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David Katz, M.D.

David Katz, M.D.

Posted: January 2, 2011 11:50 AM

There will be many potential reasons for post-holiday torpor, most of them fairly obvious -- from saying goodbye to loved ones we won't see for some time, to loosening belts and paying bills. But if after tallying the obvious you still can't fully account for your lassitude, somewhat less obvious explanations deserve consideration as well. Two hormones figure prominently among the relevant suspects.

The first is vitamin D.

In general, a nutrient is something we must ingest and metabolize. We usually burn nutrients, or their breakdown products, as fuel; or use them to build a part of ourselves. By and large, nutrients are either fuel, or construction material.

Hormones are neither. If a nutrient is fuel, a hormone determines how much gets tossed on the fire. If a nutrient is construction material, a hormone may be both builder, and architect. Hormones are regulators of body function. They travel through the blood stream, bind to receptors throughout the body, and exert effects far removed in place, time, and character from their origins.

Which brings us back to vitamin D. We have long been preoccupied with vitamin D as a nutrient because of its prominence in the recent history of public health. In the latter part of the 19th and early 20th centuries, there was a massive shift of the workforce -- including young children -- from farm to factory. Factories in Europe and the U.S. routinely involved work from before dawn to after dusk with an abrupt decline in ambient sun exposure resulting.

At the time, the effects of sunlight on skin were the almost exclusive source of vitamin D, so no sun meant vitamin D deficiency. This manifested as an epidemic of rickets -- a stunting condition of impaired bone growth in children. The epidemic ended when the cause was identified, and dairy products were fortified as they still are with vitamin D. We have focused on vitamin D as a nutrient rather than a hormone, and on its specific effects on bone, ever since.

Only recently has that begun to change, as the scientific literature has filled up with studies suggesting other important effects of vitamin D. That there is controversy in this area is indicated by the recent IOM report on vitamin D intake, which many, myself included, think may have erred to the low side. Be that as it may, there is no doubt that vitamin D affects not just bone, but also the immune system, muscle, the cardiovascular system, and the brain.

Whether or not vitamin D directly affects mood -- from seasonal affective disorder to depression -- is uncertain. Many people are prone to the 'blues' during the short, dark days of winter, and prone to low vitamin D levels at the same time. Vitamin D deficiency may be a cause, or both may simply be effects, in turn, of sunlight deficiency. Whatever its role, vitamin D deficiency is common; some studies suggest that well over a third of the U.S. population is affected at any given time.

As research advances to sort out the details, you might as well hedge a bet in your favor. I recommend a vitamin D level near the middle of the normal reference range for the population. When I check my patients here in CT, I find that quite a few have low levels year round, but particularly in winter. If a supplement is needed to approximate the middle of the bell curve, this is one of the few I routinely do encourage. Your doctor can help determine how much you need to reach, and remain, at the target level.

Thyroid hormone is less directly tied in with the sun, but even more directly connected to mood and energy. Its reputation as a master regulator of body functions is well deserved -- there is little the body does that is not influenced by the thyroid.

Roughly 5 percent of the U.S. population develops overt hypothyroidism, the risk rising as we age, and higher in women than men. But up to four times as many may experience "sub-clinical hypothyroidism." In this condition, thyroid hormone levels are actually normal- but the pituitary gland is working overtime to keep them so. The characteristic lab results for this state are an elevated level of thyroid stimulating hormone (TSH) from the pituitary, and low normal levels of thyroid hormones.

But normal means within the normal range for the population, not necessarily normal for you. While we all tend to fall somewhere in the wide population bell curve, only a narrow range of it really tolls "normal" for any one of us. Somewhere in that curve is the spot our hormones prefer to call home.

Vitamin D, thyroid hormones, and/or TSH, can be technically in the normal range for the population (each laboratory will have its own), but still not quite right for you. If not feeling like you think you should -- if tired, or groggy, or apathetic, or blue -- confer with your doctor to determine if getting these hormones more at home might be all or part of the solution.

Make your hormones feel more at home, and they are apt to return the favor. There's no place quite like it.

Dr. David L. Katz; www.davidkatzmd.com
www.turnthetidefoundation.org

 

Follow David Katz, M.D. on Twitter: www.twitter.com/DrDavidKatz

There will be many potential reasons for post-holiday torpor, most of them fairly obvious -- from saying goodbye to loved ones we won't see for some time, to loosening belts and paying bills. But if ...
There will be many potential reasons for post-holiday torpor, most of them fairly obvious -- from saying goodbye to loved ones we won't see for some time, to loosening belts and paying bills. But if ...
 
 
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HUFFPOST SUPER USER
whisperindave
Published author and journalist for
08:08 PM on 01/03/2011
There's little mention of a real hormone culprit in the mood and energy levels of men from 30 to 90...that being testosterone. When testosterone production fails it can cause extremely depressive episodes. Oddly they are finding that for instance, at the birth of a child, a man's testosterone drops. When women are menstruating, a male's testosterone production goes up. It fluctuates all the time. But as men age the levels go down. And when this happens it is not simply sex-drive that gets lower, but even the joy of living itself can be impaired. Me who feel blue most of the time but more severely during the holidays might want to have their testosterone levels checked. For women of course estrogen is important as well. Luckily for them they can take natural estrogens orally. Testosterone has to be injected or introduced through skin patches much like a nicotine patch.
11:04 PM on 01/03/2011
Testosterone is a catch-22 problem. Low levels cause all the problems you mention, but raising the levels raises your cancer risk.
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HUFFPOST SUPER USER
Jazmo
Cause they're hip to the bull and hip to the lies.
02:02 PM on 01/03/2011
If I missed this in the article, I apologize, but I wonder how much (if any) effect the amount of sugar & fats etc. we eat over the holidays can have on our hormones, if any. I know alot of people (including myself) who maintain a healthy diet much of the year then eat a bunch of junk between Thanksgiving and New Year that we don't generally eat. If the food doesn't effect the hormones, I imagine working this unhealthy stuff back out and getting back to a regular diet might help with the torpor (perfect word for it, too).
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01:48 PM on 01/03/2011
I feel bad the moment they start playing Christmas music in the stores and the garish decorations go up outside and inside houses, stores, public building etc. Part of it is certainly the short and cold days, which prevent me to be so much outside as I usually am. But even more I am just repulsed by the blatant consumerism which floods every inch of everything during this time of year. I am especially disgusted because so many people pretend to be Christians, but nowhere and nobody in that gift-buying , over-decorating, over-eating, over-partying frenzy ever mention the birth of Christ. Probably because they realize that it is just a fairy tale. An accidental visitor from another planet watching us during this time must get the impression that it is all about Santa Clauses from department stores and putting big red bows on everything and declare it a gift. A gift, which of course should immediately be returned after Christmas because nobody really cares to gift something the other person really wants.

On the other hand I agree with you that the role of hormones should be much more explored by physicians. I attribute most of my health problems to hormones.
07:13 AM on 01/04/2011
I'm so sorry for your sad state--especially your unsatisfied longing to hear about the birth of Christ. It's His birth, life and resurrection that make the season bearable for me--not only the Thanksgiving through New Year's frenzy, but this whole season of life in the physical body. I agree that December poses its own special problems--so many people so stressed yet so locked into, as you say, "blatant consumerism". The fact is, you can celebrate the birth of Christ without all the factors that are making you feel bad. Many of us do. We're just not loud and out-there and garish about it. You can find us in some churches, in our homes, and some of us are out there helping others in the name of the One whose birth we celebrate every day.
01:25 PM on 01/03/2011
Saving healthcare costs is a personal responsibility as well. It’s certainly in your best interest so you don’t end up maintained with tubes for the rest of your life. I was a nurse and it happens every day. The healthcare industry muddied it up with the term advanced directives. It’s so simple, really. All you have to do is tell your next of kin what you do and don’t want. Take a pen and paper and write it down. Simple. There is a chance that if you become a trauma patient from a car accident. Emergency Medical Services (EMS) are obligated by law to do everything they can to prolong your life regardless of your condition without documentation. This includes CPR, life support machines and tube feeding. Your next of kin will know what you want and they will be prepared to take care of you because you talked.

I want everyone to make plans when issued a drivers license and they be updated every time a new one to be reissued so it continues into adulthood. If a teenager is old enough to drive they’re old to decide about machines to keep them alive.

The government has the right to protect itself from costs. That is why we seat belt and car insurance laws. People will now have coverage when they get sick or hurt. That’s why we have healthcare legislation. The government is protecting itself. Protect yourself, have the talk with your next of kin, write it down.
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chaya
Another proud veteran
09:58 AM on 01/03/2011
It's a neat theory, but incorrect. People feel bad after their Christmas holidays because they persist in thinking that something wonderful and magical will happen. Peace on earth, goodwill toward men, mom in the kitchen fixing tasty feasts, dad acting like a real father, children playing delightedly with the presents that are so wonderful that only Santa could have brought them. This is it, the high-point of Anglo-European culture.

Then the holidays come and everyone is quibbling and quarreling, mom is angry, dad is drunk, and the children don't like their toys.

Now the holidays are over. The toys are broken. People return, with thin wallets, to the meaningless jobs they hate, the war continues, corrupt politics continue, and there is anything but Peace on earth, goodwill toward men. Turns out Christmas was only a fantasy--that will be played out again and again.
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HUFFPOST COMMUNITY MODERATOR
MossyOak
11:27 AM on 01/03/2011
There is much truth here. Feeling much of what you stated, tired of the gift thing and being a lapsed Christian, I decided to do something totally different this year.... stayed home with my husband, no family involved, no gifts, lots of cuddling by the fire. Instead of the birth of Jesus (and capitalism) we celebrated the Winter Solstice by going on a moonlight snowshoe and fixed some nice, quiet meals together. It was the most beautiful, stressless "Christmas" we ever had.
09:16 AM on 01/03/2011
After a complete hysterectomy in '93 I went on hormone replacement therapy for seven years. I was taken off hormones in 2000 when my youngest sister was diagnosed with breast cancer and my aunt on my mother's side died of breast cancer. My doctor told me to add vitamin d to my diet any way I could, including by pill. The added benefit my doctor was looking for was bone strength, and she was right on. I recently had a bone density test and was told that my bone strength is that of a much younger woman! Woooooohooooo! Considering I have degenerative disc disease, and my age, my orthopedic was thrilled. I might also add that I live in the dreariest area for winter .... on Lake Erie, and although I get sick of cloudy skies day after day, my outlook is the same...the sun will shine again and all will be beautiful here on the north shore. Vitamin D is a wonderful thing!
08:52 AM on 01/03/2011
I've been poisoned by thyroid replacement twice and darn near died. Be very careful with the stuff. A blood test that determines whether the level is normal or too high isn't going to save your life once you hit the toxic level.
10:55 AM on 01/03/2011
Me, too. And the funny thing is, I had almost every symptom of hyperthyroidism but the numbers. Be careful! If it ain't broke, don't fix it.
12:49 PM on 01/03/2011
What's scary is that some people are taking it for weight loss.
05:22 AM on 01/03/2011
Hmm, not sure I agree with the generalization. I've usually felt more energized after the winter holidays. The commercialization of the winter holidays have made them an ossified dead weight, a log of fruit cake, an idiotic sales pitch, a tired cliche, and something more exciting to leave than approach.
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06:32 PM on 01/02/2011
I think it was getting that Wii with Netflix. I watched THREE MOVIES yesterday! Netflix! I shake my fist at you! Look what you are doing to me.
05:43 PM on 01/02/2011
During the winter I replace the fish oil with cod liver oil for that enhanced placebo effect.