How To Treat Adrenal Fatigue – It’s Not What You Think!

Content By: Ari Whitten & Dr. Bryan Walsh

In this episode,  I am speaking with Dr. Bryan Walsh, a board-certified naturopathic doctor, an expert in biochemistry and physiology, and – in my opinion – one of the most brilliant minds in the whole natural health and functional medicine space. We’re talking about how to treat adrenal fatigue.  

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Ari Whitten: Hi everyone this is Ari and welcome back. I am here with Dr. Bryan Walsh who is an expert on the subject of adrenal fatigue and he has done a lot of work debunking a lot of myths in this area and helping with shedding light on what the true underlying factors are in adrenal fatigue.

I am a huge fan of his work. I have also purchased his course Metabolic Fitness Pro, which I am also a big fan of. He is a super smart guy and I am honored to be interviewing him.

I am excited to share him with you, so welcome Dr. Bryan Walsh.

Dr. Bryan Walsh: Thank you. It is a pleasure to be here.

Ari Whitten: Yeah, so can you just tell everybody a little bit about your background, what got you into this field and your origins?

Dr. Bryan Walsh: Yeah, I will try to keep it short when you ask that question and made me go back a little further. I started out, I have always been interested in the human body. I remember preteen actually asking my mom for money to order a nutrition book in the mail and would read this thing and she would drive me around – it was too early to even drive.

I have always been interested in nutrition and how the body works. I started out as a fitness professional, quite honestly, and then I added to that being a massage therapist. I was really interested in orthopedic work as it pertained to being a fitness professional.

What I found was a bunch of people – as it probably it happens with you – asking me about nutrition and supplements and all these things that were technically outside of my scope at the time. You know, I was a law-abiding citizen, and as a fitness professional and massage therapist out in California, I didn’t feel like I could. I knew a lot about nutrition, but I was I was a little afraid legally, and so I became a naturopathic physician. I went to a four-year school and it.

For those who don’t know, a naturopathic doctor or naturopathic physician is essentially a doctor of natural medicine. And it’s this huge umbrella we learned chiropractic adjustments, acupuncture, botanical medicine, nutrition courses, all the sciences too, of course. The first two years were mostly completely science. We learned drugs and, you know, how they are used in doses and diagnosis. Anyways, that was this huge umbrella for which everything fell underneath. We even learned physical therapy modalities and that was my calling because then I could talk to anybody about anything legally.

And since then, I think the short version is, integrative medicine and conventional medicine both do things very right and very wrong. And what I try to do, in this, in short, in summary, is bridge the best of both worlds.

What conventional medicine does really well, is science. We owe what we know about the human body and how it works to Western medicine. Honestly, in Western science.

On the other hand, conventional medicine sucks at finding, or even acknowledging, things like intestinal permeability, or that low cortisol is real and it’s not just Addison’s disease, or  Candida, or all these things that are very real. There are people suffering because of them, but they don’t look for them.

Integrative medicine, on the other hand, doesn’t really appreciate science as well as I think that they should. As a whole. They are great in considering food sensitivities, heavy metal toxicity, Candida, you know, all the things that I just mentioned. But they will overlook things like cancer, and they’ll do the fancy cool tests and not look for diabetes for example.

So, I try to combine the best of both. They both offer some amazing stuff, they both kind of suck at some things. I suck at a lot of things, honestly, but I try to bring the best of both, what they both offer because it’s not polar opposites. It’s not the yin and the yang, man, we are trying to achieve the same thing, just in different ways. And as much as I can, I try to bring those together.

What the old model of adrenal fatigue is

Ari Whitten: Nice. Really well explained, I like that, a lot. Let’s get into the meat of it, let’s talk about adrenal fatigue. I know, that this field has kind of undergone a lot of evolution of thought over the last decade or two.

Originally, James Wilson came out with this idea of adrenal fatigue and then you know we had Hans Selye’s kind of model of the alarm stage, and the exhaustion stage, and all that.

Can you talk a little bit about what the old model of adrenal fatigue is, and then maybe we’ll kind of segue into the new model.

Dr. Bryan Walsh: Yeah, I think you know Hans Selye was really the one who started it. And the work that he did – James Wilson was, I think that was probably the 80’s when he did he – so Hans Selye was much, much, much, much older.

Essentially, what he did was he coined, well he, I’ll tell you this, he brought forth the knowledge that we have about adrenal physiology, in ways that we just hadn’t known prior to his work, quite honestly.

What he did, was he created – based on his experiments with lab mice and lab rats he created – sort of this paradigm of the mammalian – because he wasn’t studying it on humans – stress response.

The way that he would sometimes stress them out was to have them swim until they couldn’t swim anymore or the variety of ways of stressing out mice apparently but he would stress them out.

What he would find is from baseline levels of cortisol, which was the primary hormone that he was interested in, that they would have this initial stress response and he called it the alarms phase.

Then if the stress continued, then the alarm phase would sort of come down and cortisol levels might come down and might be in back to the normal range, But then he would call that the resistance stage, where the body was still in a stressful situation and wasn’t responding the same way

Then if the stress continued cortisol may go quite low and then he called that the exhaustion phase, and that’s where they did not have the stress reserves that they did before,

Again, you know Hans Selye is still quoted so, so often especially in the alternative medicine space. And this whole paradigm then he talks about is it’s almost dogma and it’s great, we owe a great debt of gratitude for his work. quite honestly.

Why Hans Selye's definition of cortisol levels and adrenal function is ”profoundly wrong”

But there was a paper by the guy that wrote the ”White zebras don’t get ulcers” book, Sapolsky. The guy is brilliant. And that guy’s just he’s phenomenal. But he was he co-authored a recent paper and they expressly stated – and this has been stated otherwise places as well – that Hans Selye taught us what we know, or knew, about glucocorticoids, or cortisol, or adrenal function. But based on modern science and used the phrase ”He was profoundly wrong” in terms of the things. That is not uncommon for science to not prove anything new, but disprove what we previously believed. I joke around about it, but I’m still kind of devastated that Pluto is no longer a planet because, for years, that’s what I believed, that’s what I was taught, and all of a sudden said, up no we’re not it’s not a planet. I’m like how could you how could you take the planet label away from a planet. But that just proves that we know something, we believe something, and then we just disprove it. We don’t prove something new.

And so what basically all this stuff and in the dogma that Selye proposed or is used as dogma now, is still quite present as you know. And this whole a model of adrenal fatigue that when James Wilson said when if somebody has low cortisol – which I’ll go on record as saying is absolutely true people can have low cortisol it’s not an autoimmune condition, it’s not pathology per se, they feel horrible, it sucks, I mean they are often depressed – there are some interesting studies on low cortisol and depression and mood disorders -, PTSD they have increased pain sensitivity, they have hypoglycemic tendencies, they can’t sleep, when they do wake up they feel they just they can’t even hit the snooze button, they don’t feel rested, they don’t feel recovered. It sucks, it’s real, that’s real.

But the causes of it aren’t, and this whole concept of adrenal fatigue that is going around is saying, well your adrenal and less than optimal – I’ll just quickly say too, I learned adrenal fatigue. I talked to my patients about adrenal fatigue. I even probably created a couple videos online ten years ago about adrenal fatigue and I’m embarrassed by it. Because I was taught what I was, I was teaching what I was taught, which was wrong, I shouldn’t have done that.

Ari Whitten: Yeah, like me and a thousand other people.

Dr. Bryan Walsh: Well yeah, because you learn it. You’re like well that’s cool, it makes sense, let me talk about people and I would see low cortisol and I would say this is adrenal fatigue. And the concept is that your adrenal glands are tired, they’re worn out, they’re shriveled up and they can’t make cortisol anymore.

So, you can see low cortisol on somebody on a test and the explanation is ”oh you have been under stress for a very long time” and I would have patients be like; ”well I don’t feel stressed out at all” like ”well listen you are, you have to be, your test is telling me that not only are you stressed now, but this stress has been going on for a very long time because your adrenal glands are worn out.”

That’s the story of adrenal fatigue but and  I’m sure you have plenty of questions but one of the first questions is, why is there not fatigue of any other organ?

Why is there not so in type 1 diabetics and late-stage type 2 diabetics, the pancreas no longer makes insulin why is that not called pancreatic fatigue. Why is a testicular hypogonadism the testes don’t make testosterone anymore called testicular fatigue, or ovarian fatigue, or pituitary fatigue, authority or any? There’s no such thing anywhere in medicine, anywhere.

But yet, these adrenal glands are these poor scapegoats ”oh you’ve been, so they’re worn out, they’re tired you’ve been stressed for a long time” and the thing is the science proves that no, that’s wrong. That Selye’s model was is incorrect, that he used the phrase ”profoundly wrong” when suppose, he wrote that article and the science says otherwise, but yet we still perpetuate this thing.

I can’t tell you how many patients literally a week probably in the neighborhood of five or so that will contact me saying ”I was either diagnosed with adrenal fatigue by another practitioner” or ”I’m pretty sure I have it, can you help me with my adrenal fatigue?”  No, because you don’t have adrenal fatigue, it’s not real.

Why adrenal fatigue has become a catch-all- diagnosis

Ari Whitten: Yeah, I mean, I feel it’s become a catch-all diagnosis where you found somebody’s complaining being tired. There are just a million alternative practitioners out there that are like oh it’s adrenal fatigue before they’ve even done any diagnostic tests and whether you have high cortisol or whether it’s low cortisol they’re like ”Hup, it’s adrenal fatigue.”

Like you said, have become the scapegoat for…

Dr. Bryan Walsh: Look at the symptoms, though, is in a bit, so mild depression, inability to concentrate, brain fog, pain, tired, food cravings, cravings for salt, cravings for sugar. You know, I’m like, well what condition doesn’t have those things? I mean, that’s, those are really diffuse symptoms that could also vaguely be hypothyroidism or be and that you know this is a catch-all too but chronic fatigue or fibromyalgia, all these different things, and you know, different autoimmune conditions and Candida fits a lot of those symptom profiles too. So it does, it has been a catch-all sort of wastebasket diagnosis for a lot of people.

The other thing is people. Like ”I’m stressed while my adrenals are probably shot.” No idea, yeah, you could be stressed and they could be high, I could be stressed and it could be normal, someone else could be stressed or not stressed and they are low. It has nothing to do, your perceived stress level has nothing to do with what your adrenal glands are actually doing.

The new model of adrenal fatigue

Ari Whitten: Yeah, absolutely. So the old model Hans Selye’s model, James Wilson’s model of the adrenal gland sort of getting stressed out, and worn out, and fatigued, and so they can’t produce enough cortisol. That’s profoundly wrong. What does the new model look like?

Dr. Bryan Walsh: Well there’s not any one place, that I think, that describes a new model, quite honestly. My story with this is, I wasn’t satisfied with my education, I wasn’t  satisfied with what I learned and had been taught, and it started with blood chemistry. And since I started learning about blood chemistry and the markers, where they come from, and what they mean and then I haven’t stopped, I just kept.

And then I would actually, I try to reach a dead end or already get bored with the topic, and I’d say ”Alright what else have I been taught that I should question?” and the adrenal fatigue came up, and vitamin D supplementation has come up, you know, gluten sensitivity has come up, Sibos come up all these different things but that’s how it started, and I just started  reading the literature, I started  looking at what real adrenal physiology is and what the modern scientific literature says about it, and so I can tell you and I’m – listen I don’t take credit for anything, so I would hate for someone to call this like the Walsh protocol, the Walsh model of adrenal something, rather this is just I’ve  just picked through  the literature a lot and come up with a couple things that I believe what low cortisol this so, I’ll say this again – low cortisol in patients is real. It does not have to be in an autoimmune condition, and they suffer from these symptoms.

The two things that I, it could be one, the other, or both:

#1 Functional Adrenal Insufficiency

Number one is what I’m going to call it a Functional Adrenal Insufficiency. Now I say functional because of medicine, conventional medicine says adrenal insufficiency, that’s when the adrenal glands can’t make cortisol. But they don’t consider some of the reasons, the functional reasons for this. It’s always some pathological condition so functional adrenal insufficiency is an adrenal gland that is unable to make cortisol for some reason.

Now, someone may say that that sounds just the same as adrenal fatigue. The adrenal glands aren’t wiped out, they’re not tired, they’re not overly taxed, there’s a reason why they’re not producing cortisol and in this model, the functional adrenal insufficiency, it could be things like mitochondrial dysfunction.

Why adrenal fatigue might be mitochondrial dysfunction

So to put it very simplistically. I don’t know the education level of your listeners but inside the cell, there’s a mitochondrion. Now, this is like high school biology for most people. The powerhouse of the cell makes ATP. But what needs to be known is there is, first of all, there’s this phrase or concept called adrenal dysfunction right now, and that’s conventional medicine is all over this to this is, this is real.

The mitochondria, this is really fascinating, the mitochondria take cholesterol. Everybody knows cholesterol into the mitochondria and the first step to turning cholesterol into cortisol occurs inside the mitochondria, into pregnenolone. When that happens, pregnenolone leaves the mitochondria, heads over to this thing called the endoplasmic reticulum does a few other enzymatic changes, the byproduct that heads back to the mitochondria and then the last step that turns it into cortisol, and then it’s released.

So, if nobody followed that whole thing, the bottom line is: you have to have healthy mitochondria to make cortisol and there’s this concept called mitochondrial dysfunction which is very real. There’s also something called endoplasmic reticulum stress, which is another organelle dysfunction. That too is very real, and mitochondria-endoplasmic reticulum tends to hang out really really close to each other inside of cells. So, if you have one dysfunction, you’d then have both.

So, if someone has too much oxidative stress, free radicals, mitochondrial dysfunction, it’s this is too much to explain, but NADPH deficiency, things inside the cell that are not working properly, you can’t make optimal amounts of cortisol.

Another big one today, and I have no idea how much this is actually impacting people, is the exposure to certain toxic chemicals. Certain toxic chemicals are absolutely known to inhibit every single enzyme in turning cholesterol into cortisol, and to any of the sex hormones estrogen, testosterone, doesn’t matter, but you can find a list of like 15 common different things from heavy metals, to pesticides, fungicides, and even some pharmaceutical medications that block.

I’ll just mention the enzyme 3β-Hydroxysteroid dehydrogenase which is one of the many enzymes to turn cholesterol into cortisol. Arsenic, phthalates, PCBs, dioxins they help block this enzyme. So if you have exposure to these things, you may not be making cortisol. Not because your adrenal glands are tired or wiped out, or you’ve been stressed for a really long time. It could be too much oxidative stress, it could be the mitochondria aren’t working properly or a combination. It could be nutrient deficiency that just to run the processes inside the mitochondria – and I’ll go into as much detail this as you want –

Ari Whitten: You’re doing great, I love that.

Dr. Bryan Walsh: But the process is inside the mitochondria, just to function properly, people are familiar with the Kreb cycle, maybe you’ve heard of the electron transport chain. The amount of nutrients, and when I say nutrients, I mean vitamins and minerals required to run those processes, is intense. There are so many different nutrients that if you’re deficient in some of these nutrients, the mitochondria doesn’t work. If you have too many oxidative stress or free radicals, the mitochondria don’t work. If you have certain toxic exposures, you can’t turn cortisol, into I’m sorry cholesterol into cortisol.

This this is all under that heading of what I would call a functional adrenal insufficiency. That you’re not making cortisol and it’s for some dis, not pathology, not disease process, but nutrient deficiency, too much oxidative stress, mitochondria, to something inside the adrenal glands where, if provided, they would be able to make cortisol but they are not. It’s not fatigue, it’s not, they are too tired, they’re not shriveled up, and it certainly doesn’t take two years to rebuild the adrenal glands – which I’ve heard some educators teach other practitioners – which is just bogus. It’s just totally wrong. give them the right nutrients, if that was the problem, they’ll start making cortisol in a couple of weeks. I mean so that’s one of them, okay.

Low cortisol is real

Ari Whitten: Let me just, I’d like to give the overarching paradigm. Low cortisol is real, the issue with the adrenals not being able to pump out enough cortisol is a real problem that manifests and very real symptoms. The issue is, it’s not coming from them being fatigued from stress and not being able to do it, it’s these other causes that are inhibiting them from.

Dr. Bryan Walsh: I will tell you, it may have nothing to do with stress at all. Under that premise when you think about it, it may have nothing to do with stress. Nutrient deficiency has nothing to do with stress, that’s just maybe not eating the right foods, multivitamins, poor soils, and not digesting/absorbing them. It has nothing to do with being chronically stressed.

I won’t get into this, too many, to make cortisol you make a lot of reactive oxygen species or free radicals in the process. Theoretically, someone could have been under a considerable stress making a lot of cortisol but therefore creating a lot of free radicals which then damage the cell, damage the mitochondria, if that makes sense.

So technically, that could be accurate but no, very few of those things if anything it may not be due to stress.

How toxin exposure might be the cause of adrenal fatigue

Ari Whitten: Gotcha, okay.

Dr. Bryan Walsh: Toxin exposure is not due to stress, you’re not stressed out.

Ari Whitten: Yeah, on that note, I actually recall a really interesting study that you had posted on your facebook, maybe a month or two ago. It was, I think, it was done in rats, and they were showing that glyphosate was inhibiting cortisol production. You were kind of like, well is it, you know the adrenal glands getting fatigued, but are now from stress, or is it, you know, just that you have this toxin that’s preventing the adrenals from producing cortisol?

Dr. Bryan Walsh: Yeah, but here’s the point, if you haven’t had a chance to actually read that study. Here was the really potent, so that’s one thing, so that roundup might be causing this low cortisol in people but here’s the thing, man, this is. The real kicker about that study was, that at doses far below what the EPA, and I think the World Health Organization, considered to be as and it’s known as an endocrine disruptor. When we think of endocrine disruption, we think of estrogen and testosterone and sex hormones, but at a level well below that causes issues with those other hormones. It was causing cortisol suppression, so what this study was basically saying, is small amounts of this – well under the radar of what people consider to be safe – is causing cortisol suppression in rats

Then my question was, well yeah with the exposure that we’re getting. I mean, I live in sort of farm country. Who knows with the farmers around me are – and we have well water – like, who knows what people are spraying, am I getting small amounts of this stuff, who knows? And at levels far below what’s considered to be safe by government agencies, so that’s what was really compelling about it. It’s the only study that I was so happy to find, that was the only study that I know of, that’s looked at that. It’s pretty scary stuff, but.

Ari Whitten: Yeah, sure, interesting. So, I don’t want to digress too much, but there’s one thing  that I see skeptics, like science sceptics, do often and there’s, I think, an unfortunate tendency of science, you know, people who identify themselves as skeptics to want to minimize all of the fear around different toxins, and they seem to, it seems to be popular among that crew to want to prove that all of these toxins are actually really safe and totally harmless, and you know all that kind of stuff and I don’t know if you saw recently, there was like a TV show where some guy did a stunt where he drank a thing of glyphosate to prove how safe it was, and one of the things, the way that they make arguments often is based on the LD50 buttons. And so they say, ”oh you know the LD50 of glyphosate is this much, and you know, here, it’s this much for caffeine, and it’s as much for table salt, and it’s as much for water, and for you know, whatever else, therefore, glyphosate is just as safe as table salt and water.”

Dr. Bryan Walsh: Right.

Ari Whitten: And I think that argument is just so deeply flawed, because you LD50 is one thing, the amount of substance it takes to kill you, and then the amount of substance it takes to start disrupting some important hormones and physiology that can resolve in some pretty nasty symptoms, is a whole other thing.

Dr. Bryan Walsh: Yeah, no, I know you don’t want to digress. I just put in I can’t even tell how many hours went into this, but I did an eight-hour presentation for health practitioners on this topic. I hate the topic, but of detoxification. And I will tell you that they don’t have this, they use the LD50 acutely, right? What’s the LD50 of that over 20 years? how, many people would die from exposure to a certain dose of that over 20, or 30, or 40 years? That’s still an LD50 if they’re dying from it. It’s just not right now, he doesn’t drink it and keel over. Well, that’s a different man. Yeah, and there’s there’s plenty of studies that suggest first of all, that a synergistic effect between multiple things at a lower dose is damaging to is that there’s a latent effect of these things that these. In fact, in the world of toxicology, the big phrase is the dose makes the poison. And that’s what that’s what the skeptics will say. They’ll say, ”well, you know, water is toxic if you drink enough of it because you’ll die from it.” Well, great argument. But that there’s evidence in studies that there’s a latency effect, that you can get exposed today and literally not exhibit symptoms for much, much, much later.

Just to give you one, there’s a case study published case study of a woman, a scientist, in a lab, that was exposed to a fairly high dose of mercury. Didn’t exhibit symptoms and in the study, I want to say was like at least a hundred eighty days later, 256 days or something like that. But, then, all of a sudden hundreds of days later, started having symptoms of mercury poisoning. But she had had this, like, months, and months, and months before, and the researcher said, ”maybe the dose doesn’t make the poison that it actually has to do with this latency effect.”

The the other thing I want to say is – and you can look into this later for the interest of time – this blew my mind, blew my mind when I read about it, it’s very new and it’s called a Non-monotonic dose-response. In short, what the studies on the non-monotonic dose-response suggest – and this dude, like, blew my mind – is that low doses of a given chemical, are literally just as physiologically damaging and toxic as high doses.

This is brand new, and the studies – again in the interest of time we can’t get into this – but the studies on this – and they’re all new from like 2012 and above, basically say that in the world of toxicology, we thought that this might happen, but we didn’t really believe it. Now, not only is it plausible but it’s likely happening.

The class of toxins that this happens to be occurring in and they say this is in the endocrine disruptors. It doesn’t seem to be with heavy metals, it doesn’t seem to be with a number of different other drugs, or toxins, but specifically endocrine disruptors. And you should see these curves. It’s, they usually, they use it an s-shaped curve to come up with the, what they call the non-observable adverse effect level, and then there’s a sort of S-curve and it gets more and more toxic. What they found is that it is a U and that low doses are just as physiologically damaging as high doses. This is brand new like I don’t get my mind blown very often but I read this, and I was like holy care, this is a game-changer dude. And the dose doesn’t make the poison. Anybody that says that is, at this point because the studies are out there, is just ignorant.

Ari Whitten: Wow, that’s crazy.

Dr. Bryan Walsh: It’s horrible.

#2 Adrenal Suppression or Adrenal Inhibition

Ari Whitten: So far we got low cortisol was real, the main area we’ve talked about so far is functional adrenal insufficiency. Things like mitochondrial dysfunction, endoplasmic reticulum, stress, toxins, nutrient deficiencies. So that’s one what’s, the other big thing that is going on?

Dr. Bryan Walsh: Well, I saved the other one for last because I actually think this is what’s going on more often. Now, like I said it could be the functional adrenal insufficiency, it could be this one which I mentioned or it could be a combination, quite honestly,

But this other one is what I’ll just loosely call adrenal suppression or adrenal inhibition. Which is essentially the same thing, and this is the body intentionally telling, if you will, the adrenal glands not to produce or release cortisol. Saying, ”we don’t want cortisol right now, I know you can make it if you want to, I know you’re still super strong and potent enough to make cortisol, but right now we actually want low cortisol.” Which is – it may sound strange – but it’s the body. The body does that all the time. If you get a fever the body sequester’s iron it says, ”Listen, if you have any iron floating around, let’s get rid of that, because if the microbe that’s infecting you right now has iron, it will be able to proliferate and replicate better. So, let’s get rid of all the iron.” It intentionally lowers your iron availability, just to starve, if you will, the microbe.

I personally believe that it has the ability to suppress vitamin D. So maybe that’s the reason why we’re seeing all this low vitamin D. It’s not uncommon for the body to inhibit it. If you go into a hypocaloric state, if somebody’s dieting for a competition, for example, it suppresses thyroid on purpose. It’s you’re not eating as much, let’s slow down the metabolic rate so that you don’t burn up too fast. It does it, does these things intentionally all the time.

So, why is it so strange that the body would, in certain circumstances, intentionally want low cortisol.

I will tell you that in my personal experience. I think that that is a more common cause of low cortisol than is the other one that we talked about. Though that’s entirely possible, just super hard to measure. This adrenal suppression or adrenal inhibition, the body intentionally lowering, is suppressing the adrenal glands from producing cortisol.

How infections might cause adrenal suppression

Ari Whitten: Okay, awesome. So, you mentioned one potential reason for that, which is a chronic infection of some kind, or where the body is trying to sequester iron for example.

Dr. Bryan Walsh: Oh, no, that was it that was a separate example. But infection will do that, though. And regarding the adrenal glands, yes, the infection is probably one of the most..

I always say this, in immune-related stuff, so infection of a variety of different types, low-grade chronic inflammation, that a number of what are called cytokines which are simply immune system molecules are released that literally suppress cortisol production. I mean these, they have been shown to be potent suppressors of cortisol things like, tumor necrosis factor alpha, and over time interleukin-6, and there are these things released by neutrophils called defensins – which you can kind of figure out what they do – but there is an immune cell and one of the things  that do is, it suppresses cortisol. Now, transforming growth factor-beta is a major as a major suppressor of cortisol.

So, these are all immune molecules…

Ari Whitten: All of that kind of lumped together with inflammation or infections…

Dr. Bryan Walsh: Yeah, those are two separate things. You can be infected and not inflamed, you can be inflamed and not infected, to some degree.

And the other one also has to do with infection. It’s kind of a long word abbreviated as LPS, but lipopolysaccharides. Lipopolysaccharides, the where our exposure would come from with that, would be unfriendly bacteria, we will call them, in the gut.

Ari Whitten: So, not dysbiosis?

Dr. Bryan Walsh: You can call it dysbiosis, certain bacteria typically the gram-negative bacteria. They produce toxins and this is considered to be an endogenously produced toxin because it’s something within you that’s making it. But if they make it, and you have what’s called intestinal permeability, or leaky gut, then these lipopolysaccharides or LPS can go systemic into your body and lipopolysaccharides are a potent inhibitor of cortisol, chronically.

And, here’s, – I’ll just give it a quick caveat to this – most of the studies looking at these things, look at it acutely.

Interleukin-6 actually increases cortisol levels acutely. That’s the difference, lipopolysaccharides increase cortisol levels acutely, but none of us are going to get an acute dose of lipopolysaccharides. We either have dysbiosis and leaky gut and therefore have this leak of chronic lipopolysaccharides into our system, or we don’t have it at all. We don’t have like, ”wham here’s an injection of lipopolysaccharides,” it doesn’t happen that way,

Ari Whitten: Also, outside of acute food poisoning?

Dr. Bryan Walsh: Well, yeah, possibly. Yeah, yeah, possibly, or if your subject of a laboratory

experiment when they injected you with lipopolysaccharides. But no. So, lipopolysaccharides acutely increase cortisol production but chronically suppress it. That’s another one. So somebody could have dysbiosis with intestinal permeability, circulating lipopolysaccharides and that’s causing a blunted cortisol response.

And and I’ll tell you what, lipopolysaccharides, infection, inflammation those are not adrenal fatigue. In addition to the fact that you can go straight from normal – to go back to Hans Selye -you could have normal cortisol and have an infection of some kind, go straight to low cortisol, done. There’s no alarm phase, resistance phase, exhaustion. You went straight from normal to   ”exhaustion” and it has nothing to do with this chronic stress and you are stressed and you could be stressed have high cortisol, and stressed for life and have high cortisol that you just have this really efficient system.

So going back to Hans Selye, that’s why it’s wrong. You can go straight into low cortisol just by getting an infection.

How leaky gut is linked to adrenal fatigue

Ari Whitten: Interesting. Okay, so inflammation, infections, LPS, and then that LPS goes along with leaky gut and gut dysbiosis.

Dr. Bryan Walsh: Well, it would. It’s present with dysbiosis and will only go systemic if you have intestinal permeability. Otherwise, it just stays in the gastrointestinal tract by large.

Ari Whitten: And is that, do you think this, does leaky gut commonly go with dysbiosis?

Dr. Bryan Walsh: Yeah, well yes, yes, yes, yes the studies are pretty clear on that too. that that if a real quick way to intestinal permeability is some kind of infection in the first place. It’s not the only way – like dehydration while exercising supposedly causes it, there’s a variety of things that does – but yes, infection is considered to be a quick way to intestinal permeability.

Chronic and stealth infections

Ari Whitten: Okay, and real quick on the subject of infections. More and more I’m seeing people talk about chronic infections were hidden infections, things like that. what what’s your take on, is this is just a common thing? Do you think that there’s quote unquote…

Dr. Bryan Walsh: Well I don’t know, I think the concept of a hidden infection is sexy. I mean, that’s of course, ”Uh, this stealth infection that we have to find” and it also kind of lets us off the hook, because if we can’t find it, but say it’s there, then we could treat. I don’t know.

So, with that said, viral infections and when you say hidden infections, I typically think of you know the lyme community, and some of the co-infections that occur with lyme, that are really hard to identify. But viruses which are not sexy. They were like the original stealth organism when you think about it. That these things are so old they don’t even have a cell wall themselves, to protect themselves, they have to infect another host, a cell and replicate within that cell until that cell dies. And like cockroaches, they all scurry to somewhere else.

Anybody that’s had chickenpox has a stealth infection if that makes sense, and some people it will manifest as shingles, and other people it will stay stealth all the time, and the people that it develops in, the shingles, are the people that have usually some kind of stress response. And it’s so, so insane that their immune system gets so suppressed that it can no longer keep that particular infection at bay.

So, I like your question. I personally think that there are quite a few people that have a chronic infection of some kind. I’m not going to say it a stealth infection, or a hidden infection, but it’s definitely some kind of usually a chronic viral infection and I’ll tell you, the part of the reason why I say this, is the number of people, today, that we run a blood chemistry on, that has a…

Anyways, so on our blood chemistry panel the number of people today that have low normal white blood cells, which is typically a marker, the way that we use that most often, is that there’s some chronic insult to the immune system. And it could be an autoimmune condition which could be argued, it’s a chronic insult, it could be a chronic infection of some kind which is a chronic insult, and that the immune system is not, it just lacks the robustness that it’s sort of losing this long-standing fight.

I can tell you that out of 10 average patients, probably five or six have low normal white blood cells. We don’t test for all these different hidden or stealth infections but the question is. why is our white blood cells low in so many people today? And I would not be surprised if there’s virus, viral infections that are – I don’t call them hidden but latent – there and the immune system like I mentioned with chickenpox and shingles, viruses can exist inside of us but our immune system can keep it at bay, so that it doesn’t go wild.

But then the question is, at what point, is there a point between chickenpox, and full-blown shingles, where it doesn’t manifest as shingles, but it still is impacting the body, and therefore maybe cortisol? If that makes sense.

So we don’t get full blown viral infections or the manifestations of them, but it’s rearing its head enough to cause low cortisol. So to answer your question in a long-winded way is: they do think there’s a lot of what I’ll call subclinical chronic low-grade infections, that are occurring in people and that very often are leading to low cortisol.

How low cortisol levels can be linked with cancer

Ari Whitten: Gotcha. Okay, so is there anything else that you lump into the category of are inhibition?

Dr. Bryan Walsh: Those, that’s the big one, is that it’s being inhibited, that the body, when I say inhibition, the body is intentionally suppressing its ability to synthesize and release cortisol. It wants cortisol to be low.

I don’t want to freak people out, but cancer would be a great example of this too that certain things are going on immunologically with cancer, that the body would likely want little cortisol. Same thing with viral infections.

Same thing if you get a fever. Someone gets a fever, wants to run adrenal panel I’d be willing to bet that when you’re in the heat of that fever, that you will have low cortisol. Because the immune system wants you to have low cortisol so that it can stimulate certain cells and inhibit other ones. So, no, those are the main ones just an infection, inflammation of some kind, chronic inflammation, lipopolysaccharides, dysbiosis, those be the main things in everything.

Ari Whitten: Okay, so we got these two causes adrenal inhibition you said, you think is the more common one.

Dr. Bryan Walsh: I think, yeah, as far as I can tell.

Ari Whitten: But at the same time. I mean, given what you talked about with different exposures of toxins and how they disrupt how the other endocrine disruptors and how common exposure to those things are, as well as common how common nutrient deficiencies are. I mean, I would have to imagine that those are players at least in the background.

Dr. Bryan Walsh: Yeah, I don’t think. It doesn’t help. I don’t know how. My suspicion is somebody would have to be pretty nutrient deficient, to cause low cortisol. To put it another way, okay, what are other people that have low cortisol due to inhibition? That have a subclinical nutrient deficiency that it’s contributing to it, but not. But they would not have low cortisol if that was the only reason. So, I think those are contributors, more than causative factors.

I think that the toxin issue, Again I think it’d have to be a fairly significant toxic exposure to cause clinically low cortisol. But, in somebody where it’s suppressed, I would have guessed that it’s it’s an additive effect, I think that it’s contributing to them.

Ari Whitten: okay so let’s just as a thought experiment. Let’s say you take somebody and you subject them to chronic low dose LPS exposure. You know they have gut dysbiosis and leaky gut and so they’re chronically getting this LPS leaking into the bloodstream, and then maybe they also have some kind of hidden infection suppressing cortisol and just those two causes alone, or even one of those alone, if that’s inhibiting cortisol production and lowering cortisol level is that enough to explain all of the symptoms that we see in adrenal fatigue?

Dr. Bryan Walsh: Yeah.

Ari Whitten: Okay, so just having that low cortisol will result in all of those symptoms we see that people commonly associated with adrenal fatigue.

Dr. Bryan Walsh: Yeah.

Ari Whitten: Wow.

How low cortisol can be linked to PTSD and depression

Dr. Bryan Walsh: Yeah, in fact, I’ll tell you there was one study – and I don’t have any of these things in front of me – there was a study, I forget how many subjects were in it, I forget the title of it, and I forget the journal at the moment. Though, I could send it to you after we’re done

Basically, gosh, I wish I remember it was something along the line, it looked at people who have mood disorders, and it said it was it was PTSD, depression, and there was another one involved. But basically, what they did was, they said, all these neurological mood based conditions. Is it low cortisol in the first place?

So what they did was they looked at cortisol levels in all these patients and it was low. And what they did was they gave they gave hydrocortisone, which is synthetic pharmaceutical cortisol, and I forget how many people improved. But you understand this, they said it reversed it reversed PTSD, which means that that’s code for a cure.

Well, I mean they can’t say it. They reversed PTSD, they reversed depression, they reversed these mood disorders. And when they identified low cortisol, and they gave synthetic cortisone which is their way of doing, and that’s fine, I think we’d like to try to correct it. They gave it, in the majority of the people in the study their symptoms improved, and some of them even were cured is basically what they said.

What they went on to say that perhaps, as the in the psychiatric industry we shouldn’t be moving to drugs first, but instead because of the prevalence of low cortisol with mood disorders and the fact that we can treat low cortisol and correct these mood disorders maybe we shouldn’t be giving these things like, Prozac and mood drugs first.

So, when you ask, are these associated with low cortisol? Absolutely, depression, mood disorders, anxiety, low blood sugar symptoms, can’t sleep. There’s an associate of cortisol in melatonin and substance p. They have increased pain perception, man, like just because of low cortisol. It’s very real symptoms, and it is because of low cortisol.

Ari Whitten: Wow, powerful stuff. Okay so, so we got all the paradigms here now of what’s really going on. What’s the real physiology behind a lot of these symptoms that people commonly associate with adrenal fatigue? Can you take me through a couple practical examples of what this would look like as far as a treatment plan and understanding that, of course, you’re going to do diagnostic tests, and you’re going to figure out what’s probably going on in that specific individual, before you start attacking a treatment strategy. But maybe just give a couple typical cases, and one of the layers of strategies that you address, maybe the order that you go about doing things.

What supplements you can use to balance your cortisol levels

Dr. Bryan Walsh: Well it’s that’s actually a bigger question. What I can tell you, I’ll answer the question simply.

First of all, that in somebody that has low cortisol that’s been identified by a lab.One of the things that I’ve found to be most effective is giving botanicals, or herbal compounds that are typically the kinds that you would take when you’re  getting sick so like, echinacea, goldenseal,  any of the medicinal mushrooms maitake, shiitake, reishi, those kind of things lemon balm or was also known as melissa officinalis.

And this is an interesting one is licorice root, which is historically been used for low cortisol in the first place. One of its actions it has, it has many actions, but one has to wonder if this is why it’s been so effective, is one of these actions is it increases the half-life, I should say decreases the half-life of cortisol. So, the cortisol you have exists longer. It also is antiviral, which is interesting because that’s the cause of low cortisol and it also tends to stimulate the – was not going to get into this – but the Th1 side of, it’s a Th1 stimulating botanical, which is typically what you want.

And so curiously, not only does it impact cortisol, it’s a more detailed, it’s an aldosterone antagonist so it increases sodium absorption, water absorption, can increase somebody with low cortisol blood pressure, and their blood pressure is typically really low. They usually get that orthostatic hypotension where they get lightheaded if they stand up too quickly, for example. And licorice root kind of combats that to some degree at any rate.

So, if somebody has low cortisol and they know that on a test, and that’s all the information that they have, what I would consider trying, is loading up with those types of botanicals; echinacea, goldenseal, Oregon grape or mahonia, licorice root. I mentioned the mushrooms are good usually in a tincture or extract form, licorice root can be very good. If something truly has low cortisol, they’re gonna have low blood pressure too. The big concern with licorice is that it’s going to raise your blood pressure. But in a truly low cortisol person, they have low blood pressure

And those will tend to, I have seen that normalized cortisol without having to take any adaptogens. Which are the botanicals? Things like Rhodiola, and Eleuthero caucus, and ashwagandha, and all these ginseng, is all these things that are supposed to help our body adapt.

I did some research on these, and how those adaptogens work it’s very interesting. They don’t work on the adrenal glands it turns out. But by those immune stimulating botanicals, I have seen cortisol regulate itself, normalize itself very, very quickly without taking any adrenal glandulars, any adaptogens, or any of those types of things

I think that’s the most powerful and quickest thing that somebody could find.

Ari Whitten: Okay. Medicinal mushrooms, lemon balm, licorice, echinacea, and goldenseal. Was there any anything else you want to lump into that?

Dr. Bryan Walsh: Anything that’s that supports Th1 side of things. And somebody can go online and research Th1. It’s either Th1 stimulating botanicals, or th2 inhibiting botanicals, or compounds. Those are the same thing. This is a popular topic right now, so you can go online and find some pretty long lists of some of these things

There are certain probiotics that will tend to stimulate one side of it or the other. I haven’t used those very much with low cortisol cases, though I think it’d be really interesting to do. But basically that’s the goal is to try to stimulate the Th1 side of things as much as possible and those mushrooms or good licorice root is fantastic, echinacea, goldenseal, berberine is found in  Golden Seal as well as Oregon grape or mahonia. So, berberine seems to be effective.

Ari Whitten: Gotcha, so as far as mentioned actually, I want to digress for a minute. You mentioned something about the adaptogens that they don’t really work on the adrenal glands. How do they work?

Dr. Bryan Walsh: there’s just, listen, and it was one study – it wasn’t the best-done study – but it’s really interesting. They were suggesting, that adaptogens allowed the other cells to respond to cortisol better, was basically what it was. So, it may not actually impact cortisol levels because adaptogens historically were used to help us adapt to stress, which when we didn’t have lab testing, which made us meant made us feel better, right

So, and there’s this whole thing of cortisol receptor resistance which is you’ve heard of insulin resistance as a whole other thing too. So these adaptogens were used for millennia to try to help us adapt to stressful times, and it would make people symptomatically feel better but there wasn’t any lab test to prove, and I have not seen adaptogens help improve cortisol levels on lab tests. I just haven’t. If there are practitioners that have, I’d love to see that and, I’m not questioning them but I’m saying, I just haven’t seen that very much. Interestingly is perhaps and this would make sense, maybe adaptogens don’t impact the adrenal glands but allow our other cells to respond to cortisol more normally and therefore we feel like we’re responding better.

So, all the original work, they didn’t have lab tests to say adaptogens raise or lower cortisol. They help us adapt to stress, whether it was a lot of stress or too little stress, or we had a hyper or hypo stress response, it was said that they helped but maybe that’s the mechanism, it’s actually helping all the other cells of the body respond to stress and or cortisol and or epinephrine better. Very, very fascinating, kind of 180 but interesting stuff.

Ari Whitten: Interesting. Ok so the first thing that you’ll typically do with someone, is that group of botanicals and you said you’ve seen that normalize in a month.

Dr. Bryan Walsh: I’ve seen cortisol go from tanked to completely, normal rhythm. The cortisol levels.

Ari Whitten: Wow. Ok so, let’s say that it in that person that you did that with, they still have symptoms. Maybe their cortisol hasn’t normalized yet and they still kind of feel maybe what they call adrenal fatigueie, and they feel in some of those symptoms what might the next step be,

Dr. Bryan Walsh: So, fantastic question. Here’s the thing. I would highly recommend lab testing. And here’s a great example. Let’s say somebody had low cortisol, they took some immune enhancing botanicals and their next cortisol came back as normal but they still had those symptoms.

So, then what that’s saying is that those symptoms are not real and probably not related to their cortisol levels. If their cortisol came up and that’s now normal, then all those symptoms it didn’t have to do with low cortisol, and then it’s something else entirely.

Maybe it’s low thyroid. Low thyroid and low cortisol have many same symptoms, not all, but many. Different hormone imbalances can, like I said different types of infections, so like Candida has many of the same symptoms as low cortisol; brain fog and fatigue, and you can get some achiness associated with that. So at that point, I would just want to look, food sensitivities, quite honestly. Food sensitivities can have many of the same symptoms as low cortisol as well.

So, ultimately, and I know you already know this, you need to take a sort of a real wide angle lens with this person. You don’t just want to only look at cortisol levels and only treat cortisol levels and rarely do we, in fact, it’s we usually start with a blood chemistry test. Look at blood sugar, thyroid, and all the things you can find out a blood chemistry test. But then need to start looking for, you have to look for something else if their cortisol levels are normal but they still have symptoms, something else is going on that you haven’t yet found. It could be food sensitivities, or Candida like I said, or thyroid, a number of different things.

If they take those things and their cortisol doesn’t come back up, then honestly from the research that I’ve done, it’s either suppression or a functional adrenal insufficiency, so then you really do need to consider that maybe they have massive amounts of oxidative stress, or maybe I will tell you at some point – and a medical doctor may need to get involved for this, although people can find places to run this on their own – is to run a hormone called ACTH or adrenocorticotropic releasing hormone.

ACTH – without getting into the details – is a pituitary hormone that tells the adrenal glands to release cortisol. If you were to run ACTH, it can tell you if the problem is in the adrenal glands, or if the problem is higher up.

So, just to paint a real quick picture. If someone has low cortisol, and they have normal or high ACTH then that suggests the problem is in the adrenal glands, that the pituitary glands are saying no for some reason, and either the botanicals that you gave weren’t enough to overcome the immune system or there’s excess oxidative stress or mitochondrial dysfunction, that’s  higher order. So that’s then the dysfunction is in the adrenal gland.

On the other hand, if you have somebody that has low cortisol and low normal or low ACTH then what this is saying is, their adrenal glands are not producing cortisol because they’re not being told to. The body, the adrenal glands, aren’t doing but the whole body is not even trying to do it. If ACTH is low, now you’re looking at something higher up in the pituitary, and the hypothalamus, and the brain. Something. And that’s a that’s a bigger issue, quite honestly. And one that an endocrinologist might be able to walk somebody through at that point. But if somebody has long-standing low cortisol that’s not being resolved in anything, I would suggest getting ACTH run because that will tell you if it’s the adrenal gland that’s causing the problem or if it’s something else. And if it’s something else, that’s a whole other whole other bag.

When to consider functional adrenal insufficiency vs. environmental exposures

Ari Whitten: Okay, at what point would you start considering the possibility that it’s it’s functional adrenal insufficiency and you know maybe it’s a result of toxin exposure?

Dr. Bryan Walsh: That’s  a really good question. There are some decent labs right now that look at toxin exposures – and I don’t want to get too deeply into that – of these panels that are looking at toxin exposure if they come back as positive, they’re positive. You have exposure to those chemicals. If they come back as negative it means nothing. And that’s because there’s there are some pretty awesome studies on this. That’s because if there is a bit well – I put it this way – people have tested negative in urine for a chemical, in stool, and in blood. But positive and sweat. This is the same person.

Ari Whitten: Interesting.

Dr. Bryan Walsh: So in that, that speaks to its storage and how it’s not being it’s not being liberated, unless the body is asking it to via sweat, for example. When the body heats up, you get some lye pollicis, and it gets liberated, and then it gets excreted.

But there are a couple studies, that they took about 20 people and they didn’t have, it was negative in urine, blood, and stool, and positive in sweat. And so, that to say it again, if somebody runs on of these tests that are usually urine there’s stool, there’s urine or blood-based. If they come back negative, that doesn’t mean you don’t have exposure to that chemical

So the long answer to your question is, additional testing could be very helpful. The short answer I will tell you is if you see a good practitioner, in general. They’re going to be working on you in nutrients efficiency, they’re going to have you follow, they’re going to be paying attention to your diet, and having to eat a good diet probably taking some kind of multivitamin, and dealing with possible nutrient insufficiencies. They’re probably going to be addressing excess free radicals and oxidative stress, just as a consequence of their program that they’re putting you on.Hopefully, if they’re good practitioners, if that makes sense.

How to address oxidative stress

Ari Whitten: And just I’m not to digress, but can you mention a couple strategies that you mean as far as addressing oxidative stress?

Dr. Bryan Walsh: Nutrients efficiency, will combat oxidative stress by itself as well as antioxidants. And I don’t mean supplemental if somebody falls if somebody is not following a decent diet. The following a good diet will combat oxidative stress. Their nutrient insufficiencies which both kind of work on each other

A good program is going to have somebody exercising, and therefore sweating, and therefore probably getting rid of a similar toxic load. A good practitioner is probably going to talk to the patient and say, ”listen, toxins are horrible. You need to clean up your life, you need to stop using the same cosmetics that you’ve been using, toiletries, cleaning products, and some of those types of things

So to answer your question. A good practitioner is going to be addressing those things indirectly, no matter what. Just because of you cannot be healthy if you have exposure to toxins, you cannot be healthy if you have nutrients insufficiencies. So, a good program is going to say, Mr. or Mrs. Patient, here’s all the things that you need to be doing to address, that’s only going to serve to help whatever your signs and symptoms are if that makes sense.

Ari Whitten: Yeah.

Dr. Bryan Walsh: So, the only caveat to that is, one could run a panel on for oxidative stress, and one could run a panel for toxic exposure. If they really wanted some ”hard data black and white” on if they had issues with these things or not. That said, neither of those tests are perfect but you can have oxidative stress that won’t show up on an ”oxidative stress panel,” but they’re good. They’re not perfect, but the short answer is a good practitioner is going to be had. They have you on a good program for a good solid three months, that’s going to indirectly address all these those things anyway. So, it should be a non-issue.

Ari Whitten: Gotcha. Okay, so is there any other strategy that you feel you might commonly take with people dealing with adrenal fatigue types and things like. So we went over, some of the botanicals. We went over potential toxins, addressing some of those, and oxidative stress mainly via a diet.

By the way, actually, on that note real quick would you recommend saunas?

Dr. Bryan Walsh: Yeah, I’ve no problem with that. Yeah, I love saunas, I absolutely love, I just supercharged our sauna about a week ago. I have a far infrared sauna, and I added these near infrared heat lamps on the door, it’s oh my god it’s freakin.

Ari Whitten: So the light comes in through the glass door?

Dr. Bryan Walsh: Well it’s attached to the glass door. So as the glass door closes, so you have these for heat bulbs right in front of you, and the far. My wife hates it, it’s insane.

Ari Whitten: Inside of the sauna.

Dr. Bryan Walsh: On the inside the sauna, yeah.

Ari Whitten:  Oh, nice.

Dr. Bryan Walsh: Dude it’s like it’s the best experience. I love it”

Ari Whitten: I want to do that, I just can’t figure out how to get a wire in there without like damaging the wood on the sauna.

Dr. Bryan Walsh: You know, it went right underneath the where the door closes. It’s just, I got a lamp cord, I put it all together myself, but I just got a lamp cord and the door it goes underneath and the door closes over it, no problem. I mean, I don’t know how your door setup is. But ok I’ll  have to off target now. I can’t even I can’t even tell, it’s like night and day. Oh my God, it’s fantastic.

Anyways, yeah, I don’t have you know here’s the beauty about exercise, and about sauna is. Under the care of a practitioner, they can kind of walk you through. Your body will tell when you’ve had enough, then so you know. People can say globally, oh well people with low cortisol they shouldn’t sauna. You can’t say that. They might be able to do 130 degrees for 5 minutes. But it’s something, and it’s like with exercise you don’t have somebody go and do CrossFit. You might have them, if they do nothing, maybe to start to walk for five minutes, or a treadmill, or do a few bodyweight squats, or something. And then work their way up so to say globally that, people with adrenal fatigue can’t do a certain exercise, it shouldn’t a sauna, is not true at all. And in fact, they can. And I would suggest, it’s good but they just need to do it judiciously and as their body sort of dictates.

Ari Whitten: Yeah, I completely agree. And on a side note I think, actually, the avoidance of hormetic stressors like heat exposure, like exercise, is actually crippling to people over time, if they continuously avoid those things.

Dr. Bryan Walsh: Totally agree.

How finding your purpose can help you stay healthy

Ari Whitten: Yeah, so I was I was trying to ask – and then I kind of sidetracked myself – but is there any other strategy or two that you think, might be worth mentioning here as like common things that a lot of people benefit from?

Dr. Bryan Walsh: This is gonna sound out there, it has to do – I can’t even put it in a nice little package – it has to do with loving yourself, life, feeling connected, your purpose in life. I’ll say that.

Ari Whitten: It’s not that out there, I actually have a section, in that it’s under…

Dr. Bryan Walsh: Well, I mean, compared to what we’re talking about the physiology biochemistry of adrenal issues.

Ari Whitten: Yeah, I’m the same way, where I’m like such a science guy and then I want to avoid some of the woo-woo.

Dr. Bryan Walsh: No, it’s not woo-woo, know there’s that there’s science on this now. I mean, just to quickly state, you know there’s some really interesting research about the means with which we pursue happiness. And to pursue and there’s a lot of ways,  but the studies talked about two different types that there are eudaimonic and hedonic types of forms, of looking for happiness.

Hedonic as the name would suggest, is deriving a sense of happiness or fulfillment through your own means, for yourself. So you buy a new pair of shoes, you buy an electric guitar off eBay, you’re like man, I rock, I’m awesome, I’m happy now.

Whereas eudaimonic is, you derive a sense of happiness and fulfillment by helping a greater cause, helping other people, so like helping somebody across the street, or belonging to a non-profit organization.

Which is interesting, because you could write a book – and writing a book isn’t either hedonic or eudaimonic, it’s the intention behind it – you could write a book to say ”look how great I am, I’ve helped this many patients, I am awesome.” That’s hedonic.

You could write a book to try to change the world, and it doesn’t matter if you’re the author, have your picture, or your name on it, at all. That’s eudaimonic.

And it turns out – I won’t get into all the details of it – but it turns out that our genes know which way we’re living our life. The people who tend to live a hedonic life will tend to have a higher baseline inflammation, and lower immune function, towards a viral infection, so less macrophage activity, less natural killer cell activity. People that live eudaimonic, life have a higher natural killer cell. And natural killer cells, by the way, are anti-cancer, antiviral.

So, higher natural killer cell, and lower baseline inflammation just because of how you derive happiness in your life. And so I say that’s not, woo-woo, man, because they’ve studied this stuff and it’s in the literature.

So, I would argue that that of everything, we’ve talked about is the biggest piece.

Ari Whitten: Oh, wow.

Dr. Bryan Walsh: Now, will be connected correct somebody’s low cortisol? I have no idea. Will not be connected lead to low cortisol? I have no idea. It’s not been studied, nor can I put that together empirically in my patients. It’s too difficult to do.

But what I will say, is that  I think that that’s a huge piece. Do we have a purpose in life, do we have meaning in our life, do we mean something to someone else, do we feel significant to ourselves or to others, are we loved, or even at the very least do feel or experience love for somebody else?

I don’t know how that relates to low cortisol, but my suspicion is that there’s something there.

Ari Whitten: Awesome, I love that you brought that up because I and that you said that it might be the biggest piece. I think that’s really, really cool.

Dr. Bryan Walsh: What we believe changes our physiology. There are studies on that too. that I mean, I told you, I don’t get my mind blown very much.

Just briefly, there was a study – you probably saw this – there was a woman, she blended up a vanilla shake and she poured this vanilla shake into two made up containers. One was called sensi shake, and the other one was called indulgence.

And so, the subjects were asked to really look at the ingredients, look at how many calories, at how many fats, how many carbohydrates, and then they judge the patients in two categories. One was subjective on satiety, like do you feel full or not, and it was like this is the mind blower it was the exact same shake.

She poured it into one and poured it into another one. Looked, one can, one was the other. They drank one, they’re like ”I still feel hungry.” They drink the same shake in a different, full fat, full indulgence, high-calorie drinking, and they’re like, ”I feel good”

Ari Whitten: Yeah.

Dr. Bryan Walsh: But then the kick, dude, the killer, though, is they measured ghrelin – a hormone. The hormone was different. It’s a hunter hormone, and it was different. They drank the same freakin shake, but yet a hormone responded differently based on what they believed they were drinking.

That blew my mind. Blew my mind, man. What are the implications of that with the food that we eat? Whether we think it’s healthy or not, or like oh, it just blew my mind.

So, anyways when I say it may be the most powerful influence. I, you know, if the way we, if we feel like we have a purpose in life, makes us more or less likely to get a viral infection. And viral infections can lower our cortisol, then yes, then this may be one of the most important features of it.

Ari Whitten: Well, I’ve kept you on a little bit more than an hour. I feel like I could talk to you for five more hours because this has been a blast. But, is there anything you want to leave people with? Is there any kind of one last summarizing thought maybe that you want to leave people with and then we will close?

Dr. Bryan Walsh: One is that I wish I had realized what time I was doing this because my room is now pitch-black. It’s it’s five-fifteen in Maryland and with the time change. like I wish I had complied to that.

No, you know, I. The only other thing is, that’s a good question, that nobody knows what they’re doing. None of us. That science doesn’t prove anything, it disproves what we previously believed. That any practitioner out there is just doing the best that they can, given the knowledge that they have – some have more knowledge, therefore, may do a better job than others – but that generally speaking, we’re all just doing the best we can. But none of us knows what we’re doing.

And to the last piece, I released right now, I truly believe that – I don’t know how to say it – but believing in something bigger than yourself, having a true purpose in life, and I mean a purpose. Why you’re here, I think is is one of the…

Oh, and I’ll say this, add the last piece to that is our pursuit of health. If you really think about it, is not to be healthy. You think about it, it’s what it would health brings. It brings happiness, it brings perhaps feeling sexy to somebody else, it brings having energy so that you can play with your kids, it brings the avoidance of the pain of like not being able to think faster straight or something.

So, when people are constantly chasing this thing called health or wellness. That I just, I want them to know that that’s not what it is that you’re after. You’re not after health or wellness. You’re after what those things bring.

And to really evaluate those things in your life. Because, the pursuit of beauty you never arrive, you never arrive at optimal health, you never arrive at health and wellness and if that’s your goal, you’ll be chasing your whole life.

Ari Whitten: So awesome. Well, this has been so much fun. Really, I want to bring you on again, and I want to keep doing this I feel like I want to do a series with you because this is amazing.

Dr. Bryan Walsh: Sure.

Ari Whitten: But I think we’ll leave it at that for now, and thank you so much for the call and I know everybody’s  gonna love this.

Dr. Bryan Walsh: Cool, thank you, it’s my pleasure.

Ari Whitten: Yeah, enjoy the rest of your night.

Dr. Bryan Walsh: Thanks.

Show Notes

What the old model of adrenal fatigue is (4:20)
Why Hans Selye’s definition of cortisol levels and adrenal function is ”profoundly wrong” (6:57)
Why adrenal fatigue has become a catch-all- diagnosis (11:16)
The new model of adrenal fatigue (12:42)
#1 Functional Adrenal Insufficiency (14:31)
Why adrenal fatigue might be mitochondrial dysfunction (15:18)
Low cortisol is real (19:40)
How toxin exposure might be the cause of adrenal fatigue (20:57)
#2 Adrenal Suppression or Adrenal Inhibition (28:07)
How infections might cause adrenal suppression (30:43)
How leaky gut is linked to adrenal fatigue (34:52)
Chronic and stealth infections (35:47)
How low cortisol levels can be linked with cancer (40:16)
How low cortisol can be linked to PTSD and depression (43:22)
What supplements you can use to balance your cortisol levels (46:10)
When to consider functional adrenal insufficiency vs. environmental exposures (56:43)
How to address oxidative stress (58:52)
How finding your purpose can help you stay healthy (1:03:26)

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