Adrenal Fatigue - And The 4 Main Stressors On Our Body

Do you ever wonder what actually happens to our body and adrenal glands with chronic stress? Are you experiencing more than one main stressor leading to "adrenal fatigue" aka HPA dysfunction? More studies are showing negative long term side effects from chronic stress so lets get to the bottom of it and heal the body.

Ever heard the term "adrenal fatigue"? The adrenal glands sit on top of your kidneys and one of their main functions is to produce and secrete a hormone called cortisol. It is stimulated by the hypothalamus and pituitary signals, hence HPA axis. There are many receptors throughout our body that respond to cortisol to stimulate a "fight or flight" response - aka helping us run from that dangerous tiger. However due to four main reasons, our bodies may constantly be running from the tiger when it isn't even there! This of course takes a toll on us. 

Common symptoms of HPA dysfunction:

• fatigue
• insomnia
• brain fog
• anxiety, depression
• chronic colds and flus
• weight gain
• shakiness 
• PMS
• fibromyalgia
• diabetes 
• hypothyroidism
• eczema 

How is your body responding to the stress?

The more I practice, the more I realize the importance of discovering the underlying cause and response of these symptoms for each individual and treating it accordingly. For example, if one patient has more anxiety due to an inability to clear free cortisol effectively due to poor liver or thyroid function, I would treat this much differently than with a patient who is fatigued and depressed due to a down-regulated response in the HPA axis leading to low metabolized cortisol. 

Metabolized vs free cortisol what?? A DUTCH lab test, that I do in my practice and find very valuable, can actually differentiate these hormones and how they are broken down and metabolized. For example free cortisol is how much active cortisol is on our body, representing only 3-5% of our body's cortisol, and metabolized cortisol is what our adrenal glands actually produce, representing around 80%. Blood and salivary tests only test free cortisol, which is not the full representation of what is going on! 

(The DUTCH test actually test test SO MUCH MORE than cortisol, including sex hormones and their metabolites, melatonin and liver detoxification function...all so helpful to see!)

So what is actually causing this HPA axis dysfunction? It typically is not only the day to day stress we experience at our job or due to our daily schedule. If we can decrease these triggers the normal feedback systems within our bodies will recover and symptoms will improve.

Four triggers of HPA dysfunction:

1. Perceived Stress - This is the main trigger of cortisol dysfunction. Whether it be our go-go-go lifestyle preventing us from resting and recovering, or financial, job or relationship stress. Everyone perceives stress differently and some people may be less resilient than others. That trendy word mindfulness comes in here as well as simply taking time for yourself to recovery. 
2. Inflammation - This means ANY type of inflammation, including any autoimmune condition, an inflammatory diet full of sugar and inflammatory foods, gut issues, obesity, or chronic sickness. Inflammation of any kind up-regulates the HPA feedback system to put out the fire. 
3. Blood Sugar Dysregulation - High or low blood sugar affects insulin levels, which ultimately disrupts the HPA axis. This is why is it important to eat a low sugar diet with adequate protein, fat and fibre to slow down absorption of sugar and keep you full for longer. Look for foods with less than 7g of sugar, with full fat and good quality protein. Are you experiencing an energy crash in the afternoon? This means your blood sugar is not regulated! The first thing I suggest is changing your breakfast to include a protein and fat. 
4. Circadian Rhythm Disruption - I say it time and time again that our body LOVES routine. Too much exposure to light in the evenings, aka staring at a screen all evening, and not enough sun exposure during the day, aka too much time in an office and no sunshine, can affect the hormone cycles. Your cortisol can therefore be spiking at the wrong time. 

Once we establish your main triggers and how your body is actually responding to those triggers, several Naturopathic treatment options can help along the road to recovery. I love adaptogenic or nervine herbs to calm or support the HPA axis (more to come on the difference). IV therapy can help to support the immune system and adrenals (still discounted for the month of August!). Addressing the pillars of health of diet and lifestyle are always important as well. 

Questions about what was mentioned here or curious where your hormones lie? Come in for a visit!  I am always here to help. 

In health & happiness, 

Dr. Karen

Insomnia Got Your Down? Tips For A Better Quality Sleep

With the longer days in the summer we tend to go to bed a little later and wake up with the sun a little earlier. That doesn’t mean that the time you do sleep has to be compromised! A good quality sleep is essential to maintaining good health. Take it from Kirk Parsley in this TED Talk. Sleep is when we do a lot of detoxifying, when our stress hormone cortisol decreases, when we repair our tissues and so much more. We are more productive and alert after a good night sleep therefore more effective throughout the day. 

So how do we get more sleep? Here are some simple tips to help you. 

Lifestyle Tips:

1. Stick with a routine - I say it time after time that our body loves routine. We end up with a better quality sleep when our body knows around when to shut down and when to wake up. There are several sleep cycles we go through during a night and with a good routine our body will naturally come out of the sleep cycle when needed, instead of jolting awake in the middle of a deep sleep. 
2. Bedtime routine - Melatonin production increases in the evening to help you fall asleep. Blue light from screens (ie. TVs, iPads, cell phones) block melatonin production therefore impeding the onset of sleep. Try to turn off all electronics a half hour before bed or if really necessary use an app such as f.lux to eliminate the blue light. Do a little reading right before bed, spend time with your partner or take a bath with some calming essential oils such as lavender. 
3. Leave the bedroom for sleep and sex - Are you working in bed up until you go to sleep? Watching tv? Is your bed a playground for pets and children? If you struggle with sleep try to maintain your bedroom as a sort of sanctuary and don’t bring in things you don’t need. Leave your phone outside the room, light a candle before bed, and try to avoid distractions in bed such as pets crawling around. 

Food as Medicine:

1. Avoid coffee in the afternoon - Caffeine has a half life of about 6 hours. Therefore the extra coffee to get you through the afternoon slump may affect your sleep later on. That goes for pop and caffeinated tea as well. 
2. Have a tsp of raw honey before bed - Raw or unpasteurized honey is a great source of tryptophan. The tryptophan then gets converted to serotonin and melatonin in the brain to help calm the mind and trigger sleep. It also helps maintain liver glycogen levels which the brain relies on throughout the night for energy. If you wake up around 1-3am your liver may be struggling to provide glycogen therefore this may be a good trick for you. 

Supplements/Herbs:

1. Magnesium - This is a very common deficiency as it is difficult to get a lot from our diet. Magnesium has been shown to have a calming effect on our nervous system and relaxes our muscles priming us to relax. I recommend 200-400mg of magnesium bis-glycinate to start before bed. 
2. Nervine herbs - Some of my favourite calming herbs are chamomile, passionflower and valerian. Combined in a sleepy-time tea is a great tool to use if you struggle with sleep and something I often do for my patients.
3. Melatonin - As your cortisol decreases throughout the day, melatonin starts to increase peaking during the night. It is more likely helpful for those who have low melatonin levels (something that can be tested for). I recommend starting with 0.5-3mg a half hour before bed. Many people find lower doses more sedating than higher doses and cause less dependence. 

If you are struggling with sleep, start with these simple tips but I am always here to help to discover the root cause of your sleep issues! 

In health & happiness, 

Dr. Karen

5 Reasons That Scale May Not Be Budging

Although I sometimes wish we could mimic brown bears and pack on weight and hibernate in the winter, our lives keep moving forward in the colder months. The weight, however, may still be something you have acquired and are struggling to shed. Although it may be keeping you warm at night, it might be preventing you from doing activities you love or feeling like yourself. Have you tried different diets or exercise routines but are not seeing results? Below are 5 reasons why that scale may not be budging:

1. Lack Of Sleep:

During stage 4 sleep is when we decrease inflammation, eliminate toxins and decrease cortisol, our stress hormone. It has been shown that lack of sleep increases the hormone ghrelin which stimulates hungry[1]. Therefore when we have a poor sleep, we tend to eat more the next day. We also are less inclined to make better food choices and get some exercise. Aim for 7-9 hours a night with little or no interruption.

2. Hormone Imbalance:

A common complaint for menopausal women is their belly fat, or the so-called muffin top. A decrease in estrogen stimulates a production of body fat to store estrogen. High estrogen, causing PMS symptoms, can also be a problem as it is associated with water retention. Good liver support is necessary in these cases to ensure proper estrogen excretion and balance.  

3. Chronic Stress:

When we are exposed to chronic stress, either from work, family or other factors, our nervous system is in overdrive. A spike in cortisol spikes blood sugar and can lead to increased hungry, cravings and body fat[2]. When we become burnt out our cortisol level drops, leaving us with an imbalanced hormonal system and low energy. Decreasing stress by adding more gentle exercise such as yoga, deep breathing or an adrenal support supplement may be helpful.

4. Food Sensitivities:

Do you ever feel bloated or that your stomach is hard? It may be due to a food sensitivity. This is another common barrier I see in my practice and something that is easy to control. If you are eating something your body does not agree with, an inflammatory response is produced. Inflammation leads to water retention. In my practice, when we eliminate a food sensitivity, determined via an IgG blood test or an elimination diet, we almost always see weight being shed quickly.

5. Lack Of Protein:

A lack of protein in our diet can lead to mood disorders, memory loss, increased appetite and cravings, decreased metabolism, sleep disruption, muscle loss and weight gain. In fact, I find that many patients are eating too many carbs and not enough protein when they initially come visit with me. Protein packs a punch because it stimulates the activity of many of our fat-burning and appetite-controlling hormones when we consume it in the right amounts. A serving should be the size and width of your palm and eaten three times a day with a smaller serving as a snack. For weight loss, start by having protein at each meal and only one meal a day with a focus on carbohydrates.

If you are discouraged from not seeing the scale budge, you may be experiencing one of these 5 barriers. Some extra support and testing may be all you need to start seeing results. I have seen big shifts in weight when we address these issues and even add in a little jump start. I am here to help!  

In health & happiness,

Dr. Karen

References:

[1] http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2869.2008.00662.x/full

[2] http://www.psyneuen-journal.com/article/S0306-4530(00)00035-4/abstract

Magnesium: The Relaxation Mineral

Magnesium is one of my favourite minerals and one I use a lot of in my practice due to the plethora of conditions it can help treat. Mainly it is a relaxation mineral, relaxing your muscles, mind and mood. It is a very simple mineral but a common definitely we tend to have. 

Magnesium is crucial to our bodies as it is needed in over 300 reactions as a co-enzyme. Basically if we don’t have enough magnesium our body doesn’t work optimally leading to several issues, including high blood pressure, migraines, cramps and even acid-reflux, just to name a few. Unfortunately magnesium is hard to get in our diet due to soil depletion and heavy food processing. It is also depleted from an excess of coffee or pop. It is found in foods such as seaweeds and other leafy greens, as well as nuts and seeds but it is difficult to eat enough of these foods to get sufficient magnesium levels. Multivitamins also don’t typically have enough magnesium to top up what we do get from our diet. Those supplements tend to have 0-70mg/tablet, which is far lower than the recommended dose. 

Wondering if you could use magnesium? What does magnesium help with:

• Muscle pain - relaxes skeletal muscle, which we use during exercise and which get tight during times of stress 
• Cramps - either muscle cramps like charlie-horses or hormonal cramps during your period
• Constipation - relaxes smooth muscles in your gut (magnesium citrate is the best form for this)
• Migraines - a great addition for migraine treatment plan 
• Insomnia - helpful to take before bed
• Stress - the more relaxed we are the better we can handle stress
• Hypertension
• fibromyalgia
• Acid reflux
• PMS - balances mood
• Metabolic syndrome - eg. diabetes
• Hypothyroidism 
• Osteoporosis - helps to build bone
• and so on!

I usually use magnesium bis-glycinate in my practice as it is more highly absorbable and has less side effects, ie. loose stools. Magnesium citrate is only helpful with constipation. The dose varies depending on the person and symptoms, however a good starting dose would be 400mg at night. working up from there if needed. Talk to your ND about what dose is right for you. Epsom salt baths are a great addition to your bath routine as well as they are full of magnesium. Myers intravenous therapy, which I do in my practice, is another great way to get a helpful boost of magnesium. It is a safe supplement to take however be cautious and speak to your doctor if you have hypertension, kidney disease or are pregnant. 

Crave chocolate? You might just be deficient in magnesium! 

In health & happiness, 

Dr. Karen

(Photo credit: www.purabotanica.ca; articles.mercola.com)