Serotonin deficiency due to lactose intolerance?
February 27, 2014 | 25,00 EUR | answered by Dr. med. Ralf Berg
I am 50 and have been experiencing mental (depression) and physical symptoms (severe headaches in the morning after sleeping, tense jaw muscles, tendon problems, etc.) for several years.
Some time ago, I discovered that the cause may be a serotonin deficiency:
First, I noticed that the physical symptoms improved with very intense light therapy (4-5 hours a day). I researched what happens during light therapy and had the impression that serotonin is produced in the brain via the retina.
Since it is difficult to sustain light therapy for 4-5 hours daily, I researched how serotonin production could be stimulated and came across 5-HTP and l-tryptophan.
After taking 3 g of l-tryptophan and 100 mg of 5-HTP per day for 1 month, the physical symptoms are practically gone and my mental state has greatly improved.
I then wondered what could be the cause of the serotonin deficiency. Research showed that 95% of serotonin is produced in the gut. The most obvious explanation would then be my lactose intolerance, which I never paid attention to because I did not think it was important.
Questions:
1) What do you think of the theory of serotonin deficiency due to lactose intolerance? Are such cases known?
2) I feel much better but not yet good. What should I do? Consult a gastroenterologist? Or simply live lactose-free for 6 months and see if it improves further?
Dear inquirer,
This is a difficult question for which I have also not found any literature. The following statements are not to be considered as secure knowledge, but rather reflect my opinion and advice as a practicing doctor.
1. Serotonin, and its disorders, play a significant role in depression. However, I believe it is unlikely that the amount that can be generated through the retina (to my knowledge, only stimulated in the brain, not produced in the retina) is sufficient for treatment. You are right, one cannot endure so many hours of light therapy.
2. If taking Tryptophan helps you, continue to do so. Additionally, I would recommend that you consult your primary care physician, or if they work with a neurologist/psychiatrist in this indication.
The newest and very effective generation of antidepressants are the so-called SSRIs (Serotonin Reuptake Inhibitors). These work by improving a serotonin deficiency in the brain, by increasing the concentration of serotonin in the "synaptic gap" where they work through an inhibition of reuptake into the nerve cell, thus restoring the balance of different neurotransmitters. As you have experienced, this improves symptoms.
Now, back to question 2. I would advise you to start with such an SSRI medication first. There is a good chance that your symptoms will then disappear completely. Of course, you can try to eat a lactose-free diet and see if this helps you, but regarding question 1, I have not found any connections, cases, or comorbidities known here.
The main problem is not the intake of serotonin building blocks such as Tryptophan, but rather that the formed serotonin in the brain is sufficient in certain brain regions, and in a certain ratio to the other neurotransmitters (dopamine, norepinephrine, adrenaline, etc.) available on site.
I believe that your chances of achieving this with the intake of an SSRI or SNRI are very good. I am convinced that a knowledgeable neurologist/psychiatrist can easily help you, rather than a gastrointestinal specialist.
The cause of serotonin deficiency and "true" depression is still unknown. From a medical perspective, it is understood today as a "metabolic disorder" of neurotransmitters in the brain. There is a genetic predisposition to this, but there are often triggers from the environment that can trigger a bout of depression, as well as bouts that neither the psychiatrist nor the patient can explain.
However, treatment options have greatly improved, and I can only advise you to seek specialized psychiatric advice and help without hesitation or false shame.
With kind regards, Dr. R. Berg
