Sleep Quality Matters

The quality of your sleep affects your attention span, your cognitive acuity and even your mood. That means that your ability to think clearly, regulate your emotions, and find joy in life is directly linked to how well you are sleeping at night.

And it’s not only your brain that’s affected, your body has many functions that rely on you getting regular deep sleep on a physiological level. Inadequate sleep can interrupt detoxing functions, disrupt hormones and contribute to a roster of health problems.

Sleep Quantity Matters Too – How Many Hours Do You Sleep?

Research has taught us that the average person needs a minimum of seven hours of quality sleep per night for their physiological functions and brain to function optimally, and that needs to be happening on a regular basis. It has also shown us that not everyone is getting nearly that amount of sleep, and many people don’t realize there is a huge connection between their sleep patterns and their health.

Modern Life is Creating Sleep Deficits

Why does this happen? Why are so many people unaware of their accumulating sleep deficits? Modern work demands, the increasing rarity of work/life balance, and the emergence of ‘toxic productivity’’ often celebrate our ability to get much done on little sleep. We are expected to do more on less rest, and sometimes that is to the detriment of our physical and physiological health.

Despite this, there is much you can do to improve the quality of your sleep and your health.

Why Am I Not Sleeping Properly?

While having a poor night’s sleep isn’t fun for anyone, it generally isn’t a reason for concern. We all experience it from time to time and our bodies are usually able to bounce back the following day after a decent night’s sleep. Not sleeping well does become an issue, however, if waking up tired every morning becomes the norm.

Insomnia

Insomnia is characterized by the inability to attain a good night’s sleep despite having the opportunity and environment to do so, with negative next-day consequences. In short, you sleep poorly, wake up tired or exhausted, and your next day is miserable because you don’t have the capacity to navigate it well.  Insomnia is the most common sleep disorder, affecting approximately one-third of all adults. 

Insomnia can take several forms:

1. A high-sugar snack is eaten (candy bar, pastry, sweet cereal)
2. Blood sugar levels rise fast, causing the pancreas to send out an emergency flood of insulin to move that glucose out of the blood and into the muscles.
3. Blood glucose drops fast due to the flood of insulin, making you feel hungry again, with a particular craving for a sweet treat .
4. You reach for another high-sugar snack to feed the craving, inadvertently starting the roller coaster ride all over again.
5. High insulin inhibits melatonin production.
6. You have chronic adrenal dysfunction leading to high evening cortisol levels.
7. High cortisol levels inhibit anti-duretic hormone that can lead to needing to urinate throughout the night, disrupting sleep.
8. You stay on your devices within an hour of bedtime (even two hours before can be disruptive) which raises cortisol and lowers melatonin.
9. Doing high energy exercise within 3-4 hours before bedtime. (Notice how this affects you individually)

Insomnia Symptoms

You know you are experiencing insomnia when you experience any combination of the following:

Underlying Reasons You May Be Suffering From Insomnia

Stress

Despite insomnia being rather common, what causes it can differ greatly from person to person. Several factors can trigger it, with stress being one of the most common causes of insomnia whether it comes from a specific incident or ongoing stressors such as grief or work-related issues.

Poor sleep hygiene is a common problem, meaning, for example, not getting off of devices and screens (Television included) within 1-2 hours before bed-time. Also included:

• • Exercising too close to bedtime or having high intensity lighting on in the home at night after dark.
  • Having stressful conversations before bed-time.
  • Having the last meal and liquids should be consumed 2-3 hours before bed-time.
  • Avoiding caffeine after 2pm is recommended for good sleep hygiene..

Trauma

Physical and/or physiological trauma caused by one or a series of events can cause chronic insomnia despite feeling as though you have moved past it. Sometimes a past traumatic experience affects us more deeply than previously thought and needs to be addressed by getting the right professional help.

Health Issues

Chronic pain, nightly sleep apnea, regular allergies, and ongoing digestive issues or acid reflux can cause discomfort, making it hard to fall asleep and stay asleep – thereby disrupting your body’s natural sleep cycles. External issues such as disruptive noise, an uncomfortable mattress or pillow, invasive light through the window or from electronics, and temperature fluctuations can contribute to the same difficulties in falling and staying asleep. Certain medication side effects may also be factors, such as antihypertensives, hormonal medications, respiratory medications

Hormones

As women go through perimenopause, estrogen, progesterone, and testosterone all drop which can cause well-known symptoms such as hot flashes, mood changes and fatigue. These symptoms can mean interrupted or poor quality sleep. Estrogen can affect the body’s magnesium levels, a mineral that actively helps muscles relax. As estrogen levels drop, this can lead to restless, twitchy legs at night and even muscle cramps.

Men’s hormones are also affected by getting older, with lower testosterone levels being linked to similar sleep issues to those women face. When testosterone starts to drop, so do levels of feel-good neurotransmitters dopamine and serotonin, adding stress and anxiety into the mix.

Blood Glucose Levels

Fluctuating blood glucose levels and reduced insulin sensitivity become more common as we get older, and this is all the more marked in women going through the sudden hormonal disruptions associated with perimenopause. High blood sugar levels can make you feel too warm or irritable and unsettled, leading to difficulty falling and staying asleep.

Alcohol disrupts liver function and disturbs sleep, particularly after menopause. It is important to check your blood glucose levels regularly as you mature in years, as the risk of developing diabetes increases. If you can’t fall asleep due to feeling hot and bothered after dinner, talk to your healthcare practitioner about a glucose test.

Top Ways To Improve Sleep

Whatever the reasons for your insomnia, there is a lot you can do to help bring back some balance to your body and regain a more regular, restful night’s sleep.

Good Sleep Habits

We recommend practicing good sleep hygiene to ensure lasting and restful sleep. Sleep hygiene is the accumulation of regular practices that promote great sleep where you wake up feeling refreshed every morning.

Adopt the following to get a good night’s sleep:

Bedtime Sleep Hygiene

• • Create a relaxing nightly routine that works for your lifestyle and stick to it (i.e. a warm bath or relaxing music)
  • Go to bed at the same time every night
  • Keep your bedroom quiet, dark and cool
  • No screen time for at least one hour before bed
  • Go to sleep on an empty stomach
  • Don’t “try” to sleep

Daytime Sleep Hygiene

• • Wake up at the same time every day
  • Avoid stimulants (caffeine, nicotine) after 2:00 pm
  • Limit your alcohol intake
  • Avoid taking naps longer than 20 minutes
  • Refrain from using your bed and/or bedroom for activities such as reading, working, or watching TV

Daily Lifestyle Habits for Optimal Sleep

1. 1. Exercise – Enjoy a minimum of 30-minutes of moderate daily exercise
   2. Supplements – Recommended for short-term use only, you can talk to your healthcare practitioner about whether magnesium, valerian root, ashwagandha,  5-HTP (5-hydroxytryptophan) or melatonin are appropriate for you. It depends on your history.
   3. Guided imagery, mindfulness meditation, progressive muscle relaxation, and breathing exercises
   4. Journaling
   5. Acupressure & acupuncture
   6. Cognitive Behavioral Therapy (CBT) – CBT is effective for chronic insomnia or insomnia caused by trauma. Speak to your health practitioner to find out more.
   7. Balance your hormones – hormone imbalances are common culprits when it comes to the quality of your sleep, and the quality of your sleep affects your hormone balance. Working with an Integrative/Functional Medicine practitioner allows you to uncover what’s really going on through thorough laboratory testing, and find a plan that works best for you.

We Can Help

If you have given it your best effort and are still not getting the restful sleep you need, We can help. As an Integrative/Functional Medicine Physician, together we can analyze what’s keeping you up at night and create a lifestyle plan to help improve the quality of your sleeping and waking hours.  Book an appointment with us, and together we can move forward.

To learn more and to schedule a Free Discovery Call Consultation, visit our website HERE

Here’s to Great Sleep!

Valencia Ray, MD

References

Buysse DJ. Insomnia. JAMA. 2013;309(7):706-716. doi:10.1001/jama.2013.193

Cirelli C, Tononi G. The Sleeping Brain. Cerebrum. 2017;2017:cer-07-17. Published 2017 May 1.

Kaur H, Spurling BC, Bollu PC. Chronic Insomnia. [Updated 2020 Nov 19]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-.

Watson NF, Badr MS, Belenky G, et al. Recommended amount of sleep for a healthy adult: a joint consensus statement of the American Academy of Sleep Medicine and Sleep Research Society. Sleep. 2015;38(6):843–844. doi: 10.5665/sleep.4716

Worley SL. The Extraordinary Importance of Sleep: The Detrimental Effects of Inadequate Sleep on Health and Public Safety Drive an Explosion of Sleep Research. P T. 2018;43(12):758-763.

Our Brain is of Course, a Valuable Organ

A healthy brain is crucial when it comes to our overall health, well-being, and lifestyle. And…so is our heart (and feelings). These two together are the command centers for the nervous system and underlies our ability to communicate, remember, solve problems, make decisions and live a long and full life. A healthy brain (which includes our right-brain hemisphere and emotions, so this is not just about the left-brain intellect) helps us with cognition and emotional regulation in the present, in addition to assisting in staving off functional decline as we age.

However, Brain Health is in Decline

An estimated 6.2 million Americans age 65 and older are living with Alzheimer’s dementia in 2021. By 2050, the Alzheimer’s Association estimates that number may grow to 12.7 million unless something changes drastically. And while research is still evolving, evidence is strong that people can reduce their risk of cognitive decline by making key lifestyle changes.

We know that exercise helps to improve our physical health, so what does it take to keep our brain healthy, give it a strengthening workout and boost our cognitive skills? We also know that hormone balance, sleep, and inflammation also plays a pivotal role in brain health, let’s not forget these also.

4 Tips for a Healthier Brain

1 – Reduce your Stress

While momentary stress doesn’t present a problem to brain health, continued stress that is endured for long periods of time does. Long-term stress interferes with cognition, memory, attention and contributes to conditions such as anxiety and depression. It also wrecks havoc on our hormones, adrenal system and blood sugar control, sleep and inflammation. This all can contribute to the over-stimulation of the amygdala, which regulates our fight or flight response – a normal response to stressful events that is designed to be temporary.

Research has shown us that long-term, chronic stress has a shrinking effect on the prefrontal cortex, the area of the brain responsible for memory and learning. It has also established a connection between long-term stress and cognitive decline as we age, including contributing to the likelihood of developing Alzhiemer’s disease and dementia – that is on top of the known ill effects of chronic stress on sleep patterns, inflammation and heart health.

This is why it is important to also understand our ‘parasympathetic’ nervous system that counter-balances the sympathetic, ‘fight-flight-freeze’ system. We need to consciously learn how to have greater access to our healing parasympathetic system to help us with stress.

Adapt With Stress-Reduction Strategies

Needless to say, while we can’t always control what happens to us, learning stress reduction strategies will help us live happier and better lives, while contributing to our brain health and cognitive function into old age. Here are some key practices:

• Mindfulness
• Meditation
• Qigong
• Tai Chi
• Yoga
• Guided Imagery
• Progressive Muscle Relaxation
• Journaling
• Acupressure
• Regular physical activity
• Connecting with supportive people
• Speaking with a therapist / finding professional help
• Doing something you love
• Spending time in nature
• Learning how to ‘make friends’ with feelings to develop emotional resilience (these are skill sets!)

2 – Eat the Right Foods

Ninety percent of the body’s serotonin is made by the bacteria in the gut. Serotonin is the main hormone that ensures our moods are balanced and we experience feelings of well-being, calmness, and happiness. Having low levels of serotonin contributes to developing chronic conditions such as anxiety and depression, which can have long-term effects on our brain health.  It can also affect our melatonin levels and sleep as well as sugar cravings. Thus, it’s imperative to keep our serotonin production optimal. This can be achieved by maintaining our microbiome, aka improving our gut health and digestion.

Best Practices for a Healthier Microbiome:

• Avoiding packaged and processed foods
• Avoiding foods high in refined sugar
• Avoiding foods fried in vegetable and canola oil and using a healthier alternative such as olive oil 
• Avoid alcohol
• Drinking plenty of filtered water
• Eating a diet rich in an assortment of different colored fruits and organic vegetables when possible (Mostly low-glycemic fruits)
  
• Reducing red meat intake (avoiding meats that are grain-fed and opting instead for organic, grass-fed in general)
  
• Eating enough fiber and avoiding most grains, especially gluten filled, GMO, and processed grains
  
• Increasing consumption of fermented foods such as kefir, kimchi, sauerkraut, Kombucha, and yogurt – in moderation
  

Supplements that Support the Brain

While the diet should be able to support optimal brain health, the truth is that many of us do not consume enough of some nutrients, or are not able to absorb as much as we should from our food. The following supplements have been researched for their supportive effects on the brain. Always talk to your healthcare practitioner before taking any nutritional supplement.

• Anti-inflammatory herbs such as turmeric (aka curcumin) help to reduce inflammation in the brain
• Amino acids such as (Pharma)-GABA, helps calm the brain, reduce mental stress and facilitate good sleep patterns
• A good quality probiotic can help support the gut as it manufactures serotonin
• Oils high in omega-3 fatty acids such as fish oil, and fresh ground flax seed and grass-fed ghee butter help provide the building blocks for healthy brain cells
• B vitamins and natural folate help in the production of neurotransmitters
• Vitamin D with vitamin K2-7 is particularly important during the dark winter months. One study found that people with low levels of Vitamin D have twice the risk of developing Alzheimer’s
  
• Vitamin D is also important for immune, hormone, liver function and a variety of other important health functions

3 – Sleep Well and Get Plenty of it

Good sleep hygiene is crucial to maintaining good brain health. On average, you need a minimum of seven hours of uninterrupted, quality sleep per night on a regular basis. If you fail to meet these requirements, over time your brain’s ability to think clearly, regulate your emotions, manage stress, and balance your hormonal function can be impaired. 

Fostering Healthy Sleep Habits

Here are our recommendations for healthy practices that promote great sleep – so that you wake up feeling refreshed every morning:

• Creating a relaxing bedtime ritual and committing to it (i.e. meditation or a hot shower)
• Going to bed at the same time every night
• Keeping your bedroom dark, quiet, cool and comfortable
• Limiting screen time before bed / no screen time for at least an hour before your bedtime ritual
• Waking up at the same time every day, including on weekends
• Avoiding caffeine after 2:00 pm
• Avoiding naps (can be okay if really short, like 20-minutes)
  
• Avoiding late-night meals

4 – Stay Mentally Active

Treat your brain like any other muscle, use it to not lose it.  Often life becomes habitual and this affects our cognition. It’s important to regularly challenge your brain and keep it stimulated daily to help prevent cognitive decline and reduce the risk of dementia later in life. 

Brain-Stimulating Habits

Here are some activities to consider integrating into your daily practice. Ideally, choose more than one and switch up your practice often:

• Play strategy games
• Do crossword puzzles, word games, or Sudoku
• Learn a new skill such as a musical instrument or craft
• Learn a new language
• Read a book
• Socialize and have stimulating conversations or friendly debates with a social group
• Watch funny movies and comics – laugh out loud!!!

I Am Here To Help

Developing a comprehensive wellness and nutrition plan that contributes to your brain health can be a daunting task. As a Functional Medicine practitioner, together we can create a lifestyle plan that will help support your brain health for years to come.  Book an appointment with me, and together we can move forward.

You can schedule a time for a Discovery Call at this link: DISCOVERY CALL

Be well,

Valencia Ray, MD

Resources & References

Bernstein, Rebecca. The Mind and Mental Health: How Stress Affects the Brain. Touro University Worldwide. 2016

Bremner JD. Traumatic stress: effects on the brain. Dialogues Clin Neurosci. 2006;8(4):445-461. doi:10.31887/DCNS.2006.8.4/jbremner

Cirelli C, Tononi G. The Sleeping Brain. Cerebrum. 2017;2017:cer-07-17. Published 2017 May 1.

Clapp M, Aurora N, Herrera L, Bhatia M, Wilen E, Wakefield S. Gut microbiota’s effect on mental health: The gut-brain axis. Clin Pract. 2017;7(4):987. Published 2017 Sep 15. doi:10.4081/cp.2017.987

Evrensel A, Ceylan ME. The Gut-Brain Axis: The Missing Link in Depression. Clin Psychopharmacol Neurosci. 2015;13(3):239-244. doi:10.9758/cpn.2015.13.3.239

Scott, S.B., Graham-Engeland, J.E., Engeland, C.G. et al. The Effects of Stress on Cognitive Aging, Physiology and Emotion (ESCAPE) Project. BMC Psychiatry 15, 146 (2015). https://doi.org/10.1186/s12888-015-0497-7

Understanding the stress response. Harvard Health Publishing. 2020 https://www.health.harvard.edu/staying-healthy/understanding-the-stress-response

Worley SL. The Extraordinary Importance of Sleep: The Detrimental Effects of Inadequate Sleep on Health and Public Safety Drive an Explosion of Sleep Research. P T. 2018;43(12):758-763.

That being said, there is a general understanding that getting older means developing health complications. Osteoporosis, arthritis, heart disease, diabetes, cognitive decline, hearing loss, and decreased stamina are often associated with aging. The question that remains is, is this physical decline inevitable? The answer is not necessarily. When it comes to healthy aging, lifestyle plays a role and although we may not be able to change genetics or random chance – we CAN affect their expression for greater health. This is called, ‘Epigenetics’. Also, a preventive lifestyle can make a big difference.

1 – Lower Your Stress

High levels of stress over prolonged periods of time are dangerous at any age but can be more difficult to recover from as we get older. When we experience stress, the hormone cortisol is released into our system. For instances of short-term stress, this is a good thing, cortisol acts as an internal alarm system and is crucial for keeping us safe. Once the stressful situation has passed, our cortisol level should drop in accordance with our heart rate.

How Stress Makes You Feel Older

Long-term stress often keeps our internal alarm system activated. This wreaks havoc on the body affecting our sleep and recovery time, our energy levels, our mental and emotional acuity. Prolonged stress can lead to:

• weight gain
• insomnia
• migraines
• short-term memory problems
• brain fog
• digestive problems
• inflammation
• high blood pressure
• high cholesterol
• heart disease

Over time, stress can become naturalized in our bodies. We get used to it. We know we’re stressed out but we lose track of the degree, and how long we’ve been experiencing it. Dealing with the consequences of long-term stress just becomes normal. 

Lifestyle Changes That Help

The preventative measures listed below can help minimize your cortisol levels and regain your health:

• an anti-inflammatory diet 
• acupuncture
• time in nature / being outdoors
• regular moderate exercise
• nutrient balancing and supplement support for your adrenals
• weighted blanket

2 – Manage Your Insulin

Insulin may not be something you discuss with your family doctor if you don’t have a diabetes diagnosis, but research tells us that maintaining stable insulin levels is a key to longevity. Meanwhile, insulin resistance due to chronically high insulin has been shown to predict and accelerate the development of age-related diseases including hypertension, coronary heart disease, dementia, stroke, cancer, and type 2 diabetes. A functional, healthy insulin level should be between 2-6 ideally.

Ditch Refined Carbohydrates

When we eat a steady diet of refined carbohydrates and quickly absorbed sugars, our cells slowly become more insulin resistant, requiring more insulin to maintain healthy blood sugar levels. The higher our insulin levels stay, the more resistant our cells become, eventually leading to what is often called metabolic syndrome: A collection of symptoms including fatigue, excess fat around the midsection, increased blood pressure, elevated fasting blood sugar, and increased inflammation throughout the body. 

Insulin Testing

Insulin levels go up long before they develop into issues such as hypoglycemia and prediabetes, and early detection can help change the course of what happens next. Often, we are unaware that our insulin levels have increased and are nearing dangerous levels. Lab testing to determine your levels is important in understanding where you stand now as well as having a measurement to assess your progress.

Lifestyle Changes

The actions needed to prevent and reduce insulin resistance in the early stages are fairly simple: reduce your consumption of refined carbohydrates, eat protein at every meal, and stay active. An Integrative/functional medicine practitioner can help you keep track of your insulin levels and recommend the right supplements for your specific needs.

3 – Keep Your Hormones Balanced

Hormones are messengers that affect everything in our bodies, from our growth and development to reproduction, tissue repair, metabolism, immunity, and inflammation. Keeping our hormones functioning optimally is imperative to staying healthy. As we age, however, our hormone secretion becomes less efficient, which leads to imbalances and changes in the effectiveness of our internal systems. 

Hormones and Aging

This imbalance can lead to a wide variety of health issues such as:

• unexpected weight gain or loss
• dry skin and hair 
• weak nails
• fatigue
• muscle weakness, aches, tenderness, and/or stiffness
• joint pain, stiffness, and/or swelling
• anxiety
• depression
• Brain fog, memory, and more!

Hormone Testing

If you are concerned about your hormone levels, your doctor or I can run tests to check your levels of testosterone, progesterone, estrogen, cortisol and thyroid hormones and determine your current hormonal status as well as a plan to get your hormones balanced if you are in my states of medical licensure.

A Hormone-Friendly Lifestyle

Balancing your hormones through diet and lifestyle habits can make a big difference in your overall health and the aging process. Our suggestions include:

• Eat nutrient-dense foods and healthy fats
• Plenty of sleep every night
• Stress reduction
• Regular moderate exercise
• Supplementation to help support your overall health when needed
  
• If needed, bioidentical hormone replacement therapy (BHRT) likely will help with symptoms – also important for longevity and healthy aging.

4 – Keep Inflammation at Bay

Inflammation is the body’s way of protecting itself. Physical injuries trigger the release of proteins, antibodies and increased blood flow to the area to repair the damage. 

What many people are not aware of is that long-term exposure to irritants and toxins, food sensitivities, autoimmune disorders and even stress can cause an inflammatory response too. When this response continues for more than a few days, it’s considered chronic.

How Chronic Inflammation Ages You

Chronic inflammation is a major component of accelerated aging and a risk factor for developing atherosclerosis, hypertension, diabetes, strokes, heart attacks, fibromyalgia, arthritis, sinus infections, autoimmune conditions and cancer. 

Testing for Inflammation

Functional medicine testing as well as a few of the traditional tests (if actually ordered, of course by your doctor) can help assess the status of inflammation in your body that may be being overlooked.  Food sensitivity testing can sometimes help get to the root of the problem if you have clinical signs or findings on functional stool testing.

Living an Anti-Inflammatory Lifestyle

Preventive measures for chronic systemic inflammation include:

• Adopting an anti-inflammatory diet
• Reducing stress levels
• Regular exercise
• Ensuring your vitamin D levels are good
• Including anti-inflammatory superfoods into your diet: high quality omega-3 fatty acids (fish oil), astaxanthin, medicinal spices, high quality vitamin E and others.

5 – Keep Moving

And finally, regular physical activity is crucial to aging well. As we get older we start to lose bone density and muscle mass which impacts not only our physical strength but more importantly our stability, bone strength, and immune system. Keeping active and flexible throughout all stages of life allows us to stay healthy and remain independent in our later years. 

Choose Activities that Suit You

Regular activity doesn’t have to mean team sports (although there is no harm in that.) Find a form of exercise that suits your lifestyle and level of fitness, and stick to it: Taking a walk, a Yoga or Pilates practice, swimming or cycling are all great lifelong habits. Make sure to include an element of weight resistance that helps strengthen your bones and joints as well as improve heart health.

Getting Your Body Some Help

Although aging isn’t a choice, aging well is. There is a lot you can do to optimize your version of the aging process by identifying problem areas and adopting a preventive lifestyle. It’s never too late to make a difference.

Working with a Functional Medicine practitioner is a great place to start. Together we can run labs to identify and target your specific imbalances and begin your path to better long-term health.

You can learn more by visiting my website at: https://valenciaray.com

Here’s to Greater Vibrance and Vitality!

References

Akintola AA, van Heemst D. Insulin, aging, and the brain: mechanisms and implications. Front Endocrinol (Lausanne). 2015;6:13. Published 2015 Feb 6. doi:10.3389/fendo.2015.00013

Chung HY, Kim DH, Lee EK, et al. Redefining Chronic Inflammation in Aging and Age-Related Diseases: Proposal of the Senoinflammation Concept. Aging Dis. 2019;10(2):367-382. Published 2019 Apr 1. doi:10.14336/AD.2018.0324

Ferrucci L, Fabbri E. Inflammageing: chronic inflammation in ageing, cardiovascular disease, and frailty. Nat Rev Cardiol. 2018;15(9):505-522. doi:10.1038/s41569-018-0064-2

Graham JE, Christian LM, Kiecolt-Glaser JK. Stress, age, and immune function: toward a lifespan approach. J Behav Med. 2006;29(4):389-400. doi:10.1007/s10865-006-9057-4

Hiller-Sturmhöfel S, Bartke A. The endocrine system: an overview. Alcohol Health Res World. 1998;22(3):153-164.

Lakhan SE, Vieira KF. Nutritional and herbal supplements for anxiety and anxiety-related disorders: systematic review. Nutr J. 2010;9:42. Published 2010 Oct 7. doi:10.1186/1475-2891-9-42

McMurdo ME. A healthy old age: realistic or futile goal?. BMJ. 2000;321(7269):1149-1151. doi:10.1136/bmj.321.7269.1149

Ranabir S, Reetu K. Stress and hormones. Indian J Endocrinol Metab. 2011;15(1):18-22. doi:10.4103/2230-8210.77573

Schwarz NA, Rigby BR, La Bounty P, Shelmadine B, Bowden RG. A review of weight control strategies and their effects on the regulation of hormonal balance. J Nutr Metab. 2011;2011:237932. doi:10.1155/2011/237932

Swarup S, Goyal A, Grigorova Y, et al. Metabolic Syndrome. [Updated 2020 Nov 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459248/

Thau L, Gandhi J, Sharma S. Physiology, Cortisol. [Updated 2021 Feb 9]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan.

Yaribeygi H, Panahi Y, Sahraei H, Johnston TP, Sahebkar A. The impact of stress on body function: A review. EXCLI J. 2017;16:1057-1072. Published 2017 Jul 21. doi:10.17179/excli2017-480

What Is PCOS?

Simply put, polycystic ovarian syndrome is a hormonal problem that can affect women during their reproductive years. It’s marked by irregular ovulation and higher than normal levels of the “male” hormones or androgens such as testosterone, in simplistic terms. The name refers to changes to the ovaries, which become filled with small cysts that lead to hormone imbalances.

Because PCOS can be difficult to diagnose it’s a bit uncertain how common it is, but about five to 10 percent of women may experience it during the reproductive years.

The Symptoms of PCOS

The symptoms of PCOS often start to appear slowly over time, and the changes they bring about are often easy to dismiss as normal.

If you experience the following symptoms, it may be time to talk with a healthcare practitioner:

●     Weight Gain

Gaining weight without any particular change in lifestyle, especially around the belly. Women with PCOS often develop an “apple” shape in which their body fat collects in the torso area.

●     Acne

Facial and back acne and other skin conditions such as dark patches and skin tags often go hand in hand with PCOS.

●     Hirsutism

Extra hair on the face and body, particularly on the upper lip, chest, and back as a result of hormonal imbalances.

●     Mood Changes

PCOS can particularly bring on an increased risk of depression or anxiety

●     Irregular Periods

Some women cease to menstruate at all. Others develop very heavy periods.

●     Difficulty conceiving

Cystic ovaries, as well as the accompanying hormonal imbalances, can make conception difficult, potentially leading to the need for extra help to get pregnant.

What Are the Underlying Causes Of PCOS?

Genetics

It is very often difficult to determine one precise cause for PCOS, since many factors can contribute to its development. Genetics do play a role however, so if your mother or sister has had PCOS, you are more likely to develop it.

Weight

Carrying extra weight can also contribute to PCOS. Of course, this creates a frustrating dynamic since PCOS makes you more likely to keep gaining weight. Hormonal imbalances also make it harder to lose that extra weight.

Stress

As well as the more measurable factors, some research suggests that high stress levels may play a role in the development of PCOS. That’s because stress can wreak havoc on your hormones, resulting in an overproduction of testosterone and insulin.

Insulin Resistance

Insulin resistance may be a major factor in PCOS. About 70 percent of women with PCOS also have insulin resistance. Obesity, high blood sugar, inactivity, and stress can all lead to insulin resistance, however in PCOS insulin resistance seems to be both a symptom and a driver of the condition and affects all body types. One does not have to be overweight to have PCOS.

Why PCOS Can Be Frustrating: The Shortfalls of Conventional Medicine

Not only is it difficult to diagnose PCOS, but it can also be tricky to treat. Many conventional medical care providers seek to simply mask the symptoms by putting women with PCOS on birth control pills.

One clear flaw in this approach is that birth control pills won’t help women who are trying to reverse their PCOS in order to conceive. More importantly, this approach isn’t getting to the root of the problem, in fact it may exacerbate it. Birth control pills containing estrogen can affect blood sugar homeostasis in addition to carrying other health risks. The goal should be to restore overall health, not add the potential for more problems.

The Natural Approach To PCOS

A naturopathic approach considers the whole person in treating PCOS. That means addressing the underlying causes of hormonal imbalances. The goal is to improve all aspects of a patient’s health – and consequently, reduce PCOS symptoms.

Treatment starts with a thorough evaluation of your health history as well as thorough functional testing. Although the exact protocols will vary by patient, here are some proven tips for treating PCOS.

1.   Weight Loss Plan

If you’re overweight, work with your healthcare provider to create a healthy weight-loss plan. Losing just small amounts of weight can make a big difference to PCOS symptoms. However, you want to approach weight loss in a way that doesn’t create more stress in your body as stress can have a negative effect on insulin levels. That’s why it’s important to work with your functional medicine healthcare practitioner.

2.   Natural Whole Food Diet

Eating foods without preservatives or other endocrine disruptors is the best approach to fully nourishing your body’s intricate systems.

3.   Balance Protein and Carbs

You don’t have to eliminate carbs altogether. Choose unprocessed, complex carbs and balance them with sources of lean protein. As well, keep your blood sugar stable by eating at regular intervals.

4.   Improve Gut Health

By improving your gut health to reduce inflammation and improve elimination, probiotics can help regulate hormone levels.

5.   Choose Foods High in Omega-3 Fatty Acids

Essential Fatty Acids are the building blocks of many hormones, and a deficiency in EFAs is very common. Good sources include fatty fish such as salmon or sardines, as well as eggs, nuts and seeds.

6.   Talk to your healthcare provider about supplementation

Depending on your personal profile, helpful supplements could include magnesium, vitamin D, and a natural B-complex vitamin. In particular, inositol (a B vitamin) has been proven effective for PCOS treatment. And chromium can help metabolize sugar and stabilize glucose levels. It is not a one-size-fits-all approach. The right testing by your doctor can uncover any deficiencies you may have and help you come up with a targeted supplement protocol.

7.   Get Enough Sleep

A good night’s sleep is an essential part of hormone regulation. Interestingly, studies have found that sleep problems are twice as common for women with PCOS. So be sure to pay attention to your sleep habits.

8.   Get some healthy movement

Moderate exercise will help with weight loss. It will also relieve stress and balance your cortisol levels. One study found that a mix of high-intensity interval training and strength training helps women with PCOS. However, talk to your healthcare provider about the best approach for you as many women with PCOS do better with gentle exercise.

Take Control of Your Hormones

Yes, PCOS can be frustrating. However, much research has been done recently on functional testing and effective natural, holistic treatments for PCOS. By treating your body as an integrated set of systems, you can get to the bottom of your PCOS symptoms and get on the path towards true balance and wellbeing.

Ready to take control of your health and hormones? Start by taking our free Stress Assessment and learn more about the 4-Key Stressors HERE.

References

https://www.nichd.nih.gov/health/topics/pcos

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6250088/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5655679/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5461594/

https://www.hindawi.com/journals/ecam/2012/591654/

https://www.sciencedirect.com/science/article/pii/S1756464617307727

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3277302/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4135453/

https://www.ncbi.nlm.nih.gov/pubmed/28595797

A new collective experience of social anxiety has been amplified by the Covid-19 pandemic. Whether you suffered from social anxiety before or you’ve slowly developed social anxiety since being isolated and distanced from others, returning to post-pandemic “normal” life can seem more daunting than the onset of the pandemic itself for some people.

You are not alone in your concerns. Studies show that symptoms of social anxiety have increased significantly since 2020. The good news is, there are natural and effective ways to manage and cope with anxiety that will allow you to make a smoother, at-ease transition back into society.

Signs and Symptoms of Anxiety

To manage and cope with anxiety you must first understand the symptoms associated with it. If you or a loved one are experiencing any of the following symptoms, consult your healthcare provider or physician for clarification.

According to the Anxiety & Depression Association of America, the signs and symptoms of can anxiety include:

• Feeling nervous, irritable, or on edge
• Having a sense of impending danger, panic, or doom
• Having an increased heart rate
• Breathing rapidly (hyperventilation), sweating, and/or trembling
• Feeling weak or tired
• Difficulty concentrating
• Having trouble sleeping
• Experiencing gastrointestinal (GI) problems

Over the last year, social anxiety has been front-row-and-center as we have trained our brains to perceive people themselves as a threat due to the risk of contracting the virus. Fear of going outdoors, interacting with strangers and even fear of the air we breathe in proximity to others has been a concern for many!

As more and more have either already contracted the virus and built up an immunity to it or have become vaccinated, the threat ratio has lowered, however, our brain may not recognize the change and continue to ignite our fight or flight response.

Get Ready to Face Society Once Again

Before the pandemic, you may not have had to deal with anxiety and fear of social settings as you are now. You may also be feeling the pressure from work responsibilities, friends, and/or family to return to your normal routines.

If the idea of re-engaging with society is causing you to worry, here are some tips to help:

• Get outside of the house every day. Go for a walk, go to the pharmacy, do the groceries rather than store pick up.
• If your workplace will soon require you to return back to the office, head to your place of work, and walk around to regain that comfort and routine. The same goes for those attending college/university or children who attend school and fear going back to the classroom.
• Start socializing with others on the phone, video calls and gradually return to seeing them in person one at a time when you can.

Start off slow, and steadily work towards the more challenging activities until you can feel comfortable engaging with others in society again.

Coping Strategies to Help Reduce Anxiety

There are many safe, effective, and natural ways to help cope with anxiety, whether you have been dealing with social anxiety for some time or if this a new onset of the pandemic.

Psychologists note that avoiding these issues can have the opposite effect than what you would want and only provide a temporary sense of relief while in the long run actually lead to an increase in anxiety. So, getting clear on what you can do to ease your anxiety and taking action right now is important.

Exercise

Exercise has long been known to benefit our overall health and no matter your age, current physical activity, weight, abilities, or size, even small amounts of exercise have been shown to reduce anxiety, improve sleep, reduce tension, and boost overall mood.

If you are unsure how to begin to increase your physical activity and are anxious about going too far from home, try these simple changes to your daily routine so you too can reap the benefits of physical activity.

• Engage in active family playtime. Any game that gets everyone up and moving counts!
• Catch up on household chores such as cleaning out the closet. Vacuuming is also physical activity.
• Mow the grass, go for a walk, or take a bike ride.
• Make television watching more active by doing jumping jacks or push-ups during the commercials.

Meditation and Mindfulness

Meditation is a form of calming your mind to increase focus, reduce stress, ease tension, and reduce anxiety levels. It has been scientifically shown to help alleviate the chaos that can crowd our minds, especially when faced with a fearful or anxious situation.

Using meditation to ease anxiety takes practice as in the beginning it may be difficult to calm our racing minds while diving deeper into our inner selves.

Try these mindfulness techniques that can help ground you when feeling anxious and out of control:

• Deep breathing exercises. Breathe in for five seconds, hold, breathe out for five seconds. Repeat 5 times or until you feel more calm.
• Visualize calming places like a beach, the lake, or somewhere you have fond memories.
• Keep a gratitude journal. Each morning or evening write down 3 things you are grateful for. Reach for this and read back on your thoughts to stay positive.

Supplements and Natural Therapies

Many people turn to medication in an effort to manage anxiety, but the reality is the side effects from medications can have their own impact on overall health. Natural supplements like adaptogens can help you cope, reduce depression, help with sleep and keep your system balanced while you are working through new and past anxieties. Speak with your natural health practitioner to find out what supplements will work best for your unique body.

Cannabidiol (CBD) is a derivative of the cannabis, or marijuana, plant and has been used as a treatment for a range of neuropsychiatric disorders including anxiety with positive results.

Unlike other forms of cannabis, CBD oil does not contain THC (tetrahydrocannabinol) which is the ‘high’ causing substance of marijuana, therefore, it is an effective anxiety reducer without affecting mental function.

Smells and aromas have a way of triggering memories and many plant oils have a calming effect on our body and mind. Lavender for example has been shown to reduce heart rate in the short term and help to ease sleep issues in the long term.

Do Things That Bring You Joy

Remind yourself of all the things that bring you joy and can help soothe your feelings of anxiety. Watch a funny movie or TV show, read a good book, or learn a new skill.

If you have pets, they can be a great comfort and you can rely on them for emotional support and calm your anxious feelings. Plus, walking a dog routinely outside can help ease you back into socializing with others.

Set Boundaries & Goals

How you choose to reintegrate into ‘normal’ life is your own personal choice. You may be comfortable visiting friends in an open area such as a park, but uncomfortable socializing indoors. Make a list of what you feel comfortable doing and express your fears and concerns with your loved ones so they can clearly understand your needs.

Go a step further and record your feelings, emotions, fears, goals, and expectations in a journal or diary. Often when we see our thoughts on paper, they are easier to face and approach with a calm mindset.

Lastly, be open-minded and allow yourself to be friendly (you never know if others are feeling the same way as you). While you need to have empathy for yourself and validate how you feel it’s important to understand that many people are dealing with this reemergence too and are equally anxious about what it all entails.

Can You Achieve an Anxiety-Free Return to Society?

Peer pressure exists in all stages of life so always remember you have the choice to say “no” when a situation makes you uncomfortable. Your optimal health and mindfulness are vital to re-engaging with society, therefore, when feeling anxious or stressed, try the methods above to calm your mind and release your body from the fight or flight mode.

There are, and always will be, stressors in your life. Re-engaging your inner peace by actively recognizing your anxiety triggers will allow you to focus on moving past them. Knowing your own values, fears, hopes, and future goals will help to set your mind on a new course allowing you to act on resolving your anxiety.

If you are finding your anxiety is increasing, affecting your relationships with others, or controlling your life, don’t hesitate to give us a call to schedule a free Mid-life Women’s Health Reset Discovery Call. There are natural ways to help manage your stress and keep your body balanced so these new stressors are not taking control of your thinking. Also, if your body has become imbalanced, you may have underlying gut or adrenal conditions that we can assess and address to restore the balance. Give us a call, or schedule online here.

We are here to help!

References

Bohlmeijer  E, Prenger  R, Taal  E, Cuijpers  P.  The effects of mindfulness-based stress reduction therapy on mental health of adults with a chronic medical disease: a meta-analysis.  J Psychosom Res. 2010;68(6):539-544.

Hofmann  SG, Sawyer  AT, Witt  AA, Oh  D.  The effect of mindfulness-based therapy on anxiety and depression: a meta-analytic review.  J Consult Clin Psychol. 2010;78(2):169-183.

Blessing, E.M., Steenkamp, M.M., Manzanares, J. et al. Cannabidiol as a Potential Treatment for Anxiety Disorders. Neurotherapeutics 12, 825–836 (2015).

Li-Wei Chien, Su Li Cheng, Chi Feng Liu, “The Effect of Lavender Aromatherapy on Autonomic Nervous System in Midlife Women with Insomnia”, Evidence-Based Complementary and Alternative Medicine, vol. 2012, Article ID 740813, 8 pages, 2012.

Claire Thompson, Maria C. Mancebo, Ethan Moitra,

Changes in social anxiety symptoms and loneliness after increased isolation during the COVID-19 pandemic, Psychiatry Research, Volume 298, 2021, 113834, ISSN 0165-1781.

This high insulin is associated with ‘insulin resistance’ which is what I will focus on for this article.

Our traditional system only screens for fasting glucose levels. One commonly associated condition that creates the imbalances that can lead to prediabetes is chronic stress. Yes, stress.

I want to emphasize this. Stress is a root cause for the development of prediabetes/diabetes, so for the sake of your health – you will need to understand this food/stress connection. Stress is not just related to psychological stress, though there is definitely a mind-body connection.

You see, one of cortisol’s important roles is to regulate blood sugar and it interacts with insulin. When, …

• We eat foods that are high in carbohydrates (pasta/breads), deserts, processed sugar
• We skip meals and create rollercoaster blood sugar levels
• We accumulate heavy metals in our body such as mercury, and it is not checked for

…we start to dysregulate our insulin and glucose balance.

We may not be able to produce enough insulin and our glucose levels remain abnormally elevated and starts to damage our organs. We can help this situation by eating more low glycemic foods and sometimes adding certain foods in our diet to help increase insulin responsiveness. Also, timing of meals can be helpful, particularly with certain genetic tendencies.

Insulin levels can elevate to abnormal levels also. This fuels the fire of inflammation. Toxins can contribute to blood sugar and inflammation imbalances, which throws gasoline on the process, and they are ubiquitous – in our water, soil and skin care products – even plastics in some shower curtains! In this process…many people start to gain weight, particularly in the deeper areas of the abdomen/gut.

Insulin resistance can cause belly fat over time – this weight gain is not normal ‘aging’ per se.

Classically, high insulin becomes ‘resisted’ by cell receptors as illustrated in the photograph, and higher and higher levels of insulin is called upon to try to lower the elevating glucose levels. This leads to a vicious circle.

High insulin is actually masking the glucose levels that are then going under the radar, while still affecting the lens in the eye for example, to develop what is often a ‘subcapsular’ cataract, due to higher than normal blood sugar in the blood. This causes blurry vision and glare symptoms.

High blood sugar is inflammatory, and over time it can lead to weight gain, inflammation in the peripheral nerves of the body, bone, kidney and yes, even the eyes, as examples. Sugar as you have probably heard is not a health food, and frankly can be quite toxic in excess amounts. Glucose, the form of sugar that the cells in our body use for energy, has a fairly narrow window for optimum functioning.

I will be focusing on Prediabetes Type 2, which is the form that either produces too little insulin to keep up with the blood sugar levels, or the cells in the tissues become ‘resistant’ and respond poorly to insulin with the elevation in glucose.

When this happens, insulin levels become higher and higher, thus producing more inflammation in the process. As this happens, you ‘age’ and gain weight, disrupt your hormones and can even affect your mind and mood.

In our culture of high sugar, high carbohydrate and processed foods, diabetes rates have risen dramatically as more of these unhealthy foods have increased.

What are some of the risk factors?

• Chronic stress
• Obesity – increased waist circumference (though can be ‘skinny’ otherwise) – for women >35 inches and men >40 inches
• Poor Diet – particular high in carbs and inflammatory ‘low fats’
• Genetic tendency (can control typically with diet/lifestyle)
• Physical inactivity

How does it tend to make you feel?  Are any of these symptoms familiar?

• Feeling tired, fatigue excessively
• Hungry all the time
• Constant creeping weight gain
• Just can’t lose weight
• Belly fat
• Tired after eating
• Sugar cravings
• Migrating joint aches and pains

Prediabetes Screening for Insulin Resistance

The most easily done, basic screening panel would include the following, and also your clinical history:

• HbA1C test
• Fasting plasma glucose
• Fasting insulin blood level

I will also note, that in the realm of functional medicine, the ideal level of HbA1C is less than 5.2-5.4 % of total Hb, and insulin levels ideally between 2-6 uIU/mL. I mention this because there are differences between ‘functional’ range, and ‘disease’ range.

As the name implies, functional medicine is about staying functionally healthy – not waiting until your body is in a diseased state before taking action and looking for the root cause of your symptoms.

Now, if you don’t do anything about insulin resistance what are some of the conditions that can develop that are associated with it? Well, quite a few conditions:

1. Sex hormone imbalance – high estrogen (men and women)
2. PCOS – Polycystic Ovary Disease
3. NAFLD – non-alcoholic fatty liver disease
4. High triglycerides
5. Fat
6. Low thyroid
7. High blood pressure
8. High glucose levels
9. Obesity
10. Cardiovascular Disease
11. Chronic Kidney Disease

As you can see from this list, chronic disease does not ‘just happen’. We have the ability to prevent and reverse many forms of chronic disease.

Symptoms are our body’s cry for help – you would be wise not to shut them up by only covering them up with pills and suppressants because the underlying process usually continues over time. Also, you will have to deal with any side effects of the drugs.

What are some things you can do to reverse the insulin resistance?

1. Stress regulation – top of the list!
2. Eat a personalized caloric amount to reach your healthy weight, that consists of low carb/low glycemic, high/moderate high healthy plant based monosaturated fats, some grass fed or plant-based saturated fats
3. Weight loss
4. Moderate aerobic and strength building exercise
5. Plant-based fiber (35gm/day) and prebiotic herbs
6. Deep, restful, restorative sleep – typically requires your intention to accomplish these days
7. Clean, filtered water, the number of ounces that are half your body weight in pounds on average
8. Awareness of vitamin and mineral deficiencies
9. Removal of toxins – so do a heavy metals screen, for sure – these toxins can cause prediabetes and weight gain
10. Find a Functional Medicine practitioner with medical training who can help you to diagnose, treat and coach you to implement the above, holistic science-based approaches

I hope this article is enlightening to help you to sort out the confusion for preventing prediabetes and all of the associated common annoying symptoms. With stress being so common and epidemic, now more than ever it is important to understand what it is, and how it creates disease and disrupts our immune system.

While mindfulness helps, there is much more to learn beside this important technique to truly make a lasting impact and to stay healthy. We will need to learn how to empower ourselves, since there appears to be so much resistance to changing our disease ‘health’ care system at this time.

This imbalance created by stress makes us more susceptible to not only colds and flu, but also to chronic disease development of all kinds, including anxiety and depression. Taking control of stress and learning how to better regulate it is at the top of my priority list for this reason.

Getting to the root cause is the only way to true healing. Any questions? Send me a message, if an available option leave your questions below or contact me through my website: www.ValenciaRay.com.

Why is stress and burnout such an important topic for busy professional women in particular? I put myself in this category also, and I’m so passionate about it because it almost sabotaged my life and professional work early on in my career. Women often take on too much trying to care for everyone else but themselves, and frankly, we are typically conditioned by the world around us to do so. This is one reason why we do not tend to our own stress. Another reason is that we do not know how to, nor understand what really causes stress and burnout.

What is stress? If you search the word online, you will likely see some scary images of people who look like they are being tormented with anxiety or severe mental distress. Some look totally overwhelmed and unable to cope. This is a common misconception and a gross exaggeration! The fact is, most people in our society are struggling with stress on a daily basis…even with a smile on their faces. When we realize what stress is and where it comes from, we are better empowered and enabled to avoid burnout.

As an MD medical doctor extensively experienced and trained in psychotherapy coaching techniques, and also functional medicine, stress is one of the most prevalent issues I see in my practice. I believe that you need to take a holistic Mind-Body-Spirit approach to resolve stress before it turns into burnout.

Fortunately, I have learned over time just how dangerous this is for our health and well-being and made it a part of my business (literally) to learn what stress really is, and to learn stress self-regulating skills. Let’s face it – the world around us is not likely to change much very soon. The sooner we learn how to better deal with it, the better!

Chronic stress leads to common symptoms for example, such as anxiety, irritability, weight gain, hormonal imbalances, food cravings, sleep disturbances, recurrent colds, cold hands and feet, hair loss, digestion issues, recurrent infections, low energy and libido, and even lack of motivation!

You can probably see how this will affect your confidence, career, and even relationships!

You can think of stress as feelings of overwhelm that connect with our sense of survival and activates our body’s ‘fight, flight or freeze’ response. Also, stress affects our adrenal-brain connection physiologically, which leads to these physical symptoms and if not treated at the root cause, can result in chronic disease. As stress becomes chronic, it can lead to burnout which causes common mental, emotional, and physical, ‘dis-eases’ which are currently plaguing our society at this time.

There are four key stressors that you want to learn about in order to begin to ‘take back control’ and live a more healthy and thriving life. One has a focus on the mental and emotional realms, and the other three have to do with our food and lifestyle habits.

When we overemphasize ‘hard work’ and struggle and do not understand the necessity of rest, restoration, and renewing our mind as well as how some foods contributes to this, we accelerate our aging.

We increase our risk for low energy and low libido due to inflammation and hormonal issues, and chronic weight gain in particular when we do not understand how food, mindset, and lifestyle are at the root causes of these symptoms. These symptoms are commonly associated with a variety of health concerns. Considering how expensive our traditional disease-care system is these days, ‘an ounce of prevention is worth a TON of cure’, not only a ‘pound’.

I can say that it is better and easier to stop a problem, illness, etc., from happening than to stop or correct it after it has started. Though now that I have also trained as a Functional Medicine specialist, I am grateful so say that we can actually reverse and prevent much of chronic disease that I was taught in traditional medical school to be ‘incurable. Our bodies are very resilient and can heal when we know what to do and why.

In the realm of Functional Medicine, you would be surprised how much capability we have to heal and reverse many chronic, common diseases. At the root cause of 90-95% of chronic disease is stress and the root causes of stress. This is why is it very important to educate yourself about prevention and reversing stress and burnout and their causes, and what you can do about it.

The 4 Key Stressors

Stress essentially is triggered by four basic pillars as shown in the photo below. I will briefly address all four. While you may be familiar with the idea that food, inflammation, and sleep could be connected to stress, very few health practitioners specifically discuss what follows.

The mental/emotional and even spiritual causes of stress (no sense of purpose or feeling disconnected) are often totally overlooked in terms of what is at the root cause of this category of the four stressors. I want to emphasize these areas in particular because hardly anyone talks about this area in the way I will share in this post.

1. Blood Sugar Imbalance

Sugar. Sugar by itself, in excessive amounts, can cause adrenal-axis dysfunction, known as Glycemic Dysregulation. Your brain and body need energy under perceived (whether real or imagined) stressful conditions. Sugar or glucose is one form of energy that is readily available. One important role of the adrenal gland and cortisol is glucose regulation.

Your adrenal glands (located on top of your kidneys) release cortisol as a response to regulate blood sugar levels by affecting insulin levels. While this can be helpful for acute ‘fight or flight’ they can be disastrous when we have chronic stimulation of this process, day in and day out. Individuals who consume a lot of sugar can become ‘insulin-resistant’ and this process starts to dysregulate or dysfunction. This can lead to a low blood sugar crash after a meal, which again, will retrigger the cortisol response. This rollercoaster response of the blood sugar can lead to a vicious circle and become difficult to control.

The macronutrients (fat, protein, or carbohydrate) content of our foods matter, particularly at breakfast time. If your first meal of the day is high in sugar (carbohydrates), over time you may accelerate problems within your hormonal and stress response systems. People who have chronic stress will likely to experience these types of dysregulation problems. Eating low-glycemic fruits and vegetables are quite important to this process to keep a good balance in blood sugar.

Read those labels! For the purpose of this discussion, let’s define high levels as more than 15-20 carbs per serving. Having been a ‘go-getter’ and over doing things for too long, I like many, have a history of being in the chronic stress category. I see a definite improvement in sugar craving and hunger since making this breakfast shift. I no longer need to carry protein bars and can go 4–5 hours between meals without any hunger during the daytime, even longer between dinner and breakfast the next day. What a difference!

There is no such thing as an overall ‘one size fits all’ best diet/food plan; this concept of the effects of breakfast sugar is based on the physiology of the stress response, particularly under chronic stress.

Having a ‘my diet is better than your diet’ argument is probably not going to be productive and may even raise our stress levels! In general, breaking your overnight fast (which is what ‘break-fast’ is), with high carbohydrates will likely cause mid-morning or afternoon brain fog or energy crash. Healthy fats and protein do not cause a sharp rise in blood glucose levels and tend to suppress hunger much better.

2. Chronic Inflammation

We are starting to hear more about inflammation, but we often do not connect the dot as to where this inflammation is coming from. It can come from our food sources, with sugar and processed foods leading the charge. It can come from toxins in our environment. It can also come from excessive ‘bootcamp’ style exercise!

What is often not considered as a source that is a very real source, are our toxic thoughts and emotions. Our mindset can ‘inflame’ our bodies. Just think about the effects of anger. While anger is a natural emotion and can inspire or energize us to take action, when we are chronically angry, anger itself is a cause of inflammation. Think about the idea that, ‘he was inflamed with anger.’ This is more than just a metaphor!!

One final cause I will mention here is lack of sleep! Sleep is our body’s chance to heal itself and to recover. When we don’t sleep enough or have restorative sleep, we are much more likely to trigger the biochemical responses of excessive inflammation in our body. Some inflammation is normal and an important part of our immune system, however when out of balance high or low end, it can lead to autoimmune problems or even lack of an ability to fight off infection.

3. Sleep

Well, you probably knew this was coming! I have personally come to realize just how dangerous lack of sleep is. Even as a physician of many years, I had no idea how deadly a lack of sleep can be for our health and well-being until I retrained in Functional Medicine in recent years.

There was a period of time of four years when my children were younger that I would routinely go to bed at midnight and wake up at 4:30am! This was during a time when I was also running a very busy medical practice and doing such a good job with spending time with my children, that at age 7, my son said to me, ‘mom, you don’t seem like you work because you are always here’. I built my schedule, planning and life around their schedules.

Little did he realize at that age and time just how much effort I was putting in to make this impression! Knowing what I know now, I would not have pushed myself this hard.

Lack of enough sleep can dysregulate not only your stress and cortisol, through this mechanism you can disrupt your thyroid, your sex hormones and even add inches to your waistline!

This is nothing to play with. When combined with lack of sleep, poor eating habits and inflammation, a perfect storm of chaos is created in the body’s system that can lead to prediabetes, hypothyroidism, autoimmune conditions, ‘leaky gut’ and gut disturbances, menopausal and peri-menopausal problems, PCOS, anxiety and more.

Hopefully, it is obvious why sleep is fundamental to ‘anti-aging’. As you can start to see by now, chronic disease is not about our age in years – even young adults are now experiencing these conditions with greater and greater frequency. HOW we age is what really matters.

One key area that is typically ignored is staying on technology devices or watching television into the evening hours. The blue-white light that is emitted can literally raise your cortisol and stress levels and disrupt your sleep quality! No joke! At the very least, use a good quality blue blocker eyewear protection, and even better, stay off of devices at least one hour before bedtime. Lifestyle medicine is an idea whose time has arrived and is greatly needed.

4. Mental and Emotional

Mental or emotional causes of stress can also be perceptual in terms of ‘how we see or feel’ about a situation. If this situation feels ‘novel’, or like a threat to our person or ego, or feels unpredictable or that we have a sense of loss of control…. it triggers our stress response of ‘fight, flight or freeze‘. This is why some people may love public speaking while others are terrified even at the thought of it! This category of stress requires special skills training to overcome.

Many people think that practicing mindfulness is a panacea that will alone,…and of course, in a short period of time (the quick fix), take care of this category. This is simply not the experience of many people, nor of my own. Mindfulness practice is an important aspect of beginning to retrain our brain to deal with this aspect of stress, but it is only the first step.

Mindfulness allows us to observe our thoughts and feelings, but we must then have tools and skills to ‘self-regulate’ our thoughts, feelings – intentions and attention – so that we are best able to take back the steering wheel of our mind. We must learn emotional resiliency.

This is more layered than it initially appears. This is where I tend to pay attention to stress management in a different way and where most physicians are not aware to do so. Remember stress management is not just about food, exercise, and sleep, though as I have already pointed out, they do matter.

For example, our own self-image and level of confidence will affect how we respond to the 4 Key Aspects of Mental/Emotional Stressors, which are:

• Novelty
• Threat to our ego (real or imagined)
• Lack of predictability
• Need for control

This is where learning how to transform our perception and ‘retrain our brain’ comes in. This is a skill set that we can all learn. As an entrepreneur, I can say that I am exposed to all four of these key aspects on a regular basis. I have observed in myself over the decades the power of these skills to bring greater confidence, fulfillment, less stress, and greater physical health and well-being when used with self-awareness. I now have greater emotional resiliency because of this.

A few words about spirituality and stress. When we do not have a sense of purpose or contribution that comes from our authentic heart, we may struggle with the meaning of our lives. Having a sense of connection with a higher power, purpose, or to nature can help us to live with more joy, inner peace and even tap into our own unique form of creativity easier. As you can imagine, this would all be stress alleviating on several levels.

You will generally not hear about these mental/emotional/spiritual aspects of stress management from your healthcare provider, whether in functional or traditional medicine. Understanding our ‘whole self’ is central to being able to live a life of thriving, not simply surviving.

Maintaining good health takes conscious effort in the world we live in now due to food quality challenges, excessive environment toxins, and a work environment and society that does not tend to honor self-care and downtime.

In order to be in control of our health, we will have to reeducate ourselves and look for alternative healthcare options and modalities that allow our body to tap into its natural healing powers. We can prevent and reverse many common chronic conditions when we understand how and have a strong enough desire to learn how to do so. This is a personal journey and the science is here now to validate many of the holistic approaches I use.

Yet, many of these approaches I used before the science substantiated it – like mindfulness of example – are now recognized quite broadly. Personally, I decided a while back not to wait on consensus from science but to trust my own experience – and it has served me well. I invite you to explore new ways of thinking about your health so that you can better empower yourself to thrive also.

Next Steps….

It’s my mission to help as many people as possible to live beyond stress and burnout. Please help me with this mission by sharing this blog post! ????????

If you’d like to learn more about how stress can lead to burnout, aging and low energy, I invite you to watch my free webinar on this exact topic.⁠ You can access it by going to the link at Taking Control of Stress and Burnout .

If you would like to learn how you can begin to transform your experience with stress, schedule your Free Discovery Session with me Here

The fact is, stress and lack of self-care are killing us. Stress is the basic core root reason for 90-95% of all disease, particularly chronic disease, which is crushing our country right now. Symptoms of low energy, low libido and chronic weight gain is typically associated with stress at a root cause level in some form as a medical condition. If we don’t learn how to manage and self-regulate how we perceive and deal with stress, if we don’t make room to unwind our own mind and nurture with compassion our own needs, we will continue to drive ourselves into sickness and disconnection from others, frankly.

Self-care is not selfish; it is the path of wisdom. Once we are in a better place mentally, emotionally and spiritually, we can be in a better place emotionally and have the clarity and energy to participate in the community in tangible and healthy ways instead of constantly seeking attention and validation from outside sources – like social media or by distracting our pain and feelings of isolation with drugs or busyness.

Where does this belief that to care for yourself is selfish coming from? The short answer is conditioning. We are conditioned to believe that we are supposed to self-sacrifice, that humility means ‘self-deprecation’, that we are supposed to focus exclusively on the happiness of others even to our own detriment. We are unconsciously taught that we are supposed to work ‘hard’ and worry about what others think of us if we are to be socially acceptable and ‘normal’. This conditioning is one reason why stress and the cult of busyness are so out of control. We are so external focused, we don’t know who we are, what we really want from our heart and soul, and what we value.

Therefore we live and breathe in survival mode. Too tired to sleep and too busy to think about how we are making ourselves ill in mind, body, and spirit. Yet, now that the clarion call is starting to go out regarding the majority (greater than 50%) of individuals in our society are suffering from such conditions as depression, anxiety, chronic fatigue, obesity, chronic disease, insomnia, loneliness…on and on..and there is now a growing focus for ‘self-care’ to help people to take care of their self. Suddenly also, I’m starting to notice that there is a growing conversation that ‘self-care equals selfish’. This is just not true.

Why is self-care not selfish?

1. Self-care helps us to stop the vicious circle of imbalance and have more heart space for others – doing too much and not giving yourself a break, some quiet time, some nurturing – will only continue to feed the cycle of chronic anxiety and stress which is coming from our need to ‘survive’ which is really only a perception and separates us from others psychologically. We tend to feel isolated.
2. Self-care can turn off this chronic stimulation of the ‘fight, flight, freeze’ response that contributes not only to chronic disease development but also to narcissism and self-centeredness due to insecurity, just the opposite effect of healthy self-care.
3. It is the chronic fatigue and poor diet, lack of sleep and lack of self-care lifestyle that actually make us mentally and emotionally unstable and less likely to seek support and community than when our soul is nourished and rested. Self-care is personally and societally healing.

I submit that one of the driver’s of this wildly growing trend in poor health of mind and body is because we are so externally focused – on others, work, technology and media – that:

• We neglect our sleep and struggle with fatigue and anxiety
• We work too much and are too distracted by the external call to ‘do more’
• We don’t have time/make time to learn the truth about food and lifestyle and how important all this really is – we eat ‘fast food’
• We feel chronic insecurity because the truth is – we don’t love/accept our self in general – hence we over do things to constantly prove our self-worth
• We never make time for reflection and introspection – we are too busy striving and focusing on others to our own detriment
• We become so needy due to this lack of self-awareness and neglect – that we actually do become more selfish due to our chronic competitiveness, anxiety and craving attention from others
• We are disconnected from our soul because of all this

In fact, some people are so busy ‘serving’ to get love, security and self-esteem from external sources that they are damaging their adrenal, hormonal and digestive balance – and prematurely aging themselves. Hence, what looks on the surface like altruism is actually lack of self-compassion and workaholism to cover emotional pain of some form or to gain approval.

Then when we burnout, wake up, and attempt to find more life balance and joy for ourselves so that we can be more engaged with our own lives and feel the connection to others without worrying about what we will get out of it – when we try to take care of ourselves AS we are taking care of others – here comes the finger-pointing and shaming with the label ‘selfish’. When are we going to learn that it is a both/and proposition in order to thrive?

We can BOTH care for ourselves AND care for others. In fact, I know for sure that as I stopped overdriving myself professionally and from being a pleaser or seeking validation, I learned how to value sleep, recreation, took the time to relearn how to use food as medicine and more holistic natural approaches, dealt with my fears, anxieties and compulsive behaviors – and lo and behold, I started having better relationships!

I stopped being so focused on survival and being self-centered, feeling tired and getting mental fatigue or unfocused easily by twisting myself into a knot to fit into ‘the box’ and instead I got in contact with my own unique heart and soul expression. I found my voice…one of the hardest lessons I’ve had to learn, even if it didn’t look that way to others. And, I connect with those that I feel a connection with and show them support for all the ‘right’ reasons. And, I definitely give myself some of this care also.

We can learn how to BOTH take care of our self AND take care of others. It doesn’t have to be either/or, black or white. That is the old way of thinking. Self-care is ‘personal lifestyle care’.

We are in a world that lacks joy and connection because we are so tired and burnt out, there is not enough energy to be present to the person in front of us. Instead, we seek to feel good by seeking attention, ‘likes’ on social media, and become easily distracted and addicted to our devices. We have forgotten how to ‘love the one you’re with’ as the old song goes. Frankly, this state of mind sounds more stressed and selfish to me. Making time for self-care for me has been lifesaving from a health perspective and has given me the focus, confidence, and energy to create healthy relationships and boundaries.

To attempt to shame people into submission by continuing to push them to serve others and institutions outside of their self without consideration for their own needs is ‘business as usual’.

Don’t expect to reduce the rise in chronic disease until people start to respect their own health needs for rest and restoration. Our bodies need a chance to slow down and heal. Our mind needs some silence. Our hearts need space to heal from our inner emotional wounds. Yes, we need more self-care and in doing so, we are more likely to heal our soul and thus our body, in the process…and ultimately restore healthy social bonds and community. Stressed, sick people create a stressed, sick society.

As we heal ourselves, we are in a better place to be a healing inspiration for others and also to have the time and energy to participate again in community with others.

We can learn to do this as an integrated lifestyle. As we care for our self, we also can shift the pattern of seeking attention from others and looking for love in all the wrong places. Instead, we can give it to ourselves. And as we love and care for ourselves, we make more room in our hearts to give to others. It’s just the way our mind and body works,

For those who wish to continue to neglect their own self-care, that is a personal choice as well. I do not judge this. The question I have is, can we stop interfering with the personal choices of others who are on a different path than ourselves? In so doing, maybe we can make the world less stressful and self-centered in the thinking of the collective mind. To each his/her own. Let’s us all find our own way, in our own time. Then maybe there will be more room for peace and for people to reach their own authentic expression, healthy mind and body, and their own authentic greater potential.

What are your thoughts about stress and self-care? I’d be curious to know.