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Flying with Broken Wings: Brightening Up Your Thyroid’s SAD Day
(Written by Sarah Downing, Editor, “Flying with Broken Wings”, Dear Thyroid)
In my mid-twenties, or perhaps even before then, I began to feel the urge to hibernate every winter. It seemed that I was never a morning person during the rest of the year, but in winter it got particularly bad. I was very sensitive to the change in seasons and I attributed my extra tiredness in winter to SAD or Seasonal Affective Disorder. Last year, I found out that I had Hashimoto’s (autoimmune underactive thyroid) which certainly explains the years of relentless exhaustion. What I found particularly interesting when I was first reading up on the symptoms is that hypothyroid patients are actually more prone to SAD. So what is this miserable disorder and how should we deal with it?
(S)easonal (A)ffective (D)isorder describes a phenomenon where certain susceptible individuals suffer from a complex of symptoms as the winter heralds its arrival. It typically begins in September and eases up around the end of March or the beginning of April. Symptoms include increased tiredness, insomnia and oversleeping, depression or worsening of an existing depression and carbohydrate cravings. As our body temperatures drop, our energy requirements rise by as much as 40 percent, which is why many people eat more in winter and tend to put on weight. Because it is darker in winter, our levels of the sleep-inducing hormone melatonin rise and studies show that this induces carbohydrate cravings as an instant fix to the resulting drop in body temperature and our loss of energy.
One reason hypothyroid sufferers are more prone to SAD is because the thyroid has to work extra hard when the temperatures drop and there is a reduced level of circulating thyroid hormones. As a result, it makes sense to ask your doctor to check your thyroid hormone levels at the onset of the chilly season to ensure that your thyroid is producing sufficient hormones. Some doctors even routinely prescribe extra thyroid hormone to counteract this effect. One study suggested that extreme cold (in this case in Antarctica) caused the muscles to store thyroid hormone in an effort to maintain body temperature. This meant the brain was not getting enough and so it was postulated that such SAD sufferers (including those in warmer climates) be given supplementary thyroid hormone to boost their thinking and concentration and to ease depression.
To make matters worse, those with hypothyroidism are more sensitive to the cold anyway because we tend to have a lower body temperature. There are several ways to tackle this and thyroid patients have suggested their own personal strategies here: How do you Survive and Thrive During the Winter.
People with certain thyroid disease-related conditions seem to be more prone to SAD. Such conditions include Chronic Fatigue Syndrome, fibromyalgia, candida, irritable bowel and leaky gut. Imbalances in the gut (gut dysbiosis) can trigger SAD by interfering with serotonin function. Serotonin (the “happy hormone”) is produced from the amino acid tryptophan which we get from protein foods. However, when an imbalance is present, unfriendly microorganisms such as bacteria and yeast selfishly “grab” the tryptophan for themselves before we have chance to absorb it through our intestines, causing serotonin deficiency and resulting in various forms of depression such as SAD.
You may be curious as to the exact causes of SAD. Allow me to explain here that SAD sufferers have disrupted circadian rhythms – in other words, their body clock needs a trip to the watch maker. Sunlight synchronises this body clock but the bodies of SAD sufferers may produce hormones such as cortisol and neurotransmitters that keep them awake into the wee small hours of the morning, whilst their body produces sleep-inducing chemicals such as melatonin until midday, causing them to struggle to get up in the mornings.
The reason for this is clear. When the light fades in the evening, the pineal gland begins producing melatonin, a messenger hormone that travels through the blood, lowers our body temperature and tells our body to go to sleep. In those who don’t suffer from SAD, melatonin production peaks in the middle of the night during deep sleep. At dawn, sunlight shines in our eyes and the suprachiasmatic nucleus (SCN), a small cluster of brain cells, tells the pineal gland to increase its temperature, deactivate melatonin production and wake up (pretty much like the body’s own solar power system). An interesting study suggested that lighter eye colours such as blues and greens are less susceptive to SAD because they let in more light. Melatonin can have a major effect on other hormones. Normally, hormone production from the thyroid and adrenals (cortisol and adrenaline) winds down during the peak of our melatonin production, in the middle of the night. However, for SAD sufferers this process is reversed during the winter months and melatonin levels are higher during the day, which leads to sleepiness and a reduction in these hormones that are so vital for our energy levels and metabolism. Research suggests that taking melatonin supplements between 9 and 10 in the evening may restore normal circadian rhythms and enable SAD sufferers to sleep better at night and be more awake during the day. These are available over the counter in the US.
I mentioned the “happy hormone” serotonin above. Healthy serotonin levels and functioning serotonin stimulation of the brain cell receptors are vital to maintain a good mood and ward off depression. Studies show that serotonin levels are at their lowest in winter and that SAD patients suffer from a serotonin deficiency during the day and a malfunctioning of the serotonin transmission in the brain. Serotonin is converted into melatonin and during the day healthy individuals experience low melatonin production and high serotonin production, thus giving us our get-up-and-go. However, it’s the opposite for SAD sufferers who experience high melatonin and low serotonin during the day, which leads to negative emotions and a lack of energy. Because of the serotonin connection, some people recommend taking 900 mg of St John’s wort one month prior to the onset of SAD symptoms. However, it is important to note that this herb (which is actually the most popular antidepressant prescribed in Germany for mild to moderate depression) is renowned for its side effects and interactions with other drugs, so it is best to check online or with your doctor or pharmacist.
Vitamin D also plays a vital role in a healthy body clock. SAD is caused by insufficient exposure to UV rays which are produced when sunlight hits our skin. SAD sufferers often suffer from Vitamin D deficiency and may benefit from Vitamin D supplements. In my experience, this seems to be a very common deficiency in thyroid patients anyway. Some people treat this by going to a tanning salon, which is known to induce good moods in SAD patients.
Other doctors such as the renowned Chronic Fatigue Syndrome specialist Dr. Teitelbaum are proponents of bright light therapy. Dr. Teitelbaum recommends using a 10,000 lux lightbox for 30 to 45 minutes every morning in winter (although some doctors recommend use of up to three hours daily). 10,000 lux is five- to twenty-times the intensity of normal lighting in your home or office. This simulates the frequency of sunlight and can thus alleviate SAD symptoms. Take care not to stare directly into the light due to potential eye damage, but make sure that it is close enough to supply you with the ideal dosage. Some SAD patients find it helpful to set their lamp’s automatic timer two hours before waking to create a natural sunrise effect. If you are wondering where to find such lights, the following two sites might be a good starting point: Lumie and Sunbox.
Of course, there are also other tips to prevent or reduce SAD. Eat a low-fat, healthy diet with sufficient proteins and eliminate sugar and carbs wherever possible. Sadly, we members of the “Jacked Thyroid Club” are frequently more sensitive to processed sugar, candida overgrowth, abnormal blood sugar levels and food allergies. Eliminating caffeine is also said to help, although I suspect that many SAD sufferers actually use caffeine to boost their energy levels during winter, so this may be a tough one. Certain vitamins and supplements such as magnesium, B complex, ferritin and those mentioned above (Vitamin D, melatonin and St. John’s wort) may prove effective. Upping your daily exercise and wherever possible taking walks outside is known to be beneficial. Doctors recommend 20 to 30 minutes of outdoor light exposure a day. If you don’t have the energy to go for a walk, run errands in your car with the window down. Don’t forget that sunglasses decrease the benefit of sunlight. If you suffer from SAD, leave your lights on at home and don’t spike the electricity bill by constantly turning them on and off. And last but not least, make sure you get enough sleep. With a healthy thyroid, you need around seven to eight hours, but when your thyroid is being rebellious, you may well need even more, particularly in winter.
Sources
- Search for SAD/Seasonal Affective Disorder
- Don’t Let Low Thyroid Make You SAD
- Weary Winter and My Experience with My Thyroid and SAD
- Seasonal Affective Disorder
- SAD: About Light, Depression and Melatonin
- SAD — Real and Treatable
- Sleeping Too Much? You could be SAD
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14 Responses to “Flying with Broken Wings: Brightening Up Your Thyroid’s SAD Day”
Leave a Reply to Bonnie
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Hi Sarah!
Thank your for this article.I never even thought of SAD before,but it sounds like it might be part of my problem.
Getting up in the morning is almost impossible and I can only make it through the day with a whole lot of coffee.
I also feel depressed and I can, ´t sleep at night.
The light therapy sounds pretty good.Maybe I, ´ll try that out.
Right now I, ´m ready to try everything that might help.
What are you doing to ease those SAD issues?
So…I am wondering and wondering how having OSA-Obstructive Sleep Apnea could be related to SAD. If sleep is interrupted several times nightly..for me 38 times in just an hour, then it only stands to reason that my serotonin and melatonin levels would be affected. No wonder I am exhausted and I have depression that for me right now feels untreatable. I cannot take medications, the SSRI’s that would help. I do take, with doctor’s OK, 8000 IU’s of Vitamin D3 daily, along with other vitamins that make sure the D3 gets absorbed correctly. I felt better after two weeks of starting this. That and following a controlled carb diet that is gluten free are helping me to feel better. I am hoping that the CPAP that I’m dreading, will help me sleep better and once I master that, will help me feel better all around. Breathing and sleeping. Two simple things we take for granted every day..how important they are! Thanks for sharing all this info. It certainly gives me stuff think about, and questions to ask at my next doctor’s appointment.
Thanks Sarah, for the explanation for the condition SAD. You always explain everything in such a way for us all to be to understand and relate to.
I do tend to suffer from SAD during the winter. I find as the nights start drawing in from September onwards, my energy levels start to slow down. When it starts to get dark my body feels its bed time, so in the summer its not so bad as it doesn’t bet dark till after 9ish but in the winter with lack of daylight, my body feels like going to bed at 5pm and it takes me all my time to keep myself awake and active on a winters night! I get moody and frustrated as well. Seem to function much better in the summer than in the winter. I have been on anti depressants on the past, but weaned myself off them. They say St. Johns Wart the natural anti depressant is supposed to be good, but can’t take them as they interact with my other meds. They say the bright SAD lights are supposed to help but are expensive. I would like to be able to buy one, one day, but until then I cannot comment on whether they are beneficial or not. I do find its harder to get going in the morning too in the winter due to lack of daylight and colder weather.
I do think SAD is linked to my Thyroid problems as the older I get, the worse I feel in the winter months. I always begin to feel a bit more energetic as Spring and the longer days kick in.
I guess the only way to try and overcome SAD in the winter is to eat healthily, try and get out on the good bright days in the winter, and take extra vitamins and minerals to help alleviate the condition in the winter.
Its not easy living with Thyroid disease on a day to day level. I hope now we have put our clocks forward 1 hour for the summer its now a good time to eat more healthily now that all the summer fruit, salads and veg are coming into season, get out as much as we can to get our natural vitamin D, and take all the medications, relevant vitamins and minerals to keep our bodies as healthy as we can, to try and keep our Thyroid symptoms at bay.
In addition…
For those reading this in the southern hemisphere, going into Winter, I hope that Sarah’s article will be beneficial to you through your winter months and you don’t suffer too much from SAD.
Hi Christina, thanks for your comments. If you already have thyroid disease, then you are more prone to SAD and may need extra thyroid hormone in winter. A good doctor should know that, but sadly I suspect that not many of them don’t. Right now, I’m having problems getting out of bed because of other issues (imbalanced blood sugars and the tons of meds I am on), but hopefully this will just be a temporary issue. It seems like it should. I don’t get depressed so much in winter as tired. I have considered buying myself a light, but wanted to get my thyroid and other issues sorted before I do that, although I have heard good things about light therapy. My doctor upped my dosage of thyroid hormone because he said I might need more in winter. When my other issues are sorted and my thyroid hormones can be more absorbed, I think my thyroid hormone dosage will probably go down. The numbers are very balanced, but I’m not feeling the effects as I should because my sex hormones/blood sugars are still out of whack.
Kathy, you make a very interesting point. My fiancé also has sleep apnea and is getting an op to hopefully fix it tomorrow. He had one previously, but it didn’t work because it supposedly wasn’t radical enough. The new outpatient surgeon will cut away more tissue and also shorten C’s uvula, so hopefully this will sort it. We didn’t want him to go through the stress of an op for nothing, so we figured we might as well sort it out once and for all.
I’ve also heard good stuff about the CPAP from my sister-in-law. Apparently, many sleep apnea sufferers lose weight once they start sleeping properly. The low-carb diet makes sense – as many of us thyroid sufferers are prone to high blood sugars/insulin resistance, eating too many carbs could very well induce a carb crash, as the carbs are converted to simple sugars.
What I forgot to mention in answer to Christina’s post: I actually take melatonin sleeping pills to get better sleep while my body heals. I’ve only been in treatment since December, so they still have quite a bit to sort out. As for Vitamin D, I take it too after I specifically requested my doctor to test my levels and, lo and behold, I had a deficiency. So glad I asked him.
The weather is slowly getting better here, although some places have cold weather, but more light. This isn’t one of them. It gets very dark in Germany in winter. One thing I like to do is use our sauna – we have one in our bathroom, which is more common in Europe – I hear that the best ones to use are the infrared sauna. Whilst ours isn’t one of those (I believe they are more expensive), the warmth and the heat help to ease my aching limbs that are penetrated by the cold and generally cheer me up. It’s nice to go in a toasty sauna after you’ve been out in the cold and dark.
Let us know how your doctor’s appointment goes. I’d also be very interesting to hear how your CPAP machine works for you. I’m really hoping that Corey’s op finally works. That is another reason why I have to take sleeping pills to get to sleep – he snores quite loadly, but the sleeping pills knock me out after a while. I hope that some day my body will be more balanced, so that I can get off the pills and sleep well naturally.
Hey Miriam. Good point about the southern hemisphere. Thanks for your comments. I try my best to explain things in simple terms, but that isn’t always easy when the subject matter is so complex. I have certainly learned quite a bit myself since writing my column.
Thank you so much for sharing your experiences and tips with SAD.
Sarah, this was a great article. I have used EPA/DHA very effectively for several years now.
I know people use St. John’s Wart with good results. It’s over the counter here in the USA, so whenever I see St. John’s Wart mentioned, I like to put a warning with it because I have seen it cause serious mania in people. Because it is the equivalent to an SSRI antidepressant it has the same potential side effects, so anyone with agitation/anxiety symptoms should take extra caution.
Hey Lori, thank you so much for your comments. For anyone wanting to know more about the fatty acid supplement EPA/DHA (I didn’t recognise the abbreviation, so did a quick google): http://bit.ly/94Casl.
Thank you for your comment on St John’s wort. I knew about the potential side effects such as photosensitivity/interaction with other meds, but I didn’t know so much about the mania. What you mentioned is a very important point.
Lori, I added your information about St. John’s wort to the article (but gave you credit) because I feel that it is important to mention as many thyroid disease sufferers experience agitation/anxiety.
great article.. i did not know anything abotu this. I think i have suffered with this as well.
wonderful job once again!
Thank you, Cynthia. I don’t think that that many people do know about SAD and what causes it, which is why I decided to write this article. I was particularly intrigued by the thyroid connection.
I swear by Vit D3. My doc told me to take it to try to help prevent my cancer from coming back. Then, during my thyroid journey I found out I had a deficiency and upped my intake to 4000 IU. I believe just 15 minutes in the sun will produce 10,000 IU by your body naturally. If I run out of it and forget to get more, my brain fog starts coming back as well as my inability to get out of bed.
That, with a super B complex and glucosamine/chondriatin… swear by them. Otherwise, I am a bump on the log.
Thanks for your tips, Bonnie. Both the Ds and the Bs (particularly B12) are important for energy. Apparently my D levels are fine – I got my doctor to test them – but I do take a D3/Calcium supplement too, as like many thyroid sufferers I have a Vitamin D deficiency. I can’t wait till summer and till I get a bit more energy.