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 C – The Revisit

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I have had to come back to discuss vitamin c following the August 2017 article Vitamin C – What else does it do for us? as a result of consultation queries which warrants a universal response and obviously, restriction in word limitation given for my last vitamin c topic.

In this article, I will try to further emphasize and keep in mind the relevant clinical outcome instead of the biological explanations behind vitamin c’s effectiveness on health. Whilst there isn’t a surge in vitamin c deficiency in the United Kingdom, it is worth appreciating its influence or response when one is unwell.  

The 4 most common questions I have come across in our clinic since August 2017:

  1. What is the maximum dose of vitamin c I can take in a day?

  2. When is it important to consume vitamin c?

  3. Do I have to get intravenous injections all the time to acquire more vitamin c?

  4. Does vitamin c treat common colds?

These answers to the above questions exist, but I feel that we need a legislated update for the good of mankind. My responses are:

  1. The UK recommendation is 80 mg per day, which is about an orange and a half. However, some cases of chronically ill patients have taken doses up to 50 grams safely, under the supervision of trained clinicians.

  2. It is a daily recommendation, therefore, its recommended you take that minimum a day. When unwell, I would like to suggest that more should be added to one’s diet.

  3. No, you don’t necessarily have to have injections all the time. You can acquire more through eating foods with vitamin c, particularly fruits and vegetables. Unless there is a clinical diagnosis of malnourishment/deficiency, inadequate or unsafe oral intake, food can’t pass through the intestines or there is malabsorption syndrome.

  4. As it stands, the answer is unclear, however, what we currently know is that vitamin c does not decrease the average incidence of colds in the general population, yet it halves the number of colds in physically active people.

I feel vitamin c is just as an important nutrient as the others and contributes to one’s wellbeing. In an ill patient, it has an important role to play and clearly, the traditional “low doses” are useful, but to what degree? Some controlled trials have found statistical dose-response for the duration of the common cold symptoms, with up to 6 – 8g/day of vitamin c. Other studies have even found that vitamin c prevented and benefitted patients with pneumonia and may alleviate respiratory symptoms caused by exercise. This doesn’t mean it treats it, but obviously warrants further investigations and possibly changes in recommendations of vitamin c intake.

Benefits of CQ10 – Another Antioxidant?!

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When patients ask the benefits of Coenzyme Q 10 also known as Ubiquinone, it is easier to explain the lexical meaning, however, a brief explanation on the deficiency causes and the reasons of supplementing it when or if needed is just as important.

The causes of deficiencies are suggested to be genetic, lack of nutritional content, oxidative stress caused by free radicals and ageing.

Three key CQ10 Benefits:

  • It is a powerful antioxidant, which regenerates Vitamin E, another critical antioxidant.

  • Hunts the bad free radicals and prevents cell damage to proteins, fats and other molecules.

  • Essential for the proper functioning of the energy production in the cells.

Whilst I have mentioned only the 3 benefits above, we know it that it has been proposed for use in patients with Type 2 Diabetes, Mitochondrial Diabetes, treatment of hypertension and statin- related myopathy.

Why CQ10 now?

Ubiquinone has always existed and important for the proper functioning of enzymes in our body. It’s name describes best its availability within us. It is ubiquitous, meaning it is found everywhere. I guess when science publishes consistent interesting findings of wellbeing to mankind; a social media trend tends to follow, maybe the same thing with CQ10.

If it’s everywhere, then do we need it?

Yes, we need it. Like everything else in our diet, there should be a recommended daily allowance that we should take, which hasn’t not yet been established for CQ10. However, we do know that doses ranging from 50mg – 1200mg have been used safely in adult studies. The higher doses being suggested for ill patients, from neurological disorders to cardiac disease statin users. And the lesser for the general wellbeing. It would be wise to discuss taking this supplement with your practitioner.

From my own personal opinion which is evidence based and users’ feedback, CQ10 is thought to be generally safe, with no adverse side effects reported when appropriately taken.

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.