Let’s talk about Megan. She works out. She restricts her eating to 1,200 calories per day. She’s done paleo and the keto diet.
And she’s exhausted and hasn’t lost any weight. Know anyone like Megan?
Maybe it’s you? I feel like we see many women (and men!) with Megan’s issue, and have started to really narrow in on some of the key issues contributing to poor metabolism and fatigue.
At the core of this issue, we find that we need to focus on the glandular triad – thyroid, adrenals AND growth hormone (pituitary). Each of these contributes in their own way to optimizing metabolism and energy. And if you are supporting one, without measuring and balancing the others, this could be part of the problem.
The Glandular Triad – Thyroid, Adrenal and Growth Hormone (Pituitary)
What are glands exactly? Glands are organs in the body that secrete hormones, and have many functions throughout the body. These hormones support us in different ways — mood, drive, libido, stamina, focus, and energy.
We find that they influence one another. For instance, one study in the Journal of Endocrinology and Metabolism showed the correction of adult growth hormone deficiency actually improved thyroid hormone levels, without the use of thyroid hormones.
Another study showed that the underlying cause can be an overall impact on the pituitary gland, and the true diagnosis is hypopituitarism. In this situation, the brain is being affected in some capacity – for example, this could be from a concussion, or other Traumatic Brain Injury (TBI), or certain medications. Many times the cause is unknown.
So let’s dive into the specific symptoms of deficiency in each gland. Many of their symptoms overlap – but there are certain key features that do help us lean towards one gland or another. However, best practices in the situation of fatigue and low metabolism is to look at all three.
1) Low Thyroid
Key low thyroid feature: we tend to think of thyroid deficiency when a person is fatigued and they feel sluggish, they tend to hold onto water in their tissues (swelling), and feel cold.
Symptoms of low thyroid: fatigue, feeling cold, slow metabolism, high cholesterol, swelling
Labs: Many people will ask their doctor to check their thyroid, without realizing that to optimize the thyroid you really need more than just the standard test, TSH. You also need Free T3, Free T4, TPO and TG Antibodies, Reverse T3, and ideally selenium and zinc/copper levels checked. AND if your thyroid is suboptimal, it is likely putting strain on your adrenal glands, and these need to be assessed and supported as well.
Herbs and vitamins which support the thyroid: Vitamin A, Zinc, Vitamin C, Selenium, Iodine, Vitamin D3, Guggul, Ashwaganda, Forskolhii, L-tyrosine, Turmeric
If you are positive for Hashimoto’s thyroiditis: you need to dive deep and look at irritants to your body – do you have food allergies; are you eating high lectin food groups?; do you have high levels of heavy metals in your body? Have severe gluten intolerance or celiac disease?
2) Adrenal insufficiency/fatigue
Key adrenal fatigue feature: we tend to think of adrenal fatigue when someone will sleep unlimited hours, and still wakes exhausted.
Symptoms of adrenal fatigue: fatigue, no energy no matter the length of sleep, crash in the afternoon, energy is worse with stress
Labs: plasma cortisol, salivary cortisol x 4, DHEA
Herbs and vitamins that support the adrenals: B-vitamins, Vitamin C, Bioflavonoids, Eleuthrococcus, Ashwaganda, Rhodiola, Holy Basil, Licorice, Adrenal Cortex
3) Adult Growth Hormone Insufficiency
Key adult growth hormone insufficiency feature: fatigue and slow metabolism
We often incorporate growth hormone testing when there is a presence of slow metabolism and difficulty with weight loss, in addition to fatigue. Growth hormone is naturally released by the pituitary gland in response to sleep and exercise to help replenish tissues.
Symptoms: can look very similar to low thyroid – but includes slow metabolism, sleep difficulty, chronic fatigue, poor healing
Labs: growth hormone precursors (IGF-1, IGFBP-1, IGFBP-3, Growth hormone, and if severe: a Growth Hormone Stimulation test from an endocrinologist
Herbs and vitamins to support low growth hormone: Vitamin C, L-arginine, ornithine alpha-ketoglutarate; prescription Sermorelin
If you have any of these symptoms, and would like to explore further, please reach out to us! We specialize in creating personalized energy plans, and can order the testing above, and would love to be of service to you!
Be safe and be well!
Yours in health, Dr. Angila Jaeggli