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L-tryptophan use and the eosinophilia-myalgia syndrome
1Section of Gastroenterology and Nutrition, Boston VA Medical Center, MA 02130.
Nutrition Reviews
|August 1, 1990
Summary
Eosinophilia-myalgia syndrome developed in a patient using high-dose L-tryptophan for sleep. This condition, marked by muscle pain and skin changes, is linked to L-tryptophan ingestion.
Area of Science:
- Clinical Toxicology
- Neuroscience
- Immunology
Background:
- L-tryptophan is an amino acid precursor to serotonin, often used as a dietary supplement for sleep and mood.
- The eosinophilia-myalgia syndrome (EMS) emerged in late 1989, characterized by severe myalgia and eosinophilia.
- Epidemiological studies quickly linked EMS cases to L-tryptophan consumption.
Observation:
- A patient presented with classic EMS symptoms, including myalgias, skin alterations, and significant eosinophilia.
- The patient reported using substantial quantities of L-tryptophan for its sedative effects.
- This case highlights the potential adverse effects of high-dose L-tryptophan supplementation.
Findings:
- The patient exhibited marked eosinophilia, a key diagnostic marker for EMS.
- Myalgias and characteristic skin changes were prominent clinical features.
- The association between L-tryptophan ingestion and EMS development is strongly supported by clinical observations.
Implications:
- The exact mechanism of L-tryptophan toxicity causing EMS remains undetermined.
- Public health measures, including removal from store shelves, have reduced casual L-tryptophan use.
- Further research is needed to elucidate the pathogenesis of EMS and identify potential contaminants or triggers.