Intermittent fasting is all the rage right now. And for good reason. The science behind it is there. Fasting 12, 14 and even 16 hours (especially if you’re a performance athlete) can really help whittle away fat, lean out a body and increase energy and metabolism. Nearly 40% of our energy goes towards digestion. Studies have shown that giving your body a break with digestion, “frees up” cells from focusing on digestion so that they can “troll” the body for unwanted guests such as pathogens or tumors. For the most part, intermittent fasting produces efficient results the majority of the time.
However, there are a few patients who are not ideal for intermittent fasting. I see them often in my practice and it has become somewhat of an epidemic. What I’m speaking of is lovingly known as “adrenal fatigue,” but is technically known as hypothalamus-pituitary-adrenal axis (HPA) dysfunction.
What is “adrenal fatigue?”
Adrenal fatigue refers to dysfunction or confusion in the body about how much and when to produce stress hormones, like the glucocorticoid, cortisol or adrenaline (epinephrine). Stress hormones are super important, especially if a bear jumps out of the woods to attack you. Cortisol tells the body to raise the blood pressure, wake up, increase blood sugar into the bloodstream, all in preparation for FIGHT OR FLIGHT. Its survival mode. Super valuable right? Right. Except…..if you live in most western countries. Hello guys. Being burnt out is not a badge of honor! But for some reasons we get awards and pats on the backs for running corporate shows but then falling apart emotionally and physically behind closed doors. Something’s got to give!
Medical doctors are not taught about adrenal fatigue and believe only in Addison’s disease (a hereditary disease where patients cannot make their own cortisol), therefore diagnosis in allopathic medicine is difficult and patients are often told that nothing is wrong with them. Unfortunately, this is because the testing is lagging behind. Medical doctors traditionally check a blood cortisol when a salivary cortisol test, done four times throughout the day, would be much more insightful. By the time I see them, they have often progressed to chronic fatigue and their entire hormonal cascade needs adjustment. Symptoms often include but are not inclusive of insomnia, brain fog, poor exercise tolerance and recovery, low libido, sodium cravings, fatigue, dizziness, headaches, weakened immune function, and reduced stress tolerance. Athletes will notice a longer recovery time as well as sore muscles and joint pains. I want to stress here that many times when a patient cannot lose weight it is due to this. I can’t tell you how many times I hear patients say they are eating healthy and clean and cannot lose weight. The fact is that when cortisol output is high, you can eat like a bird and won’t lose a single pound.
A recent study in the Journal, Alcohol Research showed that cortisol plays a central role in alcohol dependence and rewards pathways, so it is far more involved throughout the body than we fully understand. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3860380/
Adrenal fatigue, or HPA axis dyfunction, is a term used to describe the breakdown and dysfunction of our stress-driven hormonal cascade, that begins in the brain. The HPA axis oversees this cascade, however, when we live lifestyles fraught with poor food choices filled with chemicals, stress, too much or overworked, this system’s chemical signals eventually go a bit haywire. The hypothalamus in the brain releases CRH, corticotropin releasing factor, which signals the pituitary in the brain, to release ACTH, or adrenocorticotropic hormone into the blood. ACTH then travels to the adrenals, which sit atop the kidneys, telling them to produce cortisol, norepipherine, or epinephrine. Again, great….unless this system is chronically activated. Your body then almost becomes de-sensitized to the effects of the stress hormones, almost like what happens to type 2 diabetics with insulin resistance. Because these cells are unresponsive and slightly dysfunctional, the whole cascade becomes more unraveled as the body tries drastically to increase cortisol production. Most often, this leads to high cortisol, but low cortisol is a common sequelae as well. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1197275/
Loss of cortisol regulation and dysfunction in the feeback loop of the hypothalamic-pituitary-adrenal axis can disrupt other hormonal systems as well, and does quite frequently. Patients have trouble going and staying asleep, low libido, PMS, brain fog and even digestive abnormalities. This is because the organ and hormonal systems are intimaely connected and cannot be separated. As you can see, “adrenal fatigue” is a complex problem characterized by the Standard American diet and the Standard American lifestyle.
How Does HPA axis dysfunction, or adrenal fatigue, affect intermittent fasting?
So you may have seen me mention above that high cortisol production tells the body to release blood sugar into the bloodstream in preparation for fight or flight. So the next logical assumption would be that cortisol regulates insulin and blood sugar…… and you would be correct.
Constant deprivation of calories, even with strategic intermittent fasting, can be harmful for someone with severe HPA axis dysfunction. It is a stress on the adrenals, liver, muscles, and body to breakdown glycogen to glucose to supply the muscles and blood stream. The body is already stressed, even shocked, and asking it to continue to happily tolerate “starvation mode” will leave you nauseated, dizzy and HANGRY! The liver and muscles are having a difficult time breaking down adequate glycogen, so the cells starve, leaving you HYPOGLYCEMIC, or with low blood sugar. This is often why people pass out or have problematic low blood sugar issues-CHECK YOUR STRESS AND HPA AXIS FUNCTION! Do you have chronic and untreated “adrenal fatigue?”
The Recipe to Heal Adrenal Fatigue (what else to avoid)
My recipe for those with stress hormones that are dysfunctional is to eat 5-6 small meals a day so that you are keeping a steady blood sugar throughout the day. Eat foods that the body will recognize and be able to easily digest-like fruit, cooked vegetables, and organic proteins. Stray away from chemicals, boxed, sugary or caffeinated foods and drinks. These produce inflammation in the body and contribute to the complaint of “puffiness.” The tendancy of many with HPA dysfunction is to reach for sugar or caffeine, (Starbucks is their favorite) as this wakes them up and gives them temporary stamina. I urge you to avoid this as this is asking your body to produce more “stress hormones” when your system is already struggling. Reach for tea, which is more gentle, or decaf.
In my opinion and with my own adrenal fatigue however, I have been very tolerant of one coffee and I’ll link it here. I only have a small cup in the morning and it is organic, with no fillers, brewed for hours under cymatic sound technology, which makes it vastly different from most of the coffee industry. Check it out here. https://www.elixirfy.me
Another word to the wise-back off of high intensity interval training or HIIT and crossfit. Anerobic bursts or training, again is asking the body to sustain a stress that its not prepared to handle yet. This comes from the Western mentality that we must always push harder, be competitive, win, more, more, more. More is not always better. Pushing yourself to your limits is not always best. For many of my HPA axis patients, I prescribe yoga, walking, Tai Chi or Qi Gong. The point is to activate your parasympathetic nervous system, the rest and digest system, so that we are balanced in our lives.
Here are some other helpful tips about how to recover:
- Regulate your sleep-wake cycles. This means get a sleep mask or black out curtains if you are waking up at 4am when the sky changes hue. This also means to responsibly use electronics after dark. The blue lights from the screen are becoming a national problem as they decrease normal melatonin production in the pineal gland. You can buy some great blue light blocking glasses here! https://www.amazon.com/Blue-Light-Blocking-Glasses-Artificial/dp/B010B5GUH0?th=1. Heres a study about the probablilty of blue light damage for all you naysayers https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4734149/
- Get Outside! Get up with the sun and wind down at night. If you wake back up at night and feel anxious, do not ignore this. It is extremely beneficial to exercise in the sunlight to reset your circadian rhythm.
- Use herbs in your healing. My Stress Master uses only the highest quality adaptogenic, calming herbs to relax even the worst case of HPA axis dysfunction. If you are wiped out rather than “wired but tired,” pair this with adrenal glandular under the guidance of your heathcare professional. Mind Master is also useful for concentration and to eliminate brain fog. Please shop the link here in my store https://store.drjess.com/products/the-stress-master.
- CBD oil is a wonderful way to treat stress. CBD oil stands for cannabidiol oil and is not psychoactive. It is legal in all 50 states. Look for organic, full spectrum and at least 500mg in the bottle.
- Reduce stress in your life with work, people, family and friends. Take time for a self care routine
- Cut out inflammatory foods like processed sugar, white flour, breads, pastas, and dairy which wreak havoc on blood sugar levels and hormones. Opt for healthy carbs like brown rice and quinoa with loads of fresh fruit and vegetables. Clean, organic sources of protein are imperative too.
- Drink filtered water with lemon and Himalayan sea salt each day as this will stabilize blood pressures, dizziness and dehydration
- Use B vitamins which help ground and support us. Be sure to opt for methylated B vitamins which are already activated just in case you have a mutation that makes it hard for you to methylate on your own.
- Check your thyroid and sex hormones like estradiol, progesterone, DHEA, and testosterone. Other important minerals and vitamins useful for support are zinc, magnesium, selenium, and vitamin D.
- Change your perspective! Are you a perfectionist? Can you turn off and sit in silence? Meditation may have your name on it! Balance is much more satisfying than perfection.