Many people take SSRI antidepressants for depression. However, it’s important to ask why you are feeling depression in the first place.
Many important research strides have been made linking chronic inflammation, poor gut health, gut bacteria, and general brain health with depression.
However, we still need healthy serotonin activity, the target of SSRIs, to feel good, and some factors can impact our serotonin activity.
Do you have these low serotonin symptoms?
- Don’t find joy, pleasure, or enthusiasm in life
- Anger and rage
- Depression with lack of sunlight
- Don’t enjoy hobbies, favorite foods, friendships, or relationships
- Can’t sleep deeply or don’t feel rested from sleep
Light. The brain depends on sufficient light to manufacture serotonin, so being indoors all the time or in chronically dark or grey weather can affect serotonin activity.
Estrogen. In women an estrogen deficiency can lead to poor serotonin activity. This can explain why some women who are perimenopausal or post-menopausal experience depression .
Although it’s important to use functional medicine to address the cause of low estrogen, such as blood sugar or adrenal imbalances, some perimenopausal or post-menopausal women may still need bioidentical hormone replacement. In these situations, estrogen therapy can deplete the methyl donors necessary for serotonin synthesis, making it important to supplement with them: methyl B-12, SAMe, or MSM (methylsulfonylmethane).
Diet. Some nutritional advice will tell you to address low serotonin activity with foods high in tryptophan, a precursor amino acid to serotonin. However, clinically we really don’t see this work.
Better nutritional advice is to eat a diet that keeps blood sugar stable and does not inflame the gut or the body. This means avoiding sugar and processed carbohydrates, avoiding foods that trigger an immune response, and eating lots of diverse vegetables to foster healthy and diverse gut bacteria.
Blood sugar and gut inflammation. Unstable blood sugar — blood sugar that is either too low or too high — can significantly impact serotonin activity, leading to depression. The same goes for a diet that inflames the gut and the body.
Iron. Additionally, an iron is deficiency can cause low serotonin production. Things that can cause iron deficiency include iron anemia, celiac disease, leaky gut, heavy periods, parasites, over exercising, low stomach acid, hypothyroidism, and uterine fibroids.
Nutritional cofactors for serotonin activity
In addition to iron, nutrients serotonin synthesis requires include P-5-P (pyridoxal-5-phosphate), an active form of B-6, niacin, methyl B-12, folic acid, and magnesium.
Deficiencies in these cofactors are widespread due to how poorly most Americans eat.
Additionally, magnesium deficiencies can arise in those taking diuretics or athletes who over train.
Methyl donors such as methyl B-12 are important for the conversion of the amino acid 5-HTP to serotonin; people who take SSRI antidepressants for long periods of time deplete their methyl donors and P-5-P.
Those considering weaning off SSRIs may need to supplement with these cofactors to cover deficiencies acquired during use of the medication.
Supplements that support serotonin activity
The amino acids 5-HTP or tryptophan are precursors to serotonin. Tryptophan has been shown to more easily cross the blood-brain barrier than 5-HTP. Others prefer 5-HTP because it is only one step away from being converted to serotonin, whereas tryptophan is two steps away. Therefore, 5-HTP has more potential to boost serotonin levels. However, both work and taking both can cover your bases.
Both 5-HTP and tryptophan have been shown to be helpful in addressing depression, persistent nightmares, fibromyalgia, chronic headaches, migraines, and mood disorders.
Botanicals that increase receptor site sensitivity, ensure the breakdown of used serotonin, and provide necessary cofactors for serotonin production include St. John’s wort, SAMe, P-5-P (a form of B-6), niacinamide, magnesium citrate, methyl B-12, and folic acid.