including achy muscles.

Trazadone (Desyrel) An anti-depressant that increases serotonin levels, reduces anxiety, and promotes deep sleep. I’ve found this drug to be quite helpful when 5 HTP or melatonin doesn’t work. It can cause early morning hangover.

Side-effects associated with this tricyclic anti-depressant include upset stomach, constipation, abdominal pains, diarrhea, palpitations, rapid heartbeat, rash, swelling in arms and legs, dizziness, difficulty sleeping, confusion, fatigue, headache, ringing in the ears, loss of sex drive, weight gain or loss, and other unwanted symptoms.

Elavil (Amitriptyline) A tricyclic anti-depressant that has become synonymous with treating FMS. It was one of the first drugs to be studied in the treatment of FMS. It can be very helpful in reducing the pain associated with FMS but it has several potential unwanted side-effects such as weight gain, “early morning hangover�?neurally mediated hypotension (low blood pressure), muscle spasms, tremors, seizures, convulsions, constipation, anxiety, nervousness, fatigue, numbness and tingling in the hands and feet, fluid retention, decreased sex drive, and irregular heartbeats.

Flexeril (Cyclobenzaprine) Another muscle relaxant that is quite sedating and unlike other muscles relaxants (Znaflex) it does promote deep-restorative sleep. It acts similar to Elavil. Some of the side-effects associated with this medication include drowsiness, dizziness, dry mouth, muscle weakness, fatigue, headache, unpleasant taste, nervousness, and confusion.

Turn Down the Lights

Our biological clocks, or circadian rhythm, is controlled by the pineal gland. The pineal gland releases hormones, including melatonin, based on our sleep-wake cycles. These cycles are largely influenced by sunlight. Our bodies are designed to wake-up when light hits our eyes and to get sleepy (increased melatonin) when exposed to darkness. Our ancestors who lived before the invention of electricity were usually in bed soon after the sun went down and up with the morning sunrise.

With the invention of electricity, modern man can have light 24hrs a day. This can keep the body confused.

Good Sleep Promoting Habits

I recommend that before bed you turn off the TV and find a quiet room (not your bedroom) where you can use a soft low voltage (75 watts) lamp to read by. After 30 minutes to an hour, take your bedtime supplement or medication and then move to your bedroom. Keep the lights on low and avoid any stimulation, including the TV. In fact take the TV out of your bedroom! You may want to try a warm Epsom salt bath 30 minutes to an hour before bed. Simply pour 1 cup of Epsom salts (magnesium sulfate) into a warm bath. Soak 20-30 minutes. Again use low-light and no stimulus.

The herb lavender is calming. It can be used as a bath gel, lotion, and soap, sprinkled along with Epsom salts directly in the tub.

Dr. Rodger Murphree
3401 Independence Drive, Suite 121, Homewood, AL 35209

Toll Free Phone: 1-888-884-9577 E-mail: [email protected]

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