Can D-Phenylalanine Help with Chronic Pain, Emotional Oversensitivity and PGAD?
Please note that I am not a doctor and nothing in this blog post is intended to constitute medical advice. Always consult with a qualified healthcare practitioner.
In this month’s blog post I want to talk about one of my favourite amino acids: D-phenylalanine (DPA). Less commonly used than its mirror image counterpart, D-phenylalanine has been shown to have pain relieving and antidepressant properties which might benefit individuals suffering from conditions that leave them physically or emotionally over-sensitive. I have been using D-phenylalanine for a number of years now and in today’s post I will draw on both clinical research and my own personal experience to spotlight this lovely little ingredient.
If you cast your mind back to school chemistry lessons, you might remember that proteins are made up of small building blocks called amino acids. Within the body amino acids are used for growth and repair processes, including the manufacture of hormones, neurotransmitters and enzymes. Neurotransmitters are chemical messengers that carry information between body cells and they are what allow us to register physical pain and feel different emotions. Some amino acids can be made in the body from other amino acids and are therefore known as non-essential. Other amino acids cannot be made in the body and must be obtained through diet or supplementation. These are known as essential amino acids, because it is essential we get them!
Phenylalanine is an essential amino acid, because it cannot be made in the body. It comes in two forms: L-phenylalanine (LPA) and D-phenylalanine, which are identical mirror images (isomers) of each other. If you find this difficult to visualise, just imagine an ordinary pair of hands. They are the same, except that one is a right hand and one is a left hand. This means that if you saw a loose glove on the street, you’d be able to tell whether it was a right glove or a left glove by the direction of the thumb. Most amino acids come in a left hand version (in this case L-phenylalanine) and a right hand version (D-phenylalanine), which, although structurally similar, have different actions. Usually the body prefers its amino acids in left-hand form, but it can use phenylalanine in both forms.
L-phenylalanine occurs naturally in foods like meat, fish, eggs and nuts. You can also buy it in supplement form. D-phenylalanine does not occur abundantly in nature, but can be synthetically made in a laboratory. It is available in supplement form, but it is rare to find it on its own as it is usually mixed with L-phenylalanine and offered as DLPA. However, LPA and DPA have slightly different effects. Some people can find LPA too stimulating – it can leave them feeling jittery or agitated. DPA is far less stimulating and tends to be better tolerated by highly strung individuals, which is why I absolutely love it as a standalone supplement.
I won’t dwell too much on L-phenylalanine, because it is not the subject of today’s post. The body uses it to make tyrosine, another amino acid, as well as melanin and catecholamines. Its role in the production of melanin means it can be used to improve vitiligo, a condition in which pigment is lost from areas of skin resulting in white patches. Meanwhile, its role in the production of catecholamines, including adrenaline and noradrenaline, explains why some people find LPA too energising.
It is the D-version of phenylalanine which I think will be of most interest to Tiny Pioneer visitors. DPA is anti-inflammatory and has been shown beneficial for various types of chronic and intractable pain. It works by blocking enzymes that break down pain-relieving compounds within the body called endorphins and enkephalins. Blocking this breakdown allows more endorphins and enkephalins to circulate, which might create an analgesic effect. Clinical research has been mixed and DPA does not appear to be effective for all types of pain, but when it does work, it seems to work well, as in this small study of cancer patients. The article Nutritional Supplements in Pain Practice claims that pain relief can occur in as little as ten minutes and recommends an intake of 500-2000mg two to four times daily. However, this double blind crossover study concluded that there was no significant analgesic effect from DPA in chronic pain patients when compared to placebo.
Although interstitial cystitis can be categorised as a chronic pain condition, it is not the potential pain-relieving qualities of DPA that most interest me. As we saw above, studies into its use as an analgesic have produced mixed results, although I would definitely be interested to see how it performs specifically in bladder pain conditions. Alas, no research into that has been conducted, so if any of you try it and notice improvements in your pain levels, please do let me know!
No, there is another reason why I wanted to tell you about DPA today. I first decided to try it after reading ‘The Mood Cure’ by Julia Ross. This is a book that discusses the use of nutritional therapy, especially amino acid therapy, to address various mood imbalances. I highly recommend it, as it is both informative and very accessible, even to those with no medical knowledge. It also has some diagnostic quizzes in one of the early chapters and who doesn’t love a quiz?!
Chapter six of ‘The Mood Cure’ is called ‘Too Sensitive to Life’s Pain?’ Two of the diagnostic questions that help one to determine whether one is indeed too sensitive to life’s pain are: does emotional pain or perhaps physical pain really get to you; and have you been through a great deal of emotional or physical pain? At the time when I read this book, I was struggling with persistent genital arousal disorder (PGAD) and it occurred to me that I was indeed oversensitive to both physical and emotional pain. At the time, I cried very easily and very often – sometimes I didn’t even feel especially sad or even know why I was crying, but tears were rarely too far away.
Later in the chapter, Julia Ross discusses the use of L-phenylalanine and/or D-phenylalanine for those who are too sensitive to pain. Being somewhat stress and prone to anxiety rather than lethargy, I decided I didn’t need the energising and perking-up effects of L-phenylalanine. D-phenylalanine sounded more my cup of tea entirely. DPA is a more potent endorphin booster than LPA, so it is ideal for those who are physically oversensitive as well as emotionally so. PGAD is practically characterised by being an oversensitivity and overstimulation of the genital area and I was keen to know if DPA would dampen it at all.
Furthermore, DPA has been shown to have antidepressant properties. In one double-blind study of 40 depressed patients, a combination of LPA and DPA (i.e. DLPA) performed as well as imipramine in addressing various symptoms of depression. Another depression study, which I cannot directly access, showed that DPA alone performed as well as imipramine and worked more quickly, showing effects in only 15 days rather than the several weeks required for imipramine. This more recent animal study concluded that DPA at a dose of 30mg/kg demonstrated higher antidepressant properties than both imipramine and fluoxetine.
I decided to give DPA a try, mainly to see if it would improve my symptoms of PGAD. Honestly, I can’t be sure how much of an impact it had on them, because at around the same time I was also doing (and avoiding) lots of other things that I thought would help. It took a good while for me to break the cycle and see real progress, so I can’t be sure how much of an impact the DPA alone had. What I can tell you with certainty is that, along with L-tyrosine, it massively reduced my emotional over-sensitivity. I hadn’t really expected to see a difference there and I didn’t feel anything dramatic or earth shattering. However, after about two weeks I suddenly realised I hadn’t cried for a while. It was hard to put into words, but I felt a bit sturdier and more resilient inside. I was never really depressed as such – I didn’t suffer with apathy or extreme feelings of sadness, outside of a little PMS. I wasn’t lacking in motivation or feeling as if there was no hope. I just cried a lot and was always being told I was too sensitive. Somehow, once I was on DPA, I felt a bit less tearful and a bit more together.
The leading brand of DPA is American and on a couple of occasions all the UK suppliers have run out. This means that on a couple of occasions I also have run out. If I go more than a week or so without DPA, I notice that I become more tearful again and feel a bit less ‘solid’ inside. I am therefore quite sure that for me personally, it does help to reduce my sensitivity. My PGAD is also now much better, although as I said, I did and continue to do various things to keep this at bay, of which DPA is only one small part. Before you start emailing me questions about what else I do, please see these posts and browse through the rest of Tiny’s Blog:
- Tiny Tips for Dealing with a PGAD Flare
- Do Standing Desks Help with Interstitial Cystitis and PGAD?
- Could Iron Help with PGAD? Let’s Investigate!
I am now well underway with analysing the responses to the PGAD survey that I had live on the website a couple of years ago. One of the things I am noticing is that a lot of PGAD sufferers seem to struggle with emotional oversensitivity and crying spells, as well as ADHD and mood disorders. I don’t have exact figures yet and nor do I know how the proportions compare to the general population, but I am certainly seeing overlap. This got me to thinking that even if PGAD itself isn’t necessarily improved by DPA, surely PGAD sufferers would feel better if they weren’t always bursting into tears or struggling with their moods?
Given the clinical research into DPA and my own personal experience with it, I wanted to write a blog post about it in case anyone with PGAD wanted to try it. It might also be of interest to people with other pelvic pain conditions that are characterised by oversensitivity, such as vulvodynia, as well as people who suffer from more general physical or mental hypersensitivity. While I don’t have interstitial cystitis as such, I am prone to UTIs and react badly to ascorbic acid. People with IC might therefore be pleased to know that D-phenylalanine does not in any way irritate my bladder and I consider it to be a bladder-friendly ingredient.
Please note that phenylalanine supplements must not be taken by individuals with phenylketonuria, as they are unable to break it down leading to dangerous accumulation in the blood and brain. Phenylalanine supplements should also be avoided: in pregnancy and when breastfeeding; when taking MAO inhibitors or anti-psychotic medication; and by individuals with high blood pressure. If you are in any doubt about whether it is safe for you to take DPA, please consult with a qualified healthcare practitioner experienced in its use.
Wishing you the best of health,
Tiny x
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