Tired of feeling tired?

Far and away the biggest problem I encounter daily in my practice is fatigue and lack of energy. If that’s your problem, what may benefit you is attention to your diet, your digestion and the essential nutrients your body needs for energy and to help your cells replicate; these include vitamins, minerals, fatty acids and protein. Then you need to ensure your hormones are serving you in a balanced way.

If you’re not on the diet that’s appropriate for you and you are suffering from food allergies or intolerances, that will compromise your digestive process, which will make it difficult for you to extract the nutrients you need from your food. A digestive system that’s not providing you with the digestive juices you need to break down the food you eat and the supplements you take will make it even more difficult to obtain essential nutrients.

Once you are on the right diet and your digestive fluids are flowing, you need to ensure you are getting the vitamins, minerals, fatty acids and proteins your body needs for cellular energy and to manufacture hormones. Only then will your hormones be able to kick into gear. You need nutrients to manufacture hormones and you also need nutrients for your hormones to work. Nutrients help you make what is called ATP, which is the fuel, or energy, that powers your cells. Hormones use ATP to execute their activities, to help you think and remember and to enable you to move through your working day, exercise your body and enjoy your sexual vitality. You also need ATP to build hormones.

If you are complaining of fatigue and your health practitioner doesn’t examine your diet, evaluate your digestive process, assess your nutrient status and only then measure your hormones and identify whether they are working for you in a balanced fashion, you won’t have your fatigue dealt with in a comprehensive fashion. With regard to energy, the most important hormones that power you through the day are cortisol and thyroid hormones; then there’s the female hormone, oestrogen.

Cortisol and energy

Cortisol is actually the primary energy hormone — the one that prods you out of bed in the morning. Cortisol allows you to rise and shine by breaking down a substance called glycogen, the form in which glucose is stored in your body, thereby providing you with the substrate your body uses to make ATP. If you are tired in the morning and struggling to get going, it’s highly likely you are not adequately served by cortisol. Light-headedness, moodiness, feeling depressed and agitated and needing to argue constantly are further pointers to an inadequate production of cortisol.

Cortisol stimulates the brain waves that allow you to focus and pay attention as well those brain waves that are switched on when you meditate. This hormone will also encourage your stomach to produce hydrochloric acid, a critical component of your digestive process. You need hydrochloric acid to digest protein, which suggests that, without cortisol, you will not obtain the protein you need to look after your DNA.

It’s also possible your body is not producing cortisol in a balanced fashion. Because the demands of the work environment are so excessive and exacting in the 21st century, you might find you need to stay up late. To cope with these unnatural requirements, your body might produce extra amounts of cortisol at night when it normally would turn off production of this hormone and you might then find it difficult to get to sleep or discover you are waking up in the early hours of the morning, then battling to get back to sleep.

Your body should be producing maximal amounts of cortisol in the morning with a gradual decline as the day progresses, so that as evening approaches, your body is starting to put the brakes on cortisol production so you can have a peaceful night’s rest. Often, you’ll find the opposite taking place: your morning cortisol is basement low, while your evening cortisol production is peaking. This will lead to carbohydrate craving in the form of something sweet together with your caffeine fix just to get you going, while at night you will be over-hyped.

During restful sleep, your body repairs and regenerates damaged cells and produces hormones such as melatonin, which has the potential to protect you against cancer, and growth hormone, which helps with the growth and repair process and preserves your muscle and bone mass while safeguarding your immune system. None of this will happen in a satisfactory fashion if you are producing excessive quantities of cortisol at night. The danger is that these are silent events. You won’t know that your cells aren’t being repaired adequately, that your immune system is compromised and that your bones are crumbling, possibly until it’s too late to reverse the damage.

All of this is why it’s a good idea to have your cortisol levels assessed, especially if you are struggling for energy and good sleep patterns. The way to do this is with a saliva hormone test. It may seem strange, but a blood test will not provide accurate information on your cortisol status. This is because what the blood test measures is the amount of cortisol your body is producing together with a binding protein called cortisol-binding globulin, which is transporting cortisol around your body. Most of the cortisol level the blood test reports is actually taken up by this binding globulin, giving a falsely elevated assessment of cortisol status. You may be producing precious little cortisol but a substantial amount of the binding globulin, which is often the case, and be none the wiser from the blood test.

The saliva test, however, only quantifies free cortisol, or the amount of cortisol performing the functions cortisol is designed to execute. The beauty of the saliva test is you can also get a snapshot of cortisol production at different times of the day, which will allow you to assess whether your evening cortisol is high and your morning levels are low. Then you can employ strategies to turn this around.

If your cortisol levels are low, you might need essential nutrients, including the B vitamins, protein, minerals such as iron, magnesium, copper, zinc and manganese together with essential fatty acids. This is why you need to have your nutrient status assessed before looking into why your hormones are not working for you. If your cortisol levels are heightened in the evening, you might have to employ natural strategies such as meditation and exercise to switch them off, or use remedies like phosphatidylserine to lower your body’s production of cortisol.

Cortisol is not often talked about in the anti-ageing discussion, which is a shame as it might not be one of the sexy, over-touted hormones — like growth hormone or dehydroepiandrosterone (DHEA) — but it’s the most important energy hormone, especially at the start of your day. If you’re not producing adequate amounts of cortisol, you are simply beginning the day on the back foot and it will be an uphill struggle from then on.

Thyroid hormones and energy

If cortisol is the morning energy hormone, thyroid hormones are there to sustain you for the rest of your day. Thyroid hormones drive your energy processes, providing you with the ATP you need. Your heart muscle and brain cells need thyroid hormones to energise. Insulin, the hormone that helps to get sugar or glucose into your cells, is assisted by thyroid hormones. Without these hormones you become languid, sluggish and slow. Your memory will falter, your brain will lose its sharpness and your metabolism will start to shut down, so that you put on weight you find hard to shift. Your circulation will be compromised and you’ll suffer from cold extremities.

Thyroid hormones make substances in your liver that regulate your cholesterol levels, so if your cholesterol levels are elevated, before embarking on a course of medication you need to have your thyroid hormone levels evaluated. Thyroid hormones boost your immune system by stimulating a gland in your body called the thymus, where immune cells are matured and given extra potency. The thymus starts to shrink when you are pregnant, probably because you don’t want immune cells to reject the offspring that is growing in your body. While it may be advantageous to down-regulate the immune system when you are wishing to procreate, it’s not good to have a weakened immune system as you age. This is why ensuring adequate production of thyroid hormones is so critical. Thyroid hormones even switch on a gene that has the capacity to protect you from Alzheimer’s dementia.

As you need nutrients to make cortisol, you also need them to manufacture thyroid hormones, especially iodine, the amino acid tyrosine, selenium, zinc, fatty acids and vitamin A. You also need ATP to facilitate this process, which would bring the B vitamins, magnesium, iron, copper, manganese and amino acids into play. When you assess your thyroid hormone status, you need to have these evaluated. For the most part, standard blood tests won’t provide you with an adequate assessment. Iodine and the minerals zinc and magnesium can be assessed by a urine test on all your urine collected over a 24-hour period. Again, you’d need to find a practitioner who is aware of this kind of test.

When you have your thyroid hormone levels assessed in a blood test, make sure you have all thyroid hormones evaluated, including TSH, T3, T4 and reverse T3 or rT3. TSH stands for thyroid stimulating hormone and it does just that. If your thyroid gland is under-producing thyroid hormones, TSH will increase to rev the thyroid into action. If T3 is the metabolic accelerator and the energiser, reverse or rT3 slows things down. This will not help you if you need mental and physical energy and you are struggling to lose weight because of a slow metabolism. What increases rT3 is over-production of cortisol, low levels of zinc and a family history of low thyroid function. You may not be able to change your genes, but you can modulate your cortisol levels and optimise your zinc status.

While you are having your thyroid hormones assessed, it would also be a good idea to have your thyroid antibodies measured. Coeliac disease, which is evaluated by a blood test that measures gliadin antibodies with a positive result indicating that wheat, rye oats and barley need to be avoided, and the milder form of this disorder, gluten reactivity, also determined by a blood test and suggesting a similar diet, are both associated with autoimmune thyroid disease and raised thyroid antibody levels. In this context, the uncomplicated act of avoiding gluten might lead to significant clinical improvements.

The sugar link

If your body is producing reasonable amounts of both cortisol and thyroid hormones and you are still demonstrating evidence of hormone deficiency, including fatigue, sluggishness, poor circulation, moodiness, inability to lose weight and depression, there may be certain crucial factors that are compromising your hormone function at a receptor level. For your hormones to function, they need to interact with a cellular receptor, which is the point at which they initiate their activity. What undermines hormone activity at this juncture are your two old friends: free radicals and inflammation.

There’s a number of causes of inflammatory and free radical overload, most involving excessive consumption of sugar. It’s sugar that makes us fat, not the fat we are so desperately trying to avoid with our obsessive attachment to skinny cappuccinos and low-fat everything. Once your fat cells start to expand, it will be more difficult for sugar or glucose to enter your cells to be used to manufacture ATP or energy.

Glucose will begin to accumulate in your bloodstream and it’s this mound of glucose that will allow free radicals to multiply. At the same time, fat cells will manufacture inflammatory molecules, leading to one almighty inferno with inflammation and free radical stress reinforcing each other. In this context, it will be very difficult for cortisol and thyroid hormones to execute their functions.

Often, I find patients with under-productive thyroid hormone activity are being treated by their primary physicians or by their specialists with exceedingly high doses of thyroid hormones. Unless there is some desire to fashion some form of superhuman achievement, it would seem to make no sense that they need to receive more hormones than that which their bodies normally produce. In most cases, all they really need is to have their inflammatory and free radical status addressed and then their hormone regimen can probably be halved.

Boosting cortisol production

  • To manufacture cortisol, you need the B vitamins, zinc, magnesium, iron, manganese, coenzyme Q10, saturated fat and protein.
  • The herbs Panax ginseng (Asian ginseng) and Eleutherococcus senticosus (Siberian ginseng) increase cortisol levels.
  • Alcohol, sugar and yeast-containing foods are the enemies of cortisol.
  • Growth hormone and excessive thyroid hormone and melatonin status antagonise cortisol.

If you don’t have the energy you need, your first port of call should be your cortisol and thyroid hormone status. While growth hormone, melatonin and DHEA have been promoted as anti-ageing miracle hormones, it’s cortisol and thyroid hormone that provide you with the energy you to negotiate your day. Without these hormones, you would not be able to get up in the morning or have the energy to drive you through the day.

Dr Michael Elstein is a Sydney-based anti-ageing physician and writer. He is the author of two books: Eternal Health: the comprehensive guide to anti-ageing for the new millennium and You Have The Power: why didn’t my doctor tell me about this?

The WellBeing Team

The WellBeing Team

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