Table Talk 015


All right, welcome to the Table Talk podcast. Today we are gonna talk all about energy. So we have so many women that come to us and men and women that one of their biggest complaints is that they are tired and they don't have enough energy to get through the day. And so this American lifestyle of being busy, busy, busy, busy, busy, and all of the things we have going on really impacts that from both our mental and physical health.

So we're gonna talk about that a lot today. So I have two of my pharmacists here with me today. One, um, is in Ohio with me, Dr. Lindsey Dalton. And then we also have Dr. Nicole Grams, who is in Wisconsin. So I will let them both intro themselves for a second, which both of them I think have already been on the podcast.

So you should have heard from them by now, if you're listening to all of our episodes. So Lindsey, why don't you give us a intro about yourself and sort of what your favorite, thing to help people with is.


Yeah, so I am Lindsay Dalton. I am in Ohio and I really enjoy speaking with women, moms in particular, about all things, hormone and energy and fatigue is definitely something that I'm super passionate about as well as gut health and helping just women feel their best.


Awesome. Awesome. Nicole.


Yes, my jam is really talking about stress and mental health in connection with physical health.

Awesome. Yeah. Just diving into anxiety and all the emotions.


Yes. Yes. Great. All right. So like I mentioned, lack of energy is a common complaint among men and women in our society. It feels normal to be tired. It's almost like glorified sometimes to be busy and to have all this stuff going on. And so in conventional medicine there's often.

And I had this actually recently where a patient came and conventional medicine was like, well, something's wrong with your thyroid. But nothing was actually wrong with his thyroid. And so he, as thyroid was normal. And so instead of digging deeper, the provider gave him thyroid hormone, which actually caused a lot of other problems cuz his thyroid hormone wasn't low.

And so there's just this assumption that thyroid function is the main thing or anemia, which is when there's not enough oxygen in the red blood cells that could be due to, a couple vitamins that we're gonna talk. But still doesn't honestly address the whole picture because why is someone anemic?

How did they get to that point? Is it nutrition? Is it their anemic post pregnancy? Is it that maybe aren't absorbing those nutrients well enough. And so, so there's lots of pieces of puzzle that still have to be addressed even when we figure out, okay, it might be related to this particular nutrient.

One of the things we encourage our patients to do and why we're so passionate about functional medicine and talking about these things is that we want to arm people with information so that they can be advocate for themselves when they're in those doctor's appointments.

And when they're having conversations with their providers saying, "Hey, you know, I really don't feel well." And if conventional medicine has done all the lab work and done all the things and said, okay, well, you're fine, but you don't feel well. That's really where we come in as functional medicine providers and people, you know, looking at the whole picture and the root cause to say, okay, we have answers for why you don't feel well.

And we have ways that we can help you get there. So that's what our whole conversation is gonna be about today. And so Lindsey, why don't you lead us off talking about those nutrients that affect people potentially being anemic.


Yeah, absolutely. So there are a couple that are pretty common and even, I think conventional medicine doctors would look at. B12 is definitely one of them vitamin B12 and then iron.

So, it's funny because both of these can actually be depleted because you don't have enough stomach acid. And a lot of times that can be due to either being on a medication that decreases your stomach acid, like a PPI, like Merool or Ole or Zantac things that you can get over the counter for heartburn or for reflux.

So when you don't have strong enough stomach acid, you're not gonna be absorbing the B12 or the iron. And then people who are hypothyroid, who have underactive thyroid have not enough stomach acid as well. So really you can run these nutrients, but like Melody said, you might not know why you're actually low in these.

So taking a look at that is super important. So when we're looking at B12, looking at serum B12 or the B12 in your blood is a good marker to check for that absorption. Because, like I said, you do need that strong stomach acid in order to absorb it, MCV or mean CorpU volume. This is usually part of a CVC, which is a lab that you might get once a year at your well check.

This is usually high if you're low in B12. And then a functional marker that definitely is not common in the conventional medicine world, but we would run in functional medicine is MMA or methylmalonic acid. And this is an organic acid that is produced inside the cell when B12 is missing. So that's another good way to just kind of get the whole picture of what's going on.

And then for iron hemoglobin is super common. You're gonna get that at your yearly lab checkup. That's a marker of more of your immediate iron sufficiency. And the thing about hemoglobin is you could have a normal value, but you may actually be depleted because when you're dehydrated, which is also super common for people that can make hemoglobin look higher, so you could be depleted, but also dehydrated.

And you could look like you have a normal level. So getting something like ferritin. Which is the storage form of iron is another way to just dig a little bit deeper and get that whole picture of your iron sufficiency.


Yes. Yes. And ferritin is so important to look at for patients that are having trouble sleeping.

So if you're tired because you're not sleeping well, or you're restless, low ferritin can be a cause of that. So certainly there can be other nutrients involved, but especially in kids that are really restless and have trouble settling down to sleep, making sure you check a ferritin level can be really important.

Awesome. Okay. So B12 and iron are important nutrients to look at for and other B vitamins are involved in some of the energy production in our cells and the mitochondria, but one of the big, heavy hitters, the mitochondria is the part of our cell that produces energy. And so, I remember in grade school talking about it being like the powerhouse of the cell or something, maybe, maybe that was college.

I don't , I don't quite know, but so the powerhouse of the cell needs Coq 10 and Coq 10, is an antioxidant, but it's also involved in the energy cycles and it is depleted with aging. And so we wanna make sure that we get plenty of Coq 10, and also depleted with several medications. One of the big ones, which pharmacists listening should know that Coq 10 is depleted with statin use.

So statins are common medications used for cholesterol. They do lower LDL cholesterol and overall cholesterol. And they do have data for reduction in cardiovascular events post. If people have had history of cardiovascular events and trying to prevent them from having another, some of that may be related to the lowering of LDL, but a lot of it can also be related to the anti-inflammatory effect that they have.

So we're not saying never use a statin because there definitely are times when someone might be a good candidate for that based on their cardiovascular risk. But if they are using a statin, what we are suggesting is that they should have Coq 10 supplementation.

So Coq 10 would be really important. And most of the studies surrounding statins suggest at least a hundred milligrams of cocuten a day to prevent the statin related depletion and side effects. Some people may go as high as 200 milligrams a day. So, definitely consider that if you are a loved one is taking one of those medications, but it's also one of those things if you're really tired that can, you know, be a nutrient that you check, we can check that as, as easily at general labs, we can check a white blood cell level and we can check a total, blood count plasma level of Coq 10.

And just see where it is because a lot of times we have these wide ranges for labs and sometimes you might be at the low end of that range and need just a little bit more, to be more in an optimal range as well.

So that's something to think about when you're looking at labs. So, other things Coq 10 can be helpful with there's some data on headaches and migraines. So if that's you, if you're tired a lot and you have headaches or you, you know, find sort those are connected for you and, and your health that also might be something to look at. So those are some of the big nutrients, who wants to talk about caffeine.


I can a little bit. Okay. You might be able to explain the mechanism of action a little bit better than me, but basically I remember when I was learning about caffeine and what it actually does in the body, cuz so many people are dependent on it.

So many people need a cup or two or three of coffee in the morning to get going. Right. But that's really throwing off our hormones and our cortisol levels that we need that are naturally waking us up naturally giving us energy. But when I found out that basically. Well, the, the simplify overly simplified version of what caffeine does is basically blocks the thing that makes us feel tired in our body, right?

It doesn't actually give you more energy. It blocks the tired. And when I heard that, it was like, that's not something I wanna participate in, actually, because I wanna feel like what my body, what signals my body's actually giving me. Because it, then it just builds up.

And then when the caffeine goes away, then you crash and you're tired and you need more and more and more, and then you get dependent on it. And it's just not a good situation.


Yeah. Yeah. And some people, you know, depending on different genetic poly, what we call polymorphisms or SNPs that happen where people might have different pieces of the DNA, changed out our amino acids, changed out that cause their DNA to be different.

People can not metabolize caffeine very well. So if they do have a cup of coffee, they might have a more fast heart rate, a higher stress response because that no epi and epinephrine that was stimulated stays around longer. So that can sort of prolong some of the stress effects of caffeine. So those people, I mean, we're not negating that there is data to show that coffee and the antioxidants and coffee are beneficial for health.

So if you tolerate a cup of coffee, you know, that might be something that fits in your lifestyle. We're not saying never drink caffeine or never include this, but the dependence on caffeine is the piece that we're trying to address here and decaf coffee still has the polyphenols and, and the great, you know, if you can get a clean source of a decaf coffee, so you can still get those good health benefits, if you enjoy the cup of coffee without the crash and the effects of caffeine.

So those are things to think about. If you do enjoy that cup of coffee and it does cause you to be agitated, maybe even taking some L vine, which is some, a component of green tea that helps to balance that stress response when it happens.

So that's why you don't get that same jittery effect from green tea. Sometimes that you might actually, I get tired from green tea. I'm like drinking this caffeine and I'm like, why am I tired? But it's probably because of some of those other phytonutrients and chemicals in there that are actually helping you relax too.

So anything you wanna say, Lindsey, I know you're passionate about this topic. Anything you wanna add about caffeine?


I think the one thing that I would add, I personally love a cup of coffee in the morning. And something that I learned was it is if you're going to drink coffee in the morning, eat something first mm-hmm because you are gonna get those release of the norepinephrine, and that's gonna burn through some calories and some energy. And if you're not metabolically supported with some food and calories in your system that is gonna make that jitteriness worse. And that's gonna make that crash come harder when it's worn off.


Sure. Yeah. If you don't have the protein and the other nutrients in your body to, to give you more sustained energy.

And then the other thing with that too, is that some of the jitterness from coffee actually can come from mycotoxins, which are things that grow. They're almost like molds that can grow on coffee beans. And so sometimes finding a cleaner source of coffee can be helpful. So if you think there's Bulletproof coffee.

I mean, we are not associated with any of these brands, but like Bulletproof and there's like life something, coffee, I think that you can order online that have been tested for mycotoxins and I notice a difference if I drink a cup of traditional coffee that I can get at the place that the drive-throughs always packed versus versus having one of those that I make it make it home.

So, definitely, consider your source looking for organic sources especially when it comes to decaf. And cuz there can be some chemicals used in that process that aren't ideal for our body either. So cool. So we don't wanna get dependent on that, but consider that the coffee is not bad, but some of the other like monster drinks, oh my goodness.

I had a recent patient that was drinking, this was a patient with diabetes and a family medicine practice that was drinking eight cans of soda a day. Plus a monster plus, like other things granted has split, you know, there's high, high blood sugar involved. But I just can't even imagine like his adrenals and, and what all is going on in that, with all of that caffeine.

So, we will see when I, I said you have to get rid of. All of this like cold turkey for your health. So hopefully that's not you that you're drinking that much and addicted to that much, but definitely if you can like wean it down, to prevent the headaches as much as you can and slowly back off on that as you're trying to get healthy.

So. Sleep. Obviously not sleeping can cause you to be tired. So that's the, that's the big one, but the crazy part with fatigue is that some people are sleeping. They sleep a full night sleep and they still don't feel rested. So let's talk about that. What could be going on in someone that is sleeping?

You know, they're sleeping seven hours and they wake up and they just don't feel well or don't feel like they can get up and go.


I mean, to me that usually points to stress levels. Yes. And like what your brain is doing . Yeah. But also to a certain extent, what's your sleep hygiene? What's your blood sugar like, there's lots of different factors that can affect you in the middle of the night that are disrupting your sleep, that you don't necessarily think of.


Right. Yes. So cortisol is one of those hormones that it's actual job overnight is to wake us up. So we have this thing called the cortisol awakening response. So with cortisol starts to increase at two or 3:00 AM slowly starts to increase to the point where we're supposed to be awake in the morning and, and highest point 30 minutes after we wake up.

So if your cortisol or your adrenal response is dysregulated, that is really where we see patients that wake up and they don't get that cortisol response because there's dysregulation in that process. And they're not able to wake up. So, Lindsey anything else you wanna say about reasons why people wake up tired?


I think blood sugar is definitely something to think about too. I even noticed this with myself. Like if I have more sugar than normal before bed, my sleep is not good that night. I have to like, not eat for a certain amount of time before bed, for my blood sugar to be steady and regulated and get into that deep sleep and get enough of it to where I feel rested in the morning.


Yeah. Yeah. There's definitely studies that show any meal, whether it's a high fat meal, high sugar meal, anything, before bed can affect sleep. So that's something to consider as we don't necessarily promote like prolonged fasting all the time, especially in people that are really stressed out, you know, it couldn't be, it could be a good fit for people that are really trying to lose weight or really metabolically needing to do a big reset, but at least 10 to 12 hours of giving your gut rest is appropriate for most people.

So making sure after dinner, we're not eating a bunch of things so that we do get that quality sleep can be really important.

Along that same lines, the blood sugars can be one thing, but also hormones. So women that are, we talked about the cortisol being a hormone, but women that are postmenopausal are getting para menopausal, or even women that are not supposed to have low hormones could have low progesterone.

And progesterone is a really important hormone that helps to tell the brain sort of calming to the brain. So we do use sometimes, or we recommend use we're, we're not prescribers, but we recommend use of oral progesterone sometimes in women that have low progesterone that can help it provides GABA NAIC effects and the calming effects on the brain.

And so it can really help improve people's sleep. I had a recent patient that was not sleeping more than like three to four hours. And once she got on the hormone treatment, now, she was able to sleep like a full six to seven hours without waking up. And because of that effect and falling asleep faster. So, so it's definitely something to consider and we're not here to talk about biodentical hormone therapy today on this podcast, but it's definitely something to consider if you're trying to figure out sort of what is the root cause?

Why am I not sleeping? Why am I not feeling well when I wake up? And then for those people that do have trouble getting going during the day, One of the things that I found to be helpful is light box therapy. So when they wake up, if they're sitting a desk and they're not able, cause when we go to the window in our house, now the windows are like UV protected and we don't get that actual sunlight unless you live in a really old house that you haven't had the windows replaced in like 50 years.

But the windows that we have now are really nice, cuz they protect our furniture and all these things from fading and from the UV light. But we have to consider that our bodies were designed to have a circadian rhythm and wake up in the morning and the sun hits our eyes and on our skin and this is what's to be going on in our bodies. And then in the evening, when the sun goes down, we should have this nice melatonin release that helps us sleep. So, if you're having trouble with that circadian rhythm, trying to reset it, sometimes that can be going for a walk in the morning to try to wake yourself up and have the sunlight on your face.

If that's not an option, the light box on your desk might be a really great place to start. And they have plenty of those on different ones on Amazon and places.

And then melatonin can be helpful, but melatonin is really only helping people fall asleep. So melatonin is not something that's gonna help sustain sleep, or maybe, probably won't even have a great effect on the quality of sleep.

But if you're having trouble with actual falling asleep, getting your body to say, Hey, it's nighttime, especially in this time change thing, I hate the time change. I don't know about you guys, but I still feel like we're all outta whack, especially my kids are still not waking up at the right times are restless or not getting as, as good of sleep because of it.

So I really hope that bill passes that I swear, it's like all the time, there's a bill. And then like it passes with the one house and doesn't pass the Senate and doesn't get signed. It never happens, but we can have hope that it might this time. Because that really messes us up for several weeks. And there's like actual studies to show this.

I'm like, why are we still doing this? Anyway, so that's enough on sleep. Anything else you wanna talk about with sleep?


No, I guess I just wanted to add in my own personal story. Yeah. Because I am well, I'm a recovering ball of stress and my cortisol was super low. My progesterone was super low and for a brief period I had what's the name of it?

Continuous glucose monitor. Mm-hmm just so I could track what was going on in my body because I'm a scientist after all.


Yes. Biohacking.


So with the combination of those three things, that's where I figured that's how I figured out that it was my blood sugar in the middle of the night. That was spiking my cortisol and making me wake up at two or three in the morning.

Yeah. And it wasn't like I was having a big bowl of ice cream at night. It was just I have a little snack or whatever that didn't necessarily have protein in it. But I didn't associate that waking up with blood sugar because my blood sugar was normal on every waking test I've ever had. My A1C is fine, you know, all that was normal.

So it was really me paying attention to my continuous readings that helped me figure that out.


Very helpful, continuing glucose monitors. I mean, they've been such a game changer in my practice with patients with diabetes, but for sure, they're starting to move into this biohacking space and trying to figure out our bodies and what's optimal.

Certainly that's off label for all of those rules, but definitely still something that, that could be a useful tool to talk to your provider about because they do require a prescription. And then along with the biohacking thing, before we move on, there's, other tools like the Oura ring or the Whoop band or other things like that, that you can wear that actually show your sleep stages.

They show your heart rate variability, which is heart rate availability is the best marker that we can physically measure to look at stress that's been well studied, and also they can tell you, your temperatures too, like for women that might that could affect your cycle time and things like that, as you're trying to figure out everything going on with your bodies.

So those can be a great tool to use. I find it super helpful. It also shows you if you had that meal, like what effect had, you know, you can say, okay, well I fit the, eat this bowl of ice cream before bed. This is what my sleep looks like. If I have this glass of wine before bed. This is what my sleep looks like.

And you can see the patterns and help you. It's just like the glucose monitor in a way, like you're making adjustments in your lifestyle based on the data that you're given. And so that's really where all of these tools together can really help optimize your health. If you're willing to make adjustments in the lifestyle, based on the data.

If you're not gonna do anything with the data, then don't waste your money.

Well, we talked a little bit about thyroid back at the beginning. So let's go into a little bit more detail about thyroid who wants to take that?


I don't know how much detail you want to go into. Um, yeah, but I think there is a lot to say about thyroid and we have had a podcast on that already.




It can just be a major factor in fatigue. And I think a lot of times when we approach our physicians about feeling tired, our brains kind of just go to thyroid automatically. And unfortunately I think in a lot of cases, and even in my personal case, I was told that I had normal thyroid hormone or a normal TSH.

Like my thyroid was not an issue, but when you dig a little deeper, like in functional medicine, you might find out differently. Sure. And it's just, I think an unfortunate aspect of conventional medicine that sometimes we can be left feeling helpless.


Sure. Yeah. And sometimes people are only looking at one piece of the thyroid, which is the TSH, which honestly is the most well studied marker for adjusting thyroid hormone meds and knowing like, if you actually need them.

But there is also people that have sort of a subclinical picture where their TSH is a little bit elevated, but still within the normal range, but they still have a lot of symptoms. And we also know that there's different markers. We can actually measure the active thyroid hormone.

We can measure the sort of precursor to that. And we can also measure what happens if there's a lot of inflammation in the body and the thyroid hormone goes into what we call reverse T3. So it's blocking the effects of the active thyroid hormone. So looking at the whole picture can give us some glimpse into that.

And then the other thing with thyroid is the antibodies. So we talked about that in the previous podcast, but if you haven't listened to that, go back and listen to that because there's antibodies that can be present regardless of what the TSH is, which can be an early sign of this autoimmune picture.

And people can feel bad just from that inflammatory response. Feel tired, feel brain fog, even if they're not out of range with their TSH yet, or their other thyroid markers. So definitely working with a provider, that's going to look at the whole picture is really important to addressing this fatigue and and figuring out what the root causes.

So. All right, Lindsay, tell us about adrenals. This is your like favorite thing to talk about


it is so adrenals. We think about like cortisol when we think about adrenals and this is our body's stress response. The adrenals can also be a root cause of thyroid disease. So that's another thing to think about when you're thinking about your thyroid and when, if you are under treatment for hypothyroid and you're still feeling like not your best, it could be because of your adrenals.

So I feel like they just go hand in hand when you treat one, you really need to be looking at the other.




And when we think adrenals, it's all about stress. We live basically in a constant state of stress, whether it be emotional stress, mental, even physical. And I do think that physical stress is a huge part of the adrenal picture.

When we hear the word stress, I think people's minds automatically go to that mental, emotional stress. And they're not thinking about the physical stress and this can be things like blood sugar fluctuation. So if you're eating too much sugar or you're not eating balanced meals, your blood sugar is just gonna be on a roller coaster all day long.

And your body is constantly just trying to get it back to that baseline level. And it's just using so much energy to get us there. Physical stress can look like too much exercise, whether that be you're exercising too aggressively, or you're just not taking breaks. You're exercising seven days a week. Or maybe you're just exercising for too long of a time.

You're doing hour long cardio. When you really just need that 30 minutes to get your heart points for that day. Stress can be the little sleep that we talked about before, and then it can be toxins like your body's just trying to get rid of heavy metals and pesticides and artificial dyes and flavors that are in your food.

There's just so much when it comes to the physical stress that are just causing your adrenal hormones to be completely out of whack.


Cool. Yeah. And other thing I would add is like underlying infections. So if someone has like a yeast dysbiosis and your body's trying to fight that, or you have gut other gut bacteria outta balance to pathogens, parasites, whatever that looks like it could be.

Epstein bar virus, or it could be Lyme or another viral type infection that's affecting more of the whole body. Those types of things are causing stress to the body. And the body is actually responding in a way that it knows how to protect itself from excess cortisol, by lowering the cortisol effects.

And then we get sometimes these flat lines of cortisol. So the people that aren't waking up in the morning and, and part of what we do in this functional medicine, integrative medicine space is we look for these things. We look at what your blood sugar looks like.

Like Nicole said, we look at the exercise, how much you're doing the toxins and the underlying infections. And then we actually address those which helps resolve your fatigue and helps your adrenals to be supported better. Which is different than just throwing a supplement or a medication at someone to say, Hey, here's how you increase your energy with, with this particular thing?

I talk to a lot of people that are in this space and they're tired and they're fatigued and, and they're trying to go through this process and they wanna feel better instantly, which unfortunately doesn't happen in this. There's a lot of things we can do to work on and in six months or something and feel a lot different.

A lot of times change in the diet, addressing the blood sugar. You could feel better pretty quickly, but some of these other things might take a little longer to tease out her unpeel. You know, we all talk about peeling back the layers of an onion and, and figuring out what's going on. So I just say that because I want people to be have realistic expectations, whether they're working with us or whether they're working with other functional medicine practitioners that may take a little time, cuz it wasn't an overnight process to get where you are today. So it may take a little time to sort of peel back those layers and figure out how all these things are impacting and have your body have the ability to actually respond and, you know, get better.

All right, Nicole, tell us about mental stress and what they can do, what we can do about it.


Oh my how much time do I have?


Well, we're about 30 minutes right now. So you got 15 minutes.


I'll try to keep it brief, but you know, this is what I love talking about. Yes, yes. But I mean, even just like mental stress in general and it's not just, when you feel stressed necessarily, it's a lot of pressure that you put on yourself.

It's the self criticism talk. It's even the connection that you feel with your family or your friends, or in your community, those sorts of things cause mental stress and I like to talk about the stories that we tell ourselves about what we're doing and what we're resisting in our day.

So let's say you're running late, you're taking your kids to school. You barely got their lunches packed. Like you can tell the story that way. Or you can take a step back when you're done and say, I got the kids to school and I gave them lunches today. like, how are you? how are you telling the story to yourself?

And like sometimes we're so convinced that this is how it is, and this is, you know, the facts of the universe. But if you really take a step back and you're like, well, okay, was it really that bad? Maybe not. Maybe I can just tell myself that I did it instead of coming up with all the ways that I was insufficient in some way.

Right. Like sure. But yeah, the stories that we tell ourselves are so important for mental stress, because it's just extra mental energy and our brains already use so much energy that we have. And if we're spending more time convincing ourselves that we're wrong, convincing ourselves that we're not doing something right.

That we don't have enough. I mean, even just telling ourselves that we don't have enough time is such a stressor and it's not necessarily a fact.





But, but yeah, that. In a nutshell, I guess, in a nutshell.


So reframing conversations and reframing views can be really important in looking at how stress is impacting our body, because the thing is, we're not getting rid of stress.

Like we still have those kids to take to school. We still have those lunches to pack. We still have jobs to do people to take care of. And there's lots of things going on in our lives that we, and not everyone can quit their job and, and to lay the beach all day.

Like as much as we want. And even that might be stressful in a sense, cause I'd be bored outta my minds, so, so how do we, you know, have our body be more resilient to the stressors and part of that starts with how we frame what's going on in our life and how I think too gratitude in a lot of things and understanding it's not as bad as I'm making it sound in certain situations and some things maybe we have to just realize they're part of our life for a time being, and maybe they're not the whole, you know, this is not the whole reason I'm here.

This is not what God designed me to worry about. Like he wants me here to do my job, but he doesn't need me to, to stress about that because he is got other things that need to focus that energy on.

Um, so yeah, so awesome. And if you are someone that needs help reframing that, Nicole is your lady and you can find her on our And she does health coaching and as a clinician for the Wisconsin patients.

So supplements that can help. We talked a little bit about the vitamins.

We talked about Coq 10 and B vitamins already and thyroid support. So there's certain nutrients that can be helpful to the thyroid, which we talked about in the thyroid podcast. But as far as adaptogens, let's talk about that a little bit before we close. So adaptogens can be basically, they help sort of level the stress response in a way.

So if we have too much cortisol, they help lower the cortisol. If we don't have enough cortisol, they can help increase the cortisol, basically helping our body to be more resilient to the stress and to have a better balance in the stress response. So some of the common ones we hear about a lot that have gone back centuries are like ashwagandha. So that's a popular one. Have to be a little careful with ashwagandha in patients with high testosterone, especially women with high test testosterone are lean on the PCOS, high androgen piece. And then also the healthy basil is another one that comes to mind.

There's different, you know, different ways that these adaptogens work. So checking out those, again, a lot, some of them can have drug interactions. So as pharmacists, we always say, make sure you check with your healthcare provider on any supplements that you might start. There's a lot of like blends that can be helpful.

They can have some of like the true adaptogens, but then also some of these anxiolytic like help calming nutrients like the Alpine and banaba and some of those other ones. So if you know, you're looking for a specific recommendation, we do now have a supplement consult. So if you're just saying, Hey, I just wanna know about this supplement or how this supplement would work in my body.

If this is safe to take with my medications, we do have that now on the website with our providers, if you wanted to sign up for a quick supplement consult. That's not meant to be a place to dive into all this functional medicine stuff. So that would still be a new patient functional medicine visit. But if you're just having questions about is this safe to take with my regimen or just wanna meet a provider and ask some of those questions that might be a great place to start, but any other thoughts on adaptogens or experience that you guys have with those?

There can be, sometimes you can do those herbs and like teas and things like that too. If you want to, but I would say ashwagandha is definitely the one that we see the most in combination products, as well as other things, but some of the other ones as STR yes, I'm probably gonna pronounce these is completely wrong, but some of the mushrooms, the cor decept can be helpful in balancing things.

And aluru root is one that's commonly in combination products too. Licorice root is something else to consider, but it can cause high blood pressure. So the whole liquorice root can there's other products that they take out the piece that causes high blood pressure that we use for like gut soothing and gut healing protocols.

But the actual licorice root that has the full stress reduction benefit is something to watch out for, cuz it can, which is sort of counterintuitive. We're reducing your stress, but we're causing high blood pressure with the, with a compound. But Ola is another one. That's interesting because it is one that in high doses can reduce cortisol levels, but in small doses can help stimulate cortisol. But it helps really a really big calming effect. I've taken it a couple times and I took it at night, unfortunately, because I was like, oh, it's gonna reduce my cortisol at night. And then it was, I was so calm, but I was so alert I could not fall asleep.

So sometimes it's just figuring out what's working best for your body. I know many of you that are in this space probably have like the supplement graveyard of things that you've tried and that haven't been effective, in your medicine cabinet. But you know, you find the things as you try them that, that work for you.

And that's the whole part of precision medicine and functional medicine. But hopefully working with a provider can help you figure that out sooner. So you don't have as many supplements in that graveyard box. And we don't necessarily advocate everyone, go out and take adaptogens and, and all these supplements without knowing if that's something that you need, because we can test your adrenals and your stress response to find out.

You know, is it that you need more cortisol or is it that you're low cortisol? And if you're low cortisol, we have to figure out why before we actually start throwing some of these things at that. So that's one of the things I would say, test, we try to test and not guess is a common phrase, but there's also some barriers to testing, cuz sometimes it can be expensive, but there are a lot of things that insurance can cover when we order it with