Mood and Metabolism Part 1

By Jim LaValle R.PH, CCN

Is your glass half empty or half full?   Are you happy? Depressed? Irritable? Apathetic? Energetic? Calm? Tense? Satisfied? Do you know that the answer to these questions can be heavily influenced by your physical health? While our thoughts can dramatically affect our health, sometimes a patient's overall disposition can be a barometer for unaddressed metabolic issues such as: thyroid imbalance, poor sleep quality, food intolerances and vitamin and mineral deficiencies.

The way these metabolic disruptions affect our mood is via their effects on our neurotransmitters. The primary neurotransmitters (brain and nervous system signaling chemicals) involved in mood are serotonin and dopamine.

Serotonin is a neurotransmitter that in adequate amounts makes us feel calm, happy, relaxed and satisfied. Dopamine is a neurotransmitter that makes us feel elatedly happy and it also gives us the ability to focus. Low serotonin is considered the most common cause of depression. Low serotonin is also linked with anxiety and affects appetite. Serotonin is made from an amino acid called tryptophan. It is also a precursor to melatonin, a potent sleep hormone, so therefore a deficiency of serotonin can interfere with a good night's sleep. The most commonly prescribed class of anti-depressant drugs is called SSRIs (which stands for selective serotonin reuptake inhibiters). They block the reabsorption of serotonin allowing more availability and increased activity of this mood-lifting chemical. Sometimes SSRI's are not effective because of a lack of enough serotonin for the medication to act upon.

There are a number of factors that can influence production of serotonin, but the most common one is stress. The stress hormone cortisol blocks the production of serotonin by up regulating an enzyme that takes tryptophan and turns it into proteins, in addition to up regulating monoamine oxidase enzymes that cause serotonin to break down, thereby lowering the amount of tryptophan available for serotonin and melatonin production[i]. Thus there is huge interplay between stress and sleep, and this is important because it interrelates with mood as well.

The quality and quantity of sleep one gets has a huge impact on mood.   Anyone who has ever experienced a sleepless night knows that fatigue the next day is only the tip of the iceberg. Lack of sleep interferes with productivity, lowers immunity, and can make people feel dizzy and foggy headed. Sleep disturbance can increase irritability, and we know that sleep apnea is associated greater prevalence of depression (22%), anxiety (17%), post-traumatic stress disorder (12%) and psychosis (5%) when compared to subjects without sleep apnea[ii]. Severe sleeping problems are even a marker for suicide risk, an extreme example of how chronic insomnia and sleeping problems can affect mental health[iii]. Because sleep problems don't affect just our mood they can increase risk for heart disease and metabolic syndrome, it's important to not cheat yourself on the amount of sleep you get. If you can sleep well, but you just stay up late, realize this can have significant impact on your health as well as mood.

But sometimes people want to sleep, but they can't. If you have problems falling asleep or staying asleep it's important to look for the root causes. Some people wake up at night because their blood sugar is dropping and this can be addressed with nutrients and changes in diet. The most common thing we see influencing ability to sleep, though, is chronic stress. Chronic stress can lead to a condition called hyperarousal, which has been identified as the most common cause of disrupted sleep.   The hallmark of hyperarousal is cortisol levels that do not follow a normal pattern of being higher in the morning and afternoon and slowly decreasing toward the evening. In hyperarousal, cortisol levels elevate at night. Increased stress hormone production will start to disrupt serotonin production over time, and that is how it affects mood and sleep. There are supplements that can help normalize the stress response and cortisol patterns, which over time can help build up serotonin levels. There are also nutrients you can take to directly support better serotonin production and help put your sleep schedule back on track.

Another factor that can influence serotonin levels and mood is believe it or not, gut health. Serotonin has long been thought of as a brain chemical, but estimates are that up to 80% of serotonin in the body is found in the gut[iv]. That's right, the intestinal tract. This discovery has prompted a relatively new field of science called neurogastroenterology, or the study of brain-gut connections. Serotonin also acts upon intestinal motility, so people with irritable bowel syndrome (IBS) may not be making enough serotonin. Interestingly, generalized anxiety disorder is found to be five times more common among study participants with IBS compared with those without GI discomfort[v].   Possibly due to the presence of serotonin in the gut, anti-depressant medications designed to rebalance serotonin signaling are showing benefits for IBS symptoms[vi].

Anyone experiencing problems with digestive disorders like IBS, may find that their mood improves immensely by working on a program to restore better intestinal health and integrity of intestinal cells. Conversely they may find their intestinal health improves by working to improve their stress levels or the body's response to stress with nutraceuticals such as adaptogenic herbs. On the other hand if someone presents with a primary concern of anxiety, it may warrant addressing not just neurotransmitter imbalances, but assessing intestinal health as well. 

Another metabolic imbalance that can have significant impact on mood is thyroid function. Thyroid hormones have multiple effects on the central nervous system and therefore on mental health disorders[vii]. For example, depression can be a sign of an underactive thyroid and feeling agitated can be a sign of an overactive thyroid. In fact there is such a strong possibility of depression being related to thyroid that the  

American Association of Clinical Endocrinologists state in their medical guidelines for clinical practice that every patient diagnosed with depression should have their thyroid hormones evaluated[viii]. This is because thyroid hormones have a big impact on serotonin production[ix]. Use of triiodthyronine (T3), a thyroid hormone that impacts cellular metabolic activity, has been shown to be beneficial when added to antidepressant therapy in patients with major depressive disorder[x]. Aging, poor nutrition, stress and exposure to environmental toxins can all interfere with thyroid hormones and compromise thyroid function. If you are wrestling with depression or are not getting good results from different classes of anti-depressants, be sure to work with a skilled clinician to rule out poor thyroid function.

Your nutritional intake or lack of it can also influence your mood.   To make adequate neurotransmitters like serotonin you need adequate amino acids, and other vitamins and minerals that are needed for the conversion of the amino acids to the neurotransmitters. For example, we already mentioned that the amino acid tryptophan is needed to make serotonin, but vitamin B6 and a number of other vitamins and minerals are also needed. The same is true for dopamine production, another important influence on feeling happy and on the ability to focus. Micronutrient intakes can also be important for thyroid hormone production. Our nutritional habits can also have a big impact on our gut health, as can past health and medications. So dietary patterns and nutritional intake can profoundly influence metabolism and therefore mood, but the scope of these connections will be explored in our next newsletter.

So, it's a two way street. Your mood can affect your metabolic health and balance, and metabolic imbalances can be a huge influence on your mood. Many psychologists are starting to realize this and are beginning to incorporate some nutritional care into their practices. Mood disorders can also be an important indicator of a condition that may go unaddressed otherwise. So, if you have any problems with mood, such as anxiety or depression, we strongly recommend looking to see whether it could be stemming from a metabolic imbalance, especially if you have tried medication and it hasn't helped. At LMI if we see these two conditions in a patient, we don't just evaluate neurotransmitter levels, but look for underlying physical influences on them, such as thyroid hormones, effects of chronic stress on cortisol and sleep, intestinal health and nutritional habits and intake.

Health Habits that Help Mood

1.  Exercise

Study after study has found that exercise can improve mood, and conversely that regular exercisers report less depression. Exercise can be a great way to deal with stress, and improves production of neurotransmitters and endorphins, which not only elevate mood but help with pain management. Be careful not to overdo exercise however, as overtraining can start to cause increased cortisol and will depress mood and immunity and affect the ability to sleep.

2.  Bright Light  

Serotonin levels increase with light. When you wake up in the morning, lift your shades and let the sunlight in. If you live in a climate with long periods of low sunshine, try a light box, special full spectrum lights which you sit in front of for a few minutes each day. Just look up "light boxes" online. There is a range of products available at reasonable prices.

3.  Eat Carbs - But Carefully  

 A single high carbohydrate meal allows the amino acid tryptophan to cross the blood brain barrier to make serotonin. Avoid too many refined sugars and flours however. Sugar depletes important nutrients like chromium and magnesium, important for blood sugar regulation. Choose complex carbohydrates like oatmeal and brown rice and even with those, make sure you aren't eating more than your body can handle, as evidenced by your ability to control your weight and blood sugar.

4.  Omega 3 Fatty Acids

Make sure you get them in daily either through diet (fish) or supplements. Omega 3 fatty acids are important for healthy cell membranes, so the neurotransmitter receptors on cells can work properly.

5. Foods to help build serotonin   

High protein foods are good sources of tryptophan, so don't skimp on chicken fish, turkey, eggs and beans. Chickpeas, salmon, potatoes and bananas are good sources of vitamin B 6.

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