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March 2, 2016

How Can I Raise My Serotonin Level?

Harsh realityFeeling down? Or, anxious? Are your compulsive tendencies getting the best of you? Perhaps you have a serotonin deficiency. Serotonin is the main neurotransmitter that regulates our moods and is called the happy hormone. And, who doesn’t want to be happy? One way to raise serotonin is through antidepressant medications known as SSRIs (selective serotonin reuptake inhibitors). But, you do not need to rely on medications to raise your serotonin level.

SSRIs are the most common class of drugs used to treat depression and other mental health disorders like obsessive-compulsive disorder (OCD), panic disorder, various phobias, and anxiety disorders. A recent study published in The Clinical  Journal of Psychiatry concluded that 69% of the patients taking SSRIs DO NOT suffer from major depressive (MDD) disorder and 38% never met the criteria for any of the conditions that SSRIs are approved to treat – MDD, OCD, panic disorders, phobias, and anxiety disorders.

In short, SSRIs are over-prescribed. And, they do have side effects like weight gain, loss of libido and sexual performance, can cause sleep disturbances, and much more.

Major depressive disorder is characterized by the presence of at least five of the following symptoms. There has to be symptoms for at least two weeks.

  • Fatigue or loss of energy almost every day
  • Feelings of worthlessness or guilt almost every day
  • Impaired concentration, indecisiveness
  • Sleep disturbance: either insomnia or hypersomnia (excessive sleeping) almost every day
  • Markedly diminished interest or pleasure in almost all activities nearly every day (called anhedonia)
  • Restlessness or feeling slowed down
  • Recurring thoughts of death or suicide
  • Significant weight loss or gain (a change of more than 5% of body weight in a month

Minor depression is characterized by presence of two to four symptoms for two or more weeks. Most people prescribed SSRIs for depression fall into the minor depression category where the risks of treatment may outweigh the benefits especially when there is a triggering event (loss of job or financial hardship) which is often time limited.

How SSRIs Work

SSRIs work by preventing serotonin from being metabolized. Metabolization of neurotransmitters and nearly every chemical in the body is a natural occurrence – it is supposed to happen. In other words, blocking the metabolization of a substance can have adverse effects.

If the goal is to increase serotonin would it not make more sense to simply give you more serotonin? Well, pharmaceutical companies cannot get a patent on any chemical or substance the body naturally makes like serotonin so they rely on back door approaches to accomplish the nearly same like designing drugs that prevent the breakdown of serotonin and other neurotransmitters like acetylcholine (dementia patients).

The problem with this approach is serotonin and other neurotransmitters have downstream metabolites that have health benefits. And, if you block those downstream metabolites from being formed you do not get their benefits and instead can get side effects. Let’s look at two important metabolites of serotonin which are blocked from being made in the presence of SSRIs.

Dangers of SSRIs

Serotonin is naturally metabolized into melatonin which helps us sleep. If serotonin is not metabolized melatonin is not made in needed levels. That’s why sleep disturbance is a rather frequent side effect of SSRIs. But, probably more importantly SSRIs block the formation of 5-HIAA (5-hydroxyindole acetic acid). Patients with depression have low serotonin and generally low levels of 5-HIAA. In the presence of SSRIs serotonin goes up but since serotonin is not broken down there is even less 5-HIAA. If 5-HIAA drops below a critical threshold significant adverse effects occur.

Guess what low levels of 5-HIAA are associated with? Suicide, violent crime, addiction, and severe sleep disorders. So though SSRIs improve depression they lower 5-HIAA further in individuals already prone to low 5-HIAA levels raising the risk of suicide and other violent and destructive behavior further.

So paradoxically SSRIs as a class actually increase destructive behavior. Apparently many, if not all, recent killers involved in school shootings were on SSRIs and other psychiatric medications. This does not establish cause and effect but certainly the association needs to be studied between these medications and destructive and violent behavior.

Raise Your Serotonin Level Naturally

But, what if you can raise serotonin without blocking it’s metabolism – without blocking the formation of its downstream metabolites? That would be ideal if you suffer from some symptoms related to depression, anxiety, OCD, and phobia. You can raise your serotonin level and you can do it without a prescription. Here’s how.

You can raise serotonin by:

  • changes to your diet.
  • nutritional supplements.
  • your thoughts.
  • exercise, massage, meditation, and sunlight.

Foods to Boost Serotonin Levels

We have discussed food and nutritional supplements to boost serotonin levels in Natural Serotonin Boosters and will them summarize here. The following foods contain tryptophan which gets converted into 5-HTP (not to be confused with 5-HIAA) which gets converted into serotonin.

  • turkey
  • meat
  • peanuts
  • brown rice
  • sesame seeds
  • bananas
  • cottage cheese and milk products

Nutritional Supplements

First, taking serotonin supplements directly doesn’t work as it gets broken down to quickly in the gastrointestinal tract and is not well absorbed. The four main supplements that boost serotonin are:

  • Tryptophan
  • 5-HTP
  • St. John’s Wort
  • SAM-e

In Europe St. John’s Wort is frequently the first line management of depression recommended by physicians. 5-HTP is the immediate precursor to serotonin.

Your Thoughts

Your thoughts affect your serotonin level. It’s been said you are what you think about. Our brain chemistry influences our thoughts, but our thoughts also influence our brain chemistry. Negative thoughts beget more negative thoughts and our brain chemistry changes as a result. When you experience a negative mood – feeling blah or anxious for instance – it can be helpful to think of a situation in which you were happy or calm and break the negative thought cycle. If suffering from self-doubt think of times when you acted with confidence. Imagery can helpful too – just visualizing yourself calm, confident, energetic, upbeat can make your mood becomes more positive.

Along those lines it is helpful to avoid people and circumstances that stir up negative thoughts.

Daniel Amen, MD wrote Change Your Brain, Change Your Body that discusses the importance of our thoughts on our health. One reason why counting your blessings first thing in the morning can be healthy is it’s a way to start the day on a positive note.

Exercise, Massage, Meditation, and Sunlight

Anything that helps you relax can boost serotonin levels. Massage facilitates the breakdown of stress hormones like cortisol and adrenaline and raises levels of serotonin and dopamine (energy). Meditation does the same.

Exercise does even more. It improves serotonin levels and has a host of other health benefits that we have discussed elsewhere. Light stimulates serotonin activity. This can be natural sunlight or artificial from bright light therapy which some use to cope with seasonal affective disorder (SAD). Vitamin D, the sunshine vitamin, can also alleviate symptoms of SAD.

There are several ways to raise your serotonin level. If you have symptoms of depression from time to time consider some of these non-pharmacologic interventions especially if you do not suffer from major depressive disorder. If you think you might have major depressive disorder we recommend you first be evaluated by your physician.

As you can see from this discussion there are many ways to raise your serotonin level.

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Dr. Joe Jacko


Dr. Joe is board certified in internal medicine and sports medicine with additional training in hormone replacement therapy and regenerative medicine. He has trained or practiced at leading institutions including the Hughston Clinic, Cooper Clinic, Steadman-Hawkins Clinic of the Carolinas, and Cenegenics. He currently practices in Columbus, Ohio. Read more about Dr. Joe Jacko

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