Pagdin’s Pick Number Ten: Tryptophan & Melatonin

Yes, that’s right: the final instalment of Pagdin’s Picks for 2016 contains not one but two supplement suggestions! That’s in part because I could never stress enough the importance of a good night’s sleep. It should come as no surprise that sleep forms one of the “Four Pillars of Health” that you have read about right here in this newsletter (together with healthy nutrition, regular exercise, and reducing stress). Sleep is an absolute necessity to good health. How we feel during the daytime is closely related to how well we sleep at night. During sleep, our bodies are working to help support healthy brain function as well as maintaining our physical health. In young people, sleep also supports growth and development. The quality of your sleep will determine how well you cope, react, learn, make decisions, and get along with others. Needless to say, many of us wish the quality of our sleep were better, at least some of the time!

My approach to sleep problems avoids prescription sleeping pills because they quickly become habit-forming (ie addictive), creating terrible rebound insomnia if one stops taking them. They have also been linked to the development of dementia when used long-term. They tend to result in a groggy state of light sleep rather than deeply refreshing “REM” sleep (the deep sleep state associated with Rapid Eye Movement and dreams). Instead, I have several recommendations for natural supplements which can do the trick quite nicely.

TRYPTOPHAN is the essential amino acid which comes from turkey meat. After a big turkey dinner, we generally sleep great with a couple of good dreams. It is also found in cheese, eggs, fish, and milk, as well as nuts and some seeds (pumpkin, sesame). Over-the-counter supplements contain 50-100mg of tryptophan, but the prescription-strength tablets are either 500 or 1000mg, and the maximum safe dosage is 16,000mg per night! The body can use tryptophan to make Niacin (Vitamin B3) provided it has enough iron, riboflavin (B2) and pyridoxine (B6). Tryptophan is also used to make serotonin, which is critical for a stable mood and helps with sleep. For those on an SSRI antidepressant (eg Prozac, Celexa, Cipralex, Effexor) there can be a build-up of too much serotonin so they must be cautious with the dose of tryptophan because of this interaction. Usually 500 to 1000 mg is safe if you are on an SSRI, but higher doses can lead to “serotonin syndrome” which can include shivers and diarrhea, muscle cramps, sweats, fever, and seizures.

MELATONIN can safely be combined with tryptophan. It is a hormone produced in our pineal gland, and our production naturally declines over the age of 40. It helps maintain our internal biological clock, or “circadian rhythm”, which regulates our sleep/wake cycles. Exposure to bright light in the evening will cause production of melatonin to diminish, which is why it is important to shut off our computers and televisions well before bedtime, and to sleep in a very dark room. Supplementing with melatonin will reduce the time it takes to fall asleep, but it does not really benefit sleep quality much. It is particularly helpful for jet-lag, where a shift in your circadian rhythm has occurred and you need a re-set. I recommend starting with no more than 0.5 mg per night half an hour before bed, and increasing by 0.5 mg each week until you find the lowest effective dose that works. I do not generally recommend more than 5 mg per night. A time-release formula may give you a more sustained sleep benefit.

And as a bonus, in case that’s not enough help: MAGNESIUM is the dietary mineral I wrote about in my October column, so I will not review all the benefits here, but I will remind you that it does play an important role in the brain and that a deficiency can result in nerve excitability that impairs sleep and causes muscle cramps. It is cheap, safe, and effective. Dietary sources include green leafy veggies, fish, nuts, and beans.

“And Mama in her ‘kerchief and I in my cap
Had just settled down for a long winter’s nap…”

Your partner in Living Longer Better,

Dr. Grant Pagdin MD

PS: as usual you can pick up a bottle (or two) of “Pagdin’s Picks” at any of the following outlets:

Prescription Health Studio (540 West Ave, just off Pandosy)
Lakeside Medicine Centre (Gordon at Guisachan)
Medicine Shoppe (3957 Lakeshore Road)
Abaco Health (Gordon at Cook Rd)
Nolan’s Pharmasave (Vernon)
Summerland Pharmasave