Banish Afternoon Fatigue

Sick and Tired (Anastacia song) (Photo credit: Wikipedia)

By Dr. Mercola

Many people experience a slump in energy levels by the time the afternoon rolls around. A number of factors may contribute to this phenomenon. The most common cause is post-lunch hypoglycemia, which is related to your inability to burn fat.

Hence, addressing your diet is key if afternoon fatigue is something you contend with on a regular basis. Besides alterations in your diet, intermittent fasting is one of the most effective ways to switch your body from burning carbs to burning fat, thereby boosting your mental and physical stamina.

Other factors are related to when and how much you exercise. Poor sleep also plays a role, of course, and recent research highlights the interconnectedness between sleep and exercise.

Diet Is Key for Maintaining Your Energy Levels

There are two fuels your body can use, sugar and fat. The sad reality is that our ancestors were adapted to using fat as their primary fuel and over 99 percent of us are now adapted to using sugar or glucose as our number one fuel source.

Because most are primarily burning carbs as fuel, afternoon fatigue is typically related to post-lunch hypoglycemia. By switching your body from using carbs as its primary fuel to burning fats instead, or becoming “fat adapted,” you virtually eliminate such drops in energy levels. Overall, being adapted to burning fat instead of carbs has a number of benefits, including:

• Having plenty of accessible energy on hand, as you effectively burn stored fat for energy throughout the day. One way to tell if you’re fat adapted or not is to take note of how you feel when you skip a meal. If you can skip meals without getting ravenous and cranky (or craving carbs), you’re likely fat-adapted.
• Improved insulin and leptin sensitivity and decreased risk of virtually every known chronic degenerative disease.
• Effectively burn dietary fat for your energy, which leads to less dietary fat being stored in your adipose tissue—hence the weight loss benefits associated with fat adaptation.
• Being able to rely more on fat for energy during exertion, sparing glycogen for when you really need it. This can improve athletic performance, and helps burn more body fat. As explained by Mark Sisson, author of The Primal Blueprint, if you can handle exercising without having to carb-load, you’re probably fat-adapted. If you can work out effectively in a fasted state, you’re definitely fat-adapted.

First, Replace Carbs with Healthful Fats

Keep in mind that when we're talking about harmful carbs, we're only referring to grains and sugars, NOT vegetable carbs. You need very little if any of the former, and plenty of the latter. In fact, when you cut out sugar and grains, you need to radically increase the amount of vegetables you eat since, by volume, the grains you need to trade out are denser than vegetables. You also need to dramatically increase healthful fats, which include:

Olives and olive oil (for cold dishes)	Coconuts, and coconut oil (for all types of cooking and baking)	Butter made from raw grass-fed organic milk
Raw nuts, such as almonds or pecans	Organic pastured egg yolks	Avocados
Pasture-finished meats	Palm oil	Unheated organic nut oils

Avoid highly processed and genetically engineered omega-6 oils like corn, canola and soy as they will upset your omega 6/3 ratio. Trans fats should also be avoided, but contrary to popular advice, saturated fats are a key component of a healthy diet. A reasonable goal will be to have as much as 50-70 percent of daily calories from healthy fat, which will radically reduce your carbohydrate intake.

Fat is far more satiating than carbs, so if you have cut down on carbs and still feel ravenous, it’s a sign that you have not replaced them with sufficient amounts of healthy fat. Most people will likely notice massive improvement in their health and overall energy levels by following this approach. To help you get started on the right track, review my Nutritional Plan, which guides you through these dietary changes one step at a time.

How Intermittent Fasting Can Help

Once you’ve addressed your diet, you can try intermittent fasting. This will effectively help shift your body from carb- to fat-burning mode. Please do not embark on a fasting regimen if you’re still subsisting primarily on processed foods and fast food meals, however. Since it involves skipping meals, making sure you’re getting high quality nutrients with each meal you do eat becomes all the more critical.

Intermittent fasting involves timing your meals to allow for regular periods of fasting. It takes about six to eight hours for your body to metabolize your glycogen stores and after that you start to shift to burning fat. If you keep replenishing your glycogen by eating every eight hours (or sooner), you make it far more difficult for your body to use your fat stores as fuel. Remember, your ancient ancestors never had access to a 24/7 supply of food like virtually all of us do with modern supermarkets. By necessity they regularly engaged in periods of fasting as they had no choice.

While there are several different intermittent fasting regimens, one of the easiest to implement simply involves restricting your daily eating to a narrower window of time, say 6-8 hours, instead of grazing all day long. This equates to 16-18 hours’ worth of fasting each and every day—enough to get your body to shift into fat-burning mode. Once you have made the shift to burning fat as your primary fuel, you will be shocked at how your cravings for sugar and junk food virtually disappear.

As a precautionary note, if you're hypoglycemic, diabetic, have adrenal fatigue or pregnant (and/or breastfeeding), you are better off avoiding any type of fasting or timed meal schedule until you've normalized your blood glucose and insulin levels, or weaned your baby. Other categories of people that would be best served to avoid fasting include those living with chronic stress and those with cortisol dysregulation.

Intermittent fasting also works synergistically with high-intensity interval training (HIIT), which is a foundational part of mycomprehensive exercise recommendations. The combination of fasting and exercising maximizes the impact of cellular factors and catalysts (cyclic AMP and AMP Kinases), which force the breakdown of both fat and glycogen for energy.

Fighting Fatigue with Exercise

The issue of afternoon fatigue was recently covered in a Wall Street Journal1 article, which placed the focus on exercise. Personally, I believe that altering your diet and implementing intermittent fasting will have a far greater impact than making alterations to your exercise schedule alone. But, that said, some of the advice given may be helpful in conjunction with your dietary changes. As reported in the featured article:

“Researchers and fitness trainers say whether you exercise in the morning, afternoon or evening, small changes in your routine can keep you from suffering midday blahs.

Midday is the ideal time to exercise, some fitness experts say. A workout then can give you an energy boost lasting three to four hours... If you prefer working out in the evenings, it's best to avoid exercising two to three hours before bedtime to avoid sleep disruption... On the other hand, if you are a morning exerciser and not getting seven to nine hours of sleep, Lona Sandon, a Dallas fitness instructor and assistant clinical nutrition professor at the University of Texas Southwestern Medical Center, suggests getting to bed earlier or exercising in the evening.

To avoid midday fatigue and preserve energy throughout the day, most trainers recommend doing more moderate workouts, meaning those in which you hit 70% to 80% of your target heart rate. "Listen to what your body is telling you," says Ms. Sandon. "If you have a high-stress work environment then vigorous workouts may not make you feel better. You might be better off with restorative yoga so your brain can slow down." An ideal schedule would be two to three high-intensity workouts during the week, mixed in with lighter workouts like yoga, walking or weight training, say fitness experts.”

The Importance of Non-Exercise Movement During Your Workday

Sitting for prolonged periods of time can also be a source of fatigue. Besides that, compelling research shows that prolonged sitting in and of itself is a major contributing factor to chronic disease and reduced lifespan—even if you exercise regularly.

To counteract the adverse health effects of sitting, which go far beyond mere fatigue, make it a point to stand up every 10 minutes or so. As explained by Dr. Joan Vernikos, former director of NASA’s Life Sciences Division and author of Sitting Kills, Moving Heals, the reason for these ill effects are due to the fact that when you sit, you’re not interacting with gravity.

Based on her groundbreaking research, we now know that the key is in how many times you interact with gravity, such as standing up from your seated position, in any given day. The act of standing up makes your body interact with the forces of gravity, which is what produces beneficial health effects. Interestingly, the lipoprotein lipase is dramatically reduced during inactivity, and increases with activity, the most effective activity being standing up from a seated position. Lipoprotein lipase is an enzyme that attaches to fat in your bloodstream and transports it into your muscles to be used as fuel. So essentially, simply by standing up, you are also actively helping your body to burn fat for fuel.

After reading Dr. Vernikos's book, Sitting Kills, Moving Heals, and interviewing her, I was inspired to give some serious attention to this because even though I perform a lot of structured exercise, including high intensity interval training, I too was guilty of sitting down a vast majority of the rest of the day.

I simply set a timer on my computer to go off every 10 minutes, at which point I rise from my chair and do four jump squats. As explained by Dr. Vernikos, squatting is an extension of standing. If you squat and stand, you can get the maximum benefit of working against the force of gravity. Moving every 10 minutes or so will also get your blood pumping to oxygenate your cells, which will also combat fatigue. I mix it up though and try to do six to eight different moves every 10 minutes. The ones I currently use are one legged squats, two legged squats, lunges, jump squats, hamstring stretches and pectoral doorway stretches.

An Obvious Culprit: Poor Sleep...

Not to be ignored of course is sleep. If you’re not sleeping well, it will be next to impossible to avoid lagging energy levels. According to recent research, maintaining a regular exercise program can help improve your sleep over time2. It can also boost your cognitive performance, as evidenced by a number of studies3. In one recent study evaluating the effect of exercise on sleep,4volunteers with sleep complaints took two-hour forest-walks to assess how it affected their sleep patterns. According to the authors:

“Two hours of forest walking improved sleep characteristics; impacting actual sleep time, immobile minutes, self-rated depth of sleep, and sleep quality... Furthermore, extension of sleep duration was greater after an afternoon walk compared to a forenoon walk.”

In another study5, the results suggested that improved sleep had a beneficial influence on exercise performance the next day, rather than the exercise influencing sleep. Over time, however, exercise will tend to improve your sleep patterns, even if you’re struggling with more serious sleep problems. As reported by Yahoo News6:

“While prior research has shown that for most people, exercising can improve sleep, for insomniacs the relationship may be a bit more convoluted, the new evidence suggests. The rationale? Head researcher Baron told the New York Times that people with insomnia tend to be 'neurologically different' and have a 'hyper-arousal of the stress system.' Breaking a sweat in the gym one day isn't likely to override the system, she said, and could even exacerbate it.

Still, if you struggle with insomnia and currently don't exercise, Baron said that it's advisable to start -- but don't expect miracles. The process could take months, which can be frustrating for someone suffering from sleep deprivation. 'If you have insomnia you won't exercise yourself into sleep right away,' she said in a press release. 'It's a long-term relationship. You have to keep at it and not get discouraged.'"

Some Sleep Basics

That said, it seems clear that you can help set up a positive feedback loop where both your sleep and exercise benefits. Two key points to remember if you’re having difficulty sleeping include the following. For more tips, please see my article 33 Steps to a Good Night’s Sleep.

• Create a sleep sanctuary. This means removing items associated with entertainment, recreation, work and hobbies, and turning your bedroom into a single-purpose space—one for sleeping. Of utmost importance: Make sure your bedroom iscool, dark and quiet. These three factors can have a major impact on your sleep. In regards to temperature, studies show that the optimal room temperature for sleep is quite cool, between 60 to 68 degrees Fahrenheit, so keep the temperature in your bedroom no higher than 70 degrees.
As for light, even the tiniest bit of light in the room can disrupt your internal clock and your pineal gland's production of melatonin and serotonin, hormones involved in your body’s circadian rhythm of sleep and wakefulness. So close your bedroom door, get rid of night-lights, and most importantly, cover your windows. I recommend using blackout shades or heavy, opaque drapes. Also cover up your clock if it has a lit display. Alternatively, you could wear an eye mask to block out any stray light.
• Turn off your gadgets well before bedtime. Again, the artificial glow from your TV, iPad, computer or smartphone can serve as a stimulus for keeping you awake well past your bedtime by disrupting melatonin production. I recommend turning off all electronic gadgets at least one hour before bed. As Rothstein suggests, that time is far better spent reading a good old fashioned book, practicing relaxation techniques or meditating.

Banish Afternoon Fatigue with Appropriate Diet and Lifestyle Changes

So remember, if you’re frequently battling with afternoon fatigue, check your lunch selections, first of all. More often than not, you’ll find that the more carb-heavy your lunch, the more apt you are to feel tired an hour or two later. To remedy the situation, focus on shifting your diet from carbs to healthful fats. Once your diet has been addressed, implementing intermittent fasting is an effective strategy for really shifting your body into fat-burning mode.

Just remember that proper nutrition becomes even MORE important when fasting, so I believe that addressing your diet is your first step. Always listen to your body, and go slowly ; work your way up to 16-18 hour fasts if your normal schedule has included multiple meals a day. Also be sure to address any hypoglycemic tendencies, such as headaches, weakness, tremors or irritability, as it can get increasingly dangerous the longer you go without eating to level out your blood sugar.

Once you’re fat adapted, your energy levels will remain fairly stable throughout the entire day, and you hunger cravings will virtually disappear. Exercise and sleep are also important factors, so experiment with your workout schedule to see what works best for you. Again, proper sleep can boost your exercise performance, and exercise in turn can help improve your sleep, forming a positive feedback loop.

 http://fitness.mercola.com/sites/fitness/archive/2013/09/13/afternoon-fatigue.aspx  Link back to Mercola.com website.

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The Source of Fatigue and Disease?

Hippocrates: a conventionalized image in a Roman "portrait" bust (19th century engraving) (Photo credit: Wikipedia)

By Dr. Mercola

This is my second interview with Dr. Daniel Kalish, who is an expert on hormone balance as a foundation for optimal health. In this interview, he shares some fascinating information about how you can balance the chemicals in your brain using functional medicine laboratory testing.

Dr. Kalish is successfully using this method, which he calls the “Kalish Method,” to treat five common health problems:

1. Overweight
2. Fatigue
3. Depression
4. Female hormone imbalance
5. Gastrointestinal problems

I first met Dr. Kalish in California in the mid-1990s while attending a Functional Medicine seminar. It was immediately clear to me that he was one of the brightest individuals at the meeting.

The area of hormone testing can be a bit confusing. The information presented here helps to clarify how hormone testing can be used to detect and correct imbalances in your brain’s chemistry that underlie many of the symptoms commonly experienced today. For a more comprehensive review of his work, you may want to check out his new book, entitled The Kalish Method: Healing the Body, Mapping the Mind.

Functional Medicine: The Kalish Method

Functional medicine is a relatively new approach to health that looks at the underlying causes of disease and attempts to correct them before disease sets in. It focuses on determining the root causes by looking at your entire body and environment. Dr. Kalish’s particular approach zeroes in on three systems of your body:

1. Brain/endocrine system, which govern your body’s processes through hormones, neurotransmitters, and other biochemical messengers (control center)
2. Digestive system and nutrition (intake)
3. Detoxification system (elimination)

He addresses each of these systems with specific laboratory tests, including saliva and urine. It’s a kind of “mind mapping” — essentially, taking a snapshot of the mind by measuring things such as the quantity of serotonin and dopamine going in and out of your neurons. This is just one of the many the tests that can be performed, and this particular urine test is cutting edge technology offered by only one lab in the United States.

The Kalish approach to health offers enormous advantages, one of which is a very rapid cessation of symptoms. Patients report improvement in how they feel usually within the first month — like a “switch has been flipped.” Even for those who have struggled with lifelong depression, dramatic results are usually seen within the first couple of months. This is largely because the precise cause of the problem has been nailed down through laboratory testing.

Another major advantage is that children can be helped very easily and quickly with functional medicine, which eliminates the need for medications about 95 percent of the time.

Picking Up Ball That Conventional Medicine Has Dropped

There are profound differences between functional medicine and conventional medicine. Conventional medicine aims at identifying life-threatening diseases, but ignores the realm of more subtle issues. For example, endocrinologists look for rare and unusual disorders like Addison’s disease — things that could kill you in a week or two if left untreated. If you don’t have one of the major diseases, their interest and expertise generally wanes.

By contrast, functional medicine looks at identifying and correcting imbalances and lifestyle issues that are eroding your health over time, reducing your quality of life, and predisposing you to the development of serious health problems down the road. In other words, functional medicine aims at preventing you from ever developing those major diseases in the first place.

According to Dr. Kalish:

“There is a predictable way that the body breaks down. It doesn’t happen in different ways in different people. We have hormone and brain problems, digestive problems, and toxicity problems. There’s a methodical way you can test and correct all these issues, if you get hooked up with the right group of doctors that know how to do all this. This technology is available. It’s not a question of whether it works or not. It’s just a matter of accessing it.”

Through various carefully selected laboratory tests, your body’s chemical and hormonal imbalances are identified. Problems with your gastrointestinal function may be detected, or with how your body cleanses and rids itself of toxins. With this information, then, specific strategies can be prescribed, such as diet and lifestyle modifications, supplements, or perhaps a different approach to managing your stress. Supplements are designed to be used short-term, therapeutically, in order to accomplish a specific goal.

Interventions Used in the Kalish Method

Based on what imbalances are identified by the laboratory analyses, Dr. Kalish may prescribe a variety of natural supplements, short-term. For example, low doses of the hormones cortisol, DHEA, and pregnenolone may be prescribed to replace what’s missing in your body — just enough to balance out your system. Sometimes, amino acids, vitamins and minerals, and herbs may be used — everything from B vitamins to magnesium, to tryptophan or 5-HTP.

These agents are used to temporarily assist your body’s natural hormone producing capacity and can be discontinued when your normal endocrine function has returned. It’s typical for adrenal function to be restored within six months to a year — and sometimes in just a few months. Dr. Kalish cautions against self-prescribing these supplement because you can easily make imbalances worse, if you don’t have all of the necessary information.

A key part of Dr. Kalish’s approach is helping his patients return to a more biologically appropriate diet rich in organic, biodynamically grown foods, similar to how your ancestors ate. He also recommends occasionally exposing yourself to cold, because it produces an environmental “shock” to stress the body (in a good way), similar to exercise, which stresses your body to make it stronger.

Poor Adrenal Function May Be the Cause of Chronic Fatigue

Your adrenal glands are each no bigger than a walnut and weigh less than a grape, yet are responsible for one of the most important functions in your body: managing your stress. When your adrenal glands are overtaxed, a condition known as adrenal fatigue or adrenal exhaustion sets in, which in turn can set a cascade of disease processes into motion. One tell-tale sign of adrenal burnout is feeling chronically fatigued.

Conventionally, you’d see an endocrinologist who would evaluate your adrenal glands, or perhaps a doctor of internal medicine. Unfortunately, they tend to primarily test for specific diseases like Addison’s disease or Cushing’s disease, both of which are relatively rare.

The Kalish Method calls for testing your adrenal function by taking four saliva (or urine) samples over the course of a day. This maps out your circadian rhythm, showing how your cortisol levels rise and fall throughout your day. Saliva is collected at approximately four-hour intervals: first thing in the morning upon waking, then at noon, late afternoon, and again at night before going to bed. The Kalish Method is aimed at normalizing dysfunctional adrenals and restoring normal adrenal function. It’s a clinically validated method that’s been used for a long time, yet most physicians are still not aware of it.

“What we find is that if we just restore what’s missing in the person for a period of six months or maybe at the most 12 months, the adrenal glands and the internal production of these hormones comes back,” Dr. Kalish explains. “So, we’re actually restoring the normal production of these hormones in the body. The treatments, therefore, are relatively short-term; six months to a year. The only way we’ve found to do this real repair process is to use these really low dosages of DHEA and pregnenolone over a period of time.”

Another common hormonal cause of adrenal fatigue is hypothyroidism or underactive thyroid. Thyroid function is diagnosed by a blood test, but there’s some controversy over what is normal and what’s not. Many alternative doctors feel the conventional reference ranges are far too broad, and opt to treat people exhibiting sub-clinical thyroid symptoms.

“What’s interesting about the thyroid and the adrenals is that as the cortisol levels go up, one of the normal body mechanisms is to downregulate thyroid,” Dr. Kalish says. “So, most everybody with high cortisol is going to have lower than ideal thyroid hormone levels. At that point, it becomes a decision as to if you want to work on the adrenals, work on thyroid, or work on both together...

More than 90 percent of the time, the adrenal program is enough to restore thyroid function. The biggest reason [for doing] the adrenals first is that when you start taking thyroid hormones your internal production of thyroid hormones drop. With the adrenal glands, it’s the opposite. When you start to take these adrenal-support products, your internal production of adrenal hormones comes back. If you can restore adrenal function, you can save the person from having to be on thyroid medications potentially for the rest of their life.”

For more specifics on Dr. Kalish’s treatment protocol for adrenal fatigue, please see my previous interview with Dr. Kalish on this topic.

How Functional Medicine Can Help You Lose Weight

Besides fatigue, weight gain  and depression are the most common issues Dr. Kalish sees, and all three respond very well to his approach. For example, one of the interesting things in terms of diet and weight loss is that, as soon as he gets people’s adrenal hormones and brain chemicals back in check, he notices them gravitating toward more healthful diets.

Why is this?

Many food cravings stem from inappropriate blood sugar responses and imbalanced serotonin and dopamine levels — which control how your neurons fire. Once these are corrected, cravings go away — usually within the first month or two. Your cravings come from brain chemicals. When those chemicals are shifted, the cravings just disappear — like hitting the Reset button. Then people begin making better food choices, start to lose weight, and have more energy because insulin sensitivity and normalleptin signaling are being restored.

The key lies in reversing the distortion in your appetite center and reestablishing your normal fat burning metabolism. Of course, the mechanism for reestablishing normal fat burning is diet and exercise, but if your brain chemistry perpetually prompts you toward making bad decisions, it will be a frustrating uphill battle. Functional medicine doesn’t take the place of diet and exercise — it augments it, making it easier for you to implement the changes needed without as much emotional stress.

Are Toxins Making You Depressed?

There is very little scientific evidence for the widespread notion that depression is caused by an imbalance of your neurotransmitters. In fact, there is no correlation between serotonin level and depression. Many people with low serotonin are not depressed, and many depressed people have normal levels of serotonin. The same is true of dopamine.

However, there is good scientific evidence for a relationship between depression and environmental toxins. Toxins make their way to your brain, where they damage cells and change how your neurons fire. Being that toxins are commonplace in today’s world, part of functional medicine involves identifying environmental toxins that could be damaging your brain and contributing to mood problems, Parkinson’s, dementia, and a multitude of other diseases. We’re all exposed to these chemicals to some degree because they’re pervasive in our environment — in your air, food and water.

According to Dr. Kalish, some of the most significant environmental toxins are heavy metals, such as mercury, arsenic andaluminum. Also problematic are chemicals like benzene and toluene.

It is estimated that the average American now has between 300 and 400 different neurotoxins circulating in his or her body at any one time. Even newborn babies are now born with some level of neurotoxic chemicals on board. Your body isn’t equipped to break these down, so they tend to accumulate over time and dysregulate your biochemistry. Making matters worse, many if not most people have dysbiosis, or imbalanced gut flora, and some of these microorganisms are responsible for breaking down the toxins in your GI tract, so you can eliminate them. All of these problems contribute to today’s toxic overload.

Functional Medicine — A Valuable Tool to Help Restore Your Health

The Kalish Method is a proven method of treating problems such as overweight, fatigue, depression, hormonal imbalance and gastrointestinal dysfunction using the principles of functional medicine. A treatment is most effective when the root cause of your problem is directly addressed.

Dr. Kalish starts with specific laboratory tests that pin down the underlying cause. These tests help to determine whether your problem stems from your brain, adrenal glands or your gut, or if it’s a malfunction in your body’s detoxification process. Whatever the cause, the problem can be effectively addressed using targeted dietary changes, supplements, sleep hygiene, stress management tools and other natural interventions.

Functional medicine can be a valuable tool to help you restore your natural physiological balance. Dr. Kalish has worked with more than 8,000 patients, and every day, he sees “magical” health improvements by applying the same fundamental principles. For more information, you can visit his website, KalishInstitute.com, which details his innovative approach to functional medicine.

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