In part I of this blog, I covered the neurotransmitters of mood and the type of depression I see most often in my practice, low Serotonin “anxious depression.” I also addressed the dietary and amino acids suggestions most helpful in addressing this deficiency.
If you missed part I or want a review, click here.
Now, our attention turns to the other kind of depression I frequently see, low Catecholamine, “low energy/low motivation” depression. It’s amazing how different these two kinds of depression are.
The Year That Jake Was Sleepwalking
“I just don’t feel like I’m awake. It’s like I’m walking through life half asleep, experiencing everything through a film”
This was the first thing that Jake said to me in our initial appointment.
At the time of our first conversation, he was a 38-year-old man that came to see me exhibiting crushing symptoms of depression.
He had tried a number of antidepressants.
“But” he said, “they either made me more exhausted, which I didn’t think was possible, or made me wired so I couldn’t sleep. It was like a bad joke.“
After four or five attempts at using medication, he was done, but didn’t know where else to turn.
His drug of choice was coffee, which was the only thing that he felt kept him going. Sometimes, he had to have five or six large mugs a day just to stay alert and upright.
It was clear within five minutes of talking with Jake that he definitely had what I would call an “Eeyore” depression (think back to what Eeyore from Winnie the Pooh was like.)
Jake told me that his depression so consumed him, that he could barely lift his head, his energy was in the toilet, and he wasn’t really interested in doing any of the things that he used enjoy. Mostly he wanted to sleep. To me, the most striking thing about Jake was how joyless he seemed. He was just flat.
All in all, he felt totally “dead inside” and didn’t see any way out of his depression.
The hardest part for Jake seemed to be, that he felt had no reason to feel depressed. He had a great family, and a job he loved, and though he travelled a lot for work and often worked more than 70 hours a week, he said to me “I really have a great life” and I believed him.
Finding What’s Out of Balance
As I heard Jake’s case I was saddened by his despair, but I knew if we could identify the “root” of the problem, I could help him.
So, I began to think about the most likely causes of Jake’s depressive symptoms. I came up with a list of probable culprits (there were many others possibilities that we would might address later if necessary, but these were the most obvious.):
- Adrenal Fatigue
- Low Thyroid
- Low Catecholamines (CATS)
After comprehensive testing, we ruled out problems with his adrenal glands or thyroid issues, and started to get to work on supporting his CATS.
So what are the Catecholamines (CATS)?
The CATS are family of three neurotransmitters that you may have heard of, that are intimately involved with the chemistry of depression.
Dopamine is Involved with focus, and regulating pleasure and reward. Often memory issues happen when Dopamine is either too low or high.
Common symptoms of low Dopamine include lack of focus, addictive behaviors, and loss of pleasure and satisfaction in life.
Norepinephrine is synthesized by the adrenal glands from Dopamine. Norepinephrine helps with attention and focus and a deficiency of it can cause low energy, and lack of focus and motivation.
Epinephrine (Adrenaline) is synthesized from Norepinephrine in the adrenal glands, low levels of which, lead to decreased energy, fatigue, depression, burnout and chronic stress. High levels of it, are associated with ADHD, anxiety, and sleep issues.
In short, when we you have enough (but not too much) of the CATS, you’re alert, attentive, and feel that life is rewarding and pleasurable. Life is good!
But, when the CATS are depleted, everything is just, BLAH! It’s like you are in a slump, with no energy, not enjoying anything and unable to focus. It really feels like you are walking through life half asleep.
Low CAT Symptoms
Here is the questionnaire I use in my practice to determine whether someone has a low CATS depression. It’s adapted from Julia Ross’ book, The Mood Cure.
(3 points) ___Do you feel depressed- low, bored, and apathetic
(2 points) ___Are you mentally and physically low energy?
(2 points) ___Is your drive, enthusiasm, motivation low?
(3 points) ___Do you have a hard time with focus and concentration?
(3 points) ___Is it hard to get out of bed in the AM, or to get going?
(3 points) ___Do you need to have caffeine, or other “uppers” (like chocolate, diet drinks, or prescription drugs like Ritalin, or cocaine” to be more alert or motivated
A score of six or higher would suggest that one’s Catecholamines need support.
Jake’s score was 16!
Are Your Catecholamines low?
Though Jake’s case of low Catecholamines was extreme, so many of us live in a way that taxes our ability to support and replenish this essential brain/stress system.
Lifestyle factors that put you at risk for LOW Catecholamines
The Standard American Diet (SAD)
The SAD is high in carbohydrates and, low in protein and whole foods, which contain most of the vitamins and minerals needed to support the chemical pathways of the body. The acronym for this diet is SAD couldn’t be more accurate, because eating this way really does make us SAD!
- Low protein in the SAD, limits the amino acids necessary to make all neurotransmitters including the CATS.
- Eating Too Many Carbs causes the hormone insulin to surge, which tells the cells of the body to absorb blood sugar and most of the amino acids from the blood. With all of the amino acids moving into the cells for important bodily functions like building muscles, little is left to be turned into the CATS.
- A diet low in fruits and vegetables lacks the vitamins and minerals the body needs as cofactors to convert the amino acids L-Tyrosine and DL-Phenylalanine (DLPA) into Dopamine. These include vitamins B6 and C, iron and others. If these cofactors are limited from the diet, production of the CATS can be limited or even stopped entirely.
Stress
The CATs are “stress coping” chemicals. Norepinephrine and Epinephrine (a.k.a Adrenaline), are made by the adrenal glands, the part of the endocrine system tasked with managing stress.
This system usually works well until our stress levels overwhelm the body’s capacity to make enough of the CATS. This leads to low CAT production, which manifests as symptoms of an “Eeyore” depression.
Three Things You Can Do To Replenish Your Catecholamines
1) Eat a whole foods diet
Focus on eating:
- 25 grams of protein per meal.
- Consume carbohydrates low on the glycemic index to avoid insulin surges.
- Eat real food (grass fed/pastured meats, lots of vegetables, and good quality fat
2) Practice Stress Management
Stress management will help downregulate your central nervous system to help your CATs and adrenal glands rest and repair. Practicing gentle yoga, meditation,or breath work are a good place to start. Follow the links provided for simple practice to get started.
Find a practice you enjoy, because if you do, it will be easier to do it regularly.
Start by practicing 20 minutes every other day for a few weeks and then see if you can practice daily. You can choose a single practice or try a different one every day. One tip is to practice at the same time of day, in the same place. This will make it easier to make practice a habit.
3) Try the supplements L-Tyrosine or DL-Phenylalanine (DLPA)
The easiest and fastest way to increase the amount of the CATS available to your brain is to take the amino acids precursors L-Tyrosine or DLPA as dietary supplements. These supplements are readily available at any heath food store.
If the problem is low CATS, I have found these supplements to be an invaluable tool in addressing symptoms of low energy/low mood depression.
Which one do you start with?
In my experience L-Tyrosine is stronger of the two. If your primary issue is: fatigue, loss of interest, low mood, and poor focus start with L-Tyrosine.
If you have some anxiety along with the symptom above, I would start with DLPA. Also, if you experience cravings for comfort and sensitivity to pain along with the low energy/low mood symptoms, start with DLPA, because along with addressing symptoms of low Catecholamines, it also helps with low Endorphins.
How do you take L-Tyrosine and DLPA?
The most common reason that amino acids don’t work is that people aren’t sure how to take them. They often take them at the wrong times of day and/or don’t take the right amount.
Because of this, here is a detailed explanation of how to do a trial to find the optimal dose of L-Tyrosine or DL-Phenylalanine for you.
Dosing Directions
Take L-Tyrosine or DL-Phenylalanine supplements 20 minutes before, or 1 1/2 hours after food with protein (these supplements are protein fragments, so if taken away foods with protein, they will work more effectively.)
Buy 500 mg capsules of these supplements (the starting dose).
DAY 1: Start with (1) 500 mg capsule right when you wake, four hours later (and possibly mid-afternoon.) If you find that taking the afternoon dose disrupts your sleep stop taking it and just do the two morning doses.) Notice how you feel throughout the day on this dose.
DAY 2: increase to two 500mg capsules (1000 mg) at the same time intervals as Day 1. Pay attention to how you feel throughout the day Specifically, do you notice a reduction in the symptoms that you are taking the supplement to address (i.e depressed mood, fatigue, lack of motivation and pleasure,cravings for substances etc.)
DAY 3: If after day 2, you felt nothing or better than you did on Day 1, then increase to 3 caps per dose (1500 mg), following the dosing schedule of Day 1.
Continuing to increase your dose in 500 mg increments per dose until you see no improvement or feel worse with the increased dosage and back down to the last positive dose. This will be your Tyrosine or DLPA dose.
If you are experiencing no benefit after going up to 3000 mg each dose, I would assume that it will not be helpful to go any higher. At this point switch to the amino acid you have not tried yet and repeat the dosing process starting at the beginning. If you have tried both, consider other interventions besides amino acids to raise the CATS.
How do you know when to stop?
If you have found a helpful dose of either DLPA or L-Tyrosine it is typically advised to stay on the supplements for at least three to six months before considering a trial of coming off.
I suggest waiting long enough to make habits out of the CATS supportive lifestyle changes I have outlined in this blog. These changes will increase the likelihood of coming off of the supplements successfully. If you experiment coming off, and feel more depressed, just restart the supplements at the helpful dose. Then, wait a few more months before experimenting again with coming off.
Here’s a Dosing Example
You feel better than you felt before trying L-Tyrosine or DLPA when taking two 500 mg capsules 3x day. For examples, you feel more energy, better focus, less depressed.
The next day you try going up to 3 caps 3x day. Now, you feel more anxious and “not as good.” You would then go back down to two 500 mg capsules, 3x day as your ongoing dose of L-Tyrosine or DLPA.
A few words of caution:
Speak to your medical provider before starting either L-Tyrosine or DLPA to discuss if he or she recommends it as part of your treatment plan.
This is especially important if you are taking an SNRI antidepressant (including Wellbutrin, Cymbalta or others.) If your medical provider is ok with it, and you do decide to do a trial of either, they should be taken at least 6 hours before or after you take your antidepressant medication. Since, these amino acids need to be taken earlier in the day, the medication would have to be taken at night if tolerated.
Do not use Tyrosine or DLPA (or use with caution under a doctor’s supervision) if you have any of the following: Overactive Thyroid (Grave’s Disease,) Melanoma, High Blood Pressure, Migraine, Bipolar Disorder
Jake’s L-Tyrosine Experience:
Jake started a number of supplements typically used to raise his Catecholamine levels. L-Tyrosine was the main one, but we also gave him certain vitamins and essential fatty acids to support production of the CATS.
These included two forms of vitamin B6 (regular B6 and P5P, a methylated form), a B-complex, Vitamin C, and a large dose of fish oil (5000mg, which has been shown to support CATS production.)
Jake did not notice any improvements in his symptoms until we got up to 3000 mg of L-Tyrosine, three times a day (we kept the afternoon dose because it did not affect his sleep and helped him get through his afternoon “slump” which was the hardest part of the day for his fatigue. After a few days of taking 3000mg three times per day, Jake noticed his internal “lights coming on.” At first the lights were pretty dim but after a few weeks on this regimen, they grew consistently brighter.
Over time, he was waking up more energized. He only needed one coffee to get going (and on a few occasions he even forgot his AM brew.) Overall he felt less fatigued, more hopeful, and an increased ability to stay focused on daily tasks.
Little by little, Jake started to do things that he enjoyed, and with each success he felt encouraged and motivated to do more.
He started to spend more time with family and friends, and after a few weeks felt the energy and motivation to start exercising again.
The ability to get back to the gym (which is something that provided him with a big mood boost in the past, was a real turning point.)
After about a month of just focusing on the supplements and reengaging in life, he was able to take a hard look at his diet and cut out gluten and dairy. After about 3 months, he did a Paleo elimination diet, and found that he had several food sensitivities that contributed to his depression (he felt more depressed after reintroducing gluten and corn and noticed how much better he felt when they were out of his diet.)
At about the three month mark, Jake started a regular meditation practice which would not have been possible before he started L-Tyrosine.
Six months after starting taking L-Tyrosine he felt close to normal, but knew that maintaining a balanced lifestyle was essential to him not becoming Eeyore again.
What’s next for you?
Did you score above a six on the Catecholamine questionnaire?
Which of the low CATS symptoms prevent you from being who you want to be?
If you scored above six on the questionnaire, I wonder if you are willing to accept a challenge?
Take two months and do an CATS makeover!
Follow the three steps I outline in this blog and see how you feel!
Please share your experience in the comments section below or on my Facebook Page.
If you found this article informative please share it with any of your friends and family.
If you would like to receive more articles about integrative treatments for depression and other mental health issues, visit my website and join my mailing list.
In good (mental) health,
Dr. Josh
Dr. Josh Friedman has more than 25 years experience in mental health as a client, psychologist, and functional nutrition practitioner. After working in the field for a few years, he realized how many people were still struggling with depression and other mental health issues even after years of therapy and medication. Over time he became increasingly uncomfortable with the limitations of standard psychiatric treatment and knew there had to be a better way. Over the past decade and a half, he has committed himself to learning as much as he could about the root causes of mental health symptoms. To share this information and to help people get unstuck, he started Alternative Mental Health Solution.
What a wonderful and inspiring article. There are so many useful tips and information. Thank you
So glad you found it helpful!
Great article!
Thanks Surrey
Hoping I can help my 30 yr old son, struggling with depression with your ideas.
Hi Lisa,
What are your son’s symptoms. Does it sound like he’s low CATS?
Dr. Josh
What great articles. Been on a downward spiral with depression. Willing to give this a try…Thank you
Thanks so much for this nice sharing.
Hi Dr. Josh,
I was wondering if you could address the link between migraine and Tyrosine. My mother is Bi-polar and has migraines. I have MTHFR mutation and migraine history. My adult son also has migraine and has ASD. He has not been tested but I believe he would be MTHFR positive as well. We both have issues with anxiety and or depression. He has huge anxiety issues and I was thinking more along the lines for treatment for him. He is on an extensive supplement support program including L-Theanine, an adaptogen stress formula, omega 3’s , Lemon Balm, CoQ 10, and magnesium. He follows a gluten free/dairy free paleo diet. He exercises regularly but doesn’t have great sleep hygiene (blue light before bed) EMF exposure.
Those are the basics, any thoughts would be appreciated !!
Many thanks,
Sheridan Peterson
Hi Sheridan,
The first thing I would do would be to have food allergy testing done, especially for your son. Either IGG testing (delayed food sensitivity testing through Great Plains) or the MRT test through oxford biomedical. Other treatments with the ASD sx and migraines would be for neurofeedback training. I would look to do Infralow (Othmer system).
Best of luck,
Dr. Josh
Hi Dr. Josh, I suffe r from anxiety and depression. I have been treating my adrenal glands for 3 years with Calm PRT and or just regular Rodiola and licorice root. I recently stopped taking those, not sure if i have adrenal fatigue anymore, seems like i dont. Then i recently became so tired that i could barley function. I took three hour naps for one week. My vitamin D was insufficient so i started Vitamin D and K2 again 1-2000 mg per day. Seemed to help with low energy but i still have anxiety during social times and depression all of the other time. I also have low blood sugar problems if i dont eat regularly or the right combos or if i get anxiety. Ive tried L-Tyrosine and it gives me anxiety. Im also on Ester C, dessicated liver for B vitamins, iodine 12.5mg probably need Omegas but fish oil makes me extremely tired after i take it. Filled out the Amino Acid Therapy Chart and it seems like i need all of them, scored 10’s on almost all but melatonin. The one that stands out to me the most is the low endorphin one though because most of the time i feel numb and do not feel love even for my family which causes me a lot of psychological pain. Im not sure where i should go from here?
Sarah, I think it would be helpful to find a skilled practitioner to help you figure out what the next best step is.
The first thing I might get back onto the adrenal support again and see how you do. Also may be helpful to test (or retest) your adrenals using a 4 sample salivary adrenal test or a urine test called the DUTCH test that looks at adrenal and sex hormones.
Such a great article) And the Julia Ross book (both Mood Cure and Diet Cure) are invaluable tools. I live in NYC, and anyone with depression in this city knows it’s its next to impossible to find a good psychiatrist that costs less than $400/hr or accepts ANY insurance, so many of us are left to fend for ourselves. This usually means massive amounts of research online (and spreadsheets of comparative info in my case), weeding through thousands of comments on mental health and drug forums, trying to convince PC Drs to write prescriptions for drugs they have no familiarity with, and constant trial and error with an endless number of “miracle” supplements. So, blogs like yours, with useful info that has been properly verified, from people that have been properly vetted, is music to my eyes.
One question I have is regarding Tyrosine with SNRIs. Why is it that they should be taken at least 6 hours apart, and is there supporting info you could point me to? Thanks!!
Some of these rules I just passed down from practitioner to practitioner through an “oral tradition”. It comes from work done on SSRI and the use of tryptophan and 5htp. Because of a fear of Serotonin Syndrome, the general rule of thumb has been to not take serotonin raising supplements with SSRI meds. Many clinicians have found that spacing meds from either Tryptophan or 5HTP by at least 6 hours avoids this risk. I think that thinking has carried over to spacing Tyrosine and DLPA from SNRIs. At this point, I never suggest taking SSRIs closer than 6 hours form serotonin supplements but sometimes will give tyrosine or DLPA within an hour or 2.
hi there great article!
i’m a 25 year old male with fibromyalgia & was on methadone for pain for a year. i’ve been off that for 3 months but still feel extremely low energy. i tried DLPA to replenish dopamine etc, but by around the fourth day i was feeling catatonically tired & brain dead. this result isn’t in your suggested trial protocol and i’m wondering if you have any thoughts on this reaction (dlpa making me more tired/depressed).
is it possible that this is the result of dlpa lowering adrenaline & is it possible that this effect will go away after a few days. or should i simply stop? at this point i have no idea what else to try, i’m so weak and depleted and it’s frustrating, especially as i have no health insurance. none of the serotonin type supplements or drugs help me – just give me palpitations and increased tiredness. i was kind of hoping dlpa would be my “answer” 🙁
Hi Jack,
how much DLPA were you taking? Did you feel more energy at one dose and then it just dropped off at that same dose or did you go up in dose and the energy dropped out? Dosing tends to be very important with DLPA and other amino acids.
Hello Dr. Josh,
Thank you so very much for this information.
I have been chronically depressed for as long as I can remember. I finally decided to get help and concede to going on prescription medication, Wellbutrin, but it had no affect on me. I then discovered The Mood Cure a few days ago and am very excited about it.
I scored high in both the low serotonin and low catecholamine sections (as well as endorphins).
I tried 5htp but found it did not work for me. However, having just discovered your blog, I will repurchase it at 50 mg and follow the dosing schedule you suggest, along with making sure to take it on an empty stomach and with B6 and zinc (which I had not been doing, as a friend had given me the 5htp before I read the Mood Cure).
I have also tried L-Tyrosine and one time it worked for me and one time it did not, but I’m glad it worked at all because then I know that there’s a dosing or timing issue I must play around with.
Lastly, being in withdrawal from the Wellbutrin, I also bought GABA because this is advised for antidepressant withdrawal.
I give you all this information because I am quite overwhelmed.
I also have a long list of supplements I want to buy (B6, B complex, calcium, magnesium, etc.)
My questions are: firstly, how much B6 is necessary for treating depression? I note the B complexes often have just 2 mg in them, so should I supplement more of solely B6?
Secondly, since I am in the trial stage of all these amino acids, how should I go about testing all of them? Should I take a few days just to figure out my dosage for L-tyrosine, then a few days for GABA, then a few days for 5htp? Or do you think I can figure out the dosages for all of them simultaneously, given that I would likely be taking L-tyrosine in the mornings and maybe 5htp in the afternoons/evenings?
Thank you very much for all that you do,
I have found all I have read very helpful so far, as this can all be very confusing and overwhelming. You have cleared some doubt in my mind already, and I’ve only begun to explore your site.
Ciara
Hi Ciara,
The first issue to deal with is the wellbutrin. As long as you are in withdrawal it will be difficult to really get a sense of how the aminos will help you. How quickly did you come of the wellbutrin and are you still on some? My sense is that you will need to go back on the wellbutrin to stabilize and then go down much more slowly. I would stabilize on wellbutrin (no withdrawal symptoms) and would start the supportive supplements (100mg b6 in the AM, 50mg p5p am and 60mg of Zinc picolinate with dinner). I would also get a broad spectrum amino acid blend called Total Amino Solution by Genesca and take 2-3 caps AM, Mid AM and possibly mid afternoon and 1000mg of L-Tyrpophan in the late afternoon and evening.
Hello Dr Josh. Thank you so much for your advice.
Do you offer private help?
I was wandering if Jake was also taking any ssri or snri while you gave him the amount of tyrosine and other supplements you did?
Regard, Tom
Hi Tom,
Just tried to email you but it wouldn’t go through. I do offer individual phone/video consults. Jake was not taking medication when he tried the amino acids though he had been tried on medication before with limited response. Some people who do not respond robustly to meds do respond to amigos and vice versa.
I would be glad to help if you need it 🙂
Dr. Josh
Greetings Dr Josh. I desperately need your help or advice regarding my major depression. I just started cipralex 5 mg and 5000 units of vit D. Was hoping the amino acids will help. Please can you kindly answer in my email so i can present my whole story? Thank you so much… im really desperate
Cosmina,
Sorry to hear you are having such a hard time. Just responded to you to your email.
Dr. Josh
Dear Dr Josh,
thank you for this information. I went on your Facebook page and I’ve seen a lot of interesting articles that I will read this weekend.
I bought Tryptophan 200 and L-Phenylalanine 200 yesterday but I’m not sure how to take them as I am on cipralex, I take 1x 5mg at night.
I also would like to try GABA or Glutamine ..
could you help me ?
thank you
regards,
Debby
Debby,
Do you take the Cipralex for sleep. Looks like you got 200mg caps witch is a pretty small dose. Typical starting dose is 500mg.
If not it would be advisable to move it to the AM (you would need to as the prescriber if this is OK). The reason to move it is so that it’s a least 6 hours from the Tryptophan (as you would not want to take it at the same time as the tryptophan for risk of too much serotonin building up). Once you move the medicine, you can experiment with taking 1 cap of the tryptophan in the late afternoon and 1 cap 1/2 hr before bed. You can use the attached dosing chart to find the “best” dose for you. https://integrativedepressionsolutions.com/wp-content/uploads/2016/09/L-Tryptophan-and-5HTP-Dosing.pdf Once you find your tryptophan dose you can try Phenylalanine 1st thing in the AM and Mid morning. You can use the same general rules to find the “best” dose of Phenylalanine.
Thank you for your reply.
I take Cipralex 5mg since sept.2017 for my OCD (obsessive thought, fears,..) and it’s working well so far although I still have anxiety but I try to deal with it and obsessive thoughts have diminished.
I have been on CBT for more than 2 years
Yes, L-Tryptophan and L-Phenylalanine have 200mg dosage here in Belgium.
I’ve read the Craving Cure from Julia Ross last week and decided to buy L-tryptophan and L-phenylalanine after taking her test but I realized that I bought L-Phenylalanine instead of DL-Phenylalanine actually (I don’t even think that DLPA gets sold here in Belgium) so on Saturday I tried to take 1 cap 200mg L-Phenylalanine (more than 8 hours after taking cipralex) but I got a huge headache a few (3) hours later and got a panick Attack too, so I won’t try it anymore.
According to the results of her craving test I also need GABA. But I didn’t find it at the drugstore.
I see my GP tonight I will ask him if I can take L-Tryptophan but he doesn’t really believe in “natural” medication so I think I won’t be ok.
I never wanted to take medication because I know that they are addictive but in sept.2017 the anxiety was unbearable, plus we found out that my brother had cancer, it was and still is a really bad time for us.
Reading the Craving Cure, I learnt that amino acid can actually help our brain make more serotonin while SSRI only use the available serotonin more but it doesnt give you more serotonin and this is why I want to try the AA and also because I have cravings and keep on putting on weight even though I eat low quantities.
Everything I’ve read makes sense to me and I hope it can help me and also other people in need.
Thank you
Debora
I hope your doc is open to letting you try tryptophan. If spaced away from the medication by at least 5 hours using julia ross’ guidelines Tryptophan can help the medication work better.
Hi Dr. Josh,
I have been battling depression, low mood, no joy about life, low energy for years. I was on anti-depression medications after the loss of my baby son for quite a while but didn’t like them. I have been just going through the motions ever since. A few years ago, I was diagnosed with high blood pressure and I take 50 mg of Amlodipine. You mentioned in your blog that you shouldn’t take either L-Tyrosine or DL-Phenylaline if you have high blood pressure. My blood pressure has been regulated for some time now, do you think it would be okay to try one of these since my blood pressure is where it should be?
Hi Cynthia,
I am so sorry to hear about the loss of your son. If your blood pressure is controlled I think it would be ok to try L-tyrosine or DLPA. If your heart still feels tender with heartbreak I would think about trying DL-Phenylaline using the dosing instructions I provide. Best of luck!
Sending Love and Blessing,
Dr. Josh
Hello Dr. Josh-
What helpful information. I have leaky gut/food sensitivities and when they flare up, my mood tanks too. I’ve seen some great integrative practitioners over the years though at times rely on traditional Rx too.
I’m on 10mg paroxetine (SSRI) which for now I’m happy with. It’s keeping my mood calm so I can continue healing. However, I am so tired, low energy, etc. A definite eeyore. I’m confident my thyroid is well managed and adrenals are supported.
My question: if I move my SSRI to bedtime, can I do the L-tyrosine during the day as you describe? I just want to be safe and not mix things I shouldn’t. Thank you!
Stacey, that’s what I would do. It is generally safer to separate Tyrosine from an SSRI by at least 6 hours (so if you took the SSRI at night, it would definitely be far enough away.) I would let your Integrative Doc know to keep them in the loop.
Fascinating information and I have decided to start supplementing with L-tyrosine. Does doing so have an adverse effect on serotonin levels? Does increasing dopamine mean there will be a decrease in serotonin? Google results are mixed! Thank you so much for the valuable information.
Hi Benjamin,
I have people on Tyrosine for long periods of time without creating low serotonin symptoms. I suggest people find a good dose of tyrosine and stay on it for 3 months and then do a trial of coming off it. Some people need it long term while others can come off an maintain the initial benefit.
Dr. Josh
I have been studying your articles for a few weeks. I tried around 6 anti depressants or maybe more. Something may help for a month or so but then back to the same old feelings.
I at 63 year old white female. I related well to your Eyore example. I began your regiment and included the other vitamins you suggested. At first I felt like holy cow!! But then….
I progressed up to 3000 mg twice and 1500 for 3rd dose.
I felt worse so I backed down to 1500 2 times then last dose of 500.
I still do not feel very upbeat.
I am desperate for help. I do have a great life, I serve God and have a good family and just don’t understand this.
Is there anything else you can suggest I do or do not do?
I need to inform that I have had 3 major joint replacements. Numerous nerve impingement surgeries. I walk 1.5 miles per day. I do receive pain management.
Hi Doc!
I’m just curious why one wouldn’t combine the two together? Wondering if that would be good/effective or a no-no?
Hi BR,
We do sometimes combine the 2 together (they often come together in combined products). I tend to be careful and choose one to start with. If low energy, low mood is the biggest problem I would typically start with Tyrosine at the lowest dose and go up slowly to find the sweet spot. I would then add in the DLPA, especially if there is also a low endorphin issues (like emotional sensitivity or pain). The whole skill in this is doing a small intervention and then watching to see what you notice over a few days before adding more.
Best of luck,
Dr. Josh
I started out as a low serotonin type, but Lexapro improved that greatly. (5-HTP and l-tryptophan were unfortunately ineffective for me personally, and I needed the Pharma.)
However, after the anxiety-driven stuff was gone, I transformed into a low in CATS type (scored all 16). I had been under extreme stress for years. And, I’ve read SSRIs can deplete CATS over time. But I suspect I had a primary serotonin type of depression/anxiety that, once managed, revealed the low CATS that were there under the anxiety.
Interestingly, l-tyrosine is too stimulating (generates headaches and high BP) while DLPA took gobs (9g daily) to get any noticeable improvement. I actually was so desperate that I tried Wellbutrin at one point at the lowest dose, and that was bad – high blood pressure, anxiety, and irritability.
A little reading around brought me to try l-phenylalanine (l-pa without the d-pa). That, so far, is giving me everything I ever wanted at much lower doses (2g, for example). I am still titrating to find my best dose, but I have to say, I have energy and feel great mentally! No pounding heart or headaches or high BP.
Is there a reason you don’t recommend the L-PA instead of the DLPA?
Good job experimenting to find what works for you. I am not sure you can even get LPA as an isolated supplement. The way we teach DPA addresses endorphin issues (physical and emotional pain) and DLPA hits both the CATs and Endorphins. I would be interested if you know about a supplement that contains just LPA.
Hi Dr. Josh,
Can I take DLPA during the day and also take 3mg of melatonin before bed?
Hi Chris,
Yes it is absolutely fine to take DLPA during the day and melatonin at nigh
Best
Dr Josh