Supplements for Depression with MTHFR

MTHFR and depression are intimately linked. We’ve spoken about this before, and if you want to brush up, take a look at Season 1 Episode 8 where we explored the link between the MTHFR mutation and neurotransmitter formation via the BH4 pathway. The quick and dirty version is that when methylation isn’t working optimally, then the pathway that makes many of your major neurotransmitters, including serotonin, melatonin, dopamine, epinephrine, and norepinephrine gets stalled out too.

Season 1 Episode 33 was also all about MTHFR and depression, specifically the entirely fixable causes of depression that your doctor will typically overlook. This whole episode was about steps you can take at home to manage depression. Balancing your methylation is obviously a cornerstone, but there are so many other factors involved that are entirely in your hands.

Another great one to review is Season 1 Episode 34, where we talked about the component of depression that is quite simply a mental bad habit. The part that feels like falling into a rut mentally where your brain travels over the same tracks, the same complaints, the same problems without questioning them or without breaking those patterns. Also, Season 1 Episode 35 in which we talk about some great techniques for breaking those bad habits.

The part of depression we haven’t talked about yet is the supplement part and this is something that people ask me about all the time. At the end of the day, sometimes we really do need a pill to take the edge off while we’re making these other changes. Often, the supplement helps us to have the mental and emotional energy TO make other changes. So let’s talk about a few good options that are typically pretty safe for MTHFR folks and typically well-tolerated.

Some Amazing Depression Supplements We Won’t Be Talking About

There are some great supplements for depression that we won’t talk about today, mostly because we’ve talked about them before at great length. One of the best natural treatments for depression is, of course, balancing methylation using a good folate source or SAMe and a good B12 source. Since those are things we talk about pretty much every week, I’m going to assume you’ve got those covered. For most of my clients, balancing methylation – whether it’s through 5-LMTHF, folinic acid, food sources of natural folate, or SAM-e – is the cornerstone of their depression relief. That doesn’t mean it’s the only thing they need to do, but it’s certainly the foundation.

Another effective supplement for depression that we’ve talked about before is St. John’s Wort. We dove into that one at some length in Season 1 Episode 46 on the link between MTHFR and serotonin. Also, omega-3 fatty acids and fish oils are extremely well studied for depression and we’ve also talked about those at great length because they boost the effectiveness of B vitamins in MTHFR mutation (Season 1, Episode 42). Just remember that if you’re using fish oils for depression you may need a higher dose than the one listed on the bottle.

Saffron For Depression

Saffron is best known as a spice, adding brilliant yellow color and subtle flavor to Middle Eastern food and haute cuisine. Like most other highly-colored spices it’s absolutely packed with antioxidants, carotenoids, and biologically active compounds. In research and clinical practice, saffron shows major benefits for those with depression and it is thought that this could be through some serotonin-boosting mechanism, possibly similar to SSRI medications in which the saffron keeps serotonin in the synapse longer, basically making the same amount of serotonin do twice the work.

In fact, when compared to the actions of SSRI medications, saffron was found to be just as effective for major depressive disorder as these commonly prescribed pharmaceuticals.

Given that this is thought to directly affect serotonin levels, it is best to talk with your doctor before starting saffron if you are already taking an antidepressant medication because there may be an interaction between them.

Saffron is typically dosed around 30 mg per day in research studies.

NAC for Depression

NAC or N-acetyl cysteine is something that we have talked about before as a precursor to glutathione, which is one of your body’s key antioxidants. It is actually precisely because of this function that it is so useful for depression. People with depression are more likely to have higher levels of oxidative stress, inflammation, and inflammatory cytokines like C-reactive protein, tumor necrosis factor-alpha (TNF-a), and interleukin-6 (IL-6). By helping to moderate the inflammation, NAC actually eases symptoms of depression as well.

It is thought that NAC helps to regulate glutamine and dopamine levels in the brain and demonstrates a great ability to both cross the blood-brain barrier and also to increase levels of glutathione within the brain and central nervous system. NAC also shows promise for use with addiction and substance abuse issues.

NAC is actually an amino acid and so it is best taken on an empty stomach. If it is taken with food, then it competes with other amino acids for absorption. The doses typically used for depression are between 2 and 2.4 g/day. This can be divided into two or three doses depending on what is easiest for you to manage.

Rhodiola for Depression

Rhodiola is well known as a supplement for helping to get core energy back in situations of adrenal fatigue or exhaustion. This is because of its action as an adaptogen, and that adaptogenic ability is also thought to be the reason it helps with depression.

Studies have linked hypothalamic-pituitary-adrenal axis dysregulation (or HPA axis dysregulation for less of a mouth full), with depression. HPA axis dysregulation is exactly what is happening in clinical cases of adrenal fatigue or exhaustion. It describes a state of over-reactivity and subsequent burn-out of this vital neuro-endocrine system.

In a study that compared the effectiveness of Rhodiola to the common antidepressant Sertraline, the Rhodiola was shown to be effective, but not quite as effective as the antidepressant, but also far better tolerated with fewer side effects.

The typical dose of Rhodiola for depression is around 340 mg per day. There are other adaptogenic herbs as well, all of which may have similar benefits for depression. These include licorice root, ginseng, American ginseng, schizandra, and ashwagandha.

Thank you so much for listening, and if you’re interested in a 6-weeks to health with MTHFR course, make sure to sign up for the mailing list at tohealthwiththat.com and keep listening to the podcast for more info.

Share with friends:

S2E17: Happy Holidays and How To Make A New Years Resolution You Will Actually Keep.

First and foremost I want to say happy holidays this week. Spend time with loved ones if you can, and if you aren’t able to be with the people who matter to you, then make sure they know they matter in some way or another. This is the season when we all need to give and receive as much love and care as possible.

The holidays can be a hard time for a lot of people. If you’re struggling this season as so many people are, please reach out to someone. It could be a friend, a practitioner, family, a shelter, or hotline. Ask for help if you need it – you will be surprised at how much help is available.

This year is coming to a close and that brings with it a measure of self reflection and the almost inevitable decision to make some changes. For many of us those changes will come in the form of a New Years Resolution, and this year I’m proposing something a little bit different. Here’s why.

Saying “I love you” to yourself is surprisingly powerful. It only takes a second – try it right now.

2021 has been a tough year. Partly, because it followed 2020, which was also a tough year. Never-ending the global pandemic, many of us have faced some pretty extreme changes to the way we chose to live, the way we socialize, the way we work, the work we do, and our perceived level of freedom. I want to take a minute to acknowledge how much stress we as a collective are actually under and to honor that.

With MTHFR, it is wise to buffer ourselves from stressors like this one, and for many of us, this pandemic has worsened anxiety, increased depression, or deepened or reactivated addictions. Not only that, there is evidence that Covid affects people with MTHFR who have high levels of homocysteine more strongly than it does other folks. I want you to take just a second, take a deep breath, and say something profound. I want you to look in the mirror, right into your own eyes, and say three simple words. “I love you.”

For some of you, that will be kind of awkward or odd, for some it will trigger a smile and for some it will trigger tears. No matter what happens, this is a powerful thing you can do for yourself in only a second and it matters this year.

Now, back to the issue of New Years Resolutions.

I honestly feel that precisely zero people need more stress or striving right now. What we need is more joy, so I’m proposing a different kind of resolution this year – one you might actually keep beyond January 3rd. Here’s how to do it.

  1. Write a list of things that make you happy that you don’t take the time to do right now.  It could be big things (like travel or vacation or family camping trips) or little things (sketching, hiking, or having fresh flowers in the house). Think of at least 20 things.
  2. Take out the ones that are impossible  for some reason (costs too much, borders are closed, have to stay close to home to take care of elderly parents, etc..)  
  3. Make sure there are at least ten good things on your list and if there aren’t, repeat steps one and two until you’ve got ten or more
  4. Make your resolution, just like the big bold one below.

In 2022 I will do one wonderful thing from my happy list every week.

– Love, me.

How’s that for a resolution you can keep?!?

We all need a little more happy and a little more ease right now and putting pressure on yourself, guilting yourself, or being hard on yourself, or setting yourself up for failure isn’t going to help anybody – especially not you.

This year, make a resolution that will make your life better.

Happy New Year, Everybody! Love, Amy.

Share with friends:

S2E14: What To Do for MTHFR When You Don’t Tolerate 5-LMTHF

A couple of weeks ago we talked about two different dealbreaker scenarios where you did everything right with the methylfolate start, but you just couldn’t tolerate it. So let’s talk about what the next steps could be if you find yourself in this scenario.

5-LMTHF Nontolerator – Low Doses Feel Too High

If you were in this group, you started with a low dose of 5-LMTHF and immediately felt the symptoms of too high a dose. That usually feels like agitation, restlessness, wound-up energy, anxiety, intrusive thoughts, panic attacks, or something along those lines. Like way too much caffeine. There are a few things to do here.

Evaluate the dose you started with – Because methylfolate is available in so many giant dosage sizes, people tend to go bigger than they need to. I’ve had conversations with plenty of people who say “I started with 1000 mcg – that’s a low dose.” Actually, it’s a bit of a high dose. Even 400 mcg, which is the recommended daily allowance in most countries, is not a low dose. If the dose you started with was anything more than 200 mcg, reevaluate your definition of low and try again. The best thing to do is give your body a week away from any methylfolate and try again at a much lower dose.

My dose really was low! – This happens too. Plenty of people take a low dose – 200 or even 100 mcg – and it’s still too much. In this case, I want you to think about whether or not you tolerate food sources of natural folate.

I tolerate food sources fine. In this situation we can really work on boosting food sources of folate and maybe add a low dose folinic acid for a while. Food sources of natural folate and folinic acid both still need to go through the MTHFR enzyme, so it’s especially important in this scenario to be folic acid free. Because they still depend on the enzyme, your body makes 5-LMTHF slowly so you don’t get that big rush of methylfolate that feels like too much. This might also mean that you’re short on methyl groups. Take methylated B12 if you tolerate it, and also think about trying a methyl-donor like SAMe or TMG, which stands for trimethylglycine. Trimethylglycine, or betaine, can donate methyl groups just like SAMe can and help to move the pathway forward. With both SAMe and TMG, start the dose low and don’t change anything else for a week or two. Symptom track and let your body tell you how it’s doing. Also, don’t start those two things at the same time – try one or the other, you probably don’t need both. After a few months of this routine, it’s a good idea to try a low dose of 5-LMTHF again because chances are you’ll be able to tolerate it in the end.

I don’t do well with food sources of natural folate – This indicates that you likely won’t tolerate 5-LMTHF, maybe even ever. That’s ok – there are work-arounds in every scenario. These folks should try a low dose folinic acid, then wait a couple of weeks to make sure you tolerate that before moving on to a TMG (trimethylglycine). If you don’t tolerate folinic acid either, then we’ll keep doing the other B vitamins, try to get a methyl B12 if you can, and skip folate all together. Just go for TMG at a low dose and if you can later on, we’ll add in SAMe as well. If you don’t tolerate TMG, then choline can be a good substitute. It isn’t methylated, but it still helps. This scenario needs a lot of trial and error to find what works best for your body, but there is always a way forward. Just take it one day at a time.

If you don’t tolerate methylfolate your options are:

natural folate from foods

folinic acid

SAMe

TMG

choline

methionine

tohealthwiththat.com

The Second Scenario – 5-LMTHF Makes Me Depressed

This is a very particular scenario that happens only, as far as I know, to undermethylators with extremely low serotonin. It isn’t common, but when it does happen it’s extremely vivid. Folate normally has a beneficial effect on depression, and technically it also helps you make more serotonin, but in this scenario it has a net negative effect. The reason is that folate boosts something called SERT. SERT is a serotonin transporter and it carries serotonin back into the neuron, or brain cell, that released it. Serotonin can only produce signals when it’s between neurons in what is called the synaptic cleft, and SERT is busy cleaning it out of the synaptic cleft for recycling and reuse. For this tiny group of people who fall into a deep dark hole when they take folate, the boosted activity of SERT overwhelmed the benefits of taking folate.

For these folks, it doesn’t mean you will never be able to take methylfolate, but it does mean we have to get your serotonin out of the tanks before you do. In this situation serotonin is often so profoundly low that a prescription or two might need to be on board to bring it up. If you’re opposed to prescription antidepressants, then we can start with SAMe. SAMe is a methyl donor that can substitute for methylfolate to help your body recycle homocysteine, and it can keep the methyl groups circulating to get all of the downstream pathways moving too. It also helps to boost serotonin.

SAMe by itself is probably not going to be enough, so something like St John’s Wort, which has an incredibly body of research showing that in some cases it boosts serotonin as much as an SSRI medication, can be really helpful. For a person with higher serotonin I wouldn’t suggest trying these two supplements together without professional guidance because too many things that boost serotonin can boost it uncomfortably high, but for poeple whose serotonin is so low that they don’t tolerate any folate, that is far less likely to be a problem. Just be sure you’re working with a professional if you are taking medications and supplements together because it’s important to have someone looking at interactions for you.

The bottom line with this group is that we need to get serotonin levels up before any kind of folate is going to be possible and for some people, it never will be possible. That is ok too – there are work-arounds for our work-arounds.

Another work-around is the amino acid methionine, which is a good option if nothing else is tolerable. Choline bypasses the MTHFR gene as well, but it’s a short-term solution. There are always option because your body has so many redundancies for every system. You and I are made up of layers and layers of fail-safes so that anywhere there is a problem, there are ways to get around it. Your body is a miracle of design and it’s important to always remember how much it is doing for you at every given moment.

Share with friends:

MTHFR and JoyHacks – Boost Your Happy

Joyfulness is a beautiful and elusive thing. It’s easy and common to get bogged down with the everyday life stuff. The things that need doing, or cleaning, or getting, or disposing of. There are lots of repetitive activities, frustrating waits, stressful rushes. I get that. There is also, in all of these moments, an opportunity to be happier.

We’ve just finished talking about MTHFR and the different neurotransmitters – serotonin, dopamine, norepinephrine, and epinephrine as well as my somewhat offbeat neurotransmitter theory so it seems like a good time for some joyhacks. Small, everyday things you can do to boost your joyfulness long-term.

#Joyhack – a small everyday action, activity, or behavior that will actually boost your joy. Proven by science.

Amy Neuzil from tohealthwiththat.com

Simple Joyhacks with A Big Impact

I am 100% sure you’ve seen a list like this before, but the question is, have you acted on it? I talk to so many people about joyhacks who say they’ve heard of some of these actions but haven’t actually added any of them into their daily routine.

Almost all of these will take 5 minutes or less, with the exception of exercise (shoot for 7 – 10 minutes at least) and meditation (if you can get 10 minutes, you’re great!) These aren’t hard, you just have to remember to do them.

  • Set small goals, and meet them. The simple joy of crossing something off a list actually boosts your dopamine. It also boosts your self-confidence because every time you set goals you can meet you are showing yourself that you can finish things and you can meet your own expectations. It’s a joy double-whammy. 
  • Don’t set yourself up for failure. Be realistic about what you can achieve given your time, energy, and other demands (family, sleep, etc…) Failure has a negative impact on your joy.
  • Sleep. No matter what else you do, prioritize sleep. If you can, take a small dose of melatonin at bedtime. It helps boost serotonin, helps clear excess norepinephrine, and protects your brain from oxidative damage. Also, it improves your sleep
  • Sunlight early in the day. Getting 15 minutes of sun exposure in the morning as early as possible is a great boost to your vitamin D and all of your neurotransmitters. If sunlight isn’t possible, invest in a lightbox or a good full-spectrum bulb.
  • Exercise. Not only is exercise good for literally every health parameter we know about, but it’s also amazing for your neurotransmitters and helps your body to optimize literally every one
  • Balance your methylation. This is all about MTHFR after all…
  • Meditate. If you can meditate regularly, even if it’s just 10 to 15 minutes a day 4-5 days per week, your mental health will change rapidly. This is one of the simplest, quickest ways to hack your headspace. Meditation isn’t just sitting quietly for a few minutes, it’s an active process. There are a ton of great free or low-cost resources out there. When you first start meditating expect to notice your mind getting busier before you notice it getting calmer. That is totally normal.
  • Hold a pencil in your teeth every day for 2 minutes. This forces your body to make a smile, even when you don’t feel like it and smiling boosts your serotonin. Seriously.
  • Trade massages with someone close to you. Or, pay a professional. Human touch and massage are a big deal for neurotransmitter levels, plus it feels awesome. 
  • Listen to beautiful music, appreciate art, appreciate nature, sing, or play. You have so many great options here and each one of them will help to boost your dopamine. Whichever one makes you smile to think about. When you do this activity, do it with your whole attention. Don’t listen to music while you work on the computer – take 10 minutes and really listen.
  • Every time you notice a negative thought, come up with a positive one. Optimism and joyfulness are as much about habit as anything else. We did a whole post on breaking mental bad habits and also what to expect when you’re breaking mental bad habits, and this trick is a simple balancing act. Every time you notice yourself getting down on something, try to find three things you’re happy about or that you appreciate about that thing, person, or situation.
  • Minimize your hassles. A body of interesting research shows that the small things have a much greater impact on happiness than the big things do. That’s small hassles and also small rewards. If you can find ways to minimize your small hassles – like shifting your hours so you don’t drive in rush hour, or taking the extra junk out of your closet so the only clothes that are left are things you truly love, like a capsule wardrobe, it has a significant impact on joy.

These are all small things, and even small things can feel overwhelming when you’re overly anxious, stressed, or depressed. But go through the list and find the one that makes you smile. Maybe you’d like to play and blow bubbles in the park, or maybe the idea of holding a pencil in your teeth for two minutes a day is absurd enough to get a smile out of you. But whatever it is, pick one small thing and do it every day. Every day for at least a month – then let me know how you feel.

Share with friends:

MTHFR and Neurotransmitters – Amy’s Neurotransmitter Theory

These past few weeks we’ve been talking about the link between MTHFR and the production of different neurotransmitters via the BH4 pathway. This includes serotonin and melatonin, dopamine, and norepinephrine and epinephrine.

The research seems to mostly agree that people with mental health issues like depression or anxiety, often have imbalanced neurotransmitters. Somehow, however, that has translated into a locked-in, fixed idea pattern culturally in which depression and anxiety are always neurotransmitter issues and so supplementing or augmenting neurotransmitters is the best path forward medically.

Everyone Agrees Mental Health Is All About Neurotransmitters.

I do want to say that there are people who find a supplement or drug that works for them, stay on the same dose for 15 years, and feel great. There are those cases. These are the shining examples of neurotransmitter-based therapies working and I love seeing them because in the end, it’s a simple solution.

Unfortunately, there are also cases of people chasing down a feeling they had briefly. They get on a drug or supplement, go through the adjustment reactions, it works for six months or a year and then they’re back where they startedmentally, but taking a pill. They increase the dose, increase again, switch to a related drug or supplement and still aren’t where they want to be. They can’t match that time period when the pill was working. They switch to a different class or category of drugs or supplements, and give that a try. Each time with a six to eight-week adjustment window and a host of new or different side effects. I see this all too frequently.

There are several possible problems with the neurotransmitter-only model. We’ll start with the simplest and most obvious problem and work toward more controversial issues.

“Depression” Is a Big Word

And it seems to mean something a little bit different to everyone who says it. Likewise, with anxiety. Over the years I’ve had hundreds of clients tell me they’re depressed. They are always surprised when I ask what that means to them. Not surprisingly, the answer to that question varies greatly.

One man was highly offended at having to educate me about such a basic question. His answer was, “What do you mean what do I mean? I’m depressed! I get up in the morning, the toaster doesn’t work so I slam it on the counter four or five times, and then run out of the door without eating because it’s just too difficult. I’m depressed.” Another client told me she got up in the morning, cried in the shower, cried in the car, smiled all day through her work as a high-level executive, cried the whole way home, then smiled through dinner with her family.

You might notice that the pictures these two people have painted are very different. And these are just two examples out of a seemingly endless variety. The point is, “depression” isn’t something uniform. Sadly, when many people go to their doctor or practitioner and say “I’m depressed” there are only really a handful of standard neurotransmitter-based treatment options for such a myriad of different pictures.

Neurotransmitter Overlap

Another issue I see with the idea of working with mental health from a purely neurotransmitter direction is that the neurotransmitters have significant overlap.

Say you look at something like attention. Serotonin, dopamine, norepinephrine and epinephrine are all heavily involved in attention. Much the same with enjoyment and even alertness. In situations like this engaging in lifestyle changes to actually boost all of these neurotransmitters is a great idea and will help to cover all the bases, but taking a drug or supplement that boosts one pathway leaves plenty of gaps in the system.

It’s obvious, when you look at it this way, that boosting one pathway out of many might lead to imbalances elsewhere that show up as side effects.

It Is Not A Tug Of War

Medicine has become very mechanistic since the advent of penicillin because so many drugs, which do one precise thing in the body, have been lifesaving. I’m all for lifesaving drugs, but this model comes at a cost. We’ve backed ourselves into a corner in which we tend to oversimplify the body into being akin to a constant tug of war between opposing forces or directions of imbalance.

If we suspect serotonin is low – meaning the low side of the tug of war is winning – then we just boost up the other side so it gets higher. Easy. The problem is, neurotransmitters are less like a tug of war and more like a web, with forces pulling at twelve points instead of two. We can, of course, boost up one of those points but it becomes difficult to predict how the other twelve will react and where that will place new stressors on the body.

Your Body Is Smarter Than That

The last issue with boosting a particular neurotransmitter chemically is that for very many people this turns into chasing a dream. Think back to the scenario in the outline where someone started neurotransmitter therapy, had a golden year or nine months, then chased that for the next three years. What happened there?

Well, it is my belief, although this is not a well-researched area, that your body is pretty smart at adapting to the outside world. If your body has set your neurotransmitters at a certain level, and you do something to change that level, I have every faith that your body can reset so that they’re at that same level again, even with the new influence.

The point is, that we’re not getting to the WHY question. WHY did your body set the neurotransmitters at that level to begin with?

Maybe it really is a disfunction or pathology in which your body can’t keep up with production. That is a legitimate possibility (and MTHFR folks – if your methylation isn’t balanced then this is entirely possible because your BH4 pathway is impaired). But what if the problem isn’t production? What if there is a more complex reason for the neurotransmitters being set where they are? What if they are there to compensate for something else that is out of balance?

Your body is the most amazing thing you will ever see, touch, or possess. It is working constantly to return to health, to compensate for damage, to adapt to a dynamic world full of challenges and resources of which you aren’t consciously aware.

So If It Is Not All About Neurotransmitters, Then How Do We Fix It?

The wonderful thing is that working with neurotransmitters is still an option, but this opens up a lot of other options as well. Before you look to neurotransmitters it is important to look to other causes of mental health issues. We did a whole post previously on this topic but some of the more common ones are:

  • Low folate
  • High homocysteine
  • Low thyroid
  • Imbalanced hormones
  • Low testosterone
  • Estrogen dominance
  • Trauma or mental health history

Nobody likes that list because it’s just easier if there’s a pill for it. Sometimes the pills really are the best thing, but it’s a good idea to be open to other types of treatment as well. Be willing to let go of the idea of the magic pill if it just isn’t serving you.

Share with friends:

MTHFR and Norepinephrine

MTHFR can be with mental health issues including depression, anxiety, obsessive-compulsive traits, and global issues like bipolar disorder or schizophrenia.

Culturally, we tend to jump to the idea that all mental health issues are neurotransmitter problems and that the only way to solve them is by boosting your neurochemistry. We’ll explore this idea in a series of posts. You can find the a discussion of serotonin here and information about dopamine here. Today, we’ll discuss MTHFR and norepinephrine, which has the dubious distinction of being both a neurotransmitter, and a hormone.

With mental health issues in a person with MTHFR, it is most important to look first at your methylation because balancing your methylation can produce tremendous changes in your mental health. There are other areas to explore too, like estrogen dominance (this is an issue for us MTHFR folks), low testosterone, or thyroid dysfunction. Still, once you’ve looked at the rest of your health, you may still want to explore neurotransmitters because MTHFR ties directly into neurotransmitter formation via the BH4 pathway. Specifically, the formation of serotonin and melatonin, and the catecholamine neurotransmitters including dopamine, norepinephrine and epinephrine.

MTHFR and Norepinephrine

Norepinephrine and its metabolite, epinephrine, are unique in that although they are primarily neurotransmitters, they also function in the rest of the body as hormones. Neurotransmitters are the method your nerves use to communicate. One neuron sends a chemical signal, the neurotransmitter, across a synapse to another neuron. Hormones are released generally into your bloodstream to affect your tissues.

Norepinephrine and epinephrine are generally associated with the fight or flight response. Although these neurotransmitters do have separate functions, there is significant overlap and so in terms of mental health, it is helpful to think of them in tandem. Generally, more information is available about norepinephrine as a neurotransmitter than about epinephrine so we’ll talk primarily about it. Norepinephrine is also involved in alertness, arousal of interest, pain response, and skeletal muscle function.

Symptoms of Low Norepinephrine

  • Decreased alertness
  • Memory problems
  • Depression
  • Loss of interest
  • Brain fog
  • Fatigue
  • Lack of motivation

Conditions Associated with Low Norepinephrine

  • Fibromyalgia
  • Chronic fatigue
  • Major depressive disorder
  • ADD/ADHD
  • Hypotension, or severe low blood pressure

Boosting your Norepinephrine If You Need To

  • Exercise – as with every other neurotransmitter we’ve talked about, exercise boosts your catecholamines in a healthy way.
  • Meeting Goals – learning to set goals effectively (in a way that allows you to regularly meet them) can provide a huge boost to your norepinephrine.
  • Love – love boosts catecholamines and in a complex way is related to these neurochemicals.
  • Sleep – also as with the other neurotransmitters, sleep is integral in the healthy formation and function of norepinephrine and epinephrine.
  • Cold water plunge – this can double or even triple your norepinephrine levels in just a few minutes.
  • Sauna – if cold isn’t your thing, a sauna can accomplish the same goal, it just takes a bit more time.

Symptoms of High Norepinephrine

Norepinephrine, unlike the other neurotransmitters, is as commonly too high as it is too low.

Like dopamine, can be involved in drug-type “highs” and subsequently this list looks very much like someone who has taken too much cocaine.

  • Tense or spastic muscles.
  • Anxious, fearful, irritable, or racing thoughts.
  • Fear of crowds or small spaces.
  • Insomnia, increased wakefulness, poor sleep.
  • Difficulty concentrating.
  • Changes to blood sugar sensitivity and the way glucose and insulin are produced.
  • Headaches – people with chronic cluster headaches tend to have higher plasma levels of norepinephrine and dopamine, but high norepinephrine may lead to other types of headaches as well.
  • Pounding] heart and increased blood pressure – norepinephrine increases the contractile force of the heart and raises systolic blood pressure.
  • Sweating, generally freaking out.
  • PTSD – recent research has shown that people with PTSD may have an overactive norepinephrine system.

Decreasing High Norepinephrine

Decreasing high norepinephrine is something we all want to happen quickly, but it’s important to give your body time to adjust.

  • Lose weight – a study of obese older men showed that losing about 10 kilos (roughly 24 pounds) resulted in a 31% decrease in plasma norepinephrine levels. Bear in mind this is norepinephrine as a hormone and not as a neurotransmitter, but the levels seem to rise and fall at the same time.
  • Cognitive Behavioral Therapy – Cognitive behavioral therapy operates on the idea that people who have had long-term stress have developed ways to cope with that stress, and helping them to learn healthier ways, will have a positive impact on their levels of anxiety, perceived stress, and also their neurochemistry.
  • Melatonin + Lying down – Melatonin, mostly known as the sleep hormone, also helps to balance norepinephrine levels, but only if you take it and then lie down. Since it’s the sleep hormone, it’s probably best to do this at bedtime.
  • Meditate – Meditation packs a punch in terms of reducing stress and balancing neurochemistry.

Share with friends:

Dopamine and MTHFR

MTHFR can come with a whole host of mental health issues including depression, anxiety, obsessive-compulsive traits, and broader issues like bipolar disorder or schizophrenia.

Culturally, we tend to jump to the idea that all mental health issues are neurotransmitter problems and that the only way to solve them is by boosting your neurochemistry. We’ll explore this in a series of posts. You can find the first one, on serotonin, here. Today, we’ll discuss dopamine and MTHFR.

With MTHFR especially, it is most important to look first to your methylation and work on balancing that because balancing your methylation will produce tremendous changes in your mental health. There are other areas to explore too, like estrogen dominance (this is an issue for us MTHFR folks), low testosterone, or thyroid dysfunction. Still, once you’ve looked at the rest of your health, you may still want to explore neurotransmitters because MTHFR ties directly into neurotransmitter formation via the BH4 pathway.

Dopamine and MTHFR

Dopamine release is pleasurable and is associated with feelings of reward, so dopamine is tied into learning and motivation. The more dopamine a particular activity causes to be released, the more motivated we are to engage in that activity. Likewise, if only low levels of dopamine are released then we lack the happy reward feelings and are not very motivated to try that activity again. Dopamine is also involved in the regulation of body movements, and very low dopamine is linked to both Parkinson’s disease and schizophrenia.

Symptoms of Low Dopamine and MTHFR

While low dopamine can express as a mental health issue, the first signs might not actually be related to mental health. Also, symptoms of low dopamine can be an issue with the actual level of dopamine, but more commonly it is an issue with the levels of dopamine receptors, which are also susceptible to fluctuation.

  • Persistent constipation – Dopamine in the spinal nerves may be linked to the healthy movement of the GI tract.
  • Low enjoyment – Because dopamine produces feelings of reward, low dopamine can make you stop enjoying the things that used to make you happy.
  • Tremors, shaking hands, restless legs, or muscle twitches – Dopamine’s involvement in regulating muscle function means that low dopamine can affect these systems first.
  • Difficulty swallowing or aspiration of food – The muscles that control swallowing are also regulated by dopamine and are very small muscles with major functions. Decreasing dopamine levels can make it more challenging for this system to function the way it should.
  • Decreased sex drive – Just like dopamine is involved in reward with other activities, it’s involved with the feelings of reward that we get from sex as well.
  • Addictions – For some people, a low sense of reward can lead to addictive tendencies. Especially with drugs powerful enough to trigger that sensation.
  • Fatigue and lack of wakefulness – Dopamine is one of the reasons you feel refreshed and alert most mornings. Low dopamine or low dopamine receptors leaves you feeling groggy, fuzzy, or sleepy.
  • Weight gain – especially after periods of high dopamine stimulation, like the weight gain that follows smoking cessation. Essentially, chasing the same dopamine levels leads to overeating.
  • ADHD – research is beginning to show a link between low dopamine states, genetic polymorphisms relating to dopamine receptors, and ADHD.
  • Major depressive disorder
  • Schizophrenia
  • Parkinson’s disease

Obviously, dopamine is vital to health and wellbeing.. The biggest and most important step for MTHFR folks is going to be balancing your methylation. That means following the To Health WIth That Plan – eliminating folic acid, getting a background of good B vitamins without any folate or B12, then slowly adding in methyl folate and a good form of B12 one at a time. All of this while using your symptom tracker. If the plan is new to you, we’ve got a great “Start Here” resource for you.

Once you’ve got your methylation levels where you want them with methyl folate or folate alternatives, it’s time to address dopamine specifically. Here are some things you can try.

  • Exercise – running, dancing, or otherwise working up a sweat can push dopamine levels in certain parts of the brain, leading to the characteristic “runner’s high.”
  • Sleep sleep deprivation has been shown to reduce the number of dopamine D2 receptors in the brain, and restoring healthy sleep can replenish those numbers.
  • Losing weight – Research has shown that obesity also reduces the number of D2 receptors relative to normal. Losing weight could help to boost those receptors again.
  • Listening to music, seeing beautiful art, singing, or playing – while the survival benefit to feelings of reward from food or sex is pretty clear, this is a bit more mysterious. Uplifting or beautiful music, enjoyment of art, singing, or engaging in play stimulate the same feelings of reward via dopamine and can be used to bolster flagging levels.
  • Eat your dopamine – bananas, avocados, and plantains are good dietary sources of dopamine, and banana peel is almost 100 times richer a source than banana pulp, so maybe it’s time to make some organic whole banana smoothies. Also, eating good food sources of tyrosine, which is the precursor to dopamine, can be very helpful. These include chicken, almonds, peanuts, soy, and dairy products.
  • Reduce your stress levels – chronic exposure to stressors lowers neurotransmitters globally, including dopamine. Learning how to reduce or manage your stressors can change those levels for the better.
  • Eat less saturated fat – saturated fats like those in butter, animal fat, coconut oil, and palm oil can disrupt dopamine levels when eaten at high levels. Research shows that the changes in dopamine levels happen even without changes to weight, hormones, blood sugars, or body fat.
  • Meditate – One study showed a 64% increase in dopamine response after an hour of meditating vs an hour of sitting quietly. 64% is a whopping increase, and although an hour of meditation might not fit into everyone’s daily routine, I’m guessing you could find 15 minutes.
  • Sunlight or a light therapy box – Dopamine D2 and D3 receptor levels are much higher in people with higher sunlight exposure than they are in people with low sunlight exposure. Getting more light can boost your receptor profile.
  • Mucuna pruriens – Mucuna pruriens, otherwise known as velvet beans have a high level of L-dopa, the direct precursor to dopamine. Studies on Mucuna for Parkinson’s disease show that the benefits of Mucuna might be both stronger and longer lasting than those of traditional medications for Parkinson’s disease. Velvet beans are toxic in high amounts so always work with a practitioner to find a good dose for you.
  • Tyrosine supplements – Tyrosine, taken away from food can give your body a good supply of precursors to feed your dopamine pathway.

Neurotransmitter balance, including dopamine levels, depends strongly on your methylation, and balancing methylation is your foundational step. Once you’ve laid the foundation, addressing receptor function should be your next priority. Lifestyle changes that boost your receptors like getting good sunlight exposure, meditating, and making dietary changes, will be far better in the long run than taking supplements unless you’re in an extremely low dopamine situation like Parkinson’s or schizophrenia.

Share with friends:

Serotonin and MTHFR

MTHFR can come with a whole host of mental health issues including depression, anxiety, obsessive-compulsive traits, and more major states like bipolar disorder or schizophrenia.

Culturally, we tend to jump to the idea that all mental health issues are neurotransmitter problems and that the only way to solve them is by boosting your neurochemistry. We’ll explore this in a series of posts.

That idea, however neat and tidy, is just not true. With MTHFR especially, it is most important to look first to your methylation and work on balancing that because balancing your methylation will produce tremendous changes in your mental health state. There are other areas to explore too, like estrogen dominance (this is an issue for us MTHFR folks), low testosterone, or thyroid dysfunction. Still, once you’ve looked at the rest of your health, you may still want to examine those neurotransmitters. So let’s dive in and learn what we can about the highs and lows of particular neurotransmitter states. Especially since MTHFR ties directly into neurotransmitter formation via the BH4 pathway.

Serotonin

Serotonin helps to stabilize and modulate your mood, gives you feelings of well-being, and boosts joyfulness. It’s also involved in processes such as memory, feeling of reward, learning, and cognition. Interestingly, serotonin also has a heavy impact on digestion, with 80 – 90% found in the gut helping to regulate intestinal motility. Serotonin is also involved in such diverse processes as vasoconstriction and clotting. Given that it has so many functions, it is easy to see why problems show up vividly.

Symptoms of Low Serotonin and MTHFR

  • Depression – Although people think of this as an obvious statement, the research on serotonin and depression is actually quite mixed. Also, life events that typically cause depression, like chronic stress and trauma, have been shown to deplete serotonin levels. So while low serotonin might be a causative factor in depression, it might also be a consequence of difficult life events that cause depression.
  • Chronic Pain – Low serotonin is highly correlated with chronic pain states like fibromyalgia and many people with fibromyalgia report benefits from serotonin-boosting supplements or drugs. This could be because serotonin has the ability to strengthen the brain’s signals to the muscles. Also, conversely, if it’s in too large amounts it can make muscles like the muscles in your legs feel heavy.
  • Memory or Learning Issues – Sudden issues with memory or learning could signal a drop in serotonin.
  • Anxiety – Anxiety that appears without an obvious trauma or stressor, or anxiety that includes an obsessive-compulsive component, could well be a serotonin issue.
  • Internal Clock Problems – Serotonin along with its metabolite melatonin help to regulate your circadian rhythm. Not sleeping according to a regular schedule, having difficulty keeping a regular schedule of hunger and eating, or feeling chronically tired or constantly hyper might indicate a serotonin deficiency.
  • Sleep Trouble – Because of its relationship with your internal clock and your sleep hormone melatonin, serotonin is all tied up with your sleep. Serotonin deficiency may show up as chronic insomnia, unusual sleep patterns, chronic fatigue, or consistently vivid dreams might have low serotonin.
  • Appetite Irregularity including Eating Disorders – Low serotonin symptoms may include overeating, not eating enough, or alternating between those two states.
  • Dementia – Because of its link with memory and cognition, serotonin may play a role in dementia as well. Studies certainly show a link with early dementia but it is unclear whether low serotonin is a cause or a symptom.
  • Hyperactivity – A link exists between serotonin and ADD or ADHD People with low serotonin might fidget constantly, feel restless or agitated, or be chronically bored.

Obviously, serotonin is a big deal for your body and certainly something that you want to have enough of. In good news, working with serotonin and MTHFR gives you some really direct routes to addressing issues. The biggest and most important step for MTHFR folks is going to be balancing your methylation. That means following the To Health WIth That Plan – eliminating folic acid, getting a background of good B vitamins without any folate or B12, then slowly adding in methyl folate and a good form of B12 one at a time. All of this while using your symptom tracker. If the plan is new to you, we’ve got a great “Start Here” resource for you.

Once you’ve got your methylation levels where you want them with methyl folate or folate alternatives if you don’t tolerate folate, it’s time to address serotonin specifically. Here are some things you can try.

  • Melatonin at bedtime – Melatonin is made from serotonin, so if you’re supplementing at bedtime, it can leave you with more serotonin left over. Plus, it helps to improve sleep quality and makes falling asleep easier. It’s also a great antioxidant that crosses the blood-brain barrier, which is a total bonus.
  • SAMe – If you’re already working on methylation, SAMe might already be something you’re familiar with. If it isn’t, it can be a good boost to the BH4 pathway that helps your body to crank out the neurotransmitters. Just be careful and raise your dosage slowly because, just like methylated B vitamins, SAMe can cause reactions for MTHFR folks if we take too much, too quickly.
  • St John’s Wort – This potent herb has been incredibly well documented as an aid in depression, and it is documented to raise serotonin. In fact, research shows that when you compare St. John’s Wort to conventional SSRI medications, which are the most frequently prescribed medications for depression in North America, the results are very similar.
  • Aerobic exercise – Serotonin is made from an amino acid called tryptophan, and doing light cardio that you enjoy triggers the release of tryptophan into your blood and decreases the levels of other amino acids, hence getting more tryptophan to your brain. For an added boost, do something that makes you happy.
  • Sunshine or a light therapy box – Bright light boosts serotonin, and research has been suggesting that some might be made in our skin in response to light. If you combine your exercise with sunshine it could give you a double whammy, but if that isn’t possible, there are also light therapy boxes that can help if you have a hard time getting into the sun.
  • Massage – This doesn’t have to be anything fancy. A study of depressed pregnant women showed that 20 minutes of massage from a partner twice a week boosted their serotonin and dopamine levels and decreased the stress hormone, cortisol (along with back and leg pain).

All of this boosting is great, but I do want to give you a quick warning about serotonin syndrome, which can happen if you take serotonin-boosting supplements on top of some antidepressants, or even too many supplements. Serotonin syndrome is serious and can be life-threatening if untreated. If you’re already taking an antidepressant, or if you wish to swap out your current medication for natural methods, please talk with your doctor to develop a safe plan to do so.

Share with friends:

What To Expect When You’re Breaking A Mental Bad Habit

Last week we started our conversation about the “bad habit” component, called neuroplasticity, of depression, anxiety, intrusive thoughts, and obsessive or compulsive thoughts. This is, of course, only part of the picture. Neurotransmitter balance is a factor along with the often overlooked physical contributors to depression and other states.


We discussed three main methods for breaking mental bad habits. Those are:

  1. The Fantasy
  2. The Stop and Drop
  3. The Distraction

When you’re first trying this, it can be really helpful to try all three strategies at different times to see what works the best for you. You’ll know it works when you are able to pop yourself out of your mental bad habit – to feel different in your body and to let go of whatever thought pattern it is that you’re working on.

Stages of Resolution With Mental Bad Habits

  1. Learning. In this phase, you’re actually learning to pay attention to your thoughts and that takes more time than you would think. You may find a particular “warning” signal for you – it could be a behavior (like when I’m starting to feel this way I always log on to Facebook and click links that make me angry or I start craving XYZ food. It could also be a physical feeling – a headache in a particular place, a clenching in your belly, pain in your neck or shoulders. It could also be something more subtle like tuning into your mood more frequently.
  2. Out of Control. This phase feels like you’re moving backward. You’ve started tuning in and now you’re actually noticing how much your brain does this thing and it’s a ton! It will seem like your brain is a wild horse racing ahead of you, and it feels like the bad habit is happening more, not less.  That is a GREAT sign because the reality is that you aren’t doing the bad thing more, you’re just noticing more and that is the first step to actually changing it. This can take a few months of diligent attention, but don’t get discouraged – you’re doing it and you’re making progress.
  3. Quietening. In this phase, you start to make tangible progress and you’ll notice that the mental bad habit becomes softer somehow. Quieter.  The thoughts/feelings are still there and they still affect you, but you’re learning to let them go more quickly and it’s easier not to get pulled in by them. 
  4. Maintenance. This phase is amazing.  One day you’ll notice your mental bad habit pop up and the first thought you’ll have is “Oh! I haven’t seen that for a while.” and you’ll dismiss it and move on. This is the phase where you have the freedom to move on to something else because that bad habit is mostly gone.  It’s a good idea to still take proactive action when it pops up, but it is popping up so much less frequently that it becomes almost a curiosity when it’s there.

Great! So I’ll be mentally healthy by next week, right?

Absolutely not. I would love to say it was easy and took no time or effort, but that would be a bald-faced lie. It’s a challenge and it takes time. You’ve probably had this mental bad habit for years if not for your entire adult life, so it will take some time to break it too. And some time doesn’t mean a couple of weeks, it means months and maybe even a year. This isn’t quick, but it is SO. WORTH. IT.

Does This Work Every Time?

This works every time if you stick with it, and when there isn’t some other major imbalance. If your serotonin is actually so low it’s living in the sub basement, then this will still help fix the habit part of it, but it won’t completely normalize the serotonin (but it will bring it up – research shows these techniques are associated with higher levels of both serotonin and melatonin). Although, every day we’re learning more about what this can actually accomplish.

What IS This Witchcraft? It’s Mindfulness.

Yup. That thing that hippies and new-agey types do. Also, everybody who studies neurology and neuroscience of any sort, because as it turns out the effects are so powerful as to be almost unbelievable.

Among the many documented effects of any form of mindfulness are:

  • Increased wellbeing
  • Reduced cognitive reactivity (so external things don’t affect you so much)
  • Reduced inflammation
  • Reduced reactivity of the autonomic nervous system (you don’t get an adrenaline spike every time something bad happens)
  • Higher serotonin
  • Higher melatonin
  • increased telomerase activity (anti-aging)
Share with friends:

MTHFR and Depression

Depression is a common thread among all humans – this isn’t limited to MTHFR folks in any way, but as folks with an MTHFR variant, balancing methylation can be an effective way of tackling depression that is often overlooked by doctors and practitioners.

We always hear about neurotransmitters and depression, so much so, that I feel we overlook the fact that there are any other possible contributors. The assumption becomes that if you’re depressed, your neurotransmitters must be off somehow and if we can fix those neurotransmitters, we can fix the depression.

The problem is, this theory doesn’t actually pan out for a lot of people – especially MTHFR people. A drug that boosts the activity of serotonin in the brain should work, but often doesn’t. It has a lot of merit to explore other cuases of depression as well – especially when so many of them are fixable.

MTHFR does, of course, affect neurotransmitters via the BH4 pathway, but my experience clinically has been that balancing all of the other things goes farther than pills for neurotransmitters in most people (there are some highly notable exceptions, of course.)

Many factors play into depression and some of these are related to MTHFR, and some aren’t.

  • Low Folate and Vitamin B12 Status – This link holds true whether the person in question has an MTHFR issue or not. Lower nutritional status regarding folate and B12 means a higher risk of depression. Also, higher serum B12 and folate are shown to predict better treatment outcomes.
  • MTHFR? – It is clear that lower folate levels can increase the risk of depression, and that MTHFR can increase the risk of lower folate levels, but it isn’t absolutely clear if MTHFR increases the risk of depression independently from folate status.  There are several ways that it could – MTHFR polymorphisms have an impact on neurotransmitter formation, and also on DNA methylation, which can boost depression by itself.
  • C677T Status? – Again, this is questionable. This meta-analysis shows a link between C677T status and depression, but the fascinating thing is that another study shows that the strength of the link changes in different geographical areas. This could be due to local changes in diet, but it could also represent a big wild-card factor that tells us we have a lot to learn in this area.
  • High homocysteine – Of course high homocysteine could be a result of low folate status, but there is a clear link between homocysteine and depression (and, don’t forget, a link between MTHFR and homocysteine.)
  • Inflammation – In a classic chicken-or-egg scenario, inflammation and depression are terminally linked. If inflammation rises, so too does depression and likewise, if depression worsens, so too does inflammation. With MTHFR we do have a greater tendency toward both, so it matters to keep your inflammatory processes in check.
  • Oxidative stress – Oxidative stress is your body’s total level of reactive oxygen species (free radicals). Studies show that people with higher levels of markers for oxidative stress also have higher levels of depression and poorer responses to treatment. With MTHFR, we have the potential to have lower glutathione, which is the master antioxidant, meaning we may have higher levels of oxidative stress.
  • Insulin Resistance and Blood Sugar Issues – Research is mixed in this area. There is a clear link between depression and diabetes, but insulin resistance, which is one of the stepping stones on the path to type 2 diabetes, is less clear. The immediate and obvious link between blood sugar fluctuations and mood, is much less difficult. As anyone with a hungry toddler can tell you, the jump between hungry and “hangry” is a short one. Again, with MTHFR we do have a slightly increased tendency towards blood sugar issues, insulin resistance, and ultimately diabetes.
  • Hormones – Again, the links here aren’t clear. Low estrogen in women is linked to perimenopausal depression. Low Testosterone in men is likewise linked to depression. High estrogen presents mood and behavior shifts, and high progesterone brings on the waterworks (between naps). What is clear is that balanced hormones certainly lead to better and steadier moods, where fluctuations or abnormalities might put us into the roughs. MTHFR is, of course, involved in hormone regulation and processing, so righting the balance can be a highly productive step.
  • Sleep – A giant link exists between sleep quality and depression, and most of us have firsthand experience of that (is anybody else’s household entirely grumpy if their sleep is interrupted?)
  • Sedentary Lifestyle – There isn’t particularly a link between MTHFR and sedentary lifestyles, which is great news. There is, however, a big link between sedentary behavior and depression and also between exercise and improved quality of life mentally, emotionally, and physically. This isn’t an MTHFR issue in any way, but I would feel remiss if I left it out of the causes of depression list.

Each of the factors above is measurable and trackable and highly treatable, with or without an MTHFR mutation. Each of those factors can be worked on independently, but also any step toward a healthier lifestyle is going to help in many of those areas.

For example, balancing your methylation (which for us MTHFR folks usually means either taking a good form of folate or if we don’t tolerate folate, then finding a good work-around) will help to raise folate levels, lower homocysteine, and reduce both inflammation and oxidative stress. So one change is influencing four big contributing factors to depression. Does that mean balancing your methylation is going to fix your depression completely? Not necessarily, but it does get us closer to the goal and also improve your chances of responding better to other therapeutic interventions as well.

So from this list, we have a number of natural treatments for depression:

  • Folate, high folate diet, and anything that will help you to balance your methylation
  • B12
  • Exercise
  • Any kind of sleep therapy
  • Lower glycemic index diet for blood sugars
  • Reducing inflammatory foods
  • Antioxidants – especially the ones that cross the blood-brain barrier
  • Anything that will help you balance your hormones
  • Any anti-inflammatory

Every one of those is a book in and of itself, but seriously that is a lot of options to try, and all of them will lead to greater health regardless.

There are also two special factors that we haven’t talked about yet. One pertains more strongly to MTHFR folks, and the other is just a human-nature problem.

  • Childhood Trauma – A significant portion of depression in adults stems from childhood trauma, and unfortunately, people with the MTHFR mutations may be more susceptible to life-long depressive tendencies from childhood traumas than average. This is fixable, but it will take some work. This could be self-guided help through spiritual seeking, prayer, meditation, and self-healing techniques. It could also be professional help in the form of therapy, hypnosis, EMDR, or a myriad of other options.
  • Habit – This conversation is really neglected and so next week’s topic is going to be about expanding the habit idea and giving you some life hacks that you can start to practice at home, but any mental state, no matter what else contributes to it, has the potential for a habit component. This could be depression, anxiety, obsessive thoughts, intrusive thoughts, whatever. And sometimes you have to train yourself to break the habit in the same way that you would with any other bad habit.

I feel like all of this could appear daunting, but if you look at it another way, it also opens up so many opportunities for healing that are often overlooked. It can be incredibly discouraging when your doctor runs out of options for depression, but chances are they haven’t even scratched the surface of this list. Typically doctors look at sleep, blood sugar, and neurotransmitters in terms of depression. You now have the opportunity to dive deeper.

Share with friends: