The British government
has recently reversed its 16-year ban of the amino acid tryptophan
and will allow its sale once again as a food
supplement. The United Kingdom joins other countries such as Japan
and the Netherlands in letting the public have access to this valuable
nutrient, which is an effective treatment for depression, bipolar disorder,
insomnia, premenstrual dysphoric disorder (a component of premenstrual
syndrome), bulimia, some types of pain, and possibly migraines and
obsessive-compulsive disorder. It is time for the US Food and Drug
Administration (FDA) to follow the lead of its counterparts in these
other countries by ending its ban on this safe and effective natural
compound.
Tryptophan is one of the eight essential amino acids and is present in varying
amounts in protein-containing foods. In addition to serving as a building block
for protein synthesis, tryptophan is a precursor to serotonin, a neurotransmitter
involved in the regulation of mood, appetite, and other aspects of neuropsychiatric
function. Tryptophan is also converted in the body to niacin and picolinic
acid, the latter of which appears to play a role in zinc absorption and transport.
Numerous clinical trials have demonstrated therapeutic benefits of tryptophan,
and tens of millions of people were taking it during the 1980s, without experiencing
significant side effects. However, in 1989, an epidemic of eosinophilia-myalgia
syndrome (EMS), which affected more than 1,500 people in the US and was responsible
for at least 27 deaths, was linked to the use of tryptophan supplements, which
were subsequently banned by the FDA.
Further research traced the EMS epidemic to tryptophan made by a single Japanese
manufacturer. That company had recently changed its manufacturing process and
had inadvertently introduced one or more contaminants into the product. After
it was determined that EMS was almost certainly caused by a contaminant, and
not by tryptophan itself, the amino acid was allowed to return to the market
in several countries. To date, there have been no reports of EMS being caused
by ingestion of uncontaminated tryptophan.
Despite tryptophan's apparent safety and its obvious clinical benefits,
the FDA took years before allowing tryptophan back on the market in the US,
and then only by prescription, at a price three times what it would cost over
the counter (not including the doctor's fee). Were tryptophan readily available
to the public, it would compete successfully against some of the best-selling
drugs on the market, including Prozac, Zoloft, Paxil, Celexa, and Ambien, perhaps
reducing total annual revenues from the sale of these drugs by several billion
dollars. Tryptophan would also compete with Sarafem, a drug approved for the
treatment of premenstrual dysphoric disorder.
Sarafem is actually Prozaz (fluoxetine) under a different name. Apparently,
someone in the marketing department at Eli Lilly determined that women would
be turned off by the thought of taking Prozac for PMS, because Prozac is for
depressed people. Sarafem, on the other hand, evokes images of Seraphim, the
highest order of angels in the Celestial Hierarchy. This apparent willingness
of drug companies to mislead people with word-game mind-games is one of many
examples of their sell-drugs-any-way-you-can mentality. Therefore, it would
not be surprising if the pharmaceutical industry, which is one of the largest
contributors to political campaigns and enjoys a cozy relationship with the
FDA, has been calling in a few favors to keep tryptophan off the market.
Fortunately, almost everyone is mad at the drug companies right now, for engaging
in such misanthropic activities as price gouging, withholding evidence about
the dangers of its products, putting out misleading advertisements, and exerting
undue influence on the conduct and interpretation of research studies. A lot
of people are also mad at the FDA for various reasons. So, now is the perfect
time to point out that the public is being harmed, while the drug companies
are profiting, from the government's misguided policy regarding tryptophan.
Of course, with the unrestricted availability of tryptophan comes the responsibility
to use it wisely. The package insert should point out that tryptophan interacts
with several different antidepressants and with other drugs that inhibit serotonin
reuptake, potentially increasing both their efficacy and their toxicity. Therefore,
people taking any of these medications should not take tryptophan without supervision
by a doctor.
|
