Mood and mental health are complex and involve many factors such as diet and digestive health, as mentioned in previous blogs. Another piece of the puzzle is hormonal balance. An imbalance of hormones can affect the health of men and women and can contribute to physical, emotional and mental well-being. An in-depth understanding of the connection between hormones and our bodies can provide us with a strong foundation for understanding our health.
Female Sex Hormones
Estrogen is a hormone which plays a role in many processes in the body, including breast development, pregnancy, menstrual cycles, and mood. Estrogen affects serotonin, a chemical in our brains and bodies, known as a neurotransmitter, which influences mood, behavior, appetite, sexual function and digestion. In addition, there are estrogen receptors in the brain, in an area called the amygdala, which is largely responsible for emotional memories and mood (2). Women are more likely to suffer from depression and/or anxiety during times of estrogen fluctuations such as premenstrual, postpartum, and peri-menopause (8). A drop in estrogen, which occurs before the menstrual cycle, after childbirth, and during menopause, causes shifts in the production of neurotransmitters.
It is essential to have the proper levels and the right ratios of hormones and neurotransmitters, which means, a sudden drop or increase in either is very destabilizing on the body. Women’s bodies are designed to have fluctuations in hormones every month with menstrual cycles, and with pregnancy, but when changes are too extreme, it can result in adverse symptoms, including depressed mood and anxiety (2,8).
In addition to estrogen, another hormone, progesterone, fluctuates during the menstrual cycle and pregnancy, and a steep drop off of progesterone is associated with anxiety and depression (7). Progesterone is known as the calming and relaxing hormone, as it causes an increase of a neurotransmitter, GABA, which has a slowing and calming effect on the brain (1). It is therefore common to experience anxiety, as well as trouble sleeping, when progesterone levels are out of balance.
Proper metabolism and synthesis of hormones require complex biochemical processes that require specific nutrients and minerals. It is therefore essential to support these processes with a nutrient-rich diet and in some cases, nutritional supplementation.
Male Sex Hormones
Depression is more commonly diagnosed in females, however, males also suffer from depression and depressive symptoms. Much like with females, hormone levels in males have an effect on mood.
Testosterone naturally falls with age, and low testosterone is associated with depressive symptoms, as well as anxiety. Optimizing testosterone both naturally and with bio identical hormone replacement has been successful in mitigating depressed mood as well as several other symptoms males can experience as a result of low testosterone (8).
When thinking about male hormones, generally testosterone only comes to mind, although sex hormones in males also include estrogen, as well as progesterone, just in smaller amounts than what occurs in females. Interestingly, in younger men, high estrogen is associated with depressive symptoms. Estrogen rises in males for several reasons which include, being overweight. Fat cells, known as adipocytes, produce an enzyme called aromatase, which converts testosterone into estrogen. Excess adipocytes can, therefore, increase estrogen, as well as lower testosterone, through this biochemical process (8). Another issue regarding estrogen is plastics. Plastics contain several toxic ingredients, including BPA and BPS, which are found in things like plastic water bottles. These molecules act like estrogen in the body and stimulate estrogen receptors similar to how estrogen would (3).
Weight lifting, the removal of plastics from daily diet and personal products, specific herbs, and weight loss are natural strategies to increase testosterone.
Thyroid hormones play an important role in mood and mental health. Low thyroid, known as hypothyroidism, causes metabolism to slow down and has been associated with depression. An over-functioning thyroid, known as hyperthyroidism, speeds up the body’s processes and thus increases feelings of anxiety and agitation (4). Both of these conditions can be evaluated through lab testing. Additionally, when thyroid hormone levels are considered within normal range, but on the low end, females are shown to still be at risk of depression and depressive symptoms (6). Naturopathic doctors are trained to assess thyroid health more in-depth than conventional doctors and can identify if sub-optimal thyroid levels are contributing to mood issues.
Cortisol is a hormone secreted by the adrenal glands, which are small glands that sit on top of the kidneys. Cortisol is responsible for alertness and stress management. Cortisol levels should be highest in the morning upon waking and gradually decrease over the day, with the lowest levels at bedtime. When stress levels are too high, especially for prolonged periods of time, cortisol secretion can change in a number of ways.
- It can become too high at all times of the day.
- The pattern can change, where cortisol spikes at night.
- Cortisol production can get fatigued and levels can drop down in the morning, or at all points in the day.
All three of these scenarios result in disruptions to daily functioning, metabolism, inflammation, the ability to handle stress, and mood (5). Lower cortisol levels in the morning, as well as a spike at night, cause trouble waking in the morning and insomnia at bedtime. In addition, the inability to handle stress can lead to anxiety, panic, irritability, and depression (9).
Specific nutrients, such as vitamin C and B5, help to support the adrenal glands. Herbs, known as adaptogens, can help the body produce more cortisol in the morning, as well as breakdown cortisol in the evening to assist with proper sleep. If you think that your cortisol levels are out of balance, speak with your naturopathic doctor about testing your cortisol levels throughout the day.
Depression and mood disorders are complex and have a multitude of factors. Hormones are among these factors, however, it is essential to look at the entire picture as all of these aspects are interconnected. An individualized assessment by a licensed naturopathic doctor is the first step in identifying what factors are contributing to your physical, mental and emotional health.
- Bäckström, T., Bixo, M., Johansson, M., Nyberg, S., Ossewaarde, L., Ragagnin, G., … & van Wingen, G. (2014). Allopregnanolone and mood disorders. Progress in neurobiology, 113, 88-94.
- Fink, G., Sumner, B. E., Rosie, R., Grace, O., & Quinn, J. P. (1996). Estrogen control of central neurotransmission: effect on mood, mental state, and memory. Cellular and molecular neurobiology, 16(3), 325-344.
- Hamilton, J (2011). Study: Most Plastics Leach Hormone-Like Chemicals NPR,
- Ittermann, T., Völzke, H., Baumeister, S. E., Appel, K., & Grabe, H. J. (2015). Diagnosed thyroid disorders are associated with depression and anxiety. Social psychiatry and psychiatric epidemiology, 50(9), 1417-1425.
- Joseph, J. J., & Golden, S. H. (2017). Cortisol dysregulation: the bidirectional link between stress, depression, and type 2 diabetes mellitus. Annals of the New York Academy of Sciences, 1391(1), 20-34.
- Kim, E. Y., Kim, S. H., Rhee, S. J., Huh, I., Ha, K., Kim, J., … & Ahn, Y. M. (2015). Relationship between thyroid-stimulating hormone levels and risk of depression among the general population with normal free T4 levels. Psychoneuroendocrinology, 58, 114-119.
- Lovick, T. A., Guapo, V. G., Anselmo-Franci, J. A., Loureiro, C. M., Faleiros, M. C. M., Del Ben, C. M., & Brandão, M. L. (2017). A specific profile of luteal phase progesterone is associated with the development of premenstrual symptoms. Psychoneuroendocrinology, 75, 83-90.
- Stanikova, D., Luck, T., Bae, Y. J., Thiery, J., Ceglarek, U., Engel, C., … & Riedel-Heller, S. G. (2018). Increased estrogen level can be associated with depression in males. Psychoneuroendocrinology, 87, 196-203.
- Vedhara, K., Miles, J., Bennett, P., Plummer, S., Tallon, D., Brooks, E., … & Lightman, S. (2003). An investigation into the relationship between salivary cortisol, stress, anxiety and depression. Biological psychology, 62(2), 89-96.