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 

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

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