I see this almost every day. Stress is unavoidable, rampant, and growing. Under normal conditions, your body produces a brief surge of cortisol – the hormone released when you’re under stress—that benefits and protects you. For example, let’s say a car almost hit you on the street, you will act quickly to avoid an accident, right? That is your cortisol acting on your body and preparing it for ‘’fight’. As soon as you are safe however the levels should return to normal. That is the ideal scenario.

However, for many women like Jen, that cortisol surge never turns off. The scientific term for stressed out is hyperarousal. So many of us struggle with the effects of unrelenting stress and hyper-vigilance. Simply put, chronic stress, thanks to cortisol-beyond-its-prime syndrome, causes accelerated aging.

Beyond hopelessness and irritation, the manifestations of chronic stress appeared around Jen’s waistline. She also discovered stress made her fat, especially around her belly – and not just because the ‘’comfort foods’’ she sometimes ate. But because belly-fat cells have four times more cortisol receptors than fat elsewhere in the body.

Not all stress-triggered accelerated aging becomes so obvious. People are surprised when I tell them chronic stress can shorten the telomeres (the end area of a chromosome which protects it from deterioration) damage your energy-producing mitochondria, and generally leave your energy levels stagnating while your brain fog kicks into overdrive. I will also affect your sleep and immunity which will leave your body weak.

Look at seven stress-related issues that often go unnoticed:

1. Growth hormone. Excess stress (that’s you, cortisol)—crashes growth hormone (GH) as you grow older. GH decline accelerates aging, decreasing muscle mass, increasing in adipose tissue, reducing libido and energy, and declining blood levels of sex hormones in both women and men. Improved GH is what makes body fat lower, waist thinner, and lean body mass higher. GH also promotes a healthy metabolism while boosting energy levels.
2. Gut bacteria. Stress can disrupt the number and type of bacteria in the gut, adversely impacting immune function and overall health. Gut bacteria regulate immune function, digestion, and absorption of essential nutrients. Gut flora gone bad create numerous problems such as bacterial and fungal overgrowth, weight gain, impaired glucose metabolism, poor digestion and absorption, and a weakened immune system.
3. Insulin. This is very important because even small increases in cortisol can raise blood sugar and increase insulin resistance, a condition where cells that get too much insulin can become resistant to it. Insulin resistance accelerates age-related diseases, including hypertension, coronary heart disease, stroke, cancer, and type 2 diabetes. Or simply put: Want to really accelerate aging? Create insulin resistance.
4. Thyroid. Chronic stress delivers a serious whammy to your thyroid because a deficit or an excess of cortisol dysregulates thyroid function. In other words, body’s response to chronic stress is poorly regulated so that cortisol is either too high or too low. The result? Widespread hormone imbalance which will affect your     energy, weight, metabolism, and, well, pretty much everything. 
5. Sex hormones. Excessive cortisol decreases the hormones necessary for sexual desire and function, such as dehydroepiandrosterone (DHEA), progesterone, testosterone, and estrogen. Plus, when your level of cortisol gets too high, it can block cells from getting progesterone, which calms you down.
6. Chronic inflammation. Inflammation that sticks around for too long makes you fat and contributes to nearly every disease on the planet. If your body stays in a fight-or-flight mode, a chain reaction of inflammatory responses occurs that spells trouble on the scale and on your overall health.
7. 7.Telomeres. Telomeres protect the ends of chromosomes. Size matters here: Shorter telomere length signifies poor health and mortality. Chronic stress creates oxidative damage and free radical production, aging at the cellular level and shortening telomeres.

So how did we help Jen? We started with an easy stress reduction program, a couple of 4-7-8 relaxing breaths, walking for short distances and meditation. She also got tested for adrenal fatigue and we designed a supplement protocol to heal her adrenals and normalize the cortisol levels. We cleaned up her diet and encouraged a mild detox protocol to help with inflammation. She is now trying Reiki -a powerful stress reduction technique and reports her energy levels are much better and her headaches are almost gone.

Her healing journey has started, how about yours?

Let’s create a healthier you!

Dana Neacsu, MD

Adrenal fatigue in functional medicine is different from the Addison’s disease recognized by the conventional medicine not only from a testing perspective but also in terms of treatment and goals of care.

When your adrenal glands are overworked or dysfunctional, a condition known as adrenal fatigue or adrenal exhaustion sets in, which in turn can set a cascade of disease processes into motion. One of the most common signs of adrenal burnout is feeling chronically fatigued.

The 4 most common reasons for adrenal fatigue and dysfunction are intense emotional stress, poor diet, chronic inflammation, and underactive thyroid.

The Kalish Method normalizes dysfunctional adrenals and restores normal adrenal function. It involves nutrition changes, supplements, and stress reduction. Healing the adrenals will have a great effect on the rest of the body including the thyroid.

The adrenal protocol calls sometimes for carefully replacing just a small portion of the exact level of the missing adrenal hormones which stimulates your body to begin producing it more naturally.

In May 2016 a research study published by two Mayo Clinic researchers confirmed the efficacy of the Kalish Method showing significant improvements in GI health and quality of life in the study participants. The study was based on Dr. Kalish’s model of Functional Medicine based on 25 years of successful clinical results. Graduates of The Kalish Institute include practitioners ranging from Dr. Mercola’s medical staff to Mayo Clinic and Cleveland Clinic physicians.

A research team, including Daniel J. Kalish, founder of the Kalish Institute and Susanne M. Cutshall and Larry R. Bergstrom, currently practicing at Mayo Clinic, proudly release a study around functional medicine. The study shows a variety of stress, fatigue, and quality of life measures can be improved through functional medicine, a growing field utilizing lab-based supplement programs, including lifestyle and nutritional counseling.

The 28-week study assessed the effectiveness of a specific functional medicine approach for improving stress, energy, fatigue, digestive issues and quality of life in middle-aged women exposed to high-stress work environments. This method, known as the Kalish Method and taught exclusively through the Kalish Institute, provides a systems approach to chronic illness addressing the “whole person” rather than an isolated set of symptoms and restoring three key body systems: hormones, digestion, and detoxification.

The study, which was completed in April 2015, has been published in the May 2016 issue of Complementary Therapies in Clinical Practice

Happy reading!

Our body is quite amazing in its ability to remain functioning at a high level even when we are depleted of important nutrients for example. The challenge with this type of lifestyle is to understand when the body has been pushed too far and we cross the threshold and now we are talking about a feeling of exhaustion, not feeling rejuvenated even after sleeping or feeling extremely tired even after mild exertion.This is when you need to talk to your doctor.

So here is my approach to fatigue or lack of energy:

1.Always exclude the most common, conventional causes of fatigue like anemia, uncontrolled diabetes or kidney problems. In my experience, however most people have ‘’normal’’ blood work and they still don’t feel well.

2.Get tested for adrenal gland dysfunction or fatigue, this is different from the adrenal insufficiency recognized by conventional medicine and so is the testing. Functional medicine tests the salivary cortisol because these levels are indicative of cellular function wellbeing. The treatment usually involves addressing nutrition, sleep, stress reduction and a supplement protocol including some herbs known as adaptogens(they will stimulate or relax your body depending on whatever your body needs at any given time)

3.Check your thyroid with an extensive panel including T4 and T3 which are the active hormones and work with your doctor to determine what is the cause of thyroid imbalance(for example food sensitivities, gluten intolerance, adrenal dysfunction).Choose the right hormonal preparation to suit your body’s needs and not just the well-known synthroid.

4.Always consider a mitochondrial imbalance as a possible cause of fatigue. Mitochondria are little powerhouses existent in every cell and responsible for energy production. Unfortunately, is extremely sensitive to any kind of nutrients deficiency or environmental chemical toxicity. Luckily we can test for this imbalance as well and then correct it.

5.Make sure there is no chronic, low grade infection or inflammation in your body and I am thinking here particularly about digestive infections. I would like to emphasize the fact a lot of people do not get necessarily digestive problems with this type of infections but rather something like fatigue, skin rashes, achy joints, hormonal imbalance and so forth. Functional medicine uses a different type of stool testing much more detailed than the regular one used by conventional medicine and we also have a lower threshold for treating certain bacteria.

6.Think food intolerance as well as the reason for feeling fatigued and tired.Most people are only aware of the food allergy (rash. redness, swelling of face, difficulty breathing) which is completely different and easier to recognize. Food sensitivity can be diagnosed by a blood test and also by correlating symptoms with certain food ingested. The most common culprits are: gluten, dairy, soy. It is important to remember it takes your body a long time 4-6 weeks in average to get rid of the antibodies to a certain food so don’t expect major changes within the first couple of days. I would also recommend working with an experienced nutritionist/health coach.

7.Nutritional deficiency is a well-known cause of fatigue and pretty easy to diagnose with a blood test like Genova or Spectracell.Your doctor can then design an individualized treatment for you.

Which one applies to you?

These unwanted symptoms seem to affect up to 90 percent of my patients and especially women. It starts usually with few things here and there-not feeling up to exercise, worrying too much about small things but, quickly enough, people are developing a sense of exhaustion, generalized anxiety, lack of energy which ultimately translates into digestive and hormonal problems and weight gain.
Once people get to that stage, the physical changes further affect their emotional state, even causing depression-a vicious cycle.

I think a possible explanation for a higher occurrence in females includes tendencies for women to set up high expectations, overexertion via multitasking and lack of needed social support especially during important moments like pregnancy or illness. Many times, I jokingly tell my patients’’ We need a support group just for being a woman!’’

I also would like to mention that people can have various other symptoms-think headaches, overall achiness or brain fog- that are related to anxiety, so always pay attention to your body’s signals.

Getting to the bottom of this problem is not easy. It involves detailed testing including saliva-hormonal or nutrient testing in order to be able to design an adequate treatment plan. This is one area where functional medicine helps the most because there so many imbalances to address: is it the hormones imbalance (like adrenals or thyroid), the mitochondria(the little powerhouse we have in each cell that is producing energy), serious vitamin or mineral deficiency that slows down your body, or is it an imbalance of the neurotransmitters-the chemicals that are making neurons work?

The diagnosis, and of course the treatment, can be complex. For treatment, I think it is important to include nutrition changes, stress-reduction techniques and safe, therapeutic- grade supplements to correct those imbalances under the guidance of a skilled healthcare practitioner.

I always encourage my patients to take a close look around them and their environment, and to make safe, greener choices when they buy products-whether food, beauty or even for home.

I also believe in meeting people where they are when it comes to lifestyle changes- moderation and baby steps, and rewards as well! I also think it takes a village to get somebody healthy so I often work with a team of other practitioners including nutritionists, acupuncturists and health coaches.

A general wellness tip: Willpower is a finite product, so please don’t test it at 10 pm after a long stressful day at work by, for example, keeping unhealthy food in your fridge-there is a good chance you might lose that battle; many of us would.

Wishing you health and happiness,
Dana Neacsu