Podcast Episode #39: Adrenal Fatigue Part 2

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Topics:
1 : Hormone Supplementation [9:26] 2: Adrenal Protocols [22:49] 3: Hard time regulating blood sugar [39:33] 4: Shingles [45:07] 5: Can’t get enough sleep due to lifestyle [58:17] 6: Cycling Adaptogens [1:05:33] 7. Why running?! [1:07:37]

Don't miss Part 1 and Part 3 (with Dr. Dan Kalish)!

Show Links:

Chris Kresser: “Low T3 Syndrome IV: an autoimmune disease you’ve never heard of?”

Mary Vance of Holistic Nutrition Bytes -Holistic Nutritionist -San Francisco Bay Area

Diana Rodgers of Radiance Nutritional Therapy – Boston region Nutritional Therapist

Book How to Eat, Move and Be Healthy! By Paul Chek

Episode #15 – Adrenal Fatigue, Part 1

Click here to download the episode as an MP3.
The episodes are currently available in iTunes, Stitcher & Blog Talk Radio.

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LIZ WOLFE:Hey everyone, I’m Liz Wolfe here with Diane Sanfilippo of Balanced Bites. Welcome to the Balanced Bites podcast, episode 39, I think. Adrenal Fatigue, Part 2. And apparently, my ghetto, you know, phone is not serving its purpose at this point, according to Diane. [laughs]

DIANE SANFILIPPO:Yeah, we need to upgrade your phone situation for a variety of reasons, not the least of which is the fact that I’m pretty sure the battery life of your phone is about, like 36 minutes. So….

LIZ WOLFE:[laughs]

DIANE SANFILIPPO:Like every time I’m trying to talk to Liz, she’s like, sorry, my phone’s dead. I’m like, so this is either Liz trying to avoid talking about anything with me or…

LIZ WOLFE:I’m just like, I don’t want to talk to you. That’s all.

DIANE SANFILIPPO:Yeah, I’m sure…

LIZ WOLFE:Yeah, it’s bad. My phone’s like the old school phones that are shaped like candy bars, and they have those old ringers that are bwa-na-na-na- bwa-na-na-na. [laughs]

DIANE SANFILIPPO:Oh my God.

LIZ WOLFE:I don’t have text messages, so….kidding.

DIANE SANFILIPPO:What’s funny is that I remember when phones were really big. And then they got really small. Now they’re kind of big again. I don’t know…

LIZ WOLFE:I had a friend with the Zoolander phone, literally with the phone from Zoolander that was like the size of a Chiclet. [laughs] I’ve got candy on the brain right now…

DIANE SANFILIPPO:Uh-oh.

LIZ WOLFE:At the end of the Sugar Detox, this is really…it broke the habit, but now I’m thinking about it a little bit. Like I wonder if I’m going to have any, you know, dark chocolate any time soon. I don’t think I am. I think I’m good for now.

DIANE SANFILIPPO:[laughs] Well, that’s good.

LIZ WOLFE:I think the Detox broke the habit. Well, that’s good. So, all right everybody, remember our disclaimer: that the materials and content of this podcast are intended as general information and are not to be considered as a substitute for professional medical advice, diagnosis, or treatment.

So I might be a little bit fuzzy. I really don’t know how to fix that, Diane. Let me mess around with this headphone. I’m kidding. I have an iPhone.

DIANE SANFILIPPO:Oh, that might be better.

LIZ WOLFE:Is that better?

DIANE SANFILIPPO:Yeah, I think that’s a little better.

LIZ WOLFE:All right.

DIANE SANFILIPPO:Yeah, that is better.

LIZ WOLFE:These are pretty crappy headphones. All right, so upcoming workshops. We are closing out our Spring/Summer 2012 workshop season. We had an amazing run. Really grateful to PaleoKits and U.S. Wellness Meats for helping us bring this workshop all over the country for an extremely reasonable price. So if you’re anywhere-well, we’re booked up through Fall 2012 as well, so if you’re anywhere in a several hour radius, come see us this weekend at CrossFit Amplitude in Winston-Salem, North Carolina or CrossFit Voltage in Charlotte. We love travelers, so if you do make the trip, be sure to let us know, so we can give you extra fist bumps and high fives. I mean, we know it’s a challenge for a lot of people. But we’d love to see you, and unfortunately, there’s no guarantees that we’ll be able to make it to yoru town if we’re already scheduled in the general region. We try and be as logistics oriented in our travel as possible, such that we’re not hopping back and forth and back and forth too much. We like to stick in one region and move on to the next, so look at that schedule and see if we’re near you.

DIANE SANFILIPPO:Yeah, I think we have mostly-what’s coming up in the fall, we actually have a ton of East Coast workshops, so I think we’re trying to see if there’s a couple people we’re talking to about some last scheduling, like one last weekend that we might get in on the West Coast this fall. But otherwise, we’re mostly on the East Coast, so check out the schedule, and then definitely stay tuned for what will be coming up early 2013. I know it sounds like it’s so far away, but we book these things really far in advance. Next year we’ll definitely be getting back out that way to the West Coast, probably back to Texas, just kind of more in that direction. And probably not surprisingly, we’ll probably not be in too many cold places this winter. [laughs] I made the mistake of going to the Midwest in March a couple years ago, and I was like, what…what am I doing? [laughs]

LIZ WOLFE:What were you thinking?

DIANE SANFILIPPO:It was blistering cold. That was crazy, but anyway. We have to find out if our locations this weekend have air conditioning, just so we’re aware…

LIZ WOLFE:Yeah, yeah. We have to plan our outfits such that…we had…when we were in West Houston, we give out these feedback forms. And, remember that feedback form we got that said, “Tell Liz not to wear a shirt that she has to yank and pull on all the time”?

DIANE SANFILIPPO:Mm-hmm.

LIZ WOLFE:Well, my shirt was melting off of my body, so I had to make sure that it didn’t like [laugh]…

DIANE SANFILIPPO:[laugh] I know…

LIZ WOLFE:melt all the way off. You got to be careful. We have to pick outfits that we can sweat in with little…that’s why it’s a fence to the general crowd.

DIANE SANFILIPPO:I usually tell people right off the bat, yeah, I don’t wear anti-perspirant so you’re going to see sweat. Sorry.

LIZ WOLFE:Yup, yup. Anywho, so what else?

DIANE SANFILIPPO:I’m trying to finish my book in the next week or so, so this podcast topic is near and dear to my heart right now on adrenal fatigue because I am like teetering on not wanting to just not wake up almost every day, but I have so much that I have to do. A lot of kind of back and forth work that we’re getting done. I mean, I absoluitely understand how everyone who's asking these questions is feeling. There’s a light at the end of this tunnel, but yeah, as far as like other places that I’ll be this summer, other than sleeping in my bed, or sleeping somewhere on the beach, or possibly…

LIZ WOLFE:Sleeping somewhere in public?

DIANE SANFILIPPO:Yeah, like down the Shore, I’ll be at my Whole Foods buying some really good food, but yeah, mid-July, I will be at the CrossFit Games, as will you, right, Liz? Representing Steve’s Club and PaleoKits will be there? And I’ll just be hanging out trying to avoid the scorch on my face that happened this week at Northeast Regionals. Oh, I came home and was peeling and I had forgotten to bring that trusty zinc oxide Badger sunscreen with me, which I will not forget to bring to LA. So we’ll both be out there mid-July. Definitely look for us. Again, definitely look for Liz at the PaleoKits booth, and I don’t know, you can find me…who knows? Maybe I’ll try and wear a Bacon is Rad shirt or something. Those have sleeves. I’m not really sure how that’ll work in the LA sun. But then, er, it’s actually Carlson, California. I just say LA.

LIZ WOLFE:Oh, no, you have to be as naked as possible. I mean, it’s the CrossFit Games.

DIANE SANFILIPPO:Ugh. I’m just thinking it’s going to be some gnarly tan lines if you’re not. Like, forget the rest of these issues, I have no idea about the shade issue. So that’s mid-July. So like July 13th, 14th, 15th, I think. And then July 20th, not that probably tons of people who are listening to this will come to this event, but I’m sure there are a handful. I’ve actually gotten in contact with a few people. July 20th, that weekend there’s a Juvenile Arthritis Foundation Conference. I think it’s in New Orleans. And, so I’ll be speaking there to some of the teenagers, maybe to their parents as well about nutrition, so that will be really cool. I’m really excited about that. July 20th weekend. And then August 7th is the hard release date of my book, so I’m really excited about that. I don’t know. This home stretch is really just taking like every last bit of juice out of me. Like I’m just…Heh. I remember a couple of years ago, listening to Robb Wolf on his podcast talking about working on a book and teaching workshops and seminars, and you know, this last stretch of workshops we’ve had, since, I would say, in May 5th, I actually planned on finishing the book by the end of March….

LIZ WOLFE:Haha.

DIANE SANFILIPPO:So I didn’t think I’d be working on it right now. Yeah, yeah. The best laid plans…that’s why I don’t really plan anything for myself. So to be like trying to finish the book and to be traveling a ton to teach? Like I love love love teaching the workshops, but it is taking everything out of me. So I’ll be underground for awhile after this is done. I’m not complaining I love every bit of it. I'm thrilled to be able to do all of this, but it's just been-it's been a real gasser for me, I would even say the last 6 months. So yeah, everyone whose questions I'm going to be answering today, I feel you. I absolutely feel you, so…anything else you want to tell people before we roll into questions, 9 minutes in?

LIZ WOLFE:I think we're good. We'll get right into it. All right, question number 1 from Margaret: “Hi Diane and Liz- This may be a lengthy question, but let me give you my background. I listened to your Podcast episode #15 about adrenal issues. Great information and it really helped me understand better what’s going on. Last April is when I began my paleo journey. Within a month I was feeling great and really energized. All of a sudden I began to feel lethargic with headaches and feeling faint. I have a low thyroid which I take Synthroid for already for about 5 years, so I assumed that my thyroid was out of whack. I did read about adrenal fatigue before going into to the doctor, so I had them test my adrenals. My blood pressure was extremely low and my labs came back with a diagnosis of adrenal insufficiency/Addison's Disease. My cortisol output was 3, ACTH was 1250, testosterone and dhea were low as well. I was given hydrocort 20 mg a day, 15mg dhea, 30 mg pregnenolone, alpha base vitamin without iron, progest on days 14-28 of my cycle, testosterone, fludrocort, synthroid. I was told this is what I have to ingest pretty much everyday.

I went to about 3 different endocrine doctors until I found someone that included diet and nutrition. My dr loves that I eat Paleo, although he doesn’t eat Paleo. He thought that I may be able to decrease my hydrocort later. Well, I tried to decrease it myself by 2 mg daily. Within 2 weeks of doing this, I had an adrenal crisis and had to be rushed to the hospital. So now I am very scared to decrease this on my own. My labs come back better every time I have them done. Do you think I can ever decrease the amounts of meds/supplements that I take? Or is this too serious of a disease to mess with the meds/protocol. My hormones I take are bioidentical. I exercise maybe 2xs a week. I work a part time non stressful job from home and have 2 kids under 5. I haven’t felt this good with the way I eat in my entire life. I sleep well, eat well and am happy…but I ingest this copious amount of meds. Please give me your thoughts on my situation, what, if anything I can do or any suggestions you might have for me. Thank you.”

And just throwing in there, like we say in the beginning, we cannot give medical advice, and we will not be able to get anyone off medication. We can kind of toss around these ideas, just kjind of help shed a little bit of light on what's going on, but just everybody needs to know that we are not doctors, and that's not something that we so much deal with, but this is a great question because a lot of peole deal with it, so…Diane, should I read this food here?

DIANE SANFILIPPO:Yeah, because I am going to give her some-a couple of-I think I'm going to give her a couple of dietary recommendations based on that, so yeah.

LIZ WOLFE:Cool. “In the mornings: eggs, a vegetable and a meat (bacon/nitrate/nitrite free, etc) lunches: meat and vegetable probably from dinner the previous night; snack on olives, tomatoes, etc. Dinner is the same. I use coconut oil, renedered bacon fat, olive oil. Yoga once a week, light walking 2 times a week. Grass fed cheese once a week.” And that's about it. And she has also pre-ordered the book, which is wonderful. Way to go. So what do you think, Diane?

DIANE SANFILIPPO:[laughs] Yay! All right, so a cuple of things here. We get this type of question a lot from people who have autoimmune thyroid conditions who are always asking about coming off of their like meds, and I say that kind of with finger quotes, because the thing about these autoimmune glandular conditions is that you're not really on a medication. Yes, you're on a prescription, but what you're on is a hormone that your body can't or isn't making right now. What's happening is that the gland is probably partially destroyed, and you need that hormone. Like when you're taking that in, when it's thyroid hormone, or in this case, cortisol because its adrenal, you know, adrenal insufficiency, this is actually the real adrenal insufficiency. This is like somebody whose glands can't make the hormones, this is totally different from what most people are dealing with. Most people are not dealing with Addison's. This is the only medically diagnosable condition that's related to adrenal fatigue. So just people understand that, if you do go to your doctor, and he's no, you're fine, it's because you can't be diagnosed with this condition. That being said, it is an autoimmune condition, you may not ever be able to lower that dose. It's impossible to know whether you need all of that cortisol, or if at some point, you might need less. You know, it's not-okay, your doctor said maybe you wouldn't need as much. Maybe not, and the same thing happens with thyroid hormone. It may change over time. Your body may have different requirements in a few months or even in a few years. So paying attention to how you feel regularly is really important.

That being said, if lowering that dose put you in the hospital, I would not play around with that much. It's a hormone that your body needs. This is how critical cortisol is in the body. This is why when I make recommendations for the rest of this podcast for the people who are, you know, essentially burning the candle at both ends, like this is exactly why I want people to take it so seriously. Because even if you don't have this condition, you can end up in the hospital if you exhaust yourself. It's like the whole rock star syndrome, you know, like you just pass out. Your body-it's-that's what it is. your body is no accident. It's not just about eating more of this or that. like this is serious stuff, so you know you may need to be on this hormone prescription for forever, to whatever degree. It is not a medication like others that up or down regulate body function. It's replacing something your body can't make. So I said this before. I want people to just like kind of wipe out that little stigma about taking like a thyroid hormone or adrenal hormone. If your body can't make it, you need it. Done. Do not feel badly if you have to be taking that.

Something you might want to look into, I don't know if it would be less expensive for you or if it might feel better to try this, and again, I wouldn't, as Liz said, I wouldn't stop your medication, you know you have to talk to your doctor about what you're doing with that. But this may help lower the dose, so I don't know that this is going to really change your outlook about popping pills, like unfortunately, you're going to have to be taking supplements for this condition. But you may be able to get desiccated adrenal gland, which is a way to just sort of support your adrenal glands. This is a really common approach that people take for all different glandular conditions, so you know sometimes people take desiccated thyroid, desiccated adrenal, desiccated liver, just to support their own body function. There's a product called Isocort that may be helpful, but again, if you're taking one, and you just replace it with this other…If you feel good taking what you're taking, I wouldn't question it just because you changed your nutrition, thinking that you don't need what you were taking anymore. If you feel good, go with what makes you feel good. That is something that you could look into, and you know, mostly even recommend that just for people who might be paying out of pocket for an expensive prescription. If you're not paying out of pocket for it. If you've got insurance that covers it, it's probably less expensive to keep taking that than it would be to get this other type of supplement.

In terms of nutritional support, she doesn't really mention any starchy vegetables. I would make sure that you're getting in a least 50 grams of carbohydrates a day. Maybe in the 50-75 range. She's not super active, so I would say she needs a ton, but I would make sure that you're not putting in additional stress on your body by eating too low carbohydrates. It's not stressful for everyone to eat that way, but if you have a known adrenal insufficiency, making sure that you are getting in enough carbohydrates for a couple of reasons. One, just as a substrate for your body, you know…it can be stressful. Again, not for everyone, but it can be stressful to try and run off of ketones, so…and that's what would happen if you're eating too low carb. The other thing is, you want to be getting in plenty of vitamin C. Getting in vitamin C really comes from carbohydrate materials. So you're getting vitamin C-tons of it from strawberries, tons of it from broccoli, I would steam your broccoli. It's tough to eat raw, but if you overcook, you're losing a lot of the vitamin C. Just really seeking that out, you know. Cutting a fresh lemon, squeezing that in your water and drinking that. Making sure that your vegetables and fruits are very fresh to get the vitamin C. Vitamin C is a really big support nutrient for your adrenal glands.

Also, what's really supportive of your adrenals is a good sea salt, so the minerals and potentially iodine, just natural level. I don't tend to like iodized salt because what you generally get from a supermarket, there's other additives in there. You know, there are some people who are interested in that, get the iodine in their diet, but I think a general mineral rich salt…I like Real Salt brand. Redmond Real Salt. That's a good one. But generally speaking, too, she's doing a pretty good job with keeping her exercise levels moderate with yoga once a week and like walking. So you know, she's not complaining about anything with regards to like body composition, so if that's working for you, stick with it. I wouldn't try anything that's too intensive. And that's really it.

I think the bottom line here is just understanding that you are at a disadvantage because you've got a gland that may have been attacked by an autoimmune condition, you can't just stop taking the hormone that's replacing something your body would have made. And that's what really important to remember, and it's also important not to feel bad about it.

Do you have some more advice for her here, Liz?

LIZ WOLFE:I have had a lot of success with a few clients that have gone on a very adrenal supportive protocol with like what you were talking about, glandular I think…DrRons.com D-R-R-O-N-S. I really trust the supplements that they carry if you can't get your supplements from a practitioner. I've also had folks get a good amount of sea salt, like you're talking about. The Redmond's salt with a squeeze of warm water in the morning. I think that's a good idea, but I've also had folks with basically any kind of adrenal stuff going on, particularly any kind of diagnosed conditions or subclinical condition to do…just pull out nightshades: tomatoes, potatoes, peppers, that type of stuff. I think is worth a try. I keep hearing about a former client of mine that did that, and not only did she reduce her meds, but she also starting hitting all kinds of PRs in the gym so if that's not a great, you know, symbol of health, I don't know what is. But yeah, everything that you said, totally totally agree. Totally agree.

We should put the supplements in the show notes.

DIANE SANFILIPPO:Another…Okay, yeah, I was just doing a quick little search here. One of the supplements that I actually have on hand for myself that I'm reminding myself to pop a couple of these today. There's one from a company that's mostly only accessible by practitioners, but it looks like it's becoming available on Amazon. And I wouldn't recommend that people just kind of go out and just start popping all kinds of supplements, you know, without working with a practitioner. Obviously, we're giving this woman some advice. Her name's Margaret. Some advice based on some background she's giving us, but there's one called Adrenal Complex from a company called Designs for Health, which is one of the lines that I use in my practice. And that supplement has a lot of different adrenal supportive nutrient like we were talking about, I think it's its vitamin C, B vitamins, some adaptogenic herbs, and it also has desiccated adrenal in it. So that might be the kind of thing. There are supplements that you have to take for life when you have these conditions. same thing happens with thyroid conditions like this. Taking different selenium, different herbs, pretty much for forever ends up happening, so just might be something else for her to look into, but yeah.

Yeah, who's up next? Shannon.

LIZ WOLFE:Question number 2 from Shannon:

DIANE SANFILIPPO:Is it a long one?

LIZ WOLFE:It's a long one, but this one, I'm really excited to read this one. I think is all of these are just really great questions. Shannon says: “First, I want to start off by saying that I love your podcast and I have learned so much. I’m planning on attending your workshop in September in Naples.” Yes, we will be in Florida in September.

“I am 33 years old and have been suffering extreme fatigue for approximately 7 months with hair loss, mood swings, wild food cravings, loss of libido and persistent eczema. I had a positive ANA…”(anti-nuclear antibodies done to test for general immunity) She had that in January. “The doctor ordered a re-test and it was negative. I was told there is nothing wrong with me and that I am perfectly healthy, but no one had any explanation for my fatigue and loss of libido. I decided to see a dietitian to see what I am doing wrong because I thought maybe it was my food. She had me do an adrenal saliva test and diagnosed me with adrenal fatigue and gave me a boatload of expensive supplements which I took for a month and felt no improvement. I found a functional medicine doctor to see and he indicated that although my TSH is normal, my T3 is low and my hormones are out of balance. My FSH came back as 0. He put me on liothyronine 10mg for the thyroid and bioidentical hormone replacement therapy cream. In the 6 weeks I have been on the BHRT and thyroid meds, I have gained 10 lbs., my cravings have been completely out of control and I’m a basket case.

At this point, I am tempted to stop everything and go back to what I was doing before. I know these things take time, but 10 lbs in 6 weeks is ridiculous. I’m 5’5 and went from 132 to 142 in that short time. All of my clothes are tight and I am beside myself. I should also mention that I had a IgG4 antibody allergy test through Metametrix and found that I am allergic to eggs – probably from over-exposure, but no other food allergies. I’m also having crazy digestive issues – gas, bloating and constipation. I am so lost. What should I do?

As far as exercise, I attend a boot camp 3 times per week, heated yoga twice a week and run a 3-5 miles once a week. As far as food – I eat 90% organic, I try to stay gluten free, but it’s not always possible. Breakfast is typically quinoa cereal and turkey slices, lunch is usually a big salad with homemade dressing or salsa and avocado, dinner is often protein and green veggies, snacks are usually apples and protein, goat’s milk yogurt or a whey protein shake with almond milk or coconut milk. I do have dark chocolate almost every day after dinner and I have been throwing in my fair share of junk foods like peanut m&m’s, frozen yogurt and cookies because of my cravings.”

Yes, Diane, do you want to take it away?

DIANE SANFILIPPO:Yeah, yeah. So this is a doozy.

LIZ WOLFE:Yeah.

DIANE SANFILIPPO:A couple of things..just first off the bat. She mentions that she was on an adrenal protocol for a month, and really for the most, adrenal protocols typically take at least 3 months to really help turn things around. You have to realize how long it takes for you to get to the point where you need that support and turning the whole boat around in a month-we've said this before. When it comes to just food, it's the same thing when it comes to adrenal support: turning the boat around in a month? You can start to feel better; generally people do feel something, but it's not going to happen in that amount of time for most people. If you're on a protocol for a month and you feel nothing, or just in general…I know sometimes people are like just being price-sensitive to this, it's around 150 bucks to get the adrenal test done. But generally, getting a test done once, and then getting it done 30 days later while you're on a protocol is the best approach. And then waiting another few months to do it again because that 30 day marker while you're on a protocol can tell the practitioner if you A. are responding to the supplements that you're taking at all, B. if you're responding positively, and C. well, you probably wouldn't be responding unfavorably, but just whether or not you're responding. If you're not responding to the supplementation, then there's a different reason for your problem, so you know, the practitioner may be trying to address one reason with the protocol they're giving you, but there could be something else causing the problem. So if you're not feeling better…you know, it's not really cause to just ditch a protocol in general, but it is a cause to reassess it, look for, you know, some changes to it. This is stuff that really requires a longer period of time to fix. It's really-like it's unfortunate, but you just cannot change all of this on how you're feeling in one month. It takes a lot more time, and it takes a lot of dedication.

So you know, I think we get this a lot when we have questions where it's like we love the detail, but when people kind of paint the picture and by the end of the question, you're like “I can hear what's happening here.” Boot camp 3 times a week, hot yoga twice a week. Hot yoga is a definitely more intense situation than regular yoga and running once a week. That's actually a ton of exercise for somebody who's dealing with fatigue. Boot camp? We don't know what's happening in the boot camp, but we can guess that it's a pretty high intensity type of exercise. There is no way that I would send a person who's fatigued to boot camp ever. Not even once a week. I wouldn't even send you to hot yoga ever. I would send you to restorative yoga, just kind of a light and gentle yoga and walking. If you wanted to do any strength training, it doesn't look like she has been in her routine as it is now, but like light to moderate strength training just to keep your muscles from atrophying. But the whole deal with this fatigue thing is that it needs to be a multi-pronged approach to getting your body back to feeling good, and you can't continue to do things that push your adrenaline response, which something like a boot camp would do. It's giving you a sort of artificial high. We're going to talk about this in a little bit with somebody else who's doing some running. But overall, the exercise methods that she has are really adding stress, and she needs a new approach to exercise. And for the most part, it's not really about exercising.

It's really frustrating for people because gaining that much weight-and I'm about the same size as this person. Probably, if I were to go, you know, through that much weight gain in 6 weeks, I would absolutely understand how she's feeling-her, Shannon, I mean. Understanding the weight thing is about hormones. It's not about how many calories are you eating or what are you burning. It's about what your body is doing with all that. if you're fatigued and stressed because of that, it doesn't matter. Like, of course it matters to some degree, if you're eating 5,000 calories a day. But the reality is, your body needs 3 steps.

From a food perspective, this is one of the things where, you know, trying to stay gluten free is not always possible. We don't know how much gluten is affecting some people vs. others. If you're sensitive to gluten and you're not staying strictly gluten free, which, it's not always possible–I just don't agree with that. I think it is possible to stay 100% gluten free. A lot of people do it. If you're sensitive to gluten, this could be making your condition a lot worse, and you're kind of being flippant about it. We don't know, but being flippant about avoiding gluten, I just-I wouldn't go so far as to be eating cookies. It could be hidden in things, and if you're in a restaurant, and I wouldn't say generally that for most people, getting a little bit of it here or there, if you are really sensitive, it is problem. But if you just go ahead and grab some cookies, it's just not usually the best solution. I would just clean up your diet. Get it back to what I consider a clean Paleo diet, which would mean meat, vegetables, and when I say vegetables, it doesn't just mean non-starchy vegetables. It does also mean starchy vegetables, so a lot of times people just strip[ things away and they end up going, you know, too low carb or too low fat. Making sure that you're getting a decent amount of protein, a good amount of fat, and a good amount of starchy material. I would avoid-I know she's talking about gas, bloating, constipation. I would avoid obviously the eggs that you're allergic to. I would avoid nuts and seeds. As much as they are part of the, you know, pretty healthy balanced general Paleo diet, if you have any digestive distress, nuts and seeds can be really tough to digest well. They're not quite as high as cost of the anti-nutrients that grains are high in, but they can easily contribute to the problem.

At the same time, stress will lower your stomach acid, and gas, bloating, constipation are huge side effects of low stomach acid. So, see this is kind of like a web. It's not like a linear thing, or just one thing that needs to get fixed. With everyone who's asking these questions today, it's a web of having to address everything, and that might be overwhelming from the start, but it just needs-make your list of what needs to change, and continue to try and work on each of those things every single day until you get a point where you feel you are doing the very best you can with your nutrition, with your sleep, with your exercise.

So-she's saying, I'm trying to see here, she's saying with her food, she's still doing stuff like quinoa for breakfast, goat milk yogurt…As much as those things may not be that irritating for her, in order to find out what the baseline is, a strict elimination needs to be done. So I was saying, meat, vegetables, maybe a little bit of fruit, and good fats. Getting rid of that quinoa cereal, no shakes…whey shakes-any shakes are potentially very insulin-spiking. Getting liquid food in is a really fast way to bypass digestive functions. I would eliminate that entirely. She might also want to eliminate nightshades as you just said in the previous question. So again, just really sticking to meat, fat, veggies, starchy and non-starchy, a little bit of fruit. She should be fine. If she's worried about finding gluten in things; it's not always possible, she's saying. I have a huge list of ways to find hidden gluten. Eating at home is the easiest way, so you know, not dining out, and when you do dine out, being really diligent about asking questions.

So as for what else could be going on with her, I did a little bit of digging on some of her issues in terms of like the numbers that she was giving us, measurements…and again, this isn't really meant to be diagnostic, and this information is really pretty available for anyone. But it looks like she could be dealing with something that's autoimmune, but maybe even though she didn't come back positive on that one autoimmunity test, Chris Kresser had an article recently on Low T3 Syndrome, and relating that back to an autoimmune pituitary condition. So the pituitary gland is responsible for sending the marching orders for FSH, which is Follicle Stimulating Hormone, the sex hormone. So the pituitary gland is responsible for that, so if she's got zero output on the FSH, it could be an issue with her pituitary gland. That would contribute to all of the rest of this. That doesn't mean that there's a way to just bullet-like fix the pituitary gland…It's a the same thing as an adrenal problem. It's multi-pronged. You have to approach everything. Some of the stuff that Chris was recommending, and we'll put a link to the article, are immune-modulators, so if it is an issue with the gland, and it's autoimmune, you need to support the immune system. So getting in the sun-it's summertime now, and I don't know where she lives, but getting some vitamin D from the sun. Fermented cod liver oil/butter oil blend, which we recommend pretty much across the board for everyone will get you some vitamin D. It'll also be in balance with vitamin A. Other fat soluble vitamins will get you some omega-3, not too much, but a little bit. Vitamin C, as we said before to support the adrenals. Possibly some iodine and selenium. I would work with a practitioner, make sure that you're getting those in the right balance.

And beyond that, I would strongly, strongly recommend that she continue to seek out a practitioner who can work with her. And it's going to take time. You cannot do this in one month. It can be frustrating. You need to remind yourself that this is something that took a long time to get to, and it's going to take a long time to get out of. And I think a lot of times, people do drop a protocol pretty quickly because their expectations are just off. So coming in to work with a new practitioner with the expectation that this is something that might 3 months, 6 months, or even a year to get fixed up, and that doesn't mean you have to talk to a practitioner every single week, but it's going to be a bit of an investment of your time, energy, and possibly some money, and you have to decide whether or not you're ready for that. And if you're rock bottom enough to do that.

LIZ WOLFE:Right.

DIANE SANFILIPPO:And I kind of like throw my hands up and shrug my shoulders because I'm like, this is what you have to do. You know, that's just-there's no other way around it. I don't know what Chris Kresser's sort of caseload sort of looks like right now. I would guess that there's a pretty significant wait time to be able to work with him, so you could definitely contact him or I have a colleague who works with a lot of women who have female hormonal issues, primarily, and she also works a lot with adrenal problems. Her name is Mary Vance, and we'll put a link to her website on here. Hopefully I haven't overloaded her with referrals lately. I do send a lot of people to her./ And she's worked with Dan Kalish a bunch, so anyone who's seen him floating around, he's been surfacing a bit in the Paleo community. He's a doctor who's worked on a lot of things when it comes to hormonal imbalances. So I definitely trust her to work with people but just remember, it's going to take some time. It's like the biggest thing people need to know is that you need to be patient with yourself, patient with the practitioner, and patient with the protocol. And continue to do the testing and see what's happening, and work on all of the lifestyle approaches that need to be changed. It's not something that can just get fixed overnight unfortunately.

LIZ WOLFE:True, true.

DIANE SANFILIPPO:Any other thoughts for her?

LIZ WOLFE:Nope, just patience, like you said. I don't even like to stick with stuff for that long, and I know exactly, you know…

DIANE SANFILIPPO:Mm-hmm.

L:to accomplish some of the things I want to accomplish, it's just human nature to want something to work faster, but like you said, you didn't get there overnight, it's not going to resolve itself overnight. It will take patience and dedication, and self-acceptance potentially across those unpleasant, you know, yet very possible temporary components of finding balance again. Like weight gain or just allowing the passage of time, you know. Anyway, I think you covered it really well.

This next question from Andrew is a short one. I think we'll probably just refer to him to our buddy Diane at Radiance Nutritional Therapy.

Andrew says: “I have just listened to your podcast on adrenal fatigue. I have been dealing with significant adrenal fatigue since late 2010. I discovered why I was feeling so terrible and started making a lot of food and lifestyle changes in April of 2011. I have come a long way since then, but adrenal fatigue continues to be a major problem in my life. I believe that part of the problem of why I’m not getting better is my blood sugar. I have a hard time regulating it even though I eat well. Is there someone (either a naturopath or a nutritionist) in the Boston area that you could refer me to so I could talk to them about this? I am seeing a naturopathic doctor now, but I am not sure that he is as well versed in adrenal fatigue as I would like. Thanks in advance, Andrew eat eggs for breakfast with a piece of Ezekiel bread. I eat a variety of meat usually purchased at whole foods and organic. I usually have quinoa with the meat for lunch along with a spinach salad. The salad will have cucumbers and peppers and onions. I eat eggs for breakfast with a piece of Ezekiel bread. I eat different types of nuts for snacks and also eat gluten free crackers with hummus or tabbouleh. I eat quinoa that has wild rice, hummus, and tabbouleh.”

And, so I have to say this. I'm seeing this a lot. In my practice and just with people that I talk to, there's this subset of people that are interested in kind of the type of nutrition that we teach, Diane, that are still stuck on quinoa, generally low fat, maybe some olive oil, some hummus…

DIANE SANFILIPPO:Right.

LIZ WOLFE:Stuff like that. Kind of the Mediterranean style skewing to the low fat. I'm hearing quinoa, I feel like every single day.

DIANE SANFILIPPO:Mm-hmm.

LIZ WOLFE:So they need to look at…Look, even if we weren't Paleo-oriented people, we're nutrent-oriented people. And when I work with Paleo, I look at nutrients first. And guess what, we happen to find the most nutrients in the Paleo-oriented foods that we recommend. Whether that be organ meat, the cod liver oil/butter oil blend, you know, seafood, oysters, meat, and vegetables and healthy fats. I just don't see a lot of utility in Ezekiel bread, quinoa, hummus and that type of stuff. Maybe every once in awhile, but not like this every type of eating. I don't see a lot of utility in that when there are other options available…readily available.

DIANE SANFILIPPO:Yeah.

LIZ WOLFE:Especially when they can afford to shop at Whole Foods. And they can afford good meats, they're opting out and using supplements with kind of a cheaper grain, so….we do recommend Radiance Nutritional Therapy and we'll link to her. She's in the Boston area or in that region, so…

DIANE SANFILIPPO:Yeah, I think one of the things too when it comes to fatigue is that, you know, whether or not we think that is Ezekiel, which is a sprouted grain bread…whether or not we think that Ezekiel bread or quinoa are nutrient dense, they are carbohydrate dense, and you know, I tend to think pretty bioavailable nutrient poor. Like they may have nutrients in them, I don't know how readily available they are for us. I also don't know that they are right things that we want if we're dealing with fatigue. But at the end of the day, that's a pretty dense carbohydrate hot, and especially for breakfast. You know, I don't have a thing against carbohydrates . I've been writing about blood sugar regulation for a really long time for this chapter in the book, and it's not just about carbs are good or bad, but what kind are you eating, when are you eating them. if you start the day with carbohydrates in a dense form, you know, you could be putting yourself on a bit of a blood sugar roller coaster without even recognizing it, and that will lead to some fatigue. So making sure that you aren't ignoring the fact that you need dense protein and fat for breakfast, it's not about if it's a good food or a bad food, but the reality is what happens when they eat these foods is that they're displacing more potentially nutrient dense foods.

And also a lot of times, you know, if somebody hasn't found their sort of optimal level of health first and they're still kind of holding on to those foods because for some reason they thought they were healthy choices, you know, getting rid of them for awhile for months, not just one month, several months, to see how you really feel without them. Detaching from that emotion, I quote unquote need bread or you know, it's just something easy to fall back on. Really just changing your habits and changing your mindset around those things, and seeing what happens. You know, this isn't like, this is a good food, this is a bad food. it' just a matter of, are you missing out on some nutrient density? And also are you missing out on protein and more importantly, good fat because you're putting in that carbohydrate dense food?

LIZ WOLFE:Yeah, especially against that backdrop of blood sugar issues. I mean, I don't begrudge those folks that are extremely healthy, and I don't know, well balanced a piece of Ezekiel bread or some quinoa now and then. But then in this situation, his health is not where he wants, so that's just spot on.

DIANE SANFILIPPO:Right.

LIZ WOLFE:Right. So we'll link to Diana's website in the show notes. Next question from Lisa. Lisa says: ” I have not always handled stress very well and for the last few years was not getting enough sleep. I was a competitive cyclist who then started doing mostly CrossFit and now am trying to find a healthy mix of both of them while training for my first duathlon. I have had problems with recovery and injury. I’ll just get into a groove with my training and be feeling great, and then I’ll get rundown and sick (upper respiratory usually) and take forever to go away OR I’ll get injured and pull a muscle or get tendonitis that will take me forever to get back to training. This fall was extremely stressful for me at work (for silly reasons that shouldn’t stress me out) and I came down with shingles. I didn’t have time to exercise, and when I tried (I’m a silly CrossFitter, so of course I go back to CrossFit, instead of just a low intensity jog or something) I broke out in hives twice (once from CrossFit and once from a high intensity bike ride). My body couldn’t handle the stress of exercise.

I also was so stressed, that I caved from my Paleo lifestyle and was craving sugar in my rundown state. I also suffered depression and anxiety for the first time in my life. I’ve gotten out of that rut and am starting to lose the 10+ pounds I put on, and have significantly reduced my stress level and am back to eating a healthy Paleo lifestyle again and tracking my food and exercise. I got in a great groove with my off-season cycling training (had to take 2.5 months off from CrossFit for financial reasons and had an injured shoulder anyway) and then I got a horrible sinus infection and bronchitis that I just can’t get rid of fully and it’s been almost 3 weeks. I did some light intensity jogging with the dog when I started feeling better and then just did 2 high intensity workouts, and I feel crappy again. I just can’t get better!

I have a feeling I have some serious adrenal hormone imbalances that are causing me to get rundown so easily and injured so easily. How should I progress now to confirm this and what should I be taking? I just ordered the Royal Butter Oil/Fermented Cod Liver Oil that you recommend and am looking into finding pasture raised animal liver, but I need help and would like to know what to do to really get better.”

I'm sorry-I didn't laugh at what she saying, but she said “animal liver” and I was thinking of Hannibal Lecter and it was just funny. Okay.

“I’ve been eating about 50% calories daily from fat and the rest is protein and just under 100g of carbs a day. My fat is mostly organic chicken thighs and 100% grass fed beef and coconut oil and sardines. I take liquid fish oil daily, and take Hammer Nutrition products daily: a daily vitamin, Tissue Rejuvenator, Mito Caps, Race Caps Supreme, and Udo’s Choice Adult Probiotic. I eat about 1200 net calories/day.”

Diane, this one's really hard to get through because I just want to tell her to stop. Just stop. You're not eating enough. You're doing too much. You're killing yourself. Stop. And I'm not…

DIANE SANFILIPPO:[laughs] I know. I'm not laughing at her. It's just like…it's again, people are getting so used to this. Like she's told her own story and she knows what she needs to do, like you know, whenever somebody says, maybe this or maybe that. You know, it's like, yeah, get that. Maybe I needed more time. Maybe my body couldn't handle this. Yeah. we don't…

LIZ WOLFE:No. She's got to stop or she could end up in the hospital and not make it. And I'm not trying to be alarmist, but when you are this compromised and this stressed and working this hard, and you get a respiratory infection, there are people that do not wake up. They get sick, they end up in the hospital, and they do not wake up. We had a friend very recently where this happened. This is something where she needs to take 6 months off. She needs to stop. Feed herself well. If she wants to obsess over an activity, it needs to be like knitting or needlepoint or something like that. I'm not kidding.

DIANE SANFILIPPO:Underwater basket weaving.

LIZ WOLFE:Yes! Basket weaving! I don't want you to change your personality because you're clearly very committed. My darling dear, but Lisa, I want you to stop now. That's all I can say.

DIANE SANFILIPPO:Yeah, she's so…in the last episode of this adrenal fatigue theory, I talked about a teeter totter of signals that you're sending to your brain, and that your brain is putting out through the rest of your body. And she's like on this teeter totter where the stress signals are strong, that that, you know, one side is weighed down completely like…and then she's like, she'll take two weeks, and it'll be like, you know, there's a 150 pound person on the one side, and it's like putting a toddler on the other side, and the 150 pound person maybe comes off the ground a little bit for half a second, and then slams back down. And that sounds horrible, and then the toddler flies off, and that-you're back down exactly where you were. Possibly even a little bit lower. You possibly like, you know, start to push the sand under the teeter totter, and you dig even lower. Like you cannot think that a few weeks is going to fix this problem. It is a hole that you're in. you're' constantly defending these like really stressful signals to your body. It takes a long time to dig out of this.

yeah, I'm with you. This is really serious. You know, she's-paragraph after paragraph explaining intense, intense exercise that she's doing. And people-you know, I've seen…I don't know if I've seen it on Facebook or in some feedback on the podcast, you know, that we get down on running. It's not that I'm down on running or endurance activity. I'm down on it for people who can't and shouldn't be doing it. And that's usually who's doing. People who are trying to get these highs from exercise because they have no adrenal-cortisol output because they're so stressed and burning the candle at both ends. And I was there. I've been here. I've done this before. You know? And I know better this time. It doesn't mean that it's still not really hard but I'm not running, and I'm not trying to get back to all of those things every time.

You know, you're-you get a small feeling that you're better and you can't just do this high-intensity exercise. It's just not okay. And she's learned the lesson. She's done it. So you know, how many times do you need to hear it before it sinks in. I remember Oprah used to use this analogy, like “first, it's a whisper.” You know, then it's normal volume, and then it's a shout. And then it's like a brick wall. that crumbles over your head when you don't get the message the first few times, something will stop you. So whether you end up like one of our previous, you know, and end up in the hospital…like that's a real possibility. Like you could actually physically collapse somewhere. this happens to a lot of people. So I would just take this really seriously.

In terms of weight gain, the ten pounds, you know, she's not the first person with this issue. This happens to me, too, when I'm stressed. This is even happening right now, you know? You gain weight because of stress and eating a perfect diet isn't always the answer, but recognizing that you need to let your body be healthy to let go of the weight. It's holding onto weight because t's stressed. 1200 calories a day is a stressor. You need 1200 calories a day to lay in bed. That's a basal, metabolic amount of calories. That means you're not getting enough to fuel anything beyond laying in bed, alive and awake, performing just normal homeostasis function, okay? 1200 calories is just enough to be alive. And if that's your regular intake, that's an extreme stressor to your body. That's a crash diet amount of calories, and if anyone's doing that for any prolonged period of time, you're completely depleting your body of nutrients. You just need to rebuild. You're basically at this point a hollow shell. you need to rebuild nutritional status from the inside. You need to rebuild energy from the inside.

I recommend this book a lot for a lot of people, and I think you have to get it from his website, but Paul Chek's book, How to Eat, Move, and Be Healthy. Most of what he recommends in terms of nutrition is, you know, a general Paleo organic type approach. But in that book, and you know, I say this all the time because this is exactly who this book is for..He has exercise that he calls Zone Exercises, and you can do these things in your house, and they're not intense, and they're not depleting. They will help you build energy in your body. If you can find a Chek-and it's C-h-e-k-practitioner in your area who can help you with some of this stuff, that can be really beneficial, just to have someone to go to every week or twice a week even. Typically they're listed as personal trainers, but if someone's a higher level Chek practitioner, they can work with you on this type of thing. Unless you teach, you don't need to go in and then show up and go in for a beat down, you can do a working in vs. a working out, and just cultivating that energy.

Qi Gong is a really good type of practice to do. It's like a meditative type of practice that's physical. That's something I need to be doing. I need to remind myself of that. I'm like preaching to the choir when I tell people what to do sometimes. All of these things need to be a priority. Sleep needs to be a priority. Resting needs to be a priority, Eating enough nutrient0-dense foods needs to be a priority. Exercise and high intensity exercise is not a priority. Like this is survival mode. This is not about, you don't get to exercise that way. You're not in that camp. You're not privileged enough right now. Your body is not capable of it. You don't get that perk of life of intense exercise. you just can't do it, so you take that mentality away that this is a part of normal life. It needs to just be a totally different approach. And that's for now, and that's for awhile. And that doesn't mean you won't come back to it, but if you have a broken leg, would you continue to run on it? No. You need to let it heal for a long time. So it's the same kind of approach.

Anyone's who dealt with this will tell you. There's somebody on the cruise, I can't remember her name. Vanessa something-I can't remember her last name. But she stood up and we were talking about adrenal fatigue on the Low Carb Cruise, and her message to people was like, everything has to change. Like you cannot just change your food, just change your exercise, just try and sleep. Everything has to change, and it has to be….

LIZ WOLFE:You can't just add…

DIANE SANFILIPPO:Hmm?

LIZ WOLFE:Yeah, add supplements and expect everything to fall into line of vision.

DIANE SANFILIPPO:Yeah, it just doesn't work that way, so as much as this sounds like-you know, I feel like a broken record-but every single person who's asking these questions, who's maybe listening and is like, this sounds like me, like you need to stop. Like you just cannot think, I'm a CrossFitter so I need to do these workouts. That's just not the way to proceed. Yeah, that's kind of-that's all I have for her on that one, I mean. I would definitely…You know, if she wants to work with a practitioner…I would also recommend that she maybe contact Mary Vance to get some help on this, too. You know, Mary only works with women, so I don't generally recommend her to some of the guys who write in with questions, but I would recommend that for her.

I think we have a couple more that are pretty short, and we're coming up on an hour, but I do want to try and close off these last few just because they are shorter questions, and I know people are going to really be chinning into this episode, so we-can we close these few out? Do you have a few more minutes?

LIZ WOLFE:Yeah, you want to do 5….

DIANE SANFILIPPO:Yeah.

DIANE SANFILIPPO:5, 6, and 7? Or…

LIZ WOLFE:Yeah, they're-I think they're pretty short. I'll keep myself short-winded.

DIANE SANFILIPPO:[laughs] All right, and you know, Lisa, I was not trying to be mean. I'm saying this out of compassion and out of love and out of caring about your life, and the quality of your life going into the future. This is something that is really close to me. I lost a friend to this type of behavior, and I want you be well and I want you to be okay, so not trying to be mean. We love you, Lisa.

All right, so question number five from Mark. Mark says: Hello, I really enjoy your podcasts. I have a question regarding excessive fatigue immediately after eating a meal. It seems that as soon as I eat a meal (even when Paleo compliant with meat and veggies), I feel excessively fatigued and can’t even keep my eyes open. Obviously, this is especially a problem when I have to drive somewhere. Even on the nights I get plenty of sleep, this still happens.

Daily food; three meals typically with a protein and veggie source, possibly some fruit. My snacks are typically nuts. I estimate I'm probably consuming 1800 calories a day. I'm 5'11”, 135 pounds. I exercise about an hour a day, primarily endurance activities. I supplement with NOW Super Enzymes, Betaine HCL, NOW Vitamin D3, General Adrenal Formula and NOW Candida Formula. I also take one serving of Green Pasture Cod Liver Oil/Butter Oil Blend supplement a day based on your recommendations. Sleep is primarily my downfall due to a full time job, school, and volunteer work. In essence, it's two full time jobs. I sleep about 5 hours a night. 9 PM to 2 AM. I'm up at 2 AN to work out and study a bit before getting to work at 5 AM. I'm still trying to get over sugar which is really the last hurdle. I've purchased The 21 Sugar Detox program, but haven't started it yet. I typically eat sugar 3 times a week in the form of a pint of coconut milk ice cream. However, this fatigue isn't just related to meals I have sugar in.”

So Diane, I'll let you…I know you have some notes on this one, but I just want to say….

DIANE SANFILIPPO:Yeah.

LIZ WOLFE:Mark needs to eat more.

DIANE SANFILIPPO:Yeah, I was like uh, 5'11”, 135 pounds, barely sleeping, waking up at 2 AM. What's funny is that-not funny, but his question really ended at like, even on the nights I get plenty of sleep this still happens. He added this information because we ask people to tell us like, what food are you eating, what's your activity level like? Some people do it just right up front in the question because they understand how intricate this stuff is, and like, you know, it's a little of the psychology like, I'm learning about the person by the way that they present the question. Like he presented this question without all of this background. We dig for the background in the subsequent questions. And it's just a matter of really understanding that it's not just about oh, hey, there might be a food that's causing this issue. Like I actually started answering the question without seeing the full background that he had provided, and I was like, hey, let me just go dig back in and see if he had given us some information on what he's currently eating and then it became like a lightbulb turned on.

Basically, yeah. He's definitely not eating enough. Mark, you need to eat a lot more. 1800 calories a day is barely enough for a female whose that same weight, that much shorter. And I would say your first order of business is to do your very best to get closer to 3,000 calories a day into your body. I know that sounds probably like a lot, if what you eat now is 1800. Fat can be a really easy way to get more calories in. A tablespoon of fat is around 120 calories so you need to be eating more. You need more substrate' you need substrate for the fact that you're not sleeping enough.

Waking up at 2 AM to work out? That's something that needs to stop, like this is my…I just don't have the patience anymore to pander to like the fact that somebody wants to exercise. Again, you don't get to exercise. If you are sleeping from 9 AM to 2 AM, exercise is not a priority. Sleep is a priority. I don't even want people waking up at 5 AM to exercise, if they're not going to bed at 8 or 9 PM. So to wake up at 2 AM to exercise, all that's doing is adding negative stressors to your system. You're not getting anything positive out of that. You're taking away from your sleep, and you're adding a stressful type of activity that's depleting in endurance type athletics. So that needs to stop.

The fatigue that you're getting after a meal..there's-you know, to you, it's related to eating a meal, but your body could just…literally, that tiny bit of insulin that's being released in response to your meal could feel so severe because your body is so depleted and stressed, that you might get fatigued just from any sort of insulin response at all because your blood sugar has probably been so low that that little spike that food gives it that is a normal uptick that you need to get that increase…that's what happens when you eat. But for your body, that may feel like tired zone, just because what you're used to is so low. That's really all I have, like he's got to focus on sleep as much as possible, and if that means, which it does mean, not waking up at 2 AM to exercise, that's what it means. You need to sleep. You don't need to exercise at this point. 135 pounds at 5'11”, you need to be eating a lot more food. You're constantly making withdrawals from your body's energy account. You're not depositing enough food. You're not depositing enough nutrients, you know. Sounds like you are quite diligent about your supplement routine. I would channel that energy into your standard food routine. Getting more quality food in. I just would not address like there's a specific food that's causing this at this point. I don't think that that's the problem. I think we would be missing the forest for the trees if we kind of just took that approach.

LIZ WOLFE:Agreed. And also at this point, I think just based on his stress in his lifestyle, his digestion, despite the fact that he's supporting it with enzymes and HCL and all of that stuff, hydrochloric acid, which is stomach acid. I think his body is probably having to shunt so much blood flow and do so much work just to manage process of digestion, which maybe that's why he's undereating because he doesn't feel like he can manage a whole lot of food…

DIANE SANFILIPPO:Mm-hmm.

LIZ WOLFE:But lifestyle is creating such a problem, probably with digestion that at that point his body is shunting so much blood flow to the digestive system that he's got to take a nap. When I have that happen, which I did last week, I was so stressed out and tired that I ate something and I had to go and take a nap immediately.

DIANE SANFILIPPO:Yup.

LIZ WOLFE:That's a big red flag for me. That is this flag, so…

DIANE SANFILIPPO:Yeah, that's a really good call. And you know, that's something that we talk about with the whole like, eating around exercise thing with whether you're in fight or flight mode or rest and digest. And when you're in fight or flight mode from exercise, that's like the super high level at that time. But when somebody's living a stressful lifestyle like this, he's in fight or flight mode to some degree all the time, so any food, like you're saying, that will, you know, kind of stimulate the blood flow back to the digestive system, I mean, he's going to shut down. So yeah, that totally makes sense. Man, he needs a lot of help. A lot of help.

LIZ WOLFE:Once in awhile I'll get a good one.

DIANE SANFILIPPO:Once in a while what?

LIZ WOLFE:Every once in awhile I pop up with a gem. I wake up and got something decent to contribute. [laughs]

DIANE SANFILIPPO:Yeah, thanks. Great. All right.

LIZ WOLFE:All right, next question. Jon. “I’ve been taking Ashwaganda and Holy Basil with good success. Should I be cycling my adaptogens? I normally do two months of Holy Basil/Ashwaganda then a month of Rhodiola.”

Diane, I don't have a clue. you're going to have to get this one.

DIANE SANFILIPPO:[laughs] So just so people know, adaptogens-adaptogenic herbs-are really what Jon's referring to, and he asks this question based on the post I had on Robb Wolf.com on adrenal fatigue, which basically covers all the stuff we talked about in the first podcast on this topic, but adaptogenic herbs have this unique quality where they can come into your body and know, do you need to be uplifted, or do you need to be suppressed a little bit, and that's in terms of this signal that your brain is sending out to your adrenals, so they're just kind of like these crazy smart herbs that know, hey, is this person tired? Do we need to help them pick up a little? Or are they uber-stressed and we need to help them calm down? Just kind of how they work.

I don't…I don't have specific information on it being necessary to cycle them, but if that feels good for you, sure. You know, I absolutely think trying different things and trying different approaches. Maybe even try one month of one, one month of the other. Maybe even doing just one at a time and seeing how that feels. You know, this is nitpicky stuff, but do what feels good. If something doesn't feel good and it's not working, don't do it. I know it sounds pretty basic and simple, but yeah. That's kind of-I don't have specific information like, you know, you can overdo this. But I do think that sometimes we can become resistant to certain supplements over time. So I do like this idea of cycling them.

That's it on that one.

LIZ WOLFE:Cool.

DIANE SANFILIPPO:I think we have one more…

LIZ WOLFE:All right.

DIANE SANFILIPPO:One more quickie.

LIZ WOLFE:Yup. Last question. All right. Helen asks…

DIANE SANFILIPPO:And I think everyone listening can answer this question themselves on this one.

LIZ WOLFE:Sweet. All right, so everybody shout the answer together at the end. Okay, from Helen: “Hi Diane. Liked what you said on a podcast regarding your previous burnout, and it taking time for recovery. I had burnout 2 yrs ago, due to 4 small children, 1 with special needs, 3-4 hrs sleep per night, bereavement, too much long distance running at 5 AM & a type A personality. Discovered and implemented Paleo (thanks) in September. Sleep hygiene measures (& no babies requiring breastfeeding!) improving sleep to 5/6 hours. I do 2 strength sessions and 2 short runs per week now. Fatigue much improved but seem to have plateaued to achy fatigue especially in the mornings. I can’t manage more than 6 miles run!”

I can't manage more than run across my backyard, but this is…okay.

DIANE SANFILIPPO:That's a short run to her, apparently.

LIZ WOLFE:That's-I-this blows my mind.

“Interval sessions wear me out, so have stopped them. Even resorted to bone broth (your suggestion on podcast!); not bad for a vegetarian of 20 years! Would you have any time to make any further suggestions? I would love to regain my energy. Many thanks for all that you do. From Helen”

DIANE SANFILIPPO:So we don't have-I didn't pull in if she gave us any more background on what she is eating. But I just think it ws really funny where it says 2 strength sessions and 2 short runs a week, and then she goes on to say she can't manage more than 6 miles. Like, for me, I would assume somebody means a short run is under 3 miles. I don't know. What assumption would you make when someone says a short run?

LIZ WOLFE:I'd say running to the bathroom is a short run.

DIANE SANFILIPPO:[laughs]

LIZ WOLFE:That's about….

DIANE SANFILIPPO:[laughs] Nice. So when I dealt with adrenal fatigue, I was running. Like I was training for a half marathon. I was like ready to do another half marathon two weeks after it, and I got taken down by a gnarly it band injury; that was my brick wall to stop running, you know, at that point, or whatever. So a short run at 6 miles, that's not a short run. That's a short run to people who are running, you know, on average, ten miles maybe. But so yeah.

Recommendations? Stop running. I'm sorry. Stop running. You know, if running is something that you love, if it's a passion, you need to get yourself back to a place where you're healthy enough to do it. And you know, I've done this before with clients who are like…I had a client who was doing a lot of like really intense cycling several times a week, and she loved cycling. And I was like, okay, great, you love it, but the level at which you're doing it is harming you. So you need to get to a place where you can eventually do this thing for enjoyment, not because, you know, you're trying to get that adrenaline rush from it. Not because you think you need to burn a ton of calories.

But if you love it…I love the idea of just throwing on sneakers and an iPod, or no iPod, and just going for a run. I physically cannot handle it right now. Like I would probably start and then just end up taking a walk because I can't move my body that fast for that long. I'm just too depleted. And I think people who are still in this state just aren't getting it. It's got to be moderated. You know, you just can't run off of that stuff. You found out, you know, interval sessions were wearing you out. Interval sessions are a faster way to learn that something like running isn't working for you. Like basically, if you can't do intervals because that short burst of energy is rough for your body, then that longer more moderate intensity is absolutely not the right thing.

That's really it, you know. I want everyone who asked a question on this podcast. I want everyone who's listening, who's feeling like they're dealing with this stuff, to get that Paul Chek book and look at the zone exercises in the back. Like I almost wish he had this as an e-book that I could just like let people go download it immediately. I want people to do this stuff at home. I think the only piece of equipment you even need is like a Swiss ball, a physio ball, an exercise ball. One of those big things that people sit on at a desk sometimes. And other than that, it's all juts our own body or a chair, that kind of thing, and really work on this stuff.

And I think also, trying to work with a practitioner, you know. There are probably NTPs, people, there are probably other NCs, which is my certification which can help with this stuff. I think that you know you need to have somebody kind of working with you, to consistently remind you of how much is too much because we cannot moderate that ourselves when we're in this situation. I was running probably 20 to 30 miles a week. And would run 5 or 6 miles for a training run. And then do an hour of cardio kickboxing after that. And it was when the Olympics were on, however many years ago, in the summer time, and I remember saying that these athletes train, you know, they probably train 4 hours a day, right? Why is 2 hours a day too much? Seriously, that ws the mentality that I had. And it's so broken when people think that like they're entitled to this intense exercise when they're already so fatigued. Your lifestyle adding up to more fatigue-you just can't add that hormetic stressor of exercise. That for some people, and most people, it might be a negative stressor that becomes a positive, for you, it's a negative that's just compounding a negative. You know, when you add two negative numbers together, you still have a negative number. It just doesn't work that way for any of these people who are dealing with this fatigue, so…

I really need to reset. I think maybe we all need to take a giant vacation, and [laughs] escape from life for a little while.

LIZ WOLFE:This goes for CrossFit people, too. this goes for Olympic listeners. Like we're not just down on running, although it happens to be a common theme, it appears, amongst some of these adrenal fatigue questions.

DIANE SANFILIPPO:Yeah.

LIZ WOLFE:This is anybody who's over exercising. And that is a good subset of the population at this point.

DIANE SANFILIPPO:Yeah, w don't generally hear it from people who are just like powerlifting or Olympic lifting because the type of work that they're doing is not the same. But absolutely like form the CrossFit community. And I think part of too is between the CrossFitters and the runners, it takes a certain, like Type A personality to, you know, I would say, at least a 75% of CrossFitters have that personality. right? Like there's definitely that handful of more quiet introverted, but the Type A, go go go personality that gets into these types of exercise, really just doesn't know when to stop. And you know, this is a topic that's near and dear to me because I get the same way. You know, it's like, I get an inch and I want to take a mile. So we just have to learn this lesson and not end up completely exhausted in the hospital, like her result, you know?

LIZ WOLFE:mm-hmm.

DIANE SANFILIPPO:And two days of rest, like this is even happening to me right now while I'm writing and working on the book, no joke, I'll spend two days working hard. Like almost all day working. And the next day, I cannot work. Like I get beat down by two full days of intense brain activity of work and writing that I am forced not to do work the next day because I can't. I physically can't. Like, I just can't. focus, I'm exhausted. So, mean, that's like, it's a huge wake up call. And I think people just need to know that it's not just them, and they really do need to take care of themselves.

LIZ WOLFE:Do a Jerry Springer: “Take care of yourselves and each other.” [laughs]

DIANE SANFILIPPO:[laughs]

LIZ WOLFE:Was that Jerry Springer? Oh man, he's a smart guy.

DIANE SANFILIPPO:Only Jerry Springer.

LIZ WOLFE:You are the father! All right.

DIANE SANFILIPPO:[laughs]

LIZ WOLFE:On that note…

DIANE SANFILIPPO:We have to end on something light.

LIZ WOLFE:Everybody check out our website, BalancedBites.com. It's Diane's website, I'm part of the Balanced Bites team as well. I do a little rambling over at CaveGirlEats.com. You can find me there. Find us on our Facebook pages. Leave us a note. Come see us at one of the Balanced Bites workshops, and Diane, I'll talk to you soon. All righty.

DIANE SANFILIPPO:Til next time.

Cheers!
Diane & Liz