During the heyday of my business career, I was a self-professed workaholic. I put in long hours during the work week and regularly logged time during weekends. I traveled frequently and struggled mightily with jet lag. I short-changed exercise and had poor sleep habits. Sure, I felt rundown quite a bit of the time, but I prided myself on my ability to cope with stress. I’m not sure my body would have patted me on the back.

In Adrenal Fatigue: The 21^st Century Stress Syndrome, Dr. James L. Wilson explores the physiological consequences of life lived in the fast lane. He zeros in on the adrenal glands – a pair of tiny organs that sit atop the kidneys. They secrete hormones that influence several important physiological processes – metabolism, fat storage, blood sugar regulation, the immune system, cardio and gastrointestinal function. Through their production of cortisol, they’re key players on the body’s stress response. A surge of cortisol raises blood pressure, elevates sugar in the bloodstream, and shuts down nonessential repair and maintenance functions to prepare the body for flight or fight.

The body’s core design contemplates infrequent use of the stress response. After all, one run-in with a saber-toothed tiger might convince folks to set up camp at a safe distance. But in our modern day life, we’re repeatedly exposed to physical, emotional, environmental, and psychological stressors. When stress exceeds the body’s carrying capacity, the adrenal glands become fatigued.

Common signs of adrenal fatigue include:

• Difficulty getting up in the morning
• A feeling of fatigue or lethargy that is not relieved by sleep
• Increased effort to accomplish everyday tasks resulting in lower productivity
• Lightheadedness when standing up
  (People with adrenal fatigue tend to have low blood sugar.)
• Less enjoyment or happiness with life
• Less mental focus and increased difficulty with memory
• Frequent respiratory infections with lengthy recovery periods

Fortunately, the body is quite resilient. With proper care and attention, we can restore our adrenal glands to good working order. Here are a few strategies that Dr. Wilson recommends:

Minimize stressors and “energy robbers.” For every stressful relationship or situation, we have three avenues of response: Change it. Change ourselves to adapt to it. Or, leave it. For circumstances we deem unavoidable, we can train ourselves to reframe or refocus our perception of the situation. For example, we don’t have to give persons or situations power over our inner thoughts. We can learn to detach and/or treat the circumstance as a learning experience for which we architect the lessons.

Learn to evoke the “relaxation response.” Courtesy of Dr. Herbert Benson and his colleagues at the Harvard Medical School, we now know that a daily practice of meditation, yoga, tai chi, qi gong, guided imagery, and kindred disciplines slows breathing, lowers the heart rate, reduces oxygen consumption, relaxes muscles, and lowers blood pressure. The relaxation response is the perfect antidote to the stress response and requires just a few minutes per day.

Get regular exercise to include aerobic activity, strength training, and stretching. Exercise helps expel harmful gases and toxins, builds muscle, reduces fat, improves cellular function, and normalizes cortisol, insulin, glucose, and other hormones. When practiced faithfully, it also elevates mood.

Develop good sleep habits. Avoid exposure to blue light sources – notably TVs and other electronic devices – at least two hours before bedtime. (As an alternative, use blue blocker glasses.) Get to bed by 10:30pm every night to avoid the “second wind” that hits at 11:00pm. As needed, have a light evening snack to enable you to sleep through the night with waking to hunger pangs. If possible, avoid alarms before 8:30am to ensure that you get a full 8 hours of slumber.

Eat nutritious food. Good food provides the essential ingredients to meet your body’s demands. Small meals spread throughout the day helps keep blood sugar steady.

Dr. Wilson also provides recommendations regarding dietary supplements and hormone replacement therapy. I’ve chosen to explore these options in consultation with a naturopathic doctor. I want to make sure that I know my starting point, take the right levels of supplements, and monitor my progress all under the expert guidance of a trained professional.

Here’s to feeling great inside and out!

I got acquainted with Dr. Sara Gottfried, MD while listening to a podcast featuring her New York Times bestselling book The Hormone Cure. The book’s title wouldn’t have piqued my interest had I seen it on the library shelf. But when Dr. Gottfried shared her struggle with hormonal imbalance, it set me to wondering about the ways in which I might be affected as well.

Our bodies produce dozens of hormones. They’re chemical messengers that influence behaviors, emotions, brain chemicals, and our immune system. They also play a key role in turning food into fuel. When working well together, they operate as a powerful, graceful, and effective team. When they’re out of kilter, they can produce weight gain, mood swings, fatigue, low libido, and other unpleasant conditions. It’s not a bad thing. It’s simply the body’s way of telling us that something is wrong. And we need to listen.

Take cortisol, for example. It plays a role in hunger cravings, digestion, blood pressure regulation, sleep/wake patterns, physical activity, and our capacity to cope with stress. If we’re hiking in the woods and encounter a grizzly bear, cortisol supports our flight-or-fight response by: (i) raising our blood sugar to give us a ready supply of fuel; (ii) increasing our blood pressure to make us alert and ready to respond; and, (iii) deactivating the body’s self-repair protocols to conserve energy. It’s a wonderfully protective mechanism when called upon infrequently. It’s not so helpful when activated regularly in the fast-paced environment in which we live.

Prolonged exposure to high cortisol isn’t good for you. It can render you sleepless even if you are exhausted and have been dragging around all day. It restricts blood flow in a way that can alter brain function, decrease emotional intelligence, and accelerate age-related cognitive impairment. Excess cortisol makes weight accumulate around the midsection. It thwarts the immune system, making you susceptible to colds and infection. It can make you feel anxious, and pretty much kills the sex drive. And should your adrenal gland grow weary of pumping out all that cortisol, it may not be able to rally the troops to produce some more when you really need it.

Dr. Gottfriend’s guide to hormone balance helps women increase their energy, resilience, vitality, and sensuality through science-based natural therapies. She provides treatment protocols for 7 common conditions that affect women: high cortisol, low cortisol, low progesterone, excess estrogen, low estrogen, excess androgens, and low thyroid. The Appendices in the back of the book provide the details.

She pursues treatment in three phases. Lifestyle design is the preferred protocol as it addresses the underlying causes of the condition while taking advantage of the body’s natural ability to heal itself. For example, folks with chronically high cortisol need to make lifestyle adjustments that alleviate stress and promote relaxation. Some adjustments may be relatively easy to incorporate – e.g., adopting a healthy diet, learning to meditate, and/or signing up for yoga classes. Others may prove more challenging – e.g., changing jobs, adjusting commute patterns, and/or downsizing to relieve financial pressure.

Herbal therapies may be used to support the body’s healing process on either a short-term or long-term basis. For example, Vitamin C supplements may be leveraged to support the body’s immune response. Other herbal remedies have been shown to reduce fatigue and stress, lower blood sugar, improve cognition, and confer a sense of calm. Some may have unpleasant side effects and/or interactions with other medications. Hence, it may be advisable to pursue their use under medical supervision. If the condition warrants it, a doctor may prescribe bioidentical hormone supplements.

I confess that I struggle with the lifestyle changes recommended by Dr. Gottfried and others to help my body do its best work in service of my long-term health. It’s why I’ve taken an interest in the science of behavioral change, habit formation, and positive psychology. I’ve found that I have more success when taking sustainable “baby steps” – one new one each month – rather than attempting sweeping change on which I’ll likely falter. I’ve also surrounded myself with a team of family and friends who support my efforts and provide encouragement.

Years ago in high school biology, I learned about Gregor Mendel, the Augustinian monk who discovered genetics through his work with pea plants. Dr. Mendel bred pea plants and took careful note of shared characteristics between “parents” and “offspring.” After a great deal of experimentation, he determined that there were two genes for every trait. Dominant genes found expression whenever one gene was present in the pair; recessive genes needed to be a matched pair to manifest. Armed with this understanding, he was able to breed selectively for certain traits.

Dr. Mendel’s work set the foundation for the modern science of genetics. It teaches us that our human characteristics are the product of genetic contributions from our fathers and mothers. It explains why certain traits are more common than others – e.g., brown versus blond hair. It also informs the practice of modern medicine given the weight accorded family history when assessing potential health threats.

In their book Ultra-Prevention: The 6-Week Plan That Will Make You Healthy for Life, Dr. Mark Hyman, MD and Dr. Mark Liponis, MD argue that genetic inheritance is far less important than lifestyle choices in determining our well-being and risk of life-threatening disease. They note that while some traits (e.g., gender, race, eye color) are controlled by a fixed pair of genes, most are determined by interactions among many genes within a context that is vastly more complex than a pea plant. As such, genetic code does not always translate into genetic expression. As a proof source, Drs. Hyman and Liponis cited a Scandinavian study that assessed 44,000 pairs of identical twins to determine the genetic underpinnings of cancer. Researchers concluded that only 10% of cases could be linked to genetic inheritance. The rest were associated with lifestyle choices.

I was intrigued, so I picked up a booked entitled Epigenetics: The Ultimate Mystery of Inheritance, by Richard C. Francis. Epigenetics is the study of changes in organisms caused by variations in gene expression rather than alterations of the genetic code. By combining the two readings, I have a new (rudimentary) understanding of human genetics. Here goes…

Virtually every cell in our bodies contains an identical set of the 30,000+ genes from which the body can make over 300,000 proteins. These proteins include enzymes, antibodies, structural proteins, messenger molecules, receptors, hormones, cytokines, and others. They provide structure to maintain our bodies. They control the process of energy production, and they support cellular and organ function. While this vast information warehouse remains unchanged throughout our lifetimes, cells make the determination regarding which genes to engage (and not engage) when making proteins. These decisions are influenced by:

• The functions that cell typically performs
• The needs of the body at that moment in time
• The cellular processes in effect at that time – e.g., growth, repair, regeneration, reproduction
• The cellular environment

In simple terms, each gene has two core components: a protein-coding sequence (“manufacturing blueprints”) and a control panel. Genes activate when certain chemicals bind to their control panels. The cellular environment establishes conditions through which this engagement is more or less likely. For example, the presence of another organic molecule may inhibit access to a gene’s control panel, thereby rending its template inactive. The cellular environment is also affected by the surrounding cells with which it interacts and distant cells with which it communicates via the bloodstream. It’s also affected by the external environment. For example, if a pregnant woman experiences chronic stress, she’ll produce excess cortisol that will pass to the fetus via the placenta. Excess cortisol insinuates itself into the fetus’ cellular environment and will make the baby more sensitive to stress.

This discussion gives rise to a couple of new additions to my vocabulary, courtesy of Webster’s New World Dictionary. A genotype is “the fundamental constitution of an organism in terms of its hereditary factors” – i.e., its genetic material. A phenotype is “the manifest characteristics of an organism that result from both its heredity and its environment.” The phenotype reflects the expression of the genotype and includes such factors as skin thickness, speed of reflexes, metabolic rate, blood pressure, good/bad cholesterol, and other health indicators. While we can’t change our genotype, we can exercise a great deal of control over our phenotype!

Take, for example, a gentleman who has a genetic predisposition for heart disease. If he consistently makes healthy lifestyle choices, he may never develop a coronary condition. In fact, Dr. Dean Ornish, MD and Dr. Caldwell Esselstyn, MD demonstrated that severe heart disease can be arrested or reversed through lifestyle changes! Drs. Hyman and Liponis also note that persons who eat healthy food and avoid antibiotics tend to maintain good gut bacteria. These bacteria promote activation of a cancer suppressor gene that reduces the risk of colon cancer.

Bottom Line: We can affect our gene expression by improving our physical and cellular environments through diet, exercise, and other lifestyle choices. We don’t have to become what we inherited!