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Metabolic Therapy Overview


Why Don't I Feel Well?

Are you often tired or worn down? Do you have trouble sleeping? Do you have problems with your weight? Do you feel as though you’re cold all the time, and can’t warm up? Do you have dry skin? Do you sometimes have difficulty remembering things? If the answer is 'yes' to any of the above and you’re thinking it’s just something you have to live with, think again. While all of the above seem like nothing more than day-to-day annoyances, in reality all are symptoms of low metabolic energy. The best way to eliminate these symptoms – and restore metabolic energy – is to correct the underlying problem. What causes low metabolic energy? The most common cause is poor thyroid and/or adrenal function. Another very common cause is hormonal imbalance – especially low progesterone or estrogen dominance in women or low testosterone in men. Restoring metabolic energy helps the body help itself, letting the self repair mechanisms function well again and restore health.

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Symptoms of Low Metabolic Energy

Although many of the symptoms below seem unrelated, they may all stem from the same root problem of low metabolic energy.

General Low body temperature. Coldness. Low Energy or Fatigue. Weight problems (can't lose or gain it). Slow healing .
Brain Depression. Anxiety. Poor memory, focus, or concentration. Sleep disorders.
Immune system Under-Reactive or Over-Reactive: Frequent infections (skin, sinus, bladder, bowel, yeast problems, etc.). Allergies. Auto-immune disease.
Musculoskeletal Fatigue. Fibromyalgia (muscle or joint pains). Generalized aches/pains. Repetitive use injury and carpal tunnel syndrome. Weak connective tissues (ligaments, bones, etc). Headaches.
Sexual Loss of Libido and function. Menstrual disorders. Infertility.
Vascular Low blood pressure. High blood pressure. Raynaud’s disease.
Bowels Constipation. Gas or bloating. Digestive disorders, Irritable Bowel Syndrome (IBS)
Nervous system Numbness of hands and/or feet (usually symmetrical). Dulling or loss of senses such as vision, taste or smell.
Skin Dry. Acne. Pallor in light skin, darkening or dark patches in dark skin.
Hair Hair loss, brittle, coarse, dry or oily.

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What Causes Low Metabolic Energy?

Every process that goes on inside our bodies requires energy – specifically, metabolic energy. When the body doesn’t have enough energy to function properly, each component of the body will malfunction in its own unique way. For example, if the brain has too little energy, thought processes such as memory and focus become impaired. The body needs energy to keep itself warm – a low body temperature, therefore, usually accompanies low metabolic energy. (For more examples see the above symptoms list.) In our cells, ready to use energy is in the form of ATP (adenosine triphosphate) molecules. The body converts fats, sugars, etc. into ATP that is then used for energy. However, there are other factors involved that can affect how well our body can make this conversion from those fats and sugars into the ATP molecules. The thyroid gland, located at the base of the neck, makes the hormone T4 (thyroxine). T4 converts to T3 (triiodothyronine) and RT3 (reverse T3). The T3 turns on the ATP (energy) making machinery inside each living cell while the RT3 slows it down. Production of these thyroid hormones is controlled by TSH (Thyroid Stimulating Hormone), which is released by the pituitary gland in the brain. The pituitary takes its orders from the hypothalamus (also part of the brain). The adrenal glands, located on top of each kidney, help the body deal with stress. If the metabolic activity is excessive, the adrenals perceive this as a stress. In response to this stress, the hypothalamus will signal the pituitary to produce less TSH, thus producing decreased T4 and thyroid activity. Based on the above explanation, some of the contributors to low metabolic energy are:

  • The thyroid gland can not make enough T4 (hypothyroidism).
  • The adrenal glands are too weak to handle the stress of the body’s normal metabolic energy and force a down-regulation of energy production.
  • The enzymes (cellular machinery) which make ATP may be held back due to chemical interference such as toxins, lack of needed ingredients (vitamins or minerals), or breakdown due to auto-immune disease or old viral damage.
  • Hormonal imbalance such as growth hormone, testosterone, estrogen, or progesterone.
  • Severe caloric restriction.

As discussed earlier, when one or a combination of these factors is in place the symptoms of low metabolic energy – such as fatigue, weight issues, memory loss, cold hands, dry skin – may start to appear.

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Diagnosing Metabolic Energy Problems

To restore energy to a healthy level, the causative problem(s) must be corrected. Toxic exposure, nutritional deficiencies, food allergies (e.g., to wheat), viral, and auto-immune damage are all, to some degree, universal. If severe enough, any one of these (or a combination of several lesser ones) can overwhelm the body’s metabolic mechanisms and become the cause of the problem. However, these are not as common as the low metabolism caused by adrenal and/or thyroid dysfunction. The corrections described below relate to the most common causes we see, namely sub-optimal adrenal and/or thyroid function.

Before reading on, I wish to point out an observation I’ve made regarding the relationship of the thyroid to the adrenals. They seem to have an inverse relationship. How we appear (physically, emotionally, chemically etc. seems to be a function of how the thyroid and adrenals relate to each other. A low adrenal function can appear like an excessively high thyroid function (e.g., both may be thin, nervous, have palpitations, be pale, have unstable temperatures etc). A low thyroid function may appear as high adrenal function (e.g., both may appear heavier than expected, have a reddish facial complexion, have stable temperatures, be or appear calm etc).

If poor thyroid function is the only cause, we typically see a reddish complexion, thinning of the outer eyebrows, easy weight gain, depression, sluggishness, excessive sleep, high blood pressure, and a decreased ability to fight infection. Conversely, if poor adrenal function is the only cause, we typically see pallor, full eyebrows, difficulty gaining weight (if the problem is severe), difficulty losing weight (if the problem is moderate), anxiety, exaggerated startle reflex, insomnia and un-refreshing sleep, low blood pressure, allergies and auto-immune problems. Most people have a mixture of poor thyroid and poor adrenal function rather than purely one or the other, and therefore a mixture of symptoms. Within my practice I have developed several tools that assist in diagnosing the causative problem and facilitate treatment. They are very useful feedback tools for proper diagnosis and treatment of low metabolic energy.

  • Metabolic Scorecard™: A method for looking at symptoms to provide guidance on whether there are adrenal, thyroid, or a mixture of problems.
  • Metabolic Temperature Graph™: A method for measuring and interpreting daily temperatures to gain insight into metabolic energy issues associated with both adrenal and thyroid function.
  • Thyroid Scale™: A method of evaluating thyroid lab data (TSH, Free T4, and Free T3) relating them to optimal values as well as each other. This provides a clearer picture of what is going on as opposed to the old, 'your lab values are all normal', answer.
  • Estrogen Dominance Questionnaire: A method of looking at symptoms to determine if an estrogen / progesterone imbalance might be causing metabolic problems.

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Treatment for Low Metabolic Energy

Where to start: Adrenal vs. Thyroid?

If both the thyroid and the adrenals are weak, adrenal repair must precede thyroid repair (see Metabolic Scorecard™ to determine whether problem is adrenal, thyroid, or both). If the adrenals are weak, then even normal thyroid activity places an excessive burden on them. One may begin to feel ‘hypoadrenal’ (coldness, weight loss, dryness, fatigue, insomnia, and/or anxiety) and then the body innately turns down its own thyroid energy production by increasing production of RT3. Conversely, if the adrenals are strong and the thyroid is weak or unable to keep up with the adrenals, one begins to feel ‘hypothyroid’ (heat intolerance, weight gain and fluid retention, tiredness, excessive need to sleep and/or depression). A very common error made by medical practitioners is to focus entirely on the thyroid and ignore the adrenals In a weakened adrenal state, prescribing thyroid medication that contains T4 and/or T3 may produce limited or transient improvement. Subsequent increases of the dose offer little or no benefit as the medication pushes the energy machinery into overdrive. Unfortunately, this higher energy level is unsustainable due to the stress on the adrenals. Eventually the adrenals become fatigued and the symptoms of low energy return. If, however, the adrenals are functioning well, the thyroid hormones can do their job and the result is good metabolic energy. Another way of looking at this thyroid/adrenal relationship is to think of the thyroid as ‘generating’ the energy while the adrenals need to be able to ‘handle’ the energy. If the thyroid generated energy is excessive for the adrenals’ ability to handle it, the body will down-regulate the thyroid energy as much as it is capable of doing to accommodate what the adrenals can safely handle. Sometimes, in an effort to help the patient feel better, the physician keeps increasing the thyroid dose or even gives a T4/T3 combination like Armour Thyroid or just a T3 support like Cytomel. The problem with this is that it forces the system to function at a higher energy than the adrenals can handle. Initially the adrenals have enough reserve to handle the higher thyroid energy so the patient feels better. When the (adrenal) reserves are exhausted (this can happen in a few days, weeks or months) the patient can develop fatigue, anxiety, bursts of rapid heart beat or the feeling of such bursts (palpitations) or other symptoms of either high thyroid function or of low adrenal function (see the Metabolic Scorecard™). This is the ‘crash and burn’ phase of the thyroid treatment which ignores the adrenals’ capacity to handle the thyroid support. It is often followed by a recommendation for an anti-anxiety or anti-depressant drug.

Adrenal Repair Basics

In general, stress hurts the adrenals. We can define stress as anything which challenges our survival, joy, prosperity, security or stability. It is anything which forces our system to adapt (e.g., change of circumstances, temperature, chemistry as in a sudden change of supplements, medication or even change of diet). Infection, lack of sleep or even lack of love are stressors. The opposite of stress such as joy, sleep and rest, comfort, peace, security, stability, and good nutrition, are examples of things that help the adrenals. Avoid the stressors and seek out those things that help. Eat more proteins (especially amino acids) and fats (not vegetable oils). Limit carbohydrates, especially sugars. Avoid stimulants and physiologically stressful substances such as caffeine, diet pills, alcohol, cigarettes, etc. If you have allergies, avoid the allergens – common allergens are wheat and dairy. Although this may sound surprising, we actually tend to crave foods to which we are allergic. Metabolic activity (the chemical processes and changes going on in our body) represent a stress. At a level that can be handled by the adrenals, this stress is good for us (Eustress) and maintains life. If metabolic activity is too strong for the adrenals (e.g., excessive thyroid stimulation), it is at a level that is unhealthy (Distress) and wears the adrenals down.

Mold is a common serious stress but difficult to avoid. Reduce as much stress as possible. Even ‘good stress’, such as celebration, can sometimes be excessive for the adrenals. Look for opportunities to experience security, joy and optimism. Learn to avoid negative emotions such as fear (e.g. horror movies), anger, etc. Increase rest – get as much sleep as possible and make the timing as regular as possible. Pushing too hard, excessive work or exercise, and any sleep deprivation stresses the adrenals.

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Considering a Supplement?

Adrenal Support

Providing the body with proper support in the form of vitamin supplements is critical to repair. The minimal nutritional requirements for healthier adrenals are:

  • A healthy whole food diet which is organic, contains an adequate amount of protein and healthy fat (oil is liquid in room temperature while fat is solid in room temperature), adequate fat soluble vitamins, and without anything you are allergic to (e.g., wheat, dairy, or other specific foods you might be allergic to). Sometimes eating right for your blood type becomes the key factor.
  • B-Complex Vitamins: A very complete B-complex with lots of Vitamin B-5.
  • Vitamin Cand Antioxidants: The buffered powder form of Vitamin C is often most easily tolerated as part of a drink sipped throughout the day. It is important to take bioflavonoids with Vitamin C as these help recycle and sustain the antioxidant activity.
  • Amino Acids: Individuals with weak adrenals often cannot digest meat or proteins into amino acids very well. The adrenals thrive on amino acids. As with the Vitamin C, amino acids are best taken as part of a drink sipped throughout the day.
  • Healthy Fats: Animal fat is the best source of healthy fat but they need to be organic. If dairy or meat, the animal should, if possible, be grass fed if cow or sheep. Eggs are also healthy. Free range hens are the best source.
  • Unrefined Sea Salt: This helps the adrenals by raising a low blood pressure and assisting the body in retaining water. Plain table salt (sodium chloride) does not contain the same minerals and some people feel poorly with it.

View Dr. Rind's Adrenal Recommendation Sheet for more details and a more comprehensive treatment program Dove Health Products offers a product called Basic Cell Energy designed specifically to support the adrenal healing process. Basic Cell Energy is a very complete B complex/multivitamin supplement with the purpose of providing support for adrenal function and repair as well as general support for metabolism and energy production. To visit the Dove Health Products supplement store, click here.

Restoring Thyroid Function

For mildly poor thyroid function, one can often get the needed support with supplements such as L-Tyrosine and iodine (e.g. Prolamine Iodine) or a thyroid supporting glandular supplement (e.g. T-100). Supplements containing mixtures of thyroid nutrients are also available. Some thyroid glandular may offer more complete support.

If the thyroid condition is more severe, one may require prescription medication. Giving only T4 (e.g. Levothyroxine, Synthroid, Unithroid, Levoxyl etc) is a good choice if T4 is the only missing component. In individuals with poor conversion of T4 to T3, a desiccated thyroid preparation (e.g. Armour Thyroid Rx) often works best because it contains the needed T3 as well. Breaking up the dose into two or three doses daily provides a more stable blood level of T3 and generally produces better results. Taking the daily dose all at once in the morning tends to be stressful on the adrenals and often leaves one feeling depleted by afternoon. Evidence of this can be seen when taking daily temperatures. The adrenal stress shows up as increased temperature volatility.

Note that if the adrenals are too weak to handle the desiccated thyroid (Rx) then we often see an initial response of better energy and fewer symptoms followed by a later ‘crash’ in which energy can drop to even lower levels than before the desiccated thyroid support. Additionally, other symptoms of adrenal stress such as anxiety, insomnia, and palpitations (racing heart) can then occur. The same can be seen with fast release T3 (e.g. Cytomel) or with slow release T3.

Estrogen Dominance Support (for women)

Estrogen is generally a stimulant and presents as anxiety, agitation, muscle tension, increased cell division in female organs (e.g., uterine fibroids, breast cysts etc.) Conversely, progesterone has a calming effect such as sedation, slowed cell division etc. An imbalance which favors a predominance of the estrogenic effect (either excessive estrogen or insufficient progesterone) is called estrogen dominance. In the section on Estrogen Dominance you will learn why this is important and what you can do to correct it.

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Metabolic Therapy™ Healing

As you can see, low metabolic energy can appear as any of numerous symptoms. The best way to eliminate the symptoms is to correct the underlying problem – in most cases, poor thyroid and adrenal function. Once you’ve made the choice to correct the problem, some general principles of treatment apply:

  • If the treatment is working, one should feel improvement as time goes on. Healing crises rarely occur with thyroid and adrenal repair. They tend to occur more often with detoxification or elimination of a biological agent.
  • Successful treatment is achieved more easily through the use of feedback based on changing signs, symptoms, temperature patterns and lab values.
  • When taking supplements, especially for those who are highly sensitive or have allergies, the old nursing adage of ‘start low, go slow’ is very important to remember when restoring adrenal and thyroid function.

It is the adrenal component that is least understood or appreciated. Yet, as you can see from this article both thyroid and adrenal function can be enhanced using supplement support and lifestyle changes. And, as a result, supplement support and lifestyle changes can help you start living a normal, 'symptom' free life.

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