The Dr. Lam Show
The Dr. Lam Show
What Your Cortisol Curve Says About You
Different types of tiredness, whether it be morning fatigue, afternoon slump, or second wind can correlate to different cortisol responses in your adrenals. Watch and listen to this episode for more information.
01:25 - What is fatigue?
02:21 - Why do you feel tired in the morning?
04:40 - Why do you feel tired in the afternoon?
05:39 - Fatigue health issues
08:00 - Your second wind
08:42 - Symptoms of adrenal fatigue
11:24 - Treating the fatigue
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Are you feeling sluggish in the morning? How about needing some caffeine to pick you up? Or do you have afternoon slumps and throughout the day? Fatigue is one of the most common complaints in the doctor's office, and one of the least listened to. Today we'll be diving into the causes of fatigue and what you can do about it. This is The Dr. Lam Show. And we're here to talk about integrative and functional medicine, and empower you to take control of your health. If you enjoy the show and find it useful, please hit the like button, and subscribe to the Dr. Lam podcast as well at the YouTube channel. This is the best way to make this show more visible so that other people who need this information can find it. I'm Dr. Jeremy Lam. I'm an internal medicine doctor, who is also board certified in anti aging and regenerative medicine. I spent my medical career working in chronic disease treatment, as well as reversal.
Dr. Carrie Lam, MD:And I'm Dr. Carrie Lam. I am a family medicine physician with fellowships in functional and metabolic medicine. I'm passionate about nutrition and lifestyle medicine. Today, we will be talking about fatigue, which we are experts in and how you can transform your life to becoming fantastic. So let's start with what is fatigue?
Dr. Jeremy Lam, MD:Fatigue is feeling sluggish in the morning, getting up and not feeling refreshed. Then you know going through the morning and it's okay, but after lunch, you have an afternoon slump. And by mid afternoon, you feel like you need to take a nap to get through the day. Sometimes having a meal can perk you up, but then you start to go downhill again. You'll find that you need to get one cup of coffee in the morning and then one cup of coffee won't start working. So, you need to do 2,3 and 4, just to keep up with the demands of life. If you're that person, you might be having low energy from an adrenal standpoint. Maybe you're not able to produce enough hormones to give you that pick me up and so you're feeling tired. What is hormone responsible for this, Dr. Carrie?
Dr. Carrie Lam, MD:The anti-stress hormone, called cortisol, that your body has to draw from its reserves, to fight inflammation and give you energy. Your adrenals produce cortisol. If you're feeling tired in the morning, even after you've gotten a good night's rest of sleep, then maybe you have to look at something like adrenal fatigue. Cortisol is supposed to be high in the morning, where it's supposed to wake you up and get you to rise up very early in the morning. It peaks around 6 to 7am and then it starts to go downhill throughout the rest of the day. This can be tested in saliva, or urine. Cortisol is high in the morning, and it comes down, a steep slope. And so evening time usually have a low cortisol. So that's normal. But some people tend to have a higher level which means some people have a reverse curve, where the cortisol is low in the morning, but high at night. Their circadian rhythm and their cortisol rhythm can get very disrupted. And other people have their cortisol is low in the morning and high in the middle of the day. That points to more of a stressful type of life, where your cortisol puts out at the wrong time of day. Those who have adrenal fatigue, they just have a flat curve, meaning your adrenals are so tired, they can't even produce cortisol, the anti stress hormone anymore. So if you are going through fatigue, you want to be able to test your cortisol levels. That's the number one thing that you should do. Because that point to where you're at regarding your adrenal health. So, feeling tired in the morning, can sometimes mean that you don't have enough cortisol to wake you up and get your day started. So Dr. Jeremy, that's the morning tiredness, but can you explain the cortisol and how it looks for those who have our afternoon slumps?
Dr. Jeremy Lam, MD:Well, having that afternoon slump could be if you have a drastic drop in your cortisol. It can also mean that you are having some blood sugar issues as well as you're relating to your cortisol output along with blood sugar signs. So oftentimes is having this roller coaster up and down that is related to the cortisol being sluggish in the morning, having that slump in the afternoon. To relieve slow down and try to learn and see what's going on? What is your body trying to tell you? It's not necessarily that it is broken, but it's the body's healthy signal to tell you that, let's focus on the adrenals. As you can tell, fatigue isn't as simple as just sleeping more and going on with your life. Every organ system in your body is connected. A major change in one of them can have numerous and unexpected effects. Let's dive more deeply into those changes and look at those health problems associated with fatigue.
Dr. Carrie Lam, MD:We all live with fatigue of some extent. Life is stressful, and we get tired. The downhill happens when we try to feed into this fatigue by artificially giving ourselves short bursts of energy, whether it's coffee, or energy drinks, or sugar, like donuts, to help patch the solution. It's not really a long term plan. It doesn't really get to the root cause of why you're feeling fatigued. So we need to first start try and listen to our bodies and understand why we're fatigued and what these symptoms are telling us. So what are the common reasons that people might feel a fatigue, Dr Jeremy?
Dr. Jeremy Lam, MD:Number one is sleep issues. Not only if you have problems sleeping, but if you just don't have good sleep hygiene, you know, if you're going to sleep at 12-1 o'clock, if you're on your phone, watching TV for two hours a night, that's really disrupting your circadian rhythm. Obviously, if you don't have good sleep, then you're not going to feel rested the next day. Other issues we see commonly, is if you have thyroid imbalance. Thyroid is responsible for your energy levels for metabolism. So if there's direct issues, you might have some fatigue. That's often related to both the ovarian-adrenal and thyroid axis where we've talked about that previously. So if you do have thyroid issues, you need to make sure that your adrenals are properly regulated, because there's that connection between the thyroid and the adrenals. Make sure that you look into that if you do have thyroid issues.
Dr. Carrie Lam, MD:Right. So we call that the ovarian adrenal thyroid axis, where your hormones are very important for energy. Not only your hormones have to be well taken care of, but your gut, and your immune system and your detox pathways and your neurotransmitters. A lot of those can also contribute to fatigue. So getting down to the root cause is important. And if you need a healthcare practitioner to help you, I suggest you give us a free initial phone call 714709 1000 We'll be able to help you to this and sift through what your root cause is. So we talked about the morning fatigue, we talked about the afternoon slump. But there's another thing called the second wind, that's a very classic telltale sign of adrenal issues. That can happen when the body's adrenal system loses its reserve, and then you feel tired, but then the cortisol finally kicks in, and it rises up giving you a second chance, so to say. Usually around the evening or the night time, and then, you know, patients, our patients always say that they're more anxious or they have more energy in the evening time that somehow comes out of nowhere, and then they aren't able to sleep. That also happens very commonly in adrenal fatigue. Fatigue is one of the most common symptoms of adrenal fatigue. But, you know, it might not only be fatigue, right, Dr. Jeremy, what other symptoms tend to happen that are very common for patients who have adrenal fatigue?
Dr. Jeremy Lam, MD:They'll find that they have reduced exercise capacity, finding that they're low motivation, low moods, not being motivated to do anything. They also find that they have, tiredness, maybe some dizziness upon standing heart palpitations, and this is obviously you go through the workup, conventional workup, and things have come back normal, but you still have those symptoms going on. That can relate to that there's other things in the body, and that's where the NEM stress response comes in. Because all the symptoms that we've addressed so far like sleep or thyroid, or the heart or your gut, or your detox they all correlate to different circuits. And so we have six circuits in our neuro endo metabolic stress response. So if you're having a sleep issue or motivation or mood issue, it could be related to the neuroaffect circuit. If you have a thyroid imbalance it is due to the hormone circuit that's being imbalanced. If you find yourself having brain fog, liver congestion, not being able to detox, then that's part of your detoxification circuit. The other three circuits are defined that you have, you know, a lot of bloating, inflammation, gut, then that goes under the inflammation circuit. If you have blood sugar, weight components related to your metabolism that's related to your bioenergetic circuit. And lastly, if you find that you have cardiac symptoms, you know, the heart palpitations, fast heart rate, maybe possibly arrhythmia, poor circulation, then that relates to the cardionomic circuit. And so where does fatigue belong to Dr. Carrie?
Dr. Carrie Lam, MD:Fatigue can be anywhere in those circuits. But a lot of times the hormone circuit is the biggest one that we look at, which includes the ovarian to the adrenals, the thyroid. It's important to identify which circuit is stress. Like all those circuits that you talked about, we need to find what's the root cause and address and help those circuits. And you have to be very careful about the way you treat the fatigue. So like we talk about people using stimulants, whether it's herbs, glandulars, medication, even vitamin C can give you energy similar to doughnuts or sugary foods. So you don't want just a quick fix, you want to truly find what circuit is going wrong. How do I help benefit this circuit and get to the root cause and therefore the fatigue will be able to improve. So if you don't know what circuit you're in, you know you can definitely do a quick test on DrLam.com on what your NEM stress color is, and you can see which is your dominance circuit. Or you can always give us a call at 714-709-8000 and we can help identify what is your dominance circuit and deal with the fatigue from the root cause. Thank you for being with us here today on The Dr. Lam Show as we talked about fatigue, some of the root causes and how to get down to the neuro endo metabolic stress response. And if you find this information helpful, we hope you subscribe to our channel so that we can bring you more great content. We are here to empower you to take control of your health.
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