Low Energy? What blood work an ND may want to see.

If I was to ask you to rate your energy on a scale of 1-10 (10 being great) what would you say? If you said lower than 5/10, even after a good nights sleep, it is something that should be addressed.

I like to review blood work first when fatigue is a concern, as a few common nutrient and hormone deficiencies can be the culprit. The reference ranges I refer to may be slightly different than your MD for a few reasons.

1. I want to optimize your levels to sustain better energy.

2. I am referring to the newest reference range recommendations that will hopefully be reflected in blood work soon.

3. I see results when patients levels reach a certain level.

So what blood work do I like to see and what levels should they be at? This may vary slightly depending on someone’s health history.

• Vitamin B12 - This should be above 200 pmol/L, ideally above 450 pmol/L.

• Ferritin - You have iron deficiency anemia if your ferritin level is below 30 ug/L. Unfortunately, this is becoming more and more common in today’s society. A full iron panel is not often needed.

• TSH - Your thyroid stimulating hormone should be between 0.8-2.5 mIU/L. This can fluctuate during times of stress or hormone changes. Medication is not often needed until the level gets much higher, however supporting adrenals (stress hormones) and the thyroid gland if out of this range can help.

• Morning Cortisol - Between 7-9am your level should ideally be between 450-550 nmol/L. Cortisol is an essential hormone that plays many important roles, including regulating your body's stress response. If it is low you are most likely suffering from burnout!

There are several reasons why someone may be deficient in any of these and it is important to address the cause as well as supplement for the deficiency.

Take a look at your most recent blood work. What are your levels like? I’m happy to help improve them and ultimately your energy!

Burnout & Energy Crashes - Unpacking Reasons Why

Burnout or fatigue...a very common concern I see in practice. 😞😴 But I promise you don't have to feel like this forever! ⠀
If you have been feeling emotionally and physically drained for awhile now let's dig into some common reasons why this may be. ⠀

1. Nutrient deficiency

Have you had blood work done to check nutrient levels lately? Some common blood work I like to see for those who are struggling with energy are:⠀⠀

• ferritin (your iron stores)⠀

• B12⠀

• Thyroid panel - additional symptoms may point us to look into this⠀

• D3 - surprisingly common to be low in those that are struggling

This is often where I start because it may be the simple solution. Symptoms such a heavy periods, or poor digestion may push me to get these checked sooner rather than later as well. ⠀
If these look good, we dig a little deeper...

2. Adrenal insufficiency (aka burnout)⠀

This is the one of the most common causes of fatigue I see in practice. You may be or have been in "fight or flight" for awhile, bombarding your body with cortisol and adrenaline (those get up and go hormones). It's telling you it has had enough and won't be listening to the signals anymore. Your body has decreased its production of cortisol, affecting your circadian rhythm. ⠀
We need to support your body with adaptogen herbs such as rhodiola, ashwagandha and holy basil and vitamins such as vitamin C, magnesium and Bs to support cortisol production again. ⠀
OR....⠀
We need to calm down your nervous system with nervine herbs such as passionflower or lemon balm to decrease the "fight or flight" response. ⠀
Is this you? 

3. Female hormone imbalances

This is a big topic itself so I'll just be brushing the surface here, but hormones can definitely affect your energy level. ⠀
Do you see a cycle to your fatigue? This could mean it is related to your menstrual cycle and therefore related to imbalances in estrogen and progesterone levels. ⠀
This is normal to see happen to some extent but not to the extent it interferes with your life. I’ve touched on this before but typically we see an increase in energy the week before ovulation (we are more extroverted) and then it decreases before your period (and we are more introverted). But if you feel so wiped several days before your period we assume either progesterone is low (do you also have spotting before your period?) or estrogen is too high (crazy mood swings or breast tenderness as well?) creating an imbalance. ⠀
What is great is that we can test these hormones through blood or urine with the DUTCH test and there are many great herbs and more natural modalities such as acupuncture that can help balanced it all out. 

Any of these signs common to you? Let’s explore together.

In health & happiness,

Dr. Karen

Adaptogens for Healing Burnout

Do you feel like you are running on empty but you can’t find the time to refuel and replenish? A feeling of overwhelm can eventually turn into burnout and it is an unfortunate epidemic in our society these days. We tend to have too much going on than our bodies can handle and we don’t take the time to recharge our batteries. Women are more likely to feel the impact of overwhelm and burnout on their mental and physical well-being but that doesn’t mean we don’t see it in men. You may be a nurse who does shift work, a police officer needing to pump out adrenaline on the job, a new mom getting little sleep, or a menopausal women taking care of both teenagers and elderly parents. It all leads to the same thing if we can’t take care of ourselves! 

Some mild symptoms you may commonly experience are fatigue, poor sleep, sugar cravings and irritability. It can eventually lead to symptoms you may not acknowledge as burnout such as anxiety or depression, insomnia, poor memory, low libido, muscle soreness, inability to lose that dreaded belly fat, and a poor immune system. What we really need to watch out for is when the body can’t support itself anymore and autoimmune conditions such as Hashimotos thyroiditis or rheumatoid arthritis occur or potentially blood sugar issues or chronic hives. Eekk!

What is burnout?

Burnout is when you have pushed your stress response system pasts its limit of resilience. Your body is putting on the brakes to protect itself as best it can, forcing you to take it easy. Its the little white flag saying “I surrender.” These are the clues for you to take a step back or support your way through it. This is where adaptogens come in! Thank goodness all is not lost! 

What are adaptogens?

Adaptogens are herbs and fungi that have been around for many years. They help us adapt and heal from stress, hence the name, and they definitely come in handy in my practice! There are a few categories of adaptogens - calming, nourishing and stimulating - therefore best to know where you're at in the “burnout phase” to get the most out of them. If you use something too stimulating when you need more nourishing you may be adding fuel to the fire and cause more anxiety. 

Stimulating: These are helpful when you aren’t quite burnt-out but need support to get through an intense time, eg. studying at medical school, meeting a work deadline or working a night shift. Examples - panax ginseng, matcha, rhodiola.

Nourishing: When you need to fill the bucket up again and refuel these come in handy. They acts as building blocks lets say to boost cortisol. Most of the adaptogens fall into this category. Examples - ashwagandha, rhodiola, holy basil, licorice (not advised for high blood pressure), medicinal mushrooms. 

Calming: When someone is feeling anxious and their body needs to hit the reset button, these calming adaptogens are very helpful. They slow down the output of cortisol. Examples - schizandra (calms the mind), avena sativa, holy basil, motherwort. 

A reminder that adaptogens should not replace nourishing lifestyle habits that support a calm and relaxed state, such as meditation, sleep, nourishing food, time in nature and time with loved ones. Adaptogens are also not suitable during pregnancy. 

If you are feeling burnt-out and need a reset come chat! I’d love to help pick the right adaptogen for you. 

In health & happiness,

Dr. Karen