5-HTPvsNAC

5-HTP readily crosses the blood-brain barrier via the large neutral amino acid transporter (LAT1/SLC7A5), unlike serotonin itself which cannot. Once in the brain, aromatic L-amino acid decarboxylase (AADC, also called DOPA decarboxylase) converts 5-HTP to serotonin (5-hydroxytryptamine) using pyridoxal-5-phosphate (active vitamin B6) as a cofactor. This completely bypasses tryptophan hydroxylase (TPH2), the rate-limiting enzyme in the normal serotonin synthesis pathway from dietary L-tryptophan. The result is a reliable, dose-dependent increase in serotonin across multiple brain regions including the dorsal raphe nucleus, hippocampus, and prefrontal cortex. Elevated serotonin activates 5-HT1A autoreceptors (calming), 5-HT2A/2C postsynaptic receptors (mood modulation), and 5-HT3 receptors (gut-brain signaling). In the pineal gland, serotonin is converted by arylalkylamine N-acetyltransferase (AANAT) to N-acetylserotonin, then by hydroxyindole O-methyltransferase (HIOMT) to melatonin — explaining the sleep-promoting effects.

NAC is deacetylated to cysteine, the rate-limiting substrate for glutathione synthesis via gamma-glutamylcysteine synthetase and glutathione synthetase. Glutathione (GSH) is the primary intracellular antioxidant in neurons, neutralizing reactive oxygen species and maintaining redox balance. NAC also activates the cystine-glutamate antiporter (System Xc-, composed of SLC7A11 and SLC3A2 subunits), which exchanges extracellular cystine for intracellular glutamate in a 1:1 ratio. This non-vesicular mechanism modulates extrasynaptic glutamate levels, reducing NMDA receptor overactivation and excitotoxicity. The glutamate-modulating effect explains NAC's promise in OCD (reducing corticostriatal glutamate hyperactivity), addiction (normalizing nucleus accumbens glutamate after drug exposure), and neurodegenerative conditions involving glutamate dysregulation.