Are You Tired? by Dr. Amber Golshani


If you drag through your day, feel tired all the time, or have trouble keeping up with the kids, no doubt you have searched the internet for causes. It’s likely you have stumbled across information about adrenal fatigue.

Low or disrupted adrenal function can cause:

weight gain
disrupted sleep
low immunity
food cravings
and more…

I remember mornings, waking up to my 1 year old son crying in the other room and wondering how I was going to get through the day. I was overweight, stressed out, grumpy and tired-of course I had adrenal fatigue! I took a bunch of adrenal supplements, felt marginally better, but still I knew something wasn’t right. That’s because I was trying to fix the symptom (fatigue) and not the underlying root cause!

And while most experts will tell you the problem is the adrenal gland,

I assert that the problem actually starts in the brain.

You see, the adrenal gland is part of the hypothalamus pituitary adrenal (HPA) axis. The adrenal gland (a little triangle shaped gland that sits on top of your kidneys) is controlled by the pituitary which is controlled by the hypothalamus (both which reside deep in your brain), which sends signals to turn on or off the hormone secretion from the adrenal gland.

The Hypothalamus get its signals from our environment-such as amount of light, amount of hormones circulating such as melatonin, inflammatory hormones, and even metabolic hormones like insulin (which is largely influenced by what we eat).

Normally in response to environmental clues, the HPA axis should produce a certain rise and fall of cortisol throughout the day and night. In the morning, it should be highest, thus we have most energy through the day. As night approaches our levels of cortisol should decrease so we can rest and sleep well. Cortisol release should follow a normal circadian rhythm.

Cortisol is also released in response to stress-helping us survive periods when we need quick energy. It is a necessary hormone for survival, great for when our muscles need a quick burst of fuel to outrun a threat, or we need more circulation to our lungs to bring in more oxygen.

The problem is that in our modern world, we often feel like there is a constant threat to our lives. Even though the threats are primarily psychological, not physical, they are pervasive and persistent. Thus we react by demanding our bodies to produce more and more cortisol.

Compounded is the fact that we live OUT of sync with nature and our inborn hormonal response to it (circadian rhythm).

Artificial lights signal a year-round summer with late nights. An abundance of sugary and starchy foods cause insulin dominance. Toxin exposures, electromagnetic fields and other trappings of modern life cause HPA axis dysregulation resulting in what is called adrenal fatigue.

So you see, it’s not actually the adrenal glands fault! It’s just responding to the on and off signal coming from the brain.

When I was trying to ‘fix’ myself, I was staying up way to late, watching TV for “me” time with lights a’ blazing and usually eating a bag of chips. Yes, the whole bag. Not to mention I wasn’t exercising and did no real relaxation. No wonder a supplement didn’t help!

If you have read this far, you are probably most interested in what you can do to get better, so lets get to it.

I use a four part approach to restore normal circadian rhythm and adrenal function and build a Fatigue-Proof body. And that’s based on your lifestyle. All the supplements, herbal adaptogens and vitamins in the world won’t help you if your lifestyle isn’t Fatigue-Proofed.

How to build a Fatigue-Proof Body:

Nutrition: Eat protein and veggies at every meal. This keeps your blood sugars balanced which lessons a burden on your adrenals (cortisol raises blood sugars). If your blood sugars are dipping too low, your adrenals will need to respond by releasing cortisol in order to raise it back to the normal range . Eating this way also keeps insulin spikes to a minimum. Insulin disrupts the normal signaling of the HPA axis. Make sure you include lots of oil fish as your protein source, as they will contain the fats your brain and nerve cells need to function correctly.

Sleep: Maybe one of the most important ways to heal your HPA axis and re-establish normal circadian rhythms is to get sufficient sleep. Start by dimming lights and avoiding screens (TV, smartphones, computers) for at least an hour before bedtime. Light, especially artificial light will inhibit your brains ability to send normal signals to the adrenals. Then, aim for 9-10 hours during most months of the year. In the summer, our bodies seem more adapted to staying up later. This makes sense because there is more daylight. Your bedroom should be completely dark as any amount of light can disrupt normal nighttime hormone secretion. That means you must cover up all little lights, indicators on electronics and other glowing things. I’d also recommend black-out drapes. First thing on waking, get bright sunshine on your skin and to your eyes (unfiltered, no glasses or sunglasses) as much as possible in order to re-establish normal circadian rhythm.

Exercise: Exercise smartly! If have not been able to exercise because of fatigue, start with leisurely walking after dinner, which is the best way to balance cortisol production. I truly mean slow walking here. No jogging or power-walking. Start with a few minutes and work your way to 1 hour a day. I have also seen patients on the other end of the spectrum who are OVER-exercising. If you are tired, and you have to force yourself to exercise and you end up more tired, you are doing too much. You are actually making your situation worse as the exercise becomes another stress on your body, forcing more cortisol to be made.

Relaxation/Recovery: True relaxation is a lost art! Many people know how to rest, which is passive and simply the absence of activity, but few know how to relax or recover, which is an active restorative state that brings you back to normal. This includes all stress management techniques that recharge you such as music, meditating, getting a massage, prayer, acupuncture, using aromatherapy, guided imagery, even hobbies, sports, and reading books just for entertainment. There is no right or best way to do this, it’s what ever you like and can do on a regular basis, AND most importantly its unplugging and investing time in yourself. This does not include television or movie watching, surfing the internet, checking email, facebook or twitter, which are examples of ‘rest’ and actually drain your energy even further. Recovery is not time when you put energy OUT into something or someone else, but to energy you are directing inward to healing yourself.

Try these four steps and see what a difference they can make. If that still doesn’t help, as I mentioned there are herbal adaptogens, vitamins and other supplements that can help. Look for posts at site to cover some of my favs. I also have one of my most successful clinical protocols for dealing fatigue here .

I often send out special information to people who subscribe to my newsletter. You can do that here:

All the best, always,

Dr. Amber

For more and to connect with Dr. Amber:

Twitter @DrAmberGolshani


13 Mental Health Benefits Of Exercise

By Sophia Breene

Many people hit the gym or pound the pavement to improve cardiovascular health, build muscle, and of course, get a rockin’ bod, but working out has above-the-neck benefits, too. For the past decade or so, scientists have pondered how exercising can boost brain function. Regardless of age or fitness level (yup, this includes everyone from mall-walkers to marathoners), studies show that making time for exercise provides some serious mental benefits. Get inspired to exercise by reading up on these unexpected ways that working out can benefit mental health, relationships and lead to a healthier and happier life overall.

1. Reduce Stress
Rough day at the office? Take a walk or head to the gym for a quick workout. One of the most common mental benefits of exercise is stress relief. Working up a sweat can help manage physical and mental stress. Exercise also increases concentrations of norepinephrine, a chemical that can moderate the brain’s response to stress. So go ahead and get sweaty — working out can reduce stress and boost the body’s ability to deal with existing mental tension. Win-win!

2. Boost Happy Chemicals
Slogging through a few miles on the ‘mill can be tough, but it’s worth the effort! Exercise releases endorphins, which create feelings of happiness and euphoria. Studies have shown that exercise can even alleviate symptoms among the clinically depressed. For this reason, docs recommend that people suffering from depression or anxiety (or those who are just feeling blue) pencil in plenty of gym time. In some cases, exercise can be just as effective as antidepressant pills in treating depression. Don’t worry if you’re not exactly the gym rat type — getting a happy buzz from working out for just 30 minutes a few times a week can instantly boost overall mood.

3. Improve Self-Confidence
Hop on the treadmill to look (and more importantly, feel) like a million bucks. On a very basic level, physical fitness can boost self-esteem and improve positive self-image. Regardless of weight, size, gender or age, exercise can quickly elevate a person’s perception of his or her attractiveness, that is, self-worth. How’s that for feeling the (self) love?

4. Enjoy The Great Outdoors
For an extra boost of self-love, take that workout outside. Exercising in the great outdoors can increase self-esteem even more. Find an outdoor workout that fits your style, whether it’s rock-climbing, hiking, renting a canoe or just taking a jog in the park. Plus, all that Vitamin D acquired from soaking up the sun (while wearing sunscreen, of course!) can lessen the likelihood of experiencing depressive symptoms. Why book a spa day when a little fresh air and sunshine (and exercise) can work wonders for self-confidence and happiness?

5. Prevent Cognitive Decline
It’s unpleasant, but it’s true — as we get older, our brains get a little… hazy. As aging and degenerative diseases like Alzheimer’s kill off brain cells, the noggin actually shrinks, losing many important brain functions in the process. While exercise and a healthy diet can’t “cure” Alzheimer’s, they can help shore up the brain against cognitive decline that begins after age 45 Working out, especially between age 25 and 45, boosts the chemicals in the brain that support and prevent degeneration of the hippocampus, an important part of the brain for memory and learning.

6. Alleviate Anxiety
Quick Q&A: Which is better at relieving anxiety — a warm bubble bath or a 20-minute jog? You might be surprised at the answer. The warm and fuzzy chemicals that are released during and after exercise can help people with anxiety disorders calm down. Hopping on the track or treadmill for some moderate-to-high intensity aerobic exercise (intervals, anyone?) can reduce anxiety sensitivity. And we thought intervals were just a good way to burn calories!

7. Boost Brainpower
Those buff lab rats might be smarter than we think. Various studies on mice and men have shown that cardiovascular exercise can create new brain cells (aka neurogenesis) and improve overall brain performance. Ready to apply for a Nobel Prize? Studies suggest that a tough workout increases levels of a brain-derived protein (known as BDNF) in the body, believed to help with decision making, higher thinking and learning. Smarty (spandex) pants, indeed.

8. Sharpen Memory
Get ready to win big at Go Fish. Regular physical activity boosts memory and ability to learn new things. Getting sweaty increases production of cells in hippocampus responsible for memory and learning. For this reason, research has linked children’s brain development with level of physical fitness (take that, recess haters!). But exercise-based brainpower isn’t just for kids. Even if it’s not as fun as a game of Red Rover, working out can boost memory among grown-ups, too. A study showed that running sprints improved vocabulary retention among healthy adults.

9. Help Control Addiction
The brain releases dopamine, the “reward chemical” in response to any form of pleasure, be that exercise, sex, drugs, alcohol or food. Unfortunately, some people become addicted to dopamine and dependent on the substances that produce it, like drugs or alcohol (and more rarely, food and sex). On the bright side, exercise can help in addiction recovery. Short exercise sessions can also effectively distract drug or alcohol addicts, making them de-prioritize cravings (at least in the short term). Working out when on the wagon has other benefits, too. Alcohol abuse disrupts many body processes, including circadian rhythms. As a result, alcoholics find they can’t fall asleep (or stay asleep) without drinking. Exercise can help reboot the body clock, helping people hit the hay at the right time.

10. Increase Relaxation
Ever hit the hay after a long run or weight session at the gym? For some, a moderate workout can be the equivalent of a sleeping pill, even for people with insomnia. Moving around five to six hours before bedtime raises the body’s core temperature. When the body temp drops back to normal a few hours later, it signals the body that it’s time to sleep.

11. Get More Done
Feeling uninspired in the cubicle? The solution might be just a short walk or jog away. Research shows that workers who take time for exercise on a regular basis are more productive and have more energy than their more sedentary peers. While busy schedules can make it tough to squeeze in a gym session in the middle of the day, some experts believe that midday is the ideal time for a workout due to the body’s circadian rhythms.

12. Tap Into Creativity
Most people end a tough workout with a hot shower, but maybe we should be breaking out the colored pencils instead. A heart-pumping gym session can boost creativity for up to two hours afterwards. Supercharge post-workout inspiration by exercising outdoors and interacting with nature (see benefit #4). Next time you need a burst of creative thinking, hit the trails for a long walk or run to refresh the body and the brain at the same time.

13. Inspire Others
Whether it’s a pick-up game of soccer, a group class at the gym, or just a run with a friend, exercise rarely happens in a bubble. And that’s good news for all of us. Studies show that most people perform better on aerobic tests when paired up with a workout buddy. Pin it to inspiration or good old-fashioned competition, nobody wants to let the other person down. In fact, being part of a team is so powerful that it can actually raise athletes’ tolerances for pain. Even fitness beginners can inspire each other to push harder during a sweat session, so find a workout buddy and get moving!

Working out can have positive effects far beyond the gym (and beach season). Gaining self-confidence, getting out of a funk, and even thinking smarter are some of the motivations to take time for exercise on a regular basis.

What inspires you to stay fit?