Phenylalanine – Uses, Indications, Dosage, Interactions

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Phenylalanine is an essential amino acid (a building block for proteins in the body), meaning the body needs it for health but cannot make it. You have to get it from food. Phenylalanine is found in 3 forms. L-phenylalanine, the natural form found in proteins...

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Article Summary

Phenylalanine is an essential amino acid (a building block for proteins in the body), meaning the body needs it for health but cannot make it. You have to get it from food. Phenylalanine is found in 3 forms. L-phenylalanine, the natural form found in proteins D-phenylalanine (a mirror image of L-phenylalanine that is made in a laboratory) DL-phenylalanine, a combination of the 2 forms The...

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Seek urgent medical care if you notice

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  • Severe symptoms, breathing difficulty, fainting, confusion, or rapidly worsening illness.
  • New weakness, severe pain, high fever, or symptoms after a serious injury.
  • Any symptom that feels urgent, unusual, or unsafe for the patient.
1

Emergency now

Use emergency care for severe, sudden, rapidly worsening, or life-threatening symptoms.

2

See a doctor

Book a professional medical evaluation if symptoms persist, worsen, recur often, affect daily activities, or occur in a high-risk patient.

3

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Use this article to understand possible causes, tests, treatment options, prevention, and questions to ask your clinician.

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Definition

Phenylalanine is an essential amino acid (a building block for proteins in the body), meaning the body needs it for health but cannot make it. You have to get it from food. Phenylalanine is found in 3 forms.

  • L-phenylalanine, the natural form found in proteins
  • D-phenylalanine (a mirror image of L-phenylalanine that is made in a laboratory)
  • DL-phenylalanine, a combination of the 2 forms

The body changes phenylalanine into tyrosine, another amino acid that is needed to make proteins and brain chemicals, including L-dopa, epinephrine, norepinephrine, and thyroid hormones. Because norepinephrine affects mood, different forms of phenylalanine have been proposed to treat depression. Symptoms of phenylalanine deficiency include:

  • Confusion
  • Lack of energy
  • Depression
  • Decreased alertness
  • Memory problems
  • Lack of appetite

On the other hand, a rare metabolic disorder called phenylketonuria (PKU) occurs in people who are missing an enzyme that the body needs to use phenylalanine. That causes high levels of phenylalanine to build up. If it is not treated before 3 weeks of age, PKU can cause severe, irreversible intellectual disability. In the United States, newborns are tested for PKU during the first 48 to 72 hours of life. Older, untreated children become hyperactive with autistic behaviors, including purposeless hand movements and rhythmic rocking.

People with PKU must eat a diet that avoids phenylalanine and take tyrosine supplements for optimal brain development and growth. Compliance with treatment in people with PKU has a greater impact on cognition during the first 12 years of life compared to the influence beyond 12 years.

Uses

Chronic pain

D-phenylalanine (but not L-phenylalanine) has been proposed to treat chronic pain. Two studies that appeared to show positive results had flaws that made the findings unreliable. Other studies have found D-phenylalanine to be no more effective than placebo in reducing pain. No randomized controlled trials have been done in the past 20 years to study any possible benefit of taking D-phenylalanine for chronic pain. More research is needed to determine its safety and effectiveness.

Parkinson disease

One animal study suggests that D-phenylalanine may improve rigidity, walking disabilities, speech difficulties, and depression associated with Parkinson disease. However, there is no evidence yet whether it would have the same effect in humans. More research is needed.

Vitiligo

Preliminary studies suggest that L-phenylalanine (oral and topical) strengthens the effect of UVA radiation for people with vitiligo. Vitiligo is a condition where irregular depigmentation (loss of color) causes white patches of skin. L-phenylalanine may lead to some darkening or repigmentation of the white patches, particularly on the face. However, more research is needed to see whether L-phenylalanine is truly effective.

Depression

Studies suggest that phenylalanine may be helpful as part of a comprehensive therapy for depression, most of the studies were done in the 1970s and 1980s and were not rigorously tested. People have reported that their mood improved when they took phenylalanine. Researchers think this is because phenylalanine increases production of brain chemicals, such as dopamine and norepinephrine. Other studies suggest that elevated phenylalanine concentrations are linked to mood swings. More research is needed to tell whether phenylalanine has any real effect on depression.

Dietary Sources

L-phenylalanine is found in most foods that contain protein, including beef, poultry, pork, fish, milk, yogurt, eggs, cheese, soy products (including soy protein isolate, soybean flour, and tofu), and certain nuts and seeds. The artificial sweetener aspartame is also high in phenylalanine.

D-phenylalanine is made in the laboratory but is not found in food.

Available Forms

  • D-phenylalanine
  • L-phenylalanine
  • DL-phenylalanine (50/50 blend of D-phenylalanine and L-phenylalanine)

You can take phenylalanine as a capsule, powder, or tablet. You can also apply it as a topical cream.

How to Take It

Recommended dosages of phenylalanine vary depending on the health condition being treated. Speak to your doctor about what dose is right for you.

Precautions

Because of the potential for side effects and interactions with medications, you should only take dietary supplements under the supervision of a knowledgeable health care provider.

People with phenylketonuria (PKU), and women who are breastfeeding or are pregnant, should not take phenylalanine supplements. Aspartame, found in artificial sweeteners such as Nutrasweet, is a source of phenylalanine. People with PKU should not use aspartame. If you are pregnant, ask your doctor about using this artificial sweetener.

DL-phenylalanine should not be used in people taking antipsychotic drugs, as it may cause or worsen symptoms of tardive dyskinesia (TD). TDs are involuntary movements of the tongue, lips, face, trunk, and limbs that can occur in people taking antipsychotic drugs long term.

DL-phenylalanine may cause symptoms of anxiety, jitteriness, and hyperactivity in children.

Doses higher than 5,000 mg a day may be toxic and can cause nerve damage. High quantities of DL-phenylalanine may cause mild side effects such as nausea, heartburn, and headaches.

Possible Interactions

If you are currently being treated with medication (especially the following medications), you should not use phenylalanine without first talking to your health care provider.

Monoamine Oxidase Inhibitors: Monoamine oxidase inhibitors (MAOIs) are an older class of antidepressants drugs that are rarely used now. They include phenelzine (Nardil), isocarboxazid (Marplan), and tranylcypromine sulfate (Parnate). Taking phenylalanine while taking MAOIs may cause a severe increase in blood pressure (hypertensive crisis). This severe increase in blood pressure can lead to a heart attack or stroke. People taking MAOIs should avoid foods and supplements containing phenylalanine.

Baclofen: Phenylalanine may reduce absorption of baclofen (Lioresal), a medication used to relieve muscle spasms. Avoid taking Baclofen with a meal, especially one that is high in protein, or with phenylalanine supplements.

Levodopa: A few case reports suggest that phenylalanine may reduce the effectiveness of levodopa (Sinemet), a medication used to treat Parkinson disease. Some researchers think phenylalanine may interfere with the absorption of levodopa and worsen the person’s condition.

Selegiline: L-phenylalanine and the selective MAO inhibitor selegiline (Eldepryl, Deprenyl) may strengthen the antidepressant effects of phenylalanine. They should not be taken together.

Antipsychotic or neuroleptic drugs: L-phenylalanine may worsen TD, a side effect of these neuroleptic drugs. These drugs include phenytoin (Dilantin), valproic acid (Depakene, Depakote), and carbamazepine (Tegretol), among others.

 

Anjemo K, van Rijn M, Verkerk PH, Burgerhof JG, Heiner-Fokkema MR, van Spronsen FJ. PKU: high plasma phenylalanine concentrations are associated with increased prevalence of mood swings. Mol Genet Metab . 2011;104(3):231-4.

Camacho F, Mazuecos J. Oral and topical L-phenylalanine, clobetasol propionate, and UVA/sunlight–a new study for the treatment of vitiligo. J Drugs Dermatol . 2002;1(2):127-31.

Castro IP, Borges JM, Chagas HA, Tiburcio J, Starling AL, Aguiar MJ. Relatinships between phenylalanine levels, intelligence and socioeconomic status of patients with phenylketonuria. J Pediatr . 2012;88(4):353-6.

Dietary Guidelines for Americans 2005 . Rockville, MD : US Dept of Health and Human Services and US Dept of Agriculture; 2005.

Dillon EL, Sheffield-Moore M, Paddon-Jones D, Gilkison C, et al. Amino acid supplementation increases lean body mass, basal muscle protein synthesis, and insulin-like growth factor-I expression in older women. J Clin Endocrinol Metab . 2009 May;94(5):1630-7. Epub ahead of print.

Kliegman R. Nelson Textbook of Pediatrics . 19th ed. Philadelphia, PA: Elsevier Saunders; 2011.

Lotti T, Buggiani G, Troiano M, Assad GB, Delescluse J, De Giorgi V, Hercogova J. Targeted and combination treatments for vitiligo. Comparative evaluation of different current modalities in 458 subjects. Dermatol Ther . 2008 Jul;21 Suppl 1:S20-6.

MacLeod EL, Gleason ST, van Calcar SC, Ney DM. Reassessment of phenylalanine tolerance in adults with phenylketonuria is needed as body mass changes. Mol Genet Metab . 2009;98(4):331-7.

Poewe W. Treatments for Parkinson disease–past achievements and current clinical needs. Neurology . 2009 Feb 17;72(7 Suppl):S65-73.

Reuss S, Weiss C, Bayerl C. Phenylalanine and UVA for Vitiligo patients: probability of an effective treatment. Med Hypotheses . 2006;67(1):199-200.

Russell AL, McCarty MF. DL-phenylalanine markedly potentiates opiate analgesia – an example of nutrient/pharmaceutical up-regulation of the endogenous analgesia system. Med Hypotheses . 2000;55(4):283-8.

Sharman R, Sullivan K, Young RM, McGill J. Depressive symptoms in adolescents with early and continuously treated phenylketonuria; associations with phenylalanine and tyrosine levels. Gene . 2012;504(2):288-91.

Szczurko O, Boon HS. A systematic review of natural health product treatment for vitiligo. BMC Dermatol . 2008 May 22;8:2. Review.

Viau KS, Wengreen HJ, Ernst SL, Cantor NL, Furtado LV, Longo N. Correlation of age-specific phenylalanine levels with intellectual outcome in patients with phenylketonuria. J Inherit Metab Dis . 2011;34(4):963-71.

Vockley J, Andersson HC, Antshel KM, et al. Phenlalanine hydroxylase deficiency: diagnosis and management guideline. Genet Med . 2014;16(2):188-200.

Wissman P, Geisler S, Leblhuber F, Fuchs D. Immune activation in patients with Alzheimer’s disease is assocaitd with high serum phenylalanine concentrations. J Neurol Sci . 2013;329 (1-2):29-33.

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A simple rural-patient checklist to help you explain symptoms clearly, ask better questions, and avoid unsafe self-treatment.

Safety note: This is not a prescription or diagnosis. For severe symptoms, pregnancy danger signs, children with serious illness, chest pain, breathing difficulty, stroke-like weakness, or major injury, seek urgent care.

Which doctor may help?

Start with a registered doctor or the nearest qualified health center.

What to tell the doctor

  • Write when the problem started and how it changed.
  • Bring old prescriptions, investigation reports, and current medicines.
  • Write allergies, pregnancy status, diabetes, kidney/liver disease, and major past illnesses.
  • Bring one family member if the patient is weak, elderly, confused, or a child.

Questions to ask

  • What is the most likely cause of my symptoms?
  • Which danger signs mean I should go to hospital quickly?
  • Which tests are necessary now, and which can wait?
  • How should I take medicines safely and what side effects should I watch for?
  • When should I come for follow-up?

Tests to discuss

  • Vital signs: temperature, pulse, blood pressure, oxygen saturation
  • Basic physical examination by a clinician
  • CBC, urine test, blood sugar, or imaging only when clinically needed

Avoid these mistakes

  • Do not use antibiotics, steroid tablets/injections, or strong painkillers without proper medical advice.
  • Do not hide pregnancy, kidney disease, ulcer, allergy, or blood thinner use.
  • Do not delay emergency care when danger signs are present.

Medicine safety and first-aid guide

This section is for patient education only. It does not replace a doctor, pharmacist, or emergency care.

Safe first steps

  • Stop activity and seek urgent medical evaluation.
  • Chest pain should not be managed only with home medicine.
  • Discuss ECG and cardiac blood tests with emergency care when appropriate.

OTC medicine safety

  • Do not take random painkillers to hide chest pain before medical evaluation.

Avoid these mistakes

  • Do not start antibiotics without a proper medical decision.
  • Do not use steroid tablets or injections casually for quick relief.
  • Do not delay emergency care because of home remedies.

Get urgent help if

  • Chest pressure, sweating, breathlessness, fainting, pain spreading to arm/jaw/back, or known heart disease needs emergency care.
Medicine names, dose, and timing must be decided by a qualified clinician or pharmacist after checking age, pregnancy, allergy, other diseases, and current medicines.

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Doctor to discuss: Doctor / qualified healthcare provider
Tests to discuss with doctor
  • Basic vital signs: temperature, pulse, blood pressure, oxygen level if needed
  • Relevant blood, urine, imaging, or specialist tests only after clinical assessment
Questions to ask
  • What is the most likely cause of my symptoms?
  • Which warning signs mean I should go to emergency care?
  • Which tests are really needed now?
  • Which medicines are safe for my age, pregnancy status, allergy, kidney/liver/stomach condition, and current medicines?

Emergency warning signs such as chest pain, severe breathing difficulty, sudden weakness, confusion, severe dehydration, major injury, or loss of bladder/bowel control need urgent medical care. Do not wait for online information.

Safe pathway to proper treatment

Care roadmap for: Phenylalanine – Uses, Indications, Dosage, Interactions

Use this simple roadmap to understand the next safe steps. It is educational and does not replace examination by a doctor.

Go to emergency care if you notice:
  • Severe or rapidly worsening symptoms
  • Breathing difficulty, chest pain, fainting, confusion, severe weakness, major injury, or severe dehydration
Doctor / service to discuss: Qualified healthcare provider; specialist depends on symptoms and examination.
  1. Step 1

    Check danger signs first

    If danger signs are present, seek emergency care and do not wait for online information.

  2. Step 2

    Record the symptom story

    Write when symptoms started, severity, medicines already taken, allergies, pregnancy status, and test results.

  3. Step 3

    Visit a qualified clinician

    A doctor, nurse, or qualified healthcare provider can examine you and decide which tests or treatment are needed.

  4. Step 4

    Do only useful tests

    Do tests after clinical assessment. Avoid unnecessary tests, random antibiotics, or repeated medicines without diagnosis.

  5. Step 5

    Follow up and return early if worse

    If symptoms worsen, new warning signs appear, or treatment is not helping, return for review quickly.

Rural patient practical tips
  • Take a written symptom diary and all previous prescriptions/test reports.
  • Do not hide medicines already taken, even herbal or over-the-counter medicines.
  • Ask which warning signs mean urgent referral to hospital.

This roadmap is for education. A real diagnosis and treatment plan requires history, examination, and clinical judgment.

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Frequently Asked Questions

Is this article a replacement for a doctor?

No. It is educational content only. Patients should consult a qualified clinician for diagnosis and treatment.

When should I seek urgent care?

Seek urgent care for severe symptoms, rapidly worsening condition, breathing difficulty, severe pain, neurological changes, or any emergency warning sign.