Hormone Levels and Mental Health

By: Dr. Thomas M. Basch


                     Hormone Levels and Mental Health: What’s Missing?

Depression and anxiety levels have risen dramatically in North America over the past fifty years. Some of the increase is likely the result of a simple heightened awareness among both doctors and the public at large. Some is likely the result of a much-needed reduction in the stigma previously associated with mental illnesses, be they acute and situational or be they congenital. Most of us no longer default to “he’s nuts” or “her family is a bunch of crazies”. No doubt, the discovery of neurochemical imbalances and deficiencies, as well as the medications to help correct them, has helped the process, and this brings us to the psychiatric impact of low hormone levels. 

When hormone changes strike quickly and dramatically, as they can during and after pregnancy, the cause/effect relationship is hard to deny, but what about the far more subtle presentation of age-related hypogonadism, ie., low testosterone, and in the case of women, low testosterone as well as low estrogen/progesterone? I can tell you from my clinical experience over the past 30 years that before I new about bioidentical hormones and the hormone deficits they can treat, I missed many opportunities to most effectively treat patients suffering from depression. I just did not think that low testosterone could possibly be the primary cause of a major depression. I was wrong. 

Thankfully, I learned, and now I can do much better work for my patients. Take a look at “signs and symptoms of depression” online. Then take a look at “signs and symptoms of low testosterone” online. They look almost identical, don’t they? When my otherwise healthy Revive patients present with sadness, irritability, anxiety, memory problems, sleep problems, low sex drive, and trouble concentrating, I can be pretty confident that either depression or low T, or perhaps both, are major problems. We then draw the appropriate basic lab work needed to establish whether or not low testosterone levels are present. It would be awesome if we could measure levels of the neurochemicals, like serotonin and dopamine, at the same time because that would help us understand if deficiencies in these chemicals are also part of the problem, but that technology is not yet available. I am optimistic though that within the next ten years, this technology will be here. 

If my patient and I look over the hormone level results and determine that low T could be playing a role, the next step may well be to take the plunge into bioidentical hormone replacement therapy (BHRT). While the full benefits of BHRT typically take a year to manifest, the mood improvement comes much more quickly for most patients. Most patients will know inside of 3 months of BHRT if they are likely to benefit in terms of depression. Thankfully, the majority do. The turnarounds can be simply remarkable, and as a physician, I find this so rewarding. 

* All information subject to change. Images may contain models. Individual results are not guaranteed and may vary.