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Adrenal Fatigue
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I posted this in response to an overtraining thread in the main forum, but think this needs a topic of its own over here as I doubt I'm alone in this and think there are probably several women with similar issues that have no idea what is going on.

I was diagnosed with adrenal fatigue recently and am at somewhat of a loss as to what to do (or not do) training-wise. The dr I'm seeing is conveniently not on any insurance so I'm paying my right arm to see her, but am glad I did as the bloodwork she ordered shows a few things pretty far off whereas my GP says I'm perfectly healthy. My DHEA is very low (43 - dr wants it at 250-300), CRP (inflammation) is very high - 7.8 (normal range is 0-3, dr wants it closer to 0). My T3 is a bit low and TSH doubled in the last 2 months from 1.4 to 2.8 - so by "normal" standards, no issue with TSH however looking at the T3/T4 can see issue and dr wants TSH closer to 1.

I went back today to discuss these results and got several supplements and rx - adrenatone, adreno distress guard, calcium w/ magnesium, DHEA 25mg, multi vitamin with antioxidants and omega 3s, vitamin d 5000iu, wobenzyme (anti-inflammatory), and T3 5mcg SR.

I go back next week to discuss nutrition (she is a "nutritional wellness" doctor - MD and used to be in internal medicine and took interest in this field over the last 10 years or so) which I'm looking forward to, and exercise. I'm apparently supposed to meet with their partner to learn a 20 minute "HCG boosting" workout - pretty much HIIT or tabata on a treadmill which starts with 220-age as your max HR. So I'm not impressed there because I can blow 220-my age out of the water without really trying. I am going to give them a call tomorrow to tell them I'm not really interested in learning their workout protocol as I want to continue this hobby of mine in some shape or form -not give it up forever to instead do their 20 minute workout three time a week. I also don't want to give them that HR show and do a tough workout next week if I'm theoretically trying to rest/recover.

Kind of off track track there, but I'm looking for some guidance on how to know when to start coming back and when I'm pushing it too hard. My symptoms never came on in one acute attack - I've just said for the past year plus that I "lack resiliency." I don't recover well and cannot for the life of me lose weight. Upping the workouts and cutting the calories always used to work and over the past 1-2 years when I do that I may lose 1-2 lbs and then proceed to gain 3 back. I've lost 3 lbs of muscle and gained 5 lbs of fat in the past 1.5 years (gotta love DXA and it's sometimes insulting detail).

I ran a half-ass marathon in February (ie was supposed to be for fun but sucked every ounce of my soul out of my body) and haven't been anywhere near full capacity since then. I had the flu at Christmas and have had an awful time with asthma and allergies this year. So while I may have had a week or two here or there where my running was really going well, I'd say I've been sub par since the fall, if not longer.

I'm signed up for IMFL and have told myself I can sit on my butt until early June and pick up then if need be. The only thing is I'm having a hard time figuring out if I need to sit on my butt and do absolutely nothing, and if so, for how long, or if I should work on just doing super light workouts for the next month or so. I took 5 days off last week and my body started to get pretty upset by about day 3 or 4.

I know so much is by feel but I've been subpar for so long, it is hard now to distinguish problematic from my new normal, if that makes sense. The weight I've gained is killing me but working out more/eating less isn't quite the answer for me right now like it had been in the past.

Long post - long way of asking if anyone has had similar hormonal imbalance issues and how long after supplementing did you start to get back at it?

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Kathleen
http://kcwoodhead.blogspot.com/
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Re: Adrenal Fatigue [KWTriGrl] [ In reply to ]
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Since you're in the Houston area, I would recommend you find the nearest Life Time Fitness. Schedule an appointment with the Registered Dietician and take your current lab work with you. They are well-trained in exactly what you describe and should be less expensive compared to the MD.

Also consider metabolic testing while you are there. That way, you can get accurate heart rate data for you, as compared to 220 minus age.

I hope this helps and keep us posted as to your results!

DFL > DNF > DNS
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Re: Adrenal Fatigue [KWTriGrl] [ In reply to ]
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How's your sleep?
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Re: Adrenal Fatigue [SallyShortyPnts] [ In reply to ]
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I'm actually in Austin now - but have had vo2 and lactate threshold testing done in the past so I have a fairly good idea of my max - I just know it is way over 187 (I'm 33)...my last half marathon averaged 185. I'll look into the dieticians at lifetime here - thanks for the info!
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_________________________________________
Kathleen
http://kcwoodhead.blogspot.com/
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Re: Adrenal Fatigue [kiki] [ In reply to ]
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Not too terrible - I had been taking ambien maybe twice a week but usually to try to fall asleep early if I have an early morning workout. The last week and a half I haven't taken it - have slept in until 7:30 or 8 most days so am getting a fairly solid 9+ hours of sleep. I haven't been doing any early morning workouts lately to try to rest so haven't been shifting my schedule around like I do when I wake up before 5. I'd say I'm still not completely rested though. Glad to see I am sleeping okay without the ambien.

_________________________________________
Kathleen
http://kcwoodhead.blogspot.com/
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Re: Adrenal Fatigue [KWTriGrl] [ In reply to ]
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MarkyV has written a bit about this on his blog. I don't remember the details, but search his name on the main forum, and find the blog.

maybe she's born with it, maybe it's chlorine
If you're injured and need some sympathy, PM me and I'm very happy to write back.
disclaimer: PhD not MD
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Re: Adrenal Fatigue [KWTriGrl] [ In reply to ]
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Let me guess, your doctor conveniently sells all these supplements that you were told to take? Be very leery of any doctor who tells you to take supplements that they sell in their office and be very careful about taking supplements since they are not regulated and you can't be sure what is actually in them. I heard of one study where they reviewed 120 different supplements from different manufactures and over 30 contained banned substances. I'd take your labs and find a good endocrinologist to review them and at least get a second opinion. Also, as someone else suggested find a good RD to discuss nutrition, especially if you can find one who has experience with endurance athletes. I have done a couple consultations via phone with Bob Seebohar, who is excellent!
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Re: Adrenal Fatigue [KWTriGrl] [ In reply to ]
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Hi:

First question: Did you have your cortisol tested? Did you fast before your test? High cortisol is more of an indicator over-overtraining.

Secondly, DHEA is a banned substance. Be careful. Besides, 25mg seems like a high starting dose, it can make sleeping worse. I'd start much lower and see what you can tolerate. Like 10mg.

Third: CRP, yes, something is up in terms of inflammation.

Fourth: sex hormones? did you get those tested. estrogen, progesterone, testosterone

I ask because I've been down a rollercoaster over the past year along these lines, and was just diagnosed (yesterday) with an auto-immune (arthritis condition), and i'm pretty sure it's been playing havoc with my system for the past year. like you fatigue - sleeping a lot, weight gain - unable to lose no matter WHAT and gain just by thinking about a meal. and yes. its all fat and it sucks sucks sucks.
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Re: Adrenal Fatigue [sto] [ In reply to ]
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Blood work was all fasting, but no cortisol. Full thyroid panel, A1C, glucose, insulin, CBC, IGF-1, Ferritin, Vitamin, CMP, DHEA-s - and I'm not sure what else. I'm aware DHEA is banned however I'm not racing any time soon and I'm not anywhere near the FOP so I'm not entirely worried about it. I haven't done much research about banned substances but will before I race again - I've read briefly about TUEs but have no idea if I'd need one, etc. I'm taking the 25mg once/day in the morning and so far sleeping isn't affected. If I start having any weird side effects I will def discuss with dr. I'm starting the T3 tomorrow so glad I got a few days in of the DHEA alone before adding that to be able to distinguish if I have any immediate issues.

Sex hormones - I'm on nuvaring and have been for a long time so the dr didn't test those. She says you'd get essentially a false reading so doesn't test if you are on BC. I think she leans towards not being on BC but as far as that part of my life is concerned, I love nuvaring - I take it straight through so never have a period. As far as I know I have zero issues from it, but am aware it could all be tied in too. I'd like to try to deal with the adrenals and thyroid before throwing the sex hormones in. She doesn't test until x days into your period and I'm pretty sure it would be a few months before I got a period if I went off.

_________________________________________
Kathleen
http://kcwoodhead.blogspot.com/
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Re: Adrenal Fatigue [sto] [ In reply to ]
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Sto, what is this arthritis condition and how did they determine it?

clm
Nashville, TN
https://twitter.com/ironclm | http://ironclm.typepad.com
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Re: Adrenal Fatigue [little red] [ In reply to ]
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She does "conveniently" sell most of it in her office. I did a bit of looking into what she gave me and all seem to have positive reviews and few to none negative experiences. I'm aware the supplement world can be a bit odd but also believe they can be helpful to some people in some situations so feel it is worth a shot.

I have a friend - or friend of a friend - who is a RD here in town and she now has all my blood work (7 years worth) and is discussing with her western states winner pathologist friend. She said they love stuff like this so we'll see what they have to say.

I go back to the MD next week for the full nutritional analysis - I am also feeling this will be beneficial - learning what foods I should avoid based on my blood work and which ones are best right now for healing, recovery, etc. I will probably still call an endocrinologist soon because I just can't keep up paying out of pocket even if she has provided some great testing/feedback that traditional doctors won't do.

The RD also had some good wisdom - she said I'd start to feel better in a month or so probably assuming my diet changes based on the results. I said I've felt subpar (as I don't feel terrible...just terribly fat and a bit lazy) for so long I'm not sure I'd know when I felt better - she said when I start losing weight I will know things are working. That makes a bit of sense and I hope really is a good indicator of healing.

Curious to hear of anyone else has any other stories of recovery, etc. I posted on facebook and somewhat unsurprisingly had several friends who have gone through similar experiences.

_________________________________________
Kathleen
http://kcwoodhead.blogspot.com/
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Re: Adrenal Fatigue [little red] [ In reply to ]
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This.

The benefit of supplements is most evident in the bank account balance of the person selling them. There is no scientific evidence that supplements provide any benefit. Getting your vitamins, micronutrients, etc from natural (food/sun) sources is superior to any supplement.

I agree that you should see a real endocrinologist, and see if you have any actual medical conditions that need treatment. If not, your symptoms are very typical of emotional/physical stress, overtraining, and possibly carbohydrate intolerance.

What is your vitamin D level?

Eating only real food, and a nice variety and balance of it, is always a good start. Good luck on your recovery.

Two wheels good. Four wheels bad.
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Re: Adrenal Fatigue [ironclm] [ In reply to ]
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Ankylosing spondylitis. Quite the mouthful. In other words, my back hurts. A lot. But now I'm on this wonderful anti-inflammatory and pain is gone like the wind.
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Re: Adrenal Fatigue [KWTriGrl] [ In reply to ]
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Wanted to post a little bit of an update - still don't know a lot, but feel like I'm at least heading in a decent direction.

While I am thankful for the nutritional wellness MD for running the tests and identifying some potential problems, I don't plan to continue to see her if for nothing else the insurance issue (out of network and not keen on providing any helpful information for patients to file themselves) and that I'm not thrilled about taking 20 pills a day for the rest of my life. I knew going into it that I wouldn't necessarily follow through a plan with her, so no love lost - just glad I at least started there.

I saw an endo last week who said they differ from holistic/nutritional wellness dr's on what "normal is" and about adrenal fatigue, but I was expecting most of that too. The traditional medical system does not recognize adrenal fatigue as an issue. She said they only recognize adrenal insufficiency. She did agree though that my DHEA is very low and wants to understand why. She also agreed the inflammation is a problem. I'm having a corthrosyn stimulation test Friday to have a better look at my adrenal system.

On the diet front, the nutritional wellness dr did tell me no wheat, sugar, super low caffeine. She also told me to aim for 25g protein/meal which I'm good with. She also said though 25g/carbs per meal but none before lunch and no snacks...so basically 50g carbs/day. I'm just not so sure how I feel about that - especially after reading a good article here (http://www.paleoforwomen.com/...ertility-and-health/). I'm good with no wheat and fairly low carb (to me that would be 100-200g/day) - I suppose basically a paleo-looking diet for now but I'm not sure what I think about staying that low on carbs. The other issue is making a change to that low of carbs will inevitably leave me feeling like crap for quite a while - so hard to know when I feel like crap if it is from no carbs, adrenal issues, overdoing it or all of the above. Basically I feel like it will just muddy the waters for a while before it makes anything more clear.

Something very neat though is I've started reading Maffetone's The Big Book of Endurance Training and Racing. I was reading it because I kind of assume I'm going to take a low HR approach for several weeks as I get back into training. I did this 5 years ago when diagnosed with POTS and it seemed to work out okay. This time though reading the book I feel like lightbulbs are going off everywhere. He links overtraining to adrenal issues and also brings it all back to lack of aerobic base. I may be the prime candidate there - my max heart rate is a bit higher than most (over 200 and I'm 33), and I've generally run high, but I've just always written it off as me being different. So while I may be different to an extent, I'm also probably his prime person he talks about having no aerobic base. I ran a half marathon (small PR) in January at an 180 avg hr (8:40 pace). I ran 30 minutes this past Saturday at a whopping 10:30 pace and my last mile was 180, ending at 187. Sooo while even running 13 at that high isn't great, what happened Saturday is definitely my body saying it isn't happy.

Maffetone has some articles online that are from the book - this one is a good overview of overtraining and the adrenal system.
Overtraining - http://www.philmaffetone.com/...vertraining-syndrome

_________________________________________
Kathleen
http://kcwoodhead.blogspot.com/
Last edited by: KWTriGrl: Apr 29, 14 12:29
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Re: Adrenal Fatigue [tigerchik] [ In reply to ]
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I poked around a fair bit on his blog and it looks like his issues have never fully resolved. Scary to know it can get that bad for some. I don't think I'm anywhere near there - but I don't know if I'm in denial or have a realistic perspective :-)

_________________________________________
Kathleen
http://kcwoodhead.blogspot.com/
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Re: Adrenal Fatigue [KWTriGrl] [ In reply to ]
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he's very responsive to PMs and would probably talk if you send one.

maybe she's born with it, maybe it's chlorine
If you're injured and need some sympathy, PM me and I'm very happy to write back.
disclaimer: PhD not MD
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Re: Adrenal Fatigue [tigerchik] [ In reply to ]
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I might - we were actually on the club tri team at UT together and were fb friends once upon a time...but doubt either of us would recognize each other in person and doubt he would know me - but still not a bad idea!

_________________________________________
Kathleen
http://kcwoodhead.blogspot.com/
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Re: Adrenal Fatigue [KWTriGrl] [ In reply to ]
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You might want to do some research and reading on Bob Seebohar's Metabolic Efficiency. It's not so much low carb but eating in a way that has your body using fat versus carbs for fuel, but it might help guide you with your diet some. I cut out wheat and started following the metabolic efficiency way of eating a few years go. I found that cutting way back on carbs and eating a ton more protein and fat actually made me feel much better. I used to eat ridiculous amounts of carbs, since growing up that's how I was told I should eat as an endurance athlete, but now get almost all my carbs from just fruit, veggies, and other non-grain sources. I had a ton more energy and no energy drops, which makes sense because it's the carbs/sugar that give you the blood sugar spike and then the crash. Anyway, here is a link if you are interested in his books http://www.fuel4mance.com/books/

Glad to hear you are getting this figured out and hopefully you'll be feeling better soon!
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Re: Adrenal Fatigue [little red] [ In reply to ]
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Thanks for that info! I'll definitely look into it. I can definitely see the argument for some people not needing nearly as many carbs as some of us eat. I'm game for lowering mine - or as you say getting them from higher quality sources. I haven't really been eating grains for the last 2 weeks and that has not been terrible. I do not eat a lot of veggies though so fruit has always been my go-to. I need to work to find the right balance between it all. Sadly I ate way too many sweet potatoes when I did the Whole30 a few years ago and don't really even like those any more. Hopefully some of those tastes will come around!

_________________________________________
Kathleen
http://kcwoodhead.blogspot.com/
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Re: Adrenal Fatigue [little red] [ In reply to ]
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Do you think the metabolic efficiency book or the nutrition periodization book is a better bet (if I were to only buy one)?

_________________________________________
Kathleen
http://kcwoodhead.blogspot.com/
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Re: Adrenal Fatigue [KWTriGrl] [ In reply to ]
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I would recommend starting with the Metabolic Efficiency Training - it includes a section on nutrition periodization.
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Re: Adrenal Fatigue [KWTriGrl] [ In reply to ]
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If you are truly overtrained, the only thing that is going to have an impact on it is to completely stop everything you are doing and rest for 3 solid months at the least. I know that sound terrible, but if you keep going you risk going into complete adrenal collapse. Someone suggesting you do HIIT shows their ignorance about overtraining. Rest is what will get you back on track. You can do passive activity after a few weeks of complete rest. Overtraining is a serious issue and watching your carbs and eating paleo is not going to make you well if you truly have it. And certainly not doing a workout getting your HR up like that.

___________________________________________________
Jody

“The wild is the approaching dark mass of an outside set, and it is the unseen but very real possibility of moving shapes in the water close around us”~ Drew Kampion, The Way of the Surfer
http://andbabymakes6.com/...ertraining-syndrome/
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Re: Adrenal Fatigue [gidgetx4] [ In reply to ]
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Walking, especially in nature, does wonders for the parasympathetic nervous system (the rest and restore part of your nervous system). Also, adrenal fatigue has a big mental component to it...how you handle life and stress. Having been through it twice (the first time poo-pooing the whole 'mindset' part of recovery), it was only when I implemented journal-writing, meditation, self-evolvement reading and relaxation techniques that I healed. Super challenging at first for a type-A person, but with practice (just like sport), I got better. Best of luck to you!

Kate Galliett
Strength & Conditioning Coach
Creator, Fit for Real Life
http://www.fitforreallife.com
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Re: Adrenal Fatigue [little red] [ In reply to ]
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Did you ever happen to have your MEP tested as they describe in the book? I did last week and it was shockingly low - or perhaps not so shocking, but shows how inefficient of a fat burner I am. I'm 33 and my max is a little over 200. MAF would put me at 147 which I *thought* was low. The top of my zone 2 (tested a few years back) is 164. My MEP (point where I go from burning more fat than carbs to more carbs than fat) was 125-130. That puts me at a walk and nothing more. MEP is something that is described as changable - that you can push it to the right, while MAF doesn't move but you ideally get faster at that same heart rate. I'm having a hard time reconciling between the two. Also though Seebohar says to spend 60% or so of your training below MEP while MAF says 100% for a period of several weeks to months if you are working on the base for the first time...or if you are recovering from overtraining/adrenal issues. But if I followed MAF's 180-age, I'd be spending some time anaerobic (by his definition as I understand it).

_________________________________________
Kathleen
http://kcwoodhead.blogspot.com/
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Re: Adrenal Fatigue [KWTriGrl] [ In reply to ]
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What is your diet like currently? If you are eating high carbs then yes, you will not be burning much fat. Eat carbs = burn carbs; eat protein/fat = burn fat. A big part of metabolic efficiency and changing your body to burn more fat versus carbs is making changes through both diet AND exercise. Diet is very important.
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