Depression is a clinical diagnosis that is a result of low levels of serotonin (your happy neurotransmitter) in your brain. This is traditionally treated with anti-depressants which help keep serotonin in your brain a bit longer to try and keep you more satisfied. Most anti-depressants are meant to be used for a short term but are often prescribed and deemed one of the essentials to take forever- partially because your body becomes dependent on them. Many people who take anti-depressants have significant side effects and often still struggle with depression. Is the benefit of the drug worth it if it is not helping with depression? I will discuss alternative testing and treatment options for managing depression and depressive symptoms.

Depression may be a SYMPTOM of an underlying disease process and not just the end diagnosis. Of course, many people live with depression due to trauma or loss. For those reasons, therapy should be utilized as a piece to solving the puzzle of depression. However, processes like hypo-active thyroid, low hormone levels, and even malnutrition can cause depression! Malnutrition is quite common in the United States. The Standard American Diet (SAD) leaves much to be desired for B12, with up to 40% of Americans being deficient. There are MANY other vitamins and minerals that we lack in our diets just by eating overly processed foods and not enough healthy protein, whole grains, fruits, and vegetables. Vegan and vegetarian diets are also at risk for B deficiency.

Besides nutrition, some people are genetically unable to methylate B vitamins for optimal use. If you have a single nucleotide polymorphism (SNP) of the MTHFR gene, for example, you cannot methylate your Bs and use them in your body! I love the book, Dirty Genes by Dr. Ben Lynch. This is a great, easy read that can walk you through the most common genetic SNPs (aka “Dirty Genes”). With the help of this book, you can often find which SNP you may have and how to support that SNP with diet and supplements to get you feeling as great as you can.

Why should you care about your B vitamins?

These are the BUILDING BLOCKS for serotonin! That’s right, you can CREATE serotonin by giving your body the tools it needs! Vitamin B6, B9, and B12 combined with tryptophan are the ingredients for serotonin. Luckily, we carry this supplement combo in our clinic. Your body uses B vitamins for cellular rejuvenation, DNA modeling, and as a source of energy for so many different processes. In periods of stress, inflammation, and depression, you will require MORE B vitamins because you are burning through your reserves a lot faster just to stay afloat. Your body doesn’t create serotonin when distracted by other things, so supplementing is a great way to provide that additional support. You can also find these vitamins in the highest concentration in seafood and meats, so if you are on a vegan diet, stock up on these supplements! We also offer B12 injections in our clinic, which complement oral replacement and make you feel great!

Having your endocrine hormones evaluated is another piece of the puzzle. Did you know that both men and women benefit from testosterone optimization? Testosterone is used as a treatment for depression in many cases as it has incredible benefits in enhancing mood. Indeed, the improvements in energy, sleep, and libido help improve your mood. Knowing that hormone optimization is also improving your cardiovascular risks, bone density, lean muscle mass, and metabolism, and supporting weight loss is also something to be happy about!

A note on thyroid dysfunction

Hypothyroidism slows your metabolism down and causes symptoms of constipation, weight gain, hair loss/thinning, dry skin, chronic fatigue, and of course, DEPRESSION. If left unsupported, it can have some pretty detrimental effects on your overall health. Most primary care physicians only test a thyroid stimulating hormone (TSH) to determine thyroid health. TSH is a hormone that comes from the pituitary gland in your brain. It signals the thyroid and tells it to make more or less of your thyroid hormones. I routinely check the TSH and thyroid-specific hormones to get a better picture of how your thyroid and the pituitary-thyroid axis are working. I also like to study specific antibodies to determine if there is a presence of auto-immune thyroid destruction, known as Hashimoto’s disease. This can change the treatment plan for gaining optimal results in mood and other symptoms. Having a routine thyroid function test is always good, but I strive to make it OPTIMAL for you to feel as good as you can handle.

If this is a topic of interest to you, or you believe you can benefit from additional testing and treatment options, please do not hesitate to call our clinic and make an appointment with me!

Ashley Melchiorre, Family Nurse Practitioner