Barbell Shrugged - You Don’t Have Adrenal Fatigue. So What’s Really Going On? — Muscle Maven Radio Episode #24

Starting point is 00:00:00 August 1st to August 4th, the One Ton Challenge. In your backyard, four days to find a one rep max of the snatch, clean, jerk, squat, deadlift, and bench press. You're gonna add them all up, find your one ton total with the goal for men being 2,000 pounds and ladies 1,200. The leaderboard goes live on Thursday, August 1st, and shuts down on Sunday, August 4th. If you're going to be at the CrossFit Games, make sure you come and hang out with us. The One Ton Challenge live at the CrossFit Games, Friday, August 2nd, from 5 to 8 p.m. in the FitAid Lounge.

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Starting point is 00:01:05 That's a killer e-book with a starter kit on how to get strong and how to dominate the one-time challenge. It's been awesome. Week one is in the books with all the new shows. Jason Kalipa on Mondays. Ryan Fisher Tuesdays. Shrug Wednesdays. Thursday, the muscle maven. Friday.

Starting point is 00:01:22 Friday. That's our boy, Dr. Sean Pastuch. Laid it down last week. And then Sunday, the Barbell Life with Travis Mash. Strongest man in the world. Best coach of weightlifting right now. Friends, I appreciate you being here. Thank you.

Starting point is 00:01:36 We'll see you after the show. Good morning, Shrug Collective family. I hope you're having a fantastic summer, getting jacked and tan. I am your host for Muscle Maven Radio. My name is Ashley Van Houten, aka The Muscle Maven. And I brought back a friend of the show today because when I first had him on, it was really popular and a really informative episode. And he has plenty more to say that I think will be relevant to you guys. So back with me today is Dr. Ralph Esposito. He is a New York-based naturopathic physician, an acupuncturist, and functional medicine practitioner specializing in integrative urology and men's health. And in addition to his other work, he's also designed education

Starting point is 00:02:20 modules for health professionals, specifically on urological conditions, male and female hormone dysfunction, hypogonadism, exercise, men's health, and sexual dysfunction. So he's covering it all really. He's an adjunct professor at New York University where he lectures on integrative medicine, and he's currently serving as a medical consultant and research analyst. He is also a fantastic source of information on Instagram, so definitely give him a follow. I'm so glad that I have him on my shortlist to ask questions to, and he's always fun to chat with because really, who's more fun in conversation than a New York Italian who's getting DMs about erections all day, right? He's a national treasure. Okay, so but today's conversation is actually about a topic that is relevant to everyone. I think it's actually kind of deeply misunderstood. But a huge part of our

Starting point is 00:03:10 community of fitness people who we work hard, we work out hard, sometimes we're burning the candle at both ends. We don't always place the right emphasis on recovery. And those kind of simple, unsexy lifestyle factors as much as we should. And so the topic, of course, is adrenal fatigue. And while many of us have suffered the symptoms that we think are adrenal fatigue, or maybe even have been diagnosed, I think that generally our understanding of the mechanisms behind our adrenal system can be flawed a little bit, as is our approach to addressing our adrenal health. So Ralph is going to walk us through what's really happening when we think we have adrenal fatigue.

Starting point is 00:03:51 We're going to discuss all the lifestyle and supplemental factors that can help us improve and manage chronic stress and fatigue, which is most likely what we're actually dealing with. And we talk about whether or not it's even possible, because I'm always asking these existential questions, whether it's even possible to address these issues with young, healthy type A athletes. And maybe I'm speaking to you, maybe I'm speaking to you 10 years ago, but it's so hard to get people to make the consistent, unsexy choices when you're young and healthy and you feel good. And we're all invincible until we're not, right? So maybe we all need to learn the hard way that rest and recovery is as important as training. But I don't know. That's the existential question. But we also touch on some of his latest

Starting point is 00:04:34 research in sleep and fasting. So all in all, this one's pretty jam-packed with relevant stuff for all of you type A, hardworking people. I assume that describes everyone listening. You got to be smart if you're listening to my podcast. That's my line of reasoning. But before we get into my chat with Ralph, a word about my fantastic sponsor that I love so much, Beekeepers Naturals. Don't fast forward. I have some good stories for you. They've developed two products, especially that relate to our topics today of both optimal functioning and good sleep. And the first one is their nootropic, their Beelixer Brain Fuel, which is made with royal jelly, ginkgo biloba. It has no caffeine, amazingly, because a lot of nootropics, basically, they just like stuff a little caffeine in there.

Starting point is 00:05:20 You get a little energy boost. You think your brain's on top of the world, but really it's just caffeine. So this one has no caffeine, but it does have these compounds that can support memory and cognition. And one of the co-founders of Beekeepers literally used this supplement to heal more quickly from a concussion. And that's Daniel. I know him personally. Dude's had too many concussions based on his history. He played a lot of sports, got a lot of concussions, but you'd never know it talking to him. And they actually did. They tracked his recovery on this, that latest injury that he had supplementing as well with this brain fuel, little nootropic that

Starting point is 00:05:56 they have. It's like a little shot tastes like honey. It's delicious. And he healed faster. So Daniel, that's great. You're the best. I'm glad that you are feeling well. Okay. And then the second product is for helping with sleep. And that is their Bee Chill Hemp Honey. It's a hemp infused raw honey that they make. It's delicious. There's a lot of research out there about the efficacy of hemp extract to help calm the system, encourage relaxation. I speak from experience. I use it daily to help me chill out at night because I'm just not a chill person. I basically walk around like I just slammed four espressos at all times. So I need this stuff badly. I use it. A tablespoon of honey is not going to knock you off your fitness goals. In fact, it may help them.

Starting point is 00:06:43 So all of these things are worth trying, right? They're healthy, rigorously tested. The company is super committed to sustainability and supporting the bee populations as well as supporting us in our health journeys. And I couldn't be more proud to partner with them. So I strongly encourage you to head to beekeepersnaturals.com. Check the stuff out, read a little bit more, buy some for yourself, buy some for your friends, use the code MUSCLEMAVEN for a 15% discount, and then report back to me and let me know what you think. Okay, that's my pitch. Now on to my chat with Dr. Ralph Esposito. All right, Ralph, welcome back. Thanks for doing this with me again. I am so excited. This is going to be fun.

Starting point is 00:07:25 Yeah, I'm glad you're willing to come back and have a second talk. Although I think our first one went really well, which is of course why I want you to come back because we were having a great chat and I'm like, I don't want to keep you here for four hours, but we have so much more to talk about. And so that's why we're doing part two right now. Yeah, I feel like we left off on a cliffhanger last time. And I just I just had so much to say. But then you told me to shut up. So did I say it in Italian, though? Because it sounds nicer when you say things in Italian. There you go. Were you impressed with my with my writing, by the way, from the party?

Starting point is 00:08:02 Oh, yes, absolutely. I still have it. I saved it. I was like, wow, this is super impressive. I put a lot of work into it. Yeah, I put a lot of work into it. And then I also had an Italian person look it over and be like, Hi, can you please make sure that this isn't gibberish. But this is exactly why I started doing my Duolingo like a year ago learning Italian because I mean, not for any real reason. Like I don't get to speak any other languages much on a daily basis. I wish I did. But growing up in Canada, I learned how to speak French enough to get by because that's what we learned in school.

Starting point is 00:08:37 And I had like just zero desire to learn it. Not that it's not a beautiful language. I just, I wasn't, maybe it's one of those like exposure things because it was always around. I'm just like, meh, I, you know, take it or leave it. And I just was, but I was always jealous of people who could speak other languages. So I'm like, I just want to do this. And I've always kind of like danced around it and been super lazy about it. And I'm like, you know what? Duolingo is free and I have my phone on me at all times. Why don't I just incorporate this like into my day? And I've been doing it and I picked Italian because I love that language and I just think it's beautiful. And I picked it

Starting point is 00:09:08 up. It's funny how, well, it's not really funny, but it's funny how you pick things up so much quicker when you're into it than when someone's telling you to be into it. You know what I mean? Yeah. Yeah. So I've been kind of, yeah, it really is. And because they're so similar to, like if you learn any of these romance languages, I feel like it's a lot quicker to pick up the other ones. Because I remember like I was doing a lot of like, watching my Netflix, both Italian subtitles, or I'd listen to an Italian with English subtitles. And I was just picking it up, I think so much quicker, because I had the sort of French base anyway. But I mean, I all that to say, I am still I can like barely speak or understand much of it. But I mean, I, all that to say, I am still, I can like barely speak or understand much of it, but I mean, it's more than I could a while ago. Right. So I feel good about it. I think the lesson to take away from this is no matter whether you're learning a language in Italian, French, Greek, whatever it is, you're stimulating a part of the brain that, you know, adults don't ever stimulate typically. So if you're doing nothing else besides learning how to order pasta in Rome, you're basically making yourself smarter. So absolutely. And that's a very important thing

Starting point is 00:10:19 to know how to do when in Rome, right? When in Rome, know how to order pasta. That's the whole point. But that is a good point to make, though, because it's the same with any kind of learning, but any kind of like even physical stuff, too, because I know so many people who even at like our age, like I have friends who are kind of in their early to mid 30s or whatever, and maybe they're bored with something or they're feeling out of shape. And like, yeah, but I can't like, learn a whole new thing now. Like, I don't want to go and learn a new gym thing or a new skill or a new sport. Like I'm too old. I'm like, guys, come on, don't do this to me. There's like 65 year olds working out in the gym for the first time

Starting point is 00:10:57 and then competing in track and field or bodybuilding or CrossFit. Like, please don't, don't like throw in the towel so soon. You know, it's like that whole kind of stimulating your brain in different ways. It's like, it's like a positive reinforcement that makes you want to keep doing it and keep doing it. That's how people stay, I think, healthy, but also interested in life and happy. Yeah. And I was actually thinking about this the other day. I wasn't able to work out for, it was like four days straight. I wasn't, okay. I wasn't able to work out for, oh, it was like four days straight. I wasn't, okay, I wasn't able to get into a gym for four days straight. And then I got back into

Starting point is 00:11:31 the gym on a Monday and I did one of my typical workouts. I was like, holy crap, like I am sore. I was really, really sore. And that's what happens when you do new workouts is you basically, you know, shock the body and have it learn something new. And that's just, that's just how we get better, whether it's a muscle or your brain, it's, you got to step up to the plate and just push yourself. Yep. Yep. Just be a little uncomfortable with that discomfort when you can kind of flip the switch and make that be something that you actually sort of crave, then like the whole situation changes, you know, not people being afraid of the discomfort of the gym, you know, not people being afraid of the discomfort of the gym, you know, like being sweaty and kind of feeling a little bit of pain and being out of

Starting point is 00:12:09 breath when you can turn that around and kind of enjoy that feeling like a whole new world opens up to you. Sounds like a Disney movie song. You can do the singing. I'll do the lyrics. You do the singing. So what's been going on work-wise for you this summer? Have you been super busy, same stuff, new stuff, anything you can talk to us about? I'm still working as a medical consultant and a research analyst for a private practice here in New York City. Every day is something new. We keep on learning new things. I think a lot what has come out in the past few months is how important fasting has been and what it can do and not do for the body. I think that's been really trendy. I think one of the biggest trends now is sleep. And I don't want to say it's a

Starting point is 00:12:57 trend because it's been something that I've been educated on since med school and even before that, but just how important sleep is, especially with Matthew Walker, who's one of the major researchers in sleep, is basically like, this can change your life. It can change your life now, and it can change your life in 20, 30 years. So I've just been neck deep into the literature on sleep and fasting and how they interact, and I guess like everybody else, but I just really want to understand that because I don't want people to be going around saying, well, you know, I know that sleep is good because this guy said it. Well,

Starting point is 00:13:35 that's not how I function. Yes. Yeah. There's, there's a lot more compelling evidence than that. Absolutely. So yeah, it's just been a lot of sleep stuff. I should be sleeping a little bit more, but for the sake of science, I'm having a lot of fun just researching the crap out of sleep and seeing how it impacts the brain and the body and the hormones. And it's all fun. Cool. Have you been experimenting with any new sleep stuff for yourself personally, or is it just more kind of clinical research stuff at this point? No, a lot of it is just a lot of it actually is personal stuff. Like what does this do? So I use an aura ring, which definitely is not the, you know, it's not the, it's the best thing that we have, right? So if somebody tells me, well, my aura ring is telling

Starting point is 00:14:22 me that, you know, I'm getting X amount of hours of deep sleep on one night, I'm like, okay, that's really good. But I'm more concerned about what it's telling you consistently, moreover trends. So I've been experimenting with a lot of different things, different supplements, seeing how my sleep can vary on that. Things like theanine, which is actually pretty interesting. Ashwagandha has been something that a lot of people have been asking me about, and I've been taking it forever, but I never really paid attention to times when my sleep changes when I take it and when I don't take it. And actually, I have gone a few weeks without it and then resumed it. And I was like, wow, I actually noticed differences in my resting heart rate.

Starting point is 00:15:02 I noticed differences in my resting heart rate. I noticed differences in my deep sleep numbers. And I probably should be doing labs before and after, but there's just so many variables. Yeah. Yeah. Just trying new different things and trying to figure out exactly what's going on with a lot of these herbals. Because that's the issue. We don't have a lot of research on these herbs as to mechanism of action. We know what the end result can be or cannot be. But if you told me

Starting point is 00:15:26 how does, you know, exactly does ashwagandha work, I'd probably be lying to you if I told you it works on, you know, this receptor and that receptor in humans. Like we have an idea of what it does, but I can't give you a direct mechanism of action as to why ashwagandha impacts, you know, X, Y, or Z, sleep, hormones, stress levels, etc. Mm-hmm. It's funny you touched on both of those two elements, theanine and ashwagandha, because, well, theanine is one that I've experimented with personally and found definitely some benefit in terms of, like, calming calming general sort of feeling of calm and like

Starting point is 00:16:06 down regulation for both prepping for sleep and also offsetting the effects of caffeine. I'm sure you've seen in a lot of cases that people often take L-theanine with coffee or they there's coffee now that has theanine in it to sort of offset the jitters that people can get from coffee. And I have, this is, you know, an N equals one, just personal experiment, but I have found, I've noticed a pretty significant difference. And I think because I'm quite sensitive to caffeine, which of course does not stop me from drinking coffee every day, but still I notice I can, I can tell when I'm like, I've had too much or I'm tweaking out or rather if I'm taking something or I'm drinking a brew that doesn't do that to me. So I've noticed some pretty significant differences

Starting point is 00:16:51 with that one. And then the ashwagandha is one that I have recommended to different people, just for them to try for various reasons. And I feel like, and I've noticed you because I watch your stories and you talk about like different supplements that you're trying and supplements for men's hormonal health and ashwagandha is one that kind of keeps coming up. And I feel like I've noticed a lot of men specifically having really positive responses to using that supplement. Is there much benefit or the same benefit or anything for women to take ashwagandha as well? Or is that more, or at least more studied with men? Yeah, so the impact that it has on testosterone levels is mostly studied in men. The reason why is just because, number one, the range of male testosterone levels are obviously

Starting point is 00:17:37 much higher than women. So if you're going to notice a difference in men to have a significant difference, you're going to see it just because the range is so high, right? Your total testosterone levels basically run from 300 to about 1100 nanograms per deciliter, which is considered normal range, which I think I could have gotten my soapbox on the last podcast. But if you want me to go and rant about that again, I'm happy to rant about that again as to why that range is complete BS. But most of the research on testosterone and hormones is in men, in particular sex hormones now. That doesn't mean that it can't do that in women, but I do think that the impact that it has on women is from a reducing cortisol level effect rather than a direct impact on luteinizing hormone and FSH in men. So typically what we see in men is that when they're on ashwagandha, and the research that

Starting point is 00:18:34 I have found to be most convincing is with KSM-66, which is a particular type of ashwagandha. And that has been shown to increase FSH and LH levels. And basic physiology tells you if LH is high, which is called luteinizing hormone, it's what stimulates your lytic cells of your testes to make testosterone. Well, women don't have lytic cells, right? They don't have testes, but they have ovaries, right? And they have other sex hormone organs, which can be responding to it. But I do think that in women, they do notice the benefits in what would kind of be equivalent to a male's improvement in testosterone, right? So what do you notice when you have improved testosterone levels? You notice better libido, increased muscle strength or muscle recovery. You notice better sleep, less stress levels. Well,

Starting point is 00:19:27 all of those can also be sabotaged by high cortisol levels. And in women, I think they're a little bit more sensitive to the cortisol reducing aspect or cortisol reducing effects of ashwagandha. So I think that women notice better libido, better sleep, less stress, because ashwagandha is actually lowering their stress-induced stimulus. And as you know, as you probably know, one of my best friends, Dr. Carrie Jones, I don't know if you know her, she's the medical director of dutch and we had this whole conversation once and we actually presented at a conference and she said and i said uh you know male male libido male sex uh drive is like an on or off switch and she said well female sex drive is like a bunch of dials and twists and

Starting point is 00:20:17 turns and switches and connections right it's not so simple and i think that's why ashwagandha works so much better or works differently uh in women so i think that's why ashwagandha works so much better or works differently in women. So I think that's kind of the explanation that you can go about doing it. Although again, you know, there's so many different variables that can come into play here. Yeah. But I mean, regardless, I think that's, there's some pretty compelling reasons to give it a shot for both genders. So yeah, definitely, definitely worth kind of doing your own research and trying some things out. What about before we get into the big topic that I want us to dive into, you said the other thing that you're kind of looking at a little more these days is fasting.

Starting point is 00:20:55 Are you again, kind of doing your own experiments with that? So a little bit of my own experiments and, and also experimenting or looking at the literature. So, um, boy, I'm talking about all these great, brilliant physicians here, Dr. Gabrielle Lyon, um, as you know, brilliant doctor here in New York city. She, um, was the first to point out to me, she's, you know, I was fasting 18 hours going to deadlift 400 plus pounds and then, you know, feeling like crap. And she was talking to me, she's like, So what are you doing? I'm like, I'm sleeping fine. I'm eating fine. I'm lifting. She's like, Well, what's going on? I said, Well, yeah, yeah, I guess I am

Starting point is 00:21:35 fasting for about 18 to 20 hours and then eating, you know, after a huge lift. And she did lab numbers on me and my inflammation was through the roof. My ESR was pretty high. My thyroid hormone was shot really. I mean, it was, it's the first time I've ever experienced thyroid issues like that. My body composition was not good. You would think that you're not eating and lifting, you should be reducing your body fat. And that really opened my eyes. And I realized that actually, when you put the body under that immense amount of stress, and you know, people would say, well, time restricted feeding, you know, you're eating only six to, you know, eight to six hours, even four hours of the day, you should be fine.

Starting point is 00:22:15 But if you are somebody like myself, and even and you, Ashley, who you push yourself, right, we, for recording, we were just talking about how much we hustle and try to get things done you push the body in the gym you increase the stressors of fasting because fasting is a stress then you incorporate stressors of like lifestyle and work really you're under stress almost 24 hours a day and if you can reduce food um basically famine as a possible stressor, then you can actually improve your stress response. But if you add that stressor and basically starve yourself to the point where you're over pushing yourself, then you can basically deteriorate the body and damage the hypothalamic, hypothalamic, pituitary, gonadal, adrenal, thyroid, or axes. So then I started doing some research into it. And I was like, wow, actually, you know, time-restricted feeding is excellent for improving autophagy and improving body composition in some people, but it actually can increase stress levels and can also cause some damage to

Starting point is 00:23:23 testosterone levels in men. And that's when I started realizing, well, you know, every therapeutic has its poison dose. And so a lot of the research I've been looking at is really saying there is a magic number here. And you can even see this. If you do water fasting, you put somebody on a water fast, you do their labs after, you see the reverse T3 is super high. And why does that happen is because, you know, what stimulates reverse T3 to be produced is inflammation and the body's inflamed and it doesn't want to, you know, it's pushing that thyroid hormone to an inactive substrate. And so it's just a little bit of putting the puzzle

Starting point is 00:24:00 pieces together and then realizing this might not be for everybody. Mm-hmm. I think one of the most frustrating things about these kinds of topics are that so much of it in terms of human health, it comes down to like stress, stress on the body or stress that you're imposing or is being imposed on you. And there's good stress and there's bad stress and there's good amounts of stress and there's not so good amounts of stress. But the other thing is the things that are good are also the things that cause stress. So like exercise, which we all should do and is very good for us in improper amounts is a stressor that could negatively affect our health and our body composition. Eating is good, but if you eat too much, that's a problem. Then if you stop eating and try to fast it out for a bit, that's stress on your body. And like

Starting point is 00:24:50 a lot of these things too, I think, which can add to the confusion is that they don't register as stress for individuals. Like if you described a human being who gets four hours of sleep a night and forgets to eat most of the day and always fits in a 20k run every day, but then works 10 hours. Like, of course, everybody's gonna be like, yeah, that person's got some stress issues and cortisol and all this stuff. But a lot of us who are, quote unquote, maybe have more normal lifestyles, we have a lot of daily stressors that we may not even be clocking as such, you know, like a lot more for bodybuilding and stuff like that, and I was working out a lot, every day probably for a couple hours. And my naturopath at the time was like, you're stressing your body a lot.

Starting point is 00:25:37 And I'm like, but I don't really feel it. I don't feel stressed out. I'm not anxious. I don't have problems sleeping. I feel good. I want to go to the gym every day. And it's like, it's still a stressor. So I think it can be tough for people to parse, like, how do I move forward with a plan? How do I incorporate fasting? Because I want the autophagy. How do I incorporate working out look at that puzzle? Boy, I think so. This is

Starting point is 00:26:10 the difference between this is the difference between the art and the science of medicine. Right. And unfortunately, I conventional medicine is basically gets a reputation. So medical doctors, DOs, nurse practitioners, PhDs, you know, naturopaths, they can look at medicine in two ways. It's a straight science, double-blind, randomized, placebo-controlled trial that proves A leads to B. And then you realize that in real life, that is not true. And that's really, I think, the enlightened physician where they realize that medicine is as much of an art as it is a science. And what you have to do, I think, is just to look at the person and let's get back down to basics, like physical exam, medical intake questionnaire can give you about 70% of the information. Labs would give you another 20% to 30%, and then whatever is left over is a combination of et cetera.

Starting point is 00:27:17 I think what you first have to do is you first have to look at the foundations. You look at the basics. How do we assess this person? The first things that I go to are, what are you eating? Are you sleeping? Are you sleeping? And are you moving? Those are the two big pillars. And then I look at other things like certain testing, such as, you know, hormonal testing through lab work, you know, your sex hormones, your some of your adrenal hormones, your thyroid hormones, then I go on to urine testing, and I see, well, what are

Starting point is 00:27:43 your cortisol levels, and their metabolites doing in the urine and sometimes even in saliva, although I tend to prefer urine testing. So you kind of have to put it all together and then you say, okay, well, what is the patient telling me? And it doesn't take a genius as you just realized, you know, that you're running a 5k and then not eating and doing all these other things, you know, working and burning the candle at both ends to realize yeah something's messed up here and i'm gonna have to address this before something gives and that's what i think is the most challenging part is number one for the patient to identify that there's something going on and then for the physician to ask the

Starting point is 00:28:22 right questions to figure out what exactly is going on. And, and that's the hardest part is not the, you know, is something going on? Yes, something's going on. But what exactly is it? And that's, that's really hard part of troubleshooting. I'm glad that you kind of touched on your own struggles with this, though, because I have found and I've been talking about fasting on and off for years now, because it's just a topic that is just so, so compelling to this sort of like type A community that wants to be like jacked and healthy and like doing all the things they can be doing to be the best that they can be. So it's like fasting keeps kind of coming up over and over again. And I

Starting point is 00:29:02 normally hear that it seems like pretty stress freefree and like across the board, not necessarily a bad idea for dudes, right? Like generally healthy men seem to, and again, this is anecdotal. This is just kind of like air quotes, like what you see on social media or what you hear, what you read in the articles about fasting. And women tend tend sometimes tend to have a harder time with it. But so to hear sort of like a younger fit guy who's like pretty on top of their health, generally, having some sort of slightly, I guess, negative experiences with it, I think that's kind of good to hear, because we only hear the other way. We only hear like, oh, if you're a healthy fit, dude, you just eat once a day. It's fine. It's cool. Everything's good. You know, so knowing

Starting point is 00:29:48 that they're, again, it's a tool that can work for some people sometimes in some circumstances, but it's not necessarily like a panacea and it's going to make everybody healthy and jacked. I think there's more work that needs to be done there, right? Yeah, absolutely. And, you know, what people need to realize is that what applies to one person does not apply to you. And that's a lot what we see in social media as well. It's like, oh, that guy looks really, I mean, you look at me, most people are like, wow, you're really healthy. And then I did a post about a month ago that basically showed my food belly, but it wasn't from eating too much food. It was just, my gut was all messed up. And

Starting point is 00:30:25 it's like, oh, well, he's a doctor. He should know exactly how to fix this. Well, yeah, but it's not so simple because again, I am, I'm, I'm a physician, but I'm not my physician. Yeah. Right. And, and just like yourself, like you are very knowledgeable, actually, like, you know, you know, your stuff, but I was Ralph your stuff. Thanks, Ralph. Yeah. See, I give a compliment. You're the best. But you do. And when we talk, I'm like, holy crap, this girl can hold her own. And I still see you that you go to your own, you see your doctors because you know that this is not all visible by you. And that's where a lot of people get lost. And this is where we get into the issue of people self-diagnosing. It's like, oh, well,

Starting point is 00:31:14 you know, I Googled this and it tells me that I have, you know, I might have melanoma. It's like, oh, yeah, that's not the case. Yeah. So let's talk about let's talk about the big topic here, which is something that people I think either get self diagnosed or diagnosed by, you know, googling or their friend who knows a friend who had it or whatever. Let's talk about the big, the big topic that we're here for today, which is adrenal fatigue. Now, where do we start? Maybe, I don't know, is it real? Is adrenal fatigue a thing? Do people have it? What is it? Oh, man. So you're not going to publicize my phone number, my address. It's got Ralph all fired up and in trouble. No, I promise I won't, but they know where to find you on Instagram. So I'll find you. So, okay. Let me just put it this way.

Starting point is 00:32:13 Boy, simply put more adrenal fatigue does not exist. Right. And that is not to say that people don't experience fatigue. Right. But this whole like stage one, stage two, stage three fatigue that your adrenal glands are quote unquote shot, or my adrenal glands are, you know, run down is not true. But it is a great explanation for an observation that we see, but does not necessarily mean that it is accurate. Another thing that's in this category, which hopefully we could touch upon today, or I'll just have to geek out on a third podcast with you, is about the pregnenolone steel or the cortisol steel. Okay. But I won't go there yet. But that is also a false or a misnomer. But when you get to the adrenal fatigue aspect,

Starting point is 00:33:07 let's identify what people think adrenal fatigue is. So they think that you start off with a normal stress response, and then you have a sudden decrease in response to a stressor, right? So you basically, you, you're, you're, you're, they call it a compensation phase, where you get a stress, and then your stress levels decrease, and you basically are overwhelmed. And then you have a resistance phase, which is basically you, now you're under that chronic stress, and your stress levels then jump up and you become more resistant to the stress. So you're now in hyperdrive. And I think at this hyperdrive phase, then leads to an exhaustion or decompensation phase where your stress levels and your adrenal function just completely drops. So basically, you start at a low level because you're under an acute stressor.

Starting point is 00:34:04 It jumps up because that acute stressor then becomes a chronic stressor. And then that chronic stressor burns your adrenal glands out. And you basically, your adrenal glands become dysfunctional. Well, that is just basic physiologically impossible. Unless you have a condition called Addison's disease, which is a diagnosis of complete adrenal atrophy. So let's identify the difference. There's adrenal atrophy, which is not what people are basically confusing with adrenal fatigue. So let me know if I'm going too quickly or if I'm jumping the gun here. Well, I do have some questions. First of all, why do you think that this term adrenal fatigue entered the mainstream so much and became something that we were so quick to

Starting point is 00:34:55 diagnose ourselves with? How did this enter into the public conversation in an incorrect way? Yeah. So the founder, I guess, of the stress theory or the adrenal fatigue theory was Mr. Hans Selye. I don't know if I'm pronouncing it S-E-L-Y-E, which was in the 20th century, right? And he was one of the first endocrinologists that basically termed like the general adaptation syndrome, right? And basically he defined adrenal fatigue. And it was at that time where lab testing really wasn't so accurate. A lot of what we were doing is based on observation and symptoms. And again, for all credit, giving more credit is due, he really did try to explain why people who are overworked, overstressed, eating poorly, not exercising, are experiencing this what you would call chronic fatigue. I don't fault the men, but really it was just an explanation based on an observation.

Starting point is 00:36:05 And it started to catch on because then there was blood work. I'm sorry. Then there were labs that were being done that actually then confirmed what you were seeing. So one of the early labs that were doing a lot of, not one of them, but most of the early labs that were doing adrenal fatigue testing or basically testing your adrenal function, they were looking at your cortisol levels. And they were just looking at your cortisol levels in your saliva. And they were saying, okay, well, here are your cortisol

Starting point is 00:36:33 levels and your cortisol levels in your saliva are very, very low. So that must mean that you're really, really tired and worn out. So the test was congruent with what the person was experiencing. But then if the person was really hyper energized, and then you did their lab test or their saliva cortisol test, and you saw that their cortisol levels are high in their saliva, you're like, oh man, you must be in that phase two where you're hyperreacting. And it was just a frequent coincidence or a correlation that was not a causation. And this is the big issue with medicine is that many physicians are correlating or correlating lab values with the causation. And that is not how science works.

Starting point is 00:37:21 And when you look at data and research and you try to make correlations, you have to look at hazard ratios and odds ratios and how strong is this correlation? How close is it to being causal? So one of the great examples is smoking cigarettes. The odds ratio of a person getting lung cancer who smokes cigarettes is somewhere upwards of like nine to 10, which basically says there's a very, very high core. By the way, the farther it is from one, the higher the correlation, the positive correlation that there is. So somebody smokes, the risk of them getting lung cancer is very, very high. But you would, I'm sure there's a bunch of your listeners who are now saying, well, not everybody who smokes gets lung cancer.

Starting point is 00:38:05 And not everybody who gets lung cancer has smoked. And that's, yeah, that's a great point. That's why it's not causal. It's corollary. But it's such a high correlation that you can say that there is a very, very strong causal effect of cigarettes on lung cancer. Now, if you did the same thing with like an adrenal test, that ratio would not be a nine, 10 or 11. It might be at like, maybe like 1.1 or 1.5 or, you know, whatever the correlation would be. I don't know if the exact statistics would be enough for you to say, well,

Starting point is 00:38:37 I see two correlations that therefore it must be true. And then it just started to catch on because doctors really didn't know how to explain it. And that's why I don't do salivary cortisol testing. And I use urinary hormonal testing with a lab called Precision Analytical, which no affiliation. I just think they're an impressive lab and I like their data. So how common is Addison's disease and how do the symptoms of that differ from people who maybe just have chronic fatigue? Like how would someone know or even think to address like maybe this is what I'm dealing with? Yeah, so Addison's disease is actually pretty rare. I don't know. It's maybe, oh boy, less than 1% of the American population would have Addison's disease. I don't know the exact statistics, but it's not a common disease, right? It has a very low prevalence. And how would one know that? Well, a great example of this is ex-president JFK.

Starting point is 00:39:46 And JFK was an Irishman, right? And he was very tan. Well, it's not very typical, although there are people who are Irish who are very tan. I mean, that's not uncommon. Yeah. Not uncommon. But if you're hanging out in like Boston all year round where the sun is not very prevalent, you would understand what's going on. Actually, JFK had Addison's disease, and it basically was an atrophy of his adrenal glands.

Starting point is 00:40:16 What happens is that when your adrenal glands are unable to make cortisol, atrophy means that basically they were shrinking. Your adrenal glands are these triangular little organs that sit on top of your kidneys. Sometimes they call them suprarenal glands. And they release cortisol. They also release sex hormones. They also release other hormones that are responsible, like aldosterone, that are responsible for regulating your water, your water flow in your kidneys and your cells. But when your cortisol levels are very low, your brain then recognizes, hey, cortisol levels are really low. And also, let me be clear, free cortisol levels, because you have cortisol in the body, just like testosterone, where it's bound to sex hormone binding globulin.

Starting point is 00:41:09 So there's free and total testosterone. There's also free and total cortisol. And when you do a blood test, you're testing total cortisol. But when you do urinary testing, you can get free cortisol levels. And even sometimes with salivary testing, you can get free cortisol levels. So the brain would recognize and say, hey, there's not a lot of free cortisol here. I'm going to release a hormone called ACTH. And ACTH is also bound to another hormone called MSH. MSH stands for melanocyte-stimulating hormone. And MSH, basically melanocytes, are the things that make you make melanin. And when MSH is very high in Addison's disease, you become tan. And that is what we saw in JFK is that he had Addison's disease. He was very tan because he had high levels of MSH because his body was not making cortisol. So his brain was responding appropriately and saying, there's no cortisol here.

Starting point is 00:42:05 I need to make ACTH and then it made MS, and that's why he became 10. So that's what you would see. That's like frank adrenal insufficiency, right? That's Addison's disease. But when you have Addison's disease, you're really just like spent. You have really low fatigue. You can sometimes have issues in water regulation because cortisol also helps you with maintaining intracellular versus extracellular water. You would know if you had Addison's disease, and you probably know around birth, not at like 35 when you're drinking 10 cups of coffee in the morning and can't get out of bed. Right. Okay. All right.

Starting point is 00:42:37 So one slight advantage is the tan, but it's really kind of overwhelmed by all the bad stuff. Okay. I got it. All right. I love how you look at that too. I mean, look, we just spoke about this. but it's really kind of overwhelmed by all the bad stuff. Okay, I got it. I love how you look at that too. I mean, look, we just spoke about this. We were stuck in the grunt of winter with no sunshine.

Starting point is 00:43:00 Yes, but also we both, I think, appreciate being hashtag jacked and tan. It's great. There's nothing wrong with wanting both of those things. I'm going to hashtag you and something like that it's great. There's nothing wrong with wanting both of those things. I'm going to have to tag you in something like that today. Yes. Okay. So is the big conversation that we're having here for most people then chronic fatigue, chronic overwork, and how we focus on that? I think another thing that makes, this is why this is just like a big confusing stew of knowledge sometimes because the symptoms of chronic fatigue

Starting point is 00:43:29 can be symptoms that relate to a host of things. It could be you're just stressed out and working too hard. It could be you're not eating enough or properly. It could be symptoms of something more insidious or more serious. But I think that probably it's safe to say for the vast majority of most of us who are listening to this podcast or into health and fitness, maybe a little too into it. If we're having an experience that makes us think like, do I have adrenal fatigue? Like I always feel tired. I don't feel, you know, I'm having all these symptoms. The vast majority of us are just dealing with self-inflicted chronic fatigue, right? Is that safe to say?

Starting point is 00:44:08 Yes. I would say that chronic fatigue or – look, if you want to call it whatever you want, adrenal fatigue, adrenals are shot, I don't know what you want to call it. It's a lifestyle disease. It is a chronic lifestyle illness that is a result of poor sleep, poor exercise, poor eating, and not even just poor eating. Exercise, sleep, and nutrition that has not been, you're completely, you know, fatigued. I need you to do a ketogenic diet for four weeks. And we're going to try to repair your adrenal glands like that.

Starting point is 00:44:52 I'm going to tell you right now, there's not a chance in hell that I'm going to be able to do ketogenic diet for four weeks with the lifestyle that I maintain. And the training that I do, because I've done it, and it completely destroys my libido, I feel horrible. And I have Dutch testing, or I have lab testing to prove that my numbers don't improve with that. Right. So I think you need to be individualized to that aspect. So yeah, I think you have to tailor it to the individual. And when it comes down to it, it's basically a lifestyle condition. And the same thing that a lot of people blame other chronic fatigue syndromes to like, oh your fatigue is a cause of that. And I think one thing that I've learned that I've learned mostly just from clinical experiences, you know, when you hear hooves, think a horse, not zebra, right? So in layman's terms, if you see something that, you know, smells like an apple, looks like an apple, tastes like an apple, it's probably an apple.

Starting point is 00:46:09 Don't go ahead and start thinking that this is some exotic fruit from the Amazon. from social, financial, psychological relationship stressors think maybe those are the reasons why this person is chronically fatigued, not the fact that they might have a 1 in 100,000 chance of having an adrenal atrophy, which is pretty rare at the age of 35. Right. I think one of the hardest parts about this sort of lifestyle disease that we've all created for ourselves is that there is such a big mental component to this one, almost more than probably any other in that we all think that we're the ones who can just kind of push it a little bit further or like, this isn't, it's, you know, I can get past this. Like I can just get through the next couple of months without having a proper lifestyle or like, I don't need to do all of these like boring things that everyone, this is, this is for other people, the sleeping eight hours, the, you know, cutting back on

Starting point is 00:47:19 exercise. Like that's not me. I'm too like energetic and hard charging and ambitious. Like how can I balance wanting to hit all of these goals and be this awesome person who takes advantage of every minute of life and still have this sort of balanced, healthy lifestyle? Because for a lot of people, it sounds like slow down, do less, don't work as hard. And people have a really, really hard time accepting that. And I get it because there are stress. These are the stressors of life, right? Like sometimes our livelihoods depend on it. And I would say that your life depends on it to not push yourself to those limits.

Starting point is 00:47:56 And I'm in the game of making sure you live as long as possible, as healthy as possible. You know, before we got on the call, I told you that my father recently passed and I knew that since I was seven years old, he was sick with two heart attacks. He then ended up getting leukemia and COPD and then ended up getting something called Lewy body dementia. All of these are conditions of chronic disease, chronic illness. So if you were to tell me, you know, if you were to tell me, if you were to tell his doctors, and I could tell you this, I've had these conversations with his doctors, like, do you think that his smoking impacted this? Do you think that his diet had impacted this? Do you

Starting point is 00:48:34 think that perhaps his alcohol intake may have been impacting this? And he wasn't an alcoholic, but he definitely had alcohol pretty frequently, several a week, you know, more than a drink a night, um, on average, like, could this be impacting, you know, this person?

Starting point is 00:48:50 And like, he didn't sleep very well. And they would just like, yeah, maybe. And I would tell you, I could, I will bet my life on it,

Starting point is 00:48:56 that those were the things that impacted his quality of life. And we see that all the time. So now people are freaking out like, Oh my God, I need to get this done. I need to push myself to get this report out. I need to push myself to make sure I get on this magazine or this podcast or get this X amount of work done. And then if I told you in 40 years, that would mean nothing to you because you probably couldn't

Starting point is 00:49:22 remember half of the people that you spoke to today. That puts it all into perspective. And that's the name of the game that I'm playing. And I think that's the name of the game that a lot of people want to play, but they just don't see it. And I think Matthew Walker, one of the major researchers in sleep, really points this out. He's like, look, if you don't sleep, you risk a dementia and Alzheimer's and heart disease, they go up. And that's not living. That's just being alive. Yeah. I mean, I think, again, not to sound like sort of the pessimist, but it almost seems like this kind of awareness and understanding of how to take care of your health, there's a certain wisdom that you need to have to

Starting point is 00:50:06 really internalize that because anybody that can read can go out there and read the basic tenets of being healthy and having energy and being vibrant. And those things are across the board, get good sleep, manage your stress, eat whole, unprocessed foods as much as possible, nurture positive relationships, right? Go outside and get some sun. Like these are all things that we have heard a million times. And we can all understand on a theoretical level why those are important. Yet so many high-performing, stress-craving, and I got to say it young people, just that, you know, it's just like human nature. It's like, you know what, I can get away with this for right now. So

Starting point is 00:50:52 I'm not going to do it. Like, I'll wait till it's a problem. I'll wait till I crash. Like, not me, I'm 22. I'm fit as hell. Like, this is great. I don't have to sleep yet. Like, it almost seems like it takes and then I talked to I talked to so many smart people on this podcast. And so many people who in their history were elite athletes, or whatever they were, that was super, super high stress and hard charging stuff. And then they hit maybe they're 38, or maybe they're 40. And they've entered into a new place in their life. And they've hit a level of success. And they've or maybe they've crashed, and they've had into a new place in their life and they've hit a level of success and they've, or maybe they've crashed and they've had to reevaluate what they were doing. But I guess I just don't hear too many like 24 year old professional athletes or like CrossFit Games

Starting point is 00:51:34 athletes being like, these are the things I focus on, you know, like, so I don't even know what the question is. Cause I know you're not that kind of doctor we're not talking psychology here too much but what are some ways you think we can start to incorporate these things earlier like wait not wait until it's a crisis like how can we make this stuff a priority and still still be doing the work that we want to achieve these super ambitious goals boy that's a loaded question. Because, you know, if I'm answering the question is, what can we do now to prevent these things from happening? Or is it more of what can we do, like prevent those chronic illnesses? Or more you asking, what do we do now to help people realize that these chronic diseases are life changing. Yeah, that's the thing. How do we get the elite young people

Starting point is 00:52:28 who aren't necessarily struggling with it yet, how do we get them to respect this stuff proactively rather than wait until it's a health crisis? Good question, right? That is a great question. Perhaps maybe some of it is just putting this information out there, continuing to do it, continuing to lead by example and show it and show the negative consequences if you don't take care of these things. I mean, maybe some of it's just continuing education, I guess.

Starting point is 00:53:00 Yeah, I don't know. This is where more knowledge is not better, right? I don't think that telling somebody that if you continue to smoke that you're going to get cancer. I don't know if that information actually crosses the person's mind. I don't know if it allows them to realize, you know, I need to make this change in order to prevent these illnesses, because we see these conditions so later in life that number one, they're gonna say, well, I don't have to worry about that till, you know, I'm 70 years old. And then even then you can say, well, I'm not guaranteed to get that if I continue to do this lifestyle. And that's a great response. Like, yeah, man, I totally hear where you're coming from. But it takes the type of person to want to have to do those things now. So you could even show people the data, like somebody who's 20 something, and it wouldn't

Starting point is 00:54:03 even phase them. They would say, yeah, but look at me, I got like, you something, and it wouldn't even phase them. They would say, yeah, but look at me, I got like, you know, I'm benching, you know, 225, and I'm a beast. I really think that the way to go about it is, is not so much to have them experience it, but kind of give them an example of a time where they were not functional. And I think for a 20-something-year-old, see, this is the unfortunate thing, actually, is I see men and even women who are unwell, right? Like if I told you how many people messaged me on Instagram to tell me that they have erectile dysfunction and I know that they're younger than 30 or 40 years old, those are the men who are just like, I will do whatever it takes for this to happen, for this to go away. And then there are

Starting point is 00:54:53 men who are in their 20s like, that's never been an experience for me. But you can kind of show them an example and say, hey, remember when you were, you know, really hung over and you felt like crap the next day and you couldn't really function? Well, imagine feeling like that, you know, for most of your adulthood. That is not fun. Or somebody who's had an injury, right? Like, you know, when I was younger, thank God I've never had a sprained ankle or a sprained or had any type of muscle injury at all. Until I was like, you know, 26 in med school. And I basically damaged what was called the lateral femoral cutaneous nerve of my leg and lost all sensation to my lateral thigh. So if I flex my thigh, you basically see a flat thing on the left side of my thigh.

Starting point is 00:55:40 And I was like, holy crap, I want to do whatever I can do to make sure that this doesn't limit me in the future. And you just have to have these people have those experiences themselves. And I think experience is going to be the strongest thing that you can do. Because look, this is like asking the same question is like, how do we stop people from drunk driving? It's like they know that it's bad for them. They know that they should not be drinking and driving. But their judgment tells them like, I'm okay. It's the same thing. It's like, yeah, my brain is telling me that I'm fine right now. But you don't realize that

Starting point is 00:56:16 drinking that soda is really just killing you. Yeah. Except it doesn't you don't put anybody else at risk. Yeah, it's just painting a good picture. And I mean, I think also maybe approaching it too with some like younger people who haven't had a lot of negative experiences in their life yet is maybe approaching it in some instances less like a preachy,

Starting point is 00:56:41 if you don't do this, you're going to be decrepit in 10 years. But like, hey, do you don't do this, you're going to be decrepit in 10 years. But like, hey, do you want to have great erections and also be super strong and also have nice skin and look really good and like, have a lot of energy and be funny because your brain's working well, like sleep a little bit more, but like being a little bit more in the sort of positive framing as well. Like if you want to keep crushing the way you are, here are the super simple things you can start incorporating that you're already doing. You

Starting point is 00:57:11 just have to do them better, you know, when it comes to nutrition or whatever, sleep. Maybe that's another way to do it. Okay, so another question for you. So since we're talking in more general terms about chronic fatigue or fatigue, and that's not necessarily a cut and dried medical diagnosis. Rather, it's like an observation of a chronic thing that we're all talking about they'll of course i think probably always help and probably rarely hurt somebody but is there a level of chronic fatigue and overwork that you will reach where it requires further intervention dealing with kind of like hormones and blood tests and maybe supplementation and things like that like is there a level that people are going to reach where it's like you know what getting more sleep for you over the next couple of weeks probably isn't going to cut it. Like you need, you need more. Yeah. I, so when somebody gets to that level, you have to then decide, you know, if they're, if their cortisol levels are, are literally too low,

Starting point is 00:58:19 you know, is giving them Cortef, which is basically cortisol, is that going to solve their problem? I'm very, very hesitant and I've never prescribed or advised anybody to get Cortef or get exogenous cortisol because what it's going to do is still turn off this hypothalamic pituitary adrenal axis. Because similar to how with JFK, his body wasn't making enough cortisol. So it was trying to churn out the hormone to make more by taking in more is then going to turn off your brain to not want to make more in the first place. It's kind of like men who are on testosterone. Once they're on testosterone, if they're on it for too long, basically their brain will shut down and they won't be able to recover. And the same exact thing can happen with somebody who is, uh, taking

Starting point is 00:59:10 exogenous, uh, cortisol. So that's one thing that I would never do. Um, the other thing actually is, is really is if it take, if it took you a long time to get to this shit point, right? If it took you this long to really get this bad, where you're under so much stress, and sleep and lifestyle and exercise is not going to do it for you, like within the next few months, then it's going to take you several months, you know, it's going to take you a year to really get recovered and get you where you're going. And that's where I think herbs and adaptogens and acupuncture, all of these things together are really going to be the really the only tool that somebody can use because conventional medicine has no solution. And aside from from, you know, medical doctors and DOs and

Starting point is 00:59:59 anybody really even even naturopathic doctors who don't know how to deal with this, but aside from them telling you, you know, chill out, there's really not much you can do by giving somebody a pharmaceutical. So you're going to have to utilize sleep. You're going to have to utilize stress adaptation. You're going to have to utilize herbs and supplements like L-theanine and ashwagandha and rhodiola and relora and a bunch of these herbs to help and licorice right these are herbs that are going to be um accessory herbs so they're not the number one thing that's going to make the problem better but you have to use them in in in combination with other lifestyle things so yeah there definitely are are strides that can be made to help somebody get to a a better point but don't expect to be better in

Starting point is 01:00:46 like three weeks or four weeks. It's just, again, it took you so long to get there, you're gonna have to take some time to dig yourself out. Right. I want to touch quickly, again, on the idea of sort of adaptogens and herbal supplements and things like that. We talked about L-theanine and ashwagandha earlier. And you touched on a couple others that I've actually also played with like rhodiola. But I get a lot of questions and comments every once in a while when I post about stuff like this, or like some mushroom blend that I'm taking or adaptogens. People tend to be kind of cynical about that word adaptogens. I don't know if people maybe just are like, well, is this the newest thing that some like biohackers trying to sell me that I'm never going to notice

Starting point is 01:01:28 any difference and it's super expensive. But I mean, that's a pessimistic way to look at it. And I'm sure there's a lot of stuff out there that's useless. But it's also kind of interesting that some of these herbal remedies, which are basically the remedy that existed throughout history until we came up with modern medicine. And a lot of these things worked very, very well for a lot of people for a long time. We have such a mistrust of it. So I think it's great that someone who is in your position can speak to this stuff as well and not necessarily prescribing it across the board for everybody, like go out to your local whatever and buy all the herbs you can find. But I think

Starting point is 01:02:05 that it's worth touching on the efficacy and the importance of some of these things and that there is a lot of research backing some of these herbal supplements as well, right? Yeah. So look, I'm a naturopathic physician and I'm not going to hide that. I am trained and formally trained in clinical nutrition, in herbology, botanical medicine, in the context of conventional modern day medicine, right? So really what it comes down to is, what does the literature show? What does the research show? How does this combine and how is this congruent or incongruent with the biophysiology of the human body. And I think why a lot of herbs and supplements get a bad reputation is, number one, unfortunately, there are a lot of doctors who see this area as trendy.

Starting point is 01:02:56 It's like, oh, I want to get into this area because it's very lucrative. And I don't think those are the right people to go see. Secondly, there's a lot of programs that are teaching people how to, quote unquote, become trained and certified in how to use adaptogens and herbs. But unfortunately, they just don't understand the whole history. They don't understand the biochemistry. They don't even understand medicine well enough to implement and utilize these herbs in the proper way that they were designed to be utilized. So for example, I've seen practitioners constantly give somebody rhodiola who has, you know, immense amounts of anxiety and stress,

Starting point is 01:03:37 and they're just overheated, and they have kind of like hyperthyroid-like symptoms. And then I think to myself, that is not how that herb was designed to be made. It was actually a stimulating herb in terms of what it can do to the body. There is some literature that it might have some impact on MAOA, which is, I'm sorry, MAOB, which is monoamino oxidase, which has to do with the metabolism of neurotransmitters and serotonin, et cetera, and epinephrine and the cycling and elimination of these neurotransmitters and serotonin, et cetera, and an epinephrine and the, uh, the cycling and elimination of these, these neurotransmitters. And that's the absolute wrong thing to do for this individual, but they're using it because they were told that rhodiola is good for stress.

Starting point is 01:04:17 Right. And, and that's, that's the problem. It's like, that's like me, look, I lift, I train and you've seen, we've hung out in person like i i'm not like this skinny guy who like says he goes works out and does curls on the squat rack right like you would you would disown me yeah yeah yeah for elf you would just you would disown me if i did that for you right okay so i'm totally vouching for your fitness. Yeah. So, but I am not the one to tell you, yeah, man, you really have to be doing like this amount of reps, this amount of sets, you have to be, you know, doing, you know, uh, set a with set B. I'm not going to be doing that for you because I don't have the formal training to tell you what is the best program to get you to

Starting point is 01:05:00 get six pack abs or whatever it is. I can tell you that type of exercise you need to be doing to improve your health and your longevity like that. I can tell you, but nobody knows their lane. And in the field of naturopathic medicine and functional medicine, there's so many people that call themselves functional or integrative or holistic, but what the hell does that mean?

Starting point is 01:05:22 Like, why are you that? Like, how do you know that this person is qualified to do that? And for better yet, how do you know that I'm qualified to do that? I don't know. Like for all, you know, I could just be the schmuck who read a few books and said that he knows men's health. Right. But when you look back at it and, and obviously you and I've had conversations and hopefully you would vouch for me too, but I've done the research. I've written books. I've written in the literature. I've taught. I've done my internship at centers that actually work in the conventional and the integrative setting. And that's what you really have to look for and say, okay, this person's saying that cordyceps is good or bad for this. Well, how do I know that to be true?

Starting point is 01:06:06 What does the literature say? And are these two things consistent? So I guess that's a long way of saying you just have to, the right person, you need to find the right person to guide you because these things are not like medications that you could just take and have one indication and say, okay, it's supposed to do this. And that's what happens. Right. So I mean, I guess, again, ultimately, it's like do your research, do the due diligence to maybe visit with some naturopathic doctors, like have some conversations, do some research on the different types of supplements that maybe might work for you and bring that to

Starting point is 01:06:43 your doctor and bring that up and have that conversation. I think it's just, it can be daunting to people because this isn't, again, it isn't like, yeah, just somebody prescribes you a white pill and you take it, you feel better immediately and you take it for the rest of your life. There's a lot more of experimenting and sort of work on your end. But I think that if you're willing to do that, you're going to get some really positive results and some benefit and the benefit of being able to kind of take control of your your health and do these things without serious medical intervention, hopefully. It just yeah, it takes a little bit more work. I mean, but you see that too, in in the fitness industry as well, right? It takes time.

Starting point is 01:07:25 It takes time to build up the body. Don't expect a quick fix. And if you want a quick fix, then great, go for it. But I mean, you've probably seen this too. How many times have I seen guys who are on testosterone getting it from Joe Schmo at the gym and then come through like, yeah, well, I can't get an erection and my thyroid's all messed up. And I'm like, oh, well, you know, I can't get an erection and my thyroid's all messed up.

Starting point is 01:07:45 And I'm like, oh, well, you know, you're listening to an expert. Yeah, don't get your drugs from the locker room next time. Exactly. Good advice. That's the only thing people take from this call. Don't get drugs from the locker room. Do you have any kind of like across the board recommendations for people who are interested in adaptogens in general are interested in herbal supplements for hormonal health, either men or women? Do you have any kind of like across the board recommendations,

Starting point is 01:08:18 either like places online to go or like next steps for them to start even researching these things if they're just kind of interested in learning more about it? Oh, man. I kind of, I have a difficult time recommending just because I don't find any one resource to be the end all be all. And then, you know, PubMed is really hard to navigate. It is for the lay person. I would say that, you know, uh, examine.com is actually a pretty legit site. Um, and I would say that any site that you go to, if they don't cite, uh, or put a reference for anything that they're using. And if that doesn't go to pub med or any other like book or something like that, then I would be very skeptical of it. So if it goes to, if they link, like if Dr. Anthony is saying, yeah, well, you should be taking this herb and he's linking

Starting point is 01:09:14 a site to like Dr. Hyman and then Dr. Hyman's linking it to this guy, it's like, okay, I have to really find the primary research. But examine.com is really good. I think there's another one called Natural Database, something along that line. They just changed their name. I can't remember what they changed it to. Those would be the two major things. And then, unfortunately, you just have to find good people

Starting point is 01:09:41 that you trust online that really are there to give you good. Dr. Chris Kresser. I think Chris Kresser puts out some good information. Hyman also puts out good information. Other people who I know on like social media who really put out good stuff like Dr. Lyon puts out great stuff. Dr. Kerry Jones puts out great stuff. Really have to research every single thing that you do. Oh, Ben. Um, uh, I can't pronounce his, his, his last name. Uh, I F B B Ben.

Starting point is 01:10:13 Ben Pekulski. Pekulski. There it is. Oh, that's a great name drop. He's a good pal of mine. Fellow, uh, buff Canadian. Oh, right. He was Canadian. I forgot him I'm an Islander fan. So when John Tavares left the New York Islanders to go to Toronto, I basically cried in his arms. You just have to come to Toronto and hang out. It's a fun place. Oh, man, maybe. Yeah, we'll get you there. I mean, and I think so what you're saying too, is, you know, follow smart people online, pay attention, reach out to you on Instagram and ask you questions about ashwagandha at all hours of the evening yeah like if it's three o'clock in the morning that's the prime time to message me to talk to you about problematic erections yeah yeah tell me tell me about all of the erections that's what you signed up for ralph no i kid you

Starting point is 01:11:02 not i'm getting emails from I get I get messages like, please pay attention to this message. It is very, very important. Me and my girlfriend have been having I'm like, I don't you're a hero, Ralph. You're a hero for all of us for doing that. Listen, we got to let you go again. I know you've got some stuff to do today. But I am so glad that we were able to connect again. I think this was really helpful. It's a question that I think the idea of what adrenal fatigue is is something that people kind of dance around a lot. And I think that there's a lot of personal defensiveness when people read like, well, it's not actually a thing because as you were very quick to say, it doesn't mean that what you're experiencing isn't real.

Starting point is 01:11:41 It doesn't mean that you aren't going through something. It's just a question of getting the right information out to people so that they can move forward with knowledge and understanding. So I appreciate you as always for helping us do that. Yeah, I think I just want to leave it with one thing is I want people to realize that the information that we're trying to give people, I haven't tried to sell anybody one single thing, right? Like I'm not even trying to sell you a program or become a, I don't want you to be a patient. And I, and I make that very clear. I want people, and that's why I really like coming on your podcast. And what we can do is because we can actually talk about things without any type of incentive or motive and find people who are there to educate you for the sake of educating you, not for the sake of,

Starting point is 01:12:35 I want you to buy into X, Y, and Z. And that's what I really like about what you do. I like, you know, the circle that we're kind of in is just really genuine people. It's hard to find on social media, but I think that's what you have to really pay attention to. And it's hard to screen for, but if you ask me, and I'm sure people can ask you like, hey, do you think this person's good or this person gets good information? Or what do you think of them? And I'll be honest with you. I'll be like, yeah, that person's a quack.

Starting point is 01:13:01 Or people think I'm a quack too. Cool. But that's the thing, like ask other people like, Hey, what do you think about this person? Are they good? Are they legit? Are they not? And that's, that's how you have to navigate the area. Absolutely. I think there's a lot to be said for personal experience and word of mouth and grassroots information sharing. So I agree with you. I think we just need to you need to find your group of nerds who are as interested in learning and sharing as you are and then that's that's how it all gets started so thanks for thanks for being in my nerd group ralph hey um nerding away i mean we could just say hashtag nerd group what was the other hashtag jack tan and jack jack jack and tan

Starting point is 01:13:44 and nerdy i don't know it's getting long but we'll work on it. Yeah. It's going to blow up. It's going to go viral. All right, Ralph. Thank you for your time as always. Oh, super fun. Thanks so much. All right. Thanks everybody for listening. I hope this encourages you to maybe incorporate some more sleep and recovery, maybe a little less perfectionism in your quest to get jacked and tanned. If you have any more questions about this topic or you want me to chat about anything else with Ralph the Hormone Whisperer, reach out to me on Instagram at The Muscle Maven and just let me know what you're thinking because I'm always willing to chat and discuss ideas. And please share this episode if you enjoyed it. Everyone knows that podcasters are like Santa Claus. We

Starting point is 01:14:25 need to know that you believe in us or we disappear. So do me a solid. Please share the love. Leave a review on iTunes. Share it with someone you think could benefit. That's what this is for. Okay, so that's it. Thank you again to beekeepers for keeping me healthy and smart and chill with all of your awesome products. I've got some hemp honey on deck for my nighttime snack. So you do yourself a favor, buy yourself some treats at beekeepersnaturals.com. Use the code MUSCLEMAVEN for 15% off and try it for yourself.

Starting point is 01:14:56 All right, that's it. Until next week, have a great day.

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Barbell Shrugged - You Don’t Have Adrenal Fatigue. So What’s Really Going On? — Muscle Maven Radio Episode #24

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