QUESTION: Can I give a depressed pregnant patient tryptophan or 5HTP?
ANSWER: We should be careful with pregnancy contraindications for nutrients when the data is weighted to safety. In the case of a mom with enough B-Vitamins to process an amino acid, the use of an amino precursor within the range of nutritional need is generally quite safe. It is why I use single amino’s when required in pregnancy (l-tryptophan in this case) – at the lowest dose necessary for clinical effect.
I think the use of AA’s like this in pregnancy has been successful and safe for those of us who have done it a long time because you are very much supplying known substrate which the body may use as it will. Regarding the data often quoted in a “partially correct manner”: One study from 1986 on human feti while mom is given glucose, l-tryptophan, is fasting or is given both glucose and l-tryptophan, shows some interesting findings, notably: “Maternal administration of tryptophan is associated with an alteration in fetal breathing activity but to a lesser degree than that observed after maternal glucose loading.” Essentially glucose causes more fetal breathing change than l-tryptophan. And other things which are considered safe (exercise, eating…) cause fetal breathing changes as well. In a very well supported animal study published in 2013, the doses required to create any biologic changes in offspring were similarly unattainable in a human model due to the excessively high doses of tryptophan required for toxicity (> 3.3 g/kg maternal body weight – or on average 150 – 210 Grams l-tryptophan in a human).
Of course caution is always warranted in pregnancy, and mom needs the B-Vits to process AA’s, but as a place to start it is much safer than many other potential interventions I have seen…