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Hey everyone, it's Mikki here. You're listening to Mini Mikkipedia. And today I wanna chat about the perfect storm that is perimenopause and its impact on mood and wellbeing. The same hormones that control your menstrual cycle can influence serotonin, which is a brain chemical that promotes feelings of wellbeing and happiness. And so when our hormone levels drop, serotonin levels can also fall. This contributes to increased irritability, anxiety, and sadness.

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And here's what makes perimenopause though uniquely challenging compared to other hormonal transitions. It isn't just about low hormones, it's about the chaos of fluctuating hormones. Unlike PMS, these symptoms may come at times unrelated to your menstrual cycle and symptoms may occur for years with no pattern. This type of mood change is known as perimenopausal mood instability and does make it tricky if you're in the thick of it experiencing it.

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and you can't see any real connection between your cycle and the changes in mood. So think of estrogen as your brain's best friend for the last 30 to 40 years. During the reproductive years, the female brain has adapted to a higher supply of estrogen. Then during perimenopause, these levels fluctuate and eventually decline to a much lower level. Perimenopause is a time of significant brain reorganization and estrogen is important

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important for brain structure, cognition and mood. And the female brain contains abundant estrogen receptors. And when that steady supply becomes erratic, your brain essentially goes through a withdrawal and that withdrawal shows up or can show up as anxiety, depression, rage, and that feeling of crying at the drop of a hat. And then you've got that serotonin connection. Falling estrogen and progesterone levels can trigger mood swings that make you less able

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cope with things you'd normally let roll off your back. So you just feel less emotionally resilient. Estrogen isn't just a reproductive hormone, it's a neuromodulator that affects how your brain processes stress, makes decisions and regulates emotions. When it fluctuates wildly during perimenopause, it's like having the emotional equivalent of a wonky thermostat. And the research was pretty clear that mood changes are uh common during the transition known as perimenopause, with as many as four in 10

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women experiencing irritability, low energy, sadness, or difficulty concentrating. And most studies agree that the risk of depression increases during that menopause transition. One in three women will experience psychological changes, including anxiety and depression, through perimenopause, and the beginning of postmenopause until things settle down. The risk of depression is at its highest before and after menopause, declining two to four years

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after the last menstrual period. And there is a bit of a domino effect, so it's not just the hormones acting in isolation. A person's feelings about aging, fertility, their place in society, and other environmental social factors can also play a role. And your 40s and 50s are a time when life's pressures can be at its greatest. So many of us at this age are managing demanding jobs at the peak of our careers, raising children, being an Uber driver for all of the things that they've got going on.

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sending older children off to college or university, which is again a shift in that sort of household structure. And I know there's feelings of real sadness with parents who are experiencing this and joy for other parents. anyway, you're also potentially caring for aging parents trying to have fulfilling relationships. There is a lot going on. Then you add sleep disruption. It is common to experience bouts of insomnia during perimenopause.

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partly because of those nighttime hot flashes, but also partly due to that decline in progesterone, which changes that calming impact that progesterone has on the brain. And of course, we know that poor sleep will amplify every emotional challenge. There's something else as well, is that during perimenopause and menopause, as estrogen levels fluctuate and decline, the makeup of our gut flora also changes.

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things get too out of balance and harmful bacteria to take over, we can get this gut dysbiosis. And our gut flora also make more than 90 % of our serotonin, which is an important neurotransmitter, as I've mentioned, that helps regulate our digestion and our mood. So when your gut microbiome shifts due to hormonal changes, it can directly impact your emotional wellbeing in addition to the inflammation that can occur through this gut dysbiosis piece.

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And depression and brain changes do have this inflammatory component too. Inflammation can increase during perimenopause and it's like your body is in this low-grade inflammatory state, which makes you more reactive to stress and less resilient emotionally. So understanding these mechanisms is absolutely crucial because it tells us that perimenopausal mood changes aren't all in your head and they're the result of real, measurable changes in the brain, gut, and our

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hormone levels and also inflammatory markers. And definitely there's research looking at nutritional interventions as promising tools for the management of mood and anxiety symptoms in women during that perimenopausal transition and in post-menopausal years. When we understand the multiple pathways involved, we can address them systemically through targeted nutrition rather than just waiting it out or only relying on pharmaceutical interventions, which can absolutely be helpful, but you

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do need that foundation of good nutrition behind them to make them even better. Once we reach menopause, it can be a bit of a relief for a lot of women. And my friend Lara talks about this. Once hormones settle down, mood fluctuations can end. In the meantime, we do have some evidence-based nutrition tools that can support your brain through the transition, working with your body's own biochemistry and restoring balance and resilience. So this is why nutrition matters just so much during

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It matters all the time, but particularly now. We're not just treating symptoms, we're supporting the fundamental biochemical processes that allow your brain to adapt to this major hormonal shift with grace rather than chaos. Alrighty then, so let's get into some research backed strategies that you can use to help support your brain chemistry at a time like this. One of the first ones is of course Omega-3 fatty acids, EPA and DHA.

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EPA enriched interventions at proportions of about 60 % of total EPA plus DHA and EPA doses between one and two grams a day show statistically significant reduction in depression severity. So when you buy an Omega 3 fish oil or algae, not flax, not walnut, not chia, but the fish or algae, you want to ideally be looking at EPA

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more, slightly more EPA than DHA. And you want to look for that. What we know is that fluctuating and intermittently lowered levels of estrogen may contribute to the increased prevalence of depression and perimenopause. And treatment in studies have found that the most effective preparations appear to have at least 60 % of that EPA relative to DHA. And whilst there is no randomized controlled trial to date specifically focused on perimenopause, there

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Is that suggestion that this could be helpful? So for example, in my one of my favorite products, the Pillar Ultimate Omega, I love it, having it now, it has 540 milligrams of EPA and it has 360 milligrams of DHA. So that's in one capsule. having two capsules, which is what I have can be super helpful for helping reduce that risk of depression. So this is definitely one that has a lot of evidence.

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its use. Now vitamin D is the next one. Active vitamin D exerts protective and regulatory effects on the brain dopamine system and could potentially be similar to an antidepressant. Therefore our serum 25 OHD level, which is what we measure in the blood, may be negatively correlated with perimenopausal depression. We know that vitamin D supplementation can improve mood status and anti-inflammatory biomarkers in females with anxiety. These were in females with

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type 2 diabetes, but they also had a vitamin D deficiency. this is very common, particularly in New Zealand in winter, but not just New Zealand. I was also speaking to a lady who lives in North America right now, it's sunny, but her vitamin D level is below what is optimal. Studies suggest that taking doses over that 2000 international units or 50 micrograms are most effective for tackling vitamin D deficiency in menopausal women.

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And we know that reduced levels of estrogen make your skin and kidneys less efficient at producing certain forms of vitamin D. So your gut might not absorb it that well either. So get your vitamin D tested and then figure out the amount that you might need to lift your vitamin D level to that sufficient or optimal range. That might be 60 to 80 nanograms per deciliter in North America or 100 to 120 nanomoles per liter in New Zealand and Australia.

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There's a lot of support for the magnesium. There are meta-analyses showing a significant reduction in depression scores following magnesium supplementation and consumption of even 250 milligrams of elemental magnesium helped improve depression scores by a statistically and clinically significant mean of six points and anxiety by over four points. If you're looking at different scales for measuring anxiety and depression. And we know that

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Estrogen helps your body process magnesium and during perimenopause and menopause, as estrogen levels fall, so does magnesium. my friend Lara recommends 350 milligrams actually, potentially have magnesium glycinate, which I'll talk about soon, but that has this calming effect on the brain. And there is also an inverse relationship between B6 and the risk of depression in middle-aged and elderly women with moderate and severe depressive symptoms and anxiety.

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We know that B6 is especially valuable for mood regulation and it plays a key role in producing serotonin, dopamine and other chemical messengers known as neurotransmitters. We do also know that both low folate and low vitamin B12 status have been found in studies of depressive patients. And there is also an association between depression and low levels of these vitamins in general population studies. And low levels of folate are furthermore linked to a poor response to antidepressants.

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So that is something to be mindful of as well. And in fact, when someone is on an antidepressant, it is recommended that they also take a B complex vitamin to help that antidepressant do its job. research also shows that you get this improved response. The zinc is another one. Recent meta-analyses have demonstrated that lower serum zinc levels is linked to depression in case study or cohort studies. And there may well be evidence for

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using zinc as a treatment for depressive symptoms as well, both as an adjunct to traditional antidepressant therapy and potentially as a therapy in its own right in premenopausal women with zinc deficiency. then iron is a big one. Iron supplementation appears to improve memory and intellectual ability in participants aged between 12 and 55 years. In studies, regardless of whether the participant was initially iron insufficient or iron deficient with

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So even low ferritin with adequate iron hemoglobin stores can be linked to mood. And I see this a lot in clients. And then lastly, of course, I mentioned the gut brain connection and we know that probiotics can be used to modulate the gut dysbiosis. And there is actually plenty of research to show that taking probiotics can help improve depression anxiety scores. And it really

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boggles me actually why some people just absolutely dismiss the use of probiotics, but there's a lot of research to support this. And if you don't already, I would follow Dr. Michael Ruscio on everything probiotics and the gut. So we want one to two grams of omega threes a day with 60 % of EPA, like the one that I love, Pillar Performance. There's also Nordic Naturals. They do a great algae supplement. Carlson's is another one that's often recommended. 2000 to 4000 IU daily in vitamin D3.

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I've always recommended to take vitamin D3 with K2, though recently my friend Dr. Tony Bataji told me that might not be necessary, so that's something I'm exploring actually. Magnesium, as I mentioned, 350 to 400 milligrams daily in glycinate form, and also a B complex that does have that B6 added. Ideally, you'd have no more than about 25 milligrams of B6. And you'd also want to be testing your vitamin D,

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testing B12 and folate, zinc and iron studies, particularly if fatigue is also present with that sort of low mood. And from a diet perspective, obviously anything that is sort of protein forward, it has an abundance of vegetables. Mediterranean is always recommended and that's a little bit of a vague term. So I don't necessarily think that's the essential part of it, but definitely having really good healthy fats in your diet is great too. And just low on that ref...

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find stuff. Having fermented foods for gut health, adding in a teaspoon or a tablespoon of sauerkraut, more apple cider vinegar, water kefir, and also of course dietary omega-3s from salmon and mackerel and sardines would be super important as well. So these are things which all have like quite good research behind them. Some things which are also recommended which have less clinical research but are often recommended by some super smart naturopaths would be taurine. So

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Taurine is known as the calming amino acid. Taurine potentially suppresses age-associated weight gain. This is a preclinical trial in female mice who are in menopausal state. It can increase energy expenditure, increase bone mass, improve muscle endurance and strength. There's a bit of interest in taurine in that regard, but also can potentially reduce depressive-like and anxious behaviors. So taurine works in the brain.

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by interacting with GABA receptors. And this helps to promote beneficial GABAnergic tone or overall GABA activity. And GABA is our calming neurotransmitter. So this can lead to improved sleep quality, prevention of migraines and relief from premenstrual and perimenopausal mood symptoms. Torian is usually taken in doses of about 500 milligrams, one to three times a day. And it can cause slight drowsiness. So bedtime can be a really good time to take it.

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And then of course you've got glycine. Glycine we often hear about the context of collagen. So it is an amino acid which can deliver a slow down signal to the brain. It is classically considered to be an inhibitory transmitter alongside GABA and glutamate is the primary excitatory transmitter. And so glycine can counteract the effects of excitatory neurotransmitters and prevent the overactivity of neurons which can lead to that overstressed mind and body.

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recommended for sleep actually. magnesium glycinate, as I mentioned, is magnesium bound with glycine. And so this potentially can enhance its effectiveness. And there are brands such as Ethical Nutrients has a magnesium glycinate. Pella also has magnesium glycinate as part of its sort of three factor magnesium product. I again really love it, particularly the pineapple version. And I believe clinicians also have a good magnesium glycinate.

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is widely used as well. And there is actually some research looking at self-rating scales, taking L-theanine and improved sleep scores, self-rated depression scales, and state anxiety, inventory trait scores. in a review of five controlled studies involving 104 participants, four trials showed the use of L-theanine effectively reduced stress and anxiety.

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So that's super interesting as well. And that's not just women, but men as also. And in one particular placebo controlled double blinded crossover study determined that the effects of taking 200 milligrams of L-theanine for weeks resulted in improved depression, anxiety and sleep scores. So that's super interesting too. And that 200 milligrams is often recommended and you see that supplements from the likes of Now Foods,

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Jaro, Thorne have it in those 200 milligram doses. Inositol is also used. Often it's used in that sort PCOS environment, but it's worth noting that the level of inositol in the brain is higher than in any other tissue. And all that brain inositol is super important.

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for the healthy functioning of neurotransmitters such as dopamine, acetylcholine, gabat, and serotonin. And this is why inocytol supplements have been clinically trialed for anxiety, depression, premenstrual mood symptoms, and insomnia. And when looking, when studied in the context of PCOS, researchers have found that 12 weeks of supplements have had a favorable effect on parameters of mental health as well. And

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There's also research showing that myoinositol has an integral role in the activation of serotonin receptors, so supports the use for mood balance in the premenstrual phase of the menstrual cycle and also potentially uses in depression and interestingly panic disorder. mean, look, research is limited here, but taking an inositol supplement could definitely help and it is a recommended supplement with regards to sleep as well. So taurine 500 to 1500 milligrams daily, lysine,

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about one to three grams daily, often combined with magnesium as magnesium glycinate, L-thionine 200 to 400 milligrams daily, and nosotol two to four grams daily. And then when you're looking for synergistic combinations, obviously I talked about magnesium glycinate, taurine and magnesium both work on the GABA pathways as well. Ethical nutrients do a magnesium supplement that has taurine, that is a magnesium glycinate and also has B6 in it.

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And then L-theanine and B6 is good support for neurotransmitter production. And then of course the timing. So if you're struggling with sleep and having taurine and glycine with magnesium before bed would be really important. L-theanine can be taken in the morning or evening. And inositol can be taken in the evening, but is often used as divided doses with meals, albeit this is in the context of PCOS and insulin resistance. So all of these supplemental recommendations

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Generally speaking, they're not necessarily for you. So I know that you probably know that this is just information and worth exploring with a health practitioner, but they can be useful. But of course you've got to get your diet fundamentals right first. So this is like a little toolkit that will address multiple pathways during perimenopause in the brain. And it is based on evidence and they do work at different levels of the nervous system to support mood stability during that transition.

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So hopefully if you're someone that has struggled with your mood, getting those tests done on those particular nutrients that you can is important. Then also supplementing judiciously with diet as the foundation is the other key aspect to that. And make sure you get your sleep, get your sleep more important than anything. All right, team, you have a great week. Catch me on Instagram, threads and x @mikkiwilliden, Facebook @mikkiwillidenNutrition.

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or head to my website, mikkiwilliden.com and sign up to my recipe portal. Comes in your recipes in there. They are all awesome and you'd love them. High protein, low to moderate carbohydrate, low to moderate fat, super tasty and delicious.