Depression, Neurotransmitters & Obesity

The relationship between obesity and mental health is complex. There are several theories about how the two are linked. Some, suggest that obesity can lead to common mental health disorders, whilst others say that people with such disorders are more prone to obesity. I say, it all depends on the person and how the person handles a situation/ problem.

The brain uses a number of chemicals as messengers to communicate with other parts of itself and with the nervous system. These chemical messengers are called Neurotransmitters and are received or released by the brain’s nerve cells. Depression. has been linked to problems or imbalances in the brain with regard to the neurotransmitters: Serotonin, Noradrenaline and Dopamine.

Serotonin: Serotonin is a neurotransmitter known for its antidepressant properties. There are Serotonin receptors in the brain as well in the gut (intestines) and blood vessels. Several studies indicate that Serotonin can lower the appetite  and here is where Obesity and depression are linked. Drugs that enhance the brain’s release of Serotonin have shown to help people lose weight.

Dopamine: High levels of Dopamine are associated with increased anger and aggression, but when in balance, Dopamine gives a feeling of relaxation, happiness and pleasure. It is also known to prevent Sodium and water retention.

GABA (Gamma Amino Butyric Acid): Is the anti-stress, anti-anxiety, anti-panic neurotransmitter. Low levels of GABA could affect sleep patterns causing anxiety and stress.

Noradreanline (Norepinephrine): Noradrenaline causes several changes in the body. It increases the amount of Oxygen going to the brain -this helps think faster and clearer. Noradrenaline (along with Dopamine), has come to be recognised as a major contributing factor in attention and focus and for lowering blood pressure. Attention, Noradrenaline is not Adrenaline. There is a major difference between these two. Noradrenaline is a neurotransmitter that is produced naturally in the body and manufactured as a drug. Adrenaline, is a hormone produced by the adrenal gland and stimulates the heart rate, dilates blood vessels, air passages and a number of other functions. It is naturally produced when the body is in high-stress or physical exhilarating situations. The term “Fight or Flight” is often used to characterise the circumstances under which Adrenaline is released into the body.

An imbalance of one or more of these neurotransmitters could be a contributing factor towards depression.

In terms of nutrition, it is important to examine whether physical activity is low if or a person has a poor diet in essential nutrients. High protein diet is always beneficial, but in this case, carbohydrates are essential as they help to move Tryptophan to the brain. Tryptophan is an amino acid and when in the body, is converted into Serotonin. Foods rich in Tryptophan: Turkey, Chicken, Egg whites, Pulses, Beef, Tuna and Soya products. Refined carbohydrates such as biscuits, pastry white bread etc, are not recommended. It is best to keep blood glucose stable with the help of protein and complex carbohydrates such as vegetables, wholemeal bread, legumes. Vitamin D is essential so a supplement of Vitamin D or a B Vitamin complex could often be recommended.

Giovanna De Angelis Terzaki

Estrogen Dominance could lead to Obesity

What is Estrogen Dominance:

To begin with, Estrogens are hormones that are important for sexual and reproductive development mainly in women. They are also referred to as “Female sex hormones”. The term Estrogen refers to all of the chemically similar hormones of this group (Estrone, Estradiol, Estriol)

The body maintains a specific balance of estrogens, progesterone and testosterone.

Estrogen dominance, describes a condition where a person can have deficient, normal or excess levels of estrogen, but less or no progesterone to balance its effects in the body.

Excess estrogen in relation to progesterone, could also be received from all sorts of external- environmental factors, called xenoestrogens .

Xenoestrogens are fat-soluble and non-biodegradable in nature. A major source of xenoestrogens are pesticides, detergents, cosmetics and food cans.

Factors that could contribute towards the development of this condition are:

Diet: A poor diet in beneficial bacteria and fibre could compromise the health of the intestine. The gut integrity is of vital importance as it allows the body to absorb and digest all the necessary nutrients. If there is not an adequate amount of good bacteria, then intestinal dysbiosis could occur. A condition in which suboptimal bacteria, yeast or parasites colonise the intestines. Bad dietary choices such as sweet and highly processed foods, or antibiotic use could contribute towards Estrogen Dominance.

Excess estrogen molecules are packaged in the liver and sent to the intestines to be eliminated. Some of the “bad bacteria” are able to modify the package so that estrogen is reabsorbed into the blood to continue to act in the body.

Stress: It is also a contributing factor to the development of Estrogen Dominance.

There are several points of interaction with ovarian hormones indicating that estrogens may have a neuroprotective role in relation to stress and glucorticoid secretion and actions in the brain. Any estrogen imbalance could increase stress levels and vice-versa. Dealing with stress on a regular basis, could have an affect on the adrenal glands. This in turn could decrease the amount of produced progesterone causing progesterone deficiency, hence, Estrogen Dominance.

Menopause: Estrogen is the hormone responsible for staving off menopause. As estrogen naturally decreases with age, the onset of menopause occurs, resulting in the completion of menstruation and the end of the reproductive cycle. Estrogen production decreases by about 40% after menopause whereas progesterone decreases to about 1/120 of baseline levels. This could lead to an imbalance between estrogen and progesterone, causing an increase in estrogen activity which could result in Estrogen Dominance.

Genes: Estrogen Dominance itself is not a genetically caused condition. However, conditions such as Ovarian cysts, Endometriosis or even obesity are contributors to Estrogen Dominance and these could be hereditary traits

Obesity: Obesity contributes in the development of estrogen dominance, as fat contains enzymes that convert adrenal steroids to estrogen. The higher the fat intake, the higher the conversion of fat to estrogen .

There are many pathways and scenarios that could associate Estrogen Dominance with Obesity. For example one of them could be:

Estrogen Dominance Lack of sleep → Cortisol Imbalance → Adrenal Fatigue → Hypothyroidism → Slow Metabolism → Obesity

It is indicated that the majority of the women dealing with Estrogen Dominance, suffer from sleep disturbances. In addition, compared to men, women are twice as likely to have difficulties in falling asleep or maintaining a good sleep at night. It is documented that estrogen makes women more susceptible to stress, so this could worsen the symptoms of insomnia. The glucocorticoid hormones synthesised upon stimulation of the HPA-Axis, either by stress or pro-inflammatory cytokines that may disrupt the sleep-wake cycle, therefore worsen the existing condition (ED). What happens in Estrogen Dominance is while stimulated HPA-Axis increases cortisol synthesis, it may also decrease progestrone levels in several ways:

a) As cortisol itself is a derivative of progesterone, increase of cortisol synthesis may lead to a decrease of progesterone levels.

b) As cortisol and progesterone have the same affinity both to corticoid and progesterone receptors, cortisol may bind to progesterone receptors. This mechanism could reduce the progesterone levels again,so estrogen dominance occurs.

Several studies confirm that individuals with hormonal imbalances are prone to depression and as a consequence, sleep patterns change and become irregular.

Hormonal imbalances such as estrogen dominance have an impact to the energy levels of the person. It is interesting that the temperature of the body gets affected especially during night sleep (hot flashes) . Alteration of temperature (hot flashes) is a very common symptom in estrogen dominance and causes disruptions of sleep. The person wakes during the night. During sleep, the alternation between rapid eye movement (REM) and Non-REM sleep, is controlled by the hypothalamus, basal fore-brain and brain-stem .What happens is that transitions to wakefulness involve the reactivation of wake promoting neurons, which in turn, inhibit sleep promoting circuit.

On the Sleep and Metabolism mechanism, it is important to mention the role of Leptin and Ghrelin that links sleep with appetite. Appetite is regulated by the interaction between metabolic and hormonal signals and the central nervous system. As the hypothalamus is responsible to maintain a proper regulation of energy homoeostasis, by sensing circulating hormones such as Leptin and Ghrelin.

Leptin is a hormone produced by adipose tissues and inhibits arcuate neurons that co express neuropeptide Y (NPY) and agouti-related peptide (AgRP), activating proopiomelanocortin neurons (POMC). Ghrelin, is an appetite-stimulating hormone that has the opposite effects .

Long story short : One of the symptoms of Estrogen Dominance is hot flashes, especially during sleep that interrupt the normal flow of sleep, hence, the cortisol levels. If cortisol synthesis is increased, then progesterone levels are decreased plus, the adrenals work overtime, including the thyroid- a gland that secretes hormones regulating growth and development through the rate of metabolism. If Thyroid function is compromised due to excess cortisol synthesis could often result in hypothyroidism, meaning that metabolism is slow.

In terms of nutrition, along with a healthy diet , meaning no refined products that contain chemicals that could worsen this condition, a good amount of Ω fats is recommended together with high quality protein and high fibre.

Contact me for advice or information.

Giovanna De Angelis Terzaki

Celiac Disease Vs Gluten Intolerance. Similar but…

Celiac disease is an autoimmune condition, triggered by the consumption of gluten. Gluten Intolerance on the other hand, describes the situation where individuals find it difficult to digest gluten and deal with symptoms of bloated stomach or even weight gain.

Celiac disease is a more complicated condition with more severe symptoms (vomit, diarrhea, intestinal bleeding). Once gluten in the body, the immune system responds by damaging the villi, which allows nutrients from food to get absorbed in the small intestine and then into the blood. Celiac disease is often a genetic disease and usually, it runs in the family.

As any autoimmune condition, there is a higher number of certain antibodies, more specifically tTGA and EMA, which are found in larger amounts in the body. Carrying these so called “Celiac disease genes” it is not certain that a person will necessarily develop the disease. On the other hand, not carrying this specific combination of genes, the possibilities for a person to develop Celiac disease are slim to extremely rare. The HLA category of genes, have different variations allowing each person’s immune system to react to a wide range of foreign invaders. Their main role however, is to provide instructions for making proteins that would benefit the immune system and to distinguish the body’s own proteins from proteins made by foreign invaders. An imbalance of these genes could cause an autoimmune dysfunction, as the body’s proteins are perceived as a threat and the body fights its own body.

In general, the expression of genes in the human body is influenced by the environment. Environment, is not only the internal world but the external too. Factors that could contribute towards the expression of the genes associated to Celiac disease are: Gender, drugs, chemicals, temperature (climate), smoking, stress and lack of sunlight (Vitamin D).

Gluten Intolerance is not an allergy. It is a physical condition in the gut.The reason that more people appear to be unable to digest gluten is because modern diets are low in essential nutrients and this interferes with the body’s ability to suppress immune cells that are supposed to attack harmless proteins such as gluten. Gut dysbiosis is on the rise for a number of reasons. Sugar, alcohol, antibiotics, environmental toxins and other allergens such as GMOs, that contribute to an imbalanced intestinal flora which could lead to gluten intolerance. In terms of nutrition, the only treatment for Celiac disease or even gluten intolerance is a Gluten-Free diet. For most people, this will stop symptoms of intestinal damage. Supplements such as Iron could be necessary in severe cases with intestinal bleeding, vitamin D, plant Polyphenols and Fatty acids.

Giovanna De Angelis Terzaki