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:

Supplements For Anxiety With MTHFR

We’ve talked about how MTHFR and Anxiety are linked a couple of times and had an interview with anxiety expert Jennifer Bronsnick, but all of that still doesn’t answer one of the biggest questions about anxiety that I get, which is, “What can I take to help me fix it?”

Good question. Obviously, everyone responds differently to different supplements, just like they do with medications, but here are a few of my favorites with some perspective about how they interact with MTHFR. I’m hoping it goes without saying, but balancing your methylation should always be the first step to dealing with anxiety. The rest of these are to clean up anything that is left.

GABA

GABA is, in my opinion, a highly underrated supplement. It is an inhibitory neurotransmitter, meaning it decreases the likelihood that the neuron will fire or send a signal. In the overactive brain of someone with anxiety, this is precisely what we want. It is also crucial to healthy brain functioning, with an estimated 60 – 75% of all neurons being GABAergic (or responsive to GABA.)

There has been a long-standing debate in the research world whether or not GABA that you take by mouth can possibly cross the blood-brain barrier. It is certainly well absorbed and blood levels rise sharply within thirty minutes of taking it, but it is much harder to demonstrate brain levels in a study. Research evidence and theorizing exist on both sides of the fence, but due to its potent clinical effects, I tend to think it either does cross the BBB or it takes action on something else which has a calming effect on the central nervous system and that is just as good.

GABA is probably most known as a sleep aid, helping to calm restless minds into healthy sleep. For anxiety, however, it reduces your feeling of actual anxiety and tension, but also helps to reduce cortisol levels, increase parasympathetic nervous system activity as measured through the vagus nerve (which means your nervous system is trending more toward relaxation than stimulation). The doses used in research tend to be between 30 – 100 mg. There is a great systematic review article about GABA and its effects on anxiety from Frontiers in Neuroscience here.

GABA is the type of supplement that I feel sneaks up on anxiety. What I mean by that is taking a dose regularly that is just below the dose that would make you sleepy (this might take some trial and error) isn’t necessarily going to change your life in that first week, but it does help to get your body into a rhythm of functioning without as much hypervigilance. I love this because it takes the edge off so that you can actually work on mindfulness or breaking mental bad habits in a more protected mental space – like the GABA makes it easier to see the things your mind is doing that it doesn’t need to be doing.

As an aside, GABA also shows remarkable clinical promise for Type I Diabetes, which is insulin-dependent. In much larger doses than those taken for anxiety, GABA helps to boost insulin response in fasting and non-fasting conditions and may help to both protect and restore pancreatic beta cells. While this has very little to do with anxiety in the way we tend to think of it, there is a link between anxiety and blood sugar.

MTHFR and GABA

There is only one relevant study pertaining to MTHFR and GABA levels. This study shows mice with MTHFR polymorphisms to have altered levels of many neurotransmitters, including GABA, in different brain segments relative to wild-type mice. This study showed that mice who were heterozygous for an MTHFR SNP showed altered levels of both GABA, which is inhibitory, and glutamate, which is excitatory, in the amygdala, cerebellum, hypocampus, and thalamus.

Passionflower (Passiflora Incarnata)

Outside of having one of my favorite names in all of herbal medicine, passionflower is remarkable as a calming and soothing agent for anxiety. It can be used for short-term anxiety, such as to help patients remain calm before dental or surgical procedures or long-term for such neuropsychiatric conditions as generalized anxiety disorder and post-traumatic stress disorder. In both cases, passionflower shows remarkable benefits.

A comparison study between liquid passionflower extract and the pharmaceutical drug oxazepam, which is a benzodiazepine, showed equivalent clinical effectiveness over a period of 28 days.

Passionflower has also been used to help people who are addicted to opiates to successfully withdraw. Studies showing passionflower as an addition to clonidine, which is the standard of care, demonstrate better handling of mental symptoms in the clonidine plus passionflower group than the clonidine alone.

Passionflower can be taken as a tea, a liquid extract, or as a capsule or tablet. As with all herbal medicines, quality matters and it’s important to find products that follow the highest standards of manufacture and testing.

While passionflower hasn’t been specifically studied for use in folks with MTHFR mutations, it works well clinically in a wide range of people, and I’ve seen great results in my own clients, the majority of whom have MTHFR polymorphisms. Also, it’s pretty easy to tolerate and side effects are not common.

Adaptogenic Herbs For Anxiety

Adaptogens are herbs that help the human body resist stressors of all kinds. They quite literally help us adapt to all manner of situations with grace and strength, both literal and metaphorical. The most well-known adaptogens are herbs like ginseng, ashwagandha, and licorice which might just as well come with a sub-heading that says “Strong Like Bull.”

While there is, sadly, no research specific to MTHFR and adaptogens, there is a literal boatload of research on adaptogens and anxiety. Ashwagandha, for instance, has been shown to reduce both the feeling of anxiety and also cortisol levels after 60 days in adults with a history of chronic stress.

In general, the effects of adaptogens on cortisol levels and conditions associated with excessive cortisol, including anxiety, fatigue, abdominal obesity, and metabolic syndrome, are extremely well known. These are wonderful therapies for the management of long-term stress and anxiety disorders, although they should be used with practitioner supervision and guidance.

Licorice, for instance, is one of my favorite herbs of all time, but it is known to elevate blood pressures and so is perfect for skinny, high-strung, anxious women like myself, but not a good option for someone who struggles with blood pressure or cardiac issues.

There are, of course, hundreds of other supplements for anxiety but these are three of my go-to staples. Don’t forget to sign up for the mailing list, or join our MTHFR community here.

Share with friends:

S2E20: MTHFR and Anxiety – An Interview with Jennifer Bronsnick

This week on the podcast we’re trying something new. An interview with an anxiety expert who has also gone through her own recovery process with anxiety. The interview was clipped for the podcast episode but you can watch the full thing, on zoom, here.

MTHFR and Anxiety – an Interview with Jennifer Bronsnick.

Jennifer Bronsnick’s suggestions for Anxiety

Jennifer mentions a few tools that have been helpful for her. Here they are!

  • Eliminating alcohol
  • Cutting down or eliminating refined carbs like white flour and sugar
  • HeartMath – for more info about this, click here.
  • Existential Kink – the book by Carolyn Elliott.
  • Getting quiet to actually hear what your body might be trying to say.

Let me know what you think of the interview format – I can do more of this, or not. Just depending on you.

Share with friends:

S2E19: MTHFR and Anxiety

MTHFR and anxiety are intimately linked, mostly, we presume, because your body needs folate to make serotonin, dopamine, epinephrine, and norepinephrine. Those are most of the major neurotransmitters that affect mood and mood disorders including anxiety and depression.

More specifically, a folate molecule is needed to convert BH2 to BH4, and BH4 is needed to convert the amino acid precursor tryptophan into serotonin and tyrosine into dopamine, norepinephrine, or epinephrine. We did a post about it here.

Because of this link, working on optimizing your methylation can have a huge impact on anxiety and depression, but it isn’t the only thing you can do. Of course there are pharmaceuticals for anxiety and I’m not really going to cover those because those will probably be your doctor’s first go-to solution. And that’s fine, but there are other things as well. We’ve already talked about anxiety as a mental bad habit, and also about breaking mental bad habits. So today, let’s talk about steps you can take in your own real life to reduce anxiety.

Eat Regular Meals

This kind of sounds like a soft-ball. Like it couldn’t possibly make a difference to anybody’s anxiety level because it’s just too simple. In reality, keeping your blood sugars balanced and stable can cause a huge drop in anxiety levels, and here is why.

When your blood sugars drop, either from a skipped meal or after a sugar rush and the inevitable sugar crash that follows, your body has a low-sugar stress reaction. Sugar is absolutely vital to the functioning of your brain and so your blood has a tightly regulated amount. If that amount drops, your body literally goes into panic mode, activates your HPA, which is your hypothalamic-pituitary-adrenal axis, and pumps out stress hormones to bring your sugar levels back up.

Skipping meals is incredibly stressful for your body – and that translates to actual stress hormones that affect your level of anxiety. Keeping your blood sugars balanced through the day is far more important than you realize, and if anxiety is an issue for you, then it’s important to back some of the sugar out of your diet and make sure you eat regularly.

I know plenty of people who run on adrenalin and skip meals regularly because they’re too busy, there’s no time when the kids are running around, etc… but making time for this simple self-care can have a huge impact on how stressed you feel and also on the long-term effects of stress like sleep quality, weight gain, belly weight, and fatigue. Interestingly, blood sugar fluctuations and their corresponding changes in insulin levels are also highly linked to brain fog.

Clean Out Your Medicine Cabinet

Oddly a number of medications are known to increase anxiety. Some of those are because they have a negative effect on folate status, like birth control pills or methotrexate. Some are because they cause a caffeine-like reaction (or actually contain caffeine). These include cough and congestion formulas, many pain pills, and cold and flu medications. Also, medications for weight loss are well known for causing anxiety. Also if your dose of thyroid medication is either too low or too high it can lead to anxiety.

Decrease Your Caffeine

First, a disclaimer. I am a *huge* fan of coffee and will never, ever, ask you to stop drinking it. Having said that, different people have different levels of sensitivity to caffeine and also, women at different points in their cycle have different sensitivities to caffeine. It can help to experiment with your caffeine intake to see what works best for you, but keep a symptom tracker for a few months and try different caffeine levels – you might be surprised. In truth, any human with more caffeine than their body can easily process, is going to experience more anxiety, more edginess, and more irritability. That is just biology, so it can be a good idea to check in with your body every now and then and see if the amount you’re getting is ok for you.

Many medications contribute to anxiety, especially those like methotrexate or birth control pills that decrease folate levels.

Exercise, Yoga, and Meditation

These are all well-known moderators of anxiety, so I won’t belabor the point, but there are a few tips.

  • According to a study published in Psychiatry Research, higher intensity exercise like jogging or fast walking shows better results for reducing anxiety than gentle stretching.
  • Yoga shows better effects for anxiety than stretching or resistance training in Parkinson’s disease, but that effect may translate out to the general population as well.
  • Mindfulness meditation (as opposed to other forms) has been well documented to reduce anxiety symptoms.

There are, also, a number of supplements that are helpful for anxiety as well, but we’ll cover that in a separate post.

Thank you so much for listening today and please sign up for the mailing list at tohealthwiththat.com – we’ve got some great things coming this year and I want you to be the first to know.

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:

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:

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:

MTHFR and Decision Fatigue

We’ve had a number of heavy topics lately and I wanted to lighten it all up a bit this week by talking about something that is sorely needed for many MTHFR folks. That is ease. Ease, ironically, is something we don’t tend to do easily, especially when it comes to self-care.

The joy and devastation of the internet is that it offers every human looking around an infinite variety of opinions, an infinite number of ways to take care of themselves, and every conflicting idea in its full glory. This leaves us with an unmanageable amount of information to sift through and the burden of a ridiculous number of decisions about the best way to care for ourselves. In short, self-care requires not only the time and energy that is needed to actually exercise, eat good food and do your things, but also the mountain of time and energy needed to figure out what those things should be.

Unfortunately, “because your mother told you to” is not the rationale most people use in their decision tree on this topic unless their mother happens to be a brain surgeon, PhD, actor, or social influencer. Those are the voices we listen to these days and in some ways that is beneficial, but it becomes a clamor of 1000 voices rather than one.

Decision Fatigue

Decision fatigue is the mental and emotional strain resulting from the burden of choices. It often feels like a deep sense of weariness and can be a red flag that you’re headed for burnout. Burnout happens in self-care as easily as it happens at the office and it shows up in some potentially familiar ways.

  • Procrastination – “Nevermind, it isn’t due until Friday…”
  • Avoidance – “I just can’t deal with this today.”
  • Impulsivity – “Cooking is hard, but chips are easy.”
  • Indecision – “Oh, I don’t know. You choose.”

It’s not just the giant life-choice decisions that weigh heavily. It turns out the little ones do too. Are you wearing brown or red shoes? Will it be oatmeal, eggs, or cereal? Will you start the laundry or leave it? None of these decisions have any consequence at all, but all of them produce anxiety and require resources. The same resources have to be used for the big stuff like Should I have that procedure? Do I need to call a specialist? Or can I fit physiotherapy into my budget? Actually, just reading the list of questions is exhausting, let alone making the decisions.

In a situation like MTHFR, there isn’t truly a one-size-fits-all path forward. It’s a very individual journey and that can increase the likelihood of decision fatigue.

In good news, there are some things you can do to minimize the decision fatigue around MTHFR, make it all a little easier and free up some resources to use in other areas of your life.

Tips To Avoid the MTHFR and Decision Fatigue Problem

  1. Find your trusted source – the internet is awash with opinions, right ways forward, testimonials, and products that are miracle cures. Find one voice you trust and actually try their program, protocol or suggestions. Mixing and matching is a great idea in your wardrobe but doesn’t work so well with health management strategies. Also, this cuts down on the random “Dr. Google” ideas.
  2. Stop talking to “Dr. Google” – once you find the voice you trust, stop searching for more unless you decide to choose a different voice and follow a different path. Let one system be enough and don’t continue to search and search. Too often people don’t get the benefits of one plan because they are constantly adding in other things. It’s like mixing diets in the style of Bridget Jones.
  3. Change one thing at a time – with MTHFR, there is a tendency to have challenging or unexpected reactions to supplements or diet changes. By only changing one thing at a time and giving your body at least a week to two weeks between each change to your self-care routine, you can actually sort out which changes are useful and helpful and which ones aren’t.
  4. Streamline what you’re currently doing – this is a step that is so often overlooked and it really matters for everyone, not just for people with MTHFR issues. At least quarterly, sit down and take stock of your health habits. This includes prescriptions and supplements that you are taking, exercise, diet strategies, self-care, and practitioners. Do this on a day when you have some time and energy to spare. Be willing to let go of things that aren’t working so that you aren’t just adding more ineffective strategies to a heap of ineffective strategies you already have. Make the things you do for your health, count because they all take time, energy, and money. Talk with your doctor if there are prescriptions that might no longer be needed or that aren’t actually solving the problem they were intended to solve.
  5. Use the 80-20 rule – this aphorism tells us that 80% of your results come from 20% of your actions. I believe this applies to your health as well. Can you find the few health actions you’ve taken that are giving you your 80% and double down on those? Even better, can you let go of some or even all of the rest? I can easily tell you my 20%:
    1. Eating wheat and folic acid-enriched product-free.
    2. Prioritizing sleep and sleep hygiene.
    3. Magnesium every night
  1. Do fewer things better – doing fewer things for your health but doing them really well is far better than doing more poorly. Sticking to a diet, prioritizing sleep, and taking a multivitamin is going to be far more effective than doing a diet, detox, new exercise program, mindfulness routine, and 18- pill per day supplement program that you get right one day out of five. Pick your battles.
  2. Focus on one problem – every little symptom probably doesn’t need its own plan. Focus on one big problem like energy or sleep and let smaller stuff go.

Not only will this make each day a little bit easier, but it will also add up to better results with your health. Never underestimate a clear path forward and the power of doing only a few things, well.

Share with friends: