Once upon a blogpost, our writers ripped the mask of a silent medical enemy and dragged its face into the unflattering limelight. We acquainted you with adrenal fatigue.

Perhaps you encountered that name in fleeting conversation, or while flitting from the doctor’s office to your car—someone you know is battling this enemy and you’re wondering how they’re doing it. You’re wondering, does adrenal fatigue even exist? Or is it some hyperbolic form of laziness and unrestrained gluttony draped as a diagnosable health condition? Adrenal fatigue is, in actuality, much more than a mediocre lifestyle; it’s when our adrenal glands crash and collapse beneath ongoing, compounding stressors, compromising our body’s healthy production of stress-fighting hormones; it’s when the good guys lose to the bad guys and we’re left catching our breath behind the darkest alleys of life.

Adrenal fatigue is real and it’s not pretty.

So why don’t several medical doctors recognize adrenal fatigue as a serious diagnosis?

It is true: most conventionally trained physicians don’t recognize adrenal fatigue as a real problem. Blood tests for these fatigued patients often reflect normal hormone production. Cortisol levels hover just above the healthy threshold—just enough to evade the common hormone-related diagnoses, such as Addison’s Disease or Adrenal Insufficiency (rare conditions in which the adrenals cannot produce enough hormones on their own and life-long steroid replacement therapy is usually required). So their doctors send them off with a chill pill prescription: “Just relax more,” they say. “Take it easy and you’ll feel better.”

What is the best way to test for Adrenal fatigue?

What is superior to blood tests, measures your cortisol levels several times a day, and is often accompanied by a “stick out your tongue and say ahh”?

Saliva tests. The results from these tests are like a log mapping your 24-hour hormone-secretion cycle. The functional and integrative medicine practitioners who make use of these tests collect your spit in vials at four points during the day to track your cell tissues’ hormone levels, enabling them to correlate your physical symptoms with medical data. More accuracy and no finger pricks required—how’s that for a medical hack?

How do you reverse fatigue and restore adrenal function?

As with all worthy feats in life, this one comes with no magic pill, no quick fix drink to whisk you back into recovery. A balanced life demands a balanced lifestyle, and your persistent initiative to overcome. Here are our three MUST DO’s for beating adrenal fatigue:

#1 Declutter your relationships.

Spring is upon us, a season that invites warmer weather, rain showers, and the human impulse to declutter. Skip the dusty books and untouched clothes this year; your decluttering party will take on a new approach, and you will have your adrenals thank you for it later. We can all endure our fair share of Debby Downers and Negative Nancys. But if your exhausted adrenals have left you in a sinkhole of symptoms, those Facebook “friends—whose only contribution to your feed is Grey’s Anatomy-level drama—need to exit your social stage. So do those casual acquaintances with trademark cynicism, filling every silence with a slanderous remark. They’re not serving you any good. If anything, they’re draining whatever traces of energy you have left to function. Here is your relationship decluttering checklist, at a glance:

• Eliminate or minimize toxicity in your relationships.
• Resolve ongoing conflicts with the people in your life whom you love.
• Kindly set boundaries with negative/angry family members whose company is inevitable.
• Unfollow and/or unfriend accounts on your social media feeds whose messages, attitudes, and comments serve no purpose but to spread negativity.
• Build your social circle with kind, caring, and respectful individuals (even if that means making new friends!).

#2 Clock in some beauty sleep!

Let us let you in on a sleeping secret: somewhere between 10 p.m. and 2 a.m., our bodies repair and regenerate themselves in preparation for the stressors ahead. Our adrenals, too, work their hardest during that time block. Exercise a bit of discipline and train yourself to sleep earlier. Calm the urge to binge-watch your latest Netflix obsession, and in hours leading up to bed, dim the lights and put away your electronic devices to maximize melatonin production. Here is your beauty sleep checklist, at a glance:

• Commit to a relaxing activity before bed (yoga, meditation, praying, and stretching all help quiet your mind and prime your body for a good night’s rest).
• Keep your coffee and caffeinated tea breaks before 2 p.m.; anything after will disrupt your body’s circadian rhythm.

#3 Healing foods for your body and soul.

Historically, humans sought remedy from sources beyond a doctor’s prescription. “Let food be thy medicine,” they said. This ancient mantra spawned an alternative healing approach called “lifestyle medicine.” It is especially popular with preventable, lifestyle-related illnesses. Without shunning Western pharmaceuticals, holistic healers use food plucked from earth herself to restore balance to their patients’ bodies. Just as we are made from earth, we need her seasonal harvests to thrive and keep illness at bay. So here is your fatigue-warding, adrenal-restoring food checklist, at a glance:

• Eat small meals often. Symptoms of adrenal fatigue spike when patients skip a meal or forgo eating for an extended number of hours.
• Decorate your plate with rainbow-colored food for optimal nutrition. When planning your meals, alternate between a variety of lean protein (mostly plant-based with the occasional sustainably-sourced meat), complex carbs with a low glycemic index (quinoa, brown rice, potato medleys, whole wheat, beans, and legumes—all of which keep your blood sugar levels steady and release a constant flow of energy), healthy fats (avocados, olives/olive oil, nuts and seeds), and organic produce.
• Consume more salt. Fatigued adrenal glands trigger low sodium levels and low aldosterone production, leaving patients craving salt like it’s nobody’s business. So eat salty! Don’t worry about the risk of high blood pressure; that doesn’t apply with adrenal fatigue (but feel free to wear a blood pressure monitor for good measure). If anything, an extra dash of salt on every dish is both essential and therapeutic to your adrenal recovery.

If adrenal fatigue is your current reality, know this: restoring your adrenal glands won’t happen overnight, just as they didn’t crash overnight. Be patient when making these changes; lifestyle medicine takes time. The feelings of rejuvenation, a good night’s sleep, and endless motivation to tackle your biggest, wildest dreams are just around the corner. As always, we’re rooting for you along the way.

Missed part one of this blogpost? Learn more about Adrenal Fatigue here.

Every so often, one of us encounters an enemy that locks us into complete paralysis. E-mail messages go unchecked, laundry stacks to the height of Everest, and personal relationships shrivel like leaves beneath a merciless breeze. It’s a silent enemy, leaving behind no physical side effects (except many empty coffee cups and energy drinks to help you reach Bare Minimum Adult Functionality). Your doctor assures you that all of your lab results are normal; medically, there’s nothing wrong with you. But you know, from the bottom of your tired and weary heart, that something is wrong… Your sinuses are flaring on a cool winter day (but doctor, I don’t even have allergies). Out of nowhere, pickles, Saltine crackers, and sushi rolls doused in soy sauce surge to your Top Three Foods list (what is happening to my taste buds?!). There’s something else disrupting your groove: bathroom breaks, which are inconveniently happening every hour (c’mon doc, what digs?).

While these could be symptoms of various health conditions, a silent enemy by the name “Adrenal Fatigue” is the most common culprit. It crawls into your life and leaves behind these life-crippling symptoms:

• Extreme fatigue
• Inability to concentrate
• Lack of motivation (mainly due to lack of energy)
• Low sex drive
• Low mood
• Easily irritable
• Decreased ability to handle stress
• Brain fog
• Inability to lose weight
• Salty food cravings
• Increased urination
• Low blood sugar
• Low blood pressure
• Allergies

How does this happen?

This story, like all medical stories, begins with a tragedy. Somewhere in your body, an ecosystem of organs and parts suffers an imbalance that leaves its members malfunctioning. The ecosystem in today’s conversation is the adrenal glands. Perched above your kidneys are these small glands whose sole purpose of existence is to produce hormones: cortisol, your body’s built-in alarm system and blood-pressure-regulator; adrenaline, your body’s boxing gloves and running shoes in high stress situations; aldosterone, your body’s traffic control center for sodium, potassium, and blood flow. Each of these hormones, as well as many others, is essential to your functioning and critical for your survival. And when their production is compromised, you’re left depleted and depressed, hobbling through life’s lowest hurdles like an injured race horse. Little tasks, like meeting a work deadline or paying your bills on time, become monstrous pressures. In layman terms, you’re burnt out.

What causes adrenal fatigue?

Coping and responding to life’s stressors is easier when your adrenal glands are functioning at full capacity. They begin to fatigue, however, when that stress continues chronically and compactfully, giving you no room to rest. Picture this scenario: you came down with a case of bronchitis that eventually evolved into pneumonia. As you’re driving to your next doctor’s appointment, you’re rear-ended in highway traffic and spend what should be your recovery time making a police statement, calling your insurance agent, and visiting the auto repair shop for a claim estimate. You trudge along, coughing into your shirt sleeve, wondering what other misfortune is looming on the horizon. These are just the foreground events, major plot twists in the tragedy of your life; the background noise discloses a second layer of drama: a stressful job, an unhappy marriage, ongoing sleep deprivation, poor eating habits, failing friendships, and the loneliness that often accompanies middle age. Your adrenal glands struggle to catch up with these stressors, no matter how much more hormones they produce. Like yourself, they burn out and are no longer able to meet the body’s demands.

Perhaps our lives aren’t simply a string of tragedies. Perhaps we are healthy and well in our pursuit of a good life. There is no denying, however, that even the healthiest and happiest of us are products of the 21st century Western lifestyle. In our frittered good will, we pack our schedules with long work hours (we need the money) and graduate school (what’s a bachelor’s degree worth now, anyway?) and family obligations (let me just swing by my sister’s; I haven’t seen my nieces and nephews in weeks) and parenting (my daughter needs to be in sports and piano lessons, just like everyone else her age) and volunteering (gotta give back to the community!) and so-and-so’s dinner and so-and-so’s son’s birthday party and so-and-so’s social justice awareness event… “Chipotle for dinner okay with everyone?” you ask from the driver’s seat, remembering that you haven’t cooked for the fifth day in a row.

We are all chained to demands far beyond our capacity, and unfortunately, the very system designed to handle these demands suffers as a consequence. With too much unmanaged stress, our hormone-producing glands clash and we suffer from adrenal fatigue.

So why do many doctors refuse to recognize adrenal fatigue as a real problem?

That is a question for next week’s blog! When the conversation continues… Read Part II here.

As a pharmacist, I have witnessed the desperation of sleep-deprived patients as they fumble through aisles for a bottle of Advil PM. They resemble a parched marathon runner, fishing for a cup of water just before the finish line—fishing for the nearest lifeline in sight. For insomniacs, sleeping pills are just that: a lifeline. They are the Quick Fix to the tossing, the turning, the clock-watching agonies that haunt their every night. These pills grant them the gift of a good night’s sleep, so they become their lifeline.

According to National Sleep Foundation (NSF), millions of people aren’t meeting the recommended hours of sleep that their bodies need to function optimally. Millions of people, in other words, are sleep-deprived. But despite the NSF’s report, the number is actually significantly higher, because many people suffer in silence. Their doctors remain unaware of the issue as these insomniacs resort to over-the-counter sleeping pills for a solution (i.e. Benadryl, Tylenol PM, Advil PM, Melatonin, etc.).

But untreated insomnia often leads to bigger problems; its victims are at an increased risk of other ill conditions, such as depression, PMS, fibromyalgia, anxiety, carbohydrate cravings, binge-eating, as well as alcoholism.

So what are mainstream treatments of insomnia?

Imagine this scenario: it’s confession time. Your primary doctor listens as you spill your million grievances about your sleepless nights and unproductive work days and crippling headaches and accruing Starbucks bills, pausing only to chug down what happens to be your fourth coffee of the day. Life’s been rough. And ironically, what should be the remedy to rough day—sleep—is actually your offender.

Most patients coming in for insomnia treatment are directed toward counseling services for stress reduction. Others are taught sleep hygiene and are told to avoid caffeine (this last one functions to save both your sanity and your shrinking wallet). And when these interventions don’t work, mainstream doctors—in their time constraints and insurance reimbursement pressures—resort to prescribing sleep medication¹. What’s missing from that sequence of solutions?

As always, finding and treating the root cause.

Though prescription medications help patients fall asleep, they are only patchwork solutions to a complex problem. Patients who are dependent on these medications will regress to insomniac tendencies as soon as their pills are misplaced or finished. Consequently, their pill dependency can last a lifetime, inviting adverse side effects that were never there. Here’s another an inconvenient truth: insomnia is not the problem in and of itself; rather, it is a symptom to an invisible issue in need of diagnosis. Our approach as Functional Medicine practitioners is to uncover why our patients cannot sleep—what went wrong in the body that is disrupting this natural process?

First, what is your sleep routine?

It seems that YouTube’s trending night routine videos may have some legitimacy after all. While most of us find rich teens showcasing their skinny teas and cozy beds in Calvin Klein PJs distasteful, their message of self-care is invaluable. A consistent night routine that triggers melatonin production and primes you for sleep is critical, even into adulthood. So use this checklist of go-to activities to incorporate into your own evening hours (no YouTube documentation required):

• Waking up after a few hours of shut-eye and not being able to fall back asleep is often caused by something you ate or drank just hours before. Eat a good diet and be sure to cut back on sugary treats, alcohol, heavily-spiced foods, and caffeinated drinks after dinner. Also, swap carb-laden dishes for leafy green vegetables and healthy fats at dinner time (healthy fats include avocados, coconut, olives, nuts, and seeds). Dietary changes are proven to increase the quality of your sleep.
• Put away electronics a couple of hours before bed. It is well-documented in scientific research that visual stimulation, as well as blue light emitted from electronics, interfere with melatonin production.
• Commit to one or two de-stressing activities before bed. Some of our favorites include yoga stretches, medication, spiritual prayers, deep breathing, warm baths while essential oils burn in the background.
• Before heading to bed, dim the lights around your home and keep the temperature slightly cool. You’ll fall asleep better that way, I promise.

What if these lifestyle tips aren’t working?

Then it’s time to look a little deeper. Being deficient in essential nutrients², as you may have guessed, is another root cause of insomnia. Insomniacs who wake up abruptly and find themselves tossing and turning until sunrise are experiencing low blood sugar in their sleep. A dietary change can easily remedy this problem. `

Another common culprit masquerades as the “good guy,” with insomnia being a side effect footnoted in small print. That’s right. Several medications³ can significantly lower the amount of melatonin (the sleep hormone) in your body and leave you sleep deprived.

Poor diets and medication regimens aren’t the only sleep thieves known to man. There’s one more, and it’s the happy hormone and neurotransmitter we all love: serotonin⁴. Serotonin converts into melatonin at night and is made in the body via many enzymatic reactions from the essential amino acid tryptophan. This conversion requires many key nutrients, most importantly vitamin B6 and Zinc. Being deficient in these raw materials and expecting a good night’s sleep is like trying to pass a Calculus exam without studying. Only a few can make it. Many environmental toxins also contribute to zinc deficiency—plastic, especially. Our bodies depend on zinc to convert B6 to its active form, whereby transforming tryptophan into a serotonin. It’s a complex science. Just remember: a nourishing diet can go a long way in reviving your near-dead sleep experience.

Everyone deserves beauty sleep

You don’t need to be a medieval Disney princess or a growing adolescent to earn uninterrupted beauty sleep. And you don’t need to trade your hard-earned money on triple shot espressos and sleeping pill refills to survive your insomniac days. There’s a root cause to everything—even to sleep deprivation—and every root cause can be remedied with a holistic solution. Let’s work together to finding that solution, pill dependencies not included. Let’s make our way toward restful nights…

[1] These medications include: eszopiclone (Lunesta); ramelteon (Rozerem); zaleplon (Sonata); zolpidem (Ambien, Ambien CR); or other drugs like the antidepressant trazodone (Remeron), or benzodiazepines such as Lorazepam.

[2] For insomniacs, common deficiencies in essential nutrients include chromium, vanadium, manganese, and magnesium. Magnesium is a vital nutrient that seldom exists in modern diets. Low magnesium levels can cause a variety of imbalances in your body, including anxiety and insomnia. Taking a magnesium supplement before bed can help with sleep issues.

[3] These medications include antidepressant drugs such as fluoxetine, blood pressure medications such as amlodipine and atenolol, as well as non-steroidal anti-inflammatory drugs (NSAIDS) such as naproxen and ibuprofen, among many other.

[4] Ninety-five percent of serotonin is made in the gut. If the gut isn’t healthy, then sleep progress is virtually impossible. If you suffer from gas, bloating, diarrhea, constipation, or other inflammatory conditions, then your chances of solving your insomnia problem may be futile until you fix your gut. The secret is to find a doctor who understands the probable underlying causes of insomnia and can properly test you to discover what needs to be fixed. It really can be as simple as that!

High blood pressure.

We hear those three words all the time. And unless you have high blood pressure, you probably don’t think about it too often. Maybe during occasional check-ups, while sitting in the doctor’s office, breathing nervously as your arm weakens beneath the Merciless Inflating Cuff. Maybe… But what we don’t all know is that high blood pressure (also known as hypertension) is pervasive, affecting one in three adults in the U.S. alone. It’s also an invisible, silent killer: if left untreated, it can lead to more serious health conditions, such as coronary artery disease, stroke, heart failure, peripheral vascular disease, vision loss, and chronic kidney disease.

How is hypertension commonly treated?

The conventional medical approach for treating hypertension mainly looks like this: the Merciless Inflating Cuff detects a patient’s high blood pressure, and if the high blood pressure continues, the doctor prescribes medication to the patient. Sure, these medications are effective at lowering your blood pressure, and there is room for them in medical practice, but they’re merely patchwork. A bandaid over a symptom. A short-term solution to a deeper problem that will continue to fester, pressuring doctors to increase your medication dosage or to prescribe more medications altogether.

Here’s what you need to remember about hypertension: it is actually not a disease in and of itself. Rather, it is a symptom that your body develops as a way of screaming “something is wrong with me!” There is an internal imbalance. And a medication regimen that only increases its dosage with time cannot restore your body’s imbalance. If anything, it can sever your quality of life, causing major nutritional deficiencies as well as other adverse side effects.

So how do functional medicine practitioners treat hypertension?

Practitioners of functional medicine are the Sherlocks of disease. We slip into our white coats, tip down our specks, and ask the hard question: why? Why is my patient’s blood pressure suddenly rising? What is happening inside the body to cause this symptom? How can we restore the body’s balance and eradicate this dysfunction forever? Because we’re not interested in managing your symptoms; we want to cure them altogether. And with our patient-centered approach, we study each individual to determine the reason for his or her hypertension.

And the reasons are many. You may develop high blood pressure because of long-term nutritional deficiencies. Or maybe your body is silently battling a bacterial or viral infection. Maybe you have heavy metal toxicity, hormone imbalance, or you’ve compromised your detoxification pathways. Two people with the same symptom, like hypertension, may have developed it for different reasons. Be sure to consult a practitioner whose can determine the underlying cause of your disease before quickly prescribing medications — someone who can uncover your unique why and develop a unique treatment plan whose end goal is to grant you a life free of disease and medication.

So what can I do now to avoid hypertension?

As the saying goes, an ounce of prevention is better than a pound of cure. So what are the best tips to help you avoid high blood pressure? They can be divided into two camps: dietary choices and nutritional supplements. Let’s delve into the details.

FOR A DIET THAT PREVENTS HIGH BLOOD PRESSURE

Nourish yourself at every meal with straight-from-nature food choices. That means choosing foods that your great-grandparents recognize. Foods with short ingredient lists and ingredients that your second grader can read and understand. That means skipping out on the drive-thru egg sandwich and gas station chocolate muffin… because, though convenient, these highly processed foods are devoid of the nutrients your body needs to regulate your blood pressure (they do quite the opposite, actually).

Instead, opt for a diet rich in fruits, vegetables, nuts, and seeds. And forget what you’ve been told about low fat diets. Break away from the 90’s fat-free food boom and bump up the fat grams with foods rich in omega-3 fatty acids. That includes olives, olive oil, flax seeds, walnuts, wild caught fish, and avocados. And for magnesium-rich foods, incorporate more leafy greens in your diet, more dark chocolate (at least 85% dark), more figs, almonds, bananas, avocados, black beans, and pumpkin seeds. Lastly, get in more potassium-rich foods: coconut water, spinach, sweet potatoes, pomegranates, wild caught salmon, bananas, and avocados.

SUPPLEMENTS THAT PREVENT HIGH BLOOD PRESSURE