Why do I feel bad?

Why do I feel bad is the most common question I am asked daily by patients. Based on my experience, patients feel that since they have no energy, weight gain, and low sex drive their hormones must be unbalanced. Although hormones can certainly cause these symptoms, other factors are much more likely to affect the way you feel. Treating patients with low energy, weight gain and low sex drive requires evaluation of their nutrition, exercise, emotions, and hormones. In the following monograph I have broken down these factors to explain how they affect your overall well-being.

Nutrition

The single most important factor in your well-being is nutrition. The quality of the food you eat affects every function of your body. The nutrients you consume are used by your body not only for energy, but also for the production and regulation of every hormone you produce. A diet lacking the appropriate nutrients is responsible for the way you feel and most medical conditions. Poor diet has been blamed for the epidemics of obesity, diabetes, heat diseases and even cancers. The amount of information and opinions available regarding a proper diet is overwhelming. It would be impossible to follow every diet or take every supplement recommended by the “experts.”

I suggest the following modifications as a start:

1) Eat less food 2) Eat less processed food. Processed means foods that are ready to eat. 3) More of what you consume should be cooked at home or raw (fruits and vegetables) 4) Learn to eat a low Glycemic diet. See my article on weight loss with a low glycemic diet 5) Avoid soft drinks, sugar substitutes, and excessive caffeine 6) Consider adopting a gluten free diet 7) Vitamins and supplements as needed

You may also want to consider food allergy and micronutrient testing. We offer testing from ZRT Labs and ALCAT allergy testing. As we gain a better understanding of the effects of the environment on our genetics we realize food sensitivity can occur at any age and is responsible for many illnesses. We cannot change our genetics, but we can change what affects our genetics.

Exercise

“I don’t have time to exercise.” “I don’t have the energy to exercise.” “I am moving and busy all day.” These are the three most common excuses for not exercising. Exercise does not need to be a 2 hour session at the gym with a personal trainer. A simple 30 minute walk daily will greatly improve your well being. Most people today do not even get 30 minutes of activity a week. Daily activity helps stabilize glucose levels, improve circulation, promote weight loss and elevate your mood. Even your stress hormones, such as cortisol will improve. If you will commit to 30 minutes of activity daily for two weeks, you will become addicted to the way you feel and start to make the time to exercise daily. Over time you may even progress beyond walking and start strength training and steps to improve your core muscles. Strengthening these muscles will improve posture and reduce chronic pain. Outdoor activities will also improve your vitamin D level. Physical activity has even been shown to reduce the risk of Alzheimer and dementia.

Lifestyle

Lifestyle is a broad category of activities, relationships, and habits that affect your well being. You need to take a survey of your life and change the factors that cause you stress and prevent you from achieving maximum health and well being. Excessive stress causes inflammation and affects the body’s ability to produce the appropriate hormones. Things to consider changing include:

1) Stop smoking 2) Avoid excessive alcohol 3) Improve your sleep 4) Improve stressful relationships (family, spouse, friends) 5) Achieve a healthy balance at work 6) Time for hobbies 7) Learn techniques to reduce stress

Hormones

Hormones are vital for the normal function of our bodies. Ever organ and every process in the body is dependent on the presence of appropriate hormones. All hormones change as we age. Nutrition affects the production of hormones. Without the necessary nutrients the body cannot produce adequate thyroid, adrenal, or sex hormones (estrogen, progesterone, and testosterone). Exercise regulates the production of cortisol, insulin, and growth hormone. And finally, stress affects the production of most hormones.

Can an imbalance of hormones cause you to feel bad? Absolutely. The key is to find which hormone is the culprit and why its production is altered. Too much hormone can be just as bad as not enough hormone. Adopting the strategies above, most people will improve and balance their hormones naturally. However, if symptoms persist, hormone and nutrient testing may be necessary to help you improve. Testing identifies specific deficiencies which then determine treatment. Hormones we typically check depends on the symptoms you are experiencing. Click here for our patient symptoms form.

Adrenals

The adrenal glands are a pair of small glands located above the kidney. Most people are unfamiliar of their presence and the role they play in hormone balance. Fatigue is a common complaint of patients. If you have symptoms such as tiredness, fearfulness, allergies, frequent influenza, arthritis, anxiety, depression, reduced memory, difficulties in concentrating, insomnia, worn-out, and the inability to lose weight after extensive effort you may be suffering from adrenal fatigue.

Adrenal fatigue has a broad spectrum of non-specific, yet often debilitating symptoms. The onset of this condition is often slow and insidious. Patients are told that they are stressed and need to learn to relax more or that nothing is wrong with them or that they must be depressed. Over time, the condition worsens as the as the adrenal production continues to decline.

Signs and Symptoms of Adrenal Fatigue:

• Tendency to gain weight and unable to lose it, especially around the waist.
• High frequency of getting the flu and other respiratory diseases and these symptoms tend to last longer than usual.
• Tendency to tremble when under pressure.
• Reduced sex drive.
• Lightheaded when rising from a horizontal position.
• Unable to remember things.
• Lack of energy in the mornings and in the afternoon between 3 to 5 pm.
• Feel better suddenly for a brief period after a meal.
• Often feel tired from 9 - 10 pm, but cannot sleep.
• Need coffee or stimulants to get going in the morning.
• Cravings for salty, fatty, and high protein food such as meat and cheese.
• Increased symptoms of PMS for women; periods are heavy and then stop, or are almost stopped on the 4th day, only to start flow again on the 5th or 6th day.
• Pain in the upper back or neck with no apparent reason.
• Feels better when stress is relieved, such as on a vacation.
• Difficulties in getting up in the morning. Other signs and symptoms include:
• Mild depression
• Food and or inhalant allergies
• Lethargy and lack of energy
• Increased effort to perform daily tasks
• Decreased ability to handle stress
• Dry and thin skin
• Hypoglycemia
• Low body temperature
• Nervousness
• Palpitation
• Unexplained hair loss
• Alternating constipation and diarrhea
• Dyspepsia (heartburn)

The adrenal glands deal with the daily stresses of life. A woman must normalize her adrenal glands in order to have a total body hormonal balance. In fact, replacement of deficient hormones alone without addressing the overall health of the adrenal gland is a band-aid approach and is often ineffective in the long run. The normalization process can begin with investigating and eliminating stressors. Stressors are often chronic in nature, and can be related to lifestyle, dietary, mental, and inflammatory causes. Removal of these stressors followed by treatments to support the adrenal hormone production can result in the improvement of symptoms over time. If you feel you are experiencing these symptoms, complete the adrenal fatigue questionnaire prior to your appointment. Based on your symptoms, saliva testing may be recommended.

Thyroid

The thyroid gland acts like the body's regulator. Its main function is to help cells convert oxygen and calories into energy. It regulates heart rate, blood pressure, body temperature, metabolism, and growth. About 10 percent of the adult population is afflicted with this frequently overlooked disease of epidemic proportion. A dysfunctional thyroid can affect almost every aspect of health. It is one of the most under-diagnosed hormonal imbalances of aging, together with estrogen dominance, and adrenal fatigue. It is estimated by age 50, one out of every twelve women will have some degree of hypothyroidism. By age 60, it is one out of six. In fact, among the elderly, hypothyroidism is sometimes misdiagnosed as dementia.

As one of the master regulators of body metabolism, symptoms of low thyroid function generate a global response. Symptoms include:

• Fatigue and low energy, with need for daytime naps due to defect at cellular energy conversion and difficulty in converting from T4 to T3.
• Skin that becomes dry, scaly, rough, and cold due to increase demand on metabolism (e.g. cold weather) with little thyroid reserve.
• Excessive unexplained hair loss due to slowing down of cell turnover and tissue/hair production.
• Sensitivity to cold in a room when others are warm due to sluggish conversion of nutrients and oxygen to heat.
• Brain fog, depression due to inadequate levels of thyroid in brain.
• Constipation that is resistant to magnesium supplementation.
• Unexplained weight gain due to reduced metabolism that enlarges fat cells which sequester T4, causing depletion and further sluggishness.
• High cholesterol resistant to cholesterol lowering drugs.
• Low libido, PMS, miscarriage, and infertility due to disruption of testosterone, estrogen, and progesterone.
• Abdominal cramping and IBS due to reduced muscular activity of bowl wall due to thyroid depletion.

Administering thyroid medication in the case of advanced adrenal fatigue without concurrent attention to adrenal recovery often fails as a result. An already weak adrenal system in a low energy state may not be able to carry the extra energy output burden. What the adrenals need is rest, not extra work. Those who have hypothyroidism but fail to improve after taking thyroid replacement medication should therefore always investigate adrenal fatigue as a possible etiology for their thyroid problem. Normalization of the adrenal function in such cases is the key and often leads to spontaneous resolution of hypothyroid symptoms.

If you feel you are experiencing these symptoms, complete the symptoms questionnaire prior to your appointment.

Ovarian Hormones

The ovaries are the source of the majority of estrogen and progesterone production. The effects of estrogen are balanced by progesterone. Both hormones are needed for optimal function. Typical complaints from patients having estrogen dominance include swollen breasts and ring fingers, impatience and irritability, stomach cramps before menstrual cycle, irregular periods, fluid retention, foggy thinking, depression, and fatigue.

While sex hormones such as estrogen and progesterone decline with age gradually, there is a drastic change in the rate of decline for these two hormones during the perimenopause and menopausal years for women. From age 35 to 50, there is a seventy-five percent reduction in production of progesterone in the body. Estrogen, during the same period, only declines about thirty-five percent. By menopause, the total amount of progesterone made in the body is extremely low, while estrogen is still present in the body at about half its pre-menopausal level. When ovulation ceases, progesterone is no longer produced except for a very small amount made by the adrenal glands. With the gradual drop in estrogen accompanied by a severe drop in progesterone, there is insufficient progesterone to counteract the amount of estrogen in our body. This state is called estrogen dominance. Many women in their mid-thirties, most women during perimenopause (mid-forties), and essentially all women during menopause (age 50 and beyond) are overloaded with estrogen and at the same time suffering from progesterone deficiency because of the severe drop in physiological production during this period. Menopause, with its drastic drop in estrogen and progesterone requires special consideration. Hormone replacement is vital to your health, vitality and longevity.

Other causes of estrogen dominance include environmental estrogen exposure, obesity, stress, poor diet, lack of exercise, and incorrect hormone replacement. Adrenal and thyroid dysfunction can also contribute to the imbalance of estrogen and progesterone. If you feel you are experiencing these symptoms, complete the symptom questionnaire prior to your appointment. Based on your symptoms, saliva testing may be recommended. Therapy using high quality bio-identical hormones is available.

Conclusion

These are some of the causes of feeling bad. While controversy exists on the existence of “estrogen dominance,” “sub clinical hypothyroidism” and “adrenal fatigue,” I doubt any one will argue the success of feeling better with proper nutrition and exercise. Treatment is based on a careful determination of the possible causes of the symptoms. Testing of hormones can be done using blood, saliva and urine. Deficiencies are corrected using lifestyle changes, supplements for nutrition, and medication. Treatment is ongoing and requires lifestyle changes to prevent reoccurrences or additional problems.

Dr. Syal MD, FACOG