When therapy is not working – serotonin and you

You have been seeing your therapist for a while now, you enjoy the sessions. In fact, it is more than enjoy, they feel indulgent and you walk out of the room feeling refreshed and like you can face the week again. There is space to rant and moan, relieving your friends from the job and your therapist uses the techniques she knows so well to help in a solution-focused way. 

But, it has been a while and you manage the real issue rather than find it gone. The sessions help you through and get you from one week to the next, but you would like to be rid of the problem completely. Sometimes we need to delve a little deeper. 

How serotonin influences whole-body well-being 

Something else which may be affecting your life is serotonin. Serotonin has a wide variety of functions within the human body, often referred to as the happy chemical, serotonin contributes to well-being and happiness.

Serotonin (5-hydroxytryptamine, or 5-HT) transmits messages between nerve cells and can be mainly found in the brain, bowels, and blood platelets. Importantly serotonin is the precursor for melatonin, this means that melatonin is formed from serotonin. Melatonin considered the sleep hormone, lets the body know when it is time to sleep.    

In a normal natural rhythm, at around 9 pm your body secretes melatonin. Your body temperature drops, and it begins to prepare for sleep. Serotonin is therefore the hormone that helps regulate the body’s sleep-wake cycles and the internal clock. 

The role of tryptophan 

Now, tryptophan, which we can find in protein, produces serotonin. However, providing you are getting a vaguely healthy diet, an increase in protein in your diet will not affect the levels of serotonin. Of course, if you know your diet to be poor with barely any protein, it is important to improve your diet and include lots of protein.

There is also the option to take 5HTP supplements or tryptophan supplements, however, there is insufficient evidence of those having any effect on the symptoms of low serotonin. A nutritional therapist will be able to help you understand whether you include enough protein in your diet and speak to you about supplements.

Tryptophan requires iron, the B vitamins 3,6, 9 and vitamin C to convert into serotonin. Vitamin B9 is also known as folate. As previously mentioned, if you want to take supplements it is advisable to speak with a nutritional therapist first, but the supplements that may help your body turn tryptophan into serotonin are above. 

Alongside serotonin, tryptophan is a precursor to four other things: melatonin, kynurenine, tryptamine and 3-indole propionic acid. Connected, melatonin and serotonin are relevant for you if you struggle to sleep. Also important is the production of kynurenine and what this contributes to. 

Tryptophan is also the precursor for kynurenine. Kynurenine is the precursor for something called 3-hydroxykynurenine which we can call 3HK and quinolinic acid. 

We know that we need tryptophan to produce melatonin and serotonin, however 90% of our dietary tryptophan goes to the production of 3HK and quinolinic acid. Tryptophan resources are then used up even further by your body’s immune response, which is your body’s response to illness or injury. When you have an illness or injury the immune response triggers cytokines which trigger further inflammation. This increases the kynurenine pathway, taking 95% of tryptophan resources. The result of this is less tryptophan for the other four brain chemicals. Notably for you, serotonin, and melatonin. 

Alongside speaking with your therapist, it is advisable to ensure that your body is not in the inflammatory response. It is frustrating to know that even two nights of disrupted sleep can heighten the inflammatory response - sometimes to the point of adjusting your genes which may then take time to revert. Some infections and illnesses are unavoidable and inevitable, however, it is worth considering whether there are any underlying infections, such as gum disease that your body is continually having to fight resulting in continued inflammation response. 

Exercise is inflammatory but over the long term is anti-inflammatory. Check-in with yourself to make sure that your body is not trying to fight infection. If so, tryptophan will prioritise the kynurenine pathway, away from serotonin and melatonin, which, alongside sleep disruption, can lead to problems.

Documented health issues that can arise because of low serotonin include:

• anxiety
• depressed mood
• aggression
• impulsive behaviour
• irritability
• low self-esteem
• poor appetite
• poor memory
• eating disorders
• obsessive-compulsive disorder
• panic disorder
• post-traumatic stress disorder
• social anxiety disorder

Signs of serotonin deficiency include:

• carbohydrate cravings
• weight gain
• tiredness
• nausea
• digestive issues