When we think about the menstrual cycle and female reproductive hormones, we often limit our thinking to the ovaries and the uterus.  After all, those of us who went through high school were at a minimum imparted with the basic knowledge about these reproductive organs: the ovaries release an egg during ovulation and if its not fertilized by sperm, the uterine lining sheds every month, leading to menstruation.

Bada Bing Bada Boom…Sex Ed 101.

What we weren’t taught though, is that a woman’s menstrual cycle is considered her “5^th Vital Sign”—meaning it acts as a measure of her vitality and overall health, in all stages of her life--from adolescence throughout adulthood.

Your menstrual cycle acts very much like a canary in the coal mine: an irregular menstrual cycle is frequently the first signal that there’s an imbalance somewhere else in the endocrine system.

It’s All Connected

Your menstrual cycle is not just regulated by your ovaries, it’s also influenced by your:

• Hypothalamus and pituitary gland in the brain
• Thyroid
• Adrenal glands
• Pancreas
• Liver
• Gut

Each of these organs and glands secrete their own unique hormones and work together to create balance in your body and sustain numerous functions necessary for you to live. Hormones are simply chemical messengers that communicate with our cells and with each other, and a disturbance in one can lead to a disturbance in another. By addressing one imbalance, we can often improve another.

Even so, many women spend years coping with symptoms like irregular or painful periods, heavy bleeding, fibroids, yeast infections or fatigue and depression that then develop into more serious health issues. These women often feel disconnected to their bodies and surrender to the mistaken belief that because they’re female they’re doomed to monthly suffering- becoming passive observers in a body that feels like it’s irrational, unruly and untrustworthy. When they seek answers, they’re frequently told their out-of-control body must be tamed by drugs or surgery.

A hysterectomy is the second most common surgery performed on women in the United States, with a c-section being #1.

It doesn’t have to be this way.

You can connect with your body and tap into its inner wisdom and rhythms, and you can bring your hormones into balance.

The First Step to Connecting with Your Body

In order to connect with your body, you first need to understand how it works—and you don’t need a medical degree to do so. Let’s start with the Menstrual Cycle, your 5^th Vital Sign.

The Menstrual Cycle

DAYS 1-14: The Follicular Phase

The first full day of menstrual bleeding is considered Day 1 of a woman’s menstrual cycle, and days 1-14 are considered the follicular phase. During this phase, GnRH, or Gonadoatropin Releasing hormone is released from the Hypothalamus, signaling to the pituitary gland to release a hormone called FSH, or Follicle Stimulating Hormone. FSH is sent to the ovaries in slow pulses and stimulates the follicles of the ovaries to grow and prepare to release an egg. When the follicles grow, they make estrogen, and over the 14 days estrogen slowly increases.

DAYS 14-28: The Luteal Phase

Right around Day 14, estrogen surges and the pituitary gland switches to releasing Luteinizing Hormone, or LH. The estrogen surge in turn causes a surge of LH, which triggers progesterone production to increase and estrogen production to decrease. Ovulation typically occurs around this time as well, as the LH surge prompts the ovary to release an egg around 18-36 hours later. If a woman becomes pregnant, progesterone will continue to be produced until the end of the 1^st trimester when the placenta can make it on its own. If pregnancy does not occur, progesterone production ceases and bleeding begins—commencing menstruation.

When the Canary Sings: an irregular menstrual cycle

I mentioned multiple times that an imbalance in one part of the body can cause an imbalance in another. One example of this is your blood sugar, which is kept under control by your liver and your pancreas. High blood sugar can directly impact the body’s production of LH, the luteinizing hormone that is secreted during the second half of the menstrual cycle. Women with diabetes can experience secondary symptoms like long, irregular or inconsistent menstrual cycles, spotting between cycles or heavy blood flow, due to insulin and high blood sugar’s effects on LH, FSH, androgens and gonadotrophin levels. Nearly 30% of women with Type 2 Diabetes suffer from menstrual disturbances during their reproductive years.

Balancing blood sugar is just one way to improve these disturbances.

In addition to disorders within the endocrine system, menstrual irregularities can be brought on by stress, diet, lifestyle factors and our environment, which can lead to troubling symptoms indicating hormone imbalances, like estrogen dominance.

Reclaim Balance and Vitality

You don’t have to suffer.

You can learn to interpret the signals your body is sending you.

You can learn how to regulate your periods.

You can alleviate your PMS.

You can improve your fertility.

You can enhance your libido.

You can experience more energy and vitality, and learn tools and lifestyle shifts so you can flourish in a world that is designed to assault your endocrine system and leave you exhausted, disconnected and dysregulated.

It’s my job to partner with you and teach you how to do that, with an approach uniquely customized just for you. Learn more about my approach here, or to book a discovery call with myself or a member of my team, fill out my contact form.

Have you ever been told this?

“Your labs came back normal. We’re not seeing anything wrong.”

This is often a BIG source of frustration for many of my patients, because they’re left without answers, feel like they’re crazy and at a dead end when it comes to getting the care they need.

If this has happened to you, you’re not crazy, and...

A normal lab result doesn’t tell your whole story.

This is especially true when it comes to testing hormone levels in the blood. Your hormone health is more than a number on a page and that number doesn’t always explain why you feel like garbage.

You can have “normal” labs and still feel awful.

Our hormones are quite complex and are interwoven with other systems in the body. It’s like a spider web: when you tug on one part of it, the whole web is affected.

When assessing hormone health, it’s important to do more than just look at standard lab tests. That’s why I use an approach that considers the whole person.

Because you ARE a whole person, right?

My approach looks at PTSD…and no, it’s not that PTSD. It has to do with the

Production, Transport, Sensitivity, and Detoxification of your hormones.

Production considers what could be affecting the gland that makes the hormone, and also asks:

Do you have enough raw material to make the hormone? For example, many of your hormones are made from cholesterol, and while a ton of emphasis is placed on the risks of having too much cholesterol, you still need enough to be able to make adequate progesterone, DHEA, testosterone, estrogen and cortisol. Some endurance athletes or individuals who are undernourished may not make enough cholesterol required to make adequate hormones, which can lead to hormone deficiencies.

Transport (+ conversion + interactions) asks: Is this hormone being properly transported to where it needs to be in the body? Your body makes special proteins whose jobs are to transport hormones throughout the body. One of these is called Sex Hormone Binding Globulin, (SHBG). I like to think of transporters like SHGB as taxis in the body, picking up and dropping off hormones at their destinations.

Having too many or not enough of these taxis can affect how a hormone acts in the body. When a hormone is being taxied around by SHBG, it’s bound to it, making it inactive until it’s “dropped off” to where its needed, where it then becomes active and does its job. Too much SHBG and the hormone’s activity is diminished, too little and you can have excess hormones hanging out in the bloodstream, allowing them to be freely active and interacting with your cells and other hormones.

The “T” in PTSD also asks, How does this hormone interact with other hormones and vice versa? Does this hormone need to be converted to a different form before the body can use it? How is that impacted? An example here is your thyroid hormones. Your thyroid gland releases a hormone known as thyroxine(T4), which needs to be converted to triiodothyronine (T3), the active thyroid hormone used by your cells. Things like stress, nutrient deficiencies, poor gut or liver health and blood sugar issues can affect this conversion.

Sensitivity asks: How are your cells responding to messages they receive from your hormones? Very often we can improve our cells’ sensitivity to the signals they receive from our hormones with nutrition and lifestyle changes. Exercise is one example. Exercise, especially cardio, can improve your cells’ response to insulin and can be one effective tool for helping balance blood sugar in people with insulin resistance.

Detoxification asks: How well is your body able to get rid of excess hormones? This primarily involves looking at the health of your gut and liver, who are the heavy hitters when it comes to eliminating excess hormones from the body.

A hormone imbalance is often a response to an imbalance somewhere else in the body, and when you address one imbalance, you can improve the other.

By looking beyond a “normal” lab result and asking these PTSD questions, I help patients get to the root cause of their symptoms, and provide them with a personalized plan so that they can get back their vitality and feel like their best self again.

Does any of this sound familiar to you? Do you feel like "garbage" but don't know why?

Contact me for a complimentary discovery call and start your journey to better health and well-being!

If plain old everyday life makes it hard for you to stay on track with your health and nutrition goals, you’re not alone. I have the same challenges.

There’s a scripture that says “Little foxes spoil the vine”.* One of its applications, is that it’s often not the big things that take us out, it’s the little, unattended to things, like distractions or details. These “little foxes” can keep us from bearing fruit with our efforts.

Here are two of my own personal hacks I use to round up these little foxes to reduce stress, stay on track with my nutrition, and keep myself from feeling pulled in multiple directions. I hope they help you too.

Stress-Less Planning:

Sometimes when we fail at something, it’s not because we lack motivation or willpower, it’s because we fail to plan ahead. One of my personal hacks is to use a VERY organized “To Do” list. I organize my To-Do list by breaking it up into different categories:

• Home
• Work
• Kids
• Emails & Calls
• Errands
• Meals
• Husband (Yes, I have a category for my husband—communication and making time for each other are everything.)

By breaking down my To-Do list into categories, I can plan my days better and block schedule—meaning I block out certain chunks of time for each category on the list. So, instead of being at the mercy of every email that hits my inbox all throughout the day, I have certain times I’ve blocked out to answer most emails.

2. Five Core meals:    

Staying on track with your nutrition also involves planning. Each week I look at our family schedule and plan our meals for the week. I also designate some nights of the week for certain meals I know my family loves (Hola Taco Tuesday!), and I know that every Sunday I’m going to make a big meal, which I can use to make leftovers with during the week. This also saves money on groceries and helps prevent the buying of impulse items. For me, that means any snack that’s dill pickle flavored!

One hack I use with my patients who either have severe gastrointestinal concerns or those patients for whom finding the time to cook is difficult, is what I call “5 Core Meals”. Core meals are those meals that you know fall within your personalized nutrition guidelines, are easy to throw together, and that you actually enjoy.

The hack here is to always keep the ingredients on hand to make any of these 5 Core Meals. This can be super helpful when you’ve had a stressful, busy day and you’re tempted to order out or grab something that you know is not good for you. For some meals, you can even batch cook and freeze the extra to pull out when you need them.            

These planning hacks can help reduce the feeling of overwhelm and keep you from getting derailed by a crazy day.

*Scripture reference:

It has been estimated that 20% of the population reports being affected by adverse reactions to certain foods. Because many individuals, (even medical professionals) may confuse or use the terms food allergy, food intolerance and food sensitivity interchangeably, I’m going to take a quick minute to define the difference.

Food Allergies vs. Food Intolerances

Simply put, food allergies stimulate an immune response that creates immediate symptoms, often within 30 minutes to 2 hours, where food intolerances may not show up for hours and are not driven by the immune system. Confusion happens when the allergies and intolerances have symptoms that overlap.

Example: Cow's Milk Allergy vs. Lactose Intolerance

A cow’s milk allergy is an allergy to the protein found in milk. It can cause gastrointestinal symptoms of abdominal pain, nausea, vomiting, diarrhea and blood or mucus in stools. It can also cause oral symptoms like swelling of the lips and tongue, and symptoms outside the GI tract, like respiratory symptoms, skin rashes or eczema and even anaphylaxis.

Lactose intolerance refers to a condition that results in symptoms occurring after ingestion of foods containing lactose - the main digestible carbohydrate (sugar) found in milk and other dairy products. A person with lactose intolerance does not produce enough lactase, an enzyme found in the small intestine responsible for digesting lactose. When lactose is unable to be digested, gut bacteria go to town feeding on it (gut bacteria LOVE carbohydrates!) and ferment it. Fermentation creates gas, which then produces abdominal pain, bloating, nausea, flatulence and diarrhea.[i]

Because both lactose intolerance and milk allergy may display overlapping symptoms of abdominal pain, diarrhea and nausea, lactose intolerance can be mislabeled as a “milk allergy”. It is important to know the clear distinctions between the two conditions, however, and the different approaches to management.

First, as I mentioned, a true milk allergy creates an immune response, where a lactose intolerance does not involve the immune system—it is simply an enzyme deficiency.

Secondly, a milk allergy generally occurs in the first year of life and can lead to malabsorption and poor weight gain. The onset of symptoms with lactose intolerance most often occurs around 5-6 years of age, however different health conditions can set the stage for enzyme deficiency later in life.

The exception to this is when we see lactose intolerance in premature infants. The intestinal cells that express the enzyme lactase are formed in the third trimester, so infants born in the second trimester may experience what is called developmental lactose intolerance; frequently detected in the first few days after birth when they begin breastfeeding or consume formula containing lactose.

Treatment also differs for a milk allergy versus lactose intolerance. With a milk allergy, complete removal of any foods containing cow’s milk is necessary, while treatment for lactose intolerance is simply a low/no lactose diet or supplementation with lactase.

Food Sensitivities

That leads us to food sensitivities, a term that refers to adverse reactions to food that may involve gastrointestinal symptoms but can also include numerous other symptoms, including neurological, respiratory or musculoskeletal symptoms, behavioral and psychological symptoms, skin concerns, fatigue and headaches or migraines. That’s a BIG list!

Rather than being immediate, reactions in food sensitivities can occur hours or days later and can persist for days. Because of their delayed onset and the fact that they can share symptoms with other medical conditions, food sensitivities can be overlooked, difficult to diagnose or be misdiagnosed.

To add more to the mix, the terms food sensitivities and food intolerances are sometimes used interchangeably, as seen with the verbiage gluten intolerance or gluten sensitivity, or histamine intolerance.

Another kicker? If we go back to lactose intolerance for a second, symptoms seen in a simple lactose intolerance can vary widely between individuals and sometimes show up not only as the tell-tale gastrointestinal symptoms but also extraintestinally as headaches, vertigo, difficulty with memory and fatigue–very much like symptoms that may be seen in a sensitivity.

Testing

The diagnostic tests used to confirm a food allergy are different than those used to confirm a food intolerance or sensitivity. If your physician suspects a true food allergy, he or she will likely order a blood test to measure levels of the antibody immunoglobulin E, or IgE, which is produced in high amounts when the body has an allergic response to a food.

A second method of narrowing down food allergies is the skin prick test. For suspected lactose intolerance, a simple breath test is used to confirm a diagnosis.

Even though a food sensitivity can produce a myriad of symptoms, it is not considered an official diagnosis.

Testing for Antibodies Called IgG, IgA or IgM

In spite of this, testing does exist, and some companies offer diagnostic tests that look for other antibodies called IgG, IgA or IgM. My caution against relying heavily on these tests is that the body can produce some of these antibodies (especially IgG) upon simple exposure to a food. Presence of the antibodies does not necessarily indicate a sensitivity to that food. These tests can produce false-positive and false-negative results and I have yet to see consistent clinical results that support their reliability.

Even though results are not always consistent some practitioners will use these tests to stay out of the weeds and avoid the long road of a guessing game. Some of the tests rank a person’s sensitivity to a particular food by color—red (high sensitivity), yellow (moderate to mild sensitivity) and green (little to no sensitivity). Avoiding foods in the red may be a good starting point for some patients.

The "Gold Standard" to Determine Possible Food Sensitivities

The “gold standard” to determine possible food sensitivities, however, is not an expensive test at all. It is simply 100% elimination of a suspected food.

All sources of a suspect food or ingredient are avoided for a period of time and then reintroduced. For example: If dairy is the suspected culprit, all sources of dairy would be removed from the diet for approximately 4-6 weeks. After the elimination period, the person then “challenges” the body by loading up on dairy by having 3-4 servings of it in one 24-hour period, and then monitoring the response in their body over the next 3-5 days.

Completely eliminating a common food is often difficult for most people as it takes planning and seeking out alternate foods. When my patients are in the elimination phase, I encourage them to track their food intake and monitor their energy, mood, sleep and other symptoms they came to me with. Sometimes the changes are profound, sometimes they are small and incremental as the body begins to heal from no longer being insulted by the offending food. The keys are to totally eliminate a food (no cheating) and track your symptoms. If you cheat, you have to start all over again.

It may be challenging, but the discovery of your body’s relationship to a particular food can be life-changing and a big step toward healing and wellness.

If you feel that you have food allergies, food sensitivies or food intolerances, but don't know where to start, contact me for a consultation.

[i]Di Costanzo M and Canani RB. Lactose Intolerance: Common Misunderstandings.  Ann Nutr Metab.  2018. Suppl 4: 30-37. Doi: 10.1150/000493669.

It’s the first Mental Health Monday in June and the sun is shining.  Does anyone else notice that they start to hear their coworkers around lunchtime remark, “I’m going outside to soak up some Vitamin D.”?

Speaking of that, 

• When is the last time you had your vitamin D levels checked?  Were you told they were fine?  
• What does fine mean, anyway?  

First, we need to understand the ranges used to determine what is “normal." Most labs still use the vitamin D ranges that were established decades ago, when rickets was a concern.  Rickets is a weakening and softening of bones that develops with severe and long-term vitamin D deficiency. 

Understanding the Vitamin D Numbers

Vitamin D deficiency has been defined by the Institute of Medicine and the Endocrine Society as having a level of serum vitamin D (25−hydroxy) less than 20 ng/mL. Vitamin D insufficiency was defined as a level between 21 and 29 ng/mL. So according to these ranges, anything above 29 ng/mL is “normal”.  Or fine.  This means you’re out of the woods when it comes to rickets. This does not mean, however, that your levels are adequate enough to benefit from all of the other functions of vitamin D.

Vitamin D is not only important for maintaining calcium and phosphorous levels for bone health, but also for brain health, maintaining estrogen levels, supporting tissues and organs, preventing muscle pain, regulating blood pressure, protecting against autoimmune disease and certain cancers, along with preventing psoriasis and numerous other benefits.

Vitamin D is Important for Your Mental Wellness

Study after study has shown an association between low vitamin D levels and depression. Depression in adolescents, depression in adults, depression in the elderly and depression in postpartum moms.  Multiple studies have also shown improving patients’ vitamin D levels can drastically improve depression symptoms.  

The takeaway?  Don’t just accept the answer that your vitamin D levels are “normal”  or “fine”. Ask for the number. The sweet spot for capturing all the benefits of vitamin D is 60 ng/mL. 

Sunscreen and Vitamin D 

And what about all the fuss about sunscreen or no sunscreen to improve your vitamin D absorption?

All you need is 15-20 minutes per day of non-sunscreen sun exposure on your face and arms to maximize your ability to make vitamin D.  Those of us up here north of Boston need to check our levels in October and May, as any vitamin D stores we have built up over the summer get depleted in the winter. During our winters the sun is not strong enough for us to manufacture vitamin D via our skin.

Your Diet and Vitamin D

Healthy sources of vitamin D can also be obtained through the diet. My favorite healthy sources are fatty fish like salmon, cod liver oil, herring and sardines. Egg yolks from chickens allowed to roam and naturally forage are also high in vitamin D.

What If Supplements Aren't Improving Your Vitamin D Number

If you’ve been supplementing with vitamin D for 8 weeks or more and your levels aren’t budging, a number of things can be at play including malabsorption or a genetic variation that affects vitamin D’s ability to be utilized by the vitamin D receptors on cells. Standard testing of 25-hydroxy will tell you your vitamin D serum levels, but further testing can reveal the activity of vitamin D in its active hormone state, known as 1,25 hydroxyvitamin D.

I always remind patients that optimal nutrition is not just what we eat or supplement with, it is also how well our body breaks down, absorbs, utilizes and eliminates what we eat. These factors need to be considered when assessing vitamin D levels and patient need. So even though summer is right around the corner, knowing your vitamin D levels is still important.

If you or your child have an issue with vitamin D levels or are unsure about how much and for how long to supplement, I can help. Contact me to request a consultation.

“Don’t compare your inside with someone else’s outside”.

Today I want to talk about that comparison narrative.

Even with the years I’ve been in practice I confess there are times I am surprised when a woman confides in me that she struggles with anxiety or depression.

A couple of months ago a woman I have known for years told me she struggles with depression and unrelenting worry that keeps her up at night. This is a woman who is known by mutual friends to be thoughtful, funny, positive and an encourager. Her outside does not tell anyone what is going on inside.

Shortly after that, a smart, sassy businesswoman I admire confided in me that she has struggled with anxiety and depression for years. She is a mover and a shaker in her industry and is always perfectly coiffed and impeccably dressed. Her outside doesn’t tell any of the story of what is going on inside.

Then today I reconnected with a woman whom I haven’t seen in over a decade. Our kids were in activities together as toddlers. She was always the funny one–quick to insert a joke and laid back. I envied that she always seemed a lot more relaxed about being a new mom than I was. Today she told me the story of her years of debilitating panic attacks and anxiety that jolts her out of sleep at night. Some of her worst years were during the time we knew each other. Her happy, lighthearted demeanor on the outside tells nothing about the grip anxiety has on her inside.

These kinds of encounters happen to me at least weekly.

I can relate to all of these women. I was 14 when the panic attacks started. At first, I thought I was dying. Then I thought I was going crazy. I obsessively checked my pulse because I thought I was having a heart attack. A year or two later the intrusive, irrational thoughts started. At 16, I suffered silently with a heavy weight of shame and told no one about the fearful thoughts I was having. I thought if anyone knew my fears and horrible thoughts they would think I was a terrible person. Everyone’s outsides told me they were fine and I was not.

Yet I was also in the drama club, played softball, ran track and was on the swim team. I was class president and my grades were among the top 10 percent of my class. On the outside I was ambitious, athletic and looked like I had it all going for me. On the inside I felt like I was a collection of jagged, shattered pieces held precariously together, that with one wrong move would crumble to the floor and everyone would know who I was for real: a person with terrible thoughts who might lose control and go crazy at any moment. With the looping thoughts and freight train of panic and anxiety that followed them I felt like I was at constant war with my brain. It was exhausting.

I told no one about the intrusive thoughts until almost twelve years later when the fear and anxiety had its claws in so deep I couldn’t even function normally anymore. Most days I was even too afraid to eat, and still not sleeping. I finally confided in the amazing man who is now my husband and he encouraged me to get help. At age 29, I was diagnosed with Obsessive Compulsive Disorder. Even that scared the daylights out of me. But that day was the turning point. That was the day I began the journey to overcoming. I worked and worked and worked to get better. For years. It was scary and hard and there were days I thought dying would be easier. Over time though, faith, a supportive husband, proper nutrition, exercise, a great therapist and TONS of personal development became part of my wellness toolkit. I believe that God works everything out for good, and my story is a testimony to that.

Anxiety and OCD no longer have any power over me. You know what else has lost its power? Shame. Up until today, there have only been about 5 people who knew this story. Now it’s public, and it is an important part of my mission to help others who feel like they are broken.

There is no obvious “face” or look to anxiety or depression. There is nothing on the outside that reveals the struggle inside. Those of us who battle those conditions are excellent pretenders.

You too can be an overcomer. Know that you are anything but alone and that there are other tools you can add to your toolkit to help you get better.

Some of the most important steps to overcoming are to refuse to give the shame any territory and stop listening to the comparison narrative.

If you are struggling with anxiety or depression and are ready to take positive steps toward a more healthy and satisfying life, contact me for a consultation.

This past year has been a doozy.

We’ve been required to pivot in how our children are schooled, how we do our work, how we socialize, and how we do life—all while being expected to maintain the same level of productivity and presence. 

Many of us have had even more responsibility packed into an already overpacked schedule.  The well-meaning encouragement from some sources to “Do more during the pandemic—learn something!  Become something!  Now is the time!”, can easily be translated into even more pressure.

The impact of these multiple stressors has been enormous.

If you follow me on Instagram, you know that in honor of Stress Awareness month I posted about the damaging effects of stress and its partner in crime, cortisol. 

This post explores the answer to the question: “When is too much stress too much?”

You see, even though the impact of stress is unique to each person, there are concrete signs that your body’s ability to adapt, respond and recover from stress has reached exhaustion. 

Let’s talk about what that looks like. 

Your Stress System

You may have heard burnout referred to as adrenal fatigue, as the adrenal glands are responsible for pumping out cortisol and other hormones in response to stress. 

But this is an oversimplification of everything that’s really happening. Stress is actually handled by something called the HPA Axis, which represents complex communication between the:

• H=Hypothalamus gland
• P= Pituitary gland
• A= Adrenal glands

Not only do these glands in the HPA axis work together when we are under stress, but they also talk to our brain and regulate a number of other things including our:

• Hormones
• Mood and emotions
• Digestion
• Immune function
• Blood sugar
• Cardiovascular system
• Central nervous system

Each person’s capacity for stress is different and the body’s daily process of adapting to and repairing from its stress load is called allostasis.  

The cumulative wear and tear on your body from chronic stress is known as your allostatic load.

When that load of chronic stress becomes too much for your body to bear, you reach what is known as allostatic overload. This means you pay a price--physically, mentally, and emotionally. 

Allostatic overload causes dysregulation of the HPA axis and leads to chronic illness.  

The 3 Stages of Stress

How your body is doing at responding to your “load” of stress and how close you are to overload, can be defined by the signs and symptoms seen in the 3 stages of stress response.

These three stages of stress response are known as the General Adaptation Syndrome, and were first defined by Hans Selye MD, the “The Father of Stress” back in 1950.

Stage 1: Alarm

This is the early stage of stress, otherwise known as acute stress. This stress tends to be short-term, like during final exams week, moving, changing jobs, a work project, the holidays, dealing with a short-lived issue, etc. 

In this stage, your body is on high alert, in what we call the “fight or flight” response. Here you have high levels of stress and you may feel keyed up, anxious, or agitated. Energy-wise you may be a little tired but also wired, and your mind races when you try to sleep. 

You may feel like you have a burst of energy (adrenaline) to tackle the stress in front of you. Fatigue is not generally a concern.

In the alarm stage, your pulse is higher and your cortisol, blood pressure and blood sugar are also elevated.

Stage 2: Resistance

The resistance stage is when your body is hard at work trying to bring all those physiological responses from the short-term stress (blood sugar, heart rate, blood pressure) back to normal and maintain homeostasis. In other words, your body is trying to mitigate or repair any potential damage done by the stress.  

This can be harder for the body to do if the stress is prolonged or new stressors are added—because it still needs to be in fight or flight mode.  

In this stage, your serotonin levels are declining and you may find you are more moody or irritable, having some difficulty concentrating and feeling your energy levels dropping. 

If stress is persistent, you may have a hard time relaxing or shutting off that feeling of stress. Cortisol levels may be normal or fluctuating in this stage, however, inflammatory markers are elevated and your immune system begins to be affected. 

You may be catching every cold that’s going around, recovery from exercise is taking longer and you are feeling tired all the time.  

Stage 3: Exhaustion—aka BURNOUT.

This is a stage of depletion. In this phase, your HPA axis has become dysregulated and has lost its ability to adequately respond to stress. You’re not just fatigued, you’re exhausted, and you may be very tired in the late afternoon or evening. 

Patients will tell me they are so tired they could go to bed as soon as they come home from work, or that they often nap or fall asleep on the couch in the early evening.

In this phase, sleep issues are more frequent, with difficulty falling asleep or staying asleep. You may wake up at 4 am with your heart racing and you can’t get back to sleep, or even when you do sleep 9 or 10 hours you don’t feel rested when you wake in the morning. 

Patients in this stage also complain of more aches and pains, new illnesses, as well a feeling of indifference to the things that normally bring them joy.

Anxiety, depression, obsessive-compulsiveness, or panic attacks may be more pronounced.

There’s also an inability to handle small stressors—your emotional and physical response to little things is inflated. Everything stresses you out and everything is a chore.  

In this phase, exercise exhausts you and you may be seeing weight gain around your midsection. You feel run down and depleted.

And your libido? 

...what libido?

This late stage of stress is also reflected in low serotonin levels, low levels of stress hormones and sometimes low blood pressure. Magnesium, B vitamins, zinc, and vitamin C--those nutrients that are required for vitality and a healthy stress response are also depleted.

The effects of stress are cumulative and can persist for years, affecting many, if not all of the body systems I talked about earlier.

If any of these stages of stress sound like you, there are things you can do to help your body recover and heal, as well as build up resilience to stress.

Check back here and on my Instagram page.  I’ll be talking about lifestyle changes, nutrition, supplements and herbs that I recommend so you can get your energy, vibrancy, calm, and most importantly YOU back.

What I do every day goes far beyond just nutrition. As I listen to the stories of my patients with anxiety or other mental health concerns, what almost always emerges is a desperate need for spiritual and soul care. Today I’m going to talk about soul care.

When I ask a female patient a few gentle questions about how she is doing at making room for soul care, she almost always falls silent. In that silence, I wait, giving her time to collect herself behind the flood of tears that follow. My friends, there is a lot at stake when we ignore our soul’s need to be fed.

Soul care is what makes you feel alive. It’s whatever puts distance between you and the burden you are carrying so you can get some perspective. Soul care makes room for us to remember that we do not exist on this earth to simply be the sum of a To-Do list in human form.  It allows us to lay aside every weight and allows light to shine in the corners where the true expression of who we are–beyond someone’s mother, wife, or demands, waits. It waits for us, sometimes quietly and sometimes screaming.

In my own 30+ year journey with anxiety, the most important thing I’ve learned is that anxiety is a message, and most often a message that there is something in our life that needs attention. Sometimes the message is that we’ve been ignoring our inner voice for far too long. For me, when anxiety wakes me up at night, I’ve learned it is usually a message that God has his finger on something in my life that He wants to draw my attention to, give me His guidance, His perspective, and His peace. Other times it is a message from that other part of us longing to be expressed—for me it’s the free spirit, the writer, the adventurer and the nature girl suffocating in suburbia who needs some distance.

My husband has also come to recognize the benefits of my own personal soul care: it keeps me from ripping his face off. I’m kidding. Sort of.

Now I must ask, when is the last time you expressed that longing in you? When is the last time you paid attention to that small voice whispering to you to press in, get some distance or come alive? The longer we ignore her the more likely the whisper will manifest as a shout in our psyche or physical body.

In that regard, sometimes anxiety has a message related to our physical health. Anxiety can be a symptom of hormone imbalance, a problem with our thyroid and can be an indicator that our stress response system, the HPA axis (Hypothalamus-Pituitary-Adrenal axis) in our body is dysregulated and needs some attention. The integrity of our intestinal barrier along with multiple nutrient deficiencies have also been associated with anxiety.

When I work with patients, I teach about the functional nutrition side of anxiety--and how hormones, thyroid dysfunction, the HPA axis and the gut are all players. Soul care can influence all of these.

Here are some practical ways to fit soul care into your own life—especially during those seasons when your To-Do list has too many Must-Do’s:

1. Give yourself some margin: What wears us out and causes unnecessary stress is when, A. We underestimate the time it takes to complete a task from start to finish,  B. We don’t give ourselves or kids enough time to get ready and get somewhere, and C. We pack our schedule so full we don’t allow enough transition time between events in our schedule. Take the “hurry up” syndrome out by giving yourself a margin of an extra 10-15 minutes for and between things. It can do wonders for your stress level.
2. Seek 5-10 minutes of complete silence every day and just breathe. On some days, the only way I get this is by sitting in my car. In my garage. This is attempted when I’ve come home from somewhere and everyone else is already home. It usually works until someone realizes the garage door opened 48 seconds ago and mom hasn’t come in the house yet.
3. Be present. This means put the phone down.
4. Whatever makes you feel alive, schedule it. Then do it. If it’s coffee with a girlfriend while your kids are at sports practice, do it. (The grocery shopping can wait.) If it’s an hour at a café where you can actually read a magazine cover-to-cover and drink a cup of coffee before it gets cold, do it. Need some distance? Get it.

Our intestinal barrier protects our inner world from the outer world. It is our body’s first line of defense and is home to seventy percent of our immune system. This barrier can be injured through multiple avenues, including poor food choices, stress, pharmaceuticals, environmental exposures and more. An injured gut is a leaky gut, and a leaky gut allows unwanted invaders into the bloodstream, having detrimental effects on our entire body.

While there are advanced and costly tests as well as GI symptoms that can detect a leaky gut--the gut is the gateway to our systemic health.

This means just about any chronic condition can be linked back to a leaky gut: diabetes, cardiovascular disease, skin issues, autoimmune disorders, obesity, hormone imbalance...even our mental health.

In almost all my patients, healing the gut is usually at the top of the list. 

There are dishes to be done.

Floors to be vacuumed, laundry to be folded.

Articles to read, blogs to be written and emails to send.

Workouts to complete, patients to prepare for...

and all things mom, wife, friend and holiday-related to tend to.

Yet this is my current situation. Day 3 of snuggling on the couch with a sick little one who only wants his mama.

Even though my list of tasks has been temporarily suspended, its magnetic force still pulls me.  I’ll confess that around day two I started to get a little grumpy. I’m not one to sit still for very long and my present state of unsatisfied addiction to tackling my "To Do" list made me restless and irritable. I began fixing my thoughts on how hard it is to grow a business, accomplish goals, have a social life and do just about anything when you are a mom. I started getting jealous of my husband’s freedom to just go to work when he needed to, for as long as he needed to and everything else that comes with being a “man”.

Then I thought about the alternative. You see, I don’t have a boss. I AM the boss. If I had a boss, I would have to ask permission to take three work days off to be with my sick child. I also don’t have the heart-wrench a single mom might have, being torn between staying home when her child is sick versus needing to pay the bills. (You all are my heroes.) I also thought about the other alternative: a chronically ill child. In my focus on my own temporary inconvenience, I needed a sharp reminder that some parents endure the heartbreak of a chronically ill child and what I consider a difficult few days is their normal for weeks or months on end. Oh, Father forgive me.

Grumpiness turned to gratitude.

In addition, setting aside my internal rantings about gender bias and my husband’s “freedom”, I remembered that if I didn’t have a husband who got up every day to go to work even when he didn’t feel like it, I wouldn’t have the lifestyle that I have and the financial freedom to pursue God’s calling on my life—or the blessing of being able to respond to my three-year-old’s need for his mama. Oh, and guess what? My husband misses the kids terribly when he’s at work.

I used to listen to (and commiserate with) my female colleagues about men, husbands in particular, and how they don’t “get it”, and how they don’t know what it’s like to be a mom, do everything we do AND work, run a business, etc.

Then I accepted the reality: they’re not supposed to. They’re men.

Just like I will never understand what it’s like to be a man. I will never understand the pressures society places on them. Or what it’s like to be a father, businessman or husband. I’m not supposed to, I’m a woman. I’m not sure about you, but that frees me up from a lot of internal grumbling and misplaced expectations of my husband or male colleagues. That doesn’t mean we don’t have conversations to increase understanding, it just means we need to think about where we spend our mental energy and focus on what empowers us, not the opposite.

One of my personal mantras is: Think about what you CAN do, not what you can’t do. When life does not follow your meticulous plan do you find yourself in a downward spiral of negativity and a list of "can’t do’s" like I did?

Something that helped pull me out of this spiral was remembering God’s advice on the subject:

Summing it all up, friends, I’d say you’ll do best by filling your minds and meditating on things true, noble, reputable, authentic, compelling, gracious—the best, not the worst; the beautiful, not the ugly; things to praise, not things to curse.

- Philippians 4:8 (MSG)

To meditate is simply to think deeply about something, focus your mind on or think carefully about something. When life is not all neat and tidy, what are you meditating on? Let’s choose together to fill our minds with what we CAN do, along with the best, not the worst, the beautiful, not the ugly and things to praise, not to curse.

In the meantime I’ll be snuggling.