Balanced Podcast Episode #238: Adrenal Fatigue & Stress – Part 2

Adrenal Fatigue, Carbs & Calories - Diane Sanfilippo, Liz Wolfe | Balanced Bites

1. News and updates from Diane & Liz [2:15]
2. Shout out: Simone Miller and Jennifer Robins’ New Yiddish Kitchen [8:18]
3. Diane’s personal experience with adrenal fatigue [11:04]
4. Anatomy, physiology, and biochemistry of the adrenals [20:50]
5. How stress affects the system [28:01]
6. Contributing factors that lead to adrenal fatigue [33:19]
7. Symptoms of adrenal fatigue [41:42]
8. What to do about adrenal fatigue [44:36]
9. Try This at Home: walk outside [53:39]


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You’re listening to the Balanced Bites podcast episode 238.
Welcome to the Balanced Bites podcast with Diane Sanfilippo and Liz Wolfe. Diane is a certified nutrition consultant, and the New York Times bestselling author of Practical Paleo, The 21-Day Sugar Detox, and co-author of Mediterranean Paleo Cooking. Liz is a nutritional therapy practitioner, and the best-selling author of Eat the Yolks and The Purely Primal Skincare Guide. Together, Diane and Liz answer your questions, interview leading health and wellness experts, and share their take on modern paleo living with their friendly and balanced approach. Remember our disclaimer: The materials and content within this podcast are intended as general information only, and are not to be considered a substitute for professional medical advice, diagnosis, or treatment.
Liz Wolfe: Hey everyone, it’s Liz Wolfe, here with Diane Sanfilippo.
Diane Sanfilippo: Hey.
Liz Wolfe: Hey friend, how are you?
Diane Sanfilippo: I’m great, how are you?
Liz Wolfe: Pretty good. I hope you can’t hear all the dogs/babies/people upstairs.
Diane Sanfilippo: {laughs}
Liz Wolfe: I’m in the dungeon.
Diane Sanfilippo: It sounds pretty good to me.
Liz Wolfe: I think we’ve got a decent set up here, we should be good. Let’s hear from one of our sponsors.
Liz Wolfe: The Balanced Bites podcast is sponsored in part by the Nutritional Therapy Association. The NTA trains and certifies nutritional therapy practitioners and consultants, including me, I’m an NTP, emphasizing bio-individuality and the range of dietary strategies that support wellness. The NTA emphasizes local, whole, properly prepared nutrient dense foods as the key to restoring balance and enhancing the body’s ability to heal. Nutritional therapy practitioners and consultants learn a wide range of tools and techniques to assess and correct nutritional imbalances. To learn lots more about the nutritional therapy program, go to There are workshop venues in the US, Canada, and Australia. Fall registration will open June 2016. I know the price is increasing next year, so do not wait. If you see the NTA as part of your future, get started now. You won’t regret it.
1. News and updates from Diane & Liz [2:15]
Liz Wolfe: Diane, what are your updates?
Diane Sanfilippo: So, a couple of upcoming events. The Austin Entrepreneurs Mastermind event; I think we only have about 9 seats left. It’s a small event, 25 total people. So if you’re coming to Austin for PaleoFx, don’t miss out. If you’ve been thinking; “oh, I think might want to get a ticket,” don’t wait because before you know it, those 9 seats will be gone. And I’m sure at some point in the future I’ll have some other events, but nothing scheduled as of yet. So that’s it for that.
The Sacramento event was awesome! I think we had over 400 people there. I talked about taking things from a paleo diet to a lifestyle, what we do with the transition, how we get from feeling like this has to be a rigid, for forever thing for everyone. Which I know we talk about a ton here on the podcast. My talk will definitely be available in a video at some point, and I will be sharing that with my subscribers. So make sure you’re on my emailing list, and that you’re checking your email within, I would say the next month or so, they said I’d be able to get a video of it. It’s a pretty short talk, I think I was only up there for maybe about 20 minutes. So I’ll definitely share that with my emailing list when it’s available.
Let’s see; the only other thing is the paleo reset retreat that’s also here in relatively the Bay area. I think Chris Kresser is sort of leading that, and it’s at a place called Mayacamas Ranch in Calistoga, and I will be there for a day doing a cooking demo, answering questions, all kinds of fun stuff. My day that I will be there is April 19th; I believe that they have a full week or a partial week that you can attend. So if you’re just looking for a quick getaway, something fun and informational, paleocentric, etc., check that out. We’ll put a link on the show notes for this episode. We’ll also put it at, which I think there’s an events button on our navigation right now so you guys can check that out.
I think those are most of the updates that I’ve got going on around here. Except that pretty soon I’ll be standing on the ball again. So, for people who are following my Instagram and/or Facebook pages, I posted some stuff where I’m doing things on a physio ball. You know, I have to give you the not so business updates, as well. {laughs} I’ve been working with a trainer, getting back on, I just call it on the ball, because it’s on the big physio ball thing.
Liz Wolfe: A literal, literal ball.
Diane Sanfilippo: Like an actual ball. An actual, real life ball, people sit on it and do crunches or sit on it in their office. But no, I stand on it. {laughs} So, I’m getting there and I’m psyched. So if you guys want to see that happening, make sure you’re checking out Instagram and Facebook, all that fun stuff. So, Liz, my friend, what’s new with you?
Liz Wolfe: Oh my. I’m just plugging away at life in general. Just all of the things, and working on; I’ve been doing some stuff I’m excited about. There are parts of Baby Making and Beyond that are just completely outside my realm of expertise, so I’ve been talking with my lactation consultant who, her name is also Liz, it must be just something in that name that makes it awesome. But hopefully getting her portion all put together. She’s an IBCLC, which is amazing.
I encourage any mom or mom-to-be to look for an IBCLC, an international board certified lactation consultant, to seek one out before baby comes if you possibly can just to get one on the line for you who can help you make sure if you’re planning on breastfeeding to make that journey as seamless, or at least as well informed as possible, somebody that you can call on. Hospital lactation consultants are often great, but sometimes they’re not. So I think when it comes to lactation consultants, it’s always good to find someone you feel like you can have a good personal relationship with. I had a great experience with Liz, so hopefully we’re getting her on complete and plugged into Baby Making and Beyond.
And then I’m also chatting with Megan Garcia, whose website is She’s really, really sharp as far as feeding babies. I’ve talked with Rochelle Serna, as well, from the Rose Protocol, who is also an expert in baby led weaning. What I’m talking to Megan about, and what she’s contributing to Baby Making and Beyond, is a little bit of myth busting as far as the actual nutritional content; dietary nutritional content that kids need and when they begin to need it. There’s a lot of confusion out there about food before 1 is just for fun, or do you need to start solids at 6 months, things like that. Iron content of baby’s diet, which is kind of that micro level when we’re talking about feeding baby. She has a ton of really interesting insight. She’s a total science junkie; really up to date on all that info.
So we really do want to have Baby Making and Beyond stretch at some point beyond where we kind of stop it right now, which is that fourth trimester in infancy, and we want to keep rolling it out to the things that our BMB parents are going to want to know about later on, which is starting solids and things like that. So that’s going to be really cool, and those are just the things I’m trying to manage right now.
Managing by walking around!
Diane Sanfilippo: {laughs}
Liz Wolfe: That’s what I got.
Diane Sanfilippo: It sounds good. I like the direction it’s all heading in. I know we’ve had so many people who are waiting for it.
Liz Wolfe: I know.
Diane Sanfilippo: But you guys, this stuff takes a long time. It’s just that it’s kind of; we like sharing as it’s unfolding because otherwise it feels like; it feels like we can’t say anything about what we’re doing because it’s kind of all happening behind the scenes, and yeah. So I’m excited for that. It sounds good.
Liz Wolfe: It’s going to be amazing.
2. Shout out: Simone Miller and Jennifer Robins’ New Yiddish Kitchen [8:18]
Liz Wolfe: Alright, how about a shout out? Diane, do you have a shout out?
Diane Sanfilippo: I do. Holla! {laughing}
Liz Wolfe: {laughing}
Diane Sanfilippo: I’ve got a “holla!” this week. This is for our friend Simone Miller and Jennifer Robbins, whose new book, The New Yiddish Kitchen, just released and I feel slightly connected in a soul sister of food way to Simone, because basically whenever she or I post food photos that are at all Jew-y food, because as you know I’m half German-Jewish, half Italian, so the Jew food runs deep in my blood {laughs}.
Liz Wolfe: {laughs}
Diane Sanfilippo: So whenever we post pictures of certain foods, I’m like; yep, that’s my food right there. So we always have a good time chatting about that stuff and joking. But I’m excited for them. Their book is amazing. I mean, they’ve been posting about the bagels for a long time. I think their little catch phrase was, “Bagels are back.” Because they were delicious, but the recipes go obviously far beyond that; challah bread, matzo, everything that’s totally traditional Jewish foods for the holidays, but then regular food too. Things like pot roast that you can have any time; all different kinds of side dishes. Everything. So it’s just an awesome book.
So whether you are Jewish or not, I recommend at least flipping through it. See if there are some foods; you know, we obviously all have foods from different cultures that we love even if that’s not our culture, right? I mean, who doesn’t love bagels? But when it comes to some of these other foods, I definitely think it’s worth checking out. You guys will love it, and it’s a beautiful book, too. So I’m excited to give it tons of my family members. And actually, a lot of them have been going gluten free, so I think it will be cool for them to see different ways to approach making some of their traditional holiday recipes. So I’m pretty pumped about that, and excited for them, and congratulations ladies.
Liz Wolfe: Congratulations. I’ll share with you my sorrow about that.
Diane Sanfilippo: Wait, what am I saying congratulations? Mazel Tov! {laughing}
Liz Wolfe: Mazel!
Diane Sanfilippo: I’m a terrible Jew. Mazel.
Liz Wolfe: Today’s Mazel.
Diane Sanfilippo: That’s our Mazel of the week. {laughs}
Liz Wolfe: Oh man. So we’ve been out of my house for 2.5 months now, I don’t know if you’ve been counting but I have. We’ve been basically living out of the car for 2.5 months. And I guess my bagels went to my home address.
Diane Sanfilippo: No!
Liz Wolfe: And the construction folks hid them away somewhere, and I totally missed the bagels!
Diane Sanfilippo: Oh, bummer.
Liz Wolfe: I didn’t get them.
Diane Sanfilippo: Alright, maybe we can convince them to share a new batch as a housewarming present when you get the house done.
Liz Wolfe: Yeah, if that ever happens. No presh!
Diane Sanfilippo: {laughs}
3. Diane’s personal experience with adrenal fatigue [11:04]
Liz Wolfe: Alright, so should we get back to; well, should we tackle today’s topic, get back to the topic that we’ve been tackling the last few episodes?
Diane Sanfilippo: Yeah, we’ll get down to brass tacks on this episode.
Liz Wolfe: Cool.
Diane Sanfilippo: Alright, so this is a follow up, obviously, to our previous episode. So if you didn’t listen to that, definitely go back to 237, check it out. But that was a little bit of a less practical, tactical, tips and info type of episode. It was a little bit more background on the whole issue and what’s going on personally with people. And quickly, what we noted in that episode was just there’s a lot of foundational stuff going on with the way that we think, the way that our lives are running in terms of stress, our stress response, and the way that we set up our entire lives to be stressful, and we need to be working on that.
So one of the things that happened last week, before that episode aired, I actually was walking around and doing a Periscope walk and talk, which I do sometimes because I’m random like that. Sometimes I don’t feel like being alone on my walk, and so I turn on a Periscope. So anyway, I drew this analogy that I want to share with you guys in the episode here because I felt like this was really what you all need to understand about the way that adrenal fatigue or dysregulated HPA axis dysfunction, etc., whatever you want to call it; the way this is all working.
If you think about, we’re going to call adrenal fatigue, just because it’s easier to say that, but listen to the previous episode. {laughs} So here’s the thing, it’s not this condition, this situation that you get into. It is more of a situation than a health condition, perhaps. It’s not like a cold or flu that you get, and then you take some things for it, and you heal for a while and that’s that. I’m sorry to say that, but it’s more like an autoimmune condition. And no, I’m not saying that it is autoimmune, but I’m saying that it’s a chronic issue to be aware of that your body is prone to, especially once you’ve been there. Your personality, your mindset, your lifestyle, your nutrition, the way you train; all of that makes you prone to this. Once you dip into it once, it’s very easy to get back there. It takes effort, work, and attention to avoid it in the future.
So, I want to share with you guys, whether you have heard the story before I’m not sure, it depends on how long you’ve been listening to the podcast or if you’ve maybe had this conversation with me somewhere. But I had my own personal experience with adrenal fatigue. I think it was back in 2007. At that point in time, I was training for a half marathon; it was the first half marathon that I ever did, and I took the training really seriously. {laughs} I went to and made myself a little training schedule, and I followed it very religiously. Now, the one thing I did scale back on was training with a personal trainer because I just couldn’t lift with the trainer and then run 5 miles. It was not working. I was too sore to be doing all of it.
But the thing I didn’t scale back on; I added 25-30 miles a week in terms of running, and these were not leisurely jogs. I was doing pace training, I was doing some sprints, some intervals, things like that. And I was also doing cardio kickboxing, probably at least 3 or 4 times a week.
Liz Wolfe: Tae Bo? Were you doing Tae Bo? With Billy Blanks?
Diane Sanfilippo: {laughs} It was Turbo Kick. Oh, it was Turbo Kick, {laughs} it was not Billy Blanks Tae Bo. So picture; you guys, we’ve been saying this on the show for so long, but I’m doing these training runs pretty high intensity. I would literally go for a run for maybe anywhere from 30 to 50 or 60 minutes, and then go to cardio kickboxing. Like, immediately following the run.
Liz Wolfe: I just passed out for you.
Diane Sanfilippo: I mean, I’m passing out listening to that right now, and I’m picturing myself doing it. I would go get a coffee at maybe, I don’t know, 3, 4, 5 o’clock right before I would start all that training. I would get some coffee, I would do the training; and here’s the thing. I was definitely, I guess I was in my late 20’s at that point, and so I was working really darn hard. I mean, I had a job full time as a graphic designer/art director, and I also was running a jewelry business online, for those of you who might know. I was burning the candle at both ends insanely. So I would do all that training; I would work from 6 a.m. to 2 or 3 p.m. for my job, I would go do that training from let’s say 3 to 6 p.m.-ish, and then I would come home, eat dinner and work for more hours, from let’s say 7 or 8 till 10 or 11 p.m. at least. And then I would start it all over again the next day.
So, needless to say I was living a lifestyle where I was setting myself up for failure in terms of my energy, my hormones, all of this stuff. Now, the thing that people need to understand is that at this point in my life, everything externally that people would see, you would have said, “wow, you look great! You look so fit!” I had a 6-pack, I’m pretty sure I had a thigh gap, which was the first time in my life, I remember standing in the shower and thinking, “My legs aren’t touching?” {laughs} What is this? If any of you have seen me in person, I have a naturally curvy shape. My legs touch, for a while. There’s not a small amount of touching, it’s like the top…
Liz Wolfe: They’re hugging.
Diane Sanfilippo: Third to half of my thighs are touching {laughs}
Liz Wolfe: {laughing}
Diane Sanfilippo: This is like, I have to straddle if I want my legs to not touch.
Liz Wolfe: You have to do the Nick Miller angry stance.
Diane Sanfilippo: Pretty much. Pretty much. So this is not; that was an extremely low body fat for me. When it was tested, it was only at about 18%. When I say only, I don’t mean that’s really that low. I mean, that’s not actually that low, but that’s how athletic looking I was. I’ve heard people say you have to be at 13% body fat for a female to have a 6-pack; I don’t think that’s true. I think I was around 18, maybe 16, but I think 18%. So 6-pack abs, thigh gap, and lost my period for at least a couple of months, did not take the signals at all from those things. I definitely did not think there was anything wrong. I just thought, you know, I’m training a lot so that’s normal. Honestly, that’s what I thought. I thought, well this is what happens. Right? This is what happens to a lot of gymnasts, this is what happens to a lot of runners that you become amenorrheic, whether it’s for a short period of time or longer, and I wasn’t studying nutrition at the time. It was very shortly thereafter that I began studying nutrition much more seriously. Actually, I was studying nutrition but I really wasn’t studying it from a health perspective at the time, I was studying more simply based on macronutrients to fuel activity.
So, I just want to give you guys that note. What happened was, I was in one of those kickboxing classes, and I remember it clear as day. I could not smile. The whole reason I went to the class, the reason I’ve gone to them more recently, is to kind of laugh and dance and kick and punch and have a great time, and just smile. And I remember it happened more than once within a couple of weeks, that I went into the class, and I remember the instructor, who knew me very well. Obviously, we knew each other’s names and she was like, “hey Diane, is there something wrong?” Like, did I do something, was the class not good today, what happened? And I said, no, I just couldn’t smile. I couldn’t get my energy up.
And I really didn’t know what that meant. I did not know, and it turns out that’s what it was. I hit this point of adrenal fatigue. I pushed myself for too far for too long. And guess what? I was only running and doing that type of training for a few months. But for my body, all of that stuff piling on top of each other; the way that I was working, the way that I was handling or not handling my stress, my nutrition. I was probably not eating enough fat. I definitely was eating much lower fat at that point in time. It was just too much for me. So I’ve been there, you guys. I’ve been there.
And when I talk about all of these things about the background of how to avoid it, I’ve been there once; when I wrote Practical Paleo I almost kind of dipped into it, and it was almost inevitable. There’s an amount of emotional stress that; you can’t prevent the emotional stress of writing a book. You can try and prevent some of the physical stress by maintaining what you’re eating. This is kind of when we talk about how to prevent it. You can pay attention to what your setting your lifestyle up as. You can pay attention to your sleep, and your nutrition, and your training, but sometimes there are certain stressors you can’t avoid or control, so you need to be working on the ones that you can control.
Ok, so also with this episode, we had a cool comment from Instagram on the previous episode from SoulFedandFitLife. So she says, “Loved your content on adrenal fatigue in this podcast. Diagnosed several years ago, and it really wasn’t until I changed the structure of things in my lifestyle; sleep, workouts, mindset, that I’m beginning to see progress, along with the supportive nutrition I already had in place. We will always have stress internal and external; it’s how we approach that peace that is so important in healing. Great stuff as always, ladies.” I thought that was cool; a cool little note on our foundational episode.
4. Anatomy, physiology, and biochemistry of the adrenals [20:50]
Diane Sanfilippo: That’s a little bit of the background. If it’s cool with you Liz, I’m just going to run with this episode here. I’m going to talk a little bit about stress, the adrenals, get into some of the sciency stuff about what this whole adrenal fatigue situation is, and lay a little more foundation. We’ve talked about it in previous episodes, but I’m just going to remind folks what we’re talking about here. Sound good?
Liz Wolfe: Sounds; yeah, that sounds great to me. It will be a great refresher for me, as well.
Diane Sanfilippo: Alright, cool. So, just to go all the way back to what is stress. Stress is a specific response by the body to a stimulus, such as fear or pain that disturbs or interferes with normal physiological equilibrium. Whoo, that’s a mouthful. Stress can be physical, mental, and emotional. It’s strain or tension, and can be in occurrence, whether chronic or acute, or causative factor in a state of disease. So when we think of any type of illness that we’re dealing with, the root cause we often say is inflammation. Inflammation and stress you can almost use a little bit interchangeably when you think about a physiological response because inflammation is a stress, right, in the body. It’s a stress response.
We have to remember that emotional stress and physical physiological stress are not different. We have to remember; we talk about nutrition so much. We talk about training so much, but what we talked about in our previous episode about mindset and the way that we handle stressors is critical.
So here’s what I’m talking about; key players in this whole endocrine game of stress and adrenal function. Your adrenal glands, obviously {laughs} are critical. They are two triangular shaped glands that sit on top of your kidneys. They consist of an inner medulla and an outer cortex. The adrenal medulla produces and secretes epinephrine, so that’s adrenal, a fast acting hormone; norepinephrine, which is noradrenaline, and a small amount of dopamine in response to stimulation by sympathetic preganglionic neurons. Hopefully I’m pronouncing that right.
The adrenal cortex mediates the stress response through the production of steroid hormones, mineral corticoids, and glucocorticoids. Am I even saying that right? Corticoids. Glucocorticoids. Yes I am. I’m like, as I type these things out, and I type my notes, I’m like, am I going to say that right? Including aldosterone and cortisol respectively, as well as DHEA and sex hormone precursor. So basically your adrenals are responsible for producing a ton of stress hormones.
Now, cortisol is the one most people know about. Cortisol is a hormone released in response to any kind of systemic stress. Its primary functions are to increase blood sugar through gluconeogenesis; that means new creation of glucose. Suppress the immune system; ding, ding, ding, a little asterisk there. And aid in fat, protein, and carbohydrate metabolism. So cortisol has a lot of functions in our body, and we need to remember that it’s doing more than just kind of waking us up. It has suppressive effects on our immune system.
One of the things that we can think about when you’re training, for example, with cortisol response. You know what happens when you are maybe running or lifting or something where at first something hurts, and if you kind of keep working out, sometimes it stops hurting, and that’s a cortisol stress response. Now, not every time. Maybe you change how you’re moving or you change what’s happening. But often as your cortisol increases, it actually can help decrease pain naturally. So while you’re doing that activity you don’t feel it, and then after you feel it more. That’s because of that cortisol response.
So then we talked about the HPA axis, which is short for hypothalamus-pituitary-adrenal axis. That’s the system of communication between the neuroendocrine glands that dictate our response to stress as well as our circadian rhythms. So this is regulating everything with the way that we sort of rise in the morning, and the way that we go to sleep at night, as well as the way that we’re handling stress and responses to that throughout the day.
Neurotransmitters, excitatory and inhibitory. They’re also a part of this whole process. Neurotransmitters are chemical messengers that transmit signals from neurons to their target cells across synapses. The way that each neurotransmitter is classified is based upon which receptors they activate. So, some typically excitatory neurotransmitters include glutamate, which we’ve talked about a lot, dopamine, acetylcholine, epinephrine, which is adrenaline, norepinephrine (noradrenaline) and histamine. And some typically inhibitory neurotransmitters include serotonin, 95% of that is made in your gut; GABA, glycine, and adenosine.
So here’s the thing; it sounds like this is a lot of complicated, confusing stuff. But what I want you guys to know, is that the neurotransmitter part of this is kind of the mental/emotional stress. So you know what happens when we are just excited and stressed sitting in traffic. Right, I talked about this analogy in the previous episode. When you have this excitatory neurotransmitter response, when you have this mental stress response, you’re pushing your stress levels in one direction versus if we talk about something like serotonin, which is the happy neurotransmitter. That’s going to push us to a more calm state, versus something like dopamine, which is going to get us excited; happy, but excited instead of happy and calm like serotonin might.
Ok, so let’s see. The hippocampus and circadian rhythm; the hippocampus is a gland that regulates circadian rhythm and our body’s roughly 24-hour cycle and the biochemical process. When these pathways are well balanced in a perfect world, we wouldn’t have extreme imbalances in the system. We might experience acute bouts of imbalance. So we talk a lot about paleo stressors, {laughs} something that might have caused us to use this fight or flight response and then we would sit and chill, and then maybe a stressor would come, but it wasn’t this chronic level of stress. So we’d quickly come back to homeostasis and appropriate cortisol levels, and rhythm throughout the day if that was happening.
In balance, we have adequate amounts of serotonin, a healthy gut to promote that serotonin, and the production of melatonin at night, and the counterregulatory hormone to cortisol; as we know, that is melatonin, manages our sleep cycle while cortisol manages our wake cycle. So when we’re able to fall asleep at night easily, and wake up in the morning easily and feel rested, have good energy throughout the day we’re in a pretty good balance. When stress takes over, that’s when the balance is lost. You guys know what that feels like; you wake up, you don’t feel rested, you’re dragging in the morning. You lie down, and you just don’t feel tired. You’re “tired and wired”; that’s definitely one of the signs we’re going to talk about in just a second of this issue of adrenal fatigue.
5. How stress affects the system [28:01]
Diane Sanfilippo: So here’s the thing; how stress affects your system. I have a diagram that just kind of covers a lot of different impacts of stress on the system. We can see if we can get that into the blog post for today. It’s not critical that you see it, but different stressors affect different people in different ways, we talked about this in the previous episode, depending on your constitution. So, that’s going to just be like, your physical makeup. What happened when you were born, what happened to your cells and everything that’s kind of made you who you are, as well as your state of mental, emotional, and physical well being at the time the stressor was introduced.
So for example, if I go back to that traffic jam example; and one person is in the car as a passenger happily listening to the Balanced Bites podcast and the other one is the driver and is feeling stressed because they’re late for an interview, perhaps; their response is totally different in those two people, even though the stressor or the input might be the same.
And I remember, Liz, you had an analogy that you made or an example when you and Spence both ate the same meal, but due to different stress levels, you both had totally different response to the meal even though typically you respond similarly to different allergens and things like that. Right? It was like after he came home from something stressful.
Liz Wolfe: Yeah, he came home from deployment. We went on a little weekend trip to Niagara Falls, and literally shared every single meal on the way there, and while we were there, and he got food poisoning and I didn’t.
Diane Sanfilippo: Yeah. So this is a really good example of constitution and stress. So even if you may both have perhaps a solid constitution, the stress that he was dealing with at the time is going to lower his immunity and make that meal affect him totally differently.
And so the response can be happening on a systemic level on a daily basis if you’re eating food that you don’t tolerate; that weekly gluten bomb, cheat, whatever you want to call it that you think isn’t so bad. If it’s not working for you, it’s not working for you. If it’s really not a big deal to your system, then it’s not a big deal. But these are the things that continue to add up over time.
Also, if you just ignore the fact that you’re overtraining; because look you guys, I crossfitted for a long time. I don’t happen to right now. Liz crossfitted for a long time; we love Crossfit for a lot of reasons. But one of the biggest problems with Crossfit that I see is the group-think group training for everyone when some people truly cannot physically handle it. And the problem is, you don’t want to feel like that’s you. Most people don’t want to walk in and say, “I’m not going to do what’s written on the board.”
You guys would not believe what percentage of the time I used to walk into my Crossfit gym while I was writing books and I said, I’m not going to do what’s on the board. Because I’m confident in myself and knowing myself, knowing my stress response, knowing what happened to me the previous time I overtrained, so when I’m writing books and I know I cannot handle that type of stress. Because if I say I’m going to do what’s on the board and just take it easy, and then the whole class is moving at a certain pace around me, you know how hard it is to have yourself kind of sandbag the workout? It’s hard. I’ll tell you what, it’s easy for me to sandbag a workout because I just don’t care what people are doing around me. But I know that’s not typical, and especially when you’re maybe newer, especially to a gym where you don’t want to be that one person. So, keep that in mind.
A repeatedly excitatory response to this kind of stressor, or even a chronic internal stress such as malnutrition, gut irritation, leaky gut, etc. can push your immunoendocrine system totally off balance. I mean, this makes it obvious how important all of these inputs are, as well as kind of our ground work that we lay with the way that we think about things.
Whoo! This is a lot so far, I know.
Liz Wolfe: {laughs}
Diane Sanfilippo: This is like,
Liz Wolfe: You’re doing good.
Diane Sanfilippo: We’re making up for the non-science in the first episode with this episode. Here’s the thing, you guys. It’s not your adrenal glands’ fault what’s happening here, because they do not call the shots. Your adrenal glands just respond to what’s happening to what essentially I’m going to simplify it; what your brain tells your adrenal glands to do. And your brain is dealing with a lot.
So the single biggest contributing factor to your adrenal fatigue is stress. Obviously if we unpack stress for each individual person, it looks totally different. It’s as different as a suitcase of your stuff would be, right? This is an analogy I just thought of right now; but literally, we’re all going to pack the same kinds of things, right? So we all have the same kinds of stressors. But maybe some of us take 8 pairs of shoes and maybe some of us take 2 pairs of shoes.
Liz Wolfe: {laughs}
Diane Sanfilippo: {laughs} Maybe some of us; some people are really great at packing light and traveling light, I would not be surprise if those are similar people to people who do not take a lot stress internally. Anyway.
6. Contributing factors that lead to adrenal fatigue [33:19]
Diane Sanfilippo: So here we go; contributing factors that lead to adrenal fatigue that can be lifestyle choices, lifestyle stressors; lack of sleep, poor food choices for you; right, that’s going to vary from person to person. Use of stimulants; so this is coffee (eep!) I’m saying that with a horrible face. Pulling all nighters or “pushing through” a day despite being really tired. Look, I know this for moms or new parents, a lot of this stuff is inevitable. I get that. We’re just trying to get through all of the things that can be causing this. So pushing through despite being extremely tired. Perfectionism; I would say perfectionists and type A people are very prone to this. Staying in no-win situations for too long. That’s a big one. Overtraining, or lack of fun or stress relieving practices. Our try this at home this week is going to be tied to that. Anyone who is a student, a medical professional, parent or single parent, either way I think this can be extremely hard on anyone. Someone who is unhappily married; unhappy or unsatisfied at work; if you’re self employed or starting a new business, you have issues with drug abuse or alcohol abuse. If you’ve had alternating shift schedules, if you’re an all work and no play-type; all of that stuff, you guys, is what’s leading to it.
It’s not often mostly your food choices. It’s not often mostly just your training. It can be; I would say training more so than food choices, although poor nutrition; overtraining piled on top of poor nutrition definitely a recipe for disaster.
Life events that can lead to adrenal fatigue also. So I mentioned before that this can happen as a result of chronic stress, or it can be an acute stressor. So what happens with this balance of our neurotransmitters and our stress response is that we can get to a point where all of these small chronic stressors hit a tipping point, or it can be one big intense stressor. So if you’ve got unrelieved pressure or stress at work, like some kind of huge project; (ahem), book writing. {laughs} So that can be a huge one. Any crisis or severe emotional trauma. Death of a loved one; divorce can be one, major surgery, extended or chronic illness, sudden change in life situation, such as loss of a job or moving without much support in a new location, especially. Repeated chemical exposure, extended chemical exposure. These are all things…
Some of these we may be able to hear and say, “Oh, that’s me. That happened to me.” Some of them, the chemical exposure, you may not even know it happened. You may not even know you’ve been exposed to lead or mercury or any of this stuff.
So the problem; I know, Liz you’re having your house remediated, right?
Liz Wolfe: Yep. I’m all about; yep.
Diane Sanfilippo: So the problem of stress might not be such an issue if it weren’t compounding many stressors, right, over days, weeks, months, and years without downtime for the system. So one of the things that I’ve been paying attention to personally that I want to encourage everyone to pay attention to; and again, I can’t speak for the parents. Maybe, Liz this is something that you can speak to or just keep kind of your ear, and eye, and brain to {laughs} in the coming months and years. After an extreme bout of stress; so for me that would mean something like a day where we do a photo shoot {laughs} and then a live podcast event. Which was after weeks and months of planning for it. But that day; I’m happy, I’m fine, my energy is there. The next two days I can’t commit to anything.
And of course, I don’t have a child who is then depending on me. That’s an extremely specific choice of mine, and what I choose to put on myself stress-wise ahead of an event like that is also knowing that I don’t have that follow-up stress, if that makes sense. Liz, you kind of joked, you didn’t do anything you just showed up. Well, here’s the thing. I don’t feel that way about it {laughs}. For me, you showing up is extremely important. I wasn’t about to put all that stress of planning on you, because you can’t then take the next two days off of life and responsibility, having a child.
So part of it is, if you’re in a situation where the person or people that you’re working with don’t recognize how to help you manage your stressors without even telling you about it, you have to be responsible for that on your own. To say, if I didn’t already look out for Liz in that sense, it would be up to Liz to say, “Diane this is cool, I can do this event. I can’t help you plan it, I will show up, I will be there, I will be present, you will have me 100%, and after it I can’t do whatever we might need to do after, but I will be there for the event. Exactly saying what you can commit to doing the work, and being responsible for your self-care before and after.
That being said, this does go back to what we talked about in the last episode about saying no to things, and for me that was even, obviously the NTA conference happened that whole weekend. I said no; I’m not going to show up on Friday or Saturday, and by Sunday I was like, ok I’m feeling better. More energetic, I felt a lot better rested, and so I got up and we went for the whole day on Sunday and that was fine. But I did not overcommit myself. That’s after the last 4 years of learning how my body responds to the backlash of stress of those types of events.
These are the kinds of things that I do, and I set myself up for to not fall back into an adrenal fatigue situation because I’ve been there before. I can’t act like I don’t know what it is or that it’s going to happen. We’ve seen a lot of authors go in and out of this; authors who might be dealing with autoimmune conditions. I feel extremely; I kind of feel sorry for them that they have these conditions because they have to do the work anyway, right? I’m really lucky that I don’t have a health condition like that, and we’re putting pressure on ourselves to write these books or to do this work because we feel called to do it, and we feel responsible for it and it’s going to help people. But man, I wish people would take way more time to do that work and not put so much pressure on themselves, because their bodies are not responding positively to it. We see it happen again and again; people kind of falling back into illness. And who knows if we can prevent it.
But I know when it happens one time, it’s like, shame on me. But when it happens again, you can’t pretend you don’t know that these things are going to happen, and you can’t pretend that you don’t know that you’re now more prone to this happening. So I just wanted to put that out there.
So then, here’s the thing. If our adrenals aren’t to blame, what’s to blame? It’s really that higher order of our brain asking for that output over and over and over again, and we’re setting ourselves up for failure when we’re pushing that stress response.
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7. Symptoms of adrenal fatigue [41:42]
Diane Sanfilippo: So, ok. Before I keep rambling {laughs} is there anything you want to interject. I feel like the micromachine commercial guy with just a ton of information.
Liz Wolfe: You must have made really good notes, because you’re making total sense {laughs}.
Diane Sanfilippo: Ok good. I do have really good notes. I’ve written about this before, and we’ve talked about it on the show before, and I was like, I’m grabbing my notes because I’ve done this before.
So, here’s the thing; what are symptoms of either this HPA axis dysregulation, or sometimes I like to call it altered adrenal profile. {laughs} Obviously, fatigue. Inability recover appropriately from exercise; you might feel tired just post workout, maybe 20 or 30 minutes, but you should feel ok after that. If you’re dragging for hours throughout the day, and if you’re dragging for hours despite having refueled properly and kind of sitting down and recovering, then you’re overdoing it chronically. I’ve had clients who are aerobics instructors tell me, just teaching one class flattens them for the rest of the day. That might have been too much for you.
If you have headaches with physical or mental stress; so stress headaches, weak immune system or allergies. If you’re very slow to start in the morning. That doesn’t mean everybody who is slow to start in the morning has adrenal fatigue; my husband does not like to wake up and sprint out of bed {laughs}, and he does not have adrenal fatigue. Gastric ulcers, afternoon headaches, feeling overly full or bloated after meals. So one of the things about obviously adrenal fatigue and stress is you’ll have suppressed digestive function, so that full or bloated feeling is going to be that lower HCl as a result of this stress situation.
Craving sweets, caffeine, or even cigarettes. Blurred vision, unstable behavior, becoming shaky or lightheaded if meals are missed or delayed. We know what being hangry feels like, but then there’s kind of a next level of hangry. If you can’t stay asleep or can’t fall asleep, if you have dizziness when you move from sitting to standing or lying down to standing, or transient spells or dizziness, so not just dizziness when you’re moving from those positions, but if it’s coming and going. Asthma that’s kind of hitting you out of nowhere. Hemorrhoids and varicose veins can actually also be a sign of this. This is according to Dr. Datis Kharrazian, I didn’t make up this list. So these can all be signs.
Now, this is not like WebMD. We are not diagnosing or treating anything. So if you just have one of these symptoms, this doesn’t mean you have adrenal fatigue. If you’re noticing that multiple of these symptoms sound like you, if you just can’t figure out what’s going on, then that could be what’s happening.
8. What to do about adrenal fatigue [44:36]
Diane Sanfilippo: Alright, so what do we do about it? {laughs} This is probably one of the biggest questions, right? What do we do about it? So I feel like we have talked about this ad nauseam for so many episodes, just the general health information that we share all the time is basically trying to help you avoid this type of fatigue. But sleep is super critical. Before we even get to the nutrition and supplements, the lifestyle factors are so critical. Because you cannot just take some vitamin C and avoid gluten very strictly, and expect the stuff to resolve itself. The lifestyle factors are actually probably more important than the nutritional factors, because the lifestyle factors are what’s laying the groundwork for your brain to get out of that excitatory imbalance. Your brain needs to calm the F-down {laughs} basically. You need to just chill out. So sleep is critical.
Avoiding draining people or situations, learning to say no to things. You guys, people will not dislike you for saying now. That is a huge thing to understand. I think; I don’t know if we talked about this on the podcast, Liz but I think we shared an article. I don’t know if you shared it first, or if I shared it, or if maybe we just talked about it and I had shared it, talking about how boundaries create so much space and learning to say no is creating boundaries. It’s where you say, “I care about you but here’s my limit.” Right?
Or, for me a lot of it is even when we do events in person, I have a boundary where if I decide I’m going to go eat food, I stop talking to people and if somebody decides that, while I’m walking and saying I’m going to get lunch that they want to try and keep talking to me after I had just created a boundary that they’ve decided to continue to cross, I don’t feel badly if they feel like I’m being rude to them, because what they’re doing is actually being rude and not respecting the boundary that I’m attempting to set. Because I need to protect myself and say, “No I’m not going to talk to you right now, I need to eat lunch. Let’s talk after lunch.”
We need to understand that when we create a boundary and somebody wants to push back on that boundary, that it’s not us being mean or unlikeable or disrespectful that the person who is actually disrespecting the boundary is doing that. It’s a whole ‘nother episode. {laughs}
Avoid over training. Training versus draining; this is stuff that I think Paul Chek talks about amazingly in How to Eat, Move, and Be Healthy. I’ve talked about that book a whole bunch. Amazon doesn’t seem to have it; I feel like you have to go to Chek Institute; You can get a copy of this book. I feel like that is a great workbook to use. A lot of the way that he did work in that book has inspired some of what I did in Practical Paleo. Even his, he’s got a poop lineup and we modeled that, as noted, in Practical Paleo. So I think it’s a great book.
I’m trying to get my personal trainer to create a plan for people who are concerned that they’re dealing with adrenal fatigue to be able to do some workouts that are healing, but let’s not hold our breath for that. {laughs} Because I don’t know how soon that’s going to happen. But some meditation, restorative breathing, walking, like restorative yoga is great, light swimming can be great. I would try and avoid chlorinated pools, I would try and find a saltwater pool. Not doing swimming for the sake of increased heart rate, just doing it for the lymphatic flow, for the movement. And if you want to train with weights, it’s ok to do that. You need to make sure you’re not grimacing or making crazy faces because you’re grunting to get that weight up. Slow training, not super high intensity.
You guys know what it feels like to push your adrenaline in the workout to either you get lightheaded or you have to sit down between things, or you get that really intense heart rate going. That’s not what we’re looking for here, because what we’re looking to do is combat the brain chemistry that you’ve set up that’s told your body for however long to live in that high vibration, that high stress state. So we want to pull you back down and scale it back down.
As you start to heal, there’s a time and a place for perhaps once a week trying something that’s a little bit higher intensity, seeing how you respond. And then reintroducing. It’s almost like a stress for our protocol, where you’re removing the stress, you’re going through some healing, then you’re going to test your reintroduction over time.
Again, remember it’s not like a cold or a flu where we say, “ok in two weeks or in 30 days or 60 days or 90 days this is going to be healed.” The reintroduction of certain stressors is on a timeline we don’t know. We don’t know how long it’s going to take for you. You will start to notice as you wake up and come out of this sort of fog, you will start to notice that you’re just feeling better in general, and maybe one day you try a workout that you haven’t done in a long time, and you see what your response is to it. Anyway, we’re still talking about avoiding it.
This goes back to some of the mental stuff; when you’re not enjoying your life or something that’s happening, assess whether you can 1) Change the situation; 2) Change yourself to fit the situation; or 3) Leave the situation. {laughs} So this is a huge part of stuff that I want to teach in the future. But you are responsible for your choices. You’re responsible for what you’re doing day in and day out. There are tragedies that hit, but the vast majority of what’s going on in your life, even how you think, feel, and respond to a tragedy is up to you. And you have a choice. You always have a choice. The minute you think you don’t have a choice is when you start to create emotional trauma for yourself, and emotional stress for yourself. So we need to remember that we have choices; we need to make choices to have a positive mental attitude and change situations that are not working for us. Because if it’s not working for you, it’s working against you.
Keep a gratitude list; play, which we’re going to talk a little bit about that, getting outside, playing with friends, family, pets, board games, whatever you want to do. Something that you enjoy that makes you laugh, and smile, and interact with other people. When it comes to diet, getting it well balanced for you; obviously, we like real nutrient-dense foods, getting a variety of organic vegetables and fruits, omega-3 fatty acids through fatty cold-water fish primarily, or sea vegetables. If you guys have been seeing my Diane’ salmon bowl over on Instagram, that’s going to be a great support for adrenal fatigue along with maybe some white rice or some potatoes, something like that.
Getting some mineral salt or Himalayan sea salt added to your meals, and balancing your meals judging by your success, how do you feel entering into your next meal. If you feel shaky and overwhelmed, then perhaps your previous meal needed either more fat, more carbs, more protein; you have to work on rebalancing that.
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Diane Sanfilippo: Should I save supplements to talk about for the next episode?
Liz Wolfe: {laughs}
Diane Sanfilippo: I feel like we are over time {laughs}.
Liz Wolfe: I think so. Think this is a good place to stop and let everybody absorb and think about how it all applies to them.
Diane Sanfilippo: I think I’m going to talk to Dr. Lauren Noel for the next installment of this series, so I think it would be great if she and I talk about supplements and herbal support, and then we also might be talking about some of the hormonal cascade of what can happen with adrenal fatigue and some women’s health issues. So hopefully we can get to that there in that episode.
Liz Wolfe: Sounds good.
Diane Sanfilippo: Ok.
Liz Wolfe: Alright, so do we have a Try This At Home segment today?
Diane Sanfilippo: We do have a Try This At Home.
Liz Wolfe: Cool.
Diane Sanfilippo: While you listen to the next episode; so we’re in 238; while you listen to episode 239, and then of course all future episodes if you would like but this Try This at Home is specifically for the next episode. We want you to listen to the next episode while walking outside. I know the weather may or may not be completely conducive to that where you live, but put your gloves and your hat on if it’s chilly. We want you to walk outside while you listen to the next episode. Of course that means you’re going to have technology with you and in your ears, and most likely that’s going to be an iPhone or some kind of smart phone. Snap a picture, post it for us, tag @Balanced Bites podcast on Instagram. Liz, you have a note for the overachievers? {laughs}
Liz Wolfe: Yeah. I have an advanced; ok, so yours is the novice, I’m thinking back to Hoyle card games when we had a PC and there’s novice, there’s advanced, and there’s expert I think. So advanced level, you’re going to walk off path. I don’t care if it’s 2 inches off the path, but walk on the grass or on the more rough terrain so you give your body a new challenge. And if you’re even more advanced, maybe you’ll do that barefoot.
Diane Sanfilippo: I like that. I notice 100% I walk differently, not necessarily barefoot but if I do the 5-fingers even, which I think are a midway maybe between sneakers and barefoot. Just humor me if it’s not, because I feel like it is.
Liz Wolfe: {laughs}
Diane Sanfilippo: I’ll tell you, the proprioception that I feel from my feet and the way that I walk, how I hold myself posture-wise when I’m wearing either sneakers or 5-fingers is totally different. You can actually tell when you see someone walking towards you whether they’re barefoot or not. So it’s interesting, anyway.
Liz Wolfe: Very.
Diane Sanfilippo: And even with the 5-fingers. I can tell I look weird to people as I walk towards them, and then they look down. So anyway, it’s a cool try this at home.
Liz Wolfe: Very good. That’s it for this week. You can find me, Liz, at and you can find Diane at Join our email lists for free goodies and updates that you don’t find anywhere else on our website or on the podcast. While you’re on the internet, please leave us an iTunes review. See you next week.

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