Burnout: Part 5: A Systemic Fatigue Problem

Richmondchironeu • September 3, 2019

Hello again everyone:

In the last newsletter, we unwound the controversy between stages of conditions where things are either white, black or grey…and with burnout, we went over the point that burnout is mostly a grey condition and should be called HPA axis dysregulation or dysfunction. We also mentioned that it most often results from chronic stress of multiple types that add up to create the feelings, signs and symptoms of burnout.

When the cumulative stress of life grinds down our stress response systems, our mental, physical and biochemical reactions can become dysregulated, or dysfunctional. This is when we see things in the lab tests like the elevated or low morning cortisol, but overall normal total cortisol amounts in a day. Or we see that cortisol is low or normal all day but high at night when it should be at the lowest levels, and so on…the point is that these abnormal levels do not represent a disease (Addison’s or Cushing’s), but do represent an abnormal response to the cumulative stress burdens we are experiencing (a shade of grey situation).

When things are dysfunctional, it is usually more important to seek the underlying causes to the stress as well as support the stress response to become more functional. Please recall that ANY type of stress, (whether it is a cold or flu, a latent or hidden infection (Lyme or Strep or Mono etc.) in our gut or sinus or bladder etc., a poor diet, chemical exposures, financial stress, an autoimmune condition, digestive disorders, food intolerances or allergies of any type, poor sleep, too much or too little exercise, job stress, family stress, trauma new or old, pain, etc., etc.), too much screen time, will light up the stress response and that this response has effects across virtually all systems of our body. Stress can support or tear down:

·        Immune function

·        Gut and digestive functions

·        Hormones (thyroid, ovarian, testicular,

·        Blood sugar

·        Brain function (fog, depression, anxiety, PTSD, cognition, memory)

·        Joint health

·        Energy production (fatigue states and mitochondrial health)

·        Repair and pain inhibition (chronic degenerative conditions of any type)

·        Inflammation across many sources

·        Our ability to be resilient with adequate metabolic reserve

Here is a link to a good article that states these issues pretty well:

As Dr. Kresser states, HPA axis dysregulation is: “… a syndrome characterized by a mismatch between our modern diet and lifestyle and our innate stress–response system ( 5 ). All of these modern stressors impact the HPA axis, which in turn affects nearly every organ and system of the body, including the gut, brain, thyroid, metabolism, catabolism, and male and female reproductive system. This explains why the symptoms of HPA-D are so diverse and its effects can be so devastating.”

Bottom Line:  Once we study how stress tears us down, we see that the HPA-D can result from multiple causes and thus requires a whole-person approach to restoring resiliency and health. In the next and last installment, I will cover the primary causes that I see in practice, and some simple home remedies.

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To Avoid Chronic Disease, Watch What You Eat
By Mark Smith August 25, 2025
Hello everyone: I think I have mentioned inflammaging before but never really focused on it. So, let’s dig into this interesting topic. Inflammaging is when chronic, low-grade inflammation develops with age as dietary and environmental stress accumulates, contributing to the development of all of the various age-related diseases and health issues. It results from a loss of control over systemic inflammation, which tends to come from an unbalanced and dysregulated immune system. One of the key drivers of inflammaging is diet…which means that one of the key tools to slow and reduce aging is our what we eat as well as what we don’t eat. In this paper, the authors reveal that the typical Western Diet (what science calls the Standard American Diet or S.A.D.) is the best example of a pro-inflammatory diet pattern. “ Conclusion: Inflammation is a key physiological process in immunity and tissue repair. However, during aging it becomes increasingly more chronic. In addition, we found that certain foods such as saturated fats have pro-inflammatory activity. Taking this into account, in this review we have proposed some dietary guidelines as well as a list of compounds present in foods with anti-inflammatory activity. It must be taken into account that the amounts used in the studies that detect anti-inflammatory activity of these compounds are very high, and the intake of a single food to achieve its anti-inflammatory power is not feasible. (My Comment: what this means is that it is the overall dietary pattern that matters the most.) However, the combination of foods rich in compounds with anti-inflammatory activity could exert beneficial effects during aging and in pathologies associated with inflammation and in reducing the detrimental effects of foods with pro-inflammatory activity. Therefore, we can conclude that the compounds in our diet with anti-inflammatory activity could help alleviate the inflammatory processes derived from diseases and unhealthy diets and thereby promote healthy aging. Thus, we can use diet not only for nourishment, but also as medicine.” https://pmc.ncbi.nlm.nih.gov/articles/PMC8389628/ anti-inflammatory diet and health aging https://www.healthline.com/health/5-minute-guide-to-inflamm-aging Bottom Line: We all must age, and how we do so is largely under our own control. To create an anti-inflammatory lifestyle is not that difficult, especially if you put it all together in stages. Start with a clean, whole-food, unprocessed plant-based food plan. And to begin, first focus on what you can add into your menus and use those additions to sort of crowd out the things that are more inflammatory…sugar, refined grains, processed and pre-packaged things. Set realistic goals such as going plant based one or two days a week, or even one meal…just start and gradually work up. It has to be doable so don’t stress. Next, start moving and doing regular exercise at least three times a week…and find what you enjoy doing and focus on that. Then add activities that de-stress you, whether that is socializing, church, meditation, prayer, yoga, etc. Overall, shift your attention to giving love to things that love you back. Sugar, drive-thru and processed food like thingies do not love you back but apples or kiwis or berries or veggies do. Sitting around does not love you back but going for a short walk after a meal does love you back. Hang out and give love to the people you really like to be with, they will most always love you back. Create a love you back lifestyle and see how you feel.
By Mark Smith August 18, 2025
Hello everyone: I frequently hear about mental health issues with the people in our practice. They could be experiencing depression, or anxiety, feel flat, can’t focus or sustain attention, or may not feel well in general. These comments can come from anyone of any age…I can hear from parents about their kids, or it may be themselves experiencing these feeling. So, when I read this paper, it felt important to share it because we all seem to have mobile phones. Here is how the paper is summarized: “Concern about how smartphones affect users is widespread: half of American smartphone users—and 80% of those under age 30—worry that they use their device too much, and correlational research suggests that smartphone use is negatively related to mental health and cognitive functioning. However, few large-scale experiments have tested for causal effects. We report such an experiment, finding that blocking mobile internet for 2 weeks reduces smartphone use and improves subjective well-being (SWB) (including life satisfaction and positive affect), mental health (more than antidepressants), and sustained attention (as much as being 10 years younger). Despite the many benefits mobile internet offers, reducing the constant connection to the digital world can have large positive effects.” https://academic.oup.com/pnasnexus/article/4/2/pgaf017/8016017?utm_source=klaviyo&utm_medium=email&utm_campaign=%28Email%20-%20Chris%20Kresser%20General%20News%29%20Chris%27s%20Friday%20Favorites&utm_term=randomized%20controlled%20trial&utm_content=randomized%20controlled%20trial&_kx=fARhTo_gi8X3B_2-MaeO_RyzUl9tvT3tr4re-Dy7cNQ.my75y6 Bottom Line: It seems like a smartphone ‘timeout’ can be very beneficial for mental, emotional, physical health and can be an important part of stress reduction. The world today, with nearly instant communications, the almost constant bad and anxiety promoting news, and the fast pace of data consumption can add up to significantly stress us out and pull us down…or just simple keep us distracted. From what I can see, a ‘timeout’ may be just what the doctor ordered.
By Mark Smith August 11, 2025
Hey there everyone: As you know, inflammation causes, perpetuates, and/or aggravates every known human condition, including aging. As we age, we become more vulnerable to non-communicable diseases such as heart attack, stroke, high blood pressure, cancer, diabetes, dementia, arthritis and more. How we eat can massively reduce our inflammatory burden and promote health as we age. It is your choice. One reason that I keep writing on this is that I keep running into the mindset that these diseases are inevitable and that there is nothing we can do about it. Plus, because there are so many different diets for sale out there, it becomes hard to know what to eat. What is important for you to know is that there is a growing scientific consensus about what to eat, but the media rarely mention it and our public health authorities don’t either. It definitely seems like money is more important than our health. So…consuming an overall low-inflammatory diet is what the science is adding up to show it is the healthiest way to go, plus it actually gives you power over your future. This is a great article worth the time it takes to read it as it is pretty comprehensive. Bottom Line: “To adopt an anti-inflammatory dietary pattern, it is recommended to replace refined grains with whole grains, substitute healthy fats (such as nuts, seeds and fatty fish) for saturated and trans fats and increase the consumption of colorful fruits and vegetables while reducing the intake of sugary and processed foods. Additionally, choosing lean protein sources like fish and legumes over red and processed meats, using herbs and spices (such as turmeric, ginger, garlic and cinnamon) in place of excessive salt and sugar and consuming probiotic-rich foods (such as yogurt and kefir) instead of processed and sugary snacks are advised. These dietary adjustments can help mitigate inflammation and promote overall health.” https://www.cambridge.org/core/journals/british-journal-of-nutrition/article/overview-of-antiinflammatory-diets-and-their-promising-effects-on-noncommunicable-diseases/AA3166846841DCC1B219C063F52E2A7F (anti-inflammatory diet)
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