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Dr. Beverly R. Goode-Kanawati, Director

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Raleigh, NC 27612
Telephone: (919) 844-4552

Dr. Goode-Kanawati is board-certified in Family Practice and Emergency Medicine (ABPS)

Mind and Health: “Which Comes First,
Mood Changes or Physical Changes?”

By Beverly Goode-Kanawati, DO

What is the etiology of mood changes? Do they come about because of physiological stressors or emotional stressors? In my practice, it seems that the majority of the patients who experience significant changes in mood have dietary problems, nutritional deficiencies, allergies, chemical stressors, and life stress issues that underlie their mood swings.

Dr. Beverly Goode-Kanawati

One case involved an eight-year-old girl named “Susie” who suffered from migraine headaches, stomach upset, and temper tantrums. Her mother took Susie to her pediatrician, who in turn referred her to a neurologist. The neurologist prescribed Effexor, which did little for her headaches or mood.

When Susie and her mother came to see me, I took quite a different approach, urging a shift to a very low-sugar diet with an increase in vegetables, fresh fruits and targeted supplements. Soon she was tapered off the Effexor. Four weeks later, Susie and her mother were happy to report that her headaches had greatly diminished in frequency and severity, her stomachaches were gone, and she had had a month free of tantrums! This is a clear case of the effects of diet and nutrition on mood, pain, and behavior.

Common Physical Problems Related to Mood Disorders:

Hypoglycemia. Hypoglycemia is a problem involving blood sugar drops that does not occur in healthy people. These drops trigger adrenalin release that causes a lot of the same symptoms as anxiety. As a matter of fact, I have never over the course of my career in medicine seen a case of anxiety that did not also include hypoglycemia! This condition occurs after a person has eaten sugary substances several times per day or has skipped a lot of meals over a period of time. As with “Susie,” the answer is to avoid simple sugars, while eating a combo of protein and complex carbs several times a day.

Nutrition Deficiencies Vitamin D, Omega 3, Zinc, B12, folic acid and more! The scientific evidence relating nutritional deficiencies to depression and other mood disorders has been mounting. In our practice we measure levels of vitamin D, Omega 3 (and other important brain fats), and other factors that are related to B12 and folic acid and zinc deficiencies. It is amazing to see great improvements in mood, energy and cognitive functions when these and other nutrient deficiencies are replenished!

Thyroid Disease, as the case of “Rachel” illustrates. She had been diagnosed with hypothyroidism and depression prior to seeing me. Rachel shared: “My physician said I continued to be tired because I was depressed. I told him I was depressed because I continued to be tired. My complaints fell on deaf ears.”

I found Rachel to have low levels of both the thyroid hormones T3 and T4, so I changed her to a thyroid medication containing both. As always in our practice, we paired medication changes with other lifestyle modifications, while ensuring adequate sleep, exercise, and nutrition.
Soon after she stabilized on the new thyroid medication, Rachel was able to discontinue her anti-depressant, saying, “I felt like a new woman almost immediately.  It no longer took everything I had to get up in the morning. I even began to smile more!”

Other Hormone Deficiencies and Imbalances, as the case below illustrates. “Carol” came into the office complaining of depression, irritability, and some anxiety. She had been taking Prozac for six months, which helped these symptoms but ruined her sex drive. Carol reported she was under a lot of stress, ate a high sugar diet, and had chronic sinus stuffiness. About a year ago, she had seemed to breeze through menopause, without hot flashes, vaginal dryness, or anything else she associated with “the change.”

I explained to Carol that post-menopause, she now made smaller amounts of both estrogen and progesterone—and her progesterone was getting “used up” by the adrenal glands to make cortisol in response to the sugar, stress, and allergies. She transitioned to a healthier diet and began taking bio-identical progesterone. Carol returned six weeks later stating that she felt great, had taken herself off the Prozac and was free of depression, irritability, and anxiety. Different hormonal imbalances can produce quite different symptoms, so the key is to test and to adjust as necessary.

Neurotransmitter imbalances. Imbalances in dopamine and other neurotransmitters can present themselves with symptoms like addictive behavior and low motivation or with other imbalances, such as anxiety, depression, or even sleep disturbance. Sometimes amino acid therapy is all this is needed, where we replenish the specific amino acids that support healthier neurotransmitter creation and balance. This can allow individuals to avoid, use lower doses, or no longer need anti-depressant or other prescription drug therapy for these types of conditions. 

It is important to realize that what we eat (and how we digest it!), the stress in our lives, allergies, nutrient deficiencies and exposure to chemicals all affect both our physical health and our mental health. We need to take care in all of these areas to lead happy, healthy lives.