The Trouble with Burning Out...

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One of the commonest things we see at the clinic is burn out. Also known as adrenal fatigue (not recognised in conventional medicine). When presented to your regular doctor, most people are given a sick note to take time off work; antidepressants is a common crutch plus the advice to take it easy.

“Take a holiday!”

Easier said than done. After all, in today’s world, one big cause of burnout is overworking and money constraints. So taking time out is quite a tough option. Especially if you are the responsible type and understand that by you taking time out, others get the brunt of your workload. Not an ideal situation. This is worse when the buck stops with you.

So, does traditional management work? Yes, certainly to an extent. Rest is highly important and time away gives one the right perspective and a better ability to prioritise. It also clears the mind and hence performance is enhanced. So you end up working smarter, not harder. Most people notice that their performance and work enjoyment increases after a break.

What about antidepressants? This does make a difference. I’m not a huge fan of it but nevertheless, there is a place for it. Especially when burnout causes other symptoms like raised anxiety, difficulty falling and maintaining sleep; anger, depression and a feeling of helplessness or lack of control over one’s life. To boil things down to the very basics- antidepressants numbs a person. This means that nothing feels as bad as it potentially would. This is a very useful crutch and should not be underestimated. It buys time until your body has healed enough to take over. The danger is a reliance on antidepressants for too long.

So what is it that we do, as functional and hormonal practitioners, that make our approach different from conventional medicine? The clue is in the underlined sentence above. We go to the root of the problem and help the body heal itself; therefore speeding up recovery. I also use this approach to prevent getting to a burnt out state; or in some extreme high stress situations, to delay getting there (not ideal but life is life).

We deal with the ‘burning out’ of the adrenals, which are small glands above the kidneys that release the hormones adrenaline and cortisol amongst others. A normal reaction of stress hormone (cortisol) release is excessive production when you are stressed, to cope with the increased demands on the body. When this happens consistently over a prolonged period of time, something happens. The body now goes into a state where it cannot produce enough cortisol to meet demand. At this point, you now start producing too little cortisol, contrary to popular believe. During a burn out, you produce too little to be useful. This is when you feel the need to crawl under the duvet, turn the lights off, sleep or to try to sleep and shut the world off. This is the body’s way of trying to heal the glands, so that it is able to once again produce cortisol in the right quantity to deal with your body’s needs.

This phenomenon happens to other glands too- the most commonly known of which is the pancreas which produces insulin. Early stages of diabetes signifies a problem with too much insulin release. These people need tablets to manage their sugar intake and keep their insulin low. Late stage diabetics need insulin injections. Because they now have the opposite problem where the excessive demand on the gland has caused it to burn out and the body can no longer produce enough insulin to meet demand.

We manage adrenal fatigue or impending fatigue with the right adrenal support and hormones where necessary. This will be covered in another blog. We also educate our patients so that they can see the signs and know when to self manage because that it the end goal- for you to understand your body to such an extent that you can read what your body is trying to tell you.

One problem with this, and the reason for writing this blog, is that when we most need help is when we are at our highest point in stress and time constraints and when we are most liable to forget these principles. We forget to utilise the support. I see this again and again. This blog is a reminder that when things get tough and you need a little guidance and for someone else to steer the boat- reach out for practitioners such as ourselves. We are in a position to help your body help itself. Don’t get to burn out. Its really not worth it. It takes a really long time to heal once you’re burnt out. Don’t do that long run or that very tiring HIIT session. Just rest, be lazy, day dream, order take out if need be (short term only) and allow yourself to just be. Which reminds me, I need to take my adrenal support now….

Vitamin B3

In light of the recent publishing of Australian research, “Vitamin B3 may prevent miscarriages and birth defects” nicotinamide/niacin or simply vitamin b3 does a whole lot more for us.

Within our clinic, we provide the vitamin B12 and B complex and occasionally B1, B6 and B7. B12 is the highly requested due to, simply, deficiencies in vast populations, mainly vegans, vegetarians, malabsorption syndrome, pernicious anaemia and mostly gut related illnesses. In a healthy state, we can all absorb these nutrients, considering we are sourcing them from the right foods and maintaining a balanced diet.

Where do we get B3 from?

Vitamin B3 is mainly sourced from foods that are high in protein such as meat, fish, wheat flour, eggs, carrots, peas, peanuts, legumes, tomatoes etc. The UK’s daily recommended is 0.3 mg/kg/day.

B3 Deficiency

Severe deficiency in vitamin B3 results in pellagra, which is very rare in the United Kingdom, however, certain populations listed below are susceptible to deficiency. Four “D’s” mainly characterize the disease: diarrhoea, dermatisis, dementia and potentially, death if left untreated. Additionally, the diagnosis can be strongly suggested by examining the levels of niacin, tryptophan and compounds found for enzyme function. A combined urine excretion of a metabolite of niacin and end product of niacin less than 1.5 milligrams in 24 h indicates severe niacin deficiency.

Populations susceptible to deficiency:

  • Staple diets consisting of consuming corn and sorghum

  • Individuals with eating disorders for example, anorexia nervosa

  • Congenital malabsorption of tryptophan (amino acid) from the intestines and kidney

  • Chronic alcoholics

  • Food fadists

Why B3 now?

This happens whenever “breakthroughs” or positive significant findings come out. B3 has always been important and beneficial like all nutrients and little is promoted on why nutrients are vital for our wellbeing. Good research comes out quite often and it is only fair to say this one was a lucky pick.

Besides the recent vitamin B3 findings, here is a list of the other known benefits:

  • Essential in all cells for energy production

  • Helps with metabolism

  • Repairs our DNA

  • Maintenance of the healthy skin or aging facial skin appearance

  • Free radical scavenger

  • Influences immune cell function and survival

  • Reduces the damage ultraviolet (UV) has on our immunity

  • An adjuvant in alcoholism treatments

Future of B3

B3 has been found to be a promising agent for the chemoprevention of melanoma in high-risk population. This is currently in the early stages of study and we can only cross our fingers for now that a solid foundation can be built upon from this. The headlined findings are definitely good news worth echoing and boosting your vitamins and diet to, certainly, doing more good than harm for those trying to start a family. On the other hand, we hope future studies clarify if lower levels of B3 are a partial cause of birth defects.

As exciting as it sounds, this should not open doors for a new fad diet. This is a breakthrough study, which was done under controlled environments, in mice, mice that probably don’t smoke, possibly exercise, and have their life entirely controlled in a lab. At the end of the day, these biological effects mirror human beings, and hopefully, this research will be translated onto us soon.

Vitamin C – What else does it do for us?

 
 

It has been 7 weeks since my last blog and the clinic has been casually mannered, meaning nothing unorthodox as per patient related issues. The Harpal Clinic Team has a new addition to the team, a copied version of Harpal, whom you may see when you pay us a visit.

Once again, I have been encouraged to write about this vitamin c topic by the new intravenous therapy clients, whom have the basic understanding of this essential nutrient.

By the end of this article, like vitamin c, I hope you find this fruitful to your immune system, to support and simplify recent understandings behind it.

Without consciously thinking, the food of choice for vitamin c intake is an orange, for me at least. Possibly, the most popular amongst the huge variety of fruits and vegetables we can source from. Again without determinedly thinking the benefits of this nutrient, it is necessary for growth and our immune system. As basic as that sounds, this does not explain it all, because every other micronutrient we eat does almost the same job, therefore, a bit more insight into it feels relevant.

Vitamin c is important and chronic deficiency in it can result in scurvy. Fortunately, scurvy is rare and almost exclusively associated with malnutrition, malabsorption or psychiatric disease. Since we can almost entirely defend ourselves from this disease, which has not been epidemic for a very long time, at least in the United Kingdom, little attention has been highlighted on it’s supporting role.

It is commonly known that, to provide antioxidant protection, a Recommended Dietary Allowance (RDA) of 90 mg/day for adult men and 75 mg/day for adult women is set based on the vitamin C intake to maintain near-maximal neutrophil concentration with minimal urinary excretion of vitamin c. Despite this RDA, several studies have also reported the benefits of “intravenous high doses” which can be adequately taken without any health implications, interestingly; these doses support our health.

Benefits:

  • Biosynthesis of collagen

  • Regulation of HIF-1α, which plays an integral role in the body’s response to low oxygen

  • Confers mitochondrial protection against oxidative injury.

  • Activation of the B vitamin, folic acid

  • Conversion of cholesterol to bile acids

  • Conversion of the amino acid, tryptophan to the neurotransmitter, serotonin

  • Reduces the severity of allergic reactions

  • Protects body from deleterious effects of free radicals, pollutants and toxins

  • Tissue healing

Most recently, research has shown it to be a key antioxidant of the Central Nervous System, as multiple evidence links oxidative stress with neurodegeneration, positioning redox imbalance and reactive oxygen species as a cause of neurodegeneration.

Having explained the goodness of vitamin c, which I have only written a tenth about, it is only fair to highlight the potential side effects. The side effects are, ingesting a large dose may cause gastrointestinal distress and diarrhoea. On it’s own it works well but is effective as an adjunct supplement. Also, there have been isolated cases of allergic reactions with eczema, urticaria and asthma. Otherwise, the benefits here outweigh the risk, in this article, the risk being the benefits.