July 12, 2017 at 11:09 am #1027Helen HallidayParticipant
Any thoughts or guidance on this client would be most appreciated:
-Health history: 5 years of high stress and stress events, (divorce, single mum with busy full time executive job) no history illnesses or conditions as a child or young adult
-Her symptoms have developed over the past 2 years: weight gain, fatty liver, high cholesterol, periods stopped 1 year ago, some mild night sweats, irritability, inability to sleep, can not sleep until 1-2am and wakes at 5am, exhausted all day, craving carbs (for energy), has constant colds all year round, bloats when eats foods containing gluten, has little appetite and can only eat very small meals
-Health goals: to improve her energy levels and lose weight
-Testing: A cortisol test unsurprisingly revealed high cortisol on waking (but not out of the ref range), and elevated out of the ref range 4-5 hours after waking and prior to sleep. Thyroid came back all OK.
-What I have done so far: I started by focusing on achieving a balanced diet (good, carbs, protein, fat) and balancing blood sugar then incorporated intermittent fasting (12 hours overnight, 3 good meals a day) and then reduced grains which she has followed very well now for 3 months. She tends to get headaches with supplements so I limited supplements to BioNutri Neurolactin Plus to aid her sleep and a vitamin C reship complex for her cold. She reports that her sleep has improved slightly and she is now sleeping 5 hours instead of 3 and that her colds appear better. However, I know I am not dealing with the root cause and despite the diet changes she has not lost any weight at all.
She is open to further testing and trying different supplements and I am considering some strong support for her adrenals but am not sure what may be best. I am also considering a GI test.
I welcome any thoughts and advice
Posted by Helen Halliday on 07.12.17
March 6, 2019 at 11:11 am #1028Christine BaileyModerator
Many thanks for your question about your client with high cortisol around lunchtime and in the evening before bedtime. You mentioned that she is finding it hard to lose weight and also suffers with high cholesterol and fatty liver.
Her stressful lifestyle may be impacting her inability to lose weight in several ways. Clearly, lack of quality sleep will also not be helping. This may mean poor selection of food through the day, eating excess carbohydrates and sugary foods to keep her energy up through the day, erratic eating patterns, reliance of convenience foods as an example. More specifically however is the impact that cortisol can have on blood sugar balance and insulin resistance. Therefore, it may be the case that attention needs to be focused on improving insulin sensitivity and reducing carbohydrates. You may wish to check blood glucose and insulin levels with blood testing as well. As she has fatty liver you may need to look at overall fructose intake and alcohol which can contribute to fatty liver, quite apart from a high carb intake. Vitamin E can be helpful for this condition as well. Olive oil, omega 3 fats and walnuts have been shown to be helpful.
Gupta et al. Oily fish, coffee and walnuts: Dietary treatment for nonalcoholic fatty liver disease. World J Gastroenterol. 2015 Oct 7; 21(37): 10621–10635. https://tinyurl.com/yatqjtbb
Sato et al. Vitamin E has a beneficial effect on nonalcoholic fatty liver disease: a meta-analysis of randomized controlled trials. Nutrition. 2015 Jul-Aug;31(7-8):923-30. https://tinyurl.com/y8gwan86
Antony has very recently presented a webinar dedicated to the subject of fatty liver, and you will learn more about NAFLD and NASH by accessing that webinar, which was recorded. It is not available for very long, however.
You also mention that she bloats with gluten – therefore, if she is still eating gluten you may wish to run the Cyrex array or alternatively ask her to eliminate it completely from her diet. Her bloating could of course indicate that she may have bacterial dysbiosis so a comprehensive stool test may be appropriate.
Stress can suppress the immune system which may be one of the reasons why your client is regularly suffering with colds. Secretary IgA when suppressed can lead to more respiratory illness and may mean your client is more prone to picking up gut infections as well. Chronic stress can also lead to immune dysregulation and inflammation. You may also wish to consider whether there is a detox need for this client.
Block, et al. Psychosocial Stress and Change in Weight Among US Adults. Am J Epidemiol. 2009 Jul 15; 170(2): 181–192. https://tinyurl.com/y9qhnkqe
You mentioned that you have checked thyroid which seems within range. I would check reverse T3 as well as in some cases this can be elevated in periods of stress and longer term this can result in hypothyroid symptoms.
Dietary-wise in addition to cutting the carbohydrates I would increase the protein and low carb vegetables in her meals to see if this is helpful. Depending on her weight she may need 20-40g protein per meal. This has been shown to boost metabolism by 80 to 100 calories per day. High protein diets can also reduce obsessive thoughts about food by 60%, reduce desire for late-night snacking by half, and make you so full that you automatically eat fewer calories per day. If needed, consider a protein powder as an additional supplement to her meals.
Veldhorst, et al. Gluconeogenesis and energy expenditure after a high-protein, carbohydrate-free diet. Am J Clin Nutr. 2009 Sep;90(3):519-26. doi: 10.3945/ajcn.2009.27834. Epub 2009 Jul 29. https://tinyurl.com/khbhxr3
Leidy, et al. The effects of consuming frequent, higher protein meals on appetite and satiety during weight loss in overweight/obese men. Obesity (Silver Spring). 2011 Apr;19(4):818-24. doi: 10.1038/oby.2010.203. Epub 2010 Sep 16. https://tinyurl.com/y96qe7y8
While you don’t need to exercise to lose weight it can be helpful but importantly for your client to help her de-stress – this does not have to mean going to the gym – it could be walking for example.
To lower cortisol I would consider Phos Serine and Stabilium 200 which can help your client have more resilience to cope better – and these are detailed in the suggested supplements below.
The following supplements are suggested for you to consider in light of your relevant expertise and intimate understanding of the needs of your client or patient. They may be used in isolation or as part of a multi supplement strategy, but at all times the consideration of their use should be tied into the specific needs of the individual you are responsible for.
Fatty Liver support
Tocotrienols with vitamin E (ARG) – take 2 daily – https://tinyurl.com/y7gzchtc
Tocomin SupraBio Tocotrienols (ARG) – take 1 with breakfast & dinner – http://tinyurl.com/jv9pntj
EFA-Sirt Supreme (BRC) – take 1-2 three times daily – http://tinyurl.com/h3czc9x
Whey Concentrate (BRC) – take 1-2 servings daily or as needed – https://tinyurl.com/hslmdzg
Blood sugar balance
Bio-D-Mulsion Forte (BRC) – take 1-2 drops daily – https://tinyurl.com/yd762x74
GlucoBalance (BRC) – take 2 with each meal – https://tinyurl.com/jfhvyum
Glucofit (ARG) – take 1 before each meal – http://tinyurl.com/gwwkcnk
ALA Release (ARG) – take 1 daily – https://tinyurl.com/hp72kvl
Stabilium 200 (ARG) – take 4 in the morning – https://tinyurl.com/hhz7228
Phos Serine Complex (ARG) – take 1 mid afternoon and 1 before bedtime – http://tinyurl.com/h8fjvuv
I hope this helps with your client
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