This solo episode breaks down premenstrual dysphoric disorder (PMDD), a severe form of PMS affecting mood, cognition, and physical health in the week before menstruation. Listeners gain a clear understanding of the diagnostic criteria (five or more symptoms across most cycles within a year), common conventional treatments including SSRIs and birth control pills, and why Dr. Anthony Chaffee believes standard dietary advice, particularly the recommendation to increase carbohydrates, may actually worsen the hormonal disruption at the root of the condition.
The episode connects PMDD to two overlapping mechanisms: hormonal dysregulation driven by hyperinsulinemia and diet-related impacts on mental health. High insulin blocks the enzyme that converts testosterone to estrogen, echoing the same pathway seen in PCOS. Low LDL cholesterol, common on low-fat or plant-heavy diets, is linked to depression and even elevated suicide risk, and cholesterol is the direct precursor to all steroid hormones. Dr. Anthony Chaffee argues that a carnivore or high-fat ketogenic diet addresses both the hormonal and psychological components of PMDD simultaneously by normalizing insulin and supplying adequate cholesterol.
Key Takeaways
- High insulin levels directly block the enzyme that converts testosterone into estrogen in the ovaries, so reducing carbohydrate and sugar intake to lower insulin may help restore the testosterone-to-estrogen balance disrupted in PMDD and PCOS.
- Cholesterol is the precursor to all major steroid hormones including estrogen, progesterone, testosterone, and cortisol, meaning low-fat or plant-based diets that suppress LDL cholesterol can impair hormone production and worsen PMDD symptoms.
- Low LDL cholesterol is associated not only with higher rates of depression but also with significantly elevated suicidality, making adequate dietary fat and cholesterol intake a potentially critical factor for the mood-related symptoms of PMDD.
- Conventional PMDD treatment already targets both depression (with SSRIs) and hormonal imbalance (with birth control pills), suggesting a carnivore or high-fat ketogenic diet could address both root causes simultaneously by normalizing insulin and providing the cholesterol needed for hormone synthesis.
- What Is PMDD: Symptoms, Risk Factors, and Diagnosis
- Conventional PMDD Treatments: SSRIs, Birth Control, and Diet Changes
- PCOS, Hyperinsulinemia, and How Carbs Disrupt Estrogen and Testosterone
- Carnivore Diet for Mood Disorders, Depression, and PMDD
- Cholesterol, LDL, and Hormone Production: Why Fat Matters for PMDD
- Carnivore Diet as a First-Principles Approach to Treating PMDD
This is an auto-generated transcript from YouTube and may contain errors or inaccuracies.
hey everyone dr chaffey here just wanted to continue on with the women's health theme that i've been doing i just did a video recently talking about fertility and how to optimize your health in order to conceive and have a healthy pregnancy and also for men trying to optimize their chances of conception as well today i just wanted to talk about something called pre-menstrual dysphoric disorder or pmdd this is something i've had a few people ask me about and uh and so i want to go in a little bit about that so this is something that's a it's a bit more it's a more severe form of pms um usually happens around the same time about a week or so prior to menstruation it's not known exactly why this is and therefore there aren't really any good treatments for it as we'll talk about this is this is likely an abnormal reaction to the normal hormonal changes that we see with the cycle it can also cause a reduction in serotonin serotonin is one of the the chemicals in your brain that allows us to be happy and this is why people take selective serotonin reuptake and hec inhibitors so that they increase the efficacy of the serotonin in their brain which actually doesn't necessarily show uh that it actually does anything very beneficial actually now that we have more numbers out there but that's for another time um who's at risk of this well people that have had themselves have pms or um or their family members have had pms or pmdd you they would be at a higher risk for having that as well people with a history of depression or postpartum depression or other mood disorders can also be at risk of this as well this can be quite quite serious and quite a severe and debilitating issue that can they can leave people very make it very difficult to to live their normal life and and to work their job take care of themselves and their family and and has a number of different symptoms such as irritability being very nervous feeling like they're out of control agitation being very angry maybe unnecessarily or inappropriately to inappropriate situations difficulty concentrating depression being very very tired severe fatigue anxious confusion forgetfulness having a poor self-image and and just feeling low in general even paranoia emotional sensitivity mood swings crying spells and insomnia and then you can get physical manifestations of this and get a lot of bloating and swelling or even respiratory issues like asthma and even pain in your eyes or maybe even some blurred vision so there's a lot of things going on there but obviously that can all add up to being some a very miserable situation um how is this diagnosis is diagnosed over the course of a year sometimes people would have a journal that they would keep track of their symptoms uh with their cycle and in relation to this and and the criteria for diagnosis is over the course of one year with most of your cycles having five or more of those symptoms that we talked about so you know low mood anger and irritability reduce concentration lack of interest in things you would normally be interested in you know being moody having increased appetite insomnia feeling overwhelmed and those physical characteristics that we saw and that these would disturb your normal everyday function of your social encounters of your work or or anything else and it's not related to something else some other other issue that's that's going on this is not something that we have great treatments for but according to uh johns hopkins uh university the the normal treatment would be changes in diet like an increase in protein they even say increase in carbohydrates which obviously i would not uh agree with and i'll tell you why um reduction in sugar reduction in caffeine reduction in alcohol all of which i would absolutely agree with increased exercise try to reduce stress taking vitamins like especially like b vitamins like b6 um non-steroidal anti-inflammatories to help with the physical soreness uh that's another thing is is you can get breast tendernesses and headaches as well so this can come with physical discomfort as well and then possibly taking those ssris that we talked about the the selective serotonin reuptake inhibitors which again even for depressed patients don't necessarily should you know show as much benefit as as we would hope uh and taking birth control pills okay so so what is this all sort of lining up to um to me when i look at that you see a lot of a lot of issues that can be related to hormonal health and and depression and you know we're we're giving we're treating for depression with ssris and and other sorts of things to just move you know stress and diet and exercise as well and also addressing hormonal issues with the birth control pill which can normalize our cycle because you're just you're just getting this steady uh hit of hormones and that can if your hormones are a bit out of balance maybe this can help rebalance them as i talked about in the hormonal health and reproductive health episode a lot of this stuff comes down to what you eat it almost it entirely comes down to what you eat as i talked about in that video there's things called pcos polycystic ovarian syndrome which is a leading cause of infertility and and fibroids as well these are things that people suffer with well pcos is is now known to be caused by hyperinsulinemia so too much insulin right so this is why i would disagree with johns hopkins about eating carbs because i think that this can actually disregulate your hormones and your hormonal health and obviously if we're dealing with a hormonal issue that's not what you want to do so in pcos and anyone any woman in general insulin when you have high in high insulin this is going to block the the enzyme that converts testosterone into estrogen because we actually all make testosterone it's just that women then convert that testosterone into estrogen in their ovaries so that is how that gets converted and so when you have high insulin it blocks that conversion so they have much too high testosterone and much too low estrogen and obviously this is going to be very disruptive hormonally for a woman and this is why pcos is such is such a difficult uh condition to have people generally put on a lot of weight but you know also to do with high insulin levels and eating a lot of carbohydrates and likely sugar and also this hormonal dysregulation having too much testosterone they start growing hair in areas that they they normally wouldn't so it's called hirsutism so they might grow mustache and facial hair and get body hair or back hair and this is this isn't this isn't nice for people that don't want hair there so you know hopkins you know recognize reducing sugar so that's going to be a good thing and you know i would just think that the carbohydrates are very close but i think they they missed it on that one also we're treating what really sounds like you know psychological or mood disorders and people would have a history of depression and history of mood disorders are going to have an increased risk of pmdd okay well what do we know about this we did i did an episode with natalie west who's a clinical psychotherapist and we went through all the different ways that diet can seriously affect not only your mood not only depression but actually psychiatric issues such as schizophrenia or ocd or you know bipolar disorder these are very serious psychiatric issues and you know and depression not being leased among them that can be absolutely reversed by putting people on a carnivore diet and getting rid of all of these these different factors and carbohydrates and and uh different things in vegetables and plants that cause these problems and putting people on a ketogenic diet and especially carnivore diet you're getting people off their psychiatric medication and they're not hearing voices anymore they're not they're not having visual auditory illusion hallucinations anymore that is major major stuff and so you have an issue like pmdd where you have hormonal hormones out of balance and you're having depression issues you know going on a carnivore diet is going to address both of those things and i'm not saying that this is going to cure everything because i don't know there's no data on this no one's ever done a test on this i'm just looking at first principles on how our body works and how and how the carnivore diet works is going to reduce your insulin down to normal levels you're going to be able to convert testosterone into estrogen you're going to balance your hormones normally you're going to you're going to remove the different factors that are going to drain your you know any sort of psychological issues and and and promote depression and to promote all these mood swings and anger outbursts as well we also know from many many studies that lower cholesterol lower ldl cholesterol is actually actually implicated in depression you know and cholesterol is also the main is is the precursor to all of your all of your hormones to testosterone estrogen progestogens cortisol glucocorticoids mineralocorticoids all of your major hormones are all made from cholesterol and so if we're on say a vegetarian diet or just a standard high carb low fat american diet western diet australian diet european diet we are not going to get enough cholesterol and we are not going to make enough hormones and that's going to further disrupt your hormonal your hormonal health we also have like i said these studies that look at low ldl cholesterol have higher rates of of depression and more importantly people with low ldl cholesterol and depression have a much higher rate of suicidality so that's very serious this is this is actually causing a real real problem with people to the point that they feel that they have they they can't take it anymore they have to end their life they're so unhealthy mentally and that's that's very very scary so these are these are all linked to diet and i've discussed that in another podcast that you can look at look at the the hormonal health and the the fertility episode that i recently did as well as one with natalie west and we talk about how diet can seriously change your hormonal health and then with natalie west how it can seriously help your mental health and that's a combination of these these two combined are really what it looks like to me and from reading in the literature what pmdd is and you're having a combination of hormonal dysregulation as well as your your mood and your and your psychological health disrupted as well and both of those things are seriously affected by the things that we eat or don't eat so you're eating things that you that aren't biologically appropriate that our species wasn't designed to eat like fruits like vegetables like roots like you know mushrooms okay and you're not getting the proper human nutrition that we need meat fat cholesterol cholesterol is so important so these things are absolutely vital to our health and i would be willing to bet that this is going to seriously help people suffering from pmdd or pms if they really go pure and increase their meat increase their cholesterol they're going to optimize their hormonal health they're going to optimize their mental health and even if this doesn't do a lick for pmdd it's going to seriously change the rest of your health physically and mentally and that is going to make you much better able to deal with the serious issue of pmdd if not actually treat it directly which i bet i would be very surprised if it didn't okay guys i hope you found that helpful that's that's the the best i could do on that one because this is something that we really don't know much about and obviously we haven't done any studies on this with carnivore diet but you know according to hopkins there are dietary changes that they do and they find helpful already so you know that's that sort of link there they already treat with ssris so there's a depression component and they treat with birth control pills so there's a hormonal component so addressing this by going on a carnivore diet a high fat carnivore diet or at least a high fat ketogenic diet so that you normalize your insulin and your and your hormones will then become normalized from the cholesterol from lack of hyperinsulinemia your you should see a significant improvement i would be shocked if you didn't all right guys please let me know if you found this helpful and please let me know if you try this and it helps put it in the comments so that everyone can see what your experience with this is thank you very much hey guys thank you very much for taking the time out to listen to what i had to say if you like it then please like and subscribe to my youtube channel and podcast and if you're on youtube then please hit that little bell and subscribe and that'll let you know anytime i have a new video out which should be every week if not more and if you could share this with your friends that would help me get the word out and let me know that you like what i'm doing thanks again guys