When you think about mental health, you’re probably thinking about your brain and how that works. The picture is often much more complex. Hormones play a big part because these chemical messengers are the background to everything that happens in your body. How you feel, therefore, is not just psychological, it’s biological.

Did you know, there are a huge number of symptoms that are common to both depression and hormonal imbalance? These include low energy, dizziness, low mood, apathy, anxiety, irritability, anger, lack of enthusiasm, despair, headaches, poor concentration, feelings of hopelessness, lack of confidence, low libido, fuzzy brain, memory loss, and insomnia (although there are others).

Rebalancing your hormones naturally is not something that happens overnight, but it can be greatly improved with the help of nutritional and lifestyle change. 

Mood and Cycle

Two of the main hormones that affect your feeling of mental wellbeing and clarity are oestrogen and progesterone, and these change throughout your menstrual cycle. It’s an over-simplification – but perhaps a helpful one – to think about oestrogen largely bringing positive effects to your mood and progesterone contributing more negative effects. With such a pronounced hormonal connection on mental health, it’s small wonder that women are twice as likely to suffer from depression than men.

According to the National Institute of Mental Health, 64% of women who suffer from depression say their symptoms get worse during the pre-menstrual period. Hormones are also likely to contribute to antenatal or postnatal depression, which affect around 10-15% of new mothers. And anxiety and depression are also starting to be recognised as symptoms of the perimenopause on top of hot flushes and night sweats.

How it works

At certain times in your cycle (in the run-up to ovulation), there will be lots of oestrogen in your system and women tend to feel brighter and better in their mood. You might even notice at this time you feel better at talking and articulating yourself. In the second half of your cycle, oestrogen dips, and progesterone comes into play. For some women, this can lead to lowered mood or depression.

You might already experience this as Pre-menstrual Syndrome (PMS), a very common condition linked to the changing levels of these hormones, that might include feelings of bloating, breast tenderness or headaches, or manageable emotional symptoms like irritability. For a small number of women (about 2-8%), the effect of these hormones on their mental wellbeing is pronounced. This is called Pre-menstrual Dysphoric Disorder (PMDD); an extreme form of PMS and one that, if you think might apply to you, you will want to ask your doctor about.

Why does this happen?

One of the first things to know is that the production of dopamine and serotonin (the two main brain chemicals associated with the development of depression and psychosis) is heavily linked to levels of oestrogen. 

Research seems to suggest that there isn’t a noticeable difference in levels of oestrogen between those who are affected by mental health symptoms around their period or during the menopause – it seems some women are just especially sensitive to hormonal change, or perhaps also that lifestyle problems like stress may also play a big part.

Impact of hormones on blood sugar levels

Declining oestrogen levels have a role to play in insulin sensitivity (that means how sensitive – or not – the cells in your body are to the fat storage hormone insulin). In fact, a lack of sensitivity to insulin (or even being resistant to the effects of insulin) is lurking behind many of the common menopause symptoms, like hot flushes, fatigue and weight gain as well as symptoms of low mood like brain fog, anxiety and depression.

Hormones and mental health is a complex picture in which your physiological health and mental wellbeing are inextricably intertwined. It might be best to work with a nutrition practitioner to unravel this for you. We might be able to piece together a hormone balancing food and lifestyle plan to suit your circumstances. Get in touch if you feel you'd like to discuss this further. 

Are you functioning on all cylinders?

If you often feel you’re dragging yourself through the day or you've been struggling to lose weight for a long while despite eating all the right things, it might be worth considering whether your thyroid is doing the job it should. 

The thyroid – a butterfly-shaped gland located in the neck – is the body’s internal motor, effectively setting the speed at which the body works. If it’s not up to scratch, you might experience a whole host of uncomfortable or annoying symptoms (see below). 

The hormones it makes affect most cells in the body by increasing the basal metabolic rate, as well as augmenting heat production. That’s why people with an underactive thyroid often struggle to lose weight, feel the cold more easily and have low energy – imagine a record player playing a record at reduced speed.

Do any of these sound familiar?

• I feel tired all the time
• My hands and feet are always cold
• I’m putting on weight for no reason
• I can’t seem to lose weight whatever I do
• I’m often constipated
• My muscles ache
• I get muscle cramps more often
• I feel irritable
• Generally, I’m feeling a bit low
• I’m struggling to fall pregnant
• My periods are heavier than usual
• My hair and skin feel so dry
• My sex drive is flagging or non-existent
• I’m losing hair at the outer edge of my eyebrow.

If more than a few symptoms resonate with you, visit your GP to discuss symptoms and ask to get your thyroid tested. 

GP testing

One of three things will happen after you have a blood test at the GP. The doctor may tell you your results look normal, in which case no further action will be taken*. Or you might be sent for further testing, if the result looks a little off, either immediately or for a retest in a few months’ time. 

It’s much more common to have an underactive thyroid than an overactive one, and more common still for the underactive thyroid to be an autoimmune condition called Hashimoto’s, where the immune system destroys the thyroid gland to the extent that it can no longer function normally. 

However, even with a diagnosis, many people still experience symptoms in spite of treatment.  

What actually gets tested? 

In the UK, the first thing doctors test is Thyroid Stimulating Hormone (TSH) levels. TSH is the hormone that tells your body to produce the actual thyroid hormones. If TSH is within range, your GP is unlikely do any further tests on the assumption that the rest of the thyroid hormone-producing cascade is working correctly. 

If TSH is raised, your body is working harder than necessary to produce the right levels of thyroid hormones. At this point, your doctor may repeat the TSH test in a few months in order to compare levels. 

Alternatively, they might test your Thyroxine (T4) levels to determine whether or not you’re producing the right levels of this hormone. 

If this level is below range, you’ll likely be prescribed a synthetic form of thyroxine to supply the body with what it is not making itself. If the levels is above range, which suggests an overactive thyroid, you may be prescribed carbimazole and perhaps a beta-blocker.

*Still feeling tired and ‘rubbish’ despite treatment?

This a common problem. Initially, you may start to feel better, but many patients report sliding back into their previous pattern of symptoms.

The reasons why you’re not feeling better can be complex.

• Supplementing with T4 might not work, as what’s going on in your body might be more complicated and involve several issues.
• Some people produce enough TSH and T4, but T4 isn’t actually the hormone that does the work.
• Triiodothyronine (T3) is the ‘work horse’ that needs to be converted in the liver from T4. Some people, for various reasons, simply don’t convert it very well.
• In other cases, you might produce enough TSH, T4 and T3, but the body negates the effects of the usable T3 by making reverse T3 (rT3) –literally reversing the action of T3.
• Everything may ‘look normal’, but if you’re still dragging yourself through the day, you could have sub-clinical thyroid problems. GP ranges are quite broad, so it’s easy to fall outside the limits. 

It’s worth knowing that regular GP testing does not cover T3 or rT3, so if you’re still feeling below par, it’s worth getting a full thyroid blood screen done privately. I work with all major private laboratories and can arrange this for you.

Do you have an autoimmune thyroid problem?

Another vital piece of information, which isn’t often covered by the standard GP test, is for the presence of autoimmune thyroid antibodies (thyroid peroxidase and thyroglobulin). This indicates your immune system is attacking your thyroid.

The autoimmune disease Hashimoto’s Disease (a form of underactive thyroid) is incredibly common but unless your GP tests for the antibodies, you won’t know that you have it.

GPs generally don’t test for this as it doesn’t affect their clinical management of you – whatever the diagnosis, you’re still going to be prescribed thyroxine.

However, this test is important to nutritional therapists, as the diagnosis requires an entirely different treatment protocol.

You may have high levels of these antibodies, but no symptoms of an underactive (or overactive) thyroid. The autoimmune element always comes first. 

Hashimoto’s (underactive) and Graves’ (overactive) Disease affect the thyroid, but they are actually immune system disorders. 

Adrenal stress - the missing link in thyroid treatment

Thyroid health is closely connected with your adrenals (two walnut-shaped stress glands located on your kidneys). If you have had any significant stress, your adrenal glands may not be performing optimally – and this is very bad news for thyroid health.

Adrenal stress disrupts the complex network of interactions needed to make the right amount of thyroid hormones, suppressing the thyroid function.

There are tests available privately for this. Unfortunately, adrenal problems are not recognized by UK GPs. 

Addressing adrenal problems is important because the effects of stress affect energy production, fat storage (storing fat around the middle) and female hormone health.  

The importance of iodine

Did you know that the mineral iodine is essential for the manufacture of thyroid hormones triiodothyronine (T3) and thyroxine (T4)? Thyroid hormones contain three or four iodine atoms respectively. If you’re serious about fixing your thyroid for once and for all, you could consider a urine test to determine whether or not you have sufficient levels of iodine. 

Ready to get that thyroid back into shape?

There are a number of different tests, which we can use to measure your thyroid levels. These include a full blood draw, finger prick blood spot test and a urine test. I take a full medical history and evaluate my clients before deciding on the best option. If you have an underactive thyroid and are feeling below par, despite medication, I can help. Medication is just a piece of the puzzle. Why not contact me here.

September is PCOS or Polycystic Ovary Syndrome Awareness Month. This is a condition which research shows affects over hundred million women worldwide, easily making it the most common hormone disorder of women in reproductive age and quite possibly the leading cause of infertility in women.

PCOS is a bit of a misnomer, as not everyone with the syndrome has polycystic ovaries, and not everyone with cysts on their ovaries has PCOS! Plus, the ‘cysts; that women with PCOS have are not the same as cysts that may need to be removed, rather they are where the ovarian follicles have not gone through the maturation process and have failed to reach ovulation stage leaving ‘cysts’ on the ovaries. Official diagnosis of PCOS depends on the Rotterdam Criteria, where to be diagnosed a woman must have two of the three following symptoms:

• Oligo-ovulation (leading to irregular periods) or anovulation (leading to absent periods)
• Hyperandrogenism (elevated levels of androgens or male hormones
• Polycystic ovaries (ie enlarged ovaries each containing at least 12 follicles measuring between 2 & 9mm shown on an ultrasound)

Alongside the ‘cystic’ ovaries and irregular/absent periods, there are several other symptoms which may denote PCOS – hirsutism; acne/oily skin; weight gain & inability to lose weight; overwhelming fatigue; male-pattern baldness; depression & anxiety; low energy. These symptoms can be hugely debilitating and, in addition to these troubling symptoms, PCOS is associated with a long-term risk of diabetes and heart disease.

While the exact cause of PCOS is not fully understood, there are certain contributing factors:

• Family history of PCOS, diabetes or insulin resistance
• Hyperinsulinaemia or high levels of insulin
• Inflammation
• Adrenal androgens and stress
• Exposure to hormone-disrupting chemicals
• Post-pill surge of androgens
• A combination of all of the above

But don’t despair! The good news is that research shows that changes to nutrition and lifestyle may help with the severity of symptoms.

Decrease levels of refined carbohydrates like sugary treats, bread, pasta, cakes, biscuits, etc.

Insulin’s role is to allow cells of the body to take in blood sugar (glucose) to be used as fuel or stored as fat. However, if there are high levels of sugary foods and drinks or refined carbohydrates (hello bread!) in our diets, our bodies need to keep producing lots of insulin. Research shows that high levels of insulin in women with PCOS may cause the ovaries to overproduce testosterone, triggering our unwanted symptoms. Moving to a diet that is lower in these sorts of foods, but high in veggies, fibre and good quality protein can be helpful.

Include healthy fats and avoid unhealthy ones

Research shows that foods rich in omega-3 fatty acids, such as oily fish like salmon, mackerel, and sardines, may be protective against increased PCOS symptoms due to the anti-inflammatory effect that they have on our bodies. Plus, by avoiding trans-fats, those fats that can be found in deep-fried foods such as chips or crisps, or in shop-bought foods which contain partially hydrogenated fats/oils or shortening, can help reduce the inflammatory effect they have on our bodies. Inflammation, when our immune system is constantly activated, may be a trigger for PCOS.

Increase vitamin D-rich foods

Research shows that many women who suffer with PCOS have low levels of vitamin D. Vitamin D is a hugely important nutrient for us and does many essential jobs, including helping us to balance blood sugar and reduce inflammation; and research shows that adequate vitamin D levels are important for the development of healthy eggs and fertility. 

Decreasing levels of stress – emotional, mental, physical

Stress hormones, such as cortisol, are hugely important as an essential part of our response to stress and/or fear and kickstart several body processes which aim to increase our chances of survival. While this is great in the short-term, if the stress continues and becomes chronic, then this is where it can have a knock-on effect to our hormones, exacerbating our symptoms of PCOS. Ensuring that our blood sugar is balanced and that we are not over-exercising (very common in ladies with PCOS) can help to manage our physical stressors. Plus, ensuring that we include quality self-care including yoga, meditation and time-off will help with mental stressors and to build stress resilience.

If PCOS symptoms are impacting your life, why not get in touch with me to discuss how a personalised nutrition plan might help? Book a free 30-minute health review today – just click here to book.

Xenoestrogens are environmental pollutants with chemical structures that can mimic oestrogen in the body. These chemicals can lead to detrimental effects to our bodies, therefore awareness of xenoestrogens and avoidance where possible are the key to good health. 

For example, research shows that pollution by xenoestrogens can affect:

• Reproduction in many different animal species
• Deterioration of human sperm count
• Reports of contaminated waterways and rivers affecting the sexual characteristics of fish and other creatures
• Environmental xenoestrogens such as organochlorine pesticides have been shown to promote the growth of uterine fibroids in vivo and vitro.  Studies have found high levels of organochlorine pesticides in fibroid tumours and blood samples of women suffering from uterine fibroids.

By mimicking the action of our own oestrogen, xenoestrogens can affect our bodies and alter our hormone activity. Currently, approximately 70,000 chemicals have been registered as having hormonal effects. These chemicals have been seen to increase the oestrogen load in the body over time and are sometimes more difficult for the liver to detoxify and clear from the body.

 

These chemicals can be found in our water, air, soil and food chain, as well as in many cosmetic and household products. The human body is being bombarded with these harmful chemicals every day which may over-burden the liver, weaken our immune systems and disrupt our delicate hormonal balance. 

So, where can we find them? And how can we avoid them?

• Agricultural chemicals such as pesticides, fungicides and herbicides or hormones fed to cattle, pigs, poultry, and other livestock found in meat, dairy and eggs, are one of the biggest sources of xenoestrogens.

• Try and eat organic foods as much as you can afford, or check the Environmental Working Group’s Clean 15 and Dirty Dozen to see the worst perpetrators.
• Choose organic meat, eggs, and dairy products. Or better still, choose 100% grassfed meat and dairy products, and pastured pork and poultry.

• Avoid the common food preservative in processed foods - BHS: butylated hydroxyanisole.
• Avoid non-organic coffee and tea. They are highly sprayed with pesticides. 
• Look to use natural pest control in your home/garden, avoiding synthetic flea shampoos, flea collars, and flea pesticides for your pets and home.

• Household Cleaners and products

Many household products contain xenoestrogens, but specifically look out for laundry detergents and fabric softeners, as they may leave residues on clothing, towels, and things that touch our skin.  Air fresheners and insect repellents are also major sources of xenoestrogens.

• Use old-fashioned household cleaners like baking soda, lemon juice, and vinegar whenever possible. 
• Avoid fabric softeners and dryer sheets entirely and use a simple laundry detergent with few chemicals. 
• Be aware of gases and vapours that comes from photocopiers and printers, carpets, fibreboards, or new carpets. 
• Do not inhale and try and protect your skin from: electrical oils, lubricants, adhesive paints, lacquers, solvents, oils, paints, fuel, industrial wastes, packing materials, harsh cleaning products, fertilizers. 
• Air your house well when you can and avoid the use of air fresheners, insecticide sprays, and other products that release chemicals into the air. 
• Try safer insect repellents such as citronella or cedar.

• Cosmetics and Toiletries 

Xenoestrogens absorbed by the skin are thought to be ten times more potent than those eaten or drunk, as they travel directly to the tissues instead of passing through the liver. Therefore, be careful with your choices – look for natural plant-based products and check the ingredients carefully. Some things to avoid are: 

• Nail polish and sunscreen are more common sources of xenoestrogens, including phthalates, benzophenone-3, homosalate, 4-methyl-benzylidene camphor (4-MBC), octyl-methoxycinnamate and octyl-dimethyl-PABA. 
• Other products, including body lotions, toothpastes, soaps, gels, hairsprays, and more may contain xenoestrogens in the form of parabens, phenoxyethanol, phthalates, stearal konium chloride and other compounds. Try and choose organic or natural brands insteads.
• Phthalates are commonly found in baby lotions and powders. 
• Many perfumes, deodorizers, air fresheners have artificial scents and contain phthalates and are petrochemically based. Go for essential oils or natural, organic scents instead.

• Plastics

Plastics, especially soft plastics, contain many compounds that are considered to be xenoestrogens. One type are phthalates, which are a kind of plasticizer which are often used to make plastics soft and flexible. These compounds can leach out over time or in response to heat or light. Unfortunately, phthalates are used in a range of products from food containers and packaging to children's toys and bottles. 

Bisphenol-A (BPA) is another offender that is used for food storage or to line tin cans for canned goods. Although this protects the consumer from a metallic taste in the foods, BPA is a known xenoestrogen that can leach into the food when exposed to hear or acid.

• Never heat food with plastic in the microwave, even if it claims to be microwaveable. Use glass or ceramics instead and cover with a paper towel. 
• Use cling wrap that does not contain DEHA and replace cling wrap on meats, cheese and other foods as soon as you get home from the store. Storing food in ceramic or glass containers may be another option. 
• Avoid Teflon and other non-stick cookware. Cast iron, ceramic or is an inexpensive, durable, and healthful alternative. 
• Buy drinks in glass bottles instead of plastic. 
• Don't drink hot liquid or eat hot food from Styrofoam cups or containers. 
• Use a stainless-steel water bottle for regularly drinking rather than plastic bottles. 
• Go for long-life products in glass jars rather than tins if you can.

• Water 

Unfortunately, water treatment plants are not currently designed to remove hormonal pollutants, and agricultural and pharmaceutical runoff have created a curious epidemic among fish and frogs in many waterways in the developed world. 

• Don't switch to bottled water, which is unregulated and may be more polluted than tap water. Instead, install a reverse osmosis water system if you can. These can include under sink or whole house systems. 
• Look for tabletop water filters, such as the Berkey water filter, which are able to remove hormones from drinking water.
• Drink from a stainless steel or glass container, or choose safer plastics if you need to drink from a plastic water bottle.

Have a look at the products you use, food you eat, water your drink, plus storage and containers, cleaners and cosmetics. Think about what you can afford to change, and maybe put in a plan to replace things gradually over time. Each small change you make will be a benefit to your health in the long term.

Photo by Charles Deluvio on Unsplash

Spotlight on Endometriosis

March is Endometriosis Awareness Month. This is a condition that can affect women of any age and studies show that it affects 10-15% of menstruating women.  Endometriosis is where tissue similar to that of the womb lining grows in other places outside of the womb, such as on the ovaries or the fallopian tubes. The main risk factor for endometriosis is heredity, meaning that if your mother or older sister has it, there’s a fair chance that you may get it too. 

While the exact cause is unknown, what is evident is the problems that it causes to those who have it. With endometriosis, the womb-lining-like tissue that grows outside of the womb behaves exactly as you would expect the womb-lining to behave – in sync with the women’s monthly cycle it thickens, sheds and bleeds. But if this tissue is outside of the uterus, it has no way to exit the body as it would within the womb, causing pain that is sometimes incredibly severe. Further complications can include formation of cysts called endometriomas, plus irritation of the surrounding tissue, possible scarring and adhesions.  Fertility problems may also develop.

Symptoms include painful periods, pain during intercourse, pain when going to the loo, excessive bleeding, infertility, plus other symptoms such as fatigue, digestive issues like diarrhoea and constipation, bloating or nausea. While it can be a challenging condition to manage, working with a GP and gynaecologist can help to manage symptoms and provide a programme of care. Plus, research shows that alongside conventional medical help, changes to nutrition and lifestyle may help with the severity of symptoms.

The following nutrition tips may help with the severity of endometriosis symptoms:

Include healthy fats and avoid unhealthy ones

Research shows that foods rich in omega-3 fatty acids, such as oily fish like salmon, mackerel, and sardines, may be protective against increased endometriosis symptoms. Although an exact link was not proven, studies show that women with the highest intake of these fats were 22% less likely to be diagnosed with endometriosis compared with women with the lowest intake. 

And avoid trans-fats, those fats that can be found in deep-fried foods such as chips or crisps, or in shop-bought foods which contain partially hydrogenated fats/oils or shortening. Studies show that women with the highest intake of trans saturated fats were 48% more likely to experience endometriosis symptoms.

Increase intake of high-fibre foods

Food rich in fibre, such as pulses, legumes, and vegetables, may improve intestinal transit time and help to balance gut-friendly bacteria.  Research shows that this may help the body to naturally clear excess oestrogen, which may in turn help with improving symptoms of endometriosis.

Include phytoestrogen-rich foods

Phytoestrogens are chemicals found in certain plant foods such as soy and flaxseed which have been seen to exert a weak oestrogen-like effect on the body. However, by binding to oestrogen receptors in the body, research shows that these phytochemicals may be beneficial to women with endometriosis by encouraging the body’s natural clearance of oestrogen. 

Increase vitamin C-rich foods

Research shows that foods rich in vitamin C may be effective for the prevention and regression of endometriosis possibly by helping to manage the inflammation and growth of excess tissue. Including foods such as peppers, broccoli, Brussels sprouts, and citrus fruits on a regular basis may help with the reduction of chronic pain associated with endometriosis. 

If endometriosis symptoms are impacting your life, why not get in touch with me to discuss how a personalised nutrition plan might help? Book a free 30-minute health review today – just click here to book.