In this week’s episode of IWG Radio, Functional Medicine Physician Dr. Nicole Rivera and nutritionist Brooke Scheller discuss common reasons for fatigue and what you can do to boost your energy levels.

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Hey there, you are listening to IWG Radio, the place to be for all of your wellness needs, hosted by functional medicine physician, Dr. Nicole Rivera and functional medicine nutritionist, Brooke Shellar. We just want to take a moment to thank you so much for listening and just let you know that any of the information that is provided is strictly for an educational resource and is not intended to diagnose or treat any conditions. The lifestyle interventions discussed should not be used as a substitute for any type of conventional medical therapy.

Dr. Nicole:
Hey there, welcome back to another episode of IWG Radio. You have Dr. Nicole and Brooke Shellar, our clinical nutritionists here and we are going to be talking about adrenal fatigue versus chronic fatigue.

Yes, I think this is a really great topic because we are all tired. A lot of people are complaining that they are tired and maybe they are not really sure where it is coming from. We wanted to get to the bottom of, or help you get to the bottom of if this is something that could be influenced by something called adrenal fatigue and we will talk more about what that is, if there are possibly some underlying causes for adrenal fatigue or if there are maybe some other things going on within your body that could be contributing to fatigue. Again, we live in this fast-paced world. There's definitely a lot that is affecting our systems. I will have Dr. Nicole jump into introducing our functional medicine practice and really how we go about addressing something like fatigue.

Dr. Nicole:
Yes, I really wanted to do this podcast because I think that we live in an epidemic of fatigue right now. Just like Brooke said, everybody is tired. Nobody necessarily knows why and nobody necessarily knows what to do about it. I think maybe we read up on B vitamins and think that's a good option, but sometimes B progress is short-lived. With that being said, in my opinion chronic fatigue and adrenal fatigue are virtually the same thing. Most people that have been diagnosed with adrenal fatigue, which means the adrenal glands within the body are not functioning optimally anymore. People are generally going to be experiencing fatigue, but in addition to somebody who is experiencing adrenal issues, they might also have hormonal imbalances as well.

One of the things that I find in my clinical practice is a lot of people come to me with the diagnosis of adrenal fatigue and they said, "Oh, I've been working with an integrative physician or I have been working with a functional medicine physician and we have been trying to work on my adrenals because I am so tired and my hormones are off and that's really where all my symptoms lie is in this adrenal fatigue description."

With that type of testing I do is I automatically think, "What is the underlying root cause of your adrenal fatigue?" because the adrenals are impacted by so many different things that could be going on and hence, that means your energy levels are also going to be impacted. Some of the things I find are that underlying gastrointestinal imbalances, things like yeast bacteria parasites are a big part of the puzzle. I also find that mold exposure is another big part of the puzzle.

As Brooke and I were discussing to get ready for this podcast, she is like, "You should make sure that you mention immune system issues and how that can contribute to fatigue." One of the reasons why our immune systems are so compromised is because our bodies are trying to either fight different pathogens that are built up in our gut or immune systems are compromised because we are holding on to toxins, which could be caused by mold and sometimes they could also be caused by different types of metals like mercury. We hear about mercury in fish a lot or other types of metals that exist in our environment.

There are 100% is an immune system issue, but at the end of the day you have to figure out does someone have gut issues? Does somebody have mold exposure? Is that what is then leading to the adrenals being imbalanced and then causing fatigue?

I think that's a great point to mention because I think that there is a lot of information online about adrenal fatigue and it is true because we live in a super-overdrive world. We are on cell phones. We are on the Internet. We are answering emails every hour of the day. That is absolutely driving our stress response and that could definitely be contributing to things like adrenal fatigue.

However, what else is going on in the body because 50 years ago everyone did not have adrenal fatigue. There was, of course, some less stressors at that time. How are different things in our environment, toxins like you mentioned, even bio-toxins for mold, how are those things impacting our systems as well? Let's elaborate more on some of those different areas that you touched upon. Let's start first by talking about the gut.

Dr. Nicole:
I have a big focus on the gut in my practice and we recently released a cookbook called "Eat for your Gut." I find that unfortunately so many people coming through my doors are battling some type of gut imbalanced. I think partly it's because our food industry has changed so much. We are getting exposed to toxins left and right and because our immune systems are compromised, we are not able to fight off these different pathogens.

What I mean by "pathogens" is some people can definitely have bacterial overgrowth in their gut and the reason why that happens is because maybe you don't have enough stomach acid that will help you to fight off different bacteria that could be on your food. Then if that bacteria gets into the lower intestines then it can live there and thrive and actually feed off of your food.

Yeast, I would say is one of the most common things that I see and I see that primarily because it's fed by sugar and carbs. How many of us love sugar? How many of us love bread? Or just how much sugar is it everything that we eat nowadays? You go to the Starbucks think you are getting a black coffee, putting some milk in there. What we are not realizing is that milk has 30 grams of sugar in it. There is definitely a lot more sugar that we are exposed to on a daily basis, even if we realize it or not. That is something that will definitely contribute to yeast overgrowth in the gut. There are a lot of symptoms that go along with this. We have touched on these in previous podcasts in relation to these different microbes, so we would definitely say check that out if you want to know a little bit more what that looks like.

For lack of derailing, the primary things that happen when you have bacterial overgrowth, yeast overgrowth or even if you have had exposure to parasites may be because you have traveled outside of the country, had food poisoning, etc., what's going to happen in the body is these different microbes or pathogens that are in your gut are going to give off something called endotoxins. I explain it like a think about trash. If you have trash in your house and it is sitting there for a long time, it starts to give off odor, odor as a gas. These endotoxins also are a gas. This will travel through the body and these endotoxins specifically will actually impact your pituitary gland.

What's interesting is the pituitary gland, it produces a lot of different hormones, but one of the things they have found in the research is that these endotoxins specifically shut down the adrenal cortico-stimulating hormone. Literally, the hormone that stimulates your adrenals to work properly is getting shut down completely by having these different pathogens in your gut. It is such an interesting thing because you can focus on your adrenals and try to stimulate them and stimulate them and get things balanced and get your hormones balanced, but you are going to pretty much feel good while you are maybe taking certain supplements or certain of hormones and then as soon as you are off of those, you are going to go right back to square one because you have not figured out the root cause.

I think that's really important to mention because I think like you said, a lot of people think that it is just adrenal fatigue that is contributing to their symptoms. But the fact of the matter is and like you said there are a lot of different symptoms, if you are having bloating or maybe you have had another diagnosis of Crohn's or SIBO or IBS those two things can definitely be playing a role together.

Let's jump now to talk a little bit more about mold exposure. We did do a previous podcast on testing your home for mold, but we have not really touched much on what's going on in the body when we are exposed to mold, so why don't we go ahead and do that.

Dr. Nicole:
Mold is actually an elaborate topic and we will definitely be doing a podcast in the future to expand upon what we are going to talk about today. Mold is something that is so interesting because we think that if we do testing and it comes up positive for mold, it's not that you are maybe living in a moldy situation currently. Sometimes it can be a past exposure, but your body has not successfully shed the biotoxins, which are pretty much the byproduct of mold. It has not shed them successfully.

In the event that you currently or in the past have been exposed to mold, if you know it or not because a lot of us have … I ask people all the time, "Have you been exposed to mold? They are like, "Ah, definitely not," and their testing does come up positive.

I would definitely recommend listening to that previous podcast with I interviewed a gentleman who specializes in mold remediation and I think that's an important point to mention is that most of the time when people are being exposed to mold they don't really know it. It's not necessarily that you have the black fir growing on your walls, but it could be behind walls, behind cabinets and things like that, just something to keep in mind.

Dr. Nicole:
Yes definitely, I think that's important. In the event that you are exposed to mold, the primary thing your body will hold on to is what you call biotoxins. The biotoxins, like I said, are the byproduct of mold. What happens is it's almost like a snowball effect. Some of the things that become impacted with exposure to mold is your immune system.

A lot of people exposed to mold will have a tendency to have lots of different viruses in the body, everything from walking pneumonia, Epstein Barr Virus, herpes simplex 1, which is the cold sores or even maybe herpes simplex 2, which could be that genital version. You will tend to have a lot more of viruses in your system. On top of that one of the primary organs that it affects is your pituitary gland so go figure.

Your pituitary gland again, is the stimulating hormone for your adrenals. It also is that stimulating hormone for your thyroid and your reproductive organs. One of the primary things you see with people exposed to mold is major hormone imbalances, especially with their testosterone levels and their estrogen levels. You also will see adrenal fatigue because the adrenals are now also impacted as well. In the realm of the pituitary gland, it is the master gland of the body of the brain. It also does regulate your urination because it regulates your anti-diuretic hormones, so some people exposed to mold also will have a tendency to have more frequent urination were always feel thirsty because their body is losing so many electrolytes.

Those are some of the most common symptoms. Mold is something that should not be taken lightly. It's definitely something I find way too often in my clients when testing for it, but it is a big culprit for us feeling so fatigued and being so immune-compromised.

Now we have all these different things. We have possible gut involvement. We have possible mold exposure and then we also have that plain old maybe too much stress over the last however many years. What do you recommend? Where do people begin?

Dr. Nicole:
Of course, I definitely think that if you are someone who is experiencing major fatigue and you start to make some lifestyle modifications, maybe you start to exercise a little bit more, trying to get your endorphins up. Then you try to take more vacations or have an extra day off or just stop burning the candle at both ends essentially, give yourself more self-care and take more breaks essentially. If you start to do that and you don't notice a change in your energy levels, if they don't improve at all, then you really want to exploring what is going on in my body that might be impacted my adrenals?

I would say that is getting the right testing, typically from a functional medicine practitioner because unfortunately, doing things to evaluate the gut usually includes stool analysis and then doing things to check for exposure to mold is in-depth blood work. Unfortunately, I feel like not a lot of physicians are aware of testing for those types of things, especially when it comes to mold it might be easier to get the lab work to get diagnosed, but the treatment plan definitely varies. It's complicated. Let's just put it that way, so you need to work with somebody who is specifically trained in it.

With that being said, it starts with making those lifestyle modifications, seeing if that improves your situation. If it doesn't improve your situation, embarking on working with a physician who can support you, get you the right lab testing, give you information about what is the root cause and then and embarking on a plan from there, which might include lifestyle recommendations in addition to a diet, in addition to supplementation as well.

If you are someone listening and some of this sounds like it might be what you are experiencing, we would be more than happy to offer you a free 15 minute call with myself just to discuss more about what's going on and some possible areas that we could take a look and guide you a little bit more to feel better. Thank you so much for listening and we will talk to you soon.

Dr. Nicole:
One thing I want to mention quickly is some of you might be listening from far away. Just to know that all of our services are virtual, so we can do anything via phone or Skype. If you are someone who is resonating with this information and really need help, we can help even if you are long distance.