Why am I so irritable and moody?

Irritability and mood swings often stem from hormonal imbalances, nutritional deficiencies, sleep issues, or chronic stress affecting neurotransmitter production. Blood testing can reveal underlying causes like thyroid dysfunction, vitamin D deficiency, or cortisol imbalances that trigger mood changes.

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The Hidden Biology Behind Your Mood Swings

If you've been feeling unusually irritable or experiencing mood swings that seem to come out of nowhere, you're not alone. While it's easy to blame a bad day or stressful week, persistent irritability often has deeper biological roots that can be identified and addressed. Your mood is intricately connected to a complex network of hormones, nutrients, and neurotransmitters that work together to regulate emotional balance.

Understanding the underlying causes of irritability requires looking beyond surface-level triggers. Your body's biochemistry plays a crucial role in emotional regulation, and when key systems are out of balance, mood disturbances are often the first noticeable symptom. From thyroid hormones that regulate metabolism to vitamin deficiencies that affect neurotransmitter production, multiple factors can contribute to feeling on edge.

Hormonal Imbalances That Trigger Irritability

Thyroid Dysfunction

Your thyroid gland produces hormones that regulate nearly every aspect of metabolism, including mood regulation. Both hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid) can cause significant mood changes. Hyperthyroidism often leads to anxiety, restlessness, and irritability, while hypothyroidism typically causes depression, fatigue, and mood swings. Even subclinical thyroid dysfunction, where TSH levels are slightly outside the optimal range, can affect emotional stability.

Cortisol Patterns and Associated Mood Symptoms

Cortisol patterns should be evaluated through multiple daily measurements for accurate assessment.
Cortisol PatternMorning LevelEvening LevelCommon Mood Symptoms
NormalNormal PatternHigh (15-25 μg/dL)Low (< 5 μg/dL)Stable mood, good stress resilience
Chronic StressChronic StressElevated (> 25 μg/dL)Elevated (> 10 μg/dL)Anxiety, irritability, insomnia, racing thoughts
Adrenal FatigueAdrenal FatigueLow (< 10 μg/dL)Low (< 3 μg/dL)Fatigue, depression, poor stress tolerance
Flattened CurveFlattened CurveMid-rangeMid-rangeMood swings, afternoon fatigue, brain fog

Cortisol patterns should be evaluated through multiple daily measurements for accurate assessment.

Research shows that up to 60% of people with thyroid disorders are unaware of their condition. The connection between thyroid function and mood is so strong that thyroid testing is often recommended as a first step when evaluating unexplained mood changes. If you're experiencing persistent irritability along with other symptoms like weight changes, temperature sensitivity, or fatigue, comprehensive thyroid testing can provide valuable insights.

Sex Hormone Fluctuations

Sex hormones like estrogen, progesterone, and testosterone play crucial roles in mood regulation for both men and women. In women, hormonal fluctuations during the menstrual cycle, pregnancy, postpartum period, and menopause can trigger irritability and mood swings. The dramatic drop in estrogen during PMS or perimenopause affects serotonin production, leading to increased irritability and emotional sensitivity.

Men aren't immune to hormone-related mood changes either. Low testosterone levels, which can occur due to aging, stress, or health conditions, are associated with irritability, depression, and reduced stress tolerance. Studies indicate that men with low testosterone are significantly more likely to experience mood disorders. Additionally, imbalances in the ratio between testosterone and estradiol can affect emotional regulation in both sexes.

Cortisol and Stress Response

Cortisol, your body's primary stress hormone, follows a natural daily rhythm that affects mood and energy levels. In a healthy pattern, cortisol peaks in the morning to help you wake up and gradually declines throughout the day. However, chronic stress can disrupt this rhythm, leading to persistently elevated cortisol or a flattened cortisol curve. Both patterns are associated with increased irritability, anxiety, and mood instability.

The relationship between cortisol and mood is bidirectional. High cortisol levels can directly cause irritability and anxiety, while mood disturbances can further dysregulate cortisol production, creating a vicious cycle. Understanding your cortisol patterns through testing can help identify whether stress hormone imbalances are contributing to your mood issues.

Nutritional Deficiencies Affecting Mood

Vitamin D Deficiency

Vitamin D acts more like a hormone than a vitamin in your body, influencing numerous processes including mood regulation. Vitamin D receptors are found throughout the brain, particularly in areas associated with depression and emotional processing. Low vitamin D levels are strongly linked to increased irritability, depression, and seasonal affective disorder. Studies show that up to 42% of adults in the United States have insufficient vitamin D levels, with even higher rates in certain populations.

The connection between vitamin D and mood is particularly evident during winter months when sun exposure is limited. Supplementing with vitamin D has been shown to improve mood symptoms in people with deficiency, though optimal dosing varies based on individual levels and needs.

B Vitamin Insufficiency

B vitamins, particularly B12 and folate, are essential for neurotransmitter synthesis and nervous system function. Vitamin B12 deficiency can cause irritability, mood swings, and cognitive changes that may be mistaken for psychiatric conditions. Folate deficiency similarly affects mood by impairing the production of serotonin and dopamine. People with certain genetic variations, like MTHFR mutations, may have increased requirements for specific forms of B vitamins.

Iron and Ferritin Levels

Iron deficiency, even without anemia, can significantly impact mood and cognitive function. Ferritin, which reflects your body's iron stores, is often a more sensitive indicator than hemoglobin for detecting early deficiency. Low ferritin levels are associated with fatigue, irritability, poor concentration, and restless leg syndrome. Women of reproductive age are particularly at risk due to menstrual blood loss, and vegetarians may also have increased risk due to lower bioavailability of plant-based iron.

Blood Sugar Imbalances and Mood Volatility

Blood sugar fluctuations have immediate and profound effects on mood. When blood glucose drops too low (hypoglycemia), your body releases stress hormones like cortisol and adrenaline to raise it back up. This stress response can trigger irritability, anxiety, and difficulty concentrating. Conversely, high blood sugar can cause fatigue, brain fog, and mood swings as your body struggles to manage the excess glucose.

Reactive hypoglycemia, where blood sugar drops rapidly after eating, is a common but often overlooked cause of mood swings. This pattern typically occurs 2-4 hours after consuming high-carbohydrate meals and can lead to sudden irritability, shakiness, and anxiety. People with insulin resistance or prediabetes are particularly susceptible to these blood sugar swings, which can occur even when fasting glucose appears normal.

Long-term blood sugar dysregulation, reflected in elevated HbA1c levels, is associated with increased risk of depression and anxiety disorders. The inflammatory processes triggered by chronically elevated blood sugar can affect brain function and neurotransmitter balance. Monitoring your glucose patterns and HbA1c can help identify whether blood sugar instability is contributing to your mood issues.

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Inflammation and Its Impact on Mental Health

Chronic low-grade inflammation is increasingly recognized as a contributor to mood disorders. Inflammatory markers like high-sensitivity C-reactive protein (hs-CRP) are often elevated in people with depression and anxiety. This inflammation can originate from various sources including poor diet, chronic stress, lack of exercise, poor sleep, and underlying health conditions.

The gut-brain axis plays a crucial role in this inflammation-mood connection. An imbalanced gut microbiome can trigger systemic inflammation that affects brain function and neurotransmitter production. This explains why digestive issues often coincide with mood problems and why addressing gut health can improve emotional wellbeing.

Inflammatory cytokines can directly affect brain regions involved in mood regulation, disrupting the production and function of neurotransmitters like serotonin and dopamine. They can also interfere with the hypothalamic-pituitary-adrenal (HPA) axis, further dysregulating stress response and mood stability.

Sleep Disruption and Emotional Regulation

Poor sleep quality or insufficient sleep duration can dramatically affect mood and irritability levels. During sleep, your brain consolidates emotional memories and clears metabolic waste products. When sleep is disrupted, emotional regulation suffers, making you more reactive to stressors and prone to irritability. Research shows that even one night of sleep deprivation can increase emotional reactivity by up to 60%.

Sleep disorders like sleep apnea can cause chronic sleep fragmentation that leads to daytime irritability, even when total sleep time seems adequate. The repeated oxygen desaturations and stress responses during apnea episodes affect hormone balance and increase inflammation, both of which impact mood. If you snore, wake up gasping, or feel unrefreshed despite adequate sleep time, sleep apnea screening may be warranted.

Medical Conditions That Masquerade as Mood Problems

Several medical conditions can present primarily as mood symptoms, making diagnosis challenging without proper testing. Autoimmune conditions like Hashimoto's thyroiditis or lupus often cause mood changes before other symptoms become apparent. The immune dysfunction and inflammation associated with these conditions directly affect brain function and emotional regulation.

Polycystic ovary syndrome (PCOS) is another condition strongly linked to mood disturbances. The hormonal imbalances characteristic of PCOS, including elevated androgens and insulin resistance, contribute to increased rates of depression, anxiety, and mood swings in affected women. Similarly, endometriosis and its associated chronic pain and inflammation can significantly impact emotional wellbeing.

Cardiovascular issues, particularly those affecting blood flow to the brain, can also manifest as mood changes. Even subtle reductions in cerebral blood flow can affect cognitive function and emotional regulation. This is why addressing cardiovascular risk factors often improves mood alongside physical health markers.

Taking Action: Testing and Treatment Strategies

Identifying the root cause of irritability and mood swings requires a comprehensive approach that goes beyond surface-level assessment. Blood biomarker testing can reveal hidden imbalances in hormones, nutrients, and inflammatory markers that contribute to mood disturbances. Key markers to consider include thyroid panel (TSH, Free T3, Free T4, and TPO antibodies), sex hormones (testosterone, estrogen, progesterone), cortisol rhythm, vitamin D, B12, folate, ferritin, HbA1c, and hs-CRP.

Treatment strategies should be tailored to address identified imbalances. For hormonal issues, this might include thyroid medication, hormone replacement therapy, or natural approaches to hormone balance. Nutritional deficiencies can be corrected through targeted supplementation and dietary changes. Blood sugar regulation may require dietary modifications, exercise, and sometimes medication. Addressing inflammation often involves a multi-faceted approach including anti-inflammatory diet, stress management, improved sleep, and regular exercise.

Lifestyle modifications form the foundation of mood management regardless of underlying causes. Regular exercise has been shown to be as effective as antidepressants for mild to moderate depression. Stress management techniques like meditation, yoga, or cognitive behavioral therapy can help regulate cortisol and improve emotional resilience. Prioritizing sleep hygiene and maintaining consistent sleep-wake cycles supports hormonal balance and emotional regulation.

If you're experiencing persistent irritability or mood swings, consider uploading your existing blood test results to SiPhox Health's free analysis service for personalized insights into your biomarker levels and actionable recommendations for improving your emotional wellbeing.

When Mood Changes Signal Something More Serious

While occasional irritability is normal, certain patterns warrant immediate medical attention. If mood changes are accompanied by thoughts of self-harm, severe depression, mania, or psychosis, seek emergency care immediately. Sudden personality changes, especially with neurological symptoms like confusion, memory loss, or coordination problems, could indicate serious conditions requiring urgent evaluation.

Persistent mood symptoms that interfere with daily functioning, relationships, or work performance deserve professional evaluation even if they don't seem severe. Early intervention can prevent progression and improve outcomes. Working with healthcare providers who take an integrative approach, considering both physical and mental health factors, often yields the best results for complex mood issues.

References

  1. Anglin, R. E., Samaan, Z., Walter, S. D., & McDonald, S. D. (2013). Vitamin D deficiency and depression in adults: systematic review and meta-analysis. British Journal of Psychiatry, 202(2), 100-107.[PubMed][DOI]
  2. Bauer, M., Goetz, T., Glenn, T., & Whybrow, P. C. (2008). The thyroid-brain interaction in thyroid disorders and mood disorders. Journal of Neuroendocrinology, 20(10), 1101-1114.[PubMed][DOI]
  3. Miller, A. H., & Raison, C. L. (2016). The role of inflammation in depression: from evolutionary imperative to modern treatment target. Nature Reviews Immunology, 16(1), 22-34.[PubMed][DOI]
  4. Walther, A., Breidenstein, J., & Miller, R. (2019). Association of testosterone treatment with alleviation of depressive symptoms in men: A systematic review and meta-analysis. JAMA Psychiatry, 76(1), 31-40.[PubMed][DOI]
  5. Adam, E. K., Quinn, M. E., Tavernier, R., McQuillan, M. T., Dahlke, K. A., & Gilbert, K. E. (2017). Diurnal cortisol slopes and mental and physical health outcomes: A systematic review and meta-analysis. Psychoneuroendocrinology, 83, 25-41.[PubMed][DOI]
  6. Hidese, S., Saito, K., Asano, S., & Kunugi, H. (2018). Association between iron-deficiency anemia and depression: A web-based Japanese investigation. Psychiatry and Clinical Neurosciences, 72(7), 513-521.[PubMed][DOI]

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Frequently Asked Questions

How can I test my cortisol at home?

You can test your cortisol at home with SiPhox Health's Core Health Program, which includes cortisol testing along with other key biomarkers for mood and metabolic health. The program provides lab-quality results from the comfort of your home.

What blood tests should I get for mood swings?

Key tests for mood swings include thyroid panel (TSH, Free T3, Free T4), vitamin D, B12, folate, ferritin, cortisol, sex hormones (testosterone, estrogen), HbA1c for blood sugar, and hs-CRP for inflammation. These markers can reveal underlying imbalances affecting mood.

Can hormonal imbalances cause irritability in men?

Yes, hormonal imbalances, particularly low testosterone, can cause significant irritability in men. Low testosterone is associated with increased mood swings, depression, and reduced stress tolerance. Thyroid dysfunction and cortisol imbalances also affect mood in men.

How quickly can nutritional deficiencies affect mood?

Nutritional deficiencies can affect mood within weeks to months. B12 deficiency symptoms may appear within 4-6 weeks, while vitamin D deficiency effects develop over 2-3 months. Iron deficiency can cause mood changes before anemia develops, sometimes within weeks of depleted stores.

What's the connection between gut health and irritability?

The gut-brain axis links digestive health directly to mood. An imbalanced gut microbiome triggers inflammation that affects neurotransmitter production, particularly serotonin (90% is made in the gut). This explains why digestive issues often coincide with mood problems.

This article is licensed under CC BY 4.0. You are free to share and adapt this material with attribution.

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Benjamin Bikman earned his Ph.D. in Bioenergetics and was a postdoctoral fellow with the Duke-National University of Singapore in metabolic disorders. Currently, his professional focus as a scientist and professor (Brigham Young University) is to better understand the role of elevated insulin and nutrient metabolism in regulating obesity, diabetes, and dementia.

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View Details
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Director of Clinical Product Operations

Director of Clinical Product Operations at SiPhox Health with a background in medicine and a passion for health optimization. Experienced in leading software and clinical development teams, contributing to patents, launching health-related products, and turning diagnostics into actionable tools.

View Details
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Dr. Thompson’s interests in exercise, general cardiology and sports cardiology originated from his own distance running: he qualified for the 1972 Olympic Marathon Trials as a 3rd year medical student and finished 16th in the 1976 Boston Marathon. Dr. Thompson publishes a blog 500 Rules of Cardiology where he shares lessons and anecdotes that he has learned over his extensive career as a physician, researcher and teacher.

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Health Programs Lead, Health Innovation

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She earned her medical degree from Imperial College London, where she also completed her MSc in Human Molecular Genetics after obtaining a BSc in Biochemistry from Queen Mary University of London. Her academic research includes significant work in developmental cardiovascular genetics, with her thesis publication contributing to the understanding of genetic modifications on embryonic cardiovascular development.

View Details
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Pavel Korecky, MD

Director of Clinical Product Operations

Director of Clinical Product Operations at SiPhox Health with a background in medicine and a passion for health optimization. Experienced in leading software and clinical development teams, contributing to patents, launching health-related products, and turning diagnostics into actionable tools.

View Details
Paul Thompson, MD

Paul Thompson, MD

Advisor

Paul D. Thompson is Chief of Cardiology Emeritus of Hartford Hospital and Professor Emeritus at University of Connecticut Medical School. He has authored over 500 scientific articles on cardiovascular risk factors, the effects of exercise, and beyond. He received National Institutes of Health’s (NIH) Preventive Cardiology Academic Award, and has received NIH funding for multiple studies.

Dr. Thompson’s interests in exercise, general cardiology and sports cardiology originated from his own distance running: he qualified for the 1972 Olympic Marathon Trials as a 3rd year medical student and finished 16th in the 1976 Boston Marathon. Dr. Thompson publishes a blog 500 Rules of Cardiology where he shares lessons and anecdotes that he has learned over his extensive career as a physician, researcher and teacher.

View Details
Robert Lufkin, MD

Robert Lufkin, MD

Advisor

Physician/medical school professor (UCLA and USC) and New York Times bestselling author empowering people to take back their metabolic health with lifestyle and other tools. A veteran of the Today Show, USA Today, and a regular contributor to FOX and other network news stations, his weekly video podcast reaches over 500,000 people. After reversing chronic disease and transforming his own life he is making it his mission to help others do the same.

His latest book, ‘Lies I Taught In Medical School’ is an instant New York Times bestseller and has re-framed how we think about metabolic health and longevity. In addition to being a practicing physician, he is author of over 200 peer reviewed scientific papers and 14 books that are available in fourteen languages.

View Details
Ben Bikman, PhD

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Advisor

Benjamin Bikman earned his Ph.D. in Bioenergetics and was a postdoctoral fellow with the Duke-National University of Singapore in metabolic disorders. Currently, his professional focus as a scientist and professor (Brigham Young University) is to better understand the role of elevated insulin and nutrient metabolism in regulating obesity, diabetes, and dementia.

In addition to his academic pursuits, Dr. Bikman is the author of Why We Get Sick and How Not To Get Sick.

View Details
Tash Milinkovic, MD

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Health Programs Lead, Heart & Metabolic

Dr. Natasha Milinkovic is part of the clinical product team at SiPhox Health, having graduated from the University of Bristol Medical School. Her medical career includes rotations across medical and surgical specialties, with specialized research in vascular surgery, focusing on recovery and post-operative pain outcomes. Dr. Milinkovic built her expertise in emergency medicine as a clinical fellow at a major trauma center before practicing at a central London teaching hospital throughout the pandemic.

She has contributed to global health initiatives, implementing surgical safety standards and protocols across rural Uganda. Dr. Milinkovic initially joined SiPhox Health to spearhead the health coaching initiative and has been a key contributor in the development and launch of the Heart and Metabolic program. She is passionate about addressing health disparities by building scalable healthcare solutions.

View Details
Tsolmon Tsogbayar, MD

Tsolmon Tsogbayar, MD

Health Programs Lead, Health Innovation

Dr. Tsogbayar leverages her clinical expertise to develop innovative health solutions and evidence-based coaching. Dr. Tsogbayar previously practiced as a physician with a comprehensive training background, developing specialized expertise in cardiology and emergency medicine after gaining experience in primary care, allergy & immunology, internal medicine, and general surgery.

She earned her medical degree from Imperial College London, where she also completed her MSc in Human Molecular Genetics after obtaining a BSc in Biochemistry from Queen Mary University of London. Her academic research includes significant work in developmental cardiovascular genetics, with her thesis publication contributing to the understanding of genetic modifications on embryonic cardiovascular development.

View Details
Pavel Korecky, MD

Pavel Korecky, MD

Director of Clinical Product Operations

Director of Clinical Product Operations at SiPhox Health with a background in medicine and a passion for health optimization. Experienced in leading software and clinical development teams, contributing to patents, launching health-related products, and turning diagnostics into actionable tools.

View Details
Paul Thompson, MD

Paul Thompson, MD

Advisor

Paul D. Thompson is Chief of Cardiology Emeritus of Hartford Hospital and Professor Emeritus at University of Connecticut Medical School. He has authored over 500 scientific articles on cardiovascular risk factors, the effects of exercise, and beyond. He received National Institutes of Health’s (NIH) Preventive Cardiology Academic Award, and has received NIH funding for multiple studies.

Dr. Thompson’s interests in exercise, general cardiology and sports cardiology originated from his own distance running: he qualified for the 1972 Olympic Marathon Trials as a 3rd year medical student and finished 16th in the 1976 Boston Marathon. Dr. Thompson publishes a blog 500 Rules of Cardiology where he shares lessons and anecdotes that he has learned over his extensive career as a physician, researcher and teacher.

View Details
Robert Lufkin, MD

Robert Lufkin, MD

Advisor

Physician/medical school professor (UCLA and USC) and New York Times bestselling author empowering people to take back their metabolic health with lifestyle and other tools. A veteran of the Today Show, USA Today, and a regular contributor to FOX and other network news stations, his weekly video podcast reaches over 500,000 people. After reversing chronic disease and transforming his own life he is making it his mission to help others do the same.

His latest book, ‘Lies I Taught In Medical School’ is an instant New York Times bestseller and has re-framed how we think about metabolic health and longevity. In addition to being a practicing physician, he is author of over 200 peer reviewed scientific papers and 14 books that are available in fourteen languages.

View Details
Ben Bikman, PhD

Ben Bikman, PhD

Advisor

Benjamin Bikman earned his Ph.D. in Bioenergetics and was a postdoctoral fellow with the Duke-National University of Singapore in metabolic disorders. Currently, his professional focus as a scientist and professor (Brigham Young University) is to better understand the role of elevated insulin and nutrient metabolism in regulating obesity, diabetes, and dementia.

In addition to his academic pursuits, Dr. Bikman is the author of Why We Get Sick and How Not To Get Sick.

View Details
Tash Milinkovic, MD

Tash Milinkovic, MD

Health Programs Lead, Heart & Metabolic

Dr. Natasha Milinkovic is part of the clinical product team at SiPhox Health, having graduated from the University of Bristol Medical School. Her medical career includes rotations across medical and surgical specialties, with specialized research in vascular surgery, focusing on recovery and post-operative pain outcomes. Dr. Milinkovic built her expertise in emergency medicine as a clinical fellow at a major trauma center before practicing at a central London teaching hospital throughout the pandemic.

She has contributed to global health initiatives, implementing surgical safety standards and protocols across rural Uganda. Dr. Milinkovic initially joined SiPhox Health to spearhead the health coaching initiative and has been a key contributor in the development and launch of the Heart and Metabolic program. She is passionate about addressing health disparities by building scalable healthcare solutions.

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