Vitality 101

Jacob A. Teitelbaum, M.D

Jacob A. Teitelbaum, M.D. is a best-selling author, researcher and world-renowned medical expert on Chronic Fatigue Syndrome and Fibromyalgia (CFS/FM). Dr. Teitelbaum is a board-certified internist and director of the Annapolis Research Center for Effective CFS/Fibromyalgia Therapies. Having suffered with and overcome these illnesses in 1975, he spent the next twenty-five years creating, researching, and teaching about effective therapies. He treats patients from all over the world in his office in Annapolis, Maryland and lectures internationally. Dr. Teitelbaum is the author of the best-selling book From Fatigued to Fantastic! (Penguin Putnam Publishers), completely revised and updated August 2001. He is also author of the newly release book Three Steps to Happiness (Deva Press) His groundbreaking study entitled "Effective Treatment of Chronic Fatigue Syndrome and Fibromyalgia - A Randomized Double-Blind, Placebo - Controlled Study" was published in The Journal Of Chronic Fatigue Syndrome in August 2001. More and more Americans are feeling overworked, overtired, and overcome by life’s demands. We just do not have the energy we need to meet our responsibilities to the people we care about. More importantly, we don’t even have the energy to have fun! It seems that a constant feeling of fatigue has become part of the American way of life. Research has shown that the same processes that cause lack of energy can rob us of sleep, saddle us with excess weight, disrupt our hormonal balance, and create significant amounts of stress in our daily lives.1 Chronic stress can dramatically contribute to fatigue, sleep disorders, irritability, and anxiety.2 This research simply confirms what most of us already know - uncomfortable stress can really wear us out mentally and physically! It can take away the satisfaction of a job well done. It can take away our ability to believe in ourselves. And, sadly and maybe most importantly, continual stress can take the fun and joy out of life.2 In a separate issue of Ask the Doctor, we discussed the energy and sleeping needs of people suffering from chronic fatigue syndrome and fibromyalgia. In this issue, I discuss the 3-step process I call "Vitality 101." People do not have to accept pain, insomnia, or fatigue. It's time for everyone to feel great and have a life they love! Step 1 - Nutrition Good overall nutrition is important for everyone! As a foundation product to support energy levels, a powdered drink mix is a pleasant, easy way to ensure that you are taking all of the needed vitamins, minerals, and amino acids that you need to have great energy all through your day. In addition to the powdered energy drink mix, it is important that you also take a high potency vitamin B-complex supplement. This should include niacinamide, thiamin, riboflavin, vitamin B6, vitamin B12, pantothenic acid, and choline, which are especially important to restore the energy production needs of your body. It is also critical to get enough water, as most Americans are chronically dehydrated. Step 2 – Rest Your Body Having trouble sleeping is one of the most troubling symptoms of stress. While the stress is wearing us down and making us tired, it’s also keeping us tense and unable to relax. The result? That easy drift into sleep becomes harder and harder. And if we are lucky enough to actually get some shut-eye, stress will often wake us up, sometimes several times a night.3 This occurs because excess stress suppresses the sleep center in the brain.4,5 It is important to break the "stress/insomnia cycle" early, before it results in pain and hormonal and immune dysfunction! Because good quality sleep is how the body repairs and re-energizes itself, it may be helpful to use herbal products to promote good quality sleep. There are many natural supplements that are marketed as sleep formulas. To get the best results, it is very important that the right ingredients are in the sleep formula you buy. Look for a supplement that has a blend of herbs that promote deep sleep, such as valarian, L-theanine, hops, passionflower, Jamaica dogwood and wild lettuce. This combination of herbs is important as each herb addresses a different aspect of sleeplessness and muscle tension caused by stress. Taking only one or two of these herbs alone is much less likely to be effective. Step 3 – Manage Excess Stress Levels In this fast paced world, it is important to learn to manage the stressors in our lives. Glandular extracts, such as raw adrenal extract, can offer natural support to help our bodies deal with the effects of stress and, in turn, can boost your energy levels. Exercise is another stress buster. Using your body physically is important for good health. Find something that is fun for you, however, or you are unlikely to stick with it! Q. It will be great to get a good night’s sleep. Are there also any other natural alter- natives that could help promote relaxation and increase my energy levels during the day? A. Yes, there are. Rhodiola rosea is an all- natural herb that has long been used to help relieve stress and increase energy. Rhodiola has also been used to lift our moods, improve sexual satisfaction, and even help in certain nervous system disorders.23 First used in Siberia and Russia, Rhodiola is now being extensively studied and has been found to increase resistance to toxins (both physical and chemical), balance the work of the body, help memory storage and mental functioning, and improve resistance to physical and emotional stress.23,24 In clinical trials, the most effective Rhodiola rosea extract was found to contain 3% rosavins and 1% salidroside. While there are many Rhodiola supplements in health food stores, only those containing these specific amounts can provide the best results.23,24 Herbal Ingredient Effect on Sleep Wild Lettuce Has been found to have sedative effects.6 Hops Acts as mild sedative and has a sleep inducing effect.7,8 Jamaica Dogwood Has been found to be mildly sedative and is often used for anxiousness.9 L-Theanine Causes significant increases of neurotransmitter concentrationsin the brain, which promotes muscle relaxation and improves sleep.10,11 Valerian This herb has been clinically studied for its ability to improve sleep quality.12-20 Passionflower This herb eases nervousness and insomnia.21,22 Q. Does stress zap my energy in any other ways besides making me lay awake at night and causing me to be a zombie the next morning? A. Most people are familiar with the body's dramatic response to an emergency. The heart pounds, the muscles constrict, and the lungs expand - and while this is happening, we are capable of greater than normal strength and speed. This response is the body's way of rescuing itself when faced with an emergency. We don't have to think about it to make it happen. It's automatic. The same can be said of a chronic stress response. Whether we're late for a business meeting because we're stuck in traffic, or worrying about how we are going to pay for our children's college tuition, our response to stress happens automatically. The difference between the two is that the body's response in an emergency starts and resolves itself quickly. The response to being stuck in traffic may not. The body makes the "stress hormone", cortisol, to handle the normal stresses of day-to-day living. But in an emergency situation, the adrenal glands, located above the kidneys, secrete increased amounts of this hormone until the emergency passes. Then the body returns to its normal function. Unfortunately, however, chronic stress is more complex. When our body is subjected to increased amounts of the hormone, cortisol, for an extended time, this can damage our health and deplete our energy. Studies have shown that increased cortisol production caused by long-term, chronic stress depletes our energy levels by creating havoc with our hormone balances and exhausting our adrenal glands.25-28 Q. How can I control the stress in my life and re-energize? A. Many people who are under constant stress may have adrenal burnout. Adrenal burnout occurs when the adrenal glands are constantly producing cortisol in response to chronic stress. Over time, this exhausts the adrenal reserve, meaning the adrenal gland can no longer increase cortisol production in response to stress.29 The good news is that changes in our hormone levels can return to normal when stress is decreased. The key is learning how to deal with daily stress to allow the body to return to its normal state. I discuss additional techniques for coping with stress in my recent book Three Steps to Happiness! Healing Through Joy (see my website, www.jacobteitelbaum.com, for more information). In addition to stress control, it is important to supplement your adrenals with a glandular therapy regimen to ensure healthy cortisol levels and adrenal function.29,31 Glandular therapy, which uses the concentrated forms of bovine (cow) or porcine (pig) glands, can improve the health of our glands. Pioneers in the field of endocrinology (the study of hormones) hypothesized that glandular extracts worked by providing nutrients the body lacked and thus repaired the malfunctioning gland.30 Adrenal Extract If you are one of the unlucky folks with stressed out adrenal glands, you should see great results from taking raw adrenal supplements. Be sure to buy adrenal extract supplement that contains both whole adrenal and cortex adrenal. The best adrenal supplement should also contain vitamin C, vitamin B6, and pantothenic acid. That's because the adrenal glands use these vitamins to manufacture cortisone and other compounds. It just makes sense to purchase an adrenal supplement with these adrenal-supportive nutrients. 31-39 Liver Extract Did your grandmother ever tell you to eat your liver so that you didn't get "tired blood"? Well, it turns out that she was right. Liver extract is another glandular extract that can help improve energy levels. Liver extract is an excellent source of highly bioavailable nutrients including iron, B vitamins (especially B12), and other minerals. The stamina and energy-enhancing benefits of liver are widely touted. Liver extract has been shown to support healthy function of the liver and increase the energy levels inside our body. 40-42 Because heat will destroy the key components in the liver, a high quality liver extract supplement should be cold-processed and encapsulated to enhance speed and absorption of nutrients from liver. A high quality aqueous liver extract supplement should also contain vitamin B12 to support healthy blood iron and oxygen levels to energize. Q. I know exercise can help alleviate stress, but I am too tired to exercise and I am getting fat! A. One of the most frustrating aspects of stress is the connection to weight gain. Fatigue leads to weight gain, which leads to more fatigue, which can cause more stress, which only causes more fatigue. One of the culprits responsible for this vicious cycle is the lack of sleep. This causes growth hormone deficiency which is one of the causes of the weight gain.43,44 Bitter orange is a nutritional supplement that can give you a boost of energy to break this cycle. It comes from the unripened dried fruit of a citrus fruit called Citrus aurantium.45,46 Bitter orange extract contains a natural alkaloid, synephrine,that is related to the ephedrine alkaloids.46-49 Similar, but not identical in structure to ephedrine, synephrine can suppress your appetite, boost your energy, and increase metabolism without serious negative side effects. Synephrine attaches (in a process known as "selective binding") only to the specific receptors in the body's cell which increase the rate of fat release from body stores and increases metabolism (thermogenesis). Other substances that may help with weight loss are non-specific binders, meaning they bind to many cell receptors in the body. This can lead to side effects such as elevated heart rate, elevated blood pressure, anxiousness, insomnia, and dry mouth.47,49,50 Because bitter orange binds only to specific receptors, it does not cause these adverse effects. It's important to look for a bitter orange supplement that also contains natural sources of caffeine, such as green tea and cola nut. Scientists have found that the energy boosting properties of bitter orange extract work better when combined with caffeine. Clinical studies have found that caffeine actually prevents the body from becoming resistant to the effects of synephrine. Caffeine combined with synephrine also helps stimulate other cellular receptors that are important to weight loss.48 Q. What other supplements can help boost my energy? A. Panax ginseng has been a part of Chinese medicine for over 2,000 years. It is traditionally used to support health and the immune system.51 There is a great deal of research on this herb showing it can help our cardiovascular system, our central nervous system, our overall hormone function, and help boost our fat metabolism.52,53 Panax ginseng extract has even been found to help athletic endurance.54 But make sure that the ginseng extract you buy is bound to phosphatidylcholine. Research has shown that when ginseng (as well as other herbs) are combined with phosphatidylcholine, they work faster and are absorbed better.55 Eleutherococcus extract is another herbal supplement that helps boost energy. This funny sounding extract, formerly known as Siberian ginseng, has been used to restore vigor, improve general health, restore memory, promote healthy appetite, and increase stamina. Eleutherococcus extract diminishes fatigue and boosts energy by increasing the weight of the adrenal glands and regulating levels of cortisol.56,57 Lifestyle Treatments Altered digestion, food intolerances, decreased energy, fatigue, cognitive problems, and sleeplessness create the need for changes in daily living routines. These can include alterations in diet; exercise modifications; alterations in activities of daily living according to one's energy level; and sleep/rest management. All may require the assistance of a professional clinician, such as a chiropractor, nutrition specialist, physical and/or occupational therapist, mental health professional, or sleep therapist.16 Conclusion Super busy lives demand super strength nutrition. Start with a powdered nutritional supplement and make sure you are getting at least 8 hours of sleep a night. Rhodiola rosea, glandular extracts, and ginseng can offer natural nutritional support in your busy life to boost your energy levels. These nutritional supplements can be used daily and you will feel energized to get through each day's challenges and opportunities! References 1. Stress. National Sleep Foundation Website. Available at: http://www.sleepfoundation.org/2002poll.html. Accessed on March 6, 2003. 2. Stress and Fatigue. Discovery Health Website. Available at: http://health.discovery.com/diseasesandcond/encyclopedia/3090.html. Accessed on January 29, 2003. 3. Sleep and Depression. National Sleep Foundation Website. Available at: http://www.sleepfoundation.org/ask/sleepanddepression.html. Accessed on July 30, 2002. 4. Miller DB, O'Callaghan JP. Neuroendocrine aspects of the response to stress. Metabolism 2002 June;51 (6 Suppl 1):5-10. 5. Rodenbeck A, Hajak G. Neuroendocrine dysregulation in primary insomnia. Rev Neurol (Paris) 2001 Nov;157(11 Pt 2):S57-61. 6. Lactucarium. In: Fleming T., ed. PDR® for Herbal Medicines. Montvale, NJ: Medical Economics Company; 1998: 453-4. 7. Hops. In: Blumenthal M., ed. 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