Why You're Still So Tired: The Hidden Root Causes of Fatigue

Welcome, Synergy listeners. We are so excited that you're back with us today to, uh, be able to enjoy one more of our exciting podcasts. And today we have a really special guest. We are joined by someone who brings both deep expertise and a deeply personal perspective to the conversation on healing and vitality. Dr. Jenny Tufenkian is a naturopathic physician with over 20 years of experience practicing and teaching functional medicine. She's known for taking on some of the most complex cases of chronic illness and guiding people toward real transformation. Her own journey through illness gave her not only the knowledge but also the compassion to help those who feel stuck, exhausted, or unseen. She blends the best of modern science with ancient healing wisdom, teaching people how to create their own unique toolbox for health—physically, mentally, emotionally, and spiritually. She's also a mom of two, a teacher, and a lightbringer who believes that when we feel our best, we can shine brightly in our homes, our work, and our communities. We're so excited to talk with her today about a topic that impacts so many but is often misunderstood— fatigue— and how a functional medicine approach can help us move beyond survival into true vitality. Welcome, Dr. Jenny. We are so excited to have you here today.

Thank you so much. It's just a pleasure to be here. I can't wait for this conversation.

So we always like to start off with having you tell your story. You know, we don't land treating chronic illness without a story, a powerful story behind that. So tell us, tell us all about that.

And maybe some bumps and bruises along the way, right?

Oh yeah, there are plenty of those. Yeah, so, you know, it's interesting. I think some of you who, I think maybe Kelly and Lori, maybe you can identify with this and some of the listeners can too. Once you sort of identify, oh, I have this condition or I'm dealing with this thing, once you start digging in, in deeper and get into your journey, you can start going, oh, well maybe it actually started way sooner than I thought it did. And so I definitely have that where I'm like, oh, I think I had strands of some of these things as a child, now that I'm kind of, and as a teenager, now that I'm kind of putting it together. But my big, my big wallop, 2x4 bang by the universe happened my second year of medical school, where I was just convinced I could be Superwoman because I decided to become a doctor when I was 6 months pregnant with my first child, unexpectedly pregnant, single, had about $200 to my name and decided to become a physician. And it was a great decision. But it was a little crazy of a path. And I started and I had to do my pre-med stuff when he was tiny and then started full-time when he was 3. And it was second year medical school. He was sleeping through. I'd passed my boards with flying colors and I thought it's time to have a second child. I had married his dad, another whole story, and happily married and all of that and thought it was time. Had a series of miscarriages and one of those was at 17 weeks, hemorrhaged, passed out in the bathroom, rushed to the hospital, 5 o'clock on a Friday. And that experience threw me into what I call the dark night of the soul. I really see that we have this physical body, this mental, emotional, this energy body. We're more than just this physical body. And often dis-ease is on one or multiple of those levels, and they impact each other. And you can use this to understand why you're feeling so badly and also how to heal. And you can also use it as a, as a way of knowing where to lean in. Sometimes when we're grieving, we can use our physical body to process that emotional experience. Dark Night of the Soul, I really see as being when all 3 systems are down. That's what was for me. My physical, my mental, emotional, and energy were all flat. And I was in bed for months. I literally staring at the ceiling. I couldn't eat, I couldn't sleep. People thought I was gonna die. I was so sick. I had ice up to my knees. I mean, I was really out. And in another time, as a woman in this state, I would have— they would have thought I was going crazy because because I just could not handle anybody in the room. It was too much energy for me to have people in the room with me, and I really had to choose to live at that point. And some very intense things were happening to me at the time, and I ended up, um, needing to make that choice to live when somebody said to me, you know, you need to eat. And I remember forcing those 7 almonds down my throat just so I could live. That experience— I ended up getting a therapist in who helped me do hypnotherapy, and we were able to access some really deep subconscious things, some generational trauma trauma and other things I was processing at that time. And it got me out of the severe suicidal depression I was in, out of the severe anxiety I experienced, and got me from what I call the bed to the couch. And after months of being in bed, I moved to the couch, and I wasn't stuck in that horrible depression and fear anymore, but I was exhausted. And that's when the label of Chronic Fatigue Syndrome landed in my lap in the '90s. And I was like, "Get that label away from me! I don't have the yuppie flu!" Like, "No!" And then I was like, "Oh, maybe it actually fits. And so that— I had to take a whole year out of medical school, and I just threw everything I had at it. And, um, it took me a couple years, but I did heal, and I healed completely. I put it into 100% remission, was able to get back to full energy, 150%, had another kid, open clinics, was teaching, doing all the things. And I— and I had two thoughts. One, I'm never doing that again. And two was, I know the body can heal. Like, that experience allowed me to be present with people who very, very sick, like, you know, very sick, because I literally felt like I was looking at death. And there was a— it helped me understand that the body can regenerate even when it feels like it can't. So anyone listening who feels hopeless, please at least hear this. Like, there's always— I mean, I'm just— I've seen so many times when it's happened. So thinking nothing would like that would ever happen, it did. I had a series of events, the perfect storm of injuries, pain, some ego of refusing. I was super fit and I refused to get unfit even though I'd injured my knee, was doing all this upper body core stuff like, "Yeah, it's time to work on those arms," and then end up getting frozen shoulder. And I was perimenopausal, and so that all those lovely hormones, estrogen and progesterone, which are nice fluffy anti-inflammatories, were tanking in me. And I ended up getting to that severe pain, sleep deprivation cycle, and really quickly I relapsed. And it was so interesting. That's when I learned how easy it is for people to relapse in these conditions and how much we need to really look at what got us here so that we can get out when we start to feel like our bodies are slipping down. Um, this time I was, I was working, my family was dependent on me financially, and so the idea of going to bed for months was not really an option. I literally would be in bed and going like, If I stop working, we go into bankruptcy. Like, no joke. Like, that was the option. We're both self-employed. That's it. Like, I can't work. That's it. So I really had no choice, but I would just get up in the middle of the night because I couldn't sleep. And I just started doing PubMed. Like, what's going on? What's causing this? I even typed into Google. I don't know if everyone, anyone else has ever done this. Like, why am I so tired? You know, like at 3 o'clock in the morning. It would be a top search, actually. Help me. That was a bump.

Yes, that was a bump in the road. That darn perimenopause. I mean, it is a time where things will resurface. I see it over and over again where that's the time that people fall off that cliff if they've ever fallen off before. You are super vulnerable during that perimenopausal phase.

I think so. And I used to say that, oh, and I'd have sprinkling of perimenopause on the top. But the more that I understand the power of that change and that shift with the hormones and how it impacts everything else in your body, it wasn't a sprinkling. That was a key part of the foundation as to why that relapse happened. And I think that, you know, we can be more aware of that, you know, if for women who are in their 30s and 40s to be aware of that, that that may be something they need to be looking out for. So the story continues in that what happened during that time that was— I never expected is it used to be if I was sick or my kids needed me, my patients disappeared. And I called it the universe taking care of me. And I expected that happen this time because I was a wreck. But the opposite happened. All of these patients came to my clinic. I walked out to book a holiday and my front desk was like, you're booked for like the next 3 months, you can't go away. And I had no idea, but all these people were coming to me and it allowed me to try all these different things on myself, my patients, and they all had chronic fatigue. And that's when I really figured out that there are these 5 root causes, there are these patterns, there are these things I could listen for, for how people talk about their fatigue and what their body responded to that made it so that we could begin to create a path, a journey, a map to get them to a place of having higher energy. And I once again came out of that 150%.

So listen, you said a lot that I want to make sure we don't, we don't gloss over. And you said we're more than a body, right? We're more than a body. So you, you labeled those body, spirit, and physical, mental, emotional, and energy is how I do it.

There are different ways and different systems to look at that. And I see the energy bodies— people give different names to that energy body. And some people think of that as being a very woo-woo thing, but actually we have science that actually can see things that you can take a picture of it now. Like, it actually is really there. And we influence each other a lot by that energy body. And, and there are the people that you feel like, oh, oh my God, that they're like a energy suck. Like, I walk into a room, it's like, whoa, I just feel tired around them. And then the opposite of the people that you feel uplifted by and around. And some— it sometimes it has to do with that energy body. It can also have to do with the emotional body. Yeah. So you say the energy body and the emotional body are separate? I do. I do. I mean, they're very— they're, they're all— they're obviously, it's all intertwined, but you need those colors of a rainbow, right? There are those colors in between the colors, right? And so I think that there are those layers between the layers. And yet I do, I do, I do see them as differently. And the reason I do is because I think that I've certainly seen in my own experience of my journey of being more aware of, of this being, and in my healing, I feel like, you know, we're trained in medicine about the physical body. In naturopathic medicine, there was a sign about the physical, mental, emotional, mind, body, spirit was part of our symbol. They didn't really teach us, teach us a lot about the spirit, but we had this understanding that there is this life force in us, this thing called vitae. And when you trigger that vitae in us, amazing things can happen. And a lot of our job as a naturopathic physician is to figure out what's the obstacle to cure in that body. We know the body wants to be well. What's the obstacle to cure? How do you remove that obstacle? You know, I know both of you are deep into healthy nutrition and food. That's huge. Like, you know, if you're eating a standard American diet, that's an obstacle to cure for chronic disease right there. Yes. Yeah. And, and what is it that we can act— how can we activate that, that life force in that body? And, and we now— so yeah, that, that, that energy body, but it's so intertwined because you also look at that autonomic nervous system, which is part of the physical body. And we know that A lot of us get stuck in that sympathetic stress mode, and it's impossible for a body to heal when it's in that state. So you want to get into that parasympathetic rest and digest state. And, and that's— and, and you— and getting into that state allows that natural vitae healing force to trigger and to turn on.

I wanted to go back to that because even for me as a practitioner walking through my own healing journey, I spent a lot of time investing in the physical. Right? The lab testing, all of the things to do, all of the things to not to do. But it wasn't really until I started tapping into the limbic system healing and the somatic work, right, that I saw things come together and things to be more sustained and more predictable for me. Let's just put it that way. Yeah, yeah, I had the same journey.

And so when I had that, that second crash and those 5 things, it was really interesting because I was— I actually watched a summit on Fatigue way back. This is— this is— we're talking like 2014. And I watched the Fatigue Unsummit and got introduced to the limbic brain dysfunction and did a bunch of research on it. And there wasn't a ton back then, but I reached, you know, researched all the stuff I could and learned about it. And it was— I— and what I was noticing was that my patients were getting— I was getting better, but I still had that ceiling of needing to energy budget. And because I'd gotten 150% better before, I wasn't I'm not willing to settle for what I call beige. And I'm sorry if anybody loves the color beige, but I'm like not a beige girl. Like, I don't like a beige life. I want an exciting, passionate, up and down, you know, like doing things kind of life. Like, I don't want to be stuck in this little energy box of like, I have to protect myself all the time. And so I wanted to break out of that. And I was doing so much better. I had a pretty decent life, but I knew I still had that limit. And I remember walking with a friend, another doctor friend of mine, saying, I know what I need to do. I need to go farther in and deeper in so I can help other people go further. And I knew I had to do that limbic retraining, but I literally was resistant to doing it for a year. And this is what the limbic brain can do in terms of protecting you from wanting to change where you are in your emotional state. So it was, it was interesting.

I just want to, I want to say that again because, you know, I was just on a consult call today with someone who is profoundly having benefit from working on on the limbic system right now, but was so resistant for so long and is now being like, I wish I would have. But it's the journey that she had to go on to get to that place. Yeah. So if anybody's listening today, because we have done— we've had a podcast and talked about the limbic system and had Dr. Gupta on here too. And everybody has kind of that different way of— or a system to which they recommend using for this, uh, for limbic retraining is just, we got to do something, right? That don't wait, don't wait. It sounds hokey. I mean, that's what most people say.

It's part of us, right? Like she said, it's part of your— it is part of your being. And if we're not nurturing that part of our being, it can be an obstacle for healing, right? And I don't think most people understand that.

Yeah, I think one of the things is that we're all dealing with so much stress in the world right now. We're dealing with chemical stress, environmental stress, We're dealing with whatever underlying stuff is getting triggered in your body. You know, the more we, more we live in this body, the more stuff that can come. Yeah, yeah, right. And there's just a lot happening in the, on the planet right now that is very stressful and can easily trigger us in different ways. And so frankly, I feel like every single person needs to have some kind of practice where they're working on getting their nervous system more regulated. In calming themselves into a place of knowing that they're safe. And all that limbic retraining, insula, amygdala retraining, it's just reorganizing your brain and your body to realize that it's okay, you're safe. Like, you know, it's like that big— you know, they talk about the limbic brain being like a 3-year-old. And so you think about a 3-year-old who's either tantruming or really scared. Hard or is really insistent about wanting something, but you know it's not the best choice for them to have that candy bar. And, you know, you just think of like a 3-year-old. What would you do with a 3-year-old? You know, it's the same thing. It's just kind of like, I see you, I love you, and let's do this thing over here instead. Like, let's, let's get distracted and be happy with the butterfly, or let's, let's cuddle, let's go, let's move our bodies, let's do something else until we start laughing and smiling. And then we know we're safe, right?

Yes.

I've seen most recently, as we have dealt with just so much tragedy in our world today, is those who are quick, they're getting into that place of deep emotional— call it what you want, but it's just depression, sadness stuff. And they're becoming less and less and less adaptable. And you watch it. You know, it saddens my heart to see it. I mean, those events create and should create sadness, absolutely, but not a paralyzation. Right. Right. Yeah. And that's what it's doing in many cases for many.

Yeah, yeah, yeah, I agree. And I think that for some people, and part of the healing journey for some of us at times is to turn off the news or turn down the news and go on a news diet. Because the news is programmed to trigger us into a fear state. It's— that's what it does so that we stay attentive and watch it. And often a news fast is one of the healthiest things you can do for your life. Now, that said, there's so much happening that it sort of feels like, oh, but I want to be sure I kind of know what's going on a little bit. So there are ways of doing that in terms of having other people keep a lookout for you, or having— budgeting your news to like, you know, no news before noon, and then I have a noon— then I have a news snack, and then that's it. And then I do something and I do something really happy before the news and really happy or something after the news. And maybe what I call in happy is a misstatement. Maybe it should be I emote, you know, like I grieve, I cry, I feel my anger, I work with my fear, you know, whatever it is. But the thing is that, you know, what I really see over and over again is that right now we're, as a people, we have this— we're understanding what's happening all around the world, and yet we are powerless to do much about out it. And this is really hard on the nervous system. We're really wired to handle the emergency in front of us, or maybe the next village over. So we're really meant to be like, "Oh, there's a fire in the barn. My neighbor's barn's on fire. I'm going to, you know, go help and put that fire out." And then you get to go through the complete activation of your stress, go through the physical expression of it, have a resolution, calm down, you know, and reconnect, and then go back to your life. And instead, we get bombarded over and over again, "Oh, there's this terrible thing over here in the world. There's another thing here. There's another thing here. There's another thing here." And yet they're so far away and so out of touch, we can't do anything except sit here and frickin' worry and feel bad. And it's like, it's so hard for our nervous system. So learning how to move those feelings through your body for whatever works for you is really, really helpful. And again, this is something that's great to teach our children because it's a toolkit. It can be part of the toolkit. I'm all about the toolkit. Like, what's in your toolkit so that you can pull out so you can be more resourceful and more resilient? Or maybe it's Kelly said more resilient. Yes.

Well, we say that all the time. Like, what is in your toolkit? And sometimes we have lots of really good tools in there because sometimes we don't have good tools in there, right? Or any tools in there, right? Sometimes we have plenty of tools in there, but we forget how to use them, or we even forget that they're there. Exactly. Absolutely. So we have to be reminded of that too. So I love also what you said about allowing those emotions to go through us. It's not deflecting them and saying, don't have those emotions. You're saying move them through you because that's healing.

Metabolize them out. Yes. Metabolize them out. Exactly. So I want to go back to your Google search, right? Your Google search was— your Google search, right? When you were feeling so horrible. Yes. So let's talk about fatigue, because I think so many people are putting in that Google search, right? I feel terrible. I feel fatigued. I feel stuck. What are we going to do about it? Right? And Google's going to tell you all kinds of things to do about it. And there are a lot of people that are going to sell you a lot of kind of things to do about it. But I think if we could kind of walk through how you have framed out through all of your research that you did when you were not well, when your patients were not well, you know, you took the time to dig in and research and figure out out, like, what are those different elements that make fatigue so, so, um, impactful for someone?

Yeah, yeah. So when someone— there are different things we need to look at, and I'm just going to kind of lay out a couple of different things here. So one is it's really important to look at somebody's— when somebody's— if you're feeling exhausted, you know, one thing to look is at your health foundations. And I know both of you know all about this kind of stuff and probably have talked about it a lot, so I'm just going to kind of— and I'm sure many of you listening know about these things too, but I'm just to— I'm going to reiterate a little bit about this, and the reason why is because they're just not sexy. And so because they're not sexy, and because you've heard it before and you kind of know it, it's easy to just be like, oh yeah, whatever, and not really give it the attention and realize that this is actually incredible power that we all have at our fingertips when we re— you know, kind of reset ourselves and go, okay, I need to attend to this. So the health foundations I'm always listening for, and I usually am with a patient or a client, I'm going to choose one that we're going to focus on initially. Because I find that if you try to do everything at once, it's too much. So like working on a health foundation. So is it number 1, digestion detoxification? Or is it number 2, rhythm and sleep? Or is it number 3, mindset and spirit? Or is it number 4, movement and breath? Or is it number 5 that came in to this little system I created during the pandemic called Connection, which is connection with yourself, connection with your higher self, connection with others, community. We are social creatures and we need that connection. So that— those are what I call the health foundations. And literally, like a foundation for a building, the deeper and stronger they are, the deeper, the more resilient you can be. You know, it's like I— and, and I look at those— when a 7-Eleven or a Dairy Queen gets removed from a parking lot here, there's just a parking lot underneath. There's no foundation. Whereas you go to New York City and those big buildings, they have like huge, huge, huge foundations. So the stronger your foundation, the more resilient you can be. And often if you've been on a path of healing and you're plateauing or you feel like you're dipping, sometimes it can be good to just review, where am I here? Maybe I worked a lot on my digestion detoxification and that's actually pretty good, but maybe there's one of these other things things that if I focused on it, it could really help me. And I find one of the insidious ones is that mindset piece, because often we're still playing old tapes that we internalized as a child of, I'm not okay, I'm not good enough, I'm bad, I'm bad if I'm tired, I'm bad if I'm not productive, I'm, you know, whatever all those things are. And so that can be one that can be one of the most insidious kind of ones in there that you don't even realize it's there until you really pay attention to it.

Yeah, I think in our culture, a lot of times we're just taught to suck it up, you know, in the mindset piece. Just come on, get over it, it's over, it happened yesterday, get over it, let's move, let's go, we got things to do. And I've been guilty of that too, right? Treating myself that way. What's up? Treating myself that way, like talking to myself that way, like get over it, let's do it.

Like, yeah, yeah, exactly. And there is a place where that kind of will and, you know, motivation and kind of pick yourself up has its value. And there's also a place where it doesn't, and sort of learning how to be— know when that, that part of you— it's a good time to bring that part of you in, like, kind of like, um, or, or when it's not. Yeah, yeah.

And our listeners— I, I love that you went back to the foundation because our listeners are very well versed in the terminology of foundation. Because the reality is, is that, you know, well, I live in Florida, right? So we're always talking about, you know, the storms are going to come. It's not if they come, they're going to come, right? And you need to have an unshakable foundation, and that reassessment is very important on a regular basis. So I think that's a critical piece that we do forget, um, yeah, or have the tendency to forget.

And I also think it's one of those where we were sort of talking a little bit beforehand about— before we went live— around people dealing with chronic disease and how that, the, that complex chronic disease can almost become the grit that shines the pearl. And it can become that challenge that when you embody that as part journey and your life and you really own it, it's amazing how many beautiful things can come out of it. And the truth is that having some kind of condition or something you have to pay extra attention to means that you have to pay extra attention to these health foundations. And these health foundations are the exact same things that all the longevity experts talk about. It's also the exact same things that high performers, um, pro athletes, pro entertainers literally have teams that help them with their digestion, detoxification, with their movement, with their breathing, with their mindset. They've got coaches for this stuff. It's like—

and they're beginning to talk about it. I mean, I just heard Brenda Bouchard the other day, and, you know, and then I thought about Joyce Meyer, you know, from the— you know, I, I hear about a lot of these people, to your point, that are talking about it now because they're doing it, but they have teams of people helping them do it.

Exactly, exactly. So, so whenever you think that that's not important, that just this time it doesn't matter, just remember like how much this is— this is where we really have power to impact our health. So that's— those are the health foundations. And then I'm listening out for the root causes. And these are the root causes that I mapped out during that second time I had the crash. And this is looking at— is— has there been a— the first one is the gateway root cause. It's that hormone triangle. It's the adrenal, thyroid, ovary for, for women, and testes for male. And that simple— that triangle is like a symphony, and they like to stay in tune with each other. And if one gets out of tune, the other others get out of tune to try to match it and to try to take care of it and bring it kind of into balance. And that I call a gateway root cause because we are so on the stress express in this culture where we push ourselves. A lot of us, you know, are like me, they're moms and professionals and we work and we go and we wanna be really good at what we do. And we just ignore the signs that we need to take a break or we need to recharge or we need to heal. And so this is one of those gateway root causes that can be a huge setup so that your body becomes vulnerable to some of the other root causes. But this is one of the first ones I'm kind of listening for and testing for and seeing if it's going on with somebody. And partly because it can be really quite easily addressed through lifestyle and some really lovely herbs and things like that, so we can get ourselves rebalanced and people can feel— start feeling better within a few weeks if we, if we address this, this root cause. And so it's a really great one to start with. The second one is looking to see if there's been any kind of viral reactivation or viral overload. Of course, in this world of Long COVID, and part of my story was at the beginning of the pandemic, I was like, uh-oh, people. Like in 2020, spring of 2020, I gave a presentation. We're gonna have an uptick, we're gonna have a pandemic of chronic fatigue, myalgic encephalitis, people, because viruses and stress together, this does not look good. So, you know, it's been part of the thing and I avoided it and then I did, it did actually kick on a relapse for me. So I've been experiencing that too, which has been really interesting. But anyway, so the second one is viruses. We have this microbiome of all these other critters in us. We also have a virome. We have viruses that are in us and they lay dormant until it's a time when they can start to replicate and they're super opportunistic. So when you're stressed out, out when you have a motor vehicle accident, when you go through a divorce, when you have a bunch of exams, when your kid keeps you up for a couple years. It's really easy for those viruses to go, woohoo, let's have a party! And they start replicating and they take over your cells and they literally alter the energy production in your cells so that inside your mitochondria and suck your energy away. And they do things and they can protect themselves and hide so your immune system can't see it. So they end up— can stay there for a very long And this is a very, very common thing. And what we've seen in some, not all, but many people with long COVID is that the COVID kicked up a latent infection in them, an Epstein-Barr infection, a cytomegalovirus, a herpes 6 infection, one of those, or those are some of the typical ones that we see. And by addressing these, people can start to really reclaim that energy back for their body and get the virus, viral load down. Down. The third one is looking at mitochondrial function. Your mitochondria, these lovely little powerhouses inside the cells. I'm sure you've talked a lot about it here. Yes. And I love mitochondria. I love to geek out on mitochondria. Uh, and just to say, they are amazing, super complex little things. They're also so vulnerable. They're just these little, little sweet little things, and they get really impacted by the viruses and by toxins and things like that. And one of the ways that you can tell if your mitochondria are impacted is you have this thing called post-exertional malaise. Post-exertional malaise is when you do more than you usually do and you pay for it. So this can be, I did the dishes and the laundry and now I'm in bed. That can be a severe case. Yeah, I had a fibromyalgia patient who was like that, 10 days in bed if she did the dishes and the laundry in the same day. Or it can be like one of my trainers, and she would walk 45 minutes, but if she walked an hour and a and a half, she would have exhaustion for 3 days. And it can also be delayed. A lot of us— I had this really weird thing that happened when I got Long COVID, is that my post-exertional malaise would show up 3 or 4 days later. And we're seeing that a lot with people with Long COVID, and it seems to be an altered energy production system inside the mitochondria that we're trying to figure out what it's doing. But we have some theories.

Yeah, and what you're saying is they do the activity fine, they feel fine for a few days and all of a sudden they crash out. Yeah, I'm seeing that too.

Yeah, which is super challenging, and it's hard because, as one of my clients said, it's post-exertional malaise. So how do you know how much you can do today and not pay for it? And it, it, it, you know, more talk about the limbic, amygdala, insula brain. You can see how this starts to trigger that part of the brain because you're like, oh no, if I go to my kid— if the kid's birthday party and then I do this other thing for work, like what's gonna happen next week when I have that other thing I'm supposed to do? I, you know, it's very— it can really begin to play tricks in your head.

It's pacing very difficult. Yeah, it makes pacing your activities very difficult if you're used to pacing because of chronic illness, and then this happens. It can make it really challenging.

Yeah, it makes a little more challenging to tease out, and yet the pacing is still part important to get to a healing state. And yet it's that nuanced thing of pacing without being in the fear response, without being in that hypervigilant state, which is tricky. And I get we're talking about a lot here. I'm assuming— yeah, yeah.

Um, I have a question for you. Um, I, I was just curious if there are wearable devices or metrics in the way of diagnostic testing that might give some insight insight to your client of how much they can push? Are you recommending any of those things?

I think the HRV can be a really great— so using a wearable HRV. I have an Oura ring on. I always talk about, like, the spaceship comes where you get to go. We're all going to be on the spaceship together, right? It's like, we'll be in good company. I think this can be really great to monitor what's happening. And as, as, as a piece of information, sure, because I think what it's picking up is, uh, complex. And, you know, it's a lot to go into all the details behind that, but it is a piece. And there are different types of ways of measuring your HRV, but the HRV, I think, is— I think it's the easiest, most accessible tool we have to that. Because, and especially if you can start to see a pattern of what you're doing, some of this is just— you have to kind of map out a pattern of what happens. I honestly was in denial of my post-exertional malaise for a while. And then I had to get honest with myself and realize, like, yeah, if I do all of those things, if I go paddleboarding, kayaking, hiking—

yes. And I think some of the people who have listened to us before have heard us maybe say the push-crash syndrome, or talking about push-crash. Um, so is that, is that what you're referring to? Is that— that's definitely the push-crash cycle is definitely there.

And just to kind of weave in some of what we've already talked about around the mindset piece and around this limbic brain piece, which we'll get to in just a second with the root causes, is that what I have personally found, and for myself, and what I teach those that I work with to do, and they've also found this to be very helpful, is the more that I can be in a state of what the HeartMath calls heart-brain coherence, which is a place where I'm doing vagal tone type of breathing, I'm in a calmer state, I'm feeling safe, all the different things that we would talk about, however you practice this is, uh, um, I can do much more exertion in that state, and I, and it does not— and I don't have the energy deficit in the same way, which I find really interesting, opposed to if I'm in a stressed-out state when I'm having that activity, it's, it's much worse. So it's just something to kind of—

so do you trust your data where it shows restored on your Oura data, so where it shows stress response during the day, so daytime stress response, where it shows restored, would you consider that coherence?

Do I consider that coherence? I don't, I don't think I feel like I know enough to answer that accurately and intelligently. HeartMath has tools that I have that I've used on and off, and they show you when you're in coherence. And so I've come to understand what it feels like in my body when I'm in coherence. And so that's— that I've used that biofeedback tool to train myself to recognize what it feels like, and that's what I use. I've never looked at the two together, which would be kind of interesting. So I just don't feel like I can accurately answer that.

So for our listeners, HeartMath is a platform, and they have a device— they have several devices, but one of them is something that you can use at home, and it teaches you how to deep breathe. You can actually watch watch when your heart rate and your breath are in coherence. That's what she's talking about, coherence. And coherence is a parasympathetic healing state. And she has trained herself to recognize her body when her body's in that coherent state, which I think is phenomenal because so much we're tuning out, we're not tuning in. And so, so that's interesting.

I love that. Yeah. And a little bit more on the HeartMath pieces, they've done a lot of studying of this energy body. Body. And so a lot of what we know in terms of like peer-reviewed science around the energy body— HeartMath has actually invested a lot in this, and they've come to realize that there's actually a brain in the heart, and there's, there's a field out, out in front of us that actually knows things before the brain knows. They've done tests, really interesting tests. You can read their documents on their website, they're all free, you can just download them. And what they found is this heart-brain parents, it's the sympathetic-parasympathetic system being engaged, yes, but it's also this— literally, it's an energy flow between this energy center in the brain and the energy center in the heart. And they've studied what the pattern looks like when people are in that flow. And that— it's like being in the— you've heard athletes talk about, I'm in the flow state, or when you've been really productive and things are just moving, even if it's when you've got like 2 2 kids under the age of 5 that you're feeding and you're doing the dishes and cooking, like, you're just like, yeah, I'm in it. Like, I got it. Like, you know, I'm in the flow.

So I want to go back to something you said earlier, much earlier, but I caught it. And it was where you were not wanting to admit that you weren't fit, right? And I think that so many of us struggle with that, right? When our body is going down and you're just like, no, I'm gonna— I've got this, like, I can do this. So what took you from that denial place of not wanting to see it to being able to recognize coherence?

Yeah, I guess I'm not sure, because I think I've been in that denial state a couple times, and a couple times in the story that I've told you so far, I've been there. The first time that I really remember being in denial and realizing how easy it is to be in denial is that second time I crashed, because I'd never been so fit in my life as I was right before I crashed. Like, I I was lifting weights. I loved it. I'd never been— I'd never— I, you know, I got out of gym every time I could as a kid. Like, I hated gym as a— and in grade school, like, I didn't want to run across the field. I wanted to climb a tree and read a book. And so I was— and so for me to really love working out and feel the power of my body was just amazing. And I didn't want to lose that. I came back from a trip and, you know, the injured knee, I was already in pain, and I I remember waking up in the morning, and whereas I had been waking up with this, like, I can't wait to run up the mountain I live on, I was waking up and I'd look over at my dresser and be like, I do not know how I'm gonna get through this day. You know, I was just like, you know, I've got like 15 patients and, you know, I'm got— I, I don't know how I'm gonna do this. And that was my first waking thought. And I was in denial of what was happening to my body. I was in denial that I was relapsing back into chronic fatigue. And I think any relapse, no matter what it is, an addiction, relationship stuff, anything that you're relapsing, there is this normal phase of denial of like, no, I got it, I'm handled, it's not that bad. And that was big for me too when I went back and was like, oh. I love that.

And I think that's such a common story, right? And so I think my question comes into bridging that gap from denial to taking care of yourself in a different way? Because you were taking care of yourself in a lot of good ways, right? You're working out. But how did it look differently from moving beyond that?

Yeah, I was doing all the right things. I was getting up at 5 and meditating and going and working out and doing all the stuff and making good food so that me and my kid and we would all have great food to eat all day. I was doing all those things and it was exhausting me. I think that— but, and honestly, I think that the difference between then and now, which is quite a bit of time because we're talking That was, you know, like, again, 2014. And so how much have I learned about myself and grown and healed? And what has my experience of Long COVID brought me? Like, every time something happens, there's an opportunity, like I said, and that's been my journey too. And this has allowed me to go deeper into a deeper level of self-love in a way that I didn't even know I was missing or know how to do. And it was— and so I've been dealing with I've become conscious of some very deep unconscious patterning that when I did the limbic emotional retraining, I didn't— it's not like I coded over it, but it wasn't really— I was— there was like a whole other level that I got that now I'm working on that I really am glad to have. And so this person now would recognize sooner, I think what was going on there, because I would know what love feels like for me, rather than, than this identity of being the person that is fit and strong and works out and does everything right. You know, instead of just being like, you know what, today the body just needs this, you know, or my spirit needs this. So how do I get that in? You know, how do I make that happen?

As I sit here and listen to all of this. Um, one of the things that I hear, I feel like I hear, is that, um, and I can relate to the story because of just part of my journey of being CrossFit and then nearly died in Peru. Um, so, and my friend here being there with me to see all of this happen. But I feel like there's such a significant amount of grief. I think we think about grief as losing someone Yes. But, but when we lose something that is so important to us, perhaps in my story, I mean, my exercise was a way of keeping my weight off because I was that bigger kid. Yeah. So, you know, when I lost the ability to be able to work out, I mean, it was, it was a grieving process. Yeah, sure. And then I hear you walking through that almost like Kübler-Ross's stages of grief, right? The denial and the anger and the resentment that happens, right? You have to get to that place of acceptance. Right. Right. This is how it is. And so I think we don't think about grief for loss of foods. Like when we walk a patient through or a client through a food intolerance panel, they're losing foods. I mean, that's grieving that. It's sometimes not the food, it's the social piece of the food. Totally. But that's what I kept going back to as you were sharing your story.

I'm just sitting here listening, and that's what resonated with I think that's really a good point to bring out because I think it's true. And I used to do food sensitivity testing in my clinic. And so I totally— the food grief thing is real. It depends on what it is. It's real. And I remember when I gave up coffee, it was like, I love the ritual. Like, I loved it, you know. And but, but deeper than that, when you are— when you're dealing with an illness that does take you away from doing those things that you love, for whatever reason, there is a grieving process. And I think it's another one of those, the, the more— the sooner you're willing to acknowledge that's what you're going through, then the sooner you can give yourself the support to move through that, to get to a place where you can then take action with what is now, which is literally the opening in the clouds. It's like my dad used to fly a little airplane, and I remember him saying, I'm looking for the holes. It's looking for the holes in the cloud, and it's kind of like, where's that little hole between the dark clouds that if you just kind of like find it and go through, then it's like, wow, there's like all this blue sky and sunshine and, and that kind of thing. But I think it's true. But I also think it's important for us to remember that grief is not linear. And there are all those stages, and you can literally go through each one of those stages in a minute. And, you know, like, you can be angry. And I mean, it's like you can do rapid cycling grief, and that's normal. So I just want to say that too. I'm glad you brought that up. Oh, goodness. Yeah.

Now, I just appreciate you being so vulnerable, sharing your story in that, because I think the story is going to resonate with lots and lots of our listeners. And oftentimes we're looking at healing through the lens of, I want to be done. Yeah. You know, I just want to be done. I want the finish line. I just want the finish line. Right? And they're truly, you know, yes, you can be much better, 100%, and you can maybe even get to 150% better, right? But we don't want to be in the mindset of being done because there's richness in the growth that happens, all the different layers that you've been through and the opportunities that you've had to know yourself and love yourself in a very different way. That's really special. And I just wanted them to hear that and for me to hear that too, because it's inspirational even for me and Lori Esarey MS.

That's— thank you, that's great. Yeah, I really do see it as a journey. I really do see it as a journey up that mountain. When you think, I want to get to the top of the mountain, and there are places where you're in the foothills and it feels like, oh my gosh, I've been walking for so long, I'm just in the trees and I can't see anything, and am I ever going to get there? And then you get to this meadow and you're like, wow, this meadow is so beautiful, you know, it's a really beautiful place. And there's just a whole part of the journey of this. And, and again, when you embrace it, it's really there. I just want to— before— I know we're running out of time, and I want to get to— we didn't even get to the other root causes, just so that we can do it. So that— so the fourth root cause is looking at toxins, which are all the things that we're all in contact with, we all have in our body. And it's easy to get scared and freaked out and want to stick your head in the sand, which is an option, but it can also just be an understanding that doing things that are daily detoxing, and sometimes some of us need to do deeper detox when we're ready. Too, too many people do it too soon. But heavy metals can be a huge thing. My getting well that first time, getting my 20 mercury amalgams out of my mouth and doing a detox night and day, getting that mercury out. And can be mold, mycotoxins. I know that mycotoxins are huge and they're just really can trigger that mast cell activation in many of us, especially with a long COVID piece. The COVID piece and the mast cell, they're really close together. So the toxins are huge, and the glyphosates are altering the mitochondria. And so there's a lot of places here to look at the toxins. And then the fifth is what we've already talked about, which is that limbic amygdala insula emotional brain piece that's in the subconscious mind and is attached to that vagus nerve that connects with all the different organs and even communicates with the mitochondria. So there's become all of these different pathways between these root causes, which is why people often have 1, 2, 3, or even all 5 of them. Not everyone, but some do. And really the thing is to figure out which one is the root under the root. Like if we really focus on this one, we may be addressing a couple of them, but if we really focus on this one, how is that gonna free up the body to have more energy, more vitality to begin to address these other places?

Fatigue is so complex. Complex, right? But when you think of it through the framework of what you did, it makes it, it makes it easier to get excited about the potential of true healing. Um, and so I'm, you know, I think those frameworks are so important for people to hear too, is that there, it's not, um, there's a lot of practitioners out there that hear about fatigue and, you know, they just have one way of doing things, do diet. Yeah, right. Do this, and it's too complex for that.

Yeah, it is too complex. I really— everybody, we are all snowflakes, we're all unique. And even though you may have the diagnosis of Long COVID next to somebody else who has a diagnosis of Long COVID, how— why your body triggered into that Long COVID pattern is unique to each of you. So understanding what happened beforehand that was the trigger for that body is part of the clue to how you get well. And what did that COVID virus do in you? Did it, you know, did it go into your vascular system? It did for a lot of people and creating problems there. You know, has it triggered another viral infection? You know, how is this— is it going— is it in your mitochondria? It's a lot of people's creating mitochondrial dysfunction and people are feeling metabolically effed up, like holding on to weight in places they never did. And what they eat doesn't make sense for how they feel, like just, just backward, like literally backwards. So, you know, it's unique. And so it does take some time, but I— it's complex, but it's not, it's not impossible to work through as long as you're willing to use an algorithm and a map and take the steps and just know, yeah, it's going to take time, but I'm going to keep going. And that's, that's the piece.

Yeah. When you say take time, I know everyone, when I think laying out a realistic expectation for your clients, how do you have that discussion with them?

So usually the people that— depending on which health foundation and which root cause you're, you're working on, I mean, I, I have a pretty good idea of a general window depending on the root cause that you're working on that I can say usually within these windows we're expecting to see something where we know if we're on the right track. So, you know, like I said, with the, with that hormone triangle, if you're working with the adrenal hypothalamic pituitary axis, I mean, 2 weeks is, you know, if you know if you're on the right protocol in 2 weeks. Other stuff takes more time. Some things are faster. I have a mitochondria protocol that's 5 days. You're gonna know if you're on the right track. That doesn't mean you're cured. It's just, are we on the right track? But honestly, I bring people in, if people are working with me one-on-one, I usually bring people on for a year now. And I do a year-long thing because I find that that year is really important for us to be able to look at all the things and for, for, for, you know, for you to know that you have that year to work on stuff. And it's not a, it's not a mad dash. This is a marathon. It's not a sprint. And, and it also gives us time for when the other life things happen, for that to become material for us to do, go deeper work. Like one of my clients who I was working with for a year had a cancer scare during the time. If we had just been seeing each other one-offs, she would have been gone down the cancer trail unsupported. Instead, she did the cancer trail, and we realized— she realized how the insight of how much her emotional body was impacting her energy, because she'd been doing much better, she crashed. And it was all around the fear and all around the emotional state that she went into. And it was a huge aha. So we got to work through that. And instead of it becoming this whole crap, you know, this whole spin-out, it became like, oh, look at that, great. And so we just did a ton of work, you know, right then and there. So she was able to just keep going. And that's, that's what I see.

I love that you said that. I'm, I'm, I just want to reiterate that because I think, you know, we talk, uh, Kelly and I talk about the, the long game instead of the short game. Like, this is, this is the long game. But I think sometimes people think, particularly in the area of foundations, I've got that, right? And And it's really not about having that or not having that. It's applying that through the seasons of your life and the change. That's what that's about. So I love that you say no longer, you know, I'm not going to, you know, it's at least a 1-year commitment. Yeah. Because that's, I mean, that's how we can create sustainable change too. You're teaching them to fish. You're not giving them the fish. Exactly.

Exactly. And that's what I say in the beginning when we first meet. Because there's this place where one of my goals, obviously, is to get them better, but the other is that they know themselves better. They have that toolkit. They know what their body responds to. So years and decades from now, when we're not even in contact or whatever, they have that. So they are empowered in their healthcare because to me, that's the revolution. That's the health revolution we need is owning your own journey, owning your own health, owning your body, and becoming empowered. You take care of you, your unique, beautiful self.

Yes, I just want to like cheer, like, yeah, yeah, you know, you get so excited because it's so true. Like, they're the CEO of their health, and it is an empowered movement, and we are a part of it. And isn't it exciting to be a part of it?

It's— I, I feel blessed. I really do. I feel so blessed that I chose to do this and I get to do this work. I love it, right?

Yes.

Well, we're glad that we got an opportunity to meet you, to about your work. And, you know, obviously I, I, I think there's energy right here. You talked about energy. Um, I can feel it. Um, and I'm sure, you know, our viewership and people listening can hear it too. Um, and probably Casey in the background is, is listening too and feeling energized by it. Um, but I, I, I, I'm so thankful that we've gotten an opportunity to talk with you today. And I would love for people to know a little bit more about how they could get in contact with you and maybe even connect with you should they wanna learn more?

Yeah, sure, absolutely. The best thing is to go to my website. It's drjennytufankian.com. So that's D-R, Jenny, J-E-N-N-Y, Tufankian, T as in Tom, U, F as in Frank, E, N as in Nancy, K-I-A-N.com. And that's the best place. And you can read and watch and look at things there. And if you're interested in seeing if we're a good match to work together, either one-on-one or in my group program, then you can check out, uh, and, and apply. That's awesome.

And where are you located at? Physical? Portland, Oregon. Portland, Oregon.

Oh, I love it, love it.

Awesome. Well, thank you so much. Um, do you have anything as we close, um, anything that you would like to share? Any, um, closing remarks? Just things to uplift, inspire, and encourage as we leave here today?

Uh, thank you. I first want to say both thank you to you, Kelly, and, and Lori, for having me here, and also just for all the work you do. I mean, I can just tell from the way I was invited in and how much you really take this seriously and work deeply and work with all of those, you know, all of your clients. So thank you so much for your work. I mean, you're definitely making it happen, and I just thank you. I'd say I feel like we've said a lot today, and I just think the one thing that I would just say, just reiterate and say, that is so important is to always maintain that hope. And I know that we all come, you know, self-included, we all have those moments when it feels too hard. It feels like, you know, maybe you just got to give up, throw in the towel, there's no point, you've tried everything. And again, it's that place to, you know, have the cry or scream or whatever you need to do. And then when you're ready, it's like it's time to just get up again and knock on another door. Keep knocking on doors because I know, I have no doubt in my mind that for all of us there's always What is the next thing that we can do that can move our health on any or all of those levels that I talked about to another level so that we can experience more joy, more presence, more light in being here at this time? And I really think that that's, that is what is, is what's needed for all of us and what makes us feel good. And then we get to share that with those around us and it becomes this domino effect. Effect of positivity.

Well, keep sharing the good news and inspiring and encouraging. Thank you for spending your Friday with us this afternoon. We appreciate you.

Absolute pleasure. Thank you so much.

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