TV interview between Gayle Guyardo and Dr. Shilpa Sayana (functional medicine/inflammation specialist) discussing hidden causes of persistent fatigue, brain fog, and burnout. Dr. Sayana attributes these symptoms to hormonal imbalances (cortisol, thyroid, sex hormones), cellular energy problems (mitochondrial fuel conversion), high insulin and inflammation, and recommends targeted lab testing and treatments (e.g., low-dose thyroid, low-dose testosterone, metabolic peptides such as tirzepatide) alongside lifestyle foundations.
Questions this video answers
Within-range cortisol: 4 to 20.
Around 10 to 15 in the morning.
Before 10am.
Every 2 to 3 months until you feel like yourself.
At least twice a year.
Chapters
Coming up on Bloom, the hidden reason millions of people feel constantly tired, foggy or burned out.
But it's really not. It's your body's feedback system telling you that you're not in balance. And it's not like you just need more caffeine. You need to look deeper and understand why.
It's easy to blame stress, aging or hormones for feeling tired, foggy and stressed out. But our next guest says there could be a hidden reason that you feel this way. Joining me now to explain is functional medicine and inflammation expert Dr. Shilpa Asiana. It is so great to see you again.
Thank you so much for having me.
So I don't feel stressed or anything like that, but I do feel very drained. And you say there's a hidden reason that so many people are walking out around is feeling exhausted completely.
And we think it's normal to feel drained all the time, but it's really not. It's your body feedback system telling you that you're not in balance. And it's not like you just need more caffeine. You need to look deeper and understand why.
And you say sometimes this could be because our hormones are off balance.
Correct. And so when you are feeling tired, it's probably for two big reasons. One is your body can't change those nutrients into fuel. And this happens at a cellular level in your mitochondria, ok. Power cells in each one of your cells. And the second thing is your problem is your hormones are out of sync, like your cortisol, your thyroid and your stress hormones.
So how often should a woman have their blood drawn to find out where their hormones stand?
It's so important you say that because a lot of women don't even realize it's testing to check your stress hormones to check your energy levels. Ideally, in the beginning, you should probably have them checked every two to three months till you feel like yourself.
Oh, okay.
And once you're stable, I would say at least twice a year.
But is our regular primary doctor checking the numbers that they need to be looking at? Because I kind of felt like I was a rat on a wheel trying to figuring out. I'm like, why aren't they seeing this? And then I had to go to a specialist to see that my thyroid medicine needed to be compounded. My hormones were all out of whack and I kind of feel like I'm not getting into her enough because I still feel drained, like I need to make the time to go get that blood drawn.
Exactly. And you know, the system wasn't Set up especially for women, like, especially women during midlife. And during these natural inflection points around hormonal changes. We do need to lean in and get these numbers checked more frequently. And, you know, when I was going through my own health journey, I was a busy mom. I had a private practice, I had, you know, I was a daughter. My parents were not well. And it was a time of a lot of rapid change. And I was like, this is just being busy. But when I look deeper and I check my own hormones, my cortisol was really low in the morning, super high at night. And those symptoms were not sleeping through the day, feeling pretty tired, kind of brain foggy. And my conventional primary care doctor wasn't checking that. She's like, you look healthy, you look good. But I had to look deeper and realize that my hormones were out of balance, my inflammation was high. And once I addressed that, I could see such a profound shift.
So what markers should people be asking their doctors to look at? I mean, and again, you might have to pay out of pocket because insurance is only going to cover so much of a blood screening. The rest is sadly up to you. And it shouldn't be that our zip code is directly correlated to the kind of healthcare we get, but that's just the way the system sets people up almost to failure.
It is true. And I think now in the time of, like, social media and empowerment, we can understand what to check. And you can actually just go directly to the lab and check yourself. And you could probably do all of this for like, less than $100.
Okay, good to know, good to know.
And things like your morning cortisol, like what is your stress hormone in the morning? And the difference between conventional medicine, which I am as, and functional medicine is all about ranges. And we want to see optimal cortisol levels in the morning, not just within range, because the within range Cortisol is between 4 and 20. So you could be 5 and you could be 19 and consider it normal. So you really want to be optimal. So good morning. Cortisol should be around 10 to 15.
Is that a fasting blood check?
No, it could be, but it needs to be done before 10am because that's kind of like when you know your cortisol should be okay. Other big hormones or things to check is your inflammation levels, are they super high, is your insulin high? And what is your thyroid, Is it sluggish, especially in midlife? I think women really should lean in and check what is their insulin, what are their sex hormones and what are your stress hormones. Because once you focus on the foundation by giving them low dose thyroid hormone, giving them low dose testosterone therapy or even a metabolic peptide like tirzepatide can have profound transformations and they finally feel like they're coming back to themselves.
That's incredible. So you did rattle off some of the solutions. Tell me we only have a minute left, but what are these solutions?
So some of the solutions is once you address your foundations of life, which is like really nutrition, movement, lifestyle, joy, look deeper and measure these markers, markers such as cortisol, insulin and your hsdrp which is your inflammation. And the solutions that could impact those are low dose thyroid hormone or supplements that impact that. But have a full panel to look at what's going on. And some things such as low dose testostero therapy, even for women, we're not trying to make them men, but we're just trying to bring some of that hormone back. And then the last thing is some peptides like the low dose tirzepatide, which impacts the metabolism and lowers your insulin, which is something every mid age life woman is going through. High levels of insulin and they're like, where my body's changing, I don't feel like myself.
It's a great conversation. Thank you so much. It's such a pleasure to see you again.
So great to see you. Thanks for having me.
All right, we're going to share this story with you on Bloom Tampa Bay. And up next, Dr. Shilpa shares how chronic stress silently drains inner when Bloom returns.
