The brain chemical serotonin has achieved fame, by association, riding on the tails of the anti-depressant wonder-drug Prozac. Prozac is probably the best known anti-depressant of all and a half-a-million of the estimated 15 million users world-wide are in the UK.
Brain chemicals, such as serotonin, are the messengers which operate between nerve cells, and maintaining correct levels is critical to balance mood and behaviour. Imbalances can result in a range of behavioural problems from hyperactivity to depression. Serotonin is one of the most important brain chemicals for regulating mood, and if levels are low then depression can result.
Prozac is the most popular in a class of drugs called SSRIs (selective serotonin re-uptake inhibitors). It works by preventing serotonin from being reabsorbed by nerve endings and so keeps circulating levels of the brain chemical higher. In doing this it can be effective at restoring normal serotonin levels, and so normalising moods and improving problems with depression. But there can also be side effects to Prozac and other SSRIs (the collective term for a class of drugs which includes citalopram, fluoxetine (Prozac), fluoxamine, paroxetine and sertraline).
This is because the body is meant to naturally secrete serotonin and, by preventing this, SSRIs can cause side effects such as nausea, vomiting, dyspepsia, weight loss or weight gain, nervousness, anxiety, headaches, insomnia, dizziness and sexual dysfunction. The British National Formulary (the standard drug reference guide) even states “suicidal ideation has been linked with some SSRIs particularly fluoxetine…..”.
It also appears that normalising serotonin levels is one of the more important treatments for SAD (seasonal affective disorder). SAD is a condition where low energy levels and depression hit with the short days of the winter months, and which rights itself in the spring and summer. It seems that low serotonin is a major player in this condition, and that treatment for this can significantly enhance the conventional treatment of SAD with light therapy. Another area where Prozac is being used is in the case of severe pre-menstrual disorder, and some success has been achieved by treating it this way (though this approach only deals with the symptoms and does not attend to the basic causes).
The natural options
Because Prozac is a drug with possible side-effects it is not always appropriate to prescribe it, and it is also the case that many people are, quite rightly, wary of taking drugs. We are learning much about serotonin and the importance that it has on correct brain function, and on its wide impact on moods, depression, SAD, sleeping patterns, appetite and binge eating, and it is becoming evident in trials that employing means to normalise levels naturally can pay rich dividends. There are a number of dietary means by which we can boost serotonin levels, and there are also some potent natural supplements which can have a profound effect on the balance of this brain chemical.
Eat to boost serotonin levels
Serotonin is sometimes called our ‘satisfaction’ brain chemical because, in addition to giving us a sense of well-being, if levels are normal then we don’t feel the need to overeat sugary and refined carbohydrate foods which give us a short term serotonin boost, at the expense of a sharp drop-off soon after.
We make serotonin from an amino acid (protein building block) called tryptophan. By eating tryptophan rich foods we can naturally boost levels of serotonin. Tryptophan is not as widely distributed in our foods as other amino acids, and it is found mainly in: turkey, chicken, fish, pheasant, partridge, cottage cheese, bananas, eggs, nuts, wheat germ, avocados, milk, cheese and the legumes (beans, peas, pulses, soya), and there are also smaller amounts in breads, cereals, potatoes and rice.
Because tryptophan is such a large molecule, other more easily absorbed amino acids actively compete with it. In order to divert them, and encourage the uptake of tryptophan it is helpful moderately raise insulin levels by eating starchy foods, such as brown rice, wholemeal bread, porridge oats and jacket potatoes, alongside the protein foods.
If brain serotonin levels are low then it can be tempting to reach for foods, and substances, which will temporarily give us a boost. These include sugary foods, refined carbohydrates (such as crisps, white bread, white rice and other processed foods), and alcohol. The problem with these foods is that they perpetuate the cycle of cravings. Normalising serotonin levels is probably one of the most important, and most ignored, means of reducing the need to binge-eating and drink.
While serotonin is the messenger, it is necessary for the message to be received. The brain chemical receptors are built principally from vital fats which include EPA and DHA. These two are found mainly in oily fish, such as mackerel, salmon, tuna, herrings and sardines, and also fish oil supplements, cold-pressed flax and walnut oils. Depression has been shown to be significantly improved by introducing these fats daily, over three or four months.
Natural alternatives to Prozac
St John’s Wort is a traditional European herb, also called the sunshine herb because of its yellow flowers, and it has gained popularity in the UK. But we are nowhere near as switched on as in Germany, where it is prescribed ten times more frequently than is Prozac. It appears that the action of St John’s Wort is similar to that of Prozac in that it prevents the break down of serotonin, and so keeps levels constant.
Trials, which directly compare the effects of St John’s Wort with Prozac, are showing that St John’s Wort is more effective than Prozac in cases of mild to moderate depression, with none of the potential side effects of the drug. It is best to build up your use of St John’s Wort slowly over about three weeks to the full dose of 900 mcg daily of standardised hypericin (the active component), starting with 300 mcg daily.
Another route to raising serotonin levels, if they are deficient, is to encourage the body to make more of it. Diet is one major way in which this can be achieved, but there is a short cut for people who feel the effects of low serotonin more acutely. When we eat tryptophan-rich foods, the tryptophan is converted into a substance called 5HTP (5 hydroxytryptophan) before finally being converted into serotonin.
A West African herb, Griffonia simplicifolia is a natural source of 5HTP which is easily absorbed and highly effective at raising serotonin levels, as it is only one step away from the actual brain chemical. It is so effective that one American magazine described 5HTP as “the biochemical equivalent of a trip to Hawaii”. The effective dose can be highly individual and it is best to start with a low dose of 50mg and build up to 100mg. In some cases levels as high as 150-200mg may be needed but, in some people, less is more and 50 mg three times a week is sufficient.
One way to tell if you have got the dose right is to observe your sleeping patterns. Because serotonin is involved in the sleep cycle (by boosting levels of the ‘biorythm’ hormone, melatonin), 5HTP should improve the ability to get to sleep. On the other hand too much can lead to wakefulness, and so if it is having this effect then you are probably taking too much, or do not need it in the first place. It is best to take 5HTP later in the day, towards the evening.
Another supplement which has a direct impact on serotonin levels is the herb Rhodiola. This native of the Russian and Asian high ground (it grows at around 4,500 meters above sea level) had its light hidden under a bushel by Soviet Russia, until the new social order came about, when the West began to find out about the 60 years of research on this herb. As a powerful adaptogen – a herb or substance which is used to help the body resist the negative effects of stress – it was employed on the Russian cosmonaut space flights to reduce the problems associated with long spells of weightlessness while cooped up in a small space under high stress conditions.
But Rhodiola has another important and useful property, reducing the breakdown of serotonin. It does this by a different route to the SSRIs and acts by inhibiting another natural body chemical called MAO (monoamine oxidase) which breaks down serotonin (MOA inhibiting pharmacological drugs include Nardil and Parnate). By inhibiting MAO, Rhodiola has been shown to improve brain serotonin levels by 30%. At the same time, by inhibiting MAO, it also seems to improve levels of another brain chemical, dopamine, and so may have applications for different types of depression which include low levels of both of these brain chemicals.
Taking these serotonin enhancers and regulators can have a pronounced effect on depression, binge-eating, sleep disorders and SAD. Can you take these products all together? It is probably best to start with just one product over two or three weeks, to establish if it is helping you and to what extent. If a little is good, it does not mean that more is better, and it is not wise to take more than you need. However these products do have a synergistic effect and if you don’t quite get the effect you need from one, you can then add in a low dose of another to enhance the overall effect.
Because the effects of these herbs and 5HTP have not been studied in pregnancy it is important to avoid them when planning, or during, a pregnancy and during breast feeding. You should also not take any of these supplements alongside anti-depressant drugs without guidance from a doctor, qualified herbalist or nutritional therapist. St John’s Wort can cause photosensitivity (oversensitivity to light and sun). If you are affected by clinical depression you must seek the advice of a medical doctor or other suitably qualified health professional.