#171: Adrenal Dysfunction Affects Every Woman with Dr. Tricia Pingel

Hey beautiful, it's Dr. Tabatha. I want to share something with you that I believe God is doing right now in women's health. We're in the middle of a massive movement and most people don't even know it. Every single day, 6,000 women in the U.S. enter menopause. That's over 2 million women a year, and by 2030, that's more than 1.2 billion women worldwide. So here's the thing, most of these women feel exhausted, bloated, anxious, disconnected from themselves, and the medical system is Doctors are handing out prescriptions and quick fixes, and no one is helping women heal from the root cause of their issues. That's where Fast to Faith coaches come in. As a certified coach, you'll be equipped to help midlife women balance their hormones, heal their gut, regain their energy, and reconnect their faith, the foundation that so many of us have been missing. And from a business standpoint, woo, this is one of the most lucrative untapped opportunities in the entire health coaching world. The global health coaching industry is expected to reach over $33 billion by 2023, and midlife women are the fastest-growing, highest-spending demographic in that space. Most importantly, these women stay with their coaches. They invest deeply because they are desperate for lasting transformation— body, mind, and spirit. So if you've been feeling that pull and that whisper that you're meant to do more, This is it. Now is the time to rise, to serve, and build a purpose-driven business that not only changes other women's lives but transforms your own in the process. Because when you help one woman heal, you help her family, her marriage, her faith, and her future. That's the ripple effect that we're creating with Fast to Faith. So join me, click the link to come watch this webinar. It might be the one thing that really moves the needle for you in this Next season. I can't wait to see you in there. Hi, I'm Dr. Tabatha, the Gutsy Gynecologist. I'm a triple board-certified OB-GYN and functional medicine physician. I've embraced the world of functional medicine and wellness through my own personal health journey, and I'm super excited to share my wisdom and unique perspective as it pertains to women's health. After caring for thousands of women, I've come to realize that your gut health determines your gyn health and your overall And it's a super gutsy thing for me to go against conventional gynecology practice to bring you the truth. No more Band-Aid medicine, ladies. We're talking root cause resolution on this show. So if you're struggling with hormone imbalance, weight gain, period issues, anxiety, insomnia, you name it, then you've come to the right place. And I want to be your gutsy gynecologist. So welcome.

Thank you.

Hello, hello! This is a really important episode today because it affects every woman, every woman on Earth. I promise you, we are all impacted by some type of stress, whether it's an internal stressor, an external stressor, you name it, we all have to physiologically respond to stress of some sort, whether it's good stress, like you're trying to coordinate a big birthday party bash that you're throwing, or you're training for a marathon, or it's bad stress, like you hate your job and you don't want to see your boss, they send you terrible emails every day, or you have chronic gut infections that just won't stop. Or you have, um, whatever it is. There are so many different types of stress, and the word stress has been used to death. It has really lost its veracity, and I'm here to tell you that it's a big deal. And my guest today is going to explain why it's a big deal. We're going to talk about Adrenals, how the adrenals function, how they respond, how they adapt, what the heck is adrenal fatigue, all of it. So this is a really, really, really important episode. And so you need to tune in and please share this episode with everybody. Like, if you have any kind of social media account— Facebook, Instagram, TikTok, Pinterest. I don't know how these— that one works, but if you have more than 2 people following you, share this episode. Women need to understand that stress is actually a big deal and that it means something totally different than we think it means. We think, oh, I feel stressed out, but I can handle it. I'm doing air quotes. I can handle it. Therefore, it's not a big deal and therefore it doesn't affect my health. And we're going to debunk all of that today because that's absolutely an outright lie. And Dr. Pingel is going to explain how this is driving all of our hormone dysfunction, all of our gut issues, our thyroid problems, our sleep, our energy, our ability to heal— like, all of it, you guys. So share this, share this on your social media platforms, send it in a text link, like however you need to get it to the people that you love and care about. Because if you love and care about them, you'll want them to know these secrets. This is really important for getting your health back and for getting our loved ones' health back. So it's not just for women, send it to the men too. Like, Adrenal issues and stress issues are universal. They're not just for women, they're for men too. I'm seeing a ton of men having issues— low testosterone, high estrogen, disease processes setting in because of stress. So let me just sing her praises really quick and then we'll jump in. But I would encourage you to follow Dr. Pingel, drpingel.com. Sign up for her newsletter. She has this ultimate beauty recipe guide that's free. That's really cool. It's like using stuff in your kitchen to make health masks, beauty masks, all that kind of stuff. So if that is your jam, like, check it out. But either way, connect with her because She has helped countless women restore their health by showing them how to identify whatever stress is causing their symptoms. And you might not see it. We're going to talk about that, too. You can't see the picture when you're in the frame. She helps restore nutrient depletion caused by stress, help changing the mindset, So that you can repel new stressors coming in so that you can go on to live a happy, vibrant, energetic life. And full disclaimer, I started to have a little bit of emotional breakdown at the beginning of this episode, so send me some love when you're listening because it took a lot to hold back the tears. I'm just going through some stuff right now. I'm going to talk about it in the episode, but Send me your love. And just know that when we rise up and share our stories and help other women rise up, it not only helps that other woman, but it also helps you, right? So when I do these podcasts and I work to help you figure out your your issues and get you feeling better and turn your life around, that in turn helps me in my life. So it's just a beautiful, full-circle thing to be of service, to support other women, lift each other up, give each other grace. So I'm asking for a little grace because I shared some stuff on this episode and it got me emotional. So I appreciate all your love, you guys. I love your DMs. Your emails, like, it just fills my heart and I couldn't do this without you. I do this for you. I wouldn't do it without you. So thank you. I just wanted to say that real quick. So back to Dr. Pingle. She's the author of Total Health Turnaround, which is an awesome book. It's sold over 60,000 copies. She has a lot of do-it-yourself programs like the 30-Day Total Health Turnaround. The 7-Day Ultimate Detox, the 30-Day Walking for Weight Loss Guide, lots of cool stuff. She has a supplement line and concierge practice. She has been on numerous podcasts, some really big ones like the Dr. Axe Show, Ask the Expert with JJ Virgin, all kinds of amazing things. So she's the Hip-Hop Energy Doc. And you can see her dancing all over social media, cheering on her 2 boys at football, creating vegan recipes in the kitchen, hanging out with her dogs, her cat, her husband. She's just like a beautiful soul. I love hanging out with her. I love her energy, but you're going to love all of her wisdom and insight into Why can't you feel well? What is causing all of these symptoms to be brewing inside of you? And we might be missing the forest through the trees on this one. So there's a lot of golden nuggets in this episode. So I'm excited for you. All right, here we go. Well, welcome, Dr. Pengel, to the Gutsy Gynecologist Show.

I'm so excited to be here. Thanks so much.

Oh my gosh, I am too. I wish we were at a dance party, but this is going to have to do, right?

I mean, we can make our own.

I know. I know. And leave it to us. We would like— Tricia and I, wherever there's a convention going on, we're in the corner dancing with the DJ.

Every time.

Yeah. We get the party started every time. JJ's like, hello, it's party time. Tricia and Tab are on the dance floor. Yes. So I'm so glad you're here. I mean, you're an amazing, wonderful friend and colleague, but you just have, like, a wealth of knowledge that I really need to share with my listeners. So thanks for doing this. Absolutely.

Let's do it. Yes.

And oh my gosh. So we're going to talk about adrenals today because it's so important. And I touch on it sometimes on the podcast about how it really affects our hormone health. But you reminded me before we got on this recording, like, hmm, maybe your adrenals are kicking in with what's going on with your grandma. And I just Like, that was really profound. So thank you. I want to share, like, with everybody listening, I've been struggling the past couple of weeks. You know, even though my grandma is 96, that's so amazing. She was healthy and fine. And, you know, I didn't expect her to go anywhere. She still colors and paints and tells amazing stories. And here I am on spring break 2 weeks ago, and I get the message that she's— Gone. Getting ready to pass and I need to hurry up and come home. And that threw me for a loop. I just wasn't ready for it, right? And so I come home and I can't even focus on work because this woman who has really meant so much to me is now going to pass on and move on. And that's a lot to process. And my brain hasn't functioned for 2 weeks. And you're like, um, hello, it's because of the stress.

It's so hard. And I mean, I lost my mom and my dad and my grandmother. My grandmothers were in their 90s as well, totally vibrant. And my mom and dad were young, 59 and 69. Certainly not what, what I thought was going to happen. And it's funny because when you have a lot of stuff going on in your life and you're multitasking and you're kicking butt as a woman, which you are, you know, And you think you have everything good, you're moving along, and then something like that comes along and just gives you an emotional hit. And it's natural for your body to go into kind of a state of focusing only on that and missing all the little details. And I think this is the time where we really have to give our body more grace and understanding. And it's okay to not be 100% clear right now because you need to deal with This situation, and that is okay. So I hope you're giving yourself some permission to take care of yourself. That's what I hope for you.

Yes, I, I'm not as much as I thought because, like I said, she's 96 and, you know, this is inevitable, right? And she's had a wonderful life and she has a huge family who loves her and misses her at this point. And we're all coming together and supporting each other. So I keep hearing my mind tell me, It's not a big deal. This was supposed to happen. Just move forward. And it doesn't always work like that, right? And that's okay. So thank you for that. I think that we downplay a lot of our stressors in our life. I hear that from my patients all the time. Well, this is just my life. I'm always busy. Why is it a problem now? So I would love for you to just speak to that. Let's unpack all of it. Let's explain what the heck adrenals even do, why this crazy life of ours is driving so much hormone dysfunction and disease. And just because it's normal doesn't mean it's okay, or just because it's common doesn't mean it's normal, right?

100%. I say that all the time, right? Common does not mean normal. Yeah, I'd love to talk about this. You're going to get me so excited. I love to talk about this. So the adrenal glands live on top of our kidneys, and if you want to keep it as simple as possible, they determine whether we're going to run from a bear or whether we're going to chill out and eat bonbons and relax and digest and have sex and take care of our body and our immune system, right? So we've got basically 2 different phases of nervous systems here. that handle a situation. You walk into a room, is it stressful or not? Like, that's all the body cares about. Do I need to run or not? So I use this example of if you're in the woods and you're taking a hike, you're just kind of wandering along, and all of a sudden a bear comes around the corner. Your heart starts to beat, your blood pressure goes up, you start to sweat, and all you think about is running and getting away from that bear. That's all you can think about. You're not thinking about what you just did, where you're running, what you're seeing, where you are. You just need to survive. And the beauty is that's what our body was built to do, is survive. And it's one of the most beautiful things that we can adapt to a situation. I think it's what makes us, you know, amazingly great as human beings, but it can also harm us because we can adapt. So we run from that bear, we're supposed to get away from it and then calm down and go back to hiking and smelling the flowers. And we don't. We turn the corner and there's another bear, and then there's another bear, and then there's another bear. And funny enough, When you see enough bears, then you start to anticipate bears when they're not really there, you know? And so then the body stays in this state, which is called the fight or flight, which most of us have heard of, which is the sympathetic nervous system instead of the rest and digest phase or the parasympathetic nervous system. Right.

So, so you just keep thinking a bear's coming and it's not even showing up and you're just stuck in this sympathetic dominance. Yeah.

And it causes a huge fallout, especially in the endocrine system and all the hormones in order to adapt. Because the bottom line is your body wants to live, so it will always prioritize running. Always. And so I think we underestimate how much time we actually spend over here. And with the modern technology and us scrolling through phones and emails and beeping and running businesses and doing all these things, We're constantly running and not spending enough time over here, and it's causing a serious health detriment. In fact, I believe it's causing all of the top conditions that we see in our country every single day, just not focusing so much on that.

I think one of the most important points is that you can't be in both phases at the same time, right? So if you are in that stressed-out phase, you can't rest and digest like you mentioned. Explain that.

Yeah. And stress has been normalized. Yes. If you go to the doctor and they're like, oh, are you under stress? Yeah. Oh, okay. Yeah, that makes sense. But they don't tell you what to do about it. Right. But understanding that we actually have the power to move ourselves into the parasympathetic system, we can do that. We don't— there's no medication that does it. Right. Even when you're not sleeping, let's say you're thinking about a bear and you're trying to take a nap behind a tree, you know, they'll give you a sleeping medication, which is essentially someone walking up and hitting you over the head with a mallet. You pass out, but in your head, you're still thinking, there's a bear, there's a bear, there's a bear. We actually have the power within ourselves to move ourselves into the parasympathetic and into that rest and digest. And if we learn how to do that more, we're going to have less disease, less hormone problems, less symptoms, better energy, and we're definitely going to be more present. And you know as well as I do, just from recent experiences alone, that life is so precious. And something to be valued and loved and to be in. And we have a right to be able to live it happily and graciously and positively so that we can live till 96.

Yeah, exactly. And I think it's really important for us to acknowledge the fact that this is not just going on in our heads, right? Like, even though it is happening in our minds, our physiology is responding to those thoughts and those fear-based feelings and creating chemicals. So that's where the adrenals come in. So explain all of that because I keep hearing from my patients, well, I can handle it. I've been doing it for years, or that's how it always is. But your physiology can't handle it just because you can mentally.

Right. So we have external stressors and we have internal stressors. I think the external stressors are pretty self-explanatory, right? Death in the family, marriage, money, job, you know, all these things that are really out of our control but are kind of coming at us. Internal stressors. If you are trying to make something, if you have a conveyor belt and you're trying to produce this water bottle, right, you have all these little parts that go together and are put together down the belt in order to produce a product. Our body produces energy. That's its product. And the energy then drives other reactions. So if we have a problem in that chain, It's going to cause a chain reaction. These are internal stressors. This could be something like a deficiency in magnesium. You don't have enough magnesium available to make what needs to be made that day. Or maybe you didn't drink enough water, right? We require water for this type of thing as a catalyst. We require selenium, zinc, iron, amino acids, all these things to make all of these things on the conveyor belt. So an internal stress could be that you're deficient in something there. For example, a good example of just a common medication that people use, metformin, right, for diabetes, depletes B vitamins. Well, you could be low in B12 and not able to drive a reaction, and that's an internal stressor. So there is an actual physiological response that happens, and from that response, it causes more stress. So we end up in this hamster wheel of just compounding stressful events. So I have many women that I talk to and I say, what's your stress level? Oh, gosh, I'm good. I have a great family. I have wonderful kids. I have a good job. I just, I really have nothing to be stressed over. But then when I do their labs, I see that they're starting to move into the perimenopause or menopause phase of their life, and their hormones are kind of going like this. And that's kind of stressful on the body. So there's a stress right there.

Right.

And then when you look at treatment, potential treatment, that also causes a change in that body. So I think it's important to realize that our body is a really intuitive Balanced being, and so anything that kind of shifts it off to the body is stress, even if we don't recognize it as stress. And when you start looking at the body like that as an intuitive being, it actually makes it a lot easier to identify the stressors on your body as well. And that's what I encourage people to do. Where are you? What's going on? What's the big picture? What's moving around? Let's look at that, balance it out, help the body overcome that stress, and then it's funny. Because when you correct those internal stressors, the external stressors become a little less impactful.

I love that. Yeah, I see that all the time with women taking birth control pills or popping NSAIDs like Motrin all the time or have chronic gut issues. Like, those are all internal stressors telling the adrenal glands, we're dealing with something over here. Let's divert resources. We can't thrive because we got to go survive. Get rid of this infection, do this. Or like you said, we don't have the ingredients. Oh my gosh. Talk about the low-fat, no-fat diet of the '90s and 2000s. We weren't eating the basic ingredient to even make our hormones, right? So it's like so many of these stressors.

Yeah. So many people forget what cholesterol does in the body. I mean, cholesterol is fantastic. I mean, first of all, triglycerides give us energy, right? Now, granted, we don't want them at 300, but we need them. They're important. And if the body's working well, they work to our benefit. LDL cholesterol helping to make all of our hormones as well as even vitamin D. And it's the backbone to steroids. So all of this, let's give statins, let's block the cholesterol, let's not eat eggs, let's not eat fat.

No.

It's amazing how far we come in nutrition. And when I talk about nutrition, a lot of people ask me, hey, what bus are you on, Dr. Pingel? Are you on the plant-based bus, the keto bus, the paleo bus? And I say, I'm on the bus where you're consistent and getting nutrient-dense food. That's the bus I'm on, whatever that is for your body. All of us have a little bit different requirement based on our genetics, based on our environment. For me, I'm plant-based, but I also have to do quite a lot of plant-based protein. Right. My husband feels horrible if he's 100% plant-based. Like, he needs some meat. So I think it's important to look at what can you be consistent with? And really, are you eating to give your body the things it needs to make that water bottle, as an example, to put on that conveyor belt and really dive into where those inconsistencies are and then feed your body appropriately? Food is absolutely medicine.

Yeah, without a doubt. And fats are essential. Like, they're the backbone of all the trillions of cells in our body. Our hormones can't even bind to the cell if the cell isn't healthy with the fats, right? I've started to see this new trend. I do case reviews for FabFertile, a fertility center out of Canada, and women who have premature ovarian insufficiency, so their ovaries are not making their hormones, Their cholesterol numbers are crazy low. And I just keep going back to, this is the body's innate intelligence saying, oh, you're not making sex hormones, therefore you don't need enough. You don't need all of that cholesterol in your body, so your levels are crazy low. Like, I'm seeing total cholesterol of 120 and triglycerides in the 30s, and it's just astounding to me. And it's like, what came first, the chicken or the egg? Are they not making their cholesterol, therefore they couldn't make the hormones, or are the hormones low so they downregulated the cholesterol production? But I love that you look at all of this and you understand that stress can drive so many of these factors, and then they can, in turn, create more stress on the body. So you have to figure out where to jump into the cycle, right?

You do. And cholesterol also makes cortisol, so you can run from that bear and it will divert resources to it. So let's say that the body's like, it's the 3rd week of my cycle, I'm supposed to make progesterone this week. And it goes to make progesterone and something comes along, a huge bear. You're like, oh, man, don't make the progesterone, make cortisol. Run, run, run, run, run. And then all of a sudden you get an estrogen dominance, a relative estrogen dominance, which in labs could still show up, quote, normal estrogen at that time, but the progesterone to estrone balance is now thrown off. So guess what, guys? Now we just created another stress, right? So we're already running from a bear. The next bear is waiting. It's like, hey, I've got hot flashes, I've got cramps, I'm snappy, I'm mad at everything, my hair's falling out, I'm bloated. So we've got all these things that are now creating from such a Simple little shift that in my mind is so amazing that we can do that, but yet it's so ignored in general.

Right.

I mean, anyone who studied physiology or biochemistry could tell you 100% that cortisol has an impact on every single system in our body, every single one. It has a direct impact on nutrition as well. Direct— I mean, everything. But yet who's talking about it other than us, right? We got to get out there and talk about it more.

Yeah, exactly. I mean, I just think how common I see women making too much reverse T3 because their adrenals are off. Something simple like that, or too much cortisol destroying the gut microbiome. Like, it's literally all connected and everything, every system is talking to each other, right?

Yeah. Especially the hormone and the gut. So the endocrine and the GI, I think, should be the same doctor always.

Right. And they are completely separate in the conventional world, and nobody's talking to anybody.

It doesn't make any sense. I mean, we make serotonin in our gut. So then you bring in the nervous system. Well, guess what? If you don't have what you need to make serotonin, that's pretty stressful, too. And you're not going to sleep well, and then you're not going to sleep well, and then you're going to cause more stress. Oh, it goes on and on and on, right? I mean, all these things connect. And I think it can be very overwhelming when you are under stress to take the time to understand. But it's really Not if you just kind of work through piece by piece and really listen to what your body is trying to tell you. I think that's been one of the biggest things that I've changed in my 40s is really when I start to feel stressed out or I start to find myself not being my happy-go-lucky dancing self, I'm like, hmm, what am I doing right now? Have I been sitting at the computer too long? Have I been doing too much social media? Have there been external factors, other people that have put their energy on me that might have impacted? You know, where am I? In my hormone cycle, those types of things. And I think as I've started to do that, I've started to recognize it, nip it in the bud. And in general, 97% of the time, I'm happy-go-lucky and let things kind of roll off my back now. Oh, my gosh.

I hope everybody just heard that. That was a huge golden nugget. Like, as soon as you can start getting in tune with your body again and listening to it and then shifting your behaviors accordingly, You can avoid so many huge issues, but we as women are trained to ignore all of those messages, all those symptoms. So I love that. I mean, that's what I preach constantly is get in tune, listen to what your body is saying. And unfortunately, so many women are confused because conventional doctors— like, I remember not understanding the adrenals Whatsoever. Someone said to me, do you think I had adrenal fatigue? And I looked at her and I was like, no, because I was taught that you either have Addison's disease or Cushing's disease. You either have absolutely no adrenal production or you're off the charts with a tumor or something. There was no spectrum in between. It was black and white. And that is very much how doctors are trained. And so For a woman to be able to walk into my office, looking back, she absolutely had adrenal fatigue, but I didn't understand that as a conventional doctor. And so women are completely getting dismissed and disregarded and given bad information. And so will you just explain how the adrenals actually are a spectrum of function? It's not an on and off switch, like you either have a tumor or no function. There's way more going on than Addison's and Cushing's, you guys. And so if you're feeling all the symptoms that Dr. Pingel is talking about, it probably is your adrenals, right?

Yeah. I mean, health is a spectrum. And I know as a naturopathic physician, this is what we learn. You've got health over here and you've got disease over here. You don't just wake up one day with a disease. I mean, you could— That's what we're taught.

Literally, that's what conventional doctors are taught.

Yeah, but it's a spectrum that goes along. And as we've already talked about, this is a natural adaptation, right? That's what our hormones are intended to do. But I find there's basically 3 distinct stages. Stage 1 is what I call the Superwoman stage, right? We've all been there. We do everything. We're on it. Everyone's looking at you going, wow, you are amazing. You have a family and a husband and a job and this and that, and you're on it and you feel like you have all the energy in the world, right? That's stage 1. I'm going to come back to why that's a problem because right now it sounds great, right? Number 2, which is the stage I find most people to be in, women and men actually, is when you're going up and down. It's a roller coaster. So the cortisol rhythms are not consistent. Cortisol is supposed to be highest in the morning. And gradually drop throughout the day in a nice calm pattern, and then put you to sleep and then wake you up in the morning. You wake up with the sun, you go to bed with the sun, that type of thing. When the cortisol is going up and down throughout the day because it's being triggered by some bear, whatever that may be for you, we have stage 2, which is the roller coaster phase. Stage 3 is actually when the cortisol isn't really being produced at all, and that's more of like an Addison's or very close to an Addison's scenario. That is the disease state when you're not creating hormone, that's a pretty significant situation. I rarely see that. And that's the funny part. Very rarely do I see somebody with zero cortisol, and that's how everyone's treated. They go, oh, I have adrenal fatigue. I need to build my cortisol levels. And I'm like, whoa, hold up, hold up. If you're in stage 1, we don't want you to have more cortisol. We want you to have less cortisol. So the problem with stage 1 is you have all the resources available to make, going back to my example, as many water bottles as you want. So you pump them out, you make thousands every single day, you're kicking it, you're selling them, you're bringing in the money, you're living it all. But at some point, you're going to run out of part of it. If you're not repleting your body at that point and being aware of what your body is doing, you're going to lose what you need to make your end product, which is energy. And then you start to see adaptation, and then you move into stage 2. And that's where maybe you're totally asleep at 2 o'clock in the afternoon, but wide awake at 2 AM. Because your cortisol rhythms are switching, right? Better than that. Yeah. And maybe all of a sudden now your menstrual cycles are starting to change and you're like, oh, I must just be in perimenopause. And it's dismissed as that. The doctor's like, yeah, you're probably just going through menopause. Okay. What are you supposed to do with that? Oh, yeah, your thyroid's probably just a little bit impacted. Little things like that. That is a sign that the body is adapting to stress. If you don't do something about it, You will end up at that stage 3. And when you end up at that stage 3, usually you will also have cardiovascular disease, immune disruption, GI disruption, neurotransmitter changes, and hormone changes. So you'll already have all these symptoms. So maybe the list of symptoms will be brain fog, fatigue, hair loss, wrinkles, more common infections, raising blood pressure, and you start putting on all these medications, which then cause more stress that then worsen it. So what I love to catch people is the people in stage 1. Any of you out there, you superwomen?

Yeah. Yeah. You're listening right now. You're like power walking while you're listening to the podcast, right? On the phone, thinking of your grocery list, and you're about to pick up your kids like you're doing all the things.

Yeah. Listen up, because one, you need to be repleting your B vitamins because you're flying through them. You need to be repleting your minerals because you're flying through them. You need to be repleting your antioxidants. You're flying through them. And more importantly, you need to take time to calm the system. Go run and do what you got to do, but then go home and sit, practice gratitude, meditation, yoga, Pilates. Take those things that stressed you out every single day, those little things. You were late for something. So-and-so didn't pick up so-and-so, blah, blah, blah.

Or even stress that you enjoy because you're doing all the stuff and you're loving life like you mentioned. That is still stress. You are still in sympathetic mode.

Yeah. And you have to take care of it because otherwise symptoms will start to creep in. So if you're starting to say, gosh, I used to be great, I had great sleep, now my sleep isn't so great, that's a signal. Your brain's saying, hey, your body's like, slow down. I need some repair time. Especially women sometimes say, oh, I wake up in the morning and I'm just so tired. I'm like, yeah, your body's tired. What do you do? Could you imagine if you just ran from a bear all day long? That's exhausting, right? We need sleep. We need rest. So you have these different stages, and I think the word adrenal fatigue isn't a great word for it. And I keep trying to come up with some cool word to use because I'm going to use it. I've thought of cortisol wreaks a lot of havoc on the body. It's a havoc hormone. I use that every so often. But, you know, it's like it's a stress adaptation is what it is. It's not particularly fatigue as a symptom. You could be kicking serious butt and be depleting your adrenal glands. And I did that for so long. I was in survival mode for so long. And then something just comes along and knocks you down. Like when, when my dad passed, I just powered through. Just didn't grieve. Just— I was in school. I was, you know, I was in— I was in college. I was about to get married. I was planning a wedding. I had, you know, it's like I had grandparents that were sick. I had things I just powered through. And it wasn't until my mom passed when I was 40— my dad passed when I was 24. My mom passed when I was 40. It wasn't until my mom passed at 40 that I started even grieving for my dad.

Wow.

And I went, God, I've just been powering through. And I was sitting in front of a patient and she was giving me all her symptoms and I'm charting it, trying to be all professional. And I'm like, oh, that's me. Oh, wait, that's me. Oh, shoot, that's me. And then I realized I was absolutely in adrenal fatigue and I'm the adrenal fatigue doctor and I didn't even really notice. And when I look back, I look back on pictures of me. My hair was thinning. I had no muscle. I was wasting. I looked sad. I looked ill. And I look at pictures of me now where really all I did was start to prioritize nutrition-dense food, calming-type exercise into my routine, supplementing what I'm using on my conveyor belt, and just this mind-body gratitude reframing. And I'm like a whole different person.

Wow.

But it's crazy. You do get caught up in it.

Yeah, I mean, our friend JJ Virgin says you can't see the picture when you're in the frame, right? So I've had the same thing. Like, I'm the physician, I'm treating patients, and I'm like, holy crap, that's me. But you don't see it. And that's a really important point. And you made another really important point earlier. I don't know if everybody caught it, but Stage 2, when you're on this adrenal roller coaster, you get symptoms that a lot of people attribute to perimenopause or thyroid conditions, and it really is being driven by the adrenals. So that's like my beef is now there's a trend to say perimenopause is at 35 to 50, and it's like, that is not perimenopause. Those are symptoms. that look like perimenopause. Your hormones are tanking. You do have a hormone imbalance, but it's not because your ovaries want to fail. It's because your adrenals aren't allowing your ovaries to function properly. Am I right? Like, we have to call a spade a spade.

Well, I had even had a patient this week and she's barely 40 and she's like, I'm having hot flashes every night. Like, I'm drenching the bed. And I just ran her hormones maybe 6 months ago. She's nowhere close to menopause. And, you know, most people think, oh, my estrogen must be low. And I think, oh, her progesterone is starting to divert to cortisol. Her estrogen— she has too much estrogen. She's storing a bunch of estrogen. She's not— her liver isn't clearing her hormones appropriately because she's under stress. And I need to support her cortisol, not her estrogen, and possibly her progesterone. But there's a catch to that as well. If you put a hormone in like progesterone and your body is in cortisol mode, It's going to turn that progesterone into cortisol. So then you just end up going up in progesterone and up in progesterone and up in progesterone, and then you start getting bloated and side effects. And then the estrogen starts adapting to the progesterone. It's like, man, she has a lot of progesterone. I better bring my estrogen up. So we need to always remember that anytime we put something into the body, the body's going to adapt to it. So you want to make sure that it's not driving cortisol all the time. Because it will 100% win. Cortisol always wins. It wins over everything. And you had mentioned earlier reverse T3, which is one of my favorite things to run, actually, to check for adrenal fatigue, which is the storage of thyroid. By simply supporting the adrenal glands, I have seen reverse T3 drop and Hashimoto's antibodies go away.

Yes.

Not even touching the thyroid.

Exactly.

Now, sometimes I have to supplement thyroid depending on where they are on that health spectrum. Sometimes it's like they can barely get up in the morning. But if I can reverse it when someone's in stage 1, if I can catch that before it causes hypothyroidism and switch it and make the body work, like, I will dance every day, all day in pure excitement because I think we have the ability to catch that earlier. And the younger I catch women, the better. I absolutely do not believe that we're going to perimenopause at 35. I think we're going into adrenal fatigue, which is causing symptoms of perimenopause. Absolutely. 100%.

Cortisol is stealing your ability to make progesterone. And oh my gosh, I'm seeing a new trend now. Patients are coming to me on like 600 mg of progesterone, 800. I had someone Just 2 weeks ago, say, I finally stopped when he told me to take 1,200 milligrams of progesterone a night. I was like, holy crap, really? Like, this is happening? Practitioners think they know what they're doing with hormones. So ladies, be aware. If it doesn't seem right to you like it did to this patient, Yeah. Question it. Start doing some research. Start following Dr. Pingel and myself because that is not normal. You should not have to just increase, increase, increase these hormone levels. And your hormones are not the end-all, be-all. They are way downstream in the pathway. You need to look upstream and figure out what the hell is cortisol doing because it's robbing your ability to make these hormones. And so more is not always the answer.

Yeah.

And she was severely bloated and swollen and miserable. Progesterone is lovely and amazing and saved my life, but not at 600 or 800 milligrams.

I've never prescribed that high ever in my career, ever. And my concern would also be, is it just in? Or progesterone. There's a whole nother—

Oh, that's a whole nother topic.

I've done 300, but I'm talking this woman was in menopause. This wasn't a 35-year-old. 300 milligrams. Yeah, that's a great point. And I do think we're so like, well, what can I take for that? Well, what can I take for that? And I think we really need to look at, well, what is the body telling you it needs? Because if you are driving cortisol, a huge load of progesterone is going to give you plenty of ammo to find more bears. I mean, you'll start finding bears everywhere. Whether they were there or not, right? And creating new stressful events. And that is not what we want to do long term.

Yeah, I think that we're going to have to put up the little chicken wire pathway that we learn in physiology of all these steroid hormones and how they are produced from each other, all stemming from cholesterol. So you guys, we need to put that PDF in the show notes because they need to with their eyeballs that cholesterol goes to progesterone, progesterone goes to cortisol, to estrogen, to testosterone. You need to understand that these are all connected. These are not happening in silos the way conventional medicine would make you believe, right?

Yeah. And I have a lot of videos on that, too. I love to talk about that. So I have videos all over. I think I have some on YouTube. I have them on my I even probably talk about it in my book. I think it's like, for me, if you can see how it goes, complex biochemistry can be so simple if you just can draw it out. I mean, I drew out my entire book on a napkin in a coffee shop. I was approached to write a book, and they said, hey, you keep saying that cortisol is related to everything. Show me. Let's write about it. And I was like, all right. So I'm sitting at a coffee shop, and I have a pen and a napkin, and I drew cortisol in the middle as a circle, and I drew a link to every single thing that it triggers.

Wow.

And I found myself, and I have this napkin somewhere. I wish I had it to show you, but it just keeps going. Like, it just never stops. It's like this feeds back on that, which feeds back on this, which feeds back on this. And that's that hamster wheel. But you can interrupt it. You just have to start. I always say the body's like an onion. It's kind of got that core and it's got all these layers. You just start with one layer and then you listen to the body. What else do I need? Okay, we do the next layer. And by the time you get to that core, Your body's running pretty efficiently. I mean, you're making a ton of water bottles, but you're doing it in a normal pace and still having time to relax, right? Which is important.

I love that. So you talked about, like, you didn't even process your father's passing at 29. You waited till you were, what, 40? And your mom passes. Like, how long did it take you to reverse All the damage that you had done, so to speak. Like, how long are you seeing with your patients and clients does it take to get from stage, say, 2 back to, you know, a healthy pattern, or stage 3 to a healthy pattern? Like, what can women expect? Because everybody wants their quick fix, and I'm trying to help them understand, like, you didn't get there overnight. You're not going to get back to where you need to be, but it's definitely a lot shorter. If you get started on some things.

Yeah. And I don't think I have 100% healed. I still have moments. I mean, you've seen me in moments of weakness. I mean, I was breaking down at the beginning of this episode. Like, this is normal, right? Yeah. I mean, you know, I was 24. Well, I was, I was 12 when my, my grandparents died when I was really young. My uncle died when I was 12. My dad died when I was 24. My grandparents died in between. My mom passed, and then I had another grandparent die. So There were multiple passings. My mom was kind of the kickoff. She was kind of the last one, right? Yet she was young and it was immediate. And she was a very vibrant woman, like, involved with my kids, involved in my life, helping me run my practice. And then all of a sudden, the cancer, which had held dormant for 13 years with just stress reduction and naturopathic therapies, just kicked in. And I watched her decline very rapidly. And I think, to answer your question, up until that point, even though I was recognizing through helping other people that I had gut issues I had to heal and I had nutrition I had to clean up. And I was doing that throughout those years. So I would see small amounts of progress. The big kicker, the thing that was the catalyst for me to speed this up was when my mom passed and I realized, you know, you could be doing everything right and your life could end tomorrow. It really could. And until I actually make a concerted effort To not let all the crap in my life impact me and really hone in on why am I here? What's my purpose? What am I going to do with my life? How am I going to move forward and pay this forward to other people and be a positive impact on other people? When I did that, all of the efforts that I had put into line before that, the diet, the exercise, the supplements, all of a sudden started working. And I would say within 6 months of that moment, I mean, it took me a while. When my mom passed, I was booked out patients. I was running a full practice. I had 2 practices. I had a one-on-one concierge practice, and I had just a regular fee-for-service, thousands of patients. I was working 10-hour days. I had 2 young babies. I had backed off a little bit from that to help take care of my mom. But when she passed, I was booked out 2 months. I didn't even take the time, Tabatha. I didn't even take Yeah. Time off work. I was 100% in survival mode. And then I found myself crashing, crying every day. All of a sudden, I was like, oh my God, where's my dad? Where's my mom? Where are my grandparents? Why can't I call anybody? Where is my family? Who am I? And I went through a massive, just emotional, somewhat— I don't want to say breakdown because I think it was essential. Started doing Reiki, started doing mindset shifts. And I would say once I really committed to that, it was about 6 6 months, definitely a year until I started to see vibrancy in myself. And that was 6 years ago. So I think every year I just get better and better at being me.

Yeah.

And I love it. And I love being me. And I think we get lost being a parent and a wife and whatever we do, right? A doctor and all of that. And when you start to find yourself again, and that's why people say, why do you dance? Why are you the hip-hop energy doc? That is when I recommitted to dance. I took something I love— 6 years, 7 years ago is when I said, I'm going to do something that I love doing just for me. And I started dancing, and I couldn't remember how to dance. My body couldn't move. It wasn't— my body was completely disconnected from my head at that point. And dance brought it back together, and it brought back the joy of the moment and being joyful. And I think that's a really big lesson. And I think your point of it's never a quick fix when it comes to stress because there's always going to be stress. But managing that stress helps make all those other things that you do that seem difficult much easier.

Wow.

It's easier to commit to a diet when you listen to what your body needs. If your body says, I need fat, and you feed it fat, it's going to feel good, and that's going to feel good, right? Versus always trying to restrict things and fight what our body is trying to say. We fight it all the time. We starve it. We give it processed foods. We think we have to push exercise to a whole new level when really what we need to do is calm the body. Does that make sense?

Oh my gosh. These are like killer golden nuggets right now. And I hope everybody's getting this because you cannot supplement, you cannot diet, you cannot do stool testing and treat your gut into a healthy life if you are not addressing the Mind, body, spirit connection. If you're not processing those stressors that created all this dysfunction in the first place, like I see it every single day with my patients. I give them the gut healing regimen. I give them the thyroid medication. We we balance your hormones. We do the hormone replacement. But if you have all of these demons, you you're not processing deaths. You're not. You know, dealing with the job that you hate. You're not talking to the husband that's sleeping in the other room. Like, if you're not doing this stuff, you will not heal. That is a huge— that's the biggest blockage that there is. It doesn't freaking matter. Your adrenals will continue to pump out your stress hormone, and you will never truly make that shift. And I love that you focused on something you love. Like, that is the best prescription ever. Find what brings you joy, what reconnects you to your higher power and this whole point of being on this earth. It's not about your diagnosis and all of that. It's really why are you here and what brings you joy and connection?

Yeah. And I'm technically in my perimenopause time, and I've never felt better. I have more energy. I sleep better. In general, I mean, if I get a little too much stress, I do too much, I get some gut issues. I know how to remedy it. I listen, little things like that. But you had said earlier that your grandmother lived till 96. She was painting. She was vibrant. And I think that's something to really pay attention to. If you talk to people who have lived that life, who are in their 90s, and ask them what they do, most of the time they're doing something creative. My mom painted up until the moment that she couldn't sit in a chair.

Right.

Because chemo took her down. I mean, it just did. I don't know what to say about that. That was very stressful on her body, too stressful on her body. But she was painting up to the point. When I look at my grandmothers, who both died at 95 and 96, my maternal grandmother was dancing. She was trying to do the splits. She was singing. She was doing all these things. And my paternal grandmother played tennis. And they just went out and they did their own thing. And I think that generation had it right because they didn't have all these— they didn't have cell phones. They kind of had to be present in their common day throughout their younger years. And we are training our kids to not be present.

And we see it all the time.

Right.

And we would also ask my grandma, like, why do you think you just keep going on and going on? God's plan for you? And she would say things like, well, you know, the, the workers— she lived at an assistant care facility— the workers come in and they start telling me all their problems, and somehow I just listen to them. So I guess God wants me here to just be a listening ear and help make their day better. Or they see my paintings in the hallway and they, they tell me how it cheered them up. So she kept being of service until her last day. And I think that's a huge piece that we're missing as well, especially when we get really into more chronic disease states. We get so focused in on ourselves and what's wrong with me and why can't I heal? And you really need to turn that outward and say, how can I be of service to others? How can I help other people heal and get better on their journey? Because I promise you, that will shift you. That being of service, being in gratitude will shift your healing process. Right?

Yeah, absolutely. 100%.

I think that's what you did.

Like, you turned it around. Yeah. I mean, I had a hysterectomy at 42. Because at that point, like I said, I started listening what was going on with my body. Well, all the things that had happened throughout my body that had been ignored, the birth control pills, the storage of estrogen, all these things that nobody paid attention to, the gut issues, and that I didn't pay attention to. By the time I got that all cleaned up, I was having a major issue, and I won't bother you with it, but it was a major issue to where I had to make a decision. Do I want to keep my uterus or not? Right.

Yeah.

Most people say, oh, I had to have a hysterectomy. Now I'm in menopause. I can tell you right now, I'm not in menopause. I cycle 100%. My body feels great. It was the right choice for me. But it was interesting because I wonder if I wouldn't have listened to my body in that moment, or if I wouldn't have made those changes to really start communicating with myself, what symptoms would I still be dealing with, or what situation would I still be dealing with? I think sometimes the choice you have to make with your health isn't one you want to make. I certainly didn't want to have a hysterectomy. But when I added up everything and started listening, it was something that essentially had been ignored and mistreated for a very long time, and it had to go, unfortunately. I kind of figured that I kind of— it's like a new rebirth, like a rebirth of me. But, but, you know, now I'm managing without needing hormones because my stress hormones are in line. So I think, yeah, I think a lot of women start going through this time and they think it's to their demise. Okay, well, here we go. We're going through menopause. Life's going to suck now. Now I'm going to, you know, not have anything. And that's the wrong attitude. There's actually a lot that can be done. And there's also a lot of value for appreciating your body for telling you something was wrong. If my body wouldn't have told me that something was wrong there, I wouldn't have taken care of it. And I don't think I recognized it all the years. I never recognized it. I never recognized what was going on. And, you know, I mean, there was easily a 15-pound uterus in there. I mean, this thing was freaking huge, you know?

Oh, my gosh. Wow.

But how do you— but no one ever knew that, right? So just keep in mind that sometimes things that happen to you are actually an open door and an opportunity for you to continue to better your health, even if it wasn't the way that you wanted to go, if that makes sense.

Oh, my gosh. 100%. I truly believe life is always trying to happen for you, not to you. It's just we might be focusing on the wrong things, and you can't see the picture when you're in the frame, like we said. So that is why it's really important to go to a functional doctor, a naturopath, an integrative, someone who actually looks at all the systems, all the pieces of the puzzle, because the picture looks a lot different if you have 2 pieces of the puzzle versus all the pieces of the puzzle, right? You get a totally different picture of what the heck is going on. And so you might think, oh, that's not a big deal. Like that, that big uterus, it's annoying, but it doesn't have anything to do with what's going on here. So you just keep ignoring it for year after year. You go to a functional doctor and they're going to take all that and they're going to be like, oh, yeah, you have estrogen dominance because that big uterus is a symptom that's telling us it's because your adrenals are screwed up. So leave it to someone like us to help you put all those pieces together. But I hope that— well, I know that people listening today got so much value out of this because so many ahas, so many golden nuggets. You really do have to look upstream and connect all those dots. And if it's still not making sense to you, like, work with Dr. Pingel, reach out to somebody and help get this figured out because there is hope. And I completely agree. Like, I'm living my best life at 48, so much better than my 20s. Good Lord.

I know. I'm going to be 47 and I'm like, Everyone's like, oh my gosh, 47. I'm like, bring it on, man. Bring it on. I know I'm dancing till I'm 96.

I love it so much. Oh my gosh. So where can people follow you? How can they connect with you?

Yeah, the best place to start is drpingel.com. All of my social media links are there, but I'm on Instagram, I'm on Facebook, I'm on TikTok, not as much. I'm on Pinterest. I mean, I'm on them all, so go check that out. I have a lot of amazing nutritional defense recipes on my website so that you can start eating for your adrenal glands. I love dancing all over social media, so come dance with me. And the only thing I ask is if you do find me and you like my content, say hi.

Yeah.

Like, tell me where you're from. How'd you find me? You know, I love meeting new people. I think that's probably my biggest joy and sharing That energy with all of you out there just makes my day. So hopefully I can make your day as well. So definitely reach out.

So good. Yes, everybody needs to connect with Dr. Pingle. All in the show notes. Thank you so much. This has been such a wealth of knowledge, and I know somebody got something out of this today.

Well, I just appreciate you having me on, and I want you to go take care of yourself and give yourself some grace. Much love to you and your family. Thank you.

Wow. I know you got so many good gold nuggets out of that episode, just tons of helpful information. I hope that you're starting to see the forest for the trees, right? Like, you're putting all these pieces of the puzzle together for yourself and just for how our bodies work in general, how all of our systems are interconnected. They are talking to each other, they're responding for each other, and they're trying to stay in balance. They're trying to be in some kind of harmony, but they will always prefer survival mode before thrival mode, right? So we have to make the shift out of survival mode, and that really does start with our adrenal glands, with our stress response, how much we are stuck in that sympathetic, fight-or-flight dominant mode, and get out of it and get into the parasympathetic, rest-and-digest state that our body can thrive in. So you cannot be in both states at the same time. Like, if you didn't hear anything else out of this episode, I hope you heard that. You cannot be in fight-or-flight, stressed-out mode and in rest-and-digest and repair at the same time. So if you want to thrive and have an amazing life and have a healthy body weight and good energy and sex drive and a functioning brain to, you know, get through the day, if you want all of that stuff, That stuff lives in the parasympathetic state. That stuff lives in rest, digest, and repair. That stuff does not live in the sympathetic state of fight or flight. So you have to decide, do you want to be overweight, stressed out, not sleeping, brain not working, chronic gut issues, hormone imbalances, or do you want an amazing life where your body fits into your clothes, you feel good and comfortable, you digest your food, you have energy, you sleep, your brain works, you are available to do— be creative and do all the amazing things that you want in life? Like, literally, those are 2 separate identities. There is one version of Dr. Tabatha that is sympathetic survival Dr. Tabatha. I've lived that for 15 or 20, 30 years, something like that. There is an entirely different parasympathetic rest, digest, and repair Dr. Tabatha, which is what I try to be in the majority of the time. I fall back and I go into sympathetic Dr. Tabatha. And the word sympathetic sounds lovely, but that's not what it means. It's actually a bad word. So it's got, you know, it's a misnomer. I don't want to be the sympathetic Dr. Tabatha. I want to be the parasympathetic Dr. Tabatha. And you cannot be both at the same time. So if you start looking at life like That is going to be so much easier. What trajectory are you on at this moment? And you can switch it. You can switch it just by doing some breathing techniques. Go back and listen to my episodes. Gosh, I don't know, episode 30 or 40, so way back in the vault. But that's the cool thing about podcasts is you just scroll down and find the podcast. Like, it's there forever and you can listen whenever you want and you can go back and listen again once You've understood something else and you're like, oh, this makes more sense now. Now I'm going to do the breathing technique podcast episode because I know how important it is to be in parasympathetic mode, or my essential oils episode that I've done, meditation, like so many episodes that teach you how to go from sympathetic to parasympathetic. Now that you realize and understand the importance because of Dr. Pingel, get those tools. Pull yourself out of that state of adrenal overdrive. And if you're like, I can't even do this on my own, like, I am past that point, I need professional help, that's okay. I get professional help. We all should have some kind of professional helping with us. Reach out to Dr. Pingle, reach out to Dr. Tabatha, my team. We do all of this so you don't have to struggle. You don't have to do this on your own if you're past the point where that's even an option. So let me know. Like, I would be so appreciative if you could take 30 seconds To literally leave me a review. 5 stars would be amazing. But tell me, are you getting value out of this? Like, what is shifting in your life because of this episode or this podcast? What kind of ahas have you had? Share it with everybody you know. We are on a journey together. So I really appreciate this, and I just want to know how best to serve you. And so I need your feedback. So if you could give me that feedback, then I know what to focus on and what to create for you. And it also helps iTunes and all the podcast platforms know what you're interested in. Make your voice heard. Your voice matters. Your opinion matters. So thank you so much. Go have a kick-ass week, ladies.