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Dr Andrea Robertson is an Osteopath, Naturopath, and Nutritionist. The information shared in this podcast is for educational purposes only and does not constitute medical advice. Always consult your healthcare provider before making changes to your health regimen.

Show Notes

Episode Transcript

Episode 8

[00:00:00] This is the symptom I see cause women the most distress, because irritability is less socially acceptable than sadness, because it is visible to others, because it affects your relationships, and because it does not feel like a symptom, it feels like a personality problem. So let me be unequivocal here.

It is not a personality problem. It's your biology, and I'm gonna make that case very clearly today. Because here is what I want you to understand from the very beginning. Mood is not just in your mind. It is also in your gut, your hormones, your immune system, and your inflammatory status

Our sponsor today is Mineralite, an Australian electrolytes brand. And I have to tell you how I found them because this is a genuine story. Now, I'm really into paddle tennis, some may say obsessed , and a friend of mine introduced me to Mineralite to use for my hydration support during games. I was a little curious because I'd been recommending clients avoid those terrible sugary sports drinks for years, but I wasn't really sure what other options were available.

I now know that Mineralite is [00:01:00] the option I'll recommend. It's unflavored and contains no sugar, no sweeteners, no artificial colors, no nasty additives. Just clean electrolyte support in drops you can add to your water or any hot or cold drink. And my paddle? It was noticeably different. My energy held, my focus held, and I even won some games.

Mineralite is now in my water every single day. Go and check them out at mineralite.com.au or find them in most pharmacies and health food stores throughout Australia and New Zealand

Andrea: What if the anxiety you're carrying right now is not a reflection of who you are? What if the irritability, the emotional rawness, the low mood that arrives without a clear reason, what if that's not your personality, not your weakness, not your failure to manage stress? What if it's your biology, your gut, your hormones, your immune system, and it is something you can actually do something about?

I'm Dr. Andrea Robertson, osteopath, naturopath, and nutritionist. Here we nourish [00:02:00] because food is medicine and what you eat changes everything. We heal because the body has an extraordinary capacity to self-repair when we remove what's blocking it. And we rise because feeling well isn't the destination, it's the foundation for living the life you truly desire.

This is Nourish, Heal, and Rise.

 

 

Before we begin, a quick and important note. Everything I share on this podcast is for educational purposes only. It's not personal medical advice, and it can't be, because in the context of this podcast, I don't know your health history, your medications, and what else is happening in your body. What I want this podcast to do is give you the knowledge to ask better questions, understand your body more deeply, and make more informed decisions in partnerships with the practitioners who do know you.

If something [00:03:00] resonates and you wanna take action, please work with a qualified healthcare provider who knows your full picture

Andrea: Welcome back to Nourish, Heal, and Rise. This is episode eight, and we are continuing our series on the eight most common signs of chronic inflammation in women's bodies. Over the past seven episodes, we have moved through inflammatory fatigue, weight loss resistance, brain fog, joint pain, gut disruption, and skin conditions.

Today, we land on sign number seven, and I want to approach it with particular care because this one sits at the intersection of biology and psychology in a way that carries more weight, often some shame, and often more misunderstanding than any other topic in this series, and that is mood changes. The anxiety that feels disproportionate to your actual circumstances, the low mood that arrives without a clear cause, the irritability h- that has you snapping at the people you love most, the emotional rawness, that feeling of having no buffer, no thick skin, no ability to moderate what gets in and how hard it [00:04:00] lands

Before I go anywhere near the science, I wanna say something important, and I want to say it plainly. If you are experiencing significant anxiety, depression, or mood disruption that is affecting your daily life, please seek support from a GP, from a psychologist, from a therapist, from a psychiatrist if that's what's needed.

What I'm going to share today is not a replacement for that support. It's an additional lens, a piece of the picture that is so frequently missing from the clinical conversation, and that, when it's finally understood, changes everything about how women relate to their own emotional experience.

Because here is what I want you to understand from the very beginning. Mood is not just in your mind. It is also in your gut, your hormones, your immune system, and your inflammatory status. And the connection between chronic inflammation and mental health is one of the most exciting and most clinically significant areas of research in modern medicine right now. So let me map out exactly what we are covering today so you know what is coming. [00:05:00] We're gonna start by looking at what inflammatory mood changes actually feel like, going into the specific character of this experience.

Then we're gonna go through the science. Five specific biological mechanisms that drive mood disruption in inflamed women. And I promise that by the end of that section, the experience of mood changes will make a different kind of sense than it ever has before. Then we're gonna go into what you can actually do about it.

Seven practical targeted steps grounded directly in the biology. And we're going to finish with what recovery looks and feels like because I want you to know what you're aiming for

Okay, let me start by telling you what inflammatory mood changes actually look like. Mood changes driven by inflammation and hormonal disruption have a pretty specific character. They have a biological fingerprint, and once you can recognize that fingerprint, once you understand what you're actually looking at, the experience shifts.

It becomes almost less frightening because you understand it,

And it feels [00:06:00] easier to navigate. I have four different types of mood changes that I want to go through first. Let me start with anxiety that feels disproportionate. This is not the anxiety of a genuine threat, not the nerves before a difficult conversation, the worry about a real health concern,

the stress of a really demanding period at work. This is anxiety that arrives without a credible cause. The racing heart that turns up without warning. The background hum of low level dread that sits in your chest all day and does not move, regardless of what you do or tell yourself. The waking at 3:00 in the morning with your mind already running at full speed before you've even fully surfaced.

The persistent sense of waiting for something bad to happen without any clear sense of what. Women describe this anxiety as coming from inside their body rather than from their life, as a physical sensation rather than a thought pattern. And that distinction, anxiety that feels physical, that feels like it's arising from [00:07:00] the body itself rather than from a cognitive brain process, that's clinically significant because it is telling you something important about where the anxiety is coming from

Then I want to address low moods. Not the sadness that makes sense, like the grief of a real loss, the heaviness of genuine hardship, the disappointment of a difficult season. This is low mood that arrives without a clear cause, or that persists far beyond what the circumstances warrant. Like a flatness, a grayness, a loss of interest in things that used to bring pleasure, a lack of motivation,

a difficulty accessing genuine joy, even when, by any objective measure, life is going pretty well. An emotional numbness that sits alongside a strange rawness even, that curious and very specific combination of feeling too much and too little at the same time. Then we have irritability, the disproportionate frustration, the snapping [00:08:00] at someone you love over something really small,

The sense of being constantly on the edge of your tolerance with a fuse that is significantly shorter than it used to be. And then the shame of your own reaction of yelling at your partner or kids because you know it was out of proportion, but you couldn't help it.

This is the symptom I see cause women the most distress. Because irritability is less socially acceptable than sadness, because it is visible to others, because it affects your relationships, and because it does not feel like a symptom, it feels like a personality problem. So let me be unequivocal here.

It is not a personality problem. It's your biology, and I'm gonna make that case very clearly today. And last, we have emotional rawness. That feeling of being about to tip over. No reserves, no capacity To catch the emotional response before it arrives fully formed.

Everything lands harder than it should, like a comment from someone, a piece of news, a look from someone, and the response it triggers feels relatively [00:09:00] enormous compared to the stimulus. Women describe it as a feeling of like they're on the edge of tears all the time, like they are only just holding it all together.

What all of these experiences share, the anxiety, the low mood, the irritability, the rawness, is a nervous system that has lost its resilience, its capacity to absorb and respond proportionately, its ability to recover from stress and return to a beautiful, settled baseline. And that lost resilience, in the vast majority of women I see presenting with this picture, has a biological, inflammatory, hormonal driver that has never been addressed, or in most cases, has never even been identified.

I can think of a patient here. Let's call her Lisa for privacy reasons. So Lisa came to me after three years of what she had been told was generalized anxiety disorder. She had been through two courses of antidepressants, a year of CBT, which is cognitive behavioral therapy, [00:10:00] and countless hours of journaling and mindfulness practice.

None of it had touched that baseline anxiety for her. She was doing everything right, psychologically speaking, but no one had looked at her gut, her hormones, her inflammatory markers, or what she was eating. Within 12 weeks of us addressing these biological drivers, the anxiety she'd carried for three years, like that low hum of dread she'd come to think that was just who she was, it was gone.

Three months, it was gone. Not reduced, literally gone. And Lisa's not an outlier.

She's one of dozens of women I've seen with this exact story. The biology was driving the mood, and when the biology shifted, the mood followed. Let's now go into the science of what is actually happening in your body and brain. I wanna take you through five key biological mechanisms driving mood changes in inflamed women.

Because understanding this science doesn't just explain what is happening, it changes the way you talk to yourself about what is happening. And that shift in [00:11:00] self-narrative, it itself is part of the healing

Okay, mechanism one, the cytokine model of depression and the tryptophan steal. This is a framework that has been building in research literature for over two decades, and it represents one of the most important shifts in how we understand mood disorders. The core proposition Is this. In about one in three people with depression, chronic systemic inflammation through the sustained elevation of inflammatory cytokines may lead to depressive symptoms.

Not as a downstream consequence of feeling unwell, not as a psychological response to having a health condition, but as a direct biological mechanism operating through specific identifiable neurochemical pathways. Here's how it works.

Inflammatory cytokines, think of these as the chemical alarm signals your immune system produces when it's activated. Like the SOS messages that tell your body something is wrong. Well, they like to cross the blood-brain barrier. Think of the blood-brain barrier as the security [00:12:00] perimeter around the brain, tightly controlled and highly selective about what it lets through.

Under normal non-inflammatory conditions, that perimeter holds. But when inflammatory cytokines are chronically elevated, they signal the brain through several routes. Some crossing at weak points in the barrier, others traveling via the vagus nerve, but the result is the same. The brain's resident immune cells, microglia,

We've talked about them before in a previous episode. Well, they trigger neuroinflammation. Think of microglia as the brain's security guards. Normally protective, but when chronically activated by incoming inflammatory signals, they become part of the problem themselves.

Neuroinflammation then disrupts neurotransmitter production and function. So neurotransmitters are little molecules that transmit messages along nerves. And the most important disruption involves tryptophan, an essential amino acid that your body cannot make and must get from food.

Think [00:13:00] of tryptophan as the raw material your body uses to make serotonin. It's a neurotransmitter, and it's your primary mood-regulating, calming, sleep-supporting neurotransmitter. Under normal circumstances, the tryptophan that you consume from protein foods goes towards serotonin production. But inflammation activates an enzyme, I'm gonna go into the science here for you, called IDO, indoleamine 2,3 dioxygenase.

Think of IDO as a biochemical traffic controller, that when switched on by inflammation, redirects the tryptophan flow away from serotonin production and down a completely different route. The kynurenine pathway. And the compounds produced by this alternative pathway, particularly quinolinic acid, are themselves neurotoxic.

They damage neurons, amplify neuroinflammation, and further impair mood and [00:14:00] cognition. So the result is less serotonin, more inflammatory compounds in the brain, lower mood, higher anxiety, worse sleep, and impaired thinking. A cascade that is experienced as depression, anxiety, and emotional rawness, and that originates not in the mind,

but in an inflammatory immune response

Okay, mechanism two, cortisol dysregulation and the permanently switched on stress response. Cortisol has come up multiple times in this series in different episodes. Today I wanna focus specifically on its role in anxiety because the mechanism is direct, well understood, and explains something very particular about the anxiety that many inflamed women experience.

The HPA axis, the hypothalamic pituitary adrenals, the body's stress organs, or think of this as the brain's stress command [00:15:00] center,

Well, that control system that governs the stress response from the brain's master control regions all the way down to the adrenal glands that produce cortisol. Well, this is directly disrupted by chronic inflammation. Inflammatory cytokines interfere with the feedback loop that normally regulate cortisol production, specifically that loop that tells the whole system when enough cortisol has been produced and it's time to chill out.

And think of the HPA axis as a thermostat. In a healthy, well-regulated system, when the temperature, cortisol, rises to where it needs to be, the thermostat reads that and switches off the heating. When cortisol rises in response to a stress, the feedback loop kicks in and says, "Enough.

Relax, stress organs. No need to make more cortisol." So that's a really healthy response. But in chronic inflammation, this feedback mechanism becomes dysregulated. The thermostat malfunctions. Cortisol is produced at the wrong times in the wrong amounts, and the switch off signal [00:16:00] can't be properly received

The result is a stress response that is chronically activated, always slightly on, always slightly scanning, always slightly primed for threat. Small stresses feel disproportionate because the system is already sensitized and primed, like that threshold is raised. Recovery then from stressful events can take much longer too, because the switch-off mechanism is compromised, and the subjective experience is exactly what women describe: anxiety that feels disproportionate, a tension that never fully resolves, an inability to truly relax even when nothing is wrong.

And then there is the blood sugar connection, which feeds directly into the cortisol cycle. Every time blood sugar crashes, every time a high carbohydrate or low protein meal causes a rapid spike followed by a rapid drop in blood sugar, cortisol surges to rescue the falling glucose. [00:17:00] Every cortisol surge produces a physiological signature of anxiety.

Heart rate elevates, alertness heightens, the threat detection system activates. And if this happens multiple times across a day, which it does for many women, the nervous system is receiving repeated anxiety signals that have nothing to do with anything that's happening in their life other than just a blood sugar drop.

So these things are happening in their bloodstream, and they feel indistinguishable from anxiety that has a psychological cause. The cortisol rhythm disruption also affects sleep And poor sleep, as we have established across this series, drives further inflammation, further neuroinflammation, further HPA axis regulation.

Again, the cycle feeds itself. Now, mechanism three, the gut-brain axis and the serotonin factory you never knew you had. We looked at the gut-brain axis in the brain fog episode, the vagus nerve as the direct neural highway between the gut and the brain, [00:18:00] carrying signals in both directions continuously.

Today, I want to bring it specifically into the mood conversation because what I'm about to tell you is one of the most important things in this entire series. 90% of your serotonin is produced in your gut, not in your brain, in your gut. Let that land for a moment. Your primary mood-regulating neurotransmitter, the chemical we most associate with feeling calm, stable, and emotionally resilient, is overwhelmingly produced in your gastrointestinal tract by specialized cells in your gut lining.

It is a process that is directly dependent on the health of your gut microbiome. This single fact changes the entire conversation about mood because if the vast majority of your mood-regulating neurotransmitter is produced in your gut, then the health of your gut, the diversity of your microbiome, the integrity of your gut lining, [00:19:00] the quality of the gut-brain communication via the vagus nerve, it directly, not indirectly, not metaphorically, but directly determines the biological essence of your mood.

When the gut microbiome is dysbiotic, when the ecosystem of bacteria that produces serotonin precursors and supports the serotonin-producing cells of the gut lining is disrupted, serotonin production falls. The gut's serotonin signaling, including via the vagus nerve and through tryptophan availability, it affects brain serotonin production as well, and mood suffers.

When the gut lining is permeable, when lipopolysaccharides, they're the toxic breakdown products of certain gut bacteria, well, when they're crossing into the bloodstream, they trigger systemic immune activation. Those inflammatory compounds can reach the brain, activate the microglia, and switch on the IDO enzyme we just discussed before in mechanism one, diverting tryptophan away from serotonin.

[00:20:00] The gut inflammation and the systemic inflammatory response are working together to reduce serotonin availability simultaneously And when the vagus nerve itself is functioning suboptimally, as it does under chronic stress and chronic inflammation, the quality of the gut-brain communication deteriorates.

The brain's calming regulatory signals reach the brain less effectively. The nervous system becomes more reactive and less settled. Now, a growing body of research over the past decade has consistently found associations between gut microbiome composition and mood.

Professors Ted Dinan and John Cryan at the APO Microbiome Institute at University College in Cork have been among the leading researchers in this space. Their work was foundational in establishing that people with clinical depression have significantly less microbiome diversity than people without it.

This is why women who heal their gut consistently report that their mood improves in ways that they did not expect. [00:21:00] They came in for the bloating or the constipation, and they find that the anxiety has reduced, the emotional rawness has eased. They feel more even, more stable, more like themselves, because the biological foundation of their mood has been restored from the gut up.

Now, mechanism number four of how chronic inflammation drives our moods, and that's our hormones. Estrogen and progesterone are not just reproductive hormones. They are mood-regulating hormones with direct neurological functions, and their wobbles through perimenopause and their decline through menopause is one of the primary drivers of mood disruption in women from their mid-30s onwards

Oestrogen supports serotonin synthesis and receptor sensitivity. Think of oestrogen as a serotonin amplifier. It helps the body produce more serotonin and responds more effectively to the serotonin it produces. It supports dopamine function. So dopamine is your primary motivation and reward neurotransmitter, the chemical that makes [00:22:00] things feel interesting, worthwhile, and worth pursuing.

Think of dopamine as your get-up-and-go chemical, the one behind drive, pleasure, and the feeling of being genuinely connected with life. And oestrogen has direct anti-neuroinflammatory effects. It actively suppresses the microglial activation that drives neuroinflammation and the tryptophan diversion we discussed in mechanism one.

So as oestrogen wobbles up and down wildly through perimenopause, not a gradual, smooth decline, but a volatile, unpredictable seesawing that can go on for years, even up to 10 years. All of these mood-supporting functions become inconsistent and ultimately diminished.

The emotional volatility that so many women experience in perimenopause, like the tears that arrive without warning, the disproportionate reactions, the mood swings that are confusing even to them, they are, in large, part of a direct consequence of erratic oestrogen fluctuations affecting serotonin and dopamine function [00:23:00] in real-time, in real moment to moment.

Now, let's talk about progesterone. Progesterone is the brain's calming hormone. Here is the mechanism because I think it's worth you understanding it. Progesterone crosses into the brain, where it is converted into a compound called allopregnanolone. Think of allopregnanolone as progesterone's active brain metabolite, the form it takes once it gets inside the central nervous system.

And allopregnanolone directly enhances the activity of GABA A receptors, GABA being the brain's primary inhibitory neurotransmitter, the chemical that quietens neural activity and creates the conditions for calm, rest, and sleep. Think of GABA as your brain's volume control.

It turns the noise down, and allopregnanolone is what makes that volume control work. Here is what makes the progesterone story particularly important for mood. In early perimenopause, as ovulation becomes less consistent and you have an [00:24:00] ovulatory cycles, cycles where ovulation does not occur, or when they become more frequent, progesterone output drops.

Because progesterone is produced after ovulation by the formation of something called the corpus luteum. Think of the corpus luteum as the temporary gland that forms around an egg after an egg is released and is responsible for the progesterone surge in the second half of your cycle. So if there's no ovulation, there's no corpus luteum, there's no progesterone.

And because an ovulatory cycle is an ovulation, because they tend to increase before estrogen levels show a dramatic overall decline, many women experience a loss of their neurological calming mechanism from progesterone before they experience the classically recognized symptoms of perimenopause.

The early signs of that progesterone withdrawal are increasing anxiety, deteriorating sleep quality, a feeling of not being able to switch off, a mind that will not quieten down at night. These are often almost universally misread. [00:25:00] They're often attributed to stress, to life circumstances, to being a person who worries too much.

We need to check progesterone, and if it's low, we need to connect the dots between the hormonal shift and the mood experiences.

This is why anxiety and sleep disruption are so often the first symptoms of perimenopause to emerge, sometimes years before hot flushes, sometimes years before irregular periods, sometimes years before anything that would classically prompt a conversation about menopause. The progesterone withdrawal is happening first, and the anxiety, the sleeplessness, the emotional rawness, these are its earliest expressions.

Now, I want to mention thyroid function here as well. An underactive thyroid or even a subclinical thyroid dysfunction that sits within conventional lab ranges as normal, but maybe at the lower end, this can also contribute to depression and anxiety

Research primarily from animal models, but with growing clinical evidence, suggests thyroid hormone modulates the [00:26:00] sensitivity of serotonin receptors throughout the brain. When thyroid function is suboptimal, these receptors can become less responsive. The serotonin that is being produced has less effect.

This is one of the reasons why thyroid needs to be checked when moods are feeling unsettled. Now, mechanism five, histamine and the mood connection. This one is underappreciated, and it will resonate strongly if you have ever noticed that your anxiety or irritability is worse after certain foods, worse before your period, or worse when you're run down.

Most people know histamine as the compound behind allergic reactions, the thing you take a antihistamine for, like hay fever. But histamine is also a neurotransmitter, and in excessive amounts, it directly drives anxiety, sleep disruption, irritability, and emotional reactivity.

Here is what you need to understand about estrogen and progesterone, because they drive each other. Estrogen activates mast cells. Think of mast cells as histamine's storage depots, [00:27:00] priming them to release. At the same time, estrogen suppresses DAO, diamine oxidase, the enzyme that breaks histamine down.

Think of DAO as histamine's disposal system. So when estrogen is high, you are producing more histamine and clearing it less effectively simultaneously. And histamine, in return, stimulates the ovaries to produce more estrogen. More in, less out, feeding itself in a loop. Progesterone is the natural counterweight to this cycle.

It stabilizes mast cells and supports DAO activity. Think of it as a histamine's brake pedal, which means when progesterone declines first in perimenopause, you lose that brake at exactly the moment estrogen is spiking erratically and driving histamine up. Every estrogen serve activates the histamine system,

this is why histamine issues tend to peak during perimenopause specifically. Not because estrogen is low, but because it is [00:28:00] volatile and spiking without the progesterone buffer that used to keep it in check For many women, things do improve after menopause once the hormonal volatility settles, but not automatically.

If gut health and DAO function remain compromised for non-hormonal reasons, histamine symptoms can persist regardless of estrogen levels. And women starting hormone therapy should know that estrogen can initially worsen histamine symptoms, which is one reason micronized progesterone, which stabilizes mast cells, is such an important part of the picture for histamine-sensitive women if taking hormone therapy.

Practically speaking, if your anxiety, irritability, or mood dysregulation follows a cyclical pattern, worsens with certain foods, or flares after poor sleep, histamine is worth investigating. And your first two levers are a low-histamine diet and gut repair to restore DAO function. Both of these we [00:29:00] cover in detail with my clients in my 12-week program, and my clients respond really well when we get these things under control.

 

 

 

 

Andrea: Okay, let's now go over what you can actually do about inflammatory mood changes. I have seven specific actionable steps built directly from the biology we [00:30:00] have just covered

Step one, stabilize your blood sugar at every single meal. Given the direct immediate relationship between blood sugar crashes and cortisol-driven anxiety spikes, this is the most quickly impactful intervention for mood. And I wanna be clear about what I mean by stabilize, because this phrase kind of gets used a little loosely. So please have protein at every meal. Include 25 to 30 grams, and include healthy fats also, and fiber from vegetables and low-glycemic plant foods. Include complex rather than refined carbohydrates, and never have carbs on their own, always with protein and healthy fats.

Pay particular attention to breakfast. The cortisol awakening response, that's the natural surge of cortisol in the first 30 to 45 minutes after waking that helps you transition from sleep to alertness, this is a normal and necessary biological effect.

But if the first thing you do is eat high [00:31:00] refined carbohydrates, and if you're low in protein, you create a blood sugar spike on top of an already elevated cortisol environment. The subsequent crash activates another cortisol surge, and you have set the biochemical tone for the entire day before 9:00 in the morning.

A protein-rich breakfast, eggs, leftover protein from dinner, a protein-rich smoothie, smoked salmon, whatever works in your life. This stabilizes blood sugar. It moderates the cortisol awakening response and provides the tryptophan and tyrosine your brain needs for serotonin and dopamine production throughout the day.

Pay attention to the mid-afternoon as well. The energy and mood dip that most women reach for chocolate or caffeine to resolve, so that 3 or 4 o'clock brick wall, is almost always a blood sugar crash. A protein and healthy fat-based snack, and especially getting enough protein in early in the day

resolves it without that subsequent crash that refined sugar and [00:32:00] caffeine would create. As a snack, a handful of nuts, a boiled egg, apple with almond butter, or a small portion of leftover protein. It's simple, and the mood difference within days of doing this consistently is super life-changing. Step two, heal the gut specifically for mood.

Given that 90% of serotonin is produced in the gut, gut healing is one of the most powerful mood interventions available. So remove refined sugar. Sugar feeds dysbiotic bacterial species that impair the serotonin precursor production, that drive gut inflammation, that activate the IDO enzyme that drives tryptophan away from serotonin.

Remember that one from earlier? Sugar is the most important dietary removal for gut-based mood support. Then increase plant food diversity. The target I use clinically is to aim for 30 different plant foods per week. Not 30 servings of the same plants, but 30 [00:33:00] different ones. Vegetables, fruits, legumes, nuts, seeds, herbs, whole grains, they all count.

Plant diversity is the primary driver of microbiome diversity, and microbiome diversity is directly associated with greater serotonin precursor production and a more stable mood

Then add fermented foods, but carefully. Start slowly and watch for histamine sensitivity, which I raised this in mechanism five. Kefir, sauerkraut, kimchi, kombucha. Introduce those gradually and notice whether mood and symptoms improve or worsen. Some women with histamine issues need to approach fermented foods with caution.

I have talked about this in more depth in previous episodes. And then support your vagal tone, which I'll share more about in step four in a moment. But I will plant the seed now. The vagus nerve is the physical highway through which the gut's mood-supporting signals reach the brain. A well-functioning vagus nerve is

a direct tool for mood regulation Step three, [00:34:00] use nutrition to build your neurotransmitters. Your neurotransmitters are made of food. Serotonin from tryptophan, dopamine from tyrosine, GABA from glutamate, and the cofactors that drive these conversions of vitamins and minerals from diet and targeted supplementation.

Okay, so tryptophan-rich foods are turkey, chicken, eggs, pumpkin seeds, sesame seeds, oats, and bananas. That provides the raw material for serotonin. But there is a nuance worth knowing. Tryptophan competes with other large neutral amino acids to cross the blood-brain barrier.

Think of the entry point as doors that multiple amino acids are queuing to get through. Tryptophan needs relatively clear passage to get through , in decent amounts. Eating tryptophan-rich foods alongside complex carbohydrates rather than with large amounts of other protein actually improves tryptophan's access to the brain.

You should try my [00:35:00] turkey mint scramble in my recipe book. It's available on my website, and it's such a great breakfast or lunch or dinner, or all three as I did yesterday when I had a busy day and only wanted to cook once. Then magnesium glycinate or bisglycinate, three hundred to four hundred milligrams before bed.

This is one of the most consistent and immediately impactful mood-supporting interventions that I use clinically. Magnesium directly supports GABA function. Think of it as the mineral That helps your brain volume control work properly. It regulates NMDA receptors,

The receptors involved in excitatory neuronal activity, reducing the neural overactivation that produces anxiety. Low magnesium is directly associated with increased anxiety, poor sleep quality, and depressive symptoms. It is also heavily depleted by chronic stress,

Which means the women who need it most are more likely to be deficient. And B vitamins, methylfolate, methylcobalamin, and B6 are essential [00:36:00] co-factors for neurotransmitter synthesis.

B6 specifically is required for the conversion of tryptophan to serotonin and for the conversion of glutamate to GABA. Without adequate B6, these conversions are impaired regardless of how much raw material you have. Methofolate and methocobalamin support the methylation processes that regulate neurotransmitter breakdown and recycling.

A B complex taken daily is foundational nutritional support for mood, and an activated B is particularly important for women with MTHFR gene variants who have a reduced ability to activate B vitamins in their dietary form. I will talk about MTHFR in depth in another episode in the future, as this topic does deserve its own full episode.

But the short version is if you have an MTHFR variant, if you know about that, regular B vitamins may not help you at all, and you need an activated form

Then EPA, the long-chain omega-3 found in fatty fish and [00:37:00] concentrated fish oil, has a really strong evidence base for mood support. Multiple meta-analyses of clinical trials show that EPA supplementation at therapeutic doses has evidence for mild to moderate depression, and it works through a fundamentally different mechanism from antidepressant medication.

EPA reduces neuroinflammation. Think of EPA as directly targeting the inflammatory mechanism that is driving IDO activation and tryptophan diversion. There's that mention of the science again. Remember that. A therapeutic dose of EPA for mood is at least one gram per day, which requires a concentrated high-quality omega-3 supplement.

Not a standard fish oil capsule that has been sitting on the shelf at the discount chemist, but a properly formulated high EPA product from a reputable supplier like a practitioner-only brand. Okay. Next we have saffron. Now, I know this sounds unexpected, but bear with me. Saffron extract has a really impressive and growing evidence base for mood.

Multiple randomized control [00:38:00] trials have shown saffron extract to be comparable to low-dose antidepressants for mild to moderate depression. Its mechanisms include inhibiting the re-uptake of serotonin and dopamine in the synapses, similar in principle to antidepressant medications and reducing neuroinflammation.

A typical dose is thirty milligrams of saffron extract per day divided into two doses, morning and night. The research here is real, and it's recent, and it's worth knowing about

Okay, now we go onto step four of how we can support inflammatory mood changes. Support your vagus nerve. The vagus nerve is a lovely long nerve that creates the gut-brain connection, the actual anatomical structure through which the gut's mood-regulating signals reach the brain. And vagal tone, think of this as the strength and responsiveness of the vagal nerve signaling.

It is similar to muscle tone, but for a nerve, and it directly determines the quality of that connection. Low vagal tone [00:39:00] is associated with depression, anxiety, chronic inflammation, and poor gut function. High vagal tone is associated with emotional resilience, stable mood, and better digestive function.

And here is the very important part. Vagal tone is something you can directly improve, not over months of intensive work, but sometimes within a single session. So let me share Four things quickly that can increase vagal tone. One, do extended exhale breathing. Think four counts in through the nose, six to eight counts out through the mouth.

This is the most easily accessible vagal nerve-stimulating practice available. The extended exhale directly activates the parasympathetic nervous system, the rest, digest, and repair mode. And done for five minutes before meals or before bed or whenever anxiety is there, it reduces cortisol, it reduces inflammatory markers, and it shifts the nervous system state within [00:40:00] 90 seconds.

Not very long. Think of it as turning your nervous system's calming switch on. Next, that I wanna talk about is cold water exposure. Try ending your shower with 30 to 60 seconds of cold water. It sounds a bit terrible in winter, but it's really good. This activates the vagus nerve through a parasympathetic activation response that is deeply embedded in our neurology.

Now, it does sound unpleasant, I know that, but the neurological benefit is very real. And I love humming, singing, and chanting. The vagus nerve innervates the larynx, the voice box. So producing sound, like humming a tune in the car, singing along to a song, even gargling with water, that directly stimulates the vagus nerve through its laryngeal branches.

How cool is that? So sing, hum, gargle, all of the things. And create social connections. Have face-to-face time with people who make you feel safe, who make you laugh, who remind you of who you [00:41:00] are. There's something called the polyvagal theory, developed by neuroscientist Stephen Porges, established that the ventral vagal circuit, the branch of the vagus nerve associated with social engagement and safety, is the primary regulator of the nervous system's capacity for calm.

When we feel really safe in the presence of other people, vagal tone improves and mood stabilizes. In reverse, if we feel isolated, which so many women can retreat into isolation during busy times or because they do not have the energy to be social, it's one of the most costly things you can do for vagal tone and mood

Okay, now step five of what you can do to support inflammatory mood changes. You need to address the hormonal piece directly. I have a whole episode on this coming up next week, so listen in for that one too. For women in perimenopause or whose mood disruption follows a clear cyclical pattern, worsening the week before the period and improving after it arrives, the hormonal [00:42:00] driver needs direct attention alongside the inflammatory work.

I have a few supplements I can suggest here, but make sure you work with a qualified practitioner who knows your body and your case really well. Magnesium, again, because it belongs here as well. It specifically supports progesterone production and has well-established evidence for reducing PMS-related mood and anxiety symptoms.

Multiple clinical trials have demonstrated its benefit for the psychological symptoms of PMS. Also, vitamin B6 at doses of fifty to one hundred milligrams per day has robust evidence for PMS mood symptoms through its support of both progesterone production and serotonin synthesis. This is not a large dose relative to the therapeutic effect, and it's well-tolerated at this level for most women.

I do wanna flag this one carefully, though, because here in Australia, the TGA now requires a peripheral neuropathy warning on any supplement containing more than ten milligrams of B6. And reported cases of nerve symptoms have occurred at [00:43:00] doses well under fifty milligrams in some individuals.

So this is not something to self-prescribe at therapeutic doses. Please work with a qualified practitioner like myself or my team so that your B6 total intake across all supplements is monitored and appropriate for you specifically. Oh, and I love Vitex agnus-cactus, chaste tree berry. This is a herb with a long tradition and growing clinical evidence for supporting progesterone production and reducing perimenopausal and PMS mood symptoms.

It works by modulating the pituitary gland's hormonal output, specifically increasing LH, luteinizing hormone, which supports the corpus luteum's production of progesterone. Think of Vitex as a gentle regulator of the hormonal signaling cascade that underpins progesterone. It does need at least three months to show its full effect, and it is not appropriate for women on hormonal contraception or HRT without practitioner guidance.

It is one I will [00:44:00] only recommend during consultation, but it is a genuinely useful tool in the right context. So speak to a practitioner if this resonated with you

And for women in perimenopause where the foundational nutritional and lifestyle interventions have been thoroughly implemented, and if mood disruption remains significant, the HRT conversation is absolutely worth having with a menopause-informed practitioner.

Body identical progesterone, specifically micronized progesterone, directly supports GABA function in the brain. Its evidence for perimenopausal anxiety, sleep disruption, and emotional rawness is strong. It is not the right choice for every woman,

But for the women it is right for, the difference can be life-changing. Now, step six on how to support inflammatory mood changes. Move your body. Exercise is one of the most evidence-based mood interventions available. And I wanna tell you why, because understanding the mechanism makes the motivation different.

Something called BDNF, brain-derived neurotrophic factor, which we did discuss in the brain fog episode [00:45:00] as brain fertilizer, well, it supports the growth of new neurons and the formation of new synaptic connections. That's like little joins up between nerves. And it's one of the most important neurobiological factors in the prevention and treatment of depression.

Aerobic exercise is the most reliable BDNF stimulator available, producing increases with a single session of moderate-intensity movement. A two thousand and twenty-six updated Cochrane review, the most comprehensive assessment of exercise for depression to date, drawing on seventy-three randomized controlled trials and nearly five thousand adults, found that exercise produces a moderate reduction in depressive symptoms compared to no treatment, with effects appearing comparable to psychological therapy and similar to antidepressants.

Though that last comparison is based on fewer studies and the certainty of evidence is lower Exercise also directly reduces the pro-inflammatory cytokines that activate IDO and drive tryptophan diversion. There's that science again. Think of [00:46:00] consistent movement as systematically reducing the upstream inflammatory drivers of serotonin depletion over time and with an accumulative effect.

And exercise produces endorphins, the brain's natural pain-modulating and mood-lifting compounds, and endocannabinoids, the brain's natural anxiety-reducing compounds. The exercise high is real, and I think that's why I'm so addicted to exercise. It makes me feel so good, especially when I win my paddle games.

And to get these mood benefits, ... It doesn't necessarily require running or a gym or a certain level of fitness. Rather, it requires sustained moderate-intensity movement, anything that gets you breathing more deeply and feels slightly challenging, but it doesn't have to be max effort.

The most important thing is consistency, not intensity. A 30-minute walk every day produces more sustainable mood benefits than three intense exercise sessions a week with nothing in between. Movement that is enjoyable where possible, [00:47:00] social where you can make it, and outside in natural light. All of these amplify the mood and nervous system benefits beyond what you can get from indoor solitary exercise

And our last thing to help inflammatory mood changes, step seven, protect your sleep like it is medicine, because it is. Every mechanism driving mood disruption that we have covered today, IDO activation, cortisol dysregulation, gut-brain axis impairment, hormonal fluctuation, it's all worsened by inadequate sleep.

Sleep is not a luxury sitting at the bottom of your priority list. For mood, it is foundational, and it needs to be a priority. So I have three tricks that are relevant to support mood via sleep. I've talked about this before, but take magnesium glycinate before bed.

It supports GABA, reduces neural excitability, and improves sleep depth and quality rather than just duration. And protect the morning cortisol rhythm. Have natural light within the first 30 [00:48:00] minutes of waking, and definitely no screen time in the first 30 minutes. A well-calibrated morning cortisol peak produced by morning light exposure sets the circadian rhythm correctly, which directly improves sleep quality the following night.

And of course, you know me by now, no alcohol. And I know this is an uncomfortable one for many women, because the evening glass of wine is often used as relaxation or anxiety relief. And in the short term, it does briefly suppress the nervous system.

But alcohol suppresses REM sleep, the brain's overnight emotional processing mode. During REM sleep, the brain processes the emotional experiences of the day, integrating and contextualizing them in a way that reduces their emotional charge. When REM sleep is suppressed by alcohol, those experiences are not processed.

The emotional residue is carried into the next day, and the heightened reactivity, irritability, [00:49:00] and rawness that many women experience the morning after drinking and attribute to stress, to hormones, to being hungover, to just being the way they are, it is in part a consequence of emotionally unprocessed experiences from the previous day.

It is the alcohol, not you. And for women in perimenopause, directly addressing the hot flushes and night sweats that are fragmenting sleep is essential, because fragmented sleep in perimenopause drives inflammatory cascades that worsen every mechanism we have discussed today. The anti-inflammatory and the sometimes low histamine dietary approach I recommend in my three-week inflammation detox and my 12-week whole health solution is specifically designed to address this, because the dietary drivers of hot flushes are real, and we can change them.

There'll be more on that in next week's episode on hormones. So to bring it all together, your seven steps for addressing inflammatory mood changes. One, stabilize blood sugar every meal, every single one. Two, [00:50:00] heal the gut specifically for serotonin production. Three, build your neurotransmitters through nutrition and targeted supplementation.

Four, support the vagus nerve directly. Five, address the hormonal drivers. Six, move your body consistently. And seven, protect your sleep like it is the most important medicine you have, because for mood, it is

I want to finish with what recovery actually looks and feels like. When the biology shifts, when the inflammatory load comes down, when the gut begins to heal, and the blood sugar stabilizes, and the nutrients are in place, the nervous system is being directly supported. The mood shifts in ways that feel to many women almost miraculous.

But they're not miraculous, they're entirely predictable, and they're the direct consequence of biology changing. The anxiety quietens, not suddenly, rather usually over days and weeks, where the background hum reduces. The [00:51:00] waking at 3:00 in the morning with a racing mind becomes less frequent. The disproportionate tension in the chest that never quite resolves, or that sense of waiting for something bad to happen, well, all that eases.

Not because life has changed, but because the biological signal driving that anxiety has changed

The irritability softens. The fuse gets longer. No more short fuses. Women describe feeling, sometimes for the first time in years, like they can choose their response rather than just be reactive. That pause between stimulus and reaction, that space that was completely gone, well, that pause comes back, and the emotional rawness lifts.

Things still land, but you're not numbed, and they land proportionately, and they do not linger in the same way, and your filter comes back online. And the low mood, the flatness, the grayness, the loss of genuine pleasure, it starts to lift. Women describe color coming back into their experience, interest returning, motivation to [00:52:00] do stuff comes back.

The capacity for joy, not just going through the motions, is back too. Lisa, the patient I mentioned at the beginning, described it as a feeling of being herself again, not a better version of herself, but herself. The self that had been there all along, obscured by biology that she hadn't had addressed.

That is what is possible, and it is not reserved for women with extraordinary willpower or special circumstances. It's available to you through the same biology. So start with two things today. Stabilize your blood sugar at every meal, protein, fat, healthy fats, fiber, and nothing refined, and no solo carbohydrates on their own.

And take magnesium glycinate before bed tonight. These two interventions alone begin shifting the biochemistry environment of anxiety within days

Next week, we are moving on to the final episode in this series on inflammation, sign number eight, hormonal chaos. The sign that pulls everything together and shows [00:53:00] perhaps more clearly than any other why inflammation and hormonal health are not two separate conversations. They are one conversation, and when you understand how they interact, the whole picture comes into focus in a way that it never has before.

So please hit subscribe or follow the show on whatever platform you are listening on right now, because you do not want to miss a single episode. And if someone in your life needs to hear this, please share it with them too. Because the more women who have access to this kind of information, the better.

Just a little note, all of my free resources, my three-week inflammation detox, and my 12-week whole health solution program can be found at andrearobertson.health. Everything you need is right there waiting for you. If you have loved today's episode, please take 30 seconds to leave a review on Apple Podcasts, Spotify, or wherever you listen to your podcasts.

It genuinely helps more women find the show so they can nourish, heal, and rise too. Until next week, nourish your body, keep healing, and never stop rising. I'm Dr. Andrea Robertson, and this has been [00:54:00] Nourish, Heal, and