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Fatigue and Your Adrenals – Episode 40


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rethinking-fatigueAdrenal-related issues are seemingly epidemic today—many people complain of some degree of “adrenal fatigue” or “burnout.” This is hardly surprising given the high stress levels of modern life. But what exactly does this mean? What is the connection, really, between fatigue and your adrenals?

The unfortunate truth is adrenal-related issues are poorly understood. In addition, most conventional healthcare providers still practice using outdated theoretical models from the 1950s, which fail to hold up in the face of modern stress physiology. In fact, the vast majority of so-called “adrenal issues” have nothing whatsoever to do with the adrenal glands themselves! Nora Gedgaudas offers a cutting-edge paradigm that will not only help modernize adrenal concepts, but will also help individuals better identify what type of “adrenal dysregulation” they have and what to do about it. Nora outlines this approach in her latest book, Rethinking Fatigue: What Your Adrenals are Really Telling You and What You Can Do About It. Join Nora and Sarah, The Healthy Home Economist for what promises to be an eye-opening conversation about this modern epidemic.

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Sarah:  Hi everyone, this is Sarah, The Healthy Home Economist back with my latest broadcast as part of the Fearless Parent Radio Network.  Fearless Parent Radio is the destination for parents who desire a positive, proactive source of information and who insist on an evidence based approach to health and aren’t afraid of rocking the boat to find out the answers they seek.  Welcome!  My guest today is Nora Gedgaudas.  An author of the international bestselling book Primal Body, Primal Mind: Beyond the Paleo Diet for Total Health and A Longer Life. She is widely recognized as an expert on the Paleo diet as well as autoimmune nutrion and mental health issue. Nora is a highly successful and experienced nutritional consultant, speaker, and educator, and widely interviewed on national and international radio, popular podcasts, television, and film. Nora has appeared on the Dr. Oz Show; Mercola.com; Sydney, Australia’s Today Show and Coast to Coast A.M.  In fact, she just returned from world-wind tour of the Down Under continent. Her own popular podcasts are available for free download on her website primalbody-primalmind.com along with articles and newsletters. Nora maintains a private practice in Portland, Oregon as a board-certified nutritional consultant and a board-certified clinical neurofeedback specialist.  I first met Nora at the 2010 Wise Traditions Conference in King of Prussia, Pennsylvania where I was entirely, and I mean entirely blown away by her presentation on nutrition and mental health.  Since that time, I have been a huge fan of her work and am happy to call her a friend as well.  Today, Nora and I are going to chat about her latest book Rethinking Fatigue:  What Your Adrenal Glands Are Really Telling You and What You Can Do About ItWelcome to the show Nora.

Nora:     Awe, Sarah, thank you for that lovely, generous introduction and it’s so great to be talking to you again.

Sarah:    Yes, we have to do a podcast so we can chat.

Nora:     I know; we have to do a podcast to actually talk to each other.

Sarah:    Well, glad you’re back from Australia; how exciting.  I hear it went very well.  I’m very excited to dig into the nitty gritty of your new e-book which I just loved it.  Loved it.  Really got me thinking outside the box about adrenal fatigue and…wow, this is a real big problem today.  I was shocked when I read through it.  SO I was reading through it and I was thinking that everyone I know sort of fits this paradigm.

Nora:     Yes, in some way shape or form.  It’s kind of impossible to not be impacted by stress in this rather unnatural world we have created for ourselves.  Our ancestors would not even know how to begin to deal with what we deal with on a daily basis.

Sarah:    That’s right and even if we try…and I am constantly, it’s a constant adjustment process.  I don’t think you ever actually get to the point where you actually think you’ve got it all.  I don’t think you ever get to that point.  But even if you consciously try as I do on a daily basis and keep it simple, keep it uncomplicated and keep it as stress free as possible you still the stress of everything and everyone around you is so impactful and learning how to deal with this so it doesn’t negatively impact your health.  That is a tall order.

Nora:     It’s an extremely tall order for your entire body.  The average sort of typical stress reaction generates a cascade of 1,400 biochemical events in your body.  And we have to figure out how to manage those reactions in some way, shape or form so that we can better manage our own health but it’s a kind of thing where stress really, and it’s one of the things I use as a definition of stress is looking at it in terms of what it is.  Stress isn’t really what happens to us, it’s really how we respond to what happens to us in life.  And unfortunately a lot of people are really really mismanaged the things that come at them and we all need a set of techniques to try to modulate stress.  We should all be meditating every day every one of us.  Unless you’re too busy, in which case you should really really be meditating.

Sarah:    If you’re too busy, you really need it more than anyone.

Nora:     Exactly.  There is a joke that everybody should meditate for twenty minutes a day unless you’re too busy and then you should mediate for an hour.  We all need a multitude of stress management techniques in order to alter the way we perceive the stress around us.  Right, because there is this sort of a threshold.  What I do with neurofeedback and training people’s brains is kind of sophisticated form of brain training leads to better stress management and in effect sort of raises the threshold of what we do and don’t consider stressful in life.  So it’s actually one of the best techniques out there for kind of putting your brain on a long term autopilot for better stress management.  But I’m not sure it’s 100% enough.  I think we need to be addressing this on a lot of different levels and the daily disciplines and obviously quality exercise and detoxification and obviously eating as well as you possibly can and avoiding the things that are more likely to agitate your nervous system and trigger the stress responses.  So it’s a multi-pronged approach but with that said, adrenal dysregulation is one of those things that gets tossed around.  I mean the whole idea of adrenal fatigue; adrenal burn-out gets tossed around as though ‘well of course there is such thing as adrenal burn out. I have it.  I’ve got it in spades. I invented it.’  People say that without really understanding what it is that they are saying.  This is sort of heralding back…echoing back to the 1950s when a Canadian endocrinologist by the name of Dr. Hans Selye. He was a genius.  He was brilliant.  He was nominated close to ten times for the Noble Prize.  He had this, he was one of the first to really open up the subject of wanting to understand Stressociology and even coined that term “stress.”  He generated a model of adrenal fatigue that operated in stages and you know proposed this as how stress works in the body and here is how it impacts the adrenals over time.  You start out with an “Alarmed Phase” where cortisol is really high and then you have a “Resistance Phase” where the cortisol levels could either be high or low and eventually you’re in the “Exhaustion Phase” where cortisol becomes chronically depressed and that starts getting further and further broken down into these seven different subset progressive stages of adrenal exhaustion and stage seven of course is the last nail in the coffin.  These toasty, smoldering nuggets that used to be your adrenals are just sort of sitting there.  The natural health community has really embraced Celie’s ideas.  I think the mainstream medical community found it interesting for awhile but have long since sort of abandoned that almost like a conspiracy theory now where people go to their doctors and talk about adrenal burnout and their doctors roll their eyes and they feel that they are not being understand.  And honestly, nobody is understanding because it doesn’t work that way.  The adrenals in Celie’s model of adrenal dysregulation, we’ll say “Glandular Model of Progressive Burnout” and that’s not the way it works it turns out.  That doesn’t mean that you can’t have dysregulation with the way your adrenals function but at least on a base level, your adrenal glands are basically two little hormone factories sitting on top of your kidneys and they are pumping out hormones and doing what they are told to do by your brain.  And so ultimately, most of what’s thought of adrenal dysregulation is really more so do to brain based mechanisms and dysregulation that resultants faulty signaling to your adrenal glands…or what could be poor integration of your cortisol rhythms.  So that’s just one part of the equation and the brain I actually brake down into four different aspects of brain function that contributes to adrenal dysregulation when a signal is off and I also list a whole bunch potential symptoms associated with these different types of dysregulation and you can kind of use that to kind of screen where you are at and then based on whatever fits for you, is also a pretty detailed list of suggestions as to how to address it on that level.  And this is one reason why adrenal supplements tend to not do very much for people.  I’ve heard people complain that ‘there isn’t an adrenal supplement strong enough to bring my adrenals back from the dead’.  Well you know it may be.  It’s not a glandular thing but there certainly may be brain dis-regulation involved or it may be due to some underlying thing happening that you are not aware or we may have an autoimmune condition that hasn’t been diagnosed or there may be underlying mitochondrial dysfunction do to any number of things or it could be all of those things to some degree or another.  And you just have to figure out how to dig deeper.  And that’s what I attempted to do with this book.

Sarah:    You know, that was one of the most fascinating aspects of the book and I’m sure as you said that was at the point of the book is that if you have adrenal problems, your problem is not your problem.  It’s actually the bran or the immune system or mitochondrial problem.  But what really grabbed me, Nora, was when you talked about the autoimmune aspects of adrenal dysfunction.  Everyone is talking about Hashimoto’s.

Nora:     Yeah, no lie.

Sarah:    Every woman I know over the age of 35 either has Hashimoto’s or is terrified of getting Hashimoto’s or is recovering from Hashimotos’  One of those three.  But what you are saying is that the same thing can happen to your adrenal glands.

Nora:     The same thing can happen to any organ or tissue in your body. They’re right now; they’ve identified already 100 different types of autoimmune disease.  There is literally 100 different things in your body that could be impacted by autoimmunity and at least forty additional diseases that are thought to have an autoimmune component.  This is the single greatest health challenge facing a medical system today and for the foreseeable future and yet medicine, conventional medicine in particular is ill equipped to deal with this.  We are talking about a systemic thing.  The conventional sort of Newtonian model of medicine that views the human body as a machine made up of its component parts which it is not.  It is really a complex system of interrelationships is what it is.  The problem is that everything in medicine is totally compartmentalized.  You have your psychiatrists, your gastroenterologists over here; you got your ear, nose & throat guy over there and your pediatricians over here…on and on and on as if all these things had nothing to do with each other.  All of these different things have an interrelationship involved.  Just because, for instance, you have something going on with your thyroid doesn’t mean that it’s a thyroid issue.  If you have Hashimoto’s, for example close to 90% of all thyroid cases of low thyroid in general, are autoimmune in nature.  And if that’s the case, your problem isn’t thyroid based – it’s immune based and you have to address on that level.  And that’s true the one sort of semi silver lining in this is that there similar mechanisms driving most autoimmune diseases that you can address on immunologic level.  You don’t cure or recover from Hashimoto’s.  What you do is you manage it.  Once those genes switch on, they don’t switch off.  But you have to identify what the triggers are for you.  Could it be gluten? Could it be some heavy metal like mercury or aluminum or who knows what? Could it be something happening in the environment;  chemical compound in the environment that is trigging for you? Everybody has different things.  Could be dysbiosis; could be all kinds of things.  Could be a combination of things.   Obviously, dietary antigens are a huge part of this.  But you have to figure out what they are.  There is only one lab doing that work and that’s Cyrex Labs and I don’t have any financial ties to them whatsoever.  They’re the only people in the world doing this work.  And accurately, I might add.  And comprehensively.  But you figure that out and then you have to basically remove those antigens; you have to remove those triggers.  And then you basically work at putting out the fire which is the inflammation and then you do what you can to heal the damage that you can.  And how well you are going to be able to do that is going to depend upon how far the condition has progressed.  In most cases, autoimmunity is not diagnosed until it is its end stages.  And once it’s there, there is not a lot left to manage.  You just sort of dig in your fingernails and hang on for dear life. Whatever the tissue is, it’s mostly destroyed.  You’re not diagnosable with, for instance; well actually that’s not true in all cases, for instance celiac disease is defined classically by the medical system as a state of total villous atrophy in small intestine.  In other words, you have the little shag carpeting in there, you have celiac disease when that shag carpeting has turned into berber 100% and you’re celiac.  And if its only 50% you’re fine, go home, have some more bread.  You’re fine until you get to that end stage.  Now the good news with something like celiac is to cure a symptom, stop eating the gluten 100% totally and completely and avoid one its cross reactive compounds that you have an immune activity to.  And you can reverse that process; at least in your gut.  The problem is that celiac disease, and this is a quote from the Journal of Neurology, may at times be almost entirely a neurological disease and responsible not only for leading not only the cognitive, uh, let’s see, affecting the brain and nervous system and also cognitive and psychiatric illness.  And this is a vector for things like Alzheimer’s disease and other forms of dementia potentially as well.  Roughly half of everyone with a gluten-immune activity is producing logical antibodies and that’s where it really gets scary.    Celiac disease might be a primarily, if not exclusively, a neurological disease affecting not only the brain and nervous system but also cognitive and psychiatric illness.  I just remembered it now; it just all came to me.  So that’s the other part of this.  Autoimmune antibodies are little bit like cockroaches.  If you have one, you may have many.   And that’s becoming increasingly the norm.  I run a lot of antibody panels in my practice and it’s unusual just to see one antibody reaction.  I always a little startled when I only see one.  I’m like “wow, you’re lucky”.  Most people aren’t that lucky that I see.  So of course in the book that we are actually talking about, which is not per se autoimmunity but there’s a chapter on that.  IM referring to the commonality with which people are actually showing up with adrenal autoimmune antibodies.

Sarah:    Describe your typical patient who comes in and what they’re experiencing and the process of getting control so they can kind of get their life back.

Nora:     Well, it depends on who they are.  I have people; I’ve worked with a little bit of every kind of complaint that a person could possibly have walking through my door.  And mind you, I work a lot with the brain.  So I end up with people complaining about symptoms like they’re depressed or they’re extremely anxious or they can’t focus on anything.  They don’t sleep at night or they get migraines all the time or they might have a seizure problem or maybe they suffered a closed head injury or maybe they just have weird symptoms and nobody has ever been able to identify what is actually going on with them.  I’ve had a large number of those over the years.  The good news is I don’t need a diagnosis to work with people because I’m not treating disease.  I’m working with helping people manage their own states better and helping to support their health along the way and offering them the kinds of things that are known to be helpful in supporting the particular symptoms they may present with but it’s not like a treatment per se.  but it could be anything.  You know.  I’ve worked with people complaining about gastrointestinal symptoms and bi-polar symptoms, depression, all kinds of things.  It kind of covers the whole spectrum – autism, Aspergers, turrets and so over twenty years of working with eight clients a day, five days a week, I’ve gotten pretty good at kind of knowing…getting the sense of what I’m dealing with or might be dealing with and figuring out what some of the things to rule out.  Because you can have somebody that is anxious and that can be anything.  I’m not automatically assuming they’re adrenals are stoked or that it’s just a hypoglycemic thing or that they have Hashimoto’s.  There are a number of things that need to be ruled out so use a battery of tests, some rather comprehensive blood work and also immunologic testing is nearly always part of the thing now because it is such a ubiquitous problem.  Right now it’s recognized that autoimmunity is the number three cause of morbidity and mortality in the entire industrialized world behind cancer and heart disease.  But it’s interesting because the number one cause of death, for instance, in a celiac patient is a cardiovascular event.  The number two cause of death is malignancy.  So there is overlap.  So the American Auto-Immune Related Diseases Association and the NIH both recognize that roughly 53 million Americans are presenting with autoimmunity now.   Compare that 9 million with cancer and 22 million with cardiovascular disease and you’ve got something that is more than twice both combined.   So there’s, I think those statistics of the number three cause need to be modified some.   But I don’t know if they will be.    The problem is that autoimmunity can manifest in so many different types of symptoms because it can literally affect every tissue in the body.  So it tends to be poorly identified.

Sarah:    Exactly.  And as you said, most people don’t really go to the doctor until it’s in its end stage.  I’m sure these numbers don’t even include the people walking around with mild autoimmune disease and they’re just going to get nothing but worse.  Because if you don’t address it, it just gets worse; it never goes away.

Nora:     When it comes to Hashimoto’s, which you mentioned earlier, totally off topic but that’s cool, I can go anywhere, again your endocrinologist, your physician, however well meaning they are, they are not going to give a rat’s behind whether you are autoimmune or not in all probability.  You may or may not get tested for those antibodies.  They often assume because they do on some level recognize that the majority of low functioning thyroid cases and the vast majority of high functioning cases are autoimmune in nature.  But because they have nothing with which to address that, they’re going to treat it the same way regardless if it’s just primary hypothyroidism or whether its autoimmune based hypothyroidism.  They are going to give you a thyroid hormone and slap you on the rear and call it good.   You go out the door thinking you just got good medication.  And yet, if you are autoimmune, you may be taking the appropriate amount of medication and still have every symptom associated with that because cytokines can block thyroid receptors too and prevent you from being able to even use the thyroid hormone that you’re able to produce.  There’s a disservice sort of happening and again, there is a bit of disconnect too between the field of immunology and the field of medicine. The field of immunology in terms of where all the research is going is an avalanche of research right now in the field of immunology.  But the people involved in this they are not medical doctors, they are by and large Ph.D. researchers and what goes on in the field of medicine, the closest thing to an immunologist there is looking for whether or not you have hay fever or maybe some serious food allergy like ‘oh I bit into a strawberry and my throat closed up and I had to be rushed to the hospital’.  They’re looking in mostly at an IEG reaction to foods and things like pollen and they deal with it on that level.  And then you have your rheumatologists. Typical allergists don’t address immune reactivity that is IEG or IEA based.  That’s just not what they do.  And your rheumatologists are really the only ones dealing with things on an autoimmune level, are mainly interested in creating cocktails that they are going to administer to manage the symptoms of rheumatoid arthritis and as if it’s just a joint problem and isn’t affecting anything else in the body.  And of course medications are merely palliative.  They are not really addressing the underlying mechanisms that initiate or drive these problems so that’s a very big disconnect.  And again, the nature of mainstream medicine…mainstream medicine is still stuck in a 400 year old paradigm of Newtonian physics and sees the human body as a collection of parts.   And everything in medicine is very compartmentalized.  And these different areas of specialty don’t necessarily communicate with each other very well. If you have adrenal autoimmunity and you’re finally diagnosed…you’re only diagnosable with adrenal autoimmunity which is called Addison’s disease.  This is the medical standard of diagnosis – when 90% tissue destruction has already occurred.  Then they decide to slap a label on it and call it something.  And then you end up going on cortisone therapy which is a nightmare.  Um, or whatever else.  But by that point, it’s very hard to try to bring yourself back.  And if you are only, however, at a point where only half of your adrenal function has been destroyed, you’re not going to have any answers.   You are going to notice it in every part of how you feel and function but you’re not going to have any answers.  When you do an ASI – that Adrenal Stress Index which is a salivary hormone panel that measures your adrenal circadian rhythm and your cortisol burden – some naturopath is going to tell you ‘oh look, you have stage 7 adrenal exhaustion.  You’ve just been stressing yourself too much.  Look at that.  Let’s put you on some adrenal supplement here.  I’m going to give you, vitamin B5.” And it does nothing.  And they’re not being necessarily better served in that instance.  And you may have a bottomed out cortisone level for a lot of different reasons but what’s important is figuring out exactly whatever it is that is underlying with you.  I’m not saying that everyone that is chronically fatigued has adrenal autoimmunity by a long shot.  I will tell you that its way more common than anyone suspects.  Its seen in medicine as a very rare condition because of the standard of diagnosis.  But the fact of the matter is that if you are actively producing antibodies that are outside the normative range, you have an autoimmune condition that if left unaddressed….you still keep doing all the same things.  You’re noshing on the gluten, still chronically exposing yourself to whatever that is trigging the cytokine storms that are destroying your tissues, you will eventually, in all likelihood be diagnosable.  Aristo Vojdani, the PhD immunologist who developed some of the testing, actually it think developed all the testing for Cyrex, wanted to call the array five panel they have the Predictive Antibody Autoimmunity Array.  It looks at 25 different tissue complexes and which ones you may happen to be producing antibodies against in your body.   And um, because they know from the literature now that if you are producing these antibodies early on, at some point, if things are allowed to progress as they have been, you may well be diagnosable at some stage with a disease that is associated with those antibodies.  Autoimmune conditions start out as silent.  In other words, you’re producing excessive antibodies relative to what you should be so you have this autoimmune process but you are not really symptomatic yet; you have no clue that something is going on so you keep going about your business.  Eventually you move into a state that is called Reactive Autoimmunity at which time you are starting to manifest symptoms.  There is more advanced tissue destruction occurring that is causing you to be aware that something is wrong.   But at that stage of the game – I call it the Crazy making stage because people just have no clue what is going on.  And then eventually they go into this advanced stage of tissue destruction where it is so debilitating that at that point physicians are forced to slap a label on it and call it something.  At that point they are more likely to look for that because the symptoms are extreme enough that they are easily identifiable and less vague.  At that point, they’re handing you cortisone therapy or they’re doing some interesting things nowadays with low dose Naltrexone but none of these things are really addressing the underlying cause or the mechanisms by which these conditions progress.  And the good news is that there is so much that can be done.  So much that can be done naturally to address these things.

Sarah:    Lets talk about that.  Let’s talk about what can be done.  You’ve touched briefly on the dietary changes that are necessary.  You also have some very interesting writing in the book about proper breathing and some of the high tech solutions that are out there for people to help manage stress.  Stuff I have never heard of before like this Sloter tank (phonetic spelling).

Nora:     Oh yeah, some really groovy stuff out there.

Sarah:    I think a lot of the people may be familiar with the GAPS diet; taking out gluten and that type of thing to rebuild the enterocytes; fix, heal and seal the gut wall and start to bring that autoimmunity and brain dysfunction from the toxins getting into the bloodstream bring it under control.  But I will tell you breathing aspect that you talk about in your book and some of these high tech stress management solution were very interesting. Can you go into some of that?

Nora:     Yeah, they’re extremely effective but low cost.

Sarah:    Yes, to change your breathing, you can do that right now. Immediately.

Nora:     It’s the fastest way to change your state and people that are chronically stressed have a tendency to, on a very subtle level, either hyperventilate or do something called “over-breathing”.  It’s also known as hypocapnia where…see when we breathe in oxygen into our lungs and lots of people – this is a really a misunderstood thing by a lot of well-meaning people – they’ll see somebody stressing out and say: “now breathe deep, take a deep breath”.  Well that isn’t necessarily fixing anything, you might actually be making the situation worse because when you draw oxygen into your lungs, the amount of oxygen that actually reaches your brain and your body isn’t dependent on how much oxygen you bring into your lungs; it’s dependent on how much CO2 you retain in the process of breathing.  And people that are really stressed, they tend to sigh a lot.  Sometimes they hyperventilate in ways that actually can be incredibly subtle that it takes a well trained eye to be able to even see it happening.  Or they’re chest breathing a lot. That is real common reaction too to stress; it’s not going into your diaphragm, it’s all kind of coming out of a knot in your chest and so what happens when you breathe in the oxygen is that it enters into your blood stream and then it attaches itself to hemoglobin.  Hemoglobin latches onto it like a pit bull and will not release that oxygen into your body until it makes contact with the appropriate amount of CO2 and its CO2 that actually releases the oxygen into your tissues so that you can use it.  But if you are hyperventilating or if you are over breathing in some way, shape or form and you are drawing in all that oxygen but you’re not retaining enough CO2 to actually make use of that oxygen, you’re actually operating in a state of subtle asphyxiation and you can send yourself into sort of a downward spiral cascade of panic attack in that state, not really understanding obviously what’s generating it.  And one of the things that you see on TV shows where somebody is hyperventilating what do people do? They hand them a paper bag, right?  So they’re breathing in and out of that paper bag because that paper bag is filled as they exhale with CO2 which they then breathe back in and that’s what calms them down.   It’s not a psychological exercise.  There’s a very strong physiological basis for that bag.  But what you can do yourself when you’re feeling excessively stressed, you find yourself sighing a lot, you almost start to dissociate in face of the stress that you are facing is you draw air in through your nose and feel it go down into the deepest part of your stomach.  There are also receptors in the diaphragm that will elicit a parasympathetic response.  When you are chest breathing, the receptors are more likely to elicit a sympathetic response which are more of a flight or fight response.  So take the breathing out of your chest and consciously put it in your diaphragm.  Doesn’t have to be huge breaths but it needs to be appropriate for the moment.  And you draw that air in and then you hold your breath for a second or two, that kind of natural pause, and then purse your lips like you have them around a little cocktail straw and then just gradually exhale and see how long you can take to exhale that breathe.  Maybe it will take you a minute to totally blow that air out and then go sort of lather, rinse, repeat – do it again.  Draw the air into your nose down into the deepest part of your stomach, pause a moment or two, purse your lips and exhale again.  And this is not that you need to breathe this way all the time but that’s a way of restoring you back to a better state of equilibrium.  You notice very quickly that by five of those breaths, you are in a totally different state by the end of that.   So breathing management is incredibly important for people prone to chronic stress.

Sarah:    You talk about the vagus nerve a little bit in your book.  In yoga class they teach you how to breathe to the point that when you are breathing out, you breathe out slowly but you make like this Darth Vader sound at the back of your throat.  I don’t know if you’ve heard that expression before but you breathe it out and this supposedly when you do that, it stimulates the vagus nerve which you talk about is the connection between the brain and the gut.

Nora:     Right!  And that’s why the composition of gut bacteria makes a big difference sometimes because there is communication going on with those populations in your gut to your brain.  The two of those things are forever intertwined. It’s interesting too that the same things that disrupt…I don’t know if this is necessarily a vagal issue but the same things too that disrupt the human gut barrier that generates the xylomon reaction also same mechanisms apply to the blood brain barrier.  So you always have to kind of be thinking in terms of both those systems being related to each other in some way.

Sarah:    Interesting.  In the last few minutes we have, let’s, if we can, talk a little bit about the ketogenic diet which you say is one of the best ways to get this – whatever is causing your adrenals a problem – under control and also some of these very intriguing high tech contraptions that are being used today to kind of…

Nora:     Right.   The contraptions can be a really great adjunct certainly but I am a big fan of…this is has got to be a comprehensive deal.  All these things kind of help support each other but one of the things that is really important is that before you start putting Band-Aids on things or attempting to kind of manage the stress you have, you really have to figure out what the underlying issues are  and with respect to adrenal dysregulation which may more often than not be a brain based issue, you’ve got to figure out what is driving that and you got to address it and first you have to identify what’s even going on and then you figure out what is driving that and then you address it.  And then I go into all the details in my book.  It’s almost like sort of a way of replacing, working with me, I’m actually not even taking new clients right now, I cant .  I’m just too overwhelmed with the existing workload that I have.  But I can hand them that book and say look, it’s all here.  It’s a tool for self empowerment and its truly what it is meant to be.  One of the reasons why I am a fan of a fat based ketogenic approach is that 1) it eliminates issues like chronic hypoglycemia which is so common in states of adrenal dysregulation because of the impact that hypoglycemia can have upon the brain and so when you are moving that dependence on glucose from mood cognitive and energy equation, then you’ve got a lot more wiggle room.  I’m not saying it’s the only thing you need to do but I am saying it’s a great step in the right direction because then you have a very steady, stable fuel source that is enormously stabilizing to your brain and nervous system in a way that a carbohydrate based diet in a million years never could.

Sarah:    And you described it as building a fire using twigs and small sticks versus building a fire with big logs.  I love that!  I love that picture it brings!  So easy to remember.

Nora:     That analogy brings it home for people.  Right because carbohydrates are the metabolic equivalent of kindling for metabolic fires.  You can have your brown rice and your whole grains and your sweet potatoes and your whatever else and that’s like twigs in your metabolic fire.  Or your white rice, white potatoes, bread, pasta, things like that, are a lot like throwing crumpled up paper on that metabolic fire.  And then you have things like alcohol or sweetened beverages and that’s a lot like throwing lighter fluid or gasoline on that metabolic fire.  And there are people that are heeding their metabolic homes all day long using nothing but kindling.  And there is a constant preoccupation with trying to see what they can do to keep that metabolic fire going all day long and of course they’re advised by nutritionists to eat more frequently, several meals throughout the day.  The answer isn’t eating more; it’s eating better.  It’s eating with greater nutrient density.  It’s putting a log on that metabolic fire so that you don’t have to worry about it all the time.  You can’t have it both ways.  You really kind of have to…you are either doing it one way or you are doing it the other way.  One, you are burning fat which is a primary source of fuel the way the human brain and the human body was actually designed.  It’s the only rational conclusion really because fat is just…even the slenderest person listening to this podcast has more than enough sufficient fat on their bodies to keep them going on some level.  I’m not saying that they would be happy about it or that I would recommend it but you could go for a month without having to eat and you could still keep alive based upon the amount of fat you are carrying around.  Conversely glucose we only have about a teaspoon of that floating around in our bloodstream or at least that’s what our body tries to keep it to at any given time.  And then the glycogen in your muscles and in your liver, you’ve got maybe a couple thousand calories worth the average person and that’s just not enough to get you through a day.  I’ve often said that most people aren’t more than two missed meals from a state of total metabolic chaos in this culture because they are relying on sugar as a primary source of fuel which is like relying on rocket fuel all the time to do every little thing and it burns off quickly, its volatile, its unreliable and it has to be replenished constantly.

Sarah:    Yeah, and if you miss a meal, you either get a headache or you’re crabby or you cannot handle….makes ordinary circumstances stressful.

Nora:     Or brain fogged or fatigued.  And the thing that I use to help people figure out whether or not they have a blood sugar problem is I ask the question “how do you feel when you haven’t eaten anything in several hours?  You’ve gone a long time without a meal, are you fatigued? Are you jittery? Do you feel agitated…that’s something that rhymes with ‘itchy’?  Do you feel brain fogged? Are you fatigued? What’s going on with that?”  and then the next question is “Once you’ve eaten, how do you feel? Do you feel more energized again? Do you feel like you’ve got that ‘get up and go’ back? Or do you feel really kind of drowsy?”  And if you’ve answered yes to any of that, then you have a problem.  You have an intolerance to a carbohydrate based diet that you have the inability to manage your blood sugar and all of those things are problematic and you are sitting there with your hand on your hip listening to me go “Well how am I supposed to feel when I haven’t eaten for hours and hours?”  Well the answer to that question is very simple – you are supposed to feel hungry.  And when you’ve eaten, the only way you are supposed to feel is not hungry.  Anything else is a problem.  It is not normal; its common – but things aren’t normal simply because they are common.

Sarah:    Correct, yes.  That is very important to know and that is something that’s uh…I see these kids just snacking on carbs all day long and they never seem to stop eating.  Mothers are amazed once they get them on some traditional foods….You factor in those healthy fats – serve them eggs for breakfast; oh wow, they can go all the way to lunch.

Nora:     Exactly.

Sarah:    You feed them pancakes for breakfast and they are hungry in thirty minutes or an hour.

Nora:     Exactly.  A lot of people too hypoglycemic you get this big surge of cortisol when you first wake up in the morning and so hypoglycemic may not feel hungry in the morning because the cortisol level is high enough that it’s got the blood sugar up so you see a lot of hypoglycemics that don’t want to eat breakfast.  Mind you they get these really wild swings and these hormones.  And then maybe 10:00 am they may just grab two or three cups of coffee and they may thing they feel fine and then they want that donut or…I’ve had people walk into my office that are very clearly among other things, hypoglycemic.  I remember one person in particular – “What have you had to eat today?” “Well, I’ve had some coffee and about 3:00pm this afternoon I had a croissant.”  Your brain has nothing to work with, I don’t even know why you are here.

Sarah:    Then they go home and eat a quart of ice cream at 9:00pm because finally they are hungry and they got to have some fat.

Nora:     Right and this person I am talking about was a bundle of nerves.  They were all over the place; they were one of the  most dysregulated people I ever saw.  It was affecting all of their relationships; ready to be fired from their job and they just couldn’t function; they were scattered all the time.  And they assumed that they were perfectly healthy.  “I’ve got all kinds of energy; look at me.”  Well, you are confusing energy with being neurotic.  You’re confusing energy with nerves.  How many people supplant true energy with things that just artificially stimulate their nervous system?  When you ask a person what’s your energy level like on a scale of one to ten every day.  They will say an eight or a nine.  And then you say “without coffee; without caffeine.”  Oh yeah, maybe a two or a three.   It’s a whole different thing.  There are so many things in our environment and in the way we have been sort of conditioned to think about food and the way we eat and drink and the way…the kinds of hours that we keep and the influence of that crazy twenty-four hour sort of sunlight called electricity and pollution and who knows what else.  All of these things sort of converge together in a way that makes it very,  very hard to have good adrenal health.  Understanding the mechanisms that deregulate it and then figuring out for starters where you are on the spectrum and what particular type of adrenal dysfunction…I wish we could have gone into the specific types; we’ve sort of been all over the place and its almost sort of been all about autoimmunity but I’m happy to talk about anything.  But you know I really did go into quite a bit of detail in terms of how to identify what is actually going on with you.  Offer people screening tools to kind of get into the ballpark of what seems to fit.  And I’ve had people write me and say “Oh my God, you’ve described me in two sentences in a way no one else has.  I just never thought of it this way, it makes total sense.”  I’ve had medical practitioners write and say “I’ve read your book and I’ve actually been able to help patients I was never ever able to help before.  It totally shifted my thinking in a way that is really benefiting my patients now.”  There is a lot of good information there can be used by practitioners but also just used by the average person to help them understand and think about what is going on with their symptoms a little differently maybe than they thought.

Sarah:    Right, and stop thinking about it as an adrenal problem and more holistic, systemic problem that needs to be addressed.  Not just with diet which I think is what everyone focuses on but very basic learning to manage the stress with breathing, all these techniques you talk about in your book are just fantastic.  I think I need to write an article about all these; a blog post about all of these amazing little contraptions.

Nora:     Yeah really, some really cool stuff.

Sarah:    Yeah, really cool stuff.

Nora:     I’ve been all over the field of neurotechnology since 1994 and so I’ve had the opportunity to try out a lot of these different things many times over.  I owned many of these things at home and many of these things can be extremely effective tools.  In fact, I need to use some of them more often.  A lot of them are quite affordable.  I do think neurofeedback has enormous potential for people in kind of training their brain in such a way that the brain learns to manage its own states better and then you’re not constantly having to use something.  I mean you will want to have some stress management techniques and technology at your fingertips but its great if you can do something to raise your fundamental stress threshold on a neurological level and that gives you wiggle room that’s hard to get any other way.  That’s what I’ve done with clients with the last twenty years that I’ve been doing neurofeedback.  We have that high windy way of life with all the bumps and potholes and sometimes it’s raining and stormy; some days are icy and it gets really treacherous to navigate at the speed that most of us travel through life.  And we get thrown and stress and trauma will soft whatever cliff we happen to be standing next to. We are only as strong as our weakest link where one person may tumble off into depression.  Another person may tumble off into alcoholism or panic attacks or migraines or whatever.  So I see neurofeedback as sort of putting a guardrail up on life.  It doesn’t prevent you from crashing through and going over but it does make navigating life’s treacherous path a lot more doable, a lot more safely.  Let’s put it that way.

Sarah:    Very good. Nora, we never have enough time to talk.

Nora:     Not ever.

Sarah:    This could be three hours.  Your book was so jam packed of information.  It’s something, as you said, it’s a handbook for anyone that has any of these symptoms and most of the people I know have trouble in this area.  Almost everyone I know.  But one question.  When I posted on my Facebook page yesterday that I would be interviewing you and the show would be airing next week, one question from one gal that I promised I would ask is – are you planning to put this e-book in a print form?

Nora:     Right now I am not planning to do that.  It’s very expensive to create a print book.  And I wanted to be able to…so Primal Body, Primal Mind has been out for a few years now and it’s done incredibly well.  Because it was conventionally published, I don’t own the intellectual material and I make very, very, very little on the actual book itself; like $0.50 a copy or something like that.   And it’s been a very poor business model for me.  It’s made me 100 times busier than I ever thought I possibly could be but that hasn’t necessarily resulted in making sense for me in a lot of ways.

Sarah:    So you’re going to keep it in an e-book for now and…

Nora:     Right now I’m actually going to have a whole e-book series.  That isn’t carved in stone and if I continue to get a lot of demand and the sales are such that it kind of becomes crazy not to do it then I might do it but right now it’s not in my plan to do it.  Most people have the ability to read books in an e-book format and it’s something that even if you don’t have a Kindle – I don’t even have a Kindle – you can download it onto your laptop with a free Kindle reader and read it there.  It’s not a particularly long book.

Sarah:    No its not.  I actually read your book on my phone while I was at my son’s guitar lessons and soccer practice.  That’s how I read it.  So I would encourage…we’re running out of time here so I just want to reiterate that Nora’s book on adrenal dysfunction .  Get a copy of it; it’s available on Amazon and also Barnes and Noble.

Nora:     Yeah, it’s on Nook.  It’s on iTunes.  It’s on Kindle, yes.

Sarah:    It’s a great read and I’m sure I will be writing some articles on it on my blog and of course linking over to your fabulous book.

Nora:     Yeah, wonderful.  I would love to see it.

Sarah:    Thank you, Nora.

Nora:     Yes, thank you, Sarah.



Nora-Gedgaudas2Nora Gedgaudas is a widely recognized expert on the Paleo diet and lifestyle. She is the author of the international bestselling book Primal Body, Primal Mind: Beyond the Paleo Diet for Total Health and A Longer Life. She is also a successful nutritional consultant, speaker, and educator, and is widely interviewed on national and international radio, popular podcasts, television, and film. Her own popular podcasts are available for free download, along with articles and newsletters. Nora maintains a private practice in Portland, Oregon as a board-certified nutritional consultant and a board-certified clinical neurofeedback specialist.

SarahSarah Pope writes the very popular The Healthy Home Economist blog and devotes herself to raising three healthy children with her husband using traditional nutritional principles as her guide. She has been the Weston A. Price Chapter Leader for Tampa/St. Petersburg, FL since 2002.



  • Anne Dicks

    I would like to listen to, Episode 40, your radio show with Sarah, the Healthy Home Economist. Can you help me with that, please?

    Thank you!

    Anne Dicks

  • patricia schlling

    I need information on Adrenal Insufficy. My doctors are treating me with prednisone and I am getting fat and having stomach pain. Help.

    • Marten

      Adrenals are the human battery, you have to balance sodium versus potassium, take adrenal homeopathic, adrenal liquitrophics, adrenal glandulars and licorice root extract, please eliminate toxic metal…..B complex is always good as vitamin A C and E….and don’t ever takes hormones, your health is your wealth, spend it wisely. Little changes can get big results

  • Michael Freed

    This is excellent. I got a copy of the Buteyko method of breathing and yes, it does work. Also, when Nora is talking about getting at the root causes of things, Arthur Janov’s Primal Scream therapy speaks to this. Although it’s very involved, the basics could best be described like this: if you’re feeling any kind of tension that constantly recurs, try to follow it down its rabbit hole instead of doing what you normally do. It exists in you as a form of energy, but one that saps yours, and if you feel it as its source, it can disappear. It always manifests as something phtsical; A rising of blood pressure, a fear or anger response. The problem is, when you try to follow it to its source, your symptoms will exacerbate. It isn’t fun when going through, but once you do, it’s like dropping a sixteen-ton weight you didn’t know you were carrying, and just the breathing method she mentions in this talk can start the process of getting you in touch with this repressed pain.

  • kelly

    neurofeedback did not work for us; we got great relief from Buteyko method because chronic inflammatory disease causes hypoxia; eliminating vitamin D helped most, the active metabolite is elevated by disease process & has detrimental epigenetic effects (this metabolite would be one to check before you get so disabled from autoimmune disease); diet is low-carb, no gluten, good fats;
    our toxic world creates 3-ways: similar epitopes of your own tissue, infections, & food proteins trigger your immune system & cross react…just doing its job…
    now we know we can’t let our guard down by vaccines & antibiotics, opportunistic infections get inside our cells & dysregulate the vitamin D receptor & the supplement does not fix it & can make you worse by immune suppression
    check out our FB page or website…free library of info for you & your doc at chronic illness recovery.org non-profit & all volunteers paying it forward

  • Lolita

    HI There
    Any advice on what foods to have & to avoid if you have RA.

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