naturopathic doctor

Why Am I Always Tired? Potential Adrenal Fatigue

Could my fatigue be my adrenals?

Top 10 Signs of Adrenal Fatigue

1.     Decreased ability to handle stress

2.     Fatigue or lack of energy, especially in the early morning and late afternoon

3.     Brain Fog

4.     Craving Salt

5.     Need to snack or eat frequently to maintain normal blood sugar

6.     Dizziness upon standing

7.     Mild anxiety or depression

8.     Insomnia

9.     Decreased Immune Function

10. Gaining weight around the midsection

What causes Adrenal Fatigue?

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Prolonged Stress

One of the MAIN functions of the adrenal glands is to mount a response to stress by secreting cortisol and adrenaline hormones. This is often referred to as you “fight or flight response,” which is a healthy and necessary response to help us appropriately manage those acute periods of stress. The issue arises when stress becomes prolonged, as this adaptive response becomes maladaptive.

Excessive Exercise

This may be one of the most commonly overlooked areas in healthcare. Just like anything else, too much of a “good thing” can be a bad thing. With the emergence of unrealistic social media-created ideals, the epidemic of excessive exercise and burnout is on the rise. Exercise is indeed a stress to the body, which causes a release of catecholamines and cortisol. A degree of stress through exercise is healthy and necessary for growth and adaptation; however, chronic over-exercise turns this anabolic activity into a catabolic one. Not only can over-exercise lead to muscle breakdown, but it can also wreak havoc on your endocrine and immune systems, leaving you victim to increased fatigue, decreased stress resilience, hormone imbalances, and lowered immune function.

Lack of Sleep

During a restful night of sleep, cortisol is at its lowest and your adrenal glands essentially get a rest. With a normal cortisol/melatonin rhythm, melatonin (your sleepy hormone) starts to make a sharp rise and cortisol (your awake hormone) takes a deep dip just before 9 pm. This 9 pm mark is thus the IDEAL time to start winding down for bed. This reverse of this pattern, where cortisol begins to spike and melatonin dips low occurs just before 6 am. The further your sleep pattern deviates from this innate cortisol/melatonin rhythm, the greater the distress on the health of the adrenal glands.

Chronic Pain

Severe pain has a profound impact on the health of the adrenals. Severe pain, whether acute or chronic, is viewed as an acute stressor by the endocrine system. Initially, the increased demand on the adrenals causes a large rise in cortisol. Over time, however, the adrenal glands are unable to keep up with demand and cortisol often drops below the normal range.

Poor Diet (Crash Dieting, Fasting, Insufficient Intake) 

One of cortisol’s main roles is to keep blood sugar stable. It does so by taking blood sugar out of stores when blood glucose starts to drop below acceptable levels. With crash dieting, fasting, or insufficient nutrient intake, the demand for cortisol increases, which places an additional stress on the adrenal glands.

Top 5 Tips to Reset Your Adrenals and Recover from Adrenal Fatigue:

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1. Get Enough Sleep

Aim to get a minimum of 8 hours of sleep each night. Some individual’s recovering from adrenal fatigue may need more, so listen to your body! Each hour before midnight counts as double, so aim to get to bed by 9 pm!

2. Know Your Limits

Set time limits on exercise.

Exercise is healthy, right? Well, it can be a detriment to your health if you are consistently overdoing it. When recovering from adrenal fatigue, it is extremely important to keep exercise at a moderate level. I typically recommend patients to keep exercise to a maximum of 1 hour of moderate exercise (such as: light cardio, resistance training, and yoga). This is not the time to do intense spin classes, cross-fit, HIIT workouts, or Bikram yoga.

Dial back your work commitments. 

For many individuals, work is a significant source of stress. This may especially be the case if you consider yourself “type A” or a people-pleaser. Make sure that you are not taking on more tasks than you can handle. Consistently working overtime, working in an emotionally toxic environment, working under high pressure of time or significance, and making long commutes can all contribute to burnout. It’s a good practice to pull out your contract and evaluate whether you are going above and beyond the job duties for which you were originally hired.

3. Reset Your Adrenals Through Diet

The main goal of an adrenal reset diet is to use macronutrients (carbohydrates, fats, proteins) to promote a healthy cortisol/melatonin rhythm through blood sugar modulation.

Three Principles to Keep in Mind:

1.  We want cortisol around — but at the right time. Cortisol, your “stress hormone” gets a bad rap. In excess and for prolonged periods of time, cortisol can indeed be bad; however, cortisol has many IMPORTANT beneficial roles in our body including: blood sugar regulation, blood pressure regulation, anti-inflammatory actions, and energy!

2.  Cortisol and Melatonin are in opposition. When Cortisol is high, melatonin is low. The reverse is also true.

3. Cortisol and Blood Sugar are in opposition. One of cortisol’s roles is to regulate blood sugar by taking sugar out of its storage form and putting it into the bloodstream when blood glucose is low. This means that when blood glucose is low, cortisol will rise in order to achieve this act. This is one reason why cortisol levels RISE after exercising.

Promoting a Healthy Rhythm With Structured Meals:

Breakfast: Breakfast should consist of a healthy protein, healthy fat, and good amount of vegetables with adequate fiber. This type of breakfast will keep morning cortisol high, as it should be.

Example: 2 Eggs (whole) + 2 pieces bacon + ½ avocado + sautéed kale

Lunch: Mid-day is the time where cortisol begins its decline. To maintain a relatively high level of cortisol, eat a lunch high in protein.  If your body is already at a point of “adrenal fatigue,” it may not be able to meet these demands, and could result in some irritability. Alternatively, eat about ½ cup of carbohydrates to encourage a natural decline in cortisol.

Example: 6 oz Chicken + salad greens + oil vinegar dressing + ¼ cup pistachios + ½ cup blueberries

Dinner: It’s finally time to start dampening that cortisol response and stimulating melatonin production! This is accomplished with a healthy portion (about 1 cup) of carbohydrates. If your meal is too low in carbohydrates, more cortisol will be released to help balance blood sugar, which could prevent you from falling asleep!

Example: 6 oz grass-fed burger lettuce wrapped with avocado, mayo, and mustard + 1 cup sweet potato wedges + asparagus

Snacks: Snacks are important, and don’t let anyone tell you otherwise. If you are in the stage of adrenal fatigue where your body is unable to mount an appropriate cortisol response, keeping your blood sugar stable can become quite difficult. For this reason, I usually recommend eating a high protein snack between meals, such as an Epic Bar, protein shake, or plain Kite Hill Greek yogurt!

Other Tips:

Avoid Stimulants: Such as coffee and energy drinks. If you need caffeine, I recommend drinking green tea, which also contains L-theanine, an amino acid that helps calm the mind by mimicking GABA.

Eat Plenty of Sea Salt: Many individuals with adrenal fatigue will crave salt due to low aldosterone, another steroid hormone produced by the adrenals. Aldosterone’s main role is to help control blood pressure through the regulation of salt content within the body. With declining aldosterone, dehydration and lowered blood pressure ensues. Increasing your intake of sea salt and trace minerals is a good way to offset some of the symptoms of lethargy, headaches, lightheadedness, irregular heartbeat, and muscle weakness.

4. Make Relaxation and Mindfulness Activities a Daily Practice

·      Meditate and/or Pray More

·      Start a Journal

·      Take Deep Breaths

·      Laugh More

·      Ground Yourself in Nature

5. Support Your Adrenals with Herbs, Nutrients, and Glandulars

** WE RECOMMEND THIS ONLY UNDER THE SUPPORT OF A TRAINED CLINICIAN**

·  B Vitamins play a big role in the stress-response and can become depleted over time with chronic stress.

·  Vitamin C has been shown to increase stress-resiliency

·  DHEA is not for everyone, and can have serious consequences if used inappropriately. However, DHEA, a pro-hormone to both testosterone and estrogen, is very helpful in those that have reached complete adrenal exhaustion, where DHEA has also begun to drop.

·  Phosphatidylserine reduces cortisol. This can be extremely helpful with a disrupted cortisol rhythm that is keeping you from sleeping!

·   Adaptogenic Herbs have been found to help the body adapt to stress and move you towards a greater state of balance. I’ve listed some of my favorite adaptogens below:

o   Holy Basil

o   Ashwaghanda

o   Astragalus

o   Glycyrhiza (Licorice)

o   Avena Sativa

o   Scutellaria

o   Schisandra

o   Eleuthrococcus senticosus (Ginseng)

o   Rhodiola

·      Glandulars are the glands of other animals. Relying on the hormones of another animal’s adrenal glands is not a long-term solution, but can be taken to help get you through the day when you are not able to create sufficient amounts of your own adrenal hormones.

This article was written by our Naturopathic Doctor, Dr. Ari Kasprowicz.

Do you believe you may be suffering from Adrenal Fatigue?

Make an appointment with Dr. Kasprowicz to get your adrenals tested today and have a plan created that is right for your individual state.

Friday's Food for Thought: The Importance of Gut Health 

We need to treat the root cause rather than just the symptoms 

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Pursuing true health care is not as simple as following a flowchart. We’ve been conditioned to want to control our symptoms with the use of a pill. Unfortunately, fast and easy symptom management WITHOUT also addressing the root cause allows progression of the underlying disorder. It is not enough to give a laxative for constipation, Beano for gas, Imodium for diarrhea, or steroids for inflammation.

Masking the symptoms does not effect a cure. These medications never address the WHY, nor do they achieve remission. Rather, you are left dependent on a pill to control your symptoms for life, without treating the cause.

Discussing conventional medicine’s compartmentalized approach vs naturopathic medicine’s integrated systems approach to digestive health

Naturopathic medicine sees your digestive system as one component of a fascinating integrated system. It does much more than digest your food — it supports your health from your immune system to your mood and your complexion. This is a primer on how we see your tummy.

The GI tract is not an isolated system

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In the conventional model of medicine, the body is segmented into its respective parts, and individual specialists focus on diagnosing and treating specific areas. But this specialization can interfere with seeing the bigger picture. The body’s systems do not function in isolation, rather our body functions as a WHOLE, and dysfunction in one area can have drastic impacts on the other systems.

The gut and your immune system

When it comes to any health concern, it is important to understand the powerful effects of gut health on the rest of the body. The system most significantly impacted by gut is the immune system.

Eighty percent of the immune system is wrapped around the intestines, and any sort of infection, inflammation, or food sensitivity can trigger an immune response with consequences such as reduced immunity, chronic inflammation, and autoimmune disorders.

For this reason, as a Naturopathic Doctor, I feel that the health of the digestive tract should be a primary focus in almost every patient. In addition to the connection with the immune system, the gut has prominent impacts on skin health and mental health.

How We Approach Digestive Health:

Optimization

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It is not enough to get a patient to a more “manageable state,” especially when it comes to the health of the digestive tract. Because the digestive tract plays such a pivotal role in our overall health, it is essential that it is functioning at its optimum. Therefore, we look at all of the following areas when treating the gut:

Digestion/Absorption

Improper digestion and absorption will not only cause GI symptoms, but can also leave the individual with insufficient nutrients. Vitamin and nutrient insufficiency can lead to a number of critical conditions; therefore, it is crucial to address this as soon as possible.

This can happen for a variety of reasons. The most common are: deficient stomach acid, issues with the release of bile from the gallbladder, insufficient pancreatic enzymes, and blunting of the intestinal villi.

Inflammation

Inflammation in our gut can lead to destruction of the intestinal lining, leading to conditions such as Chron’s and Ulcerative Colitis. It can also lead to systemic inflammation (which is the number one risk factor for cardiovascular disease).

Microbiome

We have 10x as many bugs in our gut as we do cells in our body! These bugs are crucial to our overall health, and finding the appropriate balance is key. Dysbiosis is the term we use when the microbiome has a higher concentration of pathogenic or “bad bugs” compared with commensals or beneficial bacteria. They each have their function, and the goal is to create a healthy thriving ecosystem. Antibiotic use can have quite drastically negative results on the balance of this ecosystem; therefore, it is quite common in our society to find people with a less than optimal balance.

Intestinal permeability

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The gut should be sealed off from the rest of the body. Unfortunately, there is an epidemic of what we call “leaky gut.” Leaky gut is a term that is used to describe the lack of integrity between the tight junctions, which are responsible for holding the cells of the gut lining together. This makes a leaky barrier between what is in the gut and the bloodstream, allowing for large food particles and bacteria to translocate into the bloodstream. Because these particles should NOT be in the bloodstream, the body treats them as pathogens and the immune system is triggered. This is a MAJOR cause of many autoimmune conditions and systemic inflammation.

Pathogens

We de-worm our animals, but we never think about de-worming ourselves. Whether it be parasites, pathogenic bacteria, or yeast — we see it ALL the time on stool panels. These guys are tricky to catch and many tests offered in the conventional world don’t have the sensitivity or breadth of information that we offer in our office. If you have an infection in the gut it is CRUCIAL to treat; however, in order to know what to treat, we must conduct proper testing.

 

Advanced Testing

Comprehensive Stool Panel

This is my favorite place to start with a patient specifically coming in for gut dysfunction, as it gives a COMPLETE picture of the above. Our stool panels not only have the highest sensitivity when it comes to testing for pathogens (parasites, yeast, bacteria), but they also evaluate digestive function (ability to properly break down food), inflammation/immune function, gut microbiome, and intestinal permeability.

 SIBO Testing

Tests for small intestinal overgrowth — a common cause of post-meal belching/flatulence/bloating and what is diagnosed as IBS. It can present with constipation, diarrhea, or both!

Organic Acid Tests

 Looks at indirect markers of gut health through urine metabolites. This test is particularly helpful in chronic illness with neuro/mental health symptoms or a suspicion of environmental toxicity.

 Food Allergy Panel

Not often utilized, as elimination diet is the gold standard and FREE, but for those that are data driven, it can be extremely helpful to see which foods your immune system is currently reacting to.

Address root cause rather than suppress symptoms

Comprehensive Plan   

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Effectively addressing gut disorders takes a COMPREHENSIVE plan. One or two supplements isn’t going to cut it.

We need to consider diet, lifestyle, supplementation, and sometimes medication. Often, treatments will occur in stages, and new things will be introduced and taken away as a patient progresses. The ultimate goal is to get the patient to a place where they are supplement/medication FREE and can enjoy a diverse diet.

This article was written by our Naturopathic Doctor, Dr. Ari Kasprowicz.