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This article was medically reviewed by Erik Kramer, DO, MPH and by wikiHow staff writer, Jennifer Mueller, JD. Dr. Erik Kramer is a Board-Certified Primary Care Physician at the University of Colorado. With over 15 years of experience, his clinical interests include obesity and weight management, diabetes care, and preventive care, as well as embracing a holistic approach to primary care. He received his Doctorate in Osteopathic Medicine (D.O.) from the Touro University Nevada College of Osteopathic Medicine and completed his residency at Central Maine Medical Center. Dr. Kramer is a Diplomate of the American Board of Obesity Medicine.
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Serotonin is a neurotransmitter that affects your mood, hunger, and sleep habits. Too little serotonin may lead to depression and fatigue. However, you can also have too much of a good thing. Excess serotonin is most often caused by medications that affect your body's production or absorption of the neurotransmitter and typically requires an adjustment of medication dosages. However, if you're not taking any medications or supplements that affect serotonin, you may need to adjust your diet to lower your serotonin levels.[1]
Steps
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![Step 1 Call your doctor if you recognize symptoms of serotonin syndrome.]()
Call your doctor if you recognize symptoms of serotonin syndrome. Symptoms of excess serotonin, also known as serotonin syndrome or serotonin toxicity, vary from mild and uncomfortable to life-threatening. Contact a poison control center in your area as well as a medical toxicologist and clinical pharmacologist if possible. Seek medical attention if you notice any of the following, especially if you're taking a medication that affects serotonin:[2]- Sudden mood changes, especially irritation or confusion
- Diarrhea
- Dilated pupils
- A fast or abnormal heart rate
- Increased blood pressure
- Sweating or shivering
- Fever
- Muscle stiffness, especially in the legs
- If you live the United States, you can call 1-800-222-1222 to reach your nearest poison control center.
Tip: Be on the lookout for symptoms immediately after you start taking a new medication or increase the dosage of a medication you've been taking.
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![Step 2 Tell your doctor about all medicines and supplements you're taking.]()
Tell your doctor about all medicines and supplements you're taking. If you have symptoms of excess serotonin, it's important to be honest with your doctor about any medicines or supplements you've been taking, even if you don't think they would affect your serotonin levels. Increased serotonin levels most commonly occur if you take too much of a serotonin-related medication or take more than one medication or supplement that affects serotonin.[3]- In addition to antidepressants, medications that treat severe pain, HIV/AIDS, migraine headaches, and nausea can also affect your body's use of serotonin. Over-the-counter cough medicines that contain dextromethorphan (found in brands such as Delsym, Robitussin, Mucinex, and DayQuil) can also cause excess serotonin.
- Pain medication with tramadol can also negatively interact with serotonin medication and put you at risk for serotonin syndrome.
- Herbal supplements such as ginseng and St. John's wort can also cause excess serotonin, especially if taken in conjunction with a prescription antidepressant.
- Illegal substances such as ecstasy, LSD, and cocaine can also cause excess serotonin. If you've ingested any of these substances, it's important to be honest with your doctor.
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![Step 3 Talk to your doctor about your symptoms.]()
Talk to your doctor about your symptoms. There's no specific test to diagnose excess serotonin, so doctors typically diagnose the syndrome through the process of eliminating other causes for your symptoms. They will likely ask questions to attempt to identify other potential triggers. If your symptoms occurred soon after you took a serotonin-affecting medication, that can be a good sign that you have excess serotonin.[4]- Typically, doctors treat the symptoms and wait for your serotonin levels to balance back out. For example, your doctor may put you on intravenous fluids or give you a benzodiazepine medicine, such as diazepam (Valium) or lorazepam (Ativan) to decrease agitation and relieve muscle stiffness.
- If your symptoms are severe, your doctor may recommend that you stay in a hospital for at least 24 hours under close observation. Severe serotonin syndrome can be life-threatening if not treated immediately.
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![Step 4 Follow your doctor's instructions regarding medications.]()
Follow your doctor's instructions regarding medications. If you experience excess serotonin as a result of the medications or supplements you're taking, your doctor will likely alter the dosages to prevent the problem from happening again. If your symptoms were more severe, they may wean you off the serotonin-affecting medication entirely.[5]- After experiencing the symptoms of serotonin syndrome, you may decide you no longer want to take any serotonin-affecting drugs. However, talk to your doctor about this. Don't just stop taking medication on your own. Some of these medications may cause harmful side effects as your body goes into withdrawal.
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![Step 1 Limit foods with tryptophan.]()
Limit foods with tryptophan. Tryptophan causes your body to produce serotonin. If you have a problem with excess serotonin regularly, eating fewer foods that are high in tryptophan can potentially help you control your serotonin levels. Foods that are high in tryptophan include:[6]- Seeds and nuts, such as sesame seeds, sunflower seeds, cashews, and almonds
- Soya foods, such as tofu and soybeans
- Cheese, such as mozzarella, parmesan, Romano, Swiss, and gouda
- Meats and poultry, such as lamb, beef, pork, chicken, and turkey
- Fish and shellfish, such as tuna, crab, halibut, lobster, salmon, and trout[7]
Warning: If you're limiting foods with tryptophan, monitor your health for signs that your serotonin is dropping too low. Depression, fatigue, insomnia, and difficulty concentrating are some common symptoms of serotonin deficiency.
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![Step 2 Avoid sugars and refined starches.]()
Avoid sugars and refined starches. Sugars and refined starches, such as white bread, white rice, and pasta, trigger a quick release of insulin in your body. The insulin lowers the levels of all amino acids in your bloodstream except for tryptophan. This can result in a serotonin spike.[8]- Chocolate also has relatively high levels of tryptophan, which makes it problematic if you have problems with excess serotonin.
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![Step 3 Add foods to your diet that are rich in lysine.]()
Add foods to your diet that are rich in lysine. Lysine is an amino acid that helps decrease the production of serotonin, primarily in the gut, where most of the body's serotonin is produced. Foods that are rich in lysine include:[9]- Meat and poultry
- Cheese, especially parmesan
- Fish, such as cod and sardines
- Soybeans and tofu
- Eggs
- Beans and other legumes[10]
Tip: Many foods that are high in lysine are also high in tryptophan. However, the lysine may counteract the tryptophan by slowing serotonin production.
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![Step 4 Eat more whole grains.]()
Eat more whole grains. Whole grain bread, particularly rye bread, may decrease your body's production of serotonin. Whole grain cereals also alter the production of serotonin in your intestines, which is where the majority of your body's serotonin is produced.[11]- Whole grains with lean protein will give you the best results in terms of managing your serotonin levels. For example, you might have a tuna fish sandwich on whole-grain bread.[12]
Expert Q&A
Tips
Warnings
- Do not stop taking any prescribed medications on your own without talking to your doctor. You could suffer severe withdrawal symptoms.[13]Thanks
- Do not start any new diets or nutritional supplements without first discussing it with your doctor.Thanks
References
- ↑ https://my.clevelandclinic.org/health/diseases/17687-serotonin-syndrome
- ↑ https://my.clevelandclinic.org/health/diseases/17687-serotonin-syndrome
- ↑ https://my.clevelandclinic.org/health/diseases/17687-serotonin-syndrome
- ↑ https://medlineplus.gov/ency/article/007272.htm
- ↑ https://medlineplus.gov/ency/article/007272.htm
- ↑ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4728667/
- ↑ https://www.myfooddata.com/articles/high-tryptophan-foods.php
- ↑ https://pubmed.ncbi.nlm.nih.gov/6400041/
- ↑ https://www.gastrojournal.org/article/S0016-5085(04)01340-X/fulltext
About This Article
Medical Disclaimer
The content of this article is not intended to be a substitute for professional medical advice, examination, diagnosis, or treatment. You should always contact your doctor or other qualified healthcare professional before starting, changing, or stopping any kind of health treatment.
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