Most people grossly underestimate the influence that hormones have on their bodies. Without optimally balanced levels of key hormones, including cortisol, DHEA, growth hormone, testosterone (men), estrogen and progesterone (women), you'll never come anywhere close to your true potential.
This is true regardless of your age or your level (weekend warrior to pro). And you can forget about losing weight if your hormones are out of balance. I know this firsthand from working with hundreds patients.
I like to start by optimizing the stress hormones cortisol and DHEA levels in my patients. These two hormones are made by the adrenal glands, and they can have a powerful influence on other hormones. If you're suffering from adrenal gland burnout, these hormone levels will never be optimally balanced.
Cortisol directs your body's response to stress. It breaks down different tissues to provide energy. For example, cortisol breaks down protein in muscles to provide amino acids to your liver. Cortisol influences the burning of carbohydrates and it directs the storage of fat. It also inhibits repair and immune functions.
All of these things are good for dealing with short term stresses like skiing all day or running a marathon. But if you're under chronic stress (as most of us are), the cortisol production never lets up. Your body is in a state of perpetual breakdown and perpetual fate storage.
In an ideal world, the stress would end and you'd have time to recover. Your cortisol levels would drop and your DHEA (a repair hormone that serves as cortisols counterpart) would rise. Your muscles would get their proteins back, your immune system would ramp up its efforts to fight infections, and other repairs would take place.
Unfortunately, few of us have lives that allow us to fully recover from stress. We work hard all week. We play hard on the weekend. Then on Monday we're back to work, fighting through commutes, and dealing with other stresses that keep cortisol levels elevated. Your adrenal glands can't catch a break.
Poor repair, poor immune function and impaired recovery: this is what destroys sports performance. It also causes your body to store fat. You obviously can't just eliminate the stresses in your life. But you can learn to better manage them.
Impact of stress on sex hormones
Your stress hormones indirectly control your growth hormone, testosterone (men), estrogen and progesterone (women) levels. For the sake of simplicity, I'll refer to these hormones as "sex hormones".
Your stress hormones use many of the same building blocks as your sex hormones. Since they are more vital to your survival, your body will always preferentially make stress hormones over sex hormones. If your body needs to make more stress hormones, it will steal the building blocks from your sex hormones.
As a result, burned out women may have excess body fat, lower sex drives, and sometimes have trouble getting pregnant. Guys have trouble gaining muscle, trouble losing fat, and lowered sex drives. Some burned out guys even have mild sexual dysfunction.
In most cases, correcting your stress hormone levels will allow your body to correct the sex hormone levels. That's why I like to start with the stress hormones.
Hormones influence how you look, how you feel, how quickly you age, and more. But you can't simply "take hormones" to optimize them. The truth is that optimizing hormones is a long-term project. And you can do it naturally, primarily through lifestyle changes.
How to figure out if your stress hormones are burned out...
It's a good idea to get a baseline test of your Cortisol and DHEA to see where they're at. This is done very easily with saliva samples that you can collect at home. The test kit is then sent to the lab and sophisticated assays are performed to determine what your stress hormone levels are.
Without testing, you can make an educated guess about whether your levels are out of balance based on the questionnaire at the end of this article. Frankly, the lab test is far more reliable, but more on that later.
Your stress hormones are made by your adrenal glands. When you're under prolonged stress with no real relief, your adrenal glands will start to burn out in a predictable pattern. This burnout pattern progresses through three stages. Genetics play a role in how long it takes to move through each stage.
Stage 1 Stress Hormone Burnout
In Stage 1 Burnout, your stress hormone levels are higher than normal. This means your body is still working hard to keep up with the excessive demand that you're putting on it.
Some of the symptoms may include irritability, trouble sleeping, anxiety, food cravings (fats and sweets), declining sports performance, getting more colds and/or sinus infections, nagging injuries.
Stage 2 Stress Hormone Burnout
Sooner or later, if you're in stage 1 you'll slide into Stage 2. In Stage 2, your adrenal glands can't make enough cortisol and/or DHEA to keep up with demand that your placing on your body throughout the day.
Stress is starting to wear you out. The symptoms that may go along with this include fatigue, mild depression, chronic injuries, weight gain, and all of the symptoms from Stage 1, but to a greater extent.
Stage 3 Stage 3 Stress Hormone Burnout
Luckily, I don't see too many Stage 3 Burnouts in my practice. This is generally a case where someone has really run him or herself into the ground. Some significant health problems usually accompany stage, along with symptoms like severe fatigue, significant depression, loss of any interest in sex, apathy, severe sleep troubles, and more. If you suspect that this sounds like you, you need to get help now.
Since the vast majority of my patients are in Sate 1 or Stage 2, I'll share a couple of true stories so you can see what I mean. The names a changed but the cases are real.
Jenna, a true Stage 1 Burnout...
Jenna was 29 when she came to me complaining of trouble sleeping, significant food cravings, and trouble losing the last 10 pounds of pregnancy weight. Her baby was about 18 months old, but she was still 10 pounds over her pre-pregnancy weight. She was training for a marathon, but not progressing like she used to.
After speaking with her during a consultation I discovered her sleep was poor, work was exhausting her, and she ate a lot of junk at night. When the results of her Stress Hormone Test came back, her levels were high. She was a classic Stage 1.
Matt, a true Stage 2 Burnout...
Matt was about 36 when I started working with him. He was (and is) an Ironman competitor, and had been watching his race times get worse and worse with each passing year. His training regimen was rigorous, with six to seven workouts per week. He also had a young child.
Matt did not like his job, and he traveled at least twice a month. On top of that, he drank a lot of caffeine, frequently used protein powders and energy bars instead of eating food, and slept about 6 hours per night.
When he first came to me, Matt's primary concern was declining sports performance. After a few minutes of speaking with him, it was clear that his real concerns were fatigue, moodiness, and low sex drive.
As you can guess, when we tested Matt, his cortisol and DHEA levels were both low. After years of burning the candles at both ends, his lifestyle was wearing out his adrenal glands.
Your secret weapon for balancing your stress hormones
Once you have a handle on where your hormone levels are, it's time to figure out what's driving the imbalance. More often than not, lifestyle issues are causing the problems. The good news is that these lifestyle issues can be changed.
There are 4 basic kinds of stress that will affect your stress hormones. I always work with my patients to get each of these factors under control. Sometimes it's easier said than done, but it ALWAYS makes a dramatic difference. They are:
Life stress, work stress, money stress
Sleep stress
Dietary stress
Exercise and injury stress
Let's look at how these factors applied to Jenna and Matt, and you'll see what I'm talking about.
So, getting back to Jenna...
Jenna went through a major life stress. She went through a nine month pregnancy, delivered a healthy child; breast fed for a year, and was raising a healthy toddler when she came to see me. Even though all of these are good things, they are all extremely stressful, particularly to your hormonal systems. Significant life stresses like childbirth, divorce, job loss, bankruptcy, death of a loved one, marriage, moving can all have a dramatic impact on health.
Luckily for Jenna, she got her child sleeping through the night when he was about 3 months old. So she was getting about 8 hours of sleep each night. Her sleep was probably what kept her from sliding into stage 2.
Like many new moms, Jenna got used to eating for two. Building a baby and breast feeding a baby both require incredible quantities of calories. In particular, Jenna got in the habit of eating a lot of calories at night, partly because she was hungry, and partly because the food helped her relax. Dietary stress usually involves blood sugar control issues, and this can drive your cortisol levels up. Balanced eating leads to balanced blood sugar, and this helps optimize hormones.
Again, like many new moms, Jenna started exercising too much too soon. She was running again as soon as her doctor allowed (about 10 weeks after her son was born). Training for a marathon with an already over-stressed body was only further draining her body. Excessive exercise is a significant problem for many of my patients. This will keep your cortisol high, your DHEA levels low, and prevent any meaningful recovery. For athletes, this is what destroys performance.
Moving Jenna towards balance...
The first thing I had to do was get Jenna to understand that she needed to fully recover from having the baby and nursing. Until that time, marathon training was out of the question. I limited her to no more than 3-mile runs four times a week. It seemed like too little to her, but this allowed her to exercise and recover at the same time. If she kept training for the marathon, she'd never get out of the hole she'd dug.
Even though Jenna was getting 8 hours of sleep, she felt like she could sleep more. So I told her to try to let her body get as much sleep as it needed. She agreed, and for the first three months, she slept about 10 hours a night (usually 9PM-7AM). Sleep is when your body repairs itself and when it makes most of its hormones, so it's crucial that you get it. For Jenna, this meant giving up some crappy evening TV and getting to bed.
And finally, we limited her to no more than 250 calories after 7 PM. At first, she could eat whatever she wanted to get those calories, but eventually she got in the habit of eating a small healthy snack. It took a few months, but Jenna did indeed get back to her pre-pregnancy weight without any fad dieting.
What about Matt?
Matt required more work. First, I had him work with a triathlon coach to modify his training and allow for adequate recovery. He loved training for races, so taking that away from him would have been a disaster. But his training needed to be managed by someone who could be more objective about it. We did agree that he would take two weeks off from exercise. Only stretching and walking were allowed.
From there we tackled his diet. The first rule: no more protein powder or bars. Just about every protein powder is nothing but processed junk with a big marketing budget. It's simply an inferior substitute for real food. These products often contain lots of artificial chemicals and poorly absorbed proteins. Real food is much better. A little planning ahead was all Matt needed to make sure he had food, not powder, to help his body repair itself.
Matt's sleep was totally inadequate. It was leading directly to his over-consumption of caffeine. We had to slowly add to his sleep and start tapering off of all the coffee and energy drinks. Stimulants like this force your adrenal glands to keep pumping out stress hormones when they're burned out.
And finally, I told Matt that it was time to make a career move. It doesn't matter how much money you're making if you hate what you do. Matt couldn't stand the travel any more. He had a young son, and he wanted to be home. This kind of problem is usually not as hard to fix as people think.
Bringing hormone levels back into balance naturally
I often use supplements AFTER a patient has started implementing these lifestyle changes, but never without first obtaining a stress hormone lab test. By taking into account lab results, personal history, and lifestyle issues, I'm able to custom-design supplement programs that do exactly what the name implies: supplement the efforts that you're already making. I used supplement programs with each of these patients, but I won't disclose what those programs were. I don't want anyone copying a program that was designed for someone else.
Hidden stressors may be present, too. Sometimes a patient will have a hidden internal stressor, often a low-grade digestive infection, that will drive them into a stage 1 and eventually stage 2. High morning stress hormone levels can indicate this type of problem (which requires medical treatment with antibiotics). Chronic muscular injuries are another type of hidden stressor.
Sometimes undiagnosed food allergies (to wheat or dairy for example) can create a tremendous stress on the body. Again, a careful history and information from the lab test can help figure this out.
Realistic goals and realistic time frames
One of the first things I tell a new patient is: "This is not something that you can fix overnight." People spend years getting themselves in to Stress Hormone Burnout. It usually takes about 6 months to correct a Stage 1, about a year for a Stage 2, and even longer for a Stage 3.
Six months after we started working together, Jenna decided not to train for a marathon. She was feeling great, and she and her husband were ready to have another child.
I've been working with Matt for about 9 months at the time of this writing. He's doing much better. He quit his job before he even started looking. He used that lag time to start sleeping more. First he started sleeping for seven hours, then 8. He now averages about eight and a half hours.
He landed a better job with slightly less pay, but he still does very well. Not wanting to go totally without coffee, he limits himself to two cups each morning. His first race of the season is about 3 weeks away. I have a feeling he'll be pleased with his time.
And, if you haven't guessed by now, Jenna and Matt are married.
So what can you do?
Sleep. I said it before and I'll say I again: Your body makes most of it's hormones and repairs itself during sleep. Ignoring your sleep needs a certain recipe for disaster. Most people need somewhere between 8 and 10 hours every night.
Acknowledge life stress. Some life stresses can be changed, and some can't. The key is to change the ones that you can change, and learn to cope with the ones that you can't change. These types of stresses drain your body 24 hours a day. It's impossible to rebalance your hormones without addressing them. Sometimes, professional help may be required.
Eat balanced meals. Every meal should include about 3-5 ounces of quality protein, 1-2 cups of veggies, and, if you want, some form of carbohydrates. I like to have patients test out a wheat-free diet to see how they feel (many feel great).
Fine tune your exercise so it improves your body instead of draining it. Most people reading this article are more likely to over-exercise than under exercise. I've worked with many athletes, distance athletes, lifters, etc, and many of them are almost addicted to training. So they over-train. Over training severely depletes your adrenal glands and never allows your body to repair. Hormone testing is the best way to gauge the effects of your exercise habits, since everyone is different.
And finally, get a stress hormone assessment. I like to use the functional adrenal stress profile from Biohealth Diagnostics. This is a saliva lab test that allows you to collect samples at home and then use pre-paid FedEx to send the kit to the lab. Cortisol and DHEA levels are measured at four different times throughout the day (first thing in the morning, noon, late afternoon, and bed time. This very accurate lab test is an excellent starting point for balancing your stress hormones.
It's important to take action now. Imbalanced hormones will destroy sports performance and keep you from losing weight. As time goes by, these imbalances can lead to more significant health problems, like heart disease and diabetes.
You can have your stress hormone levels tested by Dr. Hyman by scheduling a consultation or enrolling in a six-month program. From there, Dr. Hyman can help set up a natural hormone balancing plan that get you back to performing at your best.
Stress Profile Questionnaire
Next to each question assign a number between 0 and 5. You should assign values as follows:
0 = Not true
3 = Somewhat true
5 = Very true
Once you have completed the questionnaire calculate your total and locate the range you fall under on page two.
1. ___I experience problems falling asleep.
2. ___I experience problems staying asleep.
3. ___I frequently experience a second wind (high energy) late at night.
4. ___I have energy highs and lows throughout the day.
5. ___I feel tired all the time.
6. ___I need caffeine (coffee, tea, cola, etc) to get going in the morning.
7. ___I usually go to bed after 10 pm.
8. ___I frequently get less than 8 hours of sleep per night.
9. ___I am easily fatigued.
10.___Things I used to enjoy seem like a chore lately.
11.___My sex drive is lower than it used to be.
12.___I suffer from feelings of depression such as sadness, or loss of motivation.
13.___If I skip meals I feel low energy or foggy and disoriented.
14.___My ability to handle stress has decreased.
15.___I find that I am easily irritated or upset.
16.___I have had one or more stressful major life events. (i.e: divorce, job loss, new baby, new job)
17.___I tend to overwork with little time for play or relaxation for extended periods of time.
18.___I crave sweets.
19.___I frequently skip meals.
20.___I am experiencing muscle aches, headaches, or more frequent illnesses.
Scoring Your Stress Profile:
It is important to note that this is not a diagnostic test and should not be used to diagnose any conditions. It is simply a tool to help assess your likely level of adrenal burnout.
If you scored between:
0 - 30: You are in good health.
30 - 40: You are under some stress.
40 - 50: You are a candidate for adrenal burnout.
50 - 60: You are in adrenal burnout.
60 + : You are in severe adrenal burnout.
* If you scored 60 or higher it is important that you take immediate steps to correct this condition before your health is adversely affected.
If you have scored 40 or higher you are in adrenal burnout and will at some point experience the symptoms such as fatigue, weight gain, insomnia, irritability, and mood swings.
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