Depression : Is it seratonin or SSRI deficiency? (Part 4)

As we have learned in previous post of how toxins and inflammation can derail the health of our brain and triggering depression, today will be something different. We will get to know how our master metabolic gland can cause depression and symptoms as such. And yes, I'm referring to thyroid gland. This very important gland is much more well known amongst women, especially the ones who are suffering from thyroid disorders or diseases. 

People of all sorts, from an obese individual who easily feel cold, to hair loss and dry skin classic group of females, and not to mention the ones who have hard time trying to lose weight and maintain it long term. All these common thyroid symptoms are becoming more prevalence amongst the population, especially the last decade or so. You would easily see a 40% bodyfat woman in your workplace or cinema wearing long sleeve sweater, or the same old faces of 'treadmill buddies' in the gym all year round unable to shed off those fats in the body. 

Some are 'officially' diagnosed with hypothyroidism, and for others, an autoimmunity condition called Hashimotos Thyroiditis or Graves. Either or, if you are one of these patients, you could say good bye to feeling great. Apart from that, the conventional diagnosis and treatment is way far off from effective or helping the thyroid related condition. For most cases, treatments using pharmaceutical drugs, it create more problems then fixing anything at all.

Today, we will discuss about thyroid, and how its' conditions can mimick the symptoms of depression. As most people know what thyroid gland is and it's functions, let's just call it the master metabolic controller. And yes, for whoever concern about losing bodyfat and looking good, this gland is your best friend. Once you finish reading today's post, you will learn to show care for it much more, then years of thrashing it with chronic stress levels, fluoridated and chlorinated water and substances, sugars, wheat (gluten) and other thyroid destroying compounds. 

The thyroid gland is kind of a master gland. It affects just about every single cell in the body. What I like to think about what the thyroid does, in very simple terms, it actually speeds us up or slows us down. If we have an overactive thyroid, our metabolism will be quicker. Our heart rate is going to be faster. We are going to feel a little bit irritable, a little bit edgy. On the other hand, if we have an under-active thyroid, that's going to slow us down. We are going to be digesting slower, our metabolism's going to be slower. We are going to be thinking slower too. We might not be as motivated, we might be more tired. We are not going to feel as excited about life as we normally would have.

The question is, can thyroid be one of the root cause of depression? Basically, an under-active thyroid is associated with symptoms of slowing down. You think about people who maybe have brain fog. People will have symptoms of depression. They will have symptoms of fatigue. Of course, that sounds a lot like depression. Other things that happen is they may not be as motivated as they normally were, so that's apathy. That is another symptom of depression. Often times, thyroid disorders can be misdiagnosed as depression.

Thyroid working too slow or too fast. Now, let's jump a little bit into autoimmune disease for this particular gland. There are two main things that can go wrong with the thyroid. You can either have hyperthyroidism. The most common cause of that is going to be Graves' disease. This is an autoimmune condition. The other spectrum is Hashimoto's, which is the primary reason for having an under-active thyroid. That’s also an autoimmune condition.

People who have Graves disease will be more likely to have anxiety and panic attacks. They might be very, very irritable. Some patients might be even hospitalized for psychotic disorders. With Hashimoto's, in the early stages of it, what's happening is as the immune system begins to attack the thyroid gland, we have an initial transient hyperthyroidism because a lot of the thyroid cells are being dropped into the blood stream. All of these thyroid hormones are going to be too high. Then, all those get cleared out, and then all of a sudden the thyroid is no longer producing enough hormone. Then, you will be hypothyroid or you will have an under-active thyroid. This can mimic the symptoms of bipolar disorder.

In the advanced stages of Hashimoto's, people are going to feel more depressed. But in the early stages they might feel the ups and downs. Some of these patients are on heavy-duty psychotropic medications. They were hospitalized. Where in fact it was their thyroid disorder that was causing this.

The other interesting thing about Hashimoto's is that it's not really necessary to have an impaired function of the thyroid gland. Just having the Hashimoto's antibodies can be associated with feeling unwell and feeling depressed and feeling anxious and schizophrenia and bipolar disorder, borderline personality disorder. People with mental health issues have been found to have greater rates of thyroid antibodies.

The immune system basically makes antibodies to recognize foreign invaders such as bacteria, viruses, different kinds of pathogens of that sort. In autoimmune disease what happens is the immune system mistakenly makes self-antibodies. In the case of thyroid disease, the immune system will start making antibodies to the thyroid gland. Thyroid peroxidase antibodies, thyroglobulin antibodies, are the two main antibodies in Hashimoto's.

What's causing the body to trigger the antibodies? Some of the causes are going to be, if I can put them in the main categories, are food sensitivities, nutrient deficiencies, impaired ability to handle stress, impaired ability to handle toxins, gut permeability or a leaky gut, as well as chronic infections. A very good example would be someone ingesting loads of gluten in almost every meal, causing severe immune reaction and release of antibodies. Cereals for breakfast, sandwich for lunch, pasta or pizza for dinner, that would sum it up for a chaotic immune reaction in terms of dietary factor. 

For certain groups of medical professionals, it is known as molecular mimicry. That's one of the leading autoimmune theories, where the immune system recognizes something, a foreign enemy in the body, and kind of takes a snapshot of what that protein structure looks like. Then, basically it will walk around with that little snapshot. It’ll look for cells that look similar. If there's a protein sequence that is found in gluten or on a pathogen, that is similar to that of the thyroid gland, then the immune system will be attacking both.

You must be asking, "Are the doctors just not being trained on this?". Well well, if you are consulting or getting help from conventional medical doctors, good luck to you. One of the things that doctors are trained to do is just do a screening test for thyroid disease, which is known as the TSH test, thyroid stimulating hormone. This is actually a pituitary test. It doesn't measure what's happening in the thyroid gland exactly. It just measures the communication pathway. If everything is normal with you, with your communication pathways, the TSH test, if you have an underactive thyroid, is going to be elevated. For many of the alternative or holistic/clinical practitioners, TSH test is regarded a very ineffective approach and waste of time. 

We want to look at thyroid antibodies, because these can be elevated for sometimes decades before you see a change in TSH. They can actually cause a lot of their own set of symptoms, even if you have normal thyroid function. Thyroid peroxidase antibodies, TPO antibodies, and thyroglobulin antibodies are two of the biggest ones that are going to be present in about eighty to ninety percent of people with Hashimoto's.

It would be wise to get levels of free T3 and free T4 checked, which are the thyroid hormones. Those should be somewhere in the upper half of the reference range. Those are going to have slightly different reference ranges depending on the lab that you go through. Sometimes, those numbers can uncover if you have a thyroid disorder before the other numbers can. Also, looking at reverse T3 is another test that sometimes may be implicated in an under-active thyroid where all of the other labs may be normal. 

In reality, thyroid disorders are one of the most misdiagnosed of all health conditions. Most patients are not aware that thyroid medications are fluoridated and some of them contain fillers coated with gluten. If you do your own research, you will find out some shocking truths about these drugs.

Depression : Is it seratonin or SSRI deficiency? (Part 3)

In 1955, there were 38,000 people in the United States that were diagnosed as depressed. In recent years, the latest statistics showed 9 million people suffered from depression. That's a huge rise from just decades, less then 60 years of gap. We're not talking about a little bit depressed. Depressed enough that they're disabled, unable to go to work. It's the number two leading cause of disability now in terms of people not being able to show up for work anymore. It's clearly on the rise. This is happening all over the world, in many industrialized countries. 

When we talk about mood issues or depression, serotonin is the first word usually comes into mind. But how many people or even health or medical professionals know who the word serotonin means? Sero, serum, like blood, and tonin or tonifier. When they first discovered serotonin, one of its actions is that it constricts the blood vessels. Before they understood that it was a neurotransmitter, it was operating in your brain, they could see it outside the brain in the blood vessels causing things to constrict.

Serotonin is both inside your brain and outside your brain. Now we're talking about the serotonin outside the brain. It's mostly made in your gut in these enterochromaffin cells in the digestive tract. They produce 95-96% of all the serotonin in the body in the digestive tract. Your gut or also known as your second brain makes it. In the gut itself, it causes peristaltic action or contraction of the gut. That's its job there. You get tons of serotonin, you would get loose stools or diarrhea.You don't have enough serotonin you could get constipated. This again is just the serotonin in the gut.

In today's post. let's talk about toxins and free radicals affect on the brain and depression. First off, there is report from  American Academy of Pediatrics that 74 billion pounds of chemicals that are being imported or produced in the United States every single day! Is it possible then that the rise in chemicals could be associated with the rise in many of the chronic diseases we're seeing today? 

When you look at these chemicals and each and every one of them has some component of degrading mitochondrial function, whether it's in the electron transport chain, complex 1, complex 2, or whether it's in the Kreb's cycle or intermediates or co-factors. 

Let's go down to the basics. What is the mitochondria? It's the energy powerhouse of the cell. What it means is it's where you take in your outside sources of fuel. Your carbohydrates, your amino acids. your fatty acids, and you turn them into what would be considered cellular currency, something called adenosine triphosphate or ATP. It's the powerhouse. It takes in the nutrients and makes energy out of them. I'm not going to explain too much of details as you can do further research on mitochondria from the internet. 

Now, let's discuss about oxidative stress. Oxidative stress basically means destabilization, stealing of an electron from the outer orbital of a compound. Let's say you had alpha lipoic acid. Alpha lipoic acid normally has a very generous ability to give somebody an electron. When it gives somebody an electron, it's missing an electron. Alpha lipoic acid doesn't behave badly when it's missing an electron but if you have a toxin. Another example could be some benzene compound from cigarette smoke, and you're missing an electron, that substance will circulate around in the body. It will find a tissue and it will steal an electron from that substance. In doing so, it causes instability. Think of someone who always borrow money from you. Let's say your colleague or friend who always come to you and say " I need to borrow 30 bucks from you", and this loaning money activity keeps repeating again and again and causes instability. And of course, you know that something is really wrong here.

On the other hand, then there is the 'anti-oxidant' groups of people. These people often very generous and offer a helping hand. They are often giving and reduce the damage caused by the borrowers. Basically, oxidative stress means there are too many environmental people or constituents in your cell that are stealing all the time, these electrons.

The question is, what oxidative stress has to do with depression? What you can do is you can cause oxidative stress by exciting the immune system. Sometimes the immune cells will go around and attack constituents, let's say harmed cells, or let's say bacterial invaders. They’ll actually form oxidants in order to combat that particular damage or that particular organism. You can actually form radicals, what they call free radicals, that are unstable and steal electrons by activating the immune system constantly.

One good example, inflammation itself can cause that. If you don't have enough of the antioxidants around, you can destabilize in so many different ways. Any chemical that comes in that can pull off an electron. Mercury, another example, is a known toxin that everybody knows about. It can rob really, really quickly, destabilize the cell and form free radicals.

Think about it for a second. Digestion is the key for activating the inflammatory response, for activating the immune cells. You have more then 70% of your immune cells in your intestinal tract. All you have to do is excite them and then they'll secrete those inflammatory cytokines which will then end up next stop in the liver, activating the Kupffer cells there.The next step after that is the brain, activating the microglia and opening up the blood-brain-barrier. We now see there is a tight association with intestinal permeability and blood-brain-barrier permeability.

Lifestyle factors such as poor diet, smoking tobacco, things of that sort all cause oxidative stress. Now what does the oxidative stress have to do with depression? So many different ways. Let's take a simple one that everybody will understand. Let's take, for example, tryptophan metabolism. Many people when they're depressed, they'll take something called an SSRI, a selective serotonin re-uptake inhibitor. This is to keep serotonin around in the synapse longer so you will actually have activation from serotonin, the feel-good neurotransmitter. That feel-good neurotransmitter has to be made from something right?

There are building blocks for serotonin. The prime building block is tryptophan. Tryptophan is the
least common amino acid in the human body. You're lucky if you're getting couple of grams per day. It's tough to have it around so you really want to be efficient at turning tryptophan into things that you
need for proper mood like 5-HTP and serotonin but, guess what? The first step in the metabolic process, the biochemical step from taking tryptophan into 5-HTP needs a co-factor.

The co-factor is called BH4. This co-factor is very prone to oxidative stress and unstable. BH4 is also needed for other neurotransmitters such as dopamine. Phenylalanine to tyrosine and tyrosine to L-Dopa, and this very co-factor is needed but extremely prone to oxidative stress. Dopamine is known as the reward neurotransmitter. You feel accomplished in life. You feel secure with yourself.

So, if you have high level of inflammation and oxidative stress, a basic math calculation and common sense will tell you that you may not feel as happy and secure in your life due to depleted BH4 co-factor. The end products of needed neurotransmitters are low and insufficient. You may suffer from mood swings or feeling lousy most of the time.

On the other side of the coin, In states of inflammation, in states of oxidative stress, you will up regulate certain enzymes, an enzyme called IDO. This IDO enzyme actually will degrade tryptophan. Instead of pushing tryptophan through the serotonin pathway, when you have a lot of inflammation, when you're activating the microglia in the brain, for example, and you have chemical exposures, you've got stress, you have whatever it is that's activating the microglia, then you'll actually turn on these cytokines, and in turn, it turn on IDO enzymes. Cytokines is inflammatory, can activate IDO enzymes, and cause oxidative stress.

This IDO enzyme then will, instead of taking tryptophan to serotonin, will take tryptophan down this kynurenine pathway. The kynurenine pathway can actually end up producing something called quinolinic acid. It is neurotoxic and a toxin that actually binds to a very excitatory receptor in the brain called NMDA. It can lead to anxious and depressive type symptoms. In a nutshell, inflammation, oxidative stress play a crucial role in brain health and arguably one of the most important variables in determining if one is at risk of depression.

References/Journals: 
http://www.ncbi.nlm.nih.gov/pubmed/26130057
http://www.ncbi.nlm.nih.gov/pubmed/26028548
http://www.ncbi.nlm.nih.gov/pubmed/25900439
http://www.ncbi.nlm.nih.gov/pubmed/25865484
http://www.ncbi.nlm.nih.gov/pubmed/25825158
http://www.ncbi.nlm.nih.gov/pubmed/26083579
http://www.ncbi.nlm.nih.gov/pubmed/25907742