Mind & Mood Archive

Ask the doctor

Q. Recently, I felt very agitated and out of control, crying and angry about things I could ordinarily handle with ease. I was starting fights with my husband and others over relatively insignificant issues. I had been taking synthetic thyroid hormone for several decades and had very low levels of thyroid-stimulating hormone in my blood. I've stopped taking the hormone and feel better, but I feel bad about the way I snapped at my friends and family. Could thyroid hormone have been to blame for my behavior?

A. It could very well have been responsible. Low thyroid-stimulating hormone (TSH) levels mean that thyroid hormone levels are increasing. Anxiety, agitation, and restlessness are all signs of hyperthyroidism—an overactive thyroid gland or, in your case, too much thyroid hormone medication. You can let your husband and friends know that your irritability was probably caused by too high a dose of your prescription and not a permanent change in your disposition.

Participants in the Women's Health Initiative Memory Study (WHIMS) have provided a trove of information. They completed monthly questionnaires and underwent cognitive tests. Those who showed significant decline were also tested for dementia.

Recently, researchers analyzed data from 7,444 participants over 65. They had followed the women an average of seven years. Their report was published online June 15, 2015, by Alzheimer's & Dementia.

The jury is still out, but magnetic fields or mild electric currents may aid learning and help several conditions that affect women in particular.

Stimulating your brain doesn't just mean spending an evening at the theater or reading a good book. These days it can involve sitting with your head against a magnet or wearing electrodes that transmit a low-voltage current through your scalp to activate—or suppress—certain neurons in your brain. The prospect of regulating brain signals responsible for mood, pain, and learning is so compelling that scores of studies are under way to see if, and how, the approach can be used to sharpen mental skills and treat symptoms of several mind-body disorders. "Brain stimulation, if used carefully and safely, looks promising, especially if combined with other therapies," says Dr. Daniel Press, a neurologist with the Berenson-Allen Center for Noninvasive Brain Stimulation at Harvard-affiliated Beth Israel Deaconess Medical Center. Dr. Press has used noninvasive brain stimulation for almost a decade.

The world moves at a hectic pace these days. If you feel like you're constantly running on empty, you're not alone. Many people say that they just don't have the energy they need to accomplish all they need to. Sometimes the cause of fatigue is obvious — for example, getting over the flu or falling short on sleep. Sometimes a vitamin deficiency is part of the problem. It might be worth asking your doctor to check a few vitamin levels, such as the three we've listed below.

• Iron. Anemia occurs when there aren't enough red blood cells to meet the body's need for oxygen, or when these cells don't carry enough of an important protein called hemoglobin. Fatigue is usually the first sign of anemia. A blood test to measure the number of red blood cells and amount of hemoglobin can tell if you have anemia. The first step in shoring up your body's iron supply is with iron-rich foods (such as red meat, eggs, rice, and beans) or, with your doctor's okay, over-the-counter supplements.
   
• Vitamin B₁₂. Your body needs sufficient vitamin B₁₂ in order to produce healthy red blood cells.  So a deficiency in this vitamin can also cause anemia. The main sources of B₁₂ are meat and dairy products, so many people get enough through diet alone. However, it becomes harder for the body to absorb B₁₂ as you get older, and some illnesses (for example, inflammatory bowel disease) can also impair absorption. Many vegetarians and vegans become deficient in B₁₂ because they don't eat meat or dairy. When B₁₂ deficiency is diet-related, oral supplements and dietary changes to increase B₁₂ intake usually do the trick. Other causes of B₁₂ deficiency are usually treated with regular injections of vitamin B₁₂.
   
• Vitamin D. A deficit of this vitamin can sap bone and muscle strength. This vitamin is unique in that your body can produce it when your skin is exposed to sunlight, but there also aren't many natural food sources of it. You can find it in some types of fish (such as tuna and salmon) and in fortified products such as milk, orange juice, and breakfast cereals. Supplements are another way to ensure you're getting enough vitamin D (note that the D₃ form is easier to absorb than other forms of vitamin D).

For more ways to combat fatigue, buy Boosting Your Energy, a Special Health Report from Harvard Medical School.

Extra-virgin olive oil and nuts seem to contribute to the benefits.

A heart-healthy lifestyle is strongly associated with better memory and lower risk of Alzheimer's disease.

The health press is full of claims that "superfoods"—like fresh berries and leafy greens—can keep your memory sharp and hold the threat of Alzheimer's disease at bay. But for now, the evidence is preliminary at best. Your safest bet is to lead an overall heart-healthy lifestyle—including eating a plant-based diet and getting regular exercise—rather than drawing up a shopping list of alleged brain-boosting superfoods.

Unless you have symptoms of a heart problem, taking a cautionary look under the hood is unlikely to help—and could even be harmful.

Here's another reason to get depression treated as soon as possible: a Harvard study found that people with persistent symptoms of severe depression were twice as likely to suffer a stroke compared with people who have mild symptoms. The study appeared May 13, 2015, in the Journal of the American Heart Association. Researchers looked at the health information of more than 16,000 men and women ages 50 and older. The participants were interviewed every two years during a 12-year period and asked about many health issues, including depression symptoms. Researchers found that people who reported high depression symptoms at two consecutive interviews were more than twice as likely to have a first stroke than people with low depression symptoms. The stroke risk remained high even after depression symptoms went away.

The study showed only an association, and didn't prove that depression causes strokes. So why the link? Researchers speculate that depression—which is associated with high blood pressure, increased inflammation, and physical inactivity—may have a cumulative effect that causes damage to the blood vessels over time. Bottom line: Seek treatment if a case of the blues lasts more than two weeks, because it could be a sign of depression.

Now we have a better tool to calculate your chance of a brain attack if you've been diagnosed with afib.

Atrial fibrillation (afib) is among the most common heart rhythm irregularities. During a bout of afib, the usually rhythmic contractions of the heart muscle's upper chambers (the atria) are replaced by an ineffectual quiver that does not completely move blood out of the heart chamber. As a result, blood can stagnate and form clots. These clots can then travel to the brain and cause an ischemic stroke.

Find out if your sleeping habits put you at risk—and what to do about it.