i have some genetic defects in my serotonin transporters, which i found out from 23andme. now i am in perimenopause and the decline in estrogen coincides with a decline in serotonin. add to that that i carb restrict, and carbs are needed to make serotonin. so i have three factors that lead to lower levels of serotonin. i believe this is why i have hot flashes. when i take 5-htp, which is a precursor of serotonin, they are reduced about 85%. serotonin also influences mood, so it is possible that eating lower carb could lead to irritability/lower mood if you are already starting out with lower levels of serotonin like me. 5-htp might help. i take 100 mg every other night. if i take it every night, i get super sleepy. if i take it every other night, but eat a lot of carbs (like a couple thick slices of bread which spike me to 158), i will be super sleepy.
I took both GABA and 5-HTP for a bit when I was very low-carb (<20g/day) and it helped with both my sleep and mood. Now that I eat 50-100g a day I havenāt been taking it anymore though.
I just sent in my 23andme kit last week, Iāll make sure to look for that too. 
23andme kits: how specific are they?
Can they determine inborn metabolic deficiencies of glutamate?
Porphyria ?
Weāve been trying to rule these factors in/out in our family for years, but weāre always told the hereditary labs were exorbitant.
Congratulations,@v_prediabetic and @daytona, for finding whatās working for each of you
What 23andme is now allowed to disclose is somewhat limited. But you can import the raw data into Promethease for the affordable cost of $5 USD and obtain the genetic scare of your life. (Iām currently researching genetic counsellors. I am homozygous for the ābadā breast CA gene. And my daughter likely obtained the genetic component of her T1D from me, because I have 18 times the risk of a ānormalā of developing T1D myself before I die. But Iām thankful for small favors: so far, Donald Trump has not shown up on my list of genetically linked relatives. 
But neither has Gary Scheiner or any of The Beatles. 
)
daytona, when you get your 23andme data, tell me, cause i can tell you exactly what to search for in your raw genetic data. i can also send you the link to a paper that showed an association between women who had defects in their serotonin transporter snps who responded well to SSRIās re controlling their hot flashes. the SSRIās increased the efficiency (?) with which their body used their own serotonin, and so decreased their hot flashes. not all women find that SSRIās reduce hot flashes, maybe because the root cause of their hot flashes is not low serotonin. this points to the fact that hot flashes are caused by different factors, not just one.
daytona, why did you go up to 50-100 grams of carbs? how are you controlling your blood sugar? jenny ruhl eats around 100 to 150 grams of carbs a day i believe mostly controlling with metformin and occasionally prandin. she says she just feels better at a high carb level than what she used to eat.
LADA_lady, i tried out two different gene variants (snps) for porphyria, and neither was done by my version of 23andme. there are so many- at least 31- genetic variants associated with porphyria, i didnāt go through them all.
Thank you for checking!
Yes there are several types of porphyria. Our suspected type is Acute Intermittent Porphyria (quite rare).
Iāll be looking into 23andme soon!
Again, great that you have found a probable cause and possible solution for those darn hot flashes!
Oh and @rgcainmd, thank you for the Promethease tip. And 
to your discoveries, and 
to your not-relatives list!
Iām on MDI, Novolog and Levemir, with an average TDD of 100u. I also take Metformin though it does nothing for me.
I donāt have a great reason for bumping up to 100g/dayā¦ Basically when I had to go on MDI, even when being super low-carb, I just didnāt have it in me to keep restricting at that level. I figured it was safer to make the decision to lower the bar for a bit, than tempt depression and risk another burnout.
Being keto messed with my mood, even though I had great blood sugar, which is why I tried first GABA then 5-HTP. But Iām sure when I have a better handle on things, Iāll give it another go, since it helps so much with my IR.
Seeing my first endo this Tuesday and weāll see what she thinks of my ālogicā!
daytona, could you tell me at what intervals and dosage you took GABA and 5-htp? also, what brands did you use? I still love 5-htp, but it still stops working periodically. then i just take a break for a couple of days and it will work again. keeping caffeine low or zero helps me sleep better and reduces hot flashes. i am wondering if GABA would be a good addition. also i am wondering if i could substitute in l-tryptophan when the 5-htp isnāt working- just rotate them and also keep days where i donāt take anything. dr bernstein says in his book that when he tried to raise levels of neurotransmitters (he didnāt say in the book what he used, but he mentioned serotonin as one of the neurotransmitters he was trying to raise), whatever he was using would lose effectiveness after a while. he would then have to rotate in another treatment. i wish i could find what supplements he used and how he rotated them. he said he patented the process, but it was too inconvenient for most patients to follow.
Itās been 2 years since I took 5-HTP, but hereās what I remember. 
I was very careful to not take it every day to avoid building up a tolerance and avoid withdrawal symptoms. At the time, people were recommending not taking it more than 3 days in a row with at least a 2 day āwash-outā period. I started at 50mg and evaluated how it affected my sleep. After a few weeks I settled on 150mg, though thatās a very low dose. I was aiming for the minimal amount that would have an effect. What I finally settled on was 150mg on Friday and Saturday night, to help me get some uninterrupted sleep.
As for the GABA, at first I took 750mg/day but after a few weeks found that I didnāt need it every day to maintain the anti-anxiety effect. I would take a bit extra before stressful things, like interviews or doctor appointments.
23andme.com is a company which sends you a kit to test your DNA. You spit in a little cup they provide and mail it back to them. 8 weeks later they give you the raw results of your DNA. You can then use that to lookup specific genes that you were interested in.
They just provide the raw results, but you can give your results to promethease.com and they will provide more guidance and explanation of all your genes.
I was interested because I was curious about autoimmune genes, both for diabetes and others that I have as well.
Thatās really cool! Thank you for the explanation.
Daytona, before when I was putting a two day gap between taking the 5-htp, that was enough to keep me from building a tolerance. All of the sudden, a two day gap isnāt working and iāve had hot flashes at night that are making me so tired. did you also find that a two day gap was not enough? when you said you took the 5-htp on Friday and Saturday, is that because you found you needed a 5 day gap from Saturday to Friday in order to keep the 5-htp working? what did you do for sleep on the days in between?
i am thinking of trying out tryptophan in the meantime to see if i can trick my system. did you ever try that supplement out? i also have some gabapentin left. that would also stop working after a while, and i had a horrible headache and vomiting when i tried to taper down- but since i would be taking such a small amount so infrequently, i figure i wonāt build up tolerance and getting off will be easier.
i am trying to avoid hormone replacement at all costs since my mother died of breast cancer. i may need to figure out a way to take a nap in my car during the winter (insulated sleeping bag?)!! there is no place in my school (I am a teacher) to take a nice, uninterrupted nap.
i also may try to up carbs to 100 grams a day on the days iām not taking a supplement to see if my body can make enough serotonin out of the carbs to help me sleep. i donāt know how much metformin would help me in keeping my bg in check (i was diagnosed with prediabetes, but i can go up to 200 with a slice of pumpkin pie- I just mostly never eat stuff that will spike me that high). I know walking/ any kind of exercise drops my bg reliably, so scheduling in walking time or hand weight-lifting after eating might be a good strategy to get in 100 grams of carbs w/o it adversely affecting my blood sugar.
any thoughts?
Hmm, sorry I donāt have enough experience to begin to suggest how to deal with adjusting 5-HTP dosing. I was too worried about tolerance/dependency problems to take it very often, which is why I settled for only getting some good ācatch upā sleep on the weekends.
I get much better sleep now that I have been diagnosed with sleep apnea and use a CPAP machine every night. I still get hot flashes, lost 2 hours to that just last night! But overall Iām must less exhausted all the time and donāt need daily naps.
I never tried Typtophan but I am on high dose progesterone (induced menopause for endometriosis), which is partly why I get the hot flashes in the first place! 
Thanks for the quick replay, Daytona. I may just have to try out your weekend sleep catch-up method. my husband has a c-pap which really helps him. i had no idea he would just doze off in the afternoon, i just knew his snoring was super loud and i could hear him stop breathing. he had a small airway opening, plus he could not get used to sleeping on his side, which wouldāve helped. chinese babies have traditionally been laid on their backs to sleep (my husband is chinese), and the back of his skull is really flat, so maybe thatās why itās more comfortable for him to sleep on his back.
anyway, thanks again for sharing your experience.
My husband has sleep apnea too, and it was driving me crazy. He had no idea but he sounded like a freight train and would stop breathing for up to a minute at a time. I would stay up and hit him whenever he stopped breathing and eventually convinced him to get tested just to save my sanity. 
According to my husband I never snored or stop breathing. When I was so tired, even after a full nightās sleep, I got tested just to rule it out. I was stopping breathing every over minute! Turns out this is pretty common: people are aware of only menās symptoms for sleep apnea and donāt catch womenās different (less dramatic) symptoms.
@v_prediabetic- I did not know that carbs are needed to make serotonin! Wouldnāt that place many diabetics at risk for low serotonin levels? Wow!
I just got my results back from 23andme and have imported them into promethease. What should I look for?
actually, you donāt need promethease for this. below are 3 snps you can check out directly on 23andme.com. go to the 23andme.com website-log in-at the top tab click on tools-go to āraw dataā at the bottomā- in the search window copy/paste each of the snps below and see if you have the alleles that protect against hot flashes or not. if you donāt have the protective ones, my interpretation is that you produce less serotonin than women who have the protective alleles:
rs2066713 minor allele Aā> hot flashes are increased. I have one A
rs11080121 minor allele Cā> hot flashed are decreased. I donāt have any Cās.
rs1042173 minor allele Cā> hot flashes are decreased. I donāt have any Cās
Hereās the article I got the above info from: