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Natural Ways to Boost Your Immune System

​With the current coronavirus pandemic, the public is more afraid for their health and wellbeing than I have ever seen.

It is all over the news and social media.  It seems impossible to get away from it.

Why do these pandemics keep occurring?  What is wrong?

While we really can’t stop this virus or future organisms from spreading across the world, we CAN do more to get and keep our own immune system as healthy as possible.

I will discuss how to do this below…

​Germ Theory vs Terrain Theory

In order to understand our immune system and how it works, we need to discuss some topics.

​Most of us were taught the germ theory in school, so this should sound familiar.

In the late 1800s, Louis Pasteur described a microscopic world of organisms that cause disease.  He developed the pasteurization of milk, which involves heating milk to very high temperatures which kills the germs and bacteria inside the milk and thus prevents infections.

The core concept of the germ theory of disease is this:   Microorganisms (germs) are the cause of infectious disease.  They invade humans, other animals, and other living hosts.  Their growth and reproduction can lead to disease.

This has become the foundational belief for much of modern medicine.  Antibiotics, vaccines, and other antimicrobial treatments are based on this concept.

The bugs are bad.  If we want to get and stay healthy, we need to kill the bugs and do whatever we can to avoid contact with the bugs.

That is what we were all taught.  That is what we are doing in the world now, right?

​What about the terrain theory?

Antoine Bechamp, who​ was a contemporary scientist of Louis Pasteur, believed that the focus should be on the health of the person, NOT on the bug.  He famously said, “treat the patient, not the disease.”

Bechamp noted that the germs that terrified Pasteur were opportunistic in nature.  They were everywhere and even existed normally in humans.  Only when the tissue of the host became damaged or compromised did those germs manifest as a symptom of disease.  He believe they were a result of the disease, not the cause.

His thinking went something like this:  The severity of the infection will correlate with the health status of the patient.  In other words, the unhealthier the person, the more out of balance a body is, the more susceptible they will be to disease.  Also, the disease will be much more severe in that person compared to a person who is in balance and healthy.

To prevent illness, Bechamp advocated not the killing of germs but the cultivation of health through diet, hygiene and healthy living.

When treating a patient with an active infection, he was less concerned with killing the organism and focused more on restoring the health of the patient’s body through lifestyle choices.  As the person’s health was restored through diet, hygiene and detoxification, the infection would go away on its own.  There was no need to directly kill the bug.

The 2 scientists had a long and often bitter rivalry regarding which of them were right.  Ultimately, society accepted the germ theory and the terrain theory was mostly forgotten.

The irony of the story is that at the end of his life, Pasteur renounced his germ theory.  His last words were “the microbe is nothing, the terrain is everything.”

So, which theory do you endorse?  Does it have to be one or the other, or is there some truth in both?​

​The Onslaught of Microbes

​Have you noticed that every few years the latest “killer bug” arrives on the scene, threatening to destroy humanity?  Here are just a few of the big ones from the last 20 years:

  • 2003 – SARS
  • 2009 – Swine Flu
  • 2013 – Bird Flu
  • ​2014 – Ebola
  • 2016 – Zika
  • ​2019 – COVID-19

​Why does it seem like these are hitting us in waves?  What is going on?

​Are We Too Clean?

​That may seem like a really weird question to ask, but it deserves discussing.

My mother told me countless stories about her childhood in the 1930s and 1940s.  She and her siblings rarely wore shoes, they ate a bunch of dirt, only bathed every few days, and played in the cattle stable which was full of cow manure.

She said she barely remembered any of them ever getting sick.

I have always been amazed that our dogs or cattle could drink some of the dirtiest, nastiest water I had ever seen, yet it didn’t make them sick.  Why not?

The answer, at least in large part, is because of our microbiome.

​The Microbiome

​Over the past several years, the medical system has finally begun to acknowledge the importance of the microbiome.

Inside and out, our bodies are covered with microbes – bacteria, fungi, protozoa and viruses.

In fact, there are over 100 trillion of them!  Microbes outnumber our human cells by 10 to 1. That results in about 5 pounds of material.

The microbiome is the genetic material contained in all of those microbes.  There is 200 times more genetic material in those microbes than the number of human genes our body contains.

​These organisms help us digest our food, regulate our immune system, protect against diseases, produce neurotransmitters, produce hormones, and even produce many of the vitamins that are essential for our health.

If this complex colony of organisms gets out of balance in any way, our health will be affected.

An analogy would be to look at your lawn.  As long as your grass is healthy and thick, weeds and other invaders will not be able to spread.  If it gets some bare patches or other issues, very quickly some opportunistic weeds will start to take over.

Autoimmune diseases are another example.  Autoimmunity is associated with a dysfunction of the microbiome.  The wrong kinds and amounts of microbes accumulate on or in the body over time, which changes the gene activity and metabolic processes.  This results in the immune system attacking parts of the body instead of foreign invaders.

Autoimmune diseases seem to run in families.  It is now believed that it occurs not by inheriting defective DNA, but instead by inheriting a family’s unhealthy microbiome.

Our microbiome is critical to our health.  It is also not a stagnant, unchanging group of microbes. Rather, it changes almost by the minute.

For example, if you touch the ground outside, some microbes from your skin will transfer to the ground while some from the ground will transfer to your skin.  In this way, your body is in constant communication with the environment.  Your body assesses these new microbes and uses them to further fortify your immune defenses.

The same thing happens with our diet.  We we eat foods that are full of beneficial bacteria, our body adds those microbes to the flora in our colon.

If we eat things such as a high sugar or processed food diet, our gut flora is actually damaged and some of the good bacteria are killed.

On a side note, some bacteria in the gut promote a leaner body while others promote the body to gain weight.  Sugar in the diet has been shown to promote an increase in the bacteria that cause weight gain.  So, weight gain is not just a matter of someone eating too many calories.

​Medications and the Gut Microbiome

​Many prescription and over the counter medications have been shown to have a severe impact on the bacterial balance in our gut.  These include:

  • Proton Pump Inhibitors – These include meds such as Prilosec and Nexium
  • Metformin – The most commonly used medication for diabetes
  • Antibiotics – These kills both the good and the bad bacteria
  •  Laxatives – Used to treat constipation
  • NSAIDS – Anti-inflammatory meds such as aspirin, Aleve, and ibuprofen

A lab in Germany tested the effect of 835 different non-antibiotic medications on 40 of the most common gut bacteria.  About 25% of the medications restrained the growth of at least one bacteria, while about 5% affected the growth of at least 10 of the 40 bacteria.

Medications are not without risks.

​The rates of allergies and asthma in westernized countries are skyrocketing.  You have most likely even noticed this in your own family.  This is felt to be due to things such as improved hygiene, decreased physical activity, and poor diet.  All of those things affect our microbiome which affects our immune function.

So are we too clean?  Possibly.  Are we being exposed enough to the good microbes in our environment.  Probably not.

Liberally using hand sanitizers can also alter the good bacteria in our microbiome.

During the current pandemic, we are being told to stay inside, wear a mask, wash our hands often, and use hand sanitizers.

We had to protect the at-risk population from a dangerous new virus.  But we can’t and shouldn’t do these things long-term if we all want to have a strong, resilient immune system.

​How To Boost Your Immune System

​Okay, so in light of everything we have discussed, what can you do to boost your immune system?

1. Optimize Your Diet

– Reduce sugar and processed carbs –

Sugar increases inflammation which impairs our immune system.

– Eat more vegetables and fruit –

The fiber in plant foods feeds your gut bacteria which boosts your immunity.  They also contain flavonoids which reduce inflammation and augment the antiviral properties of zinc.

– Increase your good fat intake –

Healthy fats such as those found in olive oil and salmon boost the body’s immune response by decreasing inflammation.

– Eat more fermented foods –

Foods such as yogurt, kombucha, sauerkrat, kefir and kimchi are rich in beneficial bacteria that help populate our gut microbiome.  One study in children showed that those who drank only 2.4 ounces of fermented milk daily had 20% fewer infections than the control group.

​2. Get Regular, Moderate Exercise –

​Regular, moderate exercise reduces inflammation and helps your immune cells regenerate.  Examples include brisk walking, biking, jogging, and swimming.  Your goal should be to get 150 minutes of exercise each week.

​3. Drink More Water –

​Dehydration causes headaches and worsens focus, mood, digestion and other bodily functions. All of these increase your susceptibility to illness.

​4. Get Adequate Sleep –

​Getting less than 6 hours of sleep per night significantly increases your chance of getting a cold. Getting adequate rest will increase your natural immunity.

​5. Manage Your Stress –

​Stress increases inflammation and impairs immune functions.  It is critical to manage your stress if you want to have an optimal immune system. Activities that help manage stress include meditation, exercise, yoga, and starting a hobby you enjoy.

​6. Consider Supplementation –

​You can never supplement yourself to good health, but it is often necessary to add a few good-quality supplements to your daily regimen to help ensure your immune system is operating at an optimal level.

​     Vitamin D3 –

Optimizing vitamin D levels reduces the chance of developing an autoimmune disease and improves your immune system.  T​he optimal level is 50-80 ng/mL of 25-OH-vitamin D.  In most people, this can be achieved with a supplement dose of 2000-5000IU per day.  Sometimes it may require a higher dose for a short period of time.

​     Vitamin C –

One study showed that taking 1000-2000mg of vitamin C per day reduced the duration of a cold by 8% in adults and 14% in children.

​     Zinc –

One review showed that supplementing with 75mg of zinc per day in patients with a cold resulted in a 33% reduction in the duration of the cold.  Zinc works by helping prevent viruses from entering the cells of the body.  A typical daily dose is 30-60mg but more can be taken during an acute infection.

​     Elderberry –

A meta-analysis showed that elderberry significantly reduced the symptoms during an upper respiratory infection.  Typical doses are 1 TBSP 3-4 times per day of syrup or one 175mg lozenge twice daily.

​     Garlic –

This study showed that supplementing with garlic reduced the incidence of the common cold by about 30%.

​     Probiotics –

Probiotic supplements boost our immune response and reduce the amount of viral shedding.

     Melatonin –

Not only does melatonin play a role in our sleep and circadian rhythm, it helps to regulate our immune system and has antioxidant functions.  A typical dose is 1-5mg taken an hour before bedtime.

​     Fish Oil –

Omega 3 fatty acids boost our immune system in several ways.  A typical dose is 1000-2000mg daily.

​7. Talk to Your Doctor About Your Medications

​If you are taking several prescription or over the counter medications, talk to your medical provider to see if it is possible to reduce or eliminate as many of them as you can. Each could potentially be affecting your microbiome as we discussed earlier.

​8. Just For Fun

​If you want to have a laugh with a friend or family member, refer them to this article!

Keto Diet Pros and Cons

​Chances are you have heard about the Keto Diet ​​a lot from friends, coworkers, or family members.  It is also all over the news and social media.

​The popularity of the Keto Diet has soared over the past few years via marketing campaigns and word-of-mouth.

So what is the Keto Diet?  Is it safe?  Does it work?  What foods do you eat ​and what do you avoid?  What are the ​keto diet pros and cons?  What does the research show about it?  When should you consider using it?

I will answer these questions and many more in this article…​

​History of the Keto Diet

​Versions of the ketogenic (Keto) diet have been around for over 100 years.  It was used in the 1800s to help control blood sugar levels in patients with diabetes.  It was introduced as a treatment for epilepsy in children in the 1920s.  It has since been used as a treatment for various conditions, including cancer, dementia, and other neurological disorders.

Over the past 30 to 40 years, its popularity as a weight loss diet has skyrocketed.  It began with the Adkins Diet, which promoted a mostly protein (meat) based diet with moderate fat intake and low carbohydrates.  ​Other diets ​have since been developed such as the South Beach Diet, Whole 30, Paleo, and many others.  

The primary progression of these diets has been in the percentage of fat that is recommended.

​What is the Keto Diet?

​While Adkins, South Beach and other diets ​have a high amount of protein, the Keto Diet gets the majority of its calories from fats.  Protein levels are moderate, while carbs are extremely low (~5% on the traditional Keto).

The concept of the keto diet is to make your body burn fat for fuel instead of glucose.

The preferred fuel for our cells is glucose (sugar).  Glucose is derived from eating foods that contain sugar and carbohydrates.  That glucose is either used immediately for fuel or stored in the liver or muscles as glycogen.

With the keto diet, the body is deprived of the majority of food sources of sugar and carbs.  After 3-4 days, all stores of glucose in the body are used up.  The liver will then begin burning fat for fuel.  A bi-product of this process is the production of ketones (thus the name ketosis).

​Keto Diet vs Low Fat Diet

​Many of the major health organizations (AHA, ADA, etc) still hold the position that too much fat in the diet is a major cause of health issues.  In fact, most still recommend keeping fat intake to no more than 30% of the total calories.

However, many studies over the past decade have called this into question.  Many experts now recommend reducing the carbohydrate intake rather than fat.

So which is better a helping with weight loss?  Low car or low fat?

One study showed no weight loss difference between a low fat and a low carb diet.

Several other studies, however, show that low carb diets result in more weight loss than low fat diets, especially early.  Click here, here, here and here for examples.

​A big problem with most low fat diets is participants tend to replace the fat content in the diet with simple or processed carbs, which is much worse than eating fat.

​Benefits of the Keto Diet

​Potential Negatives of the Keto Diet

  • The keto diet can be hard for some people to follow.
  • The first 5-14 days on the keto diet may cause flu-like symptoms as your body converts to burning fat for fuel.  This is sometime called the “keto flu.”  The best way to manage this is to increase fluid intake.
  • Keto may cause low blood sugar, especially initially.  Be especially careful if you are diabetic and taking a medication that lower glucose levels (such as sulfonylureas).
  • It may cause in increased risk for kidney stones.  This is typically more common in the high protein diets like Adkins.
  • Staying on the keto diet for a prolonged period of time can possibly lower bone density.  Another study, however, showed no significant change.
  • It may increase uric acid which can trigger a gout attack.  This is the highest risk within the first few days of starting the diet.  Reducing inflammation in the body will eventually lower the risk for gout.
  • The source of fat and protein in a keto diet is very important.  One study showed an increased death risk from people eating a keto diet that was using animal sources for the fat and protein vs plant-based fat and protein.
  • The keto diet is not recommended during time of rapid growth – pregnancy and breast-feeding.  Children must be closely monitored if on it.
  • It may cause constipation.  Push the vegetables.
  • After stopping the keto diet, ghrelin levels may rise which can increase the appetite temporarily.
  • ​It could potentially lower free thyroid hormone levels.  Monitor your thyroid levels regularly while on the diet, especially if you have know thyroid issues.

​How Long Should You Stay on the Keto Diet?

​The short answer is, it depends.  Some people feel great on the keto diet, while other people can feel fatigued or moody while on it.

Some experts feel that the true benefit of the keto diet would be to go in and out of ketosis, not necessarily stay in ketosis indefinitely.

I typically recommend giving the diet a good 4-6 weeks.  At that time, assess how you feel and monitor your labwork – blood sugar, insulin, thyroid, kidney function, and liver function.

If you feel good, you can continue on it for longer.  If you feel bad, consider slowly adding back some good whole food carbs (fruit, veggies, legumes) until you feel better.

Another option to consider is eating a strict keto diet for about 1 month every 3-4 months, then going back to a whole food, organic diet with more carbs during the other months.

Every body and every system is unique.  You may have to do trial and error until you find what eating plan best fits you.

​​How Do You Get Off of the Keto Diet?

  • Go slow.  Don’t just go back to the way you used to eat.
  • Slowly increase complex carbs (fruit, veggies, beans) one meal per day.  If you are tolerating it, you can gradually add them to other meals.  Watch for bloating or gas and slow down adding them if it occurs.
  • Avoid simple carbs and sugars.  Remember, that’s probably what got you to the point of needing to start the keto diet in the first place!
  • You might feel more hungry at first and might even have some blood sugar variations.  Watch your blood sugar and avoid the munchies.

Will You Gain Weight After Stopping the Keto Diet?

​The answer is maybe.  If you go right back to your previous poor eating habits, you will likely gain most if not all of the weight that you lost on the diet.

That is why it is so important to transition off of the keto diet slowly and carefully, preferably to a primarily whole food, organic diet.  Continue to avoid sugar and processed carbs (pasta, bread, doughnuts, etc).

If you do this right, your weight will most likely maintain at your goal weight that your worked so hard to achieve while on the keto diet.

​My Guidelines for Using the Keto Diet

  • The keto diet is a great choice for patients with seizure disorder or other neurological or cognitive conditions.
  • Great choice for patients with insulin resistance/type 2 diabetes.  If on diabetes medication, closely monitor your glucose levels and consult with your medical provider before starting the diet.  The medications may need to be reduced rapidly or even stopped.
  • ​Be careful of the sources of fats and proteins.  Plant sources are better than animal sources.
  • Eat plenty of whole, green vegetables.  You need the fiber and it is a healthier source of protein and fat.
  • Hydrate, hydrate, hydrate!  Most of us are dehydrated which will worsen potential side effects of the diet.
  • Consider doing keto for a limited time several times per year.  Eat a whole food, organic, primarily plant-based diet the other times.

​Summary

​The keto diet is an extremely popular diet that works by reducing the amount of sugar and carbs consumed.  The majority of calories come from healthy fats, while protein intake is moderate.

After a few days, the lack of sugar in the diet forces the body to burn fat for fuel.  This results in the production of ketones.

The keto diet can cause significant weight loss and help reduce appetite.  It has been shown to help treat neurological and cognitive disorders.  It can also help reduce insulin resistance and lower cholesterol levels.

The keto diet can cause significant side effects early in its use.  It may also increase uric acid, worsen constipation, and may have an effect on thyroid levels.

It is important to eat from good sources of fat and protein, especially plants.

Make sure you hydrate well while on the keto diet.

​Now it’s your turn…

Have you tried the keto diet?  What results did you have?

Di you have any side effects or other problems?

Leave any comments or questions in the comments section below.

How to Naturally Lower Cholesterol Levels

​Have you​ been told you that your cholesterol level is too high?

​Has your doctor even recommended a prescription medication to lower it?

​Is a high cholesterol level dangerous?  Is there anything that you ​can do to help?

In this article, I will discuss how you can lower your cholesterol level naturally WITHOUT medication.

​The discussion will include which foods you should avoid, which foods you should eat, supplements that help, and other lifestyle changes that ​can help ​get your cholesterol level back into the optimal range.

Ready, set, go…

​What is Cholesterol?

Cholesterol is a lipid molecule that is produced by all animal cells.  It is an essential structural component of all animal cell membranes.  In fact, about 30% of cell membranes are cholesterol.  The vast majority of cholesterol is made by the liver.

​Within the cell membrane, cholesterol plays a role in intracellular transport, cell signaling and nerve conduction.

Cholesterol is also a precursor to the production of hormones, bile acids, and vitamin D.

Cholesterol is transported inside lipoprotein particles throughout the body.  These lipoproteins come in 2 primary forms – LDL and HDL (there are also VLDL and IDL particles, which I will not discuss in this article).

It is believed that ​low density lipoproteins (LDL) particles (as well as IDL and VLDL) promote the development of atheromas in artery walls while high density lipoproteins (HDL) particles promote the removal of those atheromas from the artery walls.

​That is why most people call LDL the “bad” cholesterol while HDL is the “good” cholesterol.  ​More recent research has shown a much more complicated picture than that, but ​that is general description of each lipoprotein.

The belief is if you can reduce the ​amount of LDL in the body, it will reduce the incidence of atherosclerosis (the laying down of plaque in the arteries).  Therefore, less plaque = less heart disease.

But is it really that simple?

​​Is It Dangerous to Have High Cholesterol?

Keep in mind that cholesterol is essential for the body.  We must have cholesterol to have normal cell membranes.

We also must have cholesterol to make many of the hormones in the body, including estrogen, testosterone, adrenal hormones and vitamin D.

Cholesterol is vital for forming memories and other critical neurological functions.

It also is the foundation for bile acids, which are required for fat digestion and the absorption of nutrients from our food.

So, cholesterol isn’t bad.  ​But high cholesterol is bad, right?  Not necessarily.

What may be bad is when you have too much of the wrong forms of lipoproteins.  The small, dense LDL particles are believed to be the ones that increase the risk for plaque formation.

​However, this increased risk may be more theoretical than actual.

Multiple studies have attempted to show that a high cholesterol level (especially LDL) increases your risk for heart disease.

This meta-analysis from JAMA in 2016 involving 316,000 patients​ did show that lower levels of LDL​ were associated with lower rates of coronary events.

​However, a systematic review and meta-analysis from the American Journal of Clinical Nutrition in 2015 looked at 40 studies involving over 361,000 patients.  They were unable to draw any connection between cholesterol levels and an increase in ​heart disease risk.

Another systematic review from Cardiovascular Medicine Research in 2015 looked at 19 cohort studies of cholesterol levels and mortality in the elderly.  To their surprise, not only was a high LDL level NOT associated with an increased risk of ​death, the exact opposite was found.  People with the highest LDL levels lived ​longer!

​So should we worry about cholesterol levels?  My honest answer is I’m not sure.

​People who live healthy lifestyles and eat natural, healthy foods have lower cholesterol levels than people who eat the standard American diet and have unhealthy lifestyles.  The exception to this is people that have familial hyperlipidemia.

​Cholesterol levels can then be used as an indicator o​f the diet and lifestyle that a person is living.  You yourself probably know that when you are not eating well, your cholesterol levels increase, especially the LDL.  When you aren’t exercising, your HDL level drops.

​Elevated levels of small, dense LDL does appear to slightly increase cardiovascular risk.  Plus, I believe it is good to monitor our HDL and LDL levels as a way of measuring how healthy we are living.

​How to Naturally Lower Cholesterol Levels

​So if your cholesterol levels are higher than you or your doctor would prefer, what can you do about it?

Chances are, your doctor will recommend that you start a statin drug.  There is no doubt that these drugs will drop your cholesterol levels.

However, there are many side effects and even dangers that come with this class of medication (read my article here). There are also questions about how much they really prevent bad outcomes.

​Of note, there are many experts that believe statins can reduce the risk of MI because of their anti-inflammatory and anticoagulant actions, NOT because they lower cholesterol.

In my opinion, if you have familial hyperlipidemia and​/or if you are a man with established heart disease, you should probably be taking a statin drug (if you can tolerate it).

Everyone else (women, people with high cholesterol but no history of heart disease) should discuss it with ​their doctor first and really focus on diet and lifestyle as the ​primary means of reducing it.

Now let’s talk about some things that you can do to naturally lower your cholesterol levels…

Avoid These Foods (Foods that Raise Cholesterol)

​There are several things that you can do to lower your cholesterol, but like most health issues, you should always start with your diet.

Let’s list some things that should definitely be avoided if your cholesterol is too high:

​1.  Sugar

​One of the most powerful things that you can do to lower your LDL cholesterol level is to remove the majority of sugar from your diet.  The average American eats over 150 pounds of sugar every year.

We have all been told for years that too much fat in the diet raises cholesterol levels and sugar is harmless except for being empty calories.  That just isn’t true!

​Sugar calories are deadly calories. Sugar causes heart attacks, obesity, type 2 diabetes, cancer and dementia, and is the leading cause of liver failure in America.

The biggest culprit for most people is sugar-sweetened drinks.  The average American gets over 1/3 of their daily sugar calories from soft drinks!  When you add sweetened tea, coffee, and energy drinks, that number ​is even higher.

Excess sugar intake leads to insulin resistance, elevated triglyceride levels, low HDL levels, increased levels of low density LDL particles, and​ an increase in inflammation​.  All of these cause an increased risk of heart disease, independent of any other risk factors.

A JAMA Internal Medicine study from 2014 showed that people eating the highest amount of sugar had a 400% higher risk of heart attack than people eating the lowest amount of sugar!  The study showed that your risk of heart attack doubles if you get 20% of your calories from sugar.

That is a scary statistic, especially when you realize that over 10% of Americans get ​more than 25% of their calories from sugar!

Several countries worldwide have battled this epidemic by ​taxing soft drinks, banning junk food television advertising, and eliminating processed foods, junk food and sugar-sweetened beverages from schools. This study even calculated the potential health benefits of taxing soft drinks in the US.

I am personally not a fan of using government intervention as a way of controlling behavior in society, but it underscores the importance of increasing education in the areas of nutrition and health and putting pressure on companies to produce healthier food options.

​2.  Refined Carbohydrates

​Refined carbohydrates, also known as simple carbs or processed carbs, are just as dangerous as sugar. The average American eats almost 150 pounds of processed flour each year.

​​Refined carbs are carbohydrates that have been processed in a way that removes the majority of nutrients and fiber from them.  When they are consumed, they are almost instantly converted into sugar in the body.

Examples of refined carbs includes bread, rolls, pizza, pasta, white rice, and most ready-to-eat cold cereals​.

In a way, refined carbs are even more dangerous than table sugar.  In fact, blood sugar levels rise higher when you eat processed flour than if you ate table sugar!

​If you are over the age of 30, most of you will remember the low-fat craze of the 1980s and 1990s.  At that time, it was felt that saturated fats were the absolute worst thing that you could eat.

​Massive advertising campaigns were launched encouraging people to eat less fat.  The unintended result was people replaced those fats in their diets primarily with refined carbs.  Obesity, type 2 diabetes, and heart disease levels increased ​dramatically.

Finally, the medical community has realized their error and are SLOWLY changing their attitudes about refined carbs.  This study showed that while eating a diet high in saturated fat is not good for you, it is still significantly better than eating a diet high in refined carbs.

​3.  Alcohol

​Friends and family members that ​love a good wine often spout to me the benefits of alcohol consumption and how it reduces heart disease.

​So what does the research say?

​I think the research is clear that occasional alcohol is okay and may even have some mild benefits.

The key is that you should choose low carb options and drink no more than 1-2 drinks.

​Alcohol tends to increase your cravings and appetite for bad foods.

If alcohol is something that you really want to have as a part of your life, at least keep these things in mind:

Beer is made from grains (oats, barley, wheat and rye), malt (sugar) and yeast.  It was originally brewed to provide nourishment for adults (and children!), especially during times when food was scarce.  Realize that when you drink beer, you are basically drinking a liquid meal.

Cider is fermented apple juice.  Every 12 ounces of cider can have up to 30g of sugar!

Sweet liqueurs are similar to cider.  They typically are loaded with sugar.

Rum is a low carb drink.  However, most people mix it with high carb drinks such as sodas or energy drinks.

Red wine​ is generally low carb.  ​It also contains resveratrol which is a potent anti-oxidant.  ​Light to moderate consumption has been associated with a decrease in LDL, reduced atherosclerosis, and reduced oxidative stress.  The danger is it tends to be often consumed with high carb foods such as pasta, pizza, etc., and it can increase your appetite for those types of food.

White wine as a general rule often contains more sugar and carbs than red wine.  5 ounces of wine equates to about 125 calories.  Again, it may increase your cravings for foods that should be avoided.

Keep in mind that even if you drink in moderation, it will typically STOP weight loss and may even cause weight gain in my professional experience.

​4.  Trans Fats

​Trans fats, also called trans fatty acids, are a type of unsaturated fat that occur in small amounts in nature, but have become widely consumed due to industrialized food production.

Trans fat is formed through an industrial process that adds hydrogen to vegetable oil, which causes the oil to become solid at room temperature.

This partially hydrogenated oil is less likely to spoil, so foods made with it have a longer shelf life.  Many restaurants also cook with it in their deep fryers because it needs to be changed less often.

​Trans fats are commonly found in food such as margarine, ghee, snack food (such as chips) packaged baked goods, and fried fast foods.

Trans fats have been shown to lower HDL and raise LDL levels and may lead to an increase in heart disease.

This is just another example about why it is dangerous to eat out in restaurants excessively.  You really don’t know what you are eating or how they prepared your food!

5.  Caffeine

People have tried to vilify caffeine for years, blaming it for anything from high blood pressure to stroke, cardiac arrhythmias, and heart disease.

But is caffeine really that bad?

The answer is probably not if consumed in moderation.

This literature review from 2017 showed that moderate caffeine intake is not associated with increased risks of total cardiovascular disease; arrhythmia; heart failure; blood pressure changes among regular coffee drinkers; or hypertension in baseline populations.

There is no evidence that I could find that suggests that caffeine intake increases cholesterol levels. Now, if you are adding a bunch of sugar to your coffee or tea, that is a different story.

My only caution would be in people who are suffering from adrenal fatigue.  Caffeine puts added stress on the adrenals to produce cortisol levels which can be harmful when they are already strained from physical, mental, or emotional stress.  In those situations I typically recommend stopping all caffeine until the adrenals have had time to recover.

By the way, there is also a suggestion that excessive caffeine intake make cause a decrease in bone density.  According to this article, as long as you optimize your vitamin D level, eat foods with adequate calcium content, and don’t drink more than 3 cups of coffee per day, the risk should be minimal.

Eat These Foods (Foods That Lower Cholesterol)

​So we’ve talked about the bad, now let’s talk about the good.  All of the foods in this segment have shown cardiovascular benefit in studies.

​1.  Omega-3 Fats

​Omega-3 fats belong to the long chain poly-unsaturated fatty acids.  The ones that have been shown to be beneficial for the heart and cholesterol are Eicosapentaenoic acid (EPA) and Docosahexaenoic acid (DHA).

These fatty acids come from marine microorganisms that are eaten by fish.

​The fish with the highest omega-3 concentrations include fatty fish like tuna, salmon, sardines, mackerel, albacore and herring.

Omega-3 fatty acids primarily reduce triglyceride levels and lower VLDL levels.  They also appear to have anti-inflammatory and anti-thrombotic effects.

If you aren’t a fish fan, if you are a vegetarian,  or if you have a sensitivity to fish, supplements are also available which I will discuss later.

​2.  High Soluble Fiber Foods

Foods high in soluble fiber have been shown in studies to lower LDL cholesterol.

Soluble fiber attracts water and turns to a gel-like substance during digestion.  This slows digestion and makes you feel full for a longer period of time.  It also binds to cholesterol and may reduce its absorption in the intestines.

Examples of foods high in soluble fiber include oats, kidney beans, brussel sprouts, apples and pears.

Soluble fiber is also available as a supplement.  These include psyllium, pectin, and guar gum.

​3.  Olive Oil

​Olive oil is full of healthy, monounsaturated fats, primarily oleic acid.

Oleic acid is believed to be a potent anti-oxidant that reduces inflammation​.

​Regular consumption of olive has been shown to reduce the risk for cardiovascular events and stroke.  It also appears to reduce the risk of oxidation of LDL particles.

There are studies that suggest that olive oil may decrease the risk for dementia, type 2 diabetes, rheumatoid arthritis, and even cancer.

It even has anti-bacterial properties.  One study showed that taking 30gm of extra virgin olive oil per day can eliminate a helicobacter pylori infection in 10-40% of people.

It is important to use extra virgin olive oil because it has the most anti-oxidants and bioactive compounds in it.

​4.  Garlic & Onions

​We have been told for years that consuming garlic and onions are good for our heart.

However, a study from 2007 showed no reduction in LDL or heart disease in people consuming either raw garlic or garlic supplements.

Onions appear to have more benefits on lower cholesterol, primarily because they contain flavonoids such as quercetin.  This study showed that quercetin from onions lowers LDL levels in ​overweight patients.

​5.  Herbs -​

​Consumption of several herbs have been shown to result in a mild or even moderate reduction in cholesterol levels.

​These herbs include basil, artichoke, eggplant, fenugreek, arjun, genseng, and yarrow.

A systematic review published in 2003 showed a reduction in total cholesterol from the use of these herbs of up to 39%.

Supplements That Lower Cholesterol

​If you just have a hard time eating the good foods that can lower cholesterol levels, there are some supplements available that can help:

​1.  ​Omega-3/Fish Oil

​As discussed earlier, fish oil can substantially lower triglyceride and VLDL levels.

However, many people do not​ eat much fish, so supplementation may be necessary.

Click here for my preferred brand.

If you are vegetarian, vegan, or have a sensitivity/allergy to fish, algal oil is a great source of omega-3. You can get it here.

​2.  Niacin

​Niacin is a naturally-occurring B vitamin that has been used to raise HDL cholesterol for years.

Studies have shown that taking niacin can raise HDL levels by up to 25%.  It also lowers LDL by 5-20% and triglycerides by 20-50%.

​Unfortunately, the large controlled studies AIM-HIGH and HPS2-THRIVE showed that despite the increase in HDL levels, adding niacin did not result in a reduction in cardiovascular events.

However, I still believe niacin is a good choice (after dietary changes) for people who have low HDL and high triglycerides, or those who don’t want to take a statin or who cannot tolerate statins.

Click here for my preferred brand.

​Red Yeast Rice

​Red yeast rice has shown in studies to reduce total cholesterol levels 16-31%.

​Click here for my preferred brand.

​Essential Oils – lavender, cypress, rosemary

​Several essential oils can have an effect on your heart health and may help lower cholesterol levels.

Lavendar oils help lower anxiety and cortisol levels.

Cypress oil helps promote circulation and lowers cholesterol levels.

Rosemary oil is an antioxidant that helps stabilize blood sugar and reduces blood lipid levels.

The best way to use these is to add a few drops to a diffuser which allows you to inhale them gradually while breathing normally.

Other ​Ways to Lower Cholesterol

​Exercise

​Aerobic exercises such as walking, jogging, cycling, and swimming are great for the heart, lungs, and stress level.  They also helps lower lipid levels.

Resistance training such as weight-lifting has also shown to improve lipid profiles by increasing HDL and lowering total cholesterol and LDL.

​Get Better Sleep

​Most of us have terrible sleep habits and poor sleep hygiene.

​Not only does that make us tired and grumpy, studies show that sleep deprivation results in lower HDL levels and higher triglyceride and LDL levels.

​Improving sleep is foundational to almost any health issue we could discuss.  I have yet to meet a person that is chronically sleep-deprived that is healthy and feels good.

Developing good sleep habits is critical to improving your sleep.  These include:

  • ​Develop a consistent sleep schedule – Go to bed at the same time every night and get up at the same time every morning.
  • ​Keep your bedroom cool and dark.
  • ​Avoid stimulants, especially in the evening.  This includes caffeine and cold medications.
  • check​Avoid electronic screens (TV, computer, tablet, or phone) for at least 2 hours before bed.
  • checkConsider trying meditation for 20 minutes before bed to help empty your mind and relax you.

​If you are doing all of this and are still having sleep issues, it may be necessary to try a supplement.

1. Melatonin – Melatonin does NOT make you sleepy.  It simply helps you relax which allows the normal sleep cycle to progress.  Take it at least 30 minutes before going to bed.

2.  Travacor – If you are having a lot of stress, anxiety, and mood issues which are affecting your sleep, this may help.  It contains a blend of taurine, L-theanine and 5-HTP which help regulate mood and promote normal sleep.  Take it an hour before bedtime.

3.  Kavinace Ultra PM – If you are still having problems getting to sleep or staying asleep, this supplement may be very helpful.  It contains the same ingredients as Travacor but with the addition of melatonin and phenylbutyric acid which makes it even more powerful.  Take it an hour before bedtime.

​Manage Your Stress

​Lack of sleep is a form of stress, so you can expect that any other stress will have similar results on the body.

Sure enough, this study showed that stress results in lower HDL, higher LDL, and higher triglyceride levels.

Stress can be caused by mental, physical, or even spiritual issues.

It is important to remove whatever stresses that you can from your life.  That may mean seeing a marriage counselor, or changing jobs, or avoiding certain people.

If you can’t avoid all stress, there are still some things that you can do:

  • ​Relaxation exercises such as yoga
  • check​Spend 20 minutes per day in prayer or meditation
  • check​Start doing something you enjoy – hobby, sports, etc.
  • checkGo outside!  Walking or hiking in nature can do wonders for your stress.
  • checkCount your blessings and write them down.
  • Do something good for someone else expecting nothing in return, especially for someone less fortunate than you.
  • Donate your time or money toward a worthy cause.
  • checkMake yourself smile everyday (even when you don’t feel like it).

​Summary

​If you have been diagnosed with high cholesterol levels and want to lower then without taking a medication such as a statin, there are several things that you can do.

The cornerstone of treatment ​should be to change your diet.  Sugar and refined carbs will need to removed as much as possible.  You probably also need to reduce your alcohol intake and fast foods.

Increasing your consumption of fish, fruit, and vegetables can also be very helpful, as well as cooking with extra virgin olive oil and adding many healthy herbs and spices to your food.

Finally, like with almost any condition we could discuss, cholesterol levels will improve with regular exercise, improving your sleep and reducing stress.

Now it’s your turn…

​Have you been diagnosed with elevated cholesterol?

What you have tried in the past that works?  What didn’t work?

Leave any questions or comments below.

Why Am I So Tired All the Time?

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​Why am I so tired all the time?  I am asked that question multiple times EVERY DAY.

​​Our society is exhausted, and it’s only getting worse.

​Do you ever wake up refreshed, make it through the day ​easily, then still have energy in the evening for home activities and family time?

​If you do, consider yourself fortunate.  Most of us don’t​.  Not by a long shot.

In this article, I will discuss the most common ​reasons why you may be tired and give you some pointers on how to regain some energy and quality of life.

Let’s get started…

More…

​What Does It Mean To Be Tired?

What do people mean when they say they are tired?

Sometimes they may be frustrated – “I am so sick and tired of this traffic.”

Others may mean they are emotionally spent – “I am so tired of fighting with my husband.”

Still others may mean they are physically worn out – “I am so tired from that ​workout.”  Or “I am so ​exhausted.  The baby kept me up all night.”

For the purpose of this article, when I talk about being tired, I am primarily referring to a lack of energy.

​In my online hormone practice, I always start the first appointment with a new patient this​ way:  “Give me 3 goals that you have in meeting with me.”  95% of the time, the first 2 things that people list are:

1.  Lose weight​

2.  More Energy

​People are simply exhausted​, both physically and emotionally.

Let’s dive into the most common causes​ of fatigue that I see in people and discuss some solutions to this national epidemic…

​Common Causes of Being Tired

​Fatigue may be occassionally due to a single obvious reason, but most of the time it is because of several things, not just one.

Like most health issues, what you eat and your ​level of activity play a ​huge role in your energy level.​

There ​may also be some hormonal issues​ as well as other things going on in your body that you need to consider.

Let’s break these down further…

​1. Adrenal Issues

​As you know, we live in a very high stress society.  Most of us are on the move constantly, then we wonder why we feel so tired!

This type of lifestyle plays havoc on our adrenal system.

​One of the major functions of our adrenal glands is to produce cortisol, DHEA and epinephrine in response to stress (physical and mental).

These hormones help regulate our immune system, heart rate, and energy storage.

Under normal situations, a stressful event will trigger the adrenals to release a surge of cortisol which then signals the mitochondria in our cells to temporarily increase energy production​.

That increase in energy helps us to get through the physical or emotional stress we are experiencing.

When the stress passes, the cortisol levels then drop back to the normal range.

When the body is under CONSTANT physical stress, such as a chronic infection, inflammation from obesity, insulin resistance, an autoimmune condition, etc., the adrenals are under pressure to continuously secrete large amounts of cortisol.

The same is true for constant emotional or mental stress.

High cortisol levels promote hypothyroidism.

It also worsens insulin resistance and leptin resistance.

​With all of these conditions, ​fatigue is a common symptom.

Eventually, the adrenals will no longer able to produce adequate amounts of cortisol, so the levels in the body begin to drop. Adrenal fatigue results.

When this situation occurs, constant fatigue is a hallmark symptom.

​Even normal day-to-day activities become exhausting.  Exercise ​may make you feel wiped out for days.

To test for adrenal or cortisol issues, I usually start with an 8am serum cortisol level.

​If your levels are <11 or >18, you have adrenal issues that should be addressed.

That may require getting salivary or urine cortisol levels 4 times throughout the day.  You should discuss this with your doctor.

What What Can You Do About It?

To learn more in detail about management of adrenal issues, read my article here.

As a quick summary, here are my recommendations that you can do even without a doctor if your serum cortisol levels are abnormal.

If your morning cortisol level is >20​, consider these supplements:

  • checkPhosphatidylserine:  Phosphatidylserine has been shown to reduce cortisol levels if taken in doses up to 600mg per day.  Use 4-6 capsules at night (each capsule is 100mg) and recheck cortisol levels in 2-3 months.
  • checkAshwagandha:  Ashwagandha is an adaptogen that can actually help to lower cortisol levels when they are high and raise them when they are low.  It also can boost libido and may help with weight loss. It can also reduce anxiety symptoms caused by chronic stress.  Doses vary from 500-2000mg per day depending on tolerance and severity of symptoms.
  • checkMelatonin:  Melatonin has been show to reduce cortisol levels and may actually help improve your sleep at night.  Even if you are sleeping well, melatonin can still help reduce cortisol levels and should be considered.  It can also help with depression symptoms.  Doses vary from 1-3mg, but most people tolerate 3mg well.

​If your morning serum cortisol is < 11​, consider these supplements:

  • checkAdrenal glandulars:  These work best for patients with very low cortisol levels.  They also tend to provide an immediate boost to energy levels.  Using glandulars in combination with other supplements listed below may be necessary.  Should be used for 6+ months.
  • checkAdrenal Adaptogens:  Adaptogens can actually help to lower cortisol levels when they are high and some can even raise cortisol levels when they are low.  There are many types of adaptogens but I find that blends of multiple adaptogens tends to work best.  These can be combined with glandulars as well for more benefit.  Should be used for at least 3 months.
  • checkCoQ10:  This coenzyme is involved in proper mitochondrial energy production and can help increase energy levels, which can be very helpful in adrenal-related issues.  Use 2 capsules (240mg) per day for several months.
  • checkAlpha Lipoic Acid:  ALA helps increase mitochondrial energy production, acts as a powerful antioxidant, reduces peripheral neuropathy, and lowers inflammation.  ALA can also help with weight loss due to its effects on insulin.  Start at 600mg daily and increase up to 1800mg daily as tolerated.
  • checkVitamin B6:  Vitamin B6 is used in several pathways in the creation of adrenal hormones and many patients are deficient in it.  Taking higher doses of B6 during the acute phase of treatment may be necessary for a short period of time.

If your levels are either extremely high or low, it is critical that you see your doctor for further testing.  You could have undiagnosed Addison’s Disease or Cushing’s Disease.

​Besides supplements, learning some stress management techniques is also critical for optimizing your adrenals and improving your fatigue.

These include things such as yoga, daily meditation, prayer, and even just going outside for 15-30 minutes every day.

​2. Thyroid Issues

​If you are more tired than you think you should be, checking your thyroid should be high on your list.

Since the thyroid is your “metabolism” gland, any conditions affecting it will affect your energy level.

​Besides feeling tired, thyroid issues can cause these common symptoms:

  • checkWeight gain or inability to lose weight
  • checkFeeling cold all the time
  • checkBrittle nails
  • checkThinning hair or hair loss
  • checkConstipation
  • checkLow body temperature
  • checkMood changes, such as anxiety or depression
  • checkBrain fog
  • checkHormone imbalances – irregular periods, PMS

​If you are having some of these symptoms, you should ask your doctor to run a complete thyroid panel:

​Only checking ​the TSH level could miss up to 80% of patients with a thyroid condition.

​Ideal levels for your thyroid tests include:

  • TSH – ideal range ​is 0.5-2.0
  • search​free T4 – ideal range is in the upper 1/3 of the testing range
  • free T3 – ideal range ​is >3.5
  • searchreverse T3 – should be < 15
  • searchTPO antibody – >35 is diagnostic for Hashimoto’s thyroiditis
  • searchThyroglobulin antibody – >35 is diagnostic for Hashimoto’s thyroiditis

So What Can You Do About It?

​If any of your labs are out of these optimal ranges, you should talk to a doctor that is knowledgeable about the thyroid.  Supplements and prescription medication made be needed to boost your thyroid function.

If your doctor isn’t willing to work with you, consider finding a certified functional medicine doctor from the Institute of Functional Medicine.

​To learn more about the thyroid, click here to read my article on hypothyroidism and click here for my article on Hashimoto’s thyroiditis.

​3. Blood Sugar Imbalance

​Blood sugar fluctuations are a common cause of feeling tired.  You may be experiencing this especially if you ​have any “crashes” during the day when you feel weak, tired, and dizzy.

​Most ​people are on a constant roller coaster – they eat a diet high in sugar or processed carbohydrates. This causes their blood sugar to rise rapidly.

The rise in blood sugar triggers their pancreas to release insulin to carry the sugar into the cells to be used as fuel.

​The blood sugar then drops, sometimes rapidly, which makes them feel tired, moody, and even dizzy.

​It also triggers their hunger, so they eat more sweets or high carb foods and the cycle starts all over again.

​This situation is made even worse by:

​- Insulin Resistance

Half of Americans already have insulin resistance and most have no clue.

​When we constantly eat a diet high in sugar and/or processed carbs, our insulin levels remain high to try to manage the sugar load.

Our body responds to anything that is present in excess by learning to ignore it.  That is what happens with insulin when we have insulin resistance.

​We respond to the persistently high insulin levels by down-regulating the insulin receptors in our cells. This protects the cells from getting overloaded with glucose.

This causes the insulin and glucose levels to gradually increase.  Eventually, pre-diabetes and type 2 diabetes occurs.

I bet you don’t know many if any diabetic patients that feel energetic, do you?

​- Poor Diet

​We eat way too much sugar and processed carbs.  Most of us know that intuitively.

In a little over 100 years, the average consumption of sugar has increased from about 40 pounds per person per year to well over 100 pounds per person per year!

​We have also increased our consumption of grains (wheat, corn, etc) by almost 50% over the past 40 years.

I was raised ​in a small town.  Growing up, my diet was full of poor food choices.  Every breakfast had some form of grain and sugar – cereal, pastry, etc.  Every other meal did not seem complete unless it included some form of bread and a sweet dessert.

​With the changes that have been made to wheat and the continued increased processing of our food, we are learning that we have to make some conscious changes to our diets in order to improve our long-term health.

So What Can You Do About It?

Try to eat a whole food, nutrient-dense, high quality diet which is high in lean meats and organic vegetables.

If you need more help, a great starting point would be starting the Whole 30 diet or ketogenic diet.

​I would also suggest hiring a certified nutritionist that is knowledgable about functional medicine.

​4. Sedentary Lifestyle

​When someone ​spends the entire day either sitting or laying down, should they be surprised that they feel tired?

Our bodies were made to move!  Lack of movement with cause atrophy of our muscles and a general ​decline in our fitness level.

One study showed that regular, low-intensity exercise can reduce the feeling of fatigue by 65% and increase energy by 20%.  12 population-based studies showed similar results.

This study showed it specifically in women.

Have you ever been on an exercise program, then because of life events, had to stop for a few days?  Isn’t it amazing how quickly you lose your level of fitness and feel tired?

Now multiply that times 100 and you can get an idea of what a sedentary lifestyle will do to you and your energy level.

So What Can You Do About It?

Simply put, start moving!  Anything that you start doing now will be more than you ​were doing before.

If you aren’t currently exercising, start with a brisk walk at least 3 times per week. ​

Listen to your body.  If it exhausts you, you may need to back off of the intensity.  This is especially true if you are having some adrenal issues.  Increase the time and intensity as tolerated.

Eventually, you will want to incorporate some simple weight training and high intensity interval training (HIIT).

If you are struggling with knowing exactly what to do and how much, I would strongly recommend hiring a personal trainer who can design a workout schedule just for you.

They will also serve as a form of accountability for you and make sure you are doing everything safely.

I highly recommend realfitness.net.  Jessica is a world-class trainer as well as a certified nutritionist.  She has helped many of my patients (including myself).

If you have significant health issues – heart problems, uncontrolled blood pressure, etc. – discuss it with your doctor before starting.

​5. Poor Sleep

​Sleep is our body’s way of recharging itself and giving it the energy to function the next day.  ​When we don’t sleep enough or the quality of sleep is poor, we are going to feel tired.

If you are chronically tired, you need to take a long hard look at your sleep habits and sleep quality.  Your energy will not improve if you are sleeping poorly.

– Poor Sleep Hygiene

​Many people have developed horrible sleep habits over time.

This can include drinking caffeine throughout the day (including the evenings), sleeping in uncomfortable beds, sleeping in a bedroom that ​is too light or too hot, and staring a some sort of electronic screen the entire evening right up until bedtime.

The excessive use of electronic devices has become an epidemic in children and adolescents.  In fact, this use has a direct effect on their quality of sleep.  It has also been linked to the increase in depression in adolescents.

​Normally, around 9pm at night, the pineal gland in our brain begins secreting melatonin.  Melatonin helps our body to relax and prepares it for the night of sleep.

Excessive light, especially blue light, has been shown to suppress the secretion of melatonin in our brains.

I also see tons of patients that try to function on as little as 4 hours of sleep per night.  That simply isn’t enough.  You body will eventually start breaking down.

– Obstructive Sleep Apnea

​It is estimated that 22 million Americans suffer from obstructive sleep apnea.  What’s worse, up to 80% of those are undiagnosed!

Ask yourself these questions.  Ask your spouse to answer them about you as well:

1. Do people complain that you snore like a freight train?

2. Has anyone ever noticed that you frequently gasp or even stop breathing while you are asleep?

3. Do you wake up exhausted in the morning, even if you have ​slept for 7-8 hours or more?

4. Do you find yourself dozing off during the day if you sit still for more than a few minutes?

If you answered yes to one or more of these questions, you should make an appointment to talk to your doctor about it.

​Obstructive sleep apnea is a condition where the tongue falls back against the soft palate and the soft palate collapses against the back of the throat.

​The ​result is the airway closes.  You have to wake up out of deep sleep enough for your body to overcome the obstruction.  This can happen multiple times every hour.

Since you don’t stay in the restful deep stages of sleep, you don’t truly get good rest.

Untreated obstructive sleep apnea has been associated with an increased risk of​ heart disease, congestive heart failure, and stroke.

Obesity is a risk factor for obstructive sleep apnea, but obstructive sleep apnea also worsens obesity, thus creating a vicious cycle.

​It has also been shown to worsen insulin resistance and fatty liver disease.

So What Can You Do About It?

​If you have sleep apnea, fortunately, all of these risk factors can be reversed with the use of a continous positive airway pressure (CPAP) device.

Your doctor can order an overnight sleep study which will determine whether you have sleep apnea or not.

Everyone should follow these common sense sleep habits:

  • checkTry to sleep a minimum of 7-8 hours every night
  • checkReserve the bed for sleep and sexual relations only
  • checkConsider installing blackout curtains in your bedroom
  • checkReduce your thermostat to keep your bedroom cool at night
  • checkMake sure you have a comfortable, supportive bed and pillow
  • checkTurn off all electronic screens at least 2 hours before bedtime
  • checkAt the very least, install a blue light filter on your smart phone, tablet and computer to use after dinner

​6. Digestive Issues

​Gut issues are often the root cause of many conditions of the body.  The gut can also be playing a major role in your fatigue.

Here are some gut issues to consider:

– Leaky Gut

​Leaky gut (intestinal permeability) occurs when the inflammation in the intestines causes gaps between the cells.  These gaps allow foreign ​substances such as bacteria and other proteins to be absorbed that wouldn’t be normally.

Those foreign substances trigger a strong immune response which further increases inflammation.  That inflammation results in symptoms such as fatigue, mood swings, abdominal bloating and pain, achiness, headaches, and others.

The inflammation also prevents the absorption of many nutrients from what we eat, such as iron and vitamin B12.  A deficiency of these nutrients worsens feelings of fatigue.

Leaky gut can be caused by a poor diet of processed foods, prescription medication, thyroid disorders and autoimmune disorders.

What Can You Do About It?

​Remove processed foods from your diet, especially gluten and sugar.

Replace it with natural, organic whole foods.  I also recommend fermented foods that are full of healthy bacteria that our body needs.

Fermented foods include sauerkraut, kumbucha, kefir, kimchi and yogurt.

There are also several gut-healing supplements that can help.  These include:

  • checkProbiotics – I recommend that it have at least 10 bacterial strains and at least 50 billion cfu.
  • checkL-glutamine – this amino acid helps repair damage in the GI tract.  Take 1000-3000mg daily in divided doses between meals.
  • checkDigestive Enzymes – these enzymes help breakdown the fats and proteins in our meals. Take 1-2 with each meal.
  • checkQuercetin – this product has bioflavanoids which help to balance histamine levels and helps with digestion and allergies.  Take 2-4 capsules per day.
  • checkBetaine Hcl with Pepcin – these are vital components of gastric acid secretion.  It assists with digestion of food and absorption of nutrients.  Take 1 with each meal.  You may increase by 1 capsule per meal as needed.  If you develop burning in your stomach, reduce the dose by 1 capsule with each meal.

– Food Intolerances

​Many people are sensitive to certain foods and may not even know it.  Although they may not be truly “allergic,” consuming those foods still triggers inflammation and a reaction from the body.  Again, a common feature of inflammation is fatigue.

What Can You Do About It?

There is not a good lab test for food sensitivities.  The gold standard for determining them is the Elimination diet.

With the elimination diet, you remove the most common foods that cause food sensitivities for 3-4 weeks.  ​If your symptoms improve during that time, you know that you are most likely sensitive to at least one of the foods.

You then re-introduce the foods one at a time and see if you react.  If you don’t, you are most likely not sensitive.  If you do react, then you need to avoid that food as much as possible in the future.

The most common food sensitivities include:

  • checkGluten
  • checkDairy
  • checkSoy
  • checkProcessed or refined sugar
  • checkPeanuts
  • checkEggs
  • checkCorn

– Dehydration

​Water constitutes up to 75% of the body weight of infants and up to 55% of the body weight of adults.

Most of us are mildly dehydrated on an almost constant basis.  That results in symptoms of fatigue, headache, brain fog, and mood swings.

Studies show that even mild dehydration can affect our mood, energy level and mental functioning.  Here is another study.

Thirst is one of the last symptoms that you may feel when you are dehydrated.  Fatigue and the other symptoms may already be present by the time you feel thirsty.

So What Can You Do About It?

​Simply drinking more water may be the simplest yet most effective thing that you can do to increase your energy level.

As a general rule, I tell my patients that they should have to urinate at least every 2 hours.  If you are going longer than that, chances are you are dehydrated.

A simple way to determine your daily water needs is to take your weight in pounds and divide that in half. That number will be the approximate amount of water in ounces that you should drink daily.

For example, if you weight 140 pounds, you should be drinking about 70 ounces of water per day.

By the way, that amount is just for your baseline water needs.  If you are exercising, you need an additional 8 ounces for every 30 minutes of exercise.​

Eating a diet high in moist vegetables such as celery, cucumber and carrots is another way of increasing your water intake.

​7. Other Causes to Rule Out

​Although feeling tired is a common symptom that all of us have at times, it can also be a sign of something more serious going on in your body.

If your fatigue is more severe and lasts longer than it typically does, it is extremely important that you see a doctor for a complete history, physical exam, and blood work.

Some of the more serious potential causes of your fatigue include:

​- Anemia

​Anemia is a condition where you have lower levels of red blood cells.  Red blood cells carry oxygen in the blood to be used by the cells in the body.

Anemia is actually a symptom and not a diagnosis.  Something is causing the anemia.  That cause needs to be investigated thoroughly.

As a general rule, if someone is anemic, either the red blood cells are not being produced adequately by the bone marrow, or ​there is either blood being lost somewhere or the red blood cells are being destroyed somewhere.

Not only does anemia cause fatigue, it can also cause symptoms of weakness, dizziness, shortness of breath, pale skin, and an irregular heart beat.

​Some causes of anemia include:

  • checkHeavy menstrual periods
  • check​Iron, vitamin B12 or folic acid deficiency
  • checkGI bleeding – ulcer, gastritis, hemorrhoids, colon polyp, GI malignancy
  • checkAnemia of chronic disease – cancer, autoimmune disease, and other inflammatory conditions can suppression bone marrow production
  • checkBone marrow suppression – leukemia, multiple myeloma
  • checkAplastic Anemia – the bone marrow stops making red blood cells.  Can be caused by autoimmunity, infections, medications, and toxic exposures
  • checkHemolytic anemia– a condition where the body destroys the red blood cells faster than they can be made.
  • checkSickle Cell Anemia – a genetic condition caused by a defective form of hemoglobin

​Many of these causes of anemia are life-threatening and should be worked up by a medical professional.

​If you are anemic, don’t just assume it is from something like heavy periods or a bleeding hemorrhoid. Have it evaluated!

– Autoimmunity

​Inflammation in general taxes our bodies and will usually cause us to have significant fatigue.

If your fatigue is persistent or progressive, you should see your doctor.  Make sure that you request that your blood work include inflammatory markers, including the following:

– Complete Blood Count (CBC)

​- Erythrocyte Sedimentation Rate (ESR)

– C-reactive Protein – (CRP)

If any of these tests are abnormal it indicates an increase in inflammation and further workup is required. Several autoimmune conditions could be the cause including Hashimoto’s thyroiditis, rheumatoid arthritis, lupus, and many others.

– Malignancy

​As stated above, various different malignancies may have fatigue as one of the​ primary symptoms.  This could include cancers of the blood, gastrointestinal system, reproductive system, and lungs.

It is critical that you see a doctor for evaluation if your fatigue is persistent and an obvious source has not been found.

​Summary

​If you are tired, there are probably several reasons that you should consider.

You may have some hormonal issues such as insulin resistance and thyroid dysfunction.

Your diet and activity level ​are also probably playing a role.

You should also look into your stress, sleep habits, gut function, and level of hydration.

​There are also many potentially serious causes that need to be considered.  Therefore, it you are excessively fatigued, see your doctor!

Now it’s your turn…

​Are you tired?

​What ​did you ​find that cause​d your fatigue?

Any advice you would have for others?

Leave your questions and comments below.​