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L-Tyrosine As A Treatment/"cure" For N, And Mouret Vs. Elwes


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#1 Andrew

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Posted 11 January 2013 - 01:25 PM

Hey all -

 

Long time lurker, first time poster, 34 years old, N with C, N first surfaced circa mid-2010.  But enough about me.

 

I was curious if anybody more science-y than me had any thoughts or insight into two fairly notable (pre-discovery of Orexin/Hypocretin deficiency as the hallmark of N) studies performed using the amino acid supplement L-Tyrosine as a treatment for N.

 

The first, conducted in 1988, was run by a French doctor named Jacques Mouret.  He conducted a 6-month trial with narcoleptic patients supplementing with L-Tyrosine and reported that they universally experienced a remission of symptoms after 6 months.  It was published in The Lancet, and it made the New York Times:

 

http://www.thelancet...e/PIIS0140-6736(88)90935-X/abstract

Abstract:

 

8 patients with narcolepsy were treated with oral tyrosine. Within six months all were free from daytime sleep attacks and cataplexy (Dr. Mouret states in the Times article linked below that the findings were confirmed in 23 add'l patients):

 

http://www.nytimes.c...p-disorder.html

 

 

Sounds too good to be true, right?  Of course it does.  The above trial was also not double-blind, placebo controlled.

 

A year later, some dudes and dudettes in the Dept. of Neurology at King's College Hospital in London led by one Dr. RD Elwes released what is (I am presuming) a "rebuttal study":  Double-blind, placebo-controlled, 4 weeks in duration, supplementing L-Tyrosine to determine efficacy against N with C. Its findings were completely the opposite of the Mouret study:

 

http://www.ncbi.nlm..../pubmed/2572797

Abstract:

 

A randomised, double-blind, placebo-controlled study of L-tyrosine was done in ten subjects with narcolepsy and cataplexy. Of twenty-eight visual analogue scales rating mood and arousal, the subjects' ratings in the tyrosine treatment (9 g daily) and placebo periods differed significantly for only three (less tired, less drowsy, more alert). Ratings of daytime drowsiness, cataplexy, sleep paralysis, night-time sleep, overall clinical response, and measurements of multiple sleep latency and tests of speed and attention did not differ significantly between tyrosine and placebo periods. Dietary supplementation with tyrosine 9 g daily for 4 weeks seems to have a mild stimulant action on the central nervous system but this effect is not clinically significant in the treatment of the narcoleptic syndrome.

 

 

My thoughts, questions and comments:

 

  • Has anybody tried supplementing Tyrosine on a long-term basis as a treatment for N?  The duration differences in the study (1 month vs. 6) are notable.  There is a lack of any other information aside from these studies, at least that I can find, on the Internet.
  • Tyrosine is a precursor to dopamine, epinephrine, norepinephrine.  Presumably, supplementing Tyrosine would maximize dopamine levels in the brain.  Dopamine agonists (e.g. amphetamine) have long been used as a treatment for N.  This blog post has some interesting thoughts on the subject.
  • I don't know the dosage used in the 6-month study, but the 4-week study used 9g a day (about 100 mg/kg for a 200-lb person).  That's a lot!  It is pretty cheap though (500g powder is ~$25 on Amazon).
  • It's kind of mind-boggling to have a study like the first one and then a lack of subsequent evidence aside from the contrary study released one year later.  While I doubt there is an island of cured formerly-sleepy French people chugging 10 grams of amino acids a day, it seems weird that this just kind of fell off.
  • There's not really any evidence of negative sides from long-term Tyrosine supplementation, aside from it being contraindicated for use alongside MAOIs (what isn't?) and hyperthyroidism (Tyrosine has been used successfully as an alternative to synthroid and other thyroid hormone supplements because it increases the body's production of thyroid hormone).
  • There is lots of anecdotal evidence on the web of Tyrosine being used successfully to promote alertness in non-N people (Google for more).
  • The US military has successfully tested Tyrosine to promote alertness for soldiers in sleep-deprived and stressful situations on a short-term basis (there is another, better paper on this that I can't seem to find at the moment).
  • Many people believe that prolonged Tyrosine supplementation is not beneficial because of the body's rate-limiter for conversion of the amino acid into neurotransmitter goodies , which is the tyrosine hydroxylase enzyme.  However, several things have been found to increase the body's production of TH, including nicotine and sleep deprivation (and cocaine, LOL).
  • There are also lots of reports on Tyrosine supplementation potentiating the effects of dopamine agonists - see this Erowid report on Tyrosine and Adderall (Google for more).  Presumably this is the body "restocking" dopamine?  Be careful if you take Tyrosine alongside stimulants (and possibly get more out of the stimulants you are using).

 

I figured if anybody would know more about this, it would be here.  I have been researching alternatives, because *vigils don't work well for me at all.  I am gluten-free and I find that on a daily basis the biggest contributor to my EDS is my carbohydrate intake.  Ironically, I, like many others with N, find myself craving simple carbs like a maniac when I wake up from naps.  Oh, what a curse we have.

 

Thanks for reading this far.  Thoughts appreciated.



#2 naplover

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Posted 12 January 2013 - 10:52 AM

I actually started Tyrosine on Wednesday (500 mg 2x/day--9 g/day is ridiculous, especially for a petite, slender person like myself). However, since yesterday, I've been very nauseated...I'm wondering if it's because of the Tyrosine. I'm going to stop it this weekend, and see if the nausea improves. 

 

I have IH and am very sensitive to meds (and supplements, apparently), so it could still be worth a shot for you.



#3 cloudtalk

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Posted 18 January 2013 - 02:59 PM

I have a book that talks about this. Its called "the ultra-mind solution: fix your broken brain by healing your body first". I'm skeptical about this book, because the "ultra-mind solution" thing sounds like classic bull*BEEP*, and the way the book is written often sounds like an infomercial or something. He also sells all the (super-expensive) supplements he thinks you should take.

 

But, some of the stuff in the book seems to make sense, too. Basically, this guy thinks almost all health problems can be solved with the right nutrition and supplements. He suggests certain supplements can be more effective with fewer side-effects than prescription medications used to treat the same neurotransmitter imbalances. He suggests L-Tyrosine for dopamine support, which will help with attention and focus. If you followed his guide you'd probably be taking a whole lot of other supplements to support other systems, too.

 

I have no idea if this stuff works or not, I haven't tried it. But if you're interested, you can get a free "companion guide" to the book, which basically summarizes the book, here: http://drhyman.com/d...ompanion-guide/ . You have to give a name and email address to download it, I think. He talks about the neurotransmitter supplements on pages 148-149 of the guide.



#4 DeathRabbit

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Posted 18 January 2013 - 03:59 PM

I don't think you can supplement Orexin, though, which is the problem. It cant pass through the blood brain barrier. But I did hear one spot of hope. They supposedly found an exogenous orexin antagonist that does. That would make us a million times worse, but if they can figure out how to switch those bad boys off, maybe they can figure out how to switch them on. It would be the ultimate stimulant because, rather than gaming the dopamine system, it would just essentially tell your body to wake up.



#5 Andrew

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Posted 18 January 2013 - 05:00 PM

Orexin-A intranasal supplementation has been going on in studies for a while (as far back as 5 years), and does cross the BBB:

 

https://www.thieme-c.../s-0029-1240077

 

http://www.narcoleps...spraystudy.aspx

 

http://www.foocus.co...ug08/Regina.pdf

 

Google for more.  Long story short, it helps with sleep at night but they have yet to demonstrate improvements in sleep onset during the day.  Still not much data on isolating and testing orexin-B.

 

 

As near as I can tell, you can even buy some for yourself if you're up to spending a couple hundred bucks on a bottle:

 

http://www.orexindie...ment_facts.html

 

http://store.orexind...exin-drops.html

 

(nice website, can't find anything else out about the company though - you can buy the drops and their phone number is (415)520-3565 if anybody feels like calling).

 

 

Anyway, the reasons why it won't come to market as a medication are much better described in this thread than I could ever do.