Topics:
1. Flashback news and updates from Diane [3:19]
2. Introducing our guest, Dr. Dan Kalish [8:23]
3. Proper adrenal function [12:09]
4. Early warning signs of adrenal fatigue [17:08]
5. Why fertility is so important [26:32]
6. Adrenal fatigue in men [30:53]
7. Four big lifestyle factors [35:12]
8. Signs of overtraining [38:54]
9. Decreasing the exercise load [51:53]
10. About caffeine [1:00:05]
Links:
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You’re listening to the Balanced Bites podcast episode 239.
Welcome to the Balanced Bites podcast with Diane Sanfilippo and Liz Wolfe. Diane is a certified nutrition consultant, and the New York Times bestselling author of Practical Paleo, The 21-Day Sugar Detox, and co-author of Mediterranean Paleo Cooking. Liz is a nutritional therapy practitioner, and the best-selling author of Eat the Yolks and The Purely Primal Skincare Guide. Together, Diane and Liz answer your questions, interview leading health and wellness experts, and share their take on modern paleo living with their friendly and balanced approach. Remember our disclaimer: The materials and content within this podcast are intended as general information only, and are not to be considered a substitute for professional medical advice, diagnosis, or treatment.
Diane Sanfilippo: Hey everyone! This week we are throwing it back to some classic Balanced Bites. We’ve got an episode that I recorded almost exactly 4 years ago with Dr. Dan Kalish. Now, what’s funny about this episode is I had just finished working on Practical Paleo, and had the very first copy of it in my hands. Before I finish my introduction, let’s hear a word from one of our sponsors.
Liz Wolfe: Our podcast sponsorship today comes from Vital Choice, an online purveyor of the world’s best wild seafood delivered right to your door; because juggling a busy life shouldn’t mean you have to forgo healthy meals. At www.vitalchoice.com, you’ll find wild Alaskan salmon, halibut, tuna, sable fish, and cod, as well as prawns, crab, and scallops. You’ll also find grass-fed organic Wagyu beef, free range heritage chicken, fresh frozen organic berries, and dark organic chocolates. Make a vital choice by eating the highest quality food you can. Vital Choice; come home to real food.
Diane Sanfilippo: So, Dr. Kalish and I sat down to talk about adrenal fatigue, and as you guys have been listening for the past few episodes, Liz and I have been talking about this. I do want to see if I can talk to Dr. Lo, still; Dr. Lauren Noel about the way adrenal fatigue kind of comes into play with women’s health and hormonal issues.
But, in the meantime, I think this episode with Dr. Kalish is just so important. He has been working with people for many, many years, and also teaching other practitioners how to help people dealing with all kinds of functional medicine issues, with adrenal fatigue being kind of at the forefront. And I absolutely love his approach; he has a super cool energy. I want to give you guys the heads up that the audio quality on this one might be a little bit different, because it was 4 years ago, but the conversation that we had and the information and insights that Dr. Kalish has for you are completely spot on, still totally accurate. I want you guys to listen to it, listen to some of the clinical advice he has, and really kind of take it to heart because Liz and I have been talking about it for a few weeks now, but I absolutely love getting Dr. Kalish’s perspective. So without anything further, let’s get into my interview with Dr. Dan Kalish.
1. Flashback news and updates from Diane [3:19]
Diane Sanfilippo: Hey everyone, this is Diane Sanfilippo, the mind behind Balanced Bites, and welcome to episode number 46 of the Balanced Bites podcast. So I am flying solo today once again, but not without an amazing guest who I’ll introduce in just a moment. Liz will be back with us for sure. There is no…Don’t worry that she won’t be back regularly. She’s just been very, very, very hard at work on a project that she will tell everyone about when she’s ready, but don’t worry. She’ll be back.
And yeah, I’ll just give you guys a couple of quick updates on some things going on in my world. A few of you noticed that I did actually end up going out to Los Angeles for the last week to the Crossfit Games after the past few weeks saying I wasn’t going to go. And this is going to be an interesting podcast to follow up that trip with, but I actually, you know, have been exhausted since finishing up the book several weeks ago, and was really just going to kind of stay home and rest. And then it just built up with me after the last episode we did last week on women, and just like thinking about all my friends being out in LA at the Games, and kind of pushing me down even further, mentally, to think of all my friends being out there having a great time, and all of my kind of Paleo people, who I will see at AHS in a couple more weeks here, but this was making me feel really down. And, you know, the only reason I wasn’t going was that I just felt like I needed to rest. So I made the decision that I was going to go pretty last minute, and that I would rest as much as I needed to, and not wake up early if people were doing things early, and not stay out too late every night. And that’s exactly what I did, and I actually feel totally fine from that trip. Probably the roughest part is the jet lag that I’m experiencing, pretty much right at this moment. {laughs} So lucky…lucky for our guest today, I’ve got this little friendly jet lag going on. But yeah, that’s pretty much it.
And the other amazing thing was that the very first copy of my book arrived to Los Angeles where…it actually went to Hayley Mason’s grandfather’s house because that at least was the one place I knew somebody would definitely be basically to receive this book. So the first copy came to Hayley’s grandfather’s house. Hayley and Bill wrote Make It Paleo, an amazing, amazing cookbook. But we basically all kind of sit around the evening we got back to the house after watching the Games for a few days, and we’ll talk more about the Games on next week’s show when I have Liz on because we were both there. But it was amazing to be able to open this package with Bill and Hayley standing there, who worked with me on all of the recipes. Just, you know, Hayley was helping me in the kitchen, and obviously they both tasted everything, and Bill was shooting all the pictures, so it was definitely a cool moment. I think I laughed a little bit and then I definitely cried {laughs} for a few minutes, just to how real it all became.
So I just want to thank everybody for your support; you know, over the last several months I’ve been sharing little bits of the process here and there, and it’s been pretty grueling, and it feels like it’s my baby and it’s born now. And to have this thing, you know, carrying it around at the Crossfit Games this past weekend and be able to share it with people, and see their interaction with the book, you know, first hand in person, which I won’t get to see with a lot of you. You know, you’re going to get this book at home and open it, and I won’t get to see your face, and so it was really cool to be able to see the reactions people had to it, right in person. And it was really cool to watch Michelle of Nom Nom Paleo flip through it with her son and kind of pick out what recipes they might make first. It was just really amazing and pretty overwhelming, so I want to say thanks to everybody for your support. And I’m really excited to share this book with you!
One other quick update just on scheduling. I have a blog post going up today, which when you hear this podcast it will be yesterday, but the official release party for the book is August 7th in San Francisco. It will be held at Rome Artisan Burgers; it’s going to be probably about a 4-hour window, and we’d love for people to kind of like graze in and out because it will be pretty overwhelming for the restaurant if 100 people show up at 6 o’clock, but I think we’re going to do it around 4 to 8 PM. I have to fly out again that night, so I can’t stick around too late. But would love to see you there. It’s a free event. I will have books for sale and for signing, and you’ll get to come experience one of my favorite restaurants in San Francisco for an amazing grass fed burger. So those are all my updates.
2. Introducing our guest, Dr. Dan Kalish [8:23]
Diane Sanfilippo: I’d love to introduce my guest, who’s been patiently waiting here on the line. I’ve got Dr. Dan Kalish on the line with me today. And for those of you who aren’t familiar with Dr. Kalish’s work, I’ll let him introduce himself a little bit in just a second here. I just want to let you guys know that I’ve known Dr. Kalish for maybe 4 or so years now. It’s been awhile. He taught my Chek Holistic Lifestyle Coaching certification maybe 4 years ago, and since then I’ve been kind of following his work a little bit from afar. One of my colleagues, Mary Vance, you know, Dr. Kalish, worked with you quite a bit or did for a very long time, and I refer a lot of people to her, so I’ve been a big fan of your work for a long time. And why don’t you introduce yourself to people a little bit.
Dr. Dan Kalish: Thank you for having me on the show. I appreciate it. So I primarily do practice functional medicine, and I’ve been in practice for about 20 years. For a long time, I don’t know for 10 or more years, I’ve also taught Chek certification programs for Holistic Lifestyle Coaching and all that good stuff. I also now spend about three quarters of my time teaching other doctors how to do functional medicine through webinars and seminar presentations and things like that. And the big focus for my teachers going way back 30, 40 years ago was, you know, looking at the adrenal glands. Dr. Timmins was, along with this man named Dr. Ilyas, the two folks that brought over this idea of salivary hormone testing from Europe in the early 80s, and started looking at the adrenal glands for the first time from a functional perspective.
And so I trained with Dr. Timmins for, gosh, 8 years, something like that, one on one, and learned quite a bit from him about how about not only test and interpret these lab tests for the adrenals, but then how to correct them. And so my main mission in teaching now is to get his work out there, because a lot of practitioners understand that the adrenals are important, and understand that they should be tested for, but, you know, don’t know exactly what the best protocols are. So it’s a little bit of secret information that’s not out there in a wide way because Dr. Timmins, you know, was pretty limited in the numbers of people that he was able to train himself. So that’s sort of my background with adrenal glands. I’ve been doing this for a long time, we talked about that.
Just in terms of my personal background, I lived in monasteries in Thailand and in Japan for about 2-2.5 years, studying Buddhism, so I have a pretty strong sort of background from that perspective in terms of meditation and stress management type stuff that would go along with that. And then I went into Chiropractic College and learned how to be a chiropractor and practiced for about 10 years as a chiropractor. But I was always mostly interested in functional medicine, and you know the shift in the more recent 10 years has been more away from patient practice. I still have a part time phone practice where I work with patients a couple days a week, but the emphasis now is much more on testing and correcting the adrenals. And lo and behold, this subject that I’ve been interested in for 20 years, and learned from the founder about, is now very much in vogue. I mean, you hear about it on the Dr. Oz show, they’re talking about adrenal gland function.
Diane Sanfilippo: {laughs}
Dr. Dan Kalish: The frustrating part for me is a lot of practitioners don’t understand the intricacies of the treatment protocol. So that’s kind of where I’m at now, is trying to let everybody know that these protocols have been around for a long time, and how to actually do them.
3. Proper adrenal function [12:09]
Diane Sanfilippo: That’s awesome. Yeah, I know this has kind of been a big topic, and you know, the people who listen to this show, and we’ve done a couple of episodes on this. You know, what I’ve kind of explained to people in the first podcast on the topic was a lot about, and you can definitely give me your take on this whole thing, because I’ve kind of learned from you and a bunch of other sort of functional medicine doctors what their takes have been, but I want to hear your take on this too. One of the big things that I had learned was just about how most of what’s happening with adrenal fatigue is lifestyle related, partially diet related. There can absolutely be the component of just internal, maybe some sort of infection or inflammation. But what’s happening is an imbalance in neurotransmitters as a result of whatever we’re doing to our bodies, or it’s happening to our bodies. It essentially sends a message to our adrenals, because our adrenal glands don’t have a brain of their own, right? They don’t know what to do unless told by our brain, here’s what you’re going to do.
So, this has been my understanding, and maybe you can give our listeners your take on kind of what are the basics of how adrenals either, you know, should work properly in a balanced way, and maybe some of the biggest things that kind of get them going out of whack.
Dr. Dan Kalish: Okay, so if you take the big picture view, you know, most of the; there are three major sources of stress that are blowing out people’s adrenals. Number one; and this is in the order of importance, right? Emotional stress is number one. Dietary stress is number two. And then inflammatory or pain related stress is number three. So emotional, dietary, and inflammatory stresses. Those are the three big things that push the adrenal glands.
So obviously emotional stress is obvious. You’re working 80 hours a week, or you just split up with your boyfriend. It could even be good emotional, like you have a book that’s coming out, or you have a baby that you just had. It doesn’t have to be bad stress, right? Just stress. Emotional stress, number one.
Dietary stress, you guys know all about because this is the whole Paleo movement is an attempt to try that solve that problem, right?
Diane Sanfilippo: Mm-hmm.
Dr. Dan Kalish:
So those are the three major sources of stress. It’s from a big picture point of view. Most of this stuff is lifestyle driven, right, because it’s emotional, dietary, all this kind of thing. And then in terms of how the body then responds to all of that, if you want to step back and take sort of a non-biased view, and you just look at the whole system, you’ve got your brain responding, you’ve got your adrenal glands responding, and you’ve got your thyroid gland responding; and for women, you have the ovaries responding as well.
So when you’re under stress, you burn through or use up your neurotransmitters, like serotonin and dopamine; your cortisol levels shoot up; your thyroid hormone levels drop; and if you’re stressed out for long enough and you’re a woman, your progesterone and estrogen levels have actually started to drop also. So you end up with this, kind of complex array of problems. I think, you know, the term they use is neuroendocrine, right?
Diane Sanfilippo: Mm-hmm.
Dr. Dan Kalish: So neuro would be the neurotransmitters; endocrine would be all the hormone related glands like the thyroid and adrenals. And where people differ is where they’re going to intervene. Are you going to work with the brain, or the adrenals, or the thyroid, or the female hormones? Or you really lay the whole thing out and see it as an integrated puzzle that you solve across the board depending on the person. That’s kind of how I see it now.
4. Early warning signs of adrenal fatigue [17:08]
Diane Sanfilippo: So is that your take…So you know, kind of a typical person who either comes to me or is listening to this podcast and writes in with questions, I mean, I have a question even from someone who wrote in that, you know we might address on another show, but, you know, I was looking at it. Maybe it’s something I could even, I don’t even need to really read it to you, but it’s like, she probably sat down for 10 minutes writing this question. And it’s almost by the end of this question, you would think she would kind of have a light bulb go on in her head that she’s like a complete picture of stress. You know, one of these people who even the dietary component is sort of in check, because we get a lot of people who are already eating a pretty clean Paleo diet, so to speak. You know they’re avoiding grains, refined foods, not eating sugar, etc., but it’s really the whole emotional and inflammatory lifestyle that’s just feeding into this. And then we’re getting a lot of women who aren’t menstruating and they, you know…it’s just like this huge big picture.
So obviously this is something you work very closely one on one with each person to determine very differently, but what are some of the overarching, just sort of things to look out for? Kind of like very first clues that; I mean, I say women because we are getting so many women that are writing in about this, and it does tend to be women that almost have the more emotional pieces that feed into this. But you know, she’s running around ragged, then she’s running the kids everywhere, and she’s also running marathons or training for a marathon and not sleeping enough. What are kind of the first signs that you end up telling these women to kind of set them on track?
Dr. Dan Kalish: In terms of potential solutions?
Diane Sanfilippo: Yeah, and also just to…
Dr. Dan Kalish: Or in terms of the early warning signs?
Diane Sanfilippo: I would say maybe some warning signs first of all, just to clue them in, that like basically, yes, we’re talking about them because I do have a lot of women who say, “I listen to your podcast and I couldn’t believe, it sounded like you were talking about me.” Yeah, what are some of those early signs that basically for them enough has been too much? Do you know what I mean? Like they are…and yeah.
Dr. Dan Kalish: Yeah, so women….It’s very predictable. So you know when you’re burning out, however you want to look at it, whether you want to look at it as an adrenal problem or brain problem or whatever. They’re what I call “the Big Five,” which are Fat, Fatigue, Depressed, Female Hormone, and GI and Digestive Problems. So when you’re stressed out enough, you’re going to put on some body fat. You know, it doesn’t have to be a lot, it could be an extra couple pounds that you’re not used to. You’re going to start to get tired, obviously. You’re going to get a little depressed, so your mood is not that great. You don’t have the enthusiasm and joy of life that you’re used to. You for sure start to develop digestive problems eventually, and that can be anything from heartburn to gas, bloating, constipation, diarrhea, all that stuff.
And then eventually your female hormones will start to fall apart. If your period has stopped, then you’re pretty far into the process. I get women all the time in their 20s who are having hot flashes and night sweats, just like, you know, a 52-year-old woman should have when she’s going through perimenopause, you know, so this happens. If you’re young and stressed, you can in a sense, sort of put yourself into early hormone decline from the female hormone side. And if your period is stopped, ultimately that’s like a very bad sign, right, because now your whole reproductive system is shut down on you. That’s a pretty significant problem that you need to address, you know.
And again, most of these things are lifestyle driven. And it’s pretty frightening, you know, I think we just saw in the news today that one of the senior vice presidents at Google just took over Yahoo, right? And the big news story is not that this woman took over Yahoo, the big story is that she’s pregnant. And she took over Yahoo.
Diane Sanfilippo: {laughs}
Dr. Dan Kalish: You know, like pregnant women can’t think or function or something. It’s kind of this 1950s mentality about women. But you know, I think these day women are in general from my experience, you know, working harder, faster, smarter than men, in a corporate workplace, in general because they have to, because there’s this massive bias against them. You know, and so in order for her to take over Yahoo, she’s probably twice as good as the five men they decided not to hire, right? And so women are under kind of an extraordinary pressure now to get all these things done, to be better than their male counterparts in the workplace just to stay equal with their male counterparts.
And to top it all off, either the design is fundamentally different, right? Men are very simplistic in their hormone design, and you know, men in general just push and push and push until they drop dead of a heart attack when they’re like 57. And they never notice that they’re having hormone imbalances except for the fact that they have to buy some Viagra or something because their sex drive is gone. But for women at much younger stages and much earlier stages of stress, they notice that something’s wrong because they have a delicate and complex monthly cycle, which starts to fall apart. And they get, in a sense, women get an early warning sign. And that could be anything as mild as, you know, PMS-type symptoms, or as severe as having your period stop, or getting hot flashes when you’re in your twenties or thirties.
Diane Sanfilippo: So, I have definitely worked with some men who, you know, are dealing with just a little bit of extra body fat, and to men who are generally running pretty lean, you know, for them, that couple of percentage points of body fat is very noticeable. You know, a lot of the athletes that I work with….
Dr. Dan Kalish: Mm-hmm.
Diane Sanfilippo: Or just, you know, low testosterone. Their energy becomes low, and for them, it’s really all, as you mentioned, testosterone, and it will be apparent in their sex drive. But yeah, I mean for women who are the vast majority of our listeners, it is much more delicate.
Can you talk a little bit more about why PMS, you know, isn’t actually normal? That, you know, it is really a sign that we have some imbalances going on. You know, most of us, as adolescent women, you know, we’re 12 to 15 years old, and we get our period, and then something becomes really painful or you know, maybe we have really, really bad symptoms, and the standard medical approach is to put us on birth control pills to manage the symptoms and adjust our hormones that way. So can you tell us a little bit about your perspective on why that’s, on why it might be happening? Why these symptoms might be so severe? And kind of what it does when we are put on the Pill?
Dr. Dan Kalish: Yeah, so I’ve tested thousands and thousands of women and I’ve seen in my training programs literally tens of thousands of these tests, right? This is not like just something I thought about the other day when I was sitting down reading a book or something. This is actually what happens in reality. Which is, and this is true for all women. When you’re under stress, your cortisol levels shoot up, your thyroid hormones drop, and the first victim of that stress response is progesterone. And what happens; you actually make every molecule of cortisol in your body from progesterone, and as those cortisol levels skyrocket from the stress, your progesterone levels decline. And if you look at
I mean we do this in the training program. We just went through 40 cases of this-40 women; case after case after case. You see the exact same patterns, which is the more depleted and burned out the cortisol is, the lower the progesterone levels become. And so, this sort of foundational principle here is that we fix the adrenal glands first, and then also, if needed, and usually this is needed, boost up the progesterone production using some natural plant-based progesterone products for a short period of time, maybe 6 months to a year to get the cycle back on track. And then during that process, you know, brainstorm with women about how they can change their lifestyle so they don’t recreate the same hormone imbalance from all the emotional stress or dietary stress.
Diane Sanfilippo: So I think it’s really important that you mentioned 6 months to a year, and the way you phrased it was a very short period of time, 6 months to a year. And that’s one of the things that you know, we talk about this so much on the podcast and in our seminars that we teach around the country that, you know, people come in to sort of a Paleo/Primal/Real Food way of eating, and they are really; they’re almost always introduced to sort of a 30-day intervention with their food. Which I think is great. You know, I even have a 21-Day Sugar Detox. We have these really short periods of time that we tell people; just do this intervention for a month, and a lot will change.
But when it comes to hormone imbalances, especially things that are very intricately tied with, you know, the brain and the rest of your female hormone system, these things have been affected by our lifestyles for 10, 20, 30, 40, 50 years and then we’re constantly having to remind women that it takes a really long time to recover.
Dr. Dan Kalish: Mm-hmm.
Diane Sanfilippo: And you know, a minimum of 3 to 6 months, and what you just said “a short period of time-6 months to a year,” like I just really want women to hear that, and men, too. You know, we do have a lot of men who listen to this show, and whether this is hitting home with them a little bit or there is someone in their life that’s really dealing with this stuff. Just to remind them that like in the scheme of things, and in the, you know, entire length of your life, 6 months to a year is a short period of time, right? And we need to kind of address all those things, and make sure we’re taking care of ourselves.
5. Why fertility is so important [26:32]
Diane Sanfilippo: So we had a handful of women say, well, what if I don’t care about fertility. Because Liz and my approach, and you know, this has been influenced by Liz very largely, is that to us, even though both of us are actually not sure that we ever want to have kids, we understand that fertility is the foundation of health, like a healthy…the healthy person is very fertile. They have a regular cycle. It’s not a painful thing; yadda, yadda, yadda; on and on, right?
Dr. Dan Kalish: Yeah, well.
Diane Sanfilippo: But we do have some women that say, “what if I don’t care about having a baby?” And we’re trying to explain to them that fertility is still the baseline of health, so how would you explain that to somebody?
Dr. Dan Kalish: Yeah, and this is the same for men and women. You know, the healthier you are, the healthier all your hormones are, including one subset of them which are the sex hormones. You know, men perceive that primarily on a sex drive basis; women would perceive it more in terms of their monthly cycle as well as their sex drive.
But you know, to be…I mean, if you think about all the things that these hormones do: testosterone, estrogen, progesterone. You know, brain function, memory, focus, cancer prevention, cardiovascular disease prevention. If you inject monkeys with progesterone, you can’t give them heart attacks. I mean, these hormones are really critical for all the kind of chronic degenerative diseases that people experience: diabetes. Progesterone has a huge role in blood sugar control. As any woman who’s been pregnant knows, you know, you’re at risk for gestational diabetes when you’re pregnant because of the change in hormones. So literally, diabetes, cancer, heart disease, all those things…brain diseases, such as Alzheimer’s, progesterone has a huge impact on the brain.
Right now all the veterans that are returning from the wars in Afghanistan and Iraq with brain injuries, the military is starting to use progesterone treatments for them; for men and women, by the way, with histories of head trauma from explosions and whatnot.
So the reproductive aspect of the hormones is just the tip of the iceberg. That’s sort of nature’s reason for having them. But you know, in terms of overall health and survival, and just a sense of well-being. Everything from memory to mood, you know. I mean, if just for the mood effect alone, why would you want to be depressed and cranky and irritable, and have a low sex drive all the time? {Laughs} That doesn’t sound like a lot of fun. And that’s true for men and women, right? Men again, you know, cover this over a little better because they don’t get the signs of things like PMS. But they’re no less susceptible to this, and usually for men, it’s more exhaustion, you know; depression, but not like they’re sad, more just like they don’t feel as doing as much as they used to. Also for men, it’s putting on 5 or 10 pounds that didn’t used to be there, even though they’re working out hard. You know, getting home after work and being really exhausted. Those are kind of the cardinal signs for men typically when they’re starting to fade out on the hormones.
Liz Wolfe: The Balanced Bites podcast is sponsored in part by the Nutritional Therapy Association. The NTA trains and certifies nutritional therapy practitioners and consultants, including me, I’m an NTP, emphasizing bio-individuality and the range of dietary strategies that support wellness. The NTA emphasizes local, whole, properly prepared nutrient dense foods as the key to restoring balance and enhancing the body’s ability to heal. Nutritional therapy practitioners and consultants learn a wide range of tools and techniques to assess and correct nutritional imbalances. To learn lots more about the nutritional therapy program, go to NutritionalTherapyAssociation.com. There are workshop venues in the US, Canada, and Australia. Fall registration will open June 2016. I know the price is increasing next year, so do not wait. If you see the NTA as part of your future, get started now. You won’t regret it.
6. Adrenal fatigue in men [30:53]
Diane Sanfilippo: Yeah, can you talk a little bit more about your experiences with what’s happening with men a little bit more? Because we, you know, we do focus just a lot more on women and you know, in my practice, there’s definitely a lot more women. But you just touched on a few of the signs. Are there any other sort of things that you know…Liz talks a lot about sympathetic women, you know, women who are very; who take everything on, and really help a lot of other people. Do you find ever that like, you know, men who maybe don’t express emotions as much deal with this more or is there any kind of you know, typical type of lifestyle that’s contributing more to it or just what you might see a little bit more with men?
Dr. Dan Kalish: Well, I mean, it depends on who you believe. I think some men, certainly. A common pattern for me is that they’re actually way more emotionally tuned in, and emotionally sensitive than women in general, and so as a result of that, they have, you know a thicker armor that they put up to kind of insulate themselves. So, I think when you get right beneath the surface for most men, there’s as much emotional vulnerability and expression and understanding as for women, if not maybe even an accelerated amount of it. And so they seem more walled off, but it doesn’t mean that there’s not a lot happening. You know? But it’s generally not expressed very well, and it’s also much harder for men to ask for help. They tend to just kind of deal with problem for a lot longer.
And I’d say half the men that I treat; at least half the men that I work with are literally brought in by their wives; almost dragged in, you know. It’s the whole, “honey, you’re going to do this,” and they’re like rolling their eyes sitting there, saying, “I don’t have a problem. What’s she talking about?” So you know whether its addiction, drugs or alcohol or sugar addiction, or it’s just the “I’m getting home after work and I’m so exhausted. I can’t deal with going out to see a movie with my girlfriend.” Or “I can’t deal with the kids,” whatever the circumstances are. You know, men just tend to kind of try to hold it together for longer without asking for help.
So the consequences of that is that, by the time I get men in my practice usually, they’re usually quite a bit more beat up in some ways than women are, and you know, have to focus more on getting better. I think the main thing for men, too, is to give them a reason why they should be doing this if they’re not taking their personal health as seriously, maybe, and they’re putting their personal health aside and saying I’m just going to keep going even though I don’t feel that great. You know, trying to figure out what’s the motivation for them to get better. Is it so that they can have a better relationship with their partner? Or so they can be around for longer for their kids? Or is it so they can be more productive at work? I work with a lot of professional athletes, a lot of CEO-type men who just want improved performance in their job or in their sport. And that can be a really good reason to get healthy, you know?
Diane Sanfilippo: Yes, definitely. I definitely see the same thing and what’s funny that you mention sort of this idea that they’re not asking for help, the men, as much. And I think a lot of the women who kind of end up down this rabbit hole are exhibiting, as you mentioned, about that, you know, the woman who’s taking over Yahoo or Google or whatever…the merger there or whatever’s happening…
Dr. Dan Kalish: Mm-hmm.
Diane Sanfilippo: A lot of these women exhibit a lot more like male qualities, you know? They’re really…or typically male qualities, I should say. You know, they’re really driven and focusing on work elements, you know…I mean, myself included. Very career driven, and don’t stop to ask for help right away, right? Like as soon as we see or feel something that’s kind of going wrong, and so when we eventually do, we really do seek it. And most of the women who come to me, and maybe you can tell me if this is pretty common of your findings, but I’m going to guess it will be; they’re really at their limit and they’re like begging for help, you know. “What can I do? I’ll do anything. “And what’s funny is I’m always having to tell them I don’t have anything MORE for them to do; I need them to do a lot less.
Dr. Dan Kalish: Yeah.
7. Four big lifestyle factors [35:12]
Diane Sanfilippo: Like whatever it is, if what they’re doing is a list of 50 things, then I need them to cut that way down. So what are some of the first things that you tell women in terms of lifestyle modifications based on, I guess, what you see most often? What are maybe the big five or so things that women are doing that they just need to shift their perspective on and maybe change about the ways they’re just leading their lives?
Dr. Dan Kalish: Yeah, so we, there are these four major factors that I cover for everybody, that they almost always they need to deal with. And we do it in a certain order, which works for most people. We usually start with the diet, because everybody knows they need to change their diet, and that’s kind of a good starting place. And you also get so many benefits, as you know, from just 30 days of eating healthy, let alone 30 years of eating healthy, you know. So it’s a great way to just sort of jumpstart people to get their attention, to make them realize that they can totally control how they feel and what they feel and their energy levels just by changing the way they eat. So that’s starting point number one.
And then we usually go after stress management strategies, so that’s the “Okay, well you’re working 7 days a week, 16 hours a day; maybe you should take a break.” You know? How about you just take Saturdays off? You know, one day a week. You know; just start to let people know, you know, every day from 5 p.m. to 7 p.m. you’re going to turn your phone and your computer off, and you’re going to go do something where you’re not wired in. Whatever people need to do to de-stress.
And then a third factor is sleep. Making sure that you teach people about how to get to sleep, when to get to sleep, how much sleep they need, how important sleep is. Because a lot of people, almost everybody who is stressed is cutting out sleep time and thinking that they’re getting away with it, you know?
And then the last factor is exercise. Not the; it’s probably the most important, in some ways. I think exercise is more important than food for a lot of people. But it’s usually harder for people to start with exercise, so we tend to start with food and then work our way down the list. And eventually we want people working out quite a bit as part of the overall solution.
Diane Sanfilippo: What’s funny is that we actually, you know, our listener base and readers, and of course, this is a generalization because we have a very wide base of listeners, but I’ll say that the majority of them pretty closely have the diet thing nailed.
Dr. Dan Kalish: Mm-hmm.
Diane Sanfilippo: A lot of them are on the end of the spectrum with exercise where they’re overdoing it. And I think it’s really hard for people to understand that the hormetic effect of exercise, the benefits we get from exercise in a positive way, even though it’s a negative stressor to the body, you know, causing this positive response, it’s hard for people to find the line of how much is too much, and understanding that there may be a point that’s too much for them right now, that maybe wasn’t too much for them 10 years ago, or maybe won’t be too much for them next year or in two years. This is something that I deal with a lot.
Even with myself right now, knowing that I’m dealing with this fatigue situation, trying to explain this to gym owners or coaches who maybe really don’t understand how all this stuff works together, that for me, that 15 minutes of really intense exercise is too much, like it’ll leave me crushed for the rest of the day. It’s a really hard thing to explain, so.
8. Signs of overtraining [38:54]
Diane Sanfilippo: Do you have any other sort of signs or ways for people to know if what they’re doing for exercise is too much? So whether it’s just the marathon runner or you know what you’re probably hearing a little bit more in the Paleo community are a lot more people who do Crossfit style workouts, which are generally not more than 20 minutes, pretty high intensity. But I’m seeing some of my clients, you know people who come to me where I just think that even that 20 minutes is a very, very intense work, you know; they’re depleted and that’s too much for them. So what can you kind of tell people about figuring out; have they gone over their limit or are they going over their limit?
Dr. Dan Kalish: Yeah, so that one’s tricky because self-perception on that one is not very accurate, usually.
Diane Sanfilippo: No. [laughs]
Dr. Dan Kalish: Because when people have burned out adrenal glands, and their cortisol levels are low, they look for ways to bring their cortisol up. And that could be anything from caffeine to sugar, which work pretty well; really well, actually; to exercise, or even work related stress. So if you work out hard enough, you can jack up your cortisol, and if your cortisol was low before, it’s going to temporarily make you feel better. The problem is that, on the flip side of that, a day or two later, when you crash, then you’re going to be down even more.
So there are some characteristics of people who have burned out adrenals that, you know, need to exercise. First of all, they kind of have to exercise because if they don’t exercise, they feel what’s really going on, which is that their adrenal glands are burned out. So that’s one kind of sign. Not that you can’t be addicted to exercise in a healthy way, but that would be like an unhealthy addiction.
And the other is, and this is a little subtle, but most people seem to be able to figure this out, is that any kind of workout, especially something like a Crossfit workout, should energize you and make you feel great that whole day and the whole next day. There should be nothing but goodness that comes from that. I mean, the normal, I worked out, I’m tired kind of feeling, but that should be very pleasant. If you’re in adrenal exhaustion, and you work out too hard, it’s going to act as a stressor. Your cortisol is going to be even more burned out later, and you’re going to feel more depleted from exercise, rather than energized.
And so, you can tell all this if you’re doing the lab testing basically. And what we see with the labs is that the healthier; this is just kind of counterintuitive, but the more burned out the adrenal glands are, the less exercise the person can handle, and the counter aspect of that is, the healthier that the person is, the better functioning that their adrenal glands are, the more exercise they can do without it causing extra stress, right? So….
Diane Sanfilippo: Mm-hmmm.
Dr. Dan Kalish: Ironically, you don’t necessarily get healthy by exercising, but as your adrenals get healthier and healthier, you can handle more and more exercise. To the point where when the adrenals are in perfect health, you could go out and run a marathon or do Crossfit as much as you feel like, and it’s not going to compromise your health, like it would if your adrenals are burned out. You know, we had a…
Diane Sanfilippo: I think…
Dr. Dan Kalish: We had this example. This is a true story. I’ll just tell you really quick.
Diane Sanfilippo: Yeah, absolutely.
Dr. Dan Kalish: This is hilarious and tragic all at the same time. Like, I can make a mini-movie on TV about this woman. So, this just came up yesterday in my clinical rounds class. So it’s a Chek practitioner actually who has been working with this client of hers for about 4 years, and she’s on my weekly call, so I’ve been tracking this patient indirectly for 4 years. So she came in because she wanted to have a baby. We tested her hormones; her adrenal and her female hormones were burned out. We warned her about the exercise thing. She ignored everything we said. She went out and trained for and ran a series of marathons. A year later, she retested her hormones, and they were, of course, a whole lot worse. We rebuilt her over the course of 2 years to the point where she was like super woman. She had the best hormones; this is not an exaggeration, we talked about this on Tuesday morning. She had the best female hormones labs I’ve ever seen ever. She had dialed in her hormones perfectly, and her progesterone output was like at 450, and we routinely see those numbers like around a 40 or a 50.
Diane Sanfilippo: Wow.
Dr. Dan Kalish: So it was like beautiful, perfect. You couldn’t get a stronger, better set of ovaries. It was like dream ovaries, right?
Diane Sanfilippo: [laughs]
Dr. Dan Kalish: Perfect. And then; this was a year ago, May. And then, she went out and started to overtrain again, and we have her most current labs, and she’s right back down to, instead of-and this is dramatic. Instead of making 450 units of progesterone on a good day, she’s making like 80.
Diane Sanfilippo: Wow.
Dr. Dan Kalish: So, I’m not against exercise. And exercise is the most important thing for us to stay healthy long term. You just have to be strategic about it, just like people are in the Paleo community with food, you know. You have to think through what’s good and what’s too much…
Diane Sanfilippo: Right.
Dr. Dan Kalish: And you know, figure that out. So like, I mean, a lot of people still are kind of trapped in that idea that being a vegan is the healthiest thing you could do. Which may be true for a small percentage of people, but probably most people wouldn’t do well on a vegan diet, you know? And again, these extremes that seem like they make sense are really context specific.
Diane Sanfilippo: Yeah, I think that hits on this idea that more is not always better, it’s sometimes just more. You know, and I think my perspective as first a Chek practitioner, and then a holistic nutritionist, and then a Crossfitter, I have a very sort of buffered view of the way that I approach exercise. Sometimes in the thick of just wanting to be a part of a community and be in class, there will be a couple of weeks where I know I’ve done a little too much. My system is sensitive to the point where it doesn’t take very long for me to get beat up again and be down into fatigue-land again, which you were explaining this woman where basically it probably took her a very long time to get too fatigued in the first place. You healed her, and then it only took probably a year or less for her to get fatigued again.
So a couple of things I want to talk about or ask about there. So one, you know, I know everything we’re talking about in terms of the imbalances that people see; the fat, fatigued, depressed, all of that are some signs that it’s like this is too much exercise for you. I really like wording things that way, this is just, for you, too much. Because there was a point when I trained for a half-marathon, and it was the last time we had the summer Olympics, so I remember thinking and comparing myself to Olympic athletes, saying “well, they must train 4 hours a day, or they do train 4 hours a day, so if I’m only training 2 hours a day, that’s not too much.” No seriously, like this is the thought process that I had.
So I would train 2 hours a day. I would be running and kickboxing classes and that was really the first lead-in to my adrenal fatigue the last time. I mean, so depleted that I was–my body fat was very low, I had a six pack, which I think for a lot of women is not, you know, not always a natural place. I don’t begrudge somebody that if it’s more natural for them to be leaner, but very low body fat. I stopped menstruating, I was very depressed. I was, you know, upping myself on coffee all day long. And that happened to me then, and I just know now it’s a lot easier to get back into, but I feel like I’m a lot more in tune with the exercise side, and a lot of people think that they’ve found this panacea in high intensity or Crossfit-style workout, that because it’s so short, that they’re okay to do it, you know, 5 or 6 days a week. Even 4 days a week.
But as a Chek practitioner and that whole other side of things, you know, we learn about working in vs. working out, kind of reading the signs, like you said, you shouldn’t be depleted for two days or two or three days later it hits you. That’s definitely happened to me, where all of a sudden out of the blue, I’m like why am I exhausted today all day? Can’t get out of bed, really tired, dragging. And that’s being in tune with it versus just trying to, you know, drink the coffee and keep going all day, which I think a lot of people are doing.
Diane Sanfilippo: So, you know, are there any other; I know people are going to listen to this and feel like they still need it hammered into their head just to understand if they’re exercising too much for them. Are there other signs that you’ve seen people experiencing that can really just drive that home for them or, I mean, any other thoughts on that?
Dr. Dan Kalish: The classic one; the classic one is the most ironic one, which is that you’re damaging your metabolism. Because cortisol, you know, if you stress yourself excessively from exercise; let me put it this way. If you’re not healthy enough to handle the amount of exercise you’re doing; that’s probably the best way to say it. So if your overall health is not good enough to handle the amount of strain you’re putting on your system, then you’re going to start to damage your metabolism by damaging your cortisol, and ironically, you’re going to start to put on body fat. Because when your cortisol is damaged, you start to gain weight. You store fat for fuel when you’re; that’s kind of the way the mechanism is set up. So this is what we used to jokingly call, boy, I’m getting old you know, back in the 80s. I can say back in the 80s.
Diane Sanfilippo: [laughs]
Dr. Dan Kalish: That’s scary.
Diane Sanfilippo: Well, they’re back because florescent clothes are back and so, florescent…
Dr. Dan Kalish: [laughs] We used to call it Chubby Aerobics Teacher Syndrome. It was a joke, obviously.
Diane Sanfilippo: Oh yeah.
Dr. Dan Kalish: You’d get these women that were teaching, I don’t know, I don’t think they do this anymore, right? They’re teaching….
Diane Sanfilippo: Oh, they do.
Dr. Dan Kalish: 5 or 6 classes every day.
Diane Sanfilippo: No, they do. They do.
Dr. Dan Kalish: They still the aerobics with the tights and the long socks? Okay.
Diane Sanfilippo: Well…there are different names for it now. Different types of classes.
Dr. Dan Kalish: Ok, maybe they have better clothes. Because it was kind of like Flashdance-looking clothing, you know, like the knee high socks and all that, and the sweatband around the forehead. But anyway…
Diane Sanfilippo: That’s what we wear to Crossfit.
Dr. Dan Kalish: [laughs] So you got these women rocking out 5, 6 hours a day every day all day teaching aerobics in the gym, and then they’re coming in to the clinics, natural health clinics, going “I don’t know what’s happening. I’m working out 5, 6 hours every day and I’m putting on more weight every month. What’s happening?” So that’s another cardinal sign. If you’re exercising to the point that you’re damaging your metabolism, the whole calories in/calories out equation’s going to fall apart. And of course, what most people do, when that starts to happen, is they just exercise more, which is going to exacerbate the problem even more.
Diane Sanfilippo: And limit calories. And limit calories.
Dr. Dan Kalish: Yeah.
Diane Sanfilippo: I think though there’s two sides to this, you know, and the diet thing; you know. All right, I have so many things we can address with this, but the diet thing, you know, we’re talking today like kind of with this understanding that most of the people listening sort of know that we’re talking about eating real whole foods, or avoiding refined foods, or mostly avoiding grains and sugar, you know. People listening to this podcast for the most have that part under control, and if they don’t, we have, you know, a Paleo 101 part 1 and 2 podcasts you can go back and listen to, just like what do we mean about what to eat and how to just eat whole food.
But I think, I really love what you said, like how healthy are you to be able to exercise, and understanding that, this is the way I explain it. Like exercise is a privilege. It’s not a right, you know. It’s not something that; walking is a right. Everyone can pretty much walk if they’re able to. They don’t have an injury or an immobility for some reason. In terms of movement, you know, we can all walk and that will be healthy for people to just walk. You know, this doesn’t mean speed walking, jogging.
But the intensity of exercise when added to an already unhealthy person is not always a positive thing, and you know, it’s something that I needed to learn firsthand and I think a lot of people unfortunately need to learn it firsthand before they believe it. That just sometimes even 10 minutes of something very intense is too much for you.
And so, do you have; I know my general recommendations and what I’m dealing with in terms of the exercise, because this really is one of the driving things and I want to talk a little bit about caffeine next because I know that exercise and caffeine are two of the biggest things. Sleep is definitely a big thing. But I know also a lot of people kind of have; along with diet, they’ve heard a lot about sleep and how to try to manage it. Even if they’re not there yet, they sort of know what to do to approach that.
9. Decreasing the exercise load [51:53]
Diane Sanfilippo: But what are some first steps that you tell people? My general approach with exercise is really peeling it back. But how does somebody go from you know training 5 days a week where they’re depleting themselves; like what are those first steps and what should they be looking at as safer ways of exercising for their adrenals versus whatever they were doing currently?
Dr. Dan Kalish: Well, a lot of times people get; if you tell someone who’s running 8 miles a day, 8 days a week that they can’t run anymore, they just get so freaked out that the emotional stress of not being able to exercise is going to freak them out even more than all the stress from all the exercise, right? So you have to step people through this one and let them have, you know, and just see where they’re at.
Diane Sanfilippo: {laughs} Let them have a little bit.
Dr. Dan Kalish: Yeah, and that’s the whole point of this supplement program is that I’m doing these tests and we’re cranking up all these adrenal hormones with the supplements, and that’s buying some time to get the person to feel better, so we can get them a more rational lifestyle plan in place. It’s the same thing as, you know, someone who’s completely addicted to gluten or sugar, sometimes you can say, hey, you have to stop eating gluten and sugar 100% starting right, you know, about 15 minutes ago. They’ll say “fine, just tell me how to do that.” And other times people, well, you know, literally just get up and walk out and start crying and just never come back.
So you have to kind of work with people where they are and be able to coach them through these transitions. You also, I think, you have to prove it to people. Because someone who’s been running 8 days a week for 8 miles for their whole life is going to think firmly and believe firmly that that’s what keeping them healthy and not understand that that’s actually what’s kind of making them sick. So you have to kind of get a wedge in there.
So usually what I do is I’ll just say, “Look, why don’t we say that you don’t work out on the weekends? And you just rest every Saturday and Sunday.” And you get as much, you know, do compromise programs like that, so they start to realize after a month of doing that, that they’re actually feeling better even though they’re doing less. This is especially important for professional athletes where their career is on the line and they’re afraid to not work out as hard as everyone else is. And then eventually what happens is the supplement programs kick in, the rest and recovery they’re doing starts to be a benefit, and they start to realize; wow, that was the fastest 10k race I’ve done in 3 years, and I feel like I hardly worked out at all. So all of a sudden, the times and the race times, and the recovery rate start to prove the point and then they get on board.
And this has worked for me with every kind of athlete from professional volleyball players to weight lifters, golfers, a lot of endurance athletes. As they get healthier, you know, they start to perform better in whatever their given sport is. And that’s where more weekend warrior people who aren’t pros, they have something more basic like they’ve lost 3 pounds or they have more energy when they get home, or those kinds of things that are a little more, you know, not as dramatic but more important to like a regular person that’s not a professional athlete.
Diane Sanfilippo: Yeah, I think this whole approach of understanding that healthy hormones are driving, you know, our moods, our level of leanness, all of the stuff. Our energy, and you know, I think what Chek practitioners really understand and one of the reasons why I know that where I’ve been, you know, told and what I tell myself about how to exercise. I know that what I need is the right hormonal response to exercise, and that it’s not about just burning calories. Or it’s not about, you know, you work out this many minutes or hours a week. It’s really about targeting it so that for your body, it’s providing the right type of hormonal response.
And so, you know, for a lot of people what I end up recommending or what I’m ending up doing myself right now, is really just some strength training a few days a week to keep my muscles doing something without ever sort of tapping into that adrenaline rush from exercise. Is that something pretty common that you end up doing with people who are ready to hear on what should you really be doing in terms of exercise? Like I’m not one of those people who’s running anywhere. {laughing}
Dr. Dan Kalish: {laughs} Yes.
Diane Sanfilippo: {laughs} If you were to ask me to run more than 400 or 800 meters, I’m like, you have to be kidding! Like, come on! But, you know, that’s kind of my thing right now for awhile where, that’s how I have to explain it to other people. I’ve been living in that adrenaline pathway for so long, that now I’m not allowed. That was the book stress and you know, all of that, my lifestyle, travel, that now it’s like I’m not allowed to do that. I’m not allowed to tap into that because it makes me feel so tired after. Is that the kind of way you end up approaching this? Go ahead.
Dr. Dan Kalish: Yeah, I mean, absolutely. If you’re that deep into things, then you’re in adrenal burnout already and your exercise strategies are just making it worse. So then you need as muc