Hormonal Impacts on Mental Health - Part 2

The influence hormones have on mood and mental health is incredibly diverse. As a naturopath, my role is to determine what underlying factors contribute to symptoms of anxiety and depression. By addressing these underlying factors, it optimizes the body’s ability to handle emotional stressors. In Part 1 of the Hormonal Impacts on Mental Health, I outlined how imbalances in the female hormones estrogen and progesterone can lead to symptoms of anxiety and depression, and particular situations where I see this in practice. Here in Part 2, I’ll be shedding light on additional hormones that may be underlying mental health concerns including thyroid hormone, and cortisol.

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Thyroid

The thyroid is an underrated gland that sits at the front of the neck above the sternum and wraps around the windpipe. It is a key player in regulating metabolism of the cells in our body. When the thyroid is not producing enough thyroid hormone this results in symptoms of hypothyroid including weight gain, constipation, dry skin, thinning hair, cold intolerance, brain fog, low energy, and low mood.

The prevalence of hypothyroidism is higher in those diagnosed with major depressive disorder than within the general population (1). Interestingly, the rates of hyperthyroid (overactive thyroid) are also higher in those with major depressive disorder than the general population, highlighting the importance of testing thyroid function.

Testing thyroid function is done by looking at blood levels of TSH (thyroid stimulating hormone) and thyroid hormones (most commonly T4). TSH levels tend to be high in those with hypothyroidism (low functioning thyroid). Although reference ranges can vary, many naturopathic doctors prefer TSH to be optimal, or below 2.5 MIU/L.

Cortisol

Cortisol is one of the body’s stress hormones. It is produced by two small glands that sit on top of each kidney known as the adrenal glands. Cortisol is typically highest in the morning to promote wakefulness, and slowly decreases throughout the day so that by the time we got to sleep it is lowest. In times of stress, the adrenal glands produce greater amounts of cortisol and at certain times this may be beneficial. Elevated cortisol levels however, are related to high blood pressure, sleep disturbances, and anxiety. A dysregulation in morning cortisol levels in particular is associated with anxiety disorders (2, 3).

Cortisol can be tested through blood or saliva. Blood testing can look at morning and evening cortisol levels, while saliva testing allows us to measure cortisol at different time points throughout the day. A healthy ‘cortisol curve’ should look like the following:

Cortisol is also interrelated with blood sugar levels. An increase in cortisol results in a spike in blood sugar. A subsequent drop in blood sugar can contribute to ‘hangry’ feelings such as shakiness, sweating, irritability, and feeling anxious. Because the two are so interrelated, it is important to balance both cortisol and blood sugar levels in order to avoid drastic changes that may lead to mood disturbances.


OPTIMIZING MENTAL HEALTH involves addressing these and other underlying physiological factors such as neurotransmitter imbalances. Not to be forgotten however, is the mental and emotional work that is required to overcome unhealthy thought patterns as well as past traumas. As a naturopath, I emphasize the importance of treating both mind and body.

If you’re interested in learning more about how your hormones may be affecting your mental wellness and what options are available, consider booking a naturopathic consultation.


References:

1. Wu, E., Chien, I., Lin, C., Chou, Y., Chou, P. (2013). Increased risk of hypothyroidism and hyperthyroidism in patients with major depressive disorder: a population-based study. Journal of Psychosomatic Research, 74(3), 233-237.

2. Vreeburg, S., Zitman, F., van Pelt, J., DeRuk, R., Verhagen, J., van Dyck, R., Hoogendijk, W… Pennix, B. (2010). Salivary cortisol levels in persons with and without different anxiety disorders. Psychosomatic Medicine, 72, 340-347.

3. Hek, K., Direk, N., Newson, R., Hofman, A., Hoogendijk, W., Mulder, C., Tiemeier, H. (2013). Anxiety disorders and salivary cortisol levels in older adults: a population-based study. Psychoneuroendocrinology, 38(2), 300-305.

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Sugar Intake, Inflammation, & Mental Health

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Hormonal Impacts on Mental Health - Part 1