Is Your Exhaustion Actually Stress? 7 Surprising Physical Symptoms Revealed with Dr. Jenski

Welcome back everybody, once again to Made for health with myself. Dr. Jensky and I, we're going to talk more about stress today. We're going to get dive, actually dive into, like, how do you know if you have stress? We're talking about psychological manifestations of stress as well as body or physiological manifestations of stress. And hopefully this will give you some tools to kind of maybe see if you're, if you're dealing with this as a part of your healing journey or just your general, you know, lifestyle, you know, your ultimate wellness journey. If you're into like biohacking, all that kind of stuff, as usual, if this information is helpful, please, like share, subscribe, follow below. That's how we get information like this out is by you following, sharing, commenting below as well. One thing I did not mention the previous episode is we'll be collecting questions from these episodes and we'll have like a Q and A session probably usually a couple weeks after the publication of this when people have had a chance to see some of the questions. So make sure if you have a question, you put it below as well. And with that, today we are going to talk about how do you know if you're stressed? And so first you know that. Is that a tall order? How do you know if you're stressed? I mean, stress.

If it's obvious, it's not a tall order, but it really depends. It depends on how you're quantifying your stress. And I guess that's what we're trying to convey is how do you quantify it? How do you know? Well, I think there are some that might seem obvious. You know, lack of sleep is one, intrusive thoughts, elevated heart rate, anxiety, feelings of panic, tremors, palpitations, sweating, anything that kind of mimics sympathetic overdrive. And so for those that don't know what the sympathetic nervous system is, it's part of the autonomic nervous system and it goes along with the parasympathetic. And so one sympathetic is fight, flight, freeze. So are you always irritable? Do you fight with everybody? Are you anxious? Are you becoming more withdrawn? Are you almost frozen or fleeing? And then the parasympathetic is rest and digest. And so sympathetic is going to rev up your heart rate, bring up your respiratory rate, bring up your blood pressure? Do you breathe a lot? Do you not take deep breaths? Do you have a high heart rate? Are you hypertensive? Do you have insomnia? Do you sweat a lot? Those are kind of the things that I would think of as part of that, beyond the obvious kind of psychological, emotional ones, what about you also think.

About how do you respond to things? Are you someone who's easily started? Does you know, if you're someone you love comes your husband, wife, spouse, friend comes behind you, is your initial response like a jerk or stall response? You know, are you, are you easily revved up? You know, do you like, if, if you read a post on social media or you hear about a life event or something happens with a friend, do you. Does it, does it either cause you to like crash emotionally or does it rev you up and then when does that linger for like four hours afterwards? Is it more like you hear about and you're sad or you're excited and then 30 minutes later you've moved on? Or are you still thinking about moving.

Beyond normal emotional response?

Yeah. Yeah. So are you still thinking about it, you know, hours and hours later? I think that's something that a lot of people don't realize who feel, who live like good lives and have good families and all that kind of stuff, but they don't realize that, you know, when they get revved up and they can't kind of bring it down, that's actually their autonomic nervous, their sympathetic nervous system is always kind of like on edge. Yeah.

That could also be genetic. That could be a comt gene snp.

True.

Because if they can't break down catecholamines, then they're kind of stuck in that hyper adrenaline, hypercholazolemic state. So I think there's lots of layers to that.

And those people also, those genetic individuals are also more prone to like things like OCD issues like that hyper focusing, sometimes even tic disorders can be associated or like hand washing. Some OCD type of things can be associated with that comti methylation issue, which, which if you live in a really dirty environment and it's stressing you out. It could be trauma. Yeah, it could be a trauma. Right? Yeah. So there's interesting things like that. Then there's like digestive issues. You know, you don't digest your food very well. You have gas gut issues. You know, if you do have. You know, it's really interesting. When I was doing my training in residency, we talked about this thing called cholinergic urticaria, which is just stress induced hives.

Yeah.

You know, that's idiopathic. It was actually idiopathic. Right. You rule out, you rule out any autoimmune diseases and say, here's your Zyrtec and Claritin and move on. With your life. And now we know that's a mast cell phenomenon which stress induced hives, you know, so skin responses, you know, stress induced eczema. When you're someone who gets a stressful situation, does your skin flare up? You know, why don't you speak to, why don't you speak to some skin stuff with stress?

Well, it's funny you should say that. Yeah. Eczema for sure. I mean, I've had eczema for most of my adulthood, and mine absolutely was tied to stress. And it's common in the setting of not only stress, but for me, certain other triggers. And being a biotoxin patient, when I'm exposed to biotoxins, my mast cells get triggered, my histamine dumps, my eczema flares. Anytime my gut gets leaky, my eczema flare. So the reality is, is that skin is an outward expression of an inward problem is the way that I describe it to patients. So things like eczema, things like psoriasis, things like rosacea, things like adult acne, to me, those are the body trying to say something's not right on the inside. Now, that might be bacterial dysbiosis, that might be sibo or sifo, that could be a toxin or nutrient deficiency. But a lot of times it's stress or stress tied to one of those other conditions. So I've noticed exponentially that when my stress is controlled and better, my skin gets better as well. So we see that all the time.

Yeah. And then with other things that can be related to stress or, you know, we mentioned sleep briefly, but, you know, you can have different types of sleep disorders. Whether it's, you know, your day's okay, you run, run, run, but then you get in bed at night and then when everything's calm, you have mind chatter and like you just, it's almost like you're. Now that you're ready to go to bed, you're exhausted and tired, and then all of a sudden it's like, bing, you know, you can't get down or you get to sleep, and then you wake up in the middle of night panicky. That's actually a type of dysautonomia in some patients where they wake up with their, their heart racing or they wake up totally alert. It's three in the morning. You know, when I initially did some functional training, it was referred, that was referred to mainly as an adrenal thing. You know, it was described as your daytime intruding into the night. But that can also be a nervous system Cyanomic response, which again ultimately is a kind of stress kind of thing.

Or a blood glucose issue, which can stress the system the same way.

Yeah. Which gets into the metabolic aspect of this as well. And then just like energy issues, like some people, you get stress and stress and stress. And ultimately your mitochondria we talked about previously, the powerhouse of the cells get dysfunctional and now your energy levels kind of start going down and you kind of like go into like a chronic fatigue kind of state where it's like you're barely making it every day and then every day you just like drop down totally exhausted and. But then all of a sudden now you can't make it through the day.

Yeah.

And people are like, well, how is this a marker of stress? It's like, well, because I'm not anxious, I'm not revved up, I'm, I wake up in the morning, I'm exhausted and.

I have non colic depression. That's when your curve is low and flat.

Right.

Like those are the stages. Like we're going to talk about that on this one.

I, we, I don't know if we actually talked about, we might talk about that. Yeah, I know what you're going at once you talk about.

I mean, so, so ultimately was it Cellier Hans Selye so you described the stages of, stages of adaptation, stress response and essentially it was the first to really fully describe what was happening in the body when someone was physiologically stressed. And essentially it's describing your relationship to cortisol and how when made appropriately, it is absolutely necessary for life and protective. And it's actually, believe it or not, not the gas, but the brakes in a stressful situation. So if you're stressed, the body releases adrenaline and noradrenaline. So your catecholamines, maybe even dopamine to a little extent, which is also a catecholamine. These are types of neurotransmitters. And then ultimately your body will then release cortisol in response to that stress response or stress chemistry. And that acts as the brake pads in that situation. And ultimately if that stressor is removed, the body goes back to its baseline and you live to fight another day. Your body's actually stronger for it. It's an adaptation. Ultimately, if you're stressed, chronically, subacutely or chronically, gas, gas, gas all the time, eventually when you're stepping on the brakes, releasing cortisol in an appropriate amount, the car doesn't slow down. And so you got to really slam on those brakes, meaning excess Cortisol needs to be released to have the same efficacy, or at least alleged. And at that point in time, you're going from what was protective to becoming deleterious to your health. And that then lends itself into this chronic elevation in cortisol and a dysregulation in that. In that whole kind of loop or cycle. You wind up with a curve that becomes flattened over time. You lose your counter regulation, which is dhea, which is protecting you from that excess cortisol. And the body just says, screw it, shut it down. Just make enough to keep this person alive. But they're not going to feel good. But I can't go on hurting myself. So the body will literally drop your cortisol production and you'll wind up with a low, flat curve and low to no dhea. And at that point in time, it's melancholic depression. It's sleeping 20 hours a day. It's barely getting through your day. It's being heavily reliant upon things like caffeine or. I only feel good when I'm in a high adrenaline situation because you're just riding that high, which eventually leads to a crash. And that's a late stage, in the way that he described it. It was literally like stages one through three. It was early adrenal fatigue all the way through to adrenal exhaustion, which is kind of what we're describing, but we don't really use that nomenclature anymore because it implies there's something inherently wrong with adrenals, with the reality being that it's the loop. It's not Cushing's, it's not Addison, but it's that loop that's dysfunctional. And so I still use that. That verbiage to kind of help patients understand the same way that I am now, hopefully. But, you know, that's kind of what I was alluding to because you go from these obvious, quote unquote obvious symptoms to. And is that what stress looks like, too? That doesn't really. It's not what I thought it looked like, but it is.

It's like the end result of it. And part of that is that HPA axis dysregulation, which is your brain back to the hypothalamus.

Yeah.

Pituitary is like, I. The way I explain it a little differently, there's like your body wants to go in hibernation because you need to sleep it off. And you sleep it off for like five months straight or whatever. It's interesting because back in the 1800s, this was called neurasthenia. And it's actually, I think Teddy Roosevelt, I think his wife actually had this. And this is an interesting little story. The treatment for it back then, okay. In the late 1800s, was to remove yourself from the stressors of culture and society to nature. Was this was the treatment?

Yes.

Now in the 1800s, before electricity, before cell phones, before cars, the treatment was to remove yourself from the stressors of culture and society. Right. And the Teddy. Because Teddy. Yeah, the Teddy Roosevelt story about that was like his wife got sick, went away, he went out. He ended up meeting John, John Law, John Mears Law, who's like a big nature. People that have been outdoors knew this guy was ultimately came president. He's. And because he saw the power of nature, he's the guy who passed the laws to preserve national wild parks and these beautiful places we have now. Because everything is getting cut down for wood and all that kind of stuff.

Vitamin N. Yeah.

And so the point is like we've known about this for a really, really long time, but now we understand it as more of a brain based issue. And ultimately it can't. You don't look stressed per se, but it's like the end result of your biasing. I need to hibernate for three to five to six months, which nobody can do.

So they get stress dose steroids or, or.

And they feel good. Yeah, they get I. Early on my career like we might have.

Everybody gets hydrocortisone.

Yeah. I would. Dexamethasone works better.

Yeah.

I was doing that early on my career for patients because I realized. I realized at this point in time that I was actually treating the decide, you know me a little bit their adrenaline stuff and they feel great for four to six weeks. And because dexamethasone has a. The half life is like six to eight hours, but the physiologic half life is like 72. Yeah. I feel safer to do it and you get a longer impact.

And so I mean, what about my journey? I mean the beginning of my journey when my adrenals. I was 39 and the first salivary cortisol test we did, it was low and flat with no DHEA. I was 39 and I was. I was an ER doc surviving on adrenaline and caffeine. And then I would crash and ultimately when did I feel at my best? In the beginning, anytime I was on prednisone, when I got on prednisone, I would feel amazing. Everything would go away. Why? Because this was getting better, amongst other things.

Would you like to share what you were treating with your prednisone.

Oh, gosh.

Everything.

My adrenals, my inflammation, my mass cells.

Mainly for the eczema stuff.

My eczema.

Yeah. Yeah. So it's funny how all that relates and correlates. Yeah, it all hooks up. So what was the other thing I wanted to say in regards to stress, sleep, that kind of stuff. And so one other caveat I want to mention about that is I've had one patient actually take this to heart and she actually disappeared for a month, went to Yogaville and she had horrible dysautonomia, Horrible, chronic fatigue. She would come to our clinic and young, attractive, come in, fall off the front desk, put her hands on it and just literally fall on.

And she.

And people look at her like she's a little histrionic. You know, she's like something psychologically weird with her wind up seeing one of the local pots guys down at VCU and top Dr. Sika, when he was still here in town and on a bunch of medications, didn't feel any better, came see me, I did a bunch of things. Ultimately, she went to Yogaville for a month, got away from everything and came back and was like, I'm better. I'm better. Off all of her prescription medications, awesome. Off all of her herbs. And it was literally her fix was Yogaville for a month, which is a place she'd pray and meditate all day long, had food prepared for her. Everybody wore the same, like, kind of like whatever. Whatever they wear, they're like scrub kind of outfit there. So. And you just kind of. And a month of that fixed her. Her dysautonomia in pots and all this kind of stuff. So that's. Stress can look very interesting. So let's. Let's transition a little bit to functional medicine. What are some things.

What about tools? What about.

That's what we're getting ready to do. Yeah. Tools. Yeah. So there are, there are. There are stress scales. And in our. Our online course, Connect to Health, when we, when people go through the stress course, we do have these tools to measure stress. To measure stress. Yeah. What are other ways that from a functional perspective. You mentioned that you already talked about the cortisol salary cortisol test.

Yeah. But just to kind of hammer that one home, I think it's vital, I think that, you know, conventional medicine doesn't give a lot of credence to this test. I think it's vital that every patient get one. It's part of the. It's an obligation in my practice, I don't know about you, but every single patient that I see, every new intake, no matter what their chief complaint is, gets poop test in a spit kit. Because I want to know what's going on in their gut and I want to know what's going on with their HPA axis. Because if I get that right, when I get that right, hopefully 80% of their problem is solved and the other 20% is specific to that individual. But it's see it over and over and over again and it's very, very rare that they're both normal right off the bat. So it's a four point salivary test. It's the best way to measure that. It's also measuring a cortisol awakening response, which is actually different than the salivary cortisol curve. It's actually showing you more the chronicity and what your resiliency is and maybe, maybe your reserves to some extent. So it's an indirect measurement of light hitting your eye and then going through to the part of your brain called the suprachiasmatic nucleus that is going to then tell the body to cortisol. And so it's your light response to it's ready, I'm ready to start and greet this day. And we see it elevated and that's anticipatory stress. Right? They're waking up, but they're stressed before they even get out of bed. And then in some individuals it's suppressed and they're, they're blunted, meaning they've lost some of their resiliency. And then you look at that four point curve and then you're looking at salivary dha. I think that's incredibly reliable. You can also measure a serum cortisol, but the only reliable measurement based on the literature is first morning, usually by or before 8am that's hard to get done. Most labs aren't opening until then anyway. So the saliva I think is great. We talked a little bit about heart rate variability. I think that's a nice objective measurement. Heart rate in general, like just sitting here, is your heart rate 90 or is your heart rate 55? And then the heart rate variability being that kind of beat to beat variation that shows the, the flexibility or functionality of your autonomic nervous system. What are other ways that you would measure it?

Well, I want to talk about the heart rate blooper because a lot of times with a lot of our dysautonomy and POTS patients, they will know like when I sit, my heart rate at rest is 90 yeah, it's 95. Yeah. And some of those individuals, when you're doing the physical exam, have what I call adrenal pupil, where, you know, you shine, like their eyeballs are like. They have these really big, like, big round eyes. And you shine a light and they shrink down, which is their parasympathetic nervous system saying, hey, it's bright, cut down. But then their sympathetic nervous system is like, I don't feel safe back up. And you can actually, I've done this with patients. You videotaped it happening because they've never seen it before. And they're like, that's kind of weird. And that's a physical exam finding of. You have. You've got a certain degree of irregularity. Something I like to do on patients as well is a nasaline test, because that's a test that helps. Look at when you go from laying on a table to sitting to standing and you have blood shifting from being evenly distributed in your body to pulling in your leg and your pelvic area and standing and going down your legs in your pelvic area. Does your autonomic nervous system have what it takes to contract vessels in your legs and keep your blood pressure and pulse stable? And for a lot of individuals, it doesn't. And so what happens is their blood pressure will either. Sometimes they'll shoot up a little bit, compensatory, come down. There's different nuances to that, but you'll. The big. The big tell is their pulse, it just kind of starts going up. And if it goes up more than 30 beats per minute in an adult or 40 in a kid, that's the diagnosis for POTS, which is postural orthostatic tachycardia cardi syndrome. Back to the cortisol waking response. I want to say something about that is like, that is. That's actually a biologic marker for resilience, but also longevity. So if someone doesn't have that 50% or greater bump up in the cortisol within 30 minutes, that's a. Like, in populations, you don't live as long as people who have that.

Yeah.

So again, you know, that's. That's not.

I mean, that goes back to the curve itself. Like, there's so much to be gained from that result that again, I go back to saying everybody should have one is like, just, okay, if you see points on that curve being elevated, you can maybe identify where in that person's day a stressor is happening, like dinner time. Is their cortisol elevated because they're busy Getting home from work, they have to make dinner for everybody. And it's a stressful time or because it's a dysglycemic event. Right. They're not stressful. Someone else is making dinner for them. They're not even coming home from work. They're staying at home during the course of the day. And we see a cortisol bump, normal, normal bump in the, at dinnertime and then normal again. Maybe it's because postprandially, that being their largest meal of the day, after they eat, their blood sugar shoots up and then cortisol responds to that stressor. So there's a lot to be gained from that. But then the shape of the curve is really the most important, and I tell patients this all the time, is that as that curve loses that lazy L and becomes a flattened curve, all cause mortality goes up. Every chronic disease state gets a little bit worse. And if you get that right, then all cause mortality goes down. Kind of like with diagnosing sleep apnea. Right? If you have undiagnosed sleep apnea, all cause mortality goes up, you treat it. All cause mortality goes down. Those are tied by the way, the two of these. And we're going to talk about sleep, I think, in some of the other episodes. But the reality is that there's so much to be gained from that downstream and risks that you can talk to patients about. This is what your stress is doing to you now. This is what your stress will be doing to you in X amount of years. That's eye opening for a lot of these patients to then take it more seriously than they, once upon a time thought they should be. Like, you know, there's a lot of impetus towards just tough it out is the badge of honor of I can, I only need three hours of sleep. And like, look at how many jobs I have. And like, no way, man. I used to be like that.

I was like that.

Now I am the polar opposite, man. Give me, give me my eight hours. I'm in bed at the same time, I wake up at the same time. I want peace and tranquility. I don't have a social life and I love it that way. Like, if you don't add value, you're not in my life. Like, it's. I have de stressed and detoxified like nobody I know and I am way better for it. And like, I think that's the reality of all this.

Yeah, I was, I used to, I used to, I literally used to say, I'll sleep when I'm dead.

Yeah.

That was something when you're in your residency, you kind of have to say.

You have to say that because that's the only way you self motivate.

That's the only way you self motivate.

I did that for 20 years in the ER. Yeah, it's flipping my shifts all the time.

Yeah. So. So we talked about the cortisol, we talked about heart rate availability, which is. I really like that as well because it get, you know, as well as you mentioned heart rate throughout the day, which you can measure either with different devices. And oura ring, you know, you can measure heart rate built in with the heart math, which I actually got. I did it for a short period of time, but it really kind of educated me how important breath work was. Yeah. Because when I, you know, heart math is this really cool technology, has a lot of data on it behind heart rate variability, which that's a fancy word for saying like when you, every time you take a breath and you breathe in, you're the beat between beat and beat, it actually lengthens a little bit because it takes longer for your heart to fill up. And so when you breath out, your heart empties faster. So actually the distance between those things shortens. And so there's actually a variation. And if you listen to a kid's heart, it sounds like it's all over the place because it literally is. You've heard these kids heart, so. And you listen to grandma's heart and it doesn't matter what she does, it's like exactly the same. So measuring that tells you how functional your autonomic nervous system is and is your heart responding to it. So heart math can measure that. But I spent I think the 3 or $400 for the device. Got it. And then realized within 10 different times of playing with it that my heart rate 100% responds to breath work. I do breath work. Five minutes, I'm in the zone with HRV. So it's kind of those things where it just reinforced to me, wow, breath work actually works.

Yeah.

Why?

How does it work?

How does it work? That's interesting. So when you. I think the short answer is no one really knows. The long answer is it does a bunch of different things. One of the things with breath work is you're actually increasing intradominal pressure and you're actually pushing on the organs in there that all innervated by your vagal nerve. So you're actually getting some vagal nerve activation of activation. The other thing that's interesting in certain ancient Asian traditions is that they'll actually have with the breath work.

This like you'll breathe out humming, chanting.

Yes. And what actually it does is actually vibrates your. Your brain, your skull and your other nervous system. And there's a whole thing called tongren, which is an ancient Chinese kind of thing, using different frequency tuning forts, forks on your skull to actually activate your nervous system. And with kids, particularly with kids with dysregulatory issues like autistic kids, that can be used to help calm them down. You know, I remember when I was doing my pediatric rotation, your kid cries a lot.

It's got colic.

You put in a rock when you put it on the washing machine. Right. And it calms down. Right. And like, we knew that, you know, 20 some years ago.

We didn't know why.

We know why. Yeah.

But it's vagal nerve still. Right? It's. You're activating the parasympathetic response.

Yeah.

And you're doing humming, chanting, singing, gargling, cold water immersion.

Yes. Yeah.

It's vagal activation. And the breath work is that too? Probably, amongst other things.

But nothing with breath work. If you do it slow, one of the things that happens is you actually drive up CO2, which actually has a relaxation effect on your nervous system and causes vasodilation. And so when you do slow, meaningful breath, and we'll actually probably skipping ahead to a future session with stress, it actually drive up CO2 levels and that actually causes vasodilation. So you're actually getting improved blood circulation to everything in your body. Hyperventilation causes vasoconstriction. And early on, when I was doing this, I actually gave myself a migraine one time doing too much hyperventilation. So I kind of have to be a little balanced with that. Yeah.

But that's why you have people that are hyperventilating. Do what? Breathe into a bag to recycle their carbon dioxide.

Yeah.

So they want. So they don't drop their levels and they don't pass out or get a migraine or somewhere in between.

Well, that's what happens with, with altitude sickness. Yeah. Is one of the issues when you go higher because oxygen levels, you breathe a little quicker to maintain your oxygen, which is fine, but the end result is you blow off CO2 and. And you get a metabolic alkalosis. And that's what, you know, diamox, you.

Know, counters, which is, you know, what I learned works really great for altitude. Rhodiola.

Oh, really?

Yeah.

Rhodiola.

Yeah, Rhodiola, which is an adaptogen it's an energizing adaptogen that you can use for cortisol imbalances if they're low and you want to energize that person. Like, I wouldn't use rhodiola in someone who is stressed and anxious or stressed and panicky, but in someone who's like, stressed and fatigued or stressed and depressed. I'm going to give them some rhodiola or I measure their cortisol and it's low. The Vikings identified this plant and used to chew on it before battle because it's not only helpful with the stress response, but it's helpful for adaptation in altitude because of some other mechanisms that I'm not 100% sure of. But the reality is that it can help.

Yeah. Oh, cool. Yeah.

I think we're going to talk about adaptogens a little bit.

Oh, we probably do. Somewhere. I haven't looked at sleep.

Also, I guess, measuring your sleep, we're talking about measurable, so heart rate variability, heart rate, a nasaline, cortisol testing, maybe serum testing, but probably not. And then sleep, like, are you sleeping? Are you getting enough sleep? What's the quality of your sleep? And I think we're going to get in depth on that in one of these other.

Sleep is like one of the three things in the triangle of health, like gut health, stress and sleep. And, you know, it's one of those things, they all interact with each other. If your gut health is off, it can affect your sleep and your metabolic reserve to stress. And if your sleep is off anyway, whether it's from dysautonomia, from stress, you don't get quality sleep all of a sudden. It affects cortisol, it affects digestion the next day. If you don't get adequate sleep, you don't get your natural. Your white blood cell count actually modulates at nighttime. Your natural killer cells pop up when you're sleeping. The glio lymphatics, which is the lymphatic trash.

We're going to get into all this.

Yeah, but all these things require good sleep. And if you're stressed and you're either having problems with sleep initiation, which we're going to talk about this probably next. Sleep maintenance or sleep efficiency, which is, you know, getting in bed on time and getting sleep, not waking up and then waking up feeling refreshed, if you have an issue with one of those three things, all of a sudden, that's going to impact everything else.

Yeah. So negatively.

Negatively. Absolutely. So I think that's.

Well, what about some Tools for not just assessment. Are we going to talk about any treatment options? Let's do.

Actually that's. Let's do that because this is the. So let's do that so, because the.

Next one we dive into sleep, I think. And so we talked about how to measure it, right. What are some of the clinical signs we've talked about? What are some of the ways to measure it? So objective. So we're talking about subjective and objective. And maybe you learned something that you didn't know was related to stress. The next thing would be what are some of the tools beyond assessment that we use maybe to kind of improve some of the stress, whether it be lifestyle or supplementation. What are some of the things that you kind of start with with your patients?

Yeah, I' a whole handout again in our course. And we actually use with our patient clinics that stress sheet that I put together that you've talked about before. You know, if there's a definite trigger, like, you know, works, work situation, life situation. If you, if you're, you know, in a relationship with someone who's narcissistic, abusive, you know, there's, there's obvious things you got to remove. You know, the other thing to think about that I, you know, that's things people, you know, they should do, but sometimes they need encouragement or they need help or support, you know, to see social work or other kind of things, or work with a counselor with those things. But I really, really, really like breath work as a tool. When I had Covid, it worked so well for me when I felt horrible anxiety after having Covid. There's so many different kinds of breath work that can be really powerful. Whether it's just regular breath work, which is, you know, box breathing is an example of that. Whether it's, you know, short term holotropic breath work, which is hyperventilation and breath holding for 20 minutes. Even the long one, which you do for like two or three hours, usually with a breath holding expert, you can actually have a certain degree of disassociation similar to psychedelic, where people will have like emotional, like emotional catharsis with. They also have like muscle contraction, a bunch of different things related to the hyperventilation. But breathwork can be, can. It fascinates me that it can work. It can be as potent as a psychedelic and some of it's, you know, resynchronizing of your nervous system. And I've not really heard a lecture in any of my functional training talking about using cold breath work. Psychedelics are super popular right now. But I really haven't heard a lecture anywhere talk about, you know, breath work by itself, as this is ridiculously powerful. Herbs are great, you know. You know, if you. If you have a cortisol response curve, it makes it really simple. Ashwagandha is a great adaptogenic curve. You know, like you mentioned Rhodiola stragalus.

I love lthenine.

Yeah, there's. There's your. Not like you're calming. You're calming herbs. Nutritionals, thinning is awesome. Phosphatidylserine is great to take before you go to bed at night. If you have high cortisol, I feel like that helps bring it down. You have the mind chatter, you're trying to go to bed at night. I can't. Thinning is awesome. Awesome for that. GABA sometimes can be really helpful to, like, get people in a Zen state.

That's why I love thinning, because it hits GABA receptors and then you get dopamine too, because it's focusing clarity. So you're like chill and aware.

Yeah. If someone has like daytime anxiety, I found it to be helpful, like with that clarity and chill throughout the day. And then I really like. I use a lot of magnesium glycinate.

Magnesium mag in general.

And bisclycinate because of magnesium pops on those MDA receptors.

Yeah.

It's very calming. And then the glycinate turns into gaba. So it's like you're getting this precursor for GABA and that. And it's really interesting. You know, high dose of magnesium can treat seizure disorders. High dose of magnesium can treat migraines.

Hypertension.

Hypertension. You know, back when I was doing my training before we had a lot of the new fancy drugs. You go in the hospital with a asthma attack. Yeah. Magnesium migraine, high blood pressure. You know, then we got these really expensive dysrhythmias. Yeah.

We used to give Ivy mag.

And it's pretty safe by mouth because if you get too much, you just get diarrhea. Yeah. So. Yeah. So what are the things you like besides those? Something else that I love.

Mag across the board. So I always start with basics. And it's okay. Like you said, identify the stressors. What can we control? What can't we control? Let's try to live the serenity rare, right?

Yeah.

And let's. Let's be wise in our decision making because even though they may be aware of a toxic situation, it's. It's not something they can get out of right now. So in that situation, instead of Them feeling helpless and stuck. We try to learn how to adapt to it a little bit while still being in it. Whatever you can cut cut, whatever you can add from a beneficial way, add from a support structure standpoint. But the reality is the addition by subtraction is always first and foremost. Next is do we need to clean up the diet? Next is what's going on with their sleep. Next is what's their activity level and what can we do about that? And I'm usually concurrently sprinkling in things like magnesium. I love all the formularies. Plus I would also add Mag 3 and 8 because it crosses the blood brain barrier, so it's calming. And you can use that at night for more people that have insomnia and want to sleep and use mag that way. I use L Theanine. Like I got stock in it. Like everybody gets L Theanine. I feel like it should be in the water. It's benign. There's no upper limit of toxicity. There's no known side effects that I'm aware of. So I'm just giving it to everybody. So even great in kids. So L. Theanine, because it's calming and most people need the calming. Ashwagandha is great because it's calming and energizing. So it can do both. And it also has some influence on other hormonal aspects. Thyroid, sex hormones, et cetera. Very old school. I like blends sometimes that have a little bit of calming, a little bit of energizing. So things that might have some ginseng and some rhodiola, but also some theanine, some phosphor, total serine. I think B vitamins are important. You know, when you're stressed, you're depleting your bees, you're depleting your mags. I like a nice B complex. Usually I'm kind of looking at their methylation status and trying to sink that up at the same time. So I'm not just blindly throwing bees at them. Omegas I like as well because they're coming from an inflammatory standpoint. But most people that are anxious have neuroinflammation and omegas can kind of bring that down, especially dha. So that's a lot of like my basic bare bones stuff. And then it gets more specialized. Does this person need some dhea? Does this person need some adrenal cortex? Do they need adrenal glandulars? Do I need to go to the pharmaceuticals? And I just kind of work my way up in that way.

But those last things you mentioned, those are all based on testing? Yes. We're not going to do those unless we have an adrenal stress profile or something that says you need DHEA or your cortisol's off or whatnot. Because people go right to glandulars, which I know is.

It's common.

It's done in other practitioners and done in different places. You are giving people cortisol, you are giving them adrenal extracts, you're giving them catecholamines. Yes.

And they don't need it if they're stressed.

And there's a difference between adrenal cortex and adrenal extract. You can get just the cortex, which is just right, the glucocort, but the, the whole adrenals going to have the medulla, which will have your catecholamines. So you actually in the wrong person, you could jack them up, you know, so that's where these. It's good to know your science and know some of these things.

And we always. This is how we practice. I mean, maybe it goes without saying, but let's just say it anyway. We test, we don't guess. I mean, we use clinical correlation. We use our clinical acumen and experience. But we do a of testing and that's like I could give anybody magnesium and they're going to be fine. Right, as long as I'm not giving them three grams. But like I can give people magnesium and gas or I can get a red blood cell magnesium and see how much they need and see how much I think I want them to take and they feel better about that. But you're not going to hurt anybody giving them a little mag or a little bit of B vitamins. It's as we're getting into these other things that are a little bit more specialized, you want to make sure that you're doing it based on testing, clinical acumen, and that the patient is aware of why they're taking it.

And one nutrient that was not mentioned that I want to mention because I have a cool historical anecdote for it is vitamin C. Yes. Vitamin C is one of the primary nutrients that is required for adrenal function. And interesting enough, when Americans came to the New World, you ever heard of scurvy? Right. Scurvy is super popular. How did Native American Indians in Canada prevent from getting scurvy in a land that has no orange trees and no lime trees, in a culture that doing sauerkraut like the German culture was not a thing? They elk. They ate elk. Adrenals. And one of the wisdom tidbits of wisdom that they share with certain missionaries and friends of the natives is that basically people, they're like, you're not going to kill us and steal our lands. We'll let you all kind of, we'll help you out with our secrets. Was eating the adrenals of wild animals, they call it, because in nature it's interesting. It's humans and some other animal. The only two animals in the world, the world that don't make their own intrinsic vitamin C. We can recycle it, but we can't make it. Goats, when they're sick, can make up to 10,000 milligrams a day of vitamin C naturally in their liver. And it gets a store in the adrenal game. We can't do that, but when we're stressed, and I've actually personally noticed this myself, when I had Covid, I was taking 20 grams a day of vitamin C and my. I was no problem. My body was chewing it up.

Catecholamine will just, they'll just tear through the sea. Yeah, the half life of a C just disappears.

And then two weeks out, I started getting diarrhea from it because I kind of addressed it. But the point is that vitamin C is. It's so super critical for adrenal function that literally your adrenal gland stores such to the extent that if you're hunting and you have scurvy, you could eat the adrenal gland of whatever ruminator you. You've hunted and you can treat yourself, prevent it. Yeah. So interesting little factor. Next time you're like, you know, so I thought that was kind of cool.

Yeah. Vitamin C. Vitamin C is important for everything. All right, what else?

That's it for today. So hope this information was helpful to everybody out there. If you have questions about what we talked about, please drop them below. Like, subscribe, follow, put your comments below. We will be doing a question and answer session later on once these have all gone out there. So put your questions below and then if you follow us when we answer them, you'll be notified of that. Otherwise, take care, be well, and we'll talk to you all soon.