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Tryptophan (Trp)

SI UNITS (recommended)

CONVENTIONAL UNITS

(Essential Aromatic Amino Acid - Precursor of Serotonin, Melatonin & Niacin)

Synonyms

  • L-Tryptophan
  • Trp
  • α-Amino-β-(indole-3-yl)propionic acid
  • Essential amino acid
  • Indole amino acid

Units of Measurement

  • µmol/L
  • mg/L
  • mg/dL
  • mg/100 mL
  • mg%
  • µg/mL

Unit Conversions

Molecular Weight of Tryptophan = 204.23 g/mol

µmol/L → mg/L

1 µmol/L=0.204 mg/L1\ \text{µmol/L} = 0.204\ \text{mg/L}1 µmol/L=0.204 mg/L 1 mg/L=4.90 µmol/L1\ \text{mg/L} = 4.90\ \text{µmol/L}1 mg/L=4.90 µmol/L

mg/dL → mg/L

1 mg/dL=10 mg/L1\ \text{mg/dL} = 10\ \text{mg/L}1 mg/dL=10 mg/L

µg/mL ↔ mg/L

1 µg/mL=1 mg/L1\ \text{µg/mL} = 1\ \text{mg/L}1 µg/mL=1 mg/L

mg/100 mL = mg% = mg/dL

Description

Tryptophan is an essential aromatic amino acid, obtained exclusively through diet.
It plays key biochemical roles:

  • Serotonin precursor (via 5-hydroxytryptophan)
  • Melatonin precursor (pineal gland)
  • Niacin (Vitamin B3) synthesis via kynurenine pathway
  • Protein building block
  • Immune regulation through kynurenine metabolites

Tryptophan metabolism is tightly linked to:

  • Mood regulation
  • Sleep cycles
  • Inflammation
  • Gut–brain axis

Physiological Role

1. Neurotransmitter precursor

  • Serotonin (mood, appetite, sleep)
  • Melatonin (circadian rhythm)

2. NAD⁺ / Niacin synthesis

Conversion to kynurenine → quinolinic acid → NAD⁺.

3. Immune–Metabolic Regulation

Indoleamine 2,3-dioxygenase (IDO) activation during inflammation → ↓ tryptophan.

4. Growth & Protein Synthesis

Essential amino acid - must be supplied through diet.

Clinical Significance

ELEVATED TRYPTOPHAN

Less common. Seen in:

1. High Protein Intake / Supplementation

Dietary excess or bodybuilding supplements.

2. Hartnup Disease (paradoxical)

Defective renal & intestinal amino acid transport → variable plasma levels.

3. Liver Disease (mild elevation)

Reduced hepatic metabolism.

4. Serotonin-Producing Tumors

Try to consume tryptophan → sometimes low; however early cases may show variable levels.

5. Pregnancy

Due to increased binding to albumin and altered metabolism.

Clinical Note: High serotonin (5-HIAA elevated) does not require high tryptophan — most carcinoid patients show low tryptophan due to serotonin overproduction.

LOW TRYPTOPHAN

1. Malnutrition / Protein Deficiency

2. Chronic Inflammation

Cytokines activate IDO, shunting tryptophan → kynurenine.

Seen in:

  • Tuberculosis
  • Autoimmune disease
  • Malignancy
  • HIV/AIDS
  • Sepsis
  • COVID-related cytokine activation (IDO pathway)

3. Liver Disease

Reduced metabolism and transport.

4. Pellagra / Niacin Deficiency

Due to:

  • Malnutrition
  • Isoniazid therapy
  • Carcinoid syndrome (tryptophan diverted to serotonin pathway)

5. Carcinoid Syndrome

Markedly ↓ tryptophan due to excessive serotonin synthesis.

6. Malabsorption

Celiac disease, Crohn’s, pancreatic insufficiency.

7. Rare Disorders

  • Tryptophan 2,3-dioxygenase defects
  • Tryptophan hydroxylase deficiency

Reference Intervals

(Tietz 8E + Mayo + ARUP, fasting sample recommended)

Plasma Tryptophan

  • 40 – 90 µmol/L
    (= 8 – 18 mg/L)

Urine Tryptophan

Useful mainly in metabolic disorders (Hartnup disease).

Diagnostic Uses

1. Nutritional Assessment

Low in protein-energy malnutrition.

2. Evaluation of Carcinoid Syndrome

Low tryptophan + high serotonin/5-HIAA.

3. Metabolic Disorders

  • Hartnup disease
  • Tryptophan metabolism defects
  • Kynurenine pathway abnormalities

4. Liver Disease Assessment

Altered amino acid profile.

5. Psychiatric & Neurologic Research

Serotonin-related pathways:

  • Depression
  • Anxiety
  • Sleep disorders

(Not standard diagnostic use.)

6. Niacin Deficiency / Pellagra

Low tryptophan due to impaired conversion.

Analytical Notes

  • Fasting sample preferred - tryptophan is diet-sensitive.
  • Avoid hemolysis; RBCs contain amino acids.
  • Plasma separated quickly to prevent degradation.
  • Quantified by LC-MS/MS or HPLC in amino-acid profiling.
  • Tryptophan decreases with prolonged sample storage.

Clinical Pearls

  • Low tryptophan is a strong inflammation marker via IDO activation.
  • Carcinoid syndrome → low Trp + very high serotonin + high 5-HIAA.
  • Tryptophan deficiency → low serotonin → insomnia, mood changes (research-based).
  • High protein meals artificially raise tryptophan - fasting is essential.
  • In pellagra, tryptophan and niacin deficiency coexist.

Interesting Fact

It takes 60 mg of tryptophan to produce 1 mg of niacin - explaining why diets low in tryptophan cause pellagra even if niacin itself is not deficient.

References

  1. Tietz Clinical Chemistry & Molecular Diagnostics, 8th Edition - Amino Acids
  2. Rosenberg et al. - Disorders of Amino Acid Metabolism
  3. Mayo Clinic Laboratories - Amino Acid Profile
  4. ARUP Consult - Amino Acid Disorders
  5. MedlinePlus (NIH) -Amino Acid Tests
  6. WHO - Niacin Deficiency / Pellagra Guidelines

Last updated: January 27, 2026

Reviewed by : Medical Review Board

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