Use Of The Dietary Supplement 5-ALA And Its Relationship With Sleep And Mood
Condition: Insomnia; Nocturnal Awakening; Irritability; Coping Behavior; Stress
MeSH terms: Sleep Initiation and Maintenance Disorders
Study type: Interventional

Summary: 
      PURPOSE: The purpose of this investigation is to determine if a relationship exists between
      the administration of a dietary supplement containing 5-ALA and sleep and mood.

      HYPOTHESIS: There are several possible mechanisms for improvement in sleep and mood. In one
      study involving test mice, researchers found that the regular administration of 5-ALA
      appeared to raise serotonin levels in the brain. One hypothesis is by increasing serotonin
      levels, 5-ALA may contribute to improvements with sleep, along with additional improvements
      in mood, calmness, irritability and coping abilities. 5-ALA may also support hormonal
      regulation, including melatonin, in the pineal gland and corticosteroid regulation in the
      adrenal glands.

      Another hypothesis is that 5-ALA may have an impact on increasing the energy and metabolism
      of cells, such that its own circadian rhythms are better defined. 5-ALA may support neuronal
      function and assistance with "mental energy" needed to deal with stress in daily life,
      producing better feelings of "coping", "less irritability" and lowering an individual's
      feelings of "fatigue", all of which may contribute to a reduction of "pessimism" regarding
      the ability to deal with daily tasks.

      DESIGN: This will be a double-blinded, randomized parallel-group comparison study.

      SAMPLE: 40 participants will be randomized to the following 2 study groups for each outcome
      variable (Sleep and Mood): Control Group - 20 participants and Intervention Group - 20
      participants. A table of random numbers will be used to assign the participants.
    

Detailed description: 
      5-Aminolevulinic Acid (5-ALA) is a dietary supplement and a naturally occurring amino acid.
      It is a natural delta amino acid; as a non-alpha amino acid, it is not a component of
      proteins. 5-ALA is synthesized in the mitochondria, and is the first compound in the
      prophyrin synthesis pathway, the pathway that leads to heme in mammals and chlorophyll in
      plants. 5-ALA has been associated with genetic information, structure and metabolism, and
      energy conversion.

      5-ALA can be found in many common foods, such as spinach, tomatoes, shitake mushrooms,
      potatoes, squid, ground beef, wine and soy sauce. The normal intake from food containing
      5-ALA is 1-2 mg/day. 5-ALA is synthesized by the body at a rate of 600 mg/day.

      Data has supported the hypothesis that supplementation with 5-ALA may be related to improved
      sleep, mood and coping abilities. This research study will further explore this potential
      relationship.

      The duration of the study for each participant is a total of 10 weeks, which include 4
      separate appointments, spaced 3-4 weeks apart. Participants in the Intervention Group will
      begin taking one daily 50 mg capsule p.o. of 5-ALA over a 6 week period, and the Control
      Group will be provided with a placebo of similar size and color.

      Before entering the research study, each participant undergoes a thorough screening process,
      including lab work (CBC and Ferritin). Once accepted into the study, the daily capsules are
      started and a diary is filled out by each participant at home each day and brought to each
      appointment for review. Instructions are given to record patterns and changes pertaining to
      sleep, mood or coping abilities. After 6 weeks, the participant is then instructed to stop
      the daily capsules but to continue daily diary recordings. They are also scheduled for one
      final appointment at week 10. At each of the 4 appointments over the 10 week period,
      assessments are performed by health care professionals, questionnaires and daily diaries are
      reviewed/recorded and anthropometric measurements are obtained.

      The product used in this investigation contains 3 components:

        -  5-Aminolevulinic acid (5-ALA) phosphate

        -  Sodium Ferrous Citrate (SFC)

        -  Corn starch as filler.

      The 5-ALA capsules and contents are Non-GMO, BSE free, and alcohol free. The products tested
      are manufactured under food GMP conditions. A certificate of analysis is available.

      Variables monitored as part of the evaluation will be assessed by comparing the intervention
      group to the control group. Two-sample t-tests will be used to assess statistical
      significance at baseline and follow-up exams. Baseline data will be summarized as means and
      standard deviations with differences among the randomized groups tested for significance by
      t-tests and chi-square tests. To measure the possible differences in rates of change in sleep
      and mood scores across follow-up time between the 5-ALA treatment and the control group,
      additional analyses will estimate differences in slopes using linear regression models. Mixed
      linear models will be fit using the proc mixed procedure in SAS 9.2. The regression models
      will include an indicator variable identifying treatment groups, a variable for weeks of
      follow-up, and interaction terms between the indicator variables and follow-up time. Results
      will be summarized as the difference in slopes comparing the intervention groups to the
      control group. Results will also be presented graphically to illustrate the estimated
      differences in slopes for the study groups. All significant tests will be two-sided.
    

Intervention name(s): 5-Aminolevulinic Acid (5-ALA); Placebo
Intervention type(s): Dietary Supplement; Dietary Supplement
Intervention description(s): 5-ALA 50 mg. p.o. daily capsules taken over 6 weeks.; Daily p.o. capsule of similar shape and color to active ingredient 5-ALA capsule taken over 6 weeks.
Other intervention name(s): 5-Aminolevulinic Acid; 5-ALA
Intervention MeSH terms: Aminolevulinic Acid
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Care Provider)
Keywords: Insomnia; Frequent Nocturnal Awakening; Irritability; Moody; Moodiness; Coping Ability; Coping Behavior; Stress; Feeling Overwhelmed