Do you wake up feeling exhausted?

Do you struggle to focus at work, even after chugging caffeine and doing your morning workout?


If you feel like you’re doing ‘all the healthy things’ but are still exhausted, you may be experiencing adrenal fatigue, also known as HPA-D.



Imagine this scenario…

As your alarm clock blares, you jolt awake in a state of panic, feeling as though you hardly slept. You quickly get ready for the gym, chugging a preworkout or cup of coffee as you make your way to do a HIIT workout. Maybe you opt for a smoothie or bowl of oatmeal with fruit or you skip breakfast altogether because you’re intermittent fasting

You head to work but find yourself stuck in traffic. You arrive late and your boss lays into you for it. You have meetings that should have been emails and feel like none of your co-workers can do their jobs. You get wrapped up in thoughts of how you’re not getting paid enough or that you hate your job.

Lunch is either skipped or eaten at your desk.  Maybe you try to eat healthy and choose a salad or a sandwich or perhaps you are so swamped you end up grabbing fast-food with the rest of the crew.  Your workday consists of four to five hours glued to your computer screen. 

When you finally get home, you unwind by putting on your Blueblocker glasses and eating dinner in front of the TV until it’s time to drag yourself to bed around 11pm. You scroll through your phone until you eventually fall asleep, sometimes aided by a Xanax, a glass of wine, or CBD gummies.

On weekends, you indulge in brunch and later have dinner and drinks with friends. You stay up late to let loose and have fun but come Sunday morning, you wake up hungover and anxious, knowing that the cycle of the daily grind will start all over again tomorrow.


Sound familiar?


This is a day in the life of many of more health-conscious patients. 

Keep on reading to learn how this seemingly healthy lifestyle contributes to burn out and how to fix it. 




When new patients walk into my office or I meet with them virtually during a Functional Medicine consultation, I ask them what an average breakfast, lunch and dinner looks like. I often hear: “I eat pretty healthy” or “I don’t eat breakfast because I’m intermittent fasting.”

When I ask about their exercise, many are doing HIIT workouts, CrossFit, or other high-intensity training.

On my intake form, I have a section where new patients rate their stress level on a scale of 1-10. Most of them are between 6-9.

Many of them are doing all the things that they think they are supposed to be doing for their health. But ‘being healthy’ can be tricky when you aren’t listening to your body and adapting your habits to your lifestyle and stress levels. 

‘Health’ is not a simple, one-size-fits-all approach that often gets touted on social media or news outlets. So even when we feel like we are ‘doing all the right things’ we may still not feel like we’re thriving because we aren’t using the tools that are appropriate for our individual bodies or lifestyles at the right time.

Multi-tasking, high demand jobs, work-hard-play-hard mentality, lack of consistent movement throughout the day, processed and sugary foods, artificial lighting and spending lots of time indoors puts our bodies into a state of chronic stress.

This results in burn-out, often referred to as ‘adrenal fatigue’ or what I prefer to call Hypothalamus-Pituitary-Adrenal Dysfunction which is a total mouthful so instead we lovingly call it HPA-D. 

And even if you’re biohacking your balls off, you’re not going to see massive changes until you find ways to manage stress and live in harmony with your circadian rhythm. 



It’s not only the obvious offenders like your job, traffic, kids, or the daily grind that cause stress — those are only examples of “PERCEIVED” stress, the emotional kind that you can consciously recognize.

There are many other “physical” types of stressors that you may not be aware of…

  • Gut infections
  • Processed foods
  • Heavy metals
  • EMF exposure
  • Poor sleep
  • Chronic disease
  • Over-exercising
  • Blue light exposure 
  • Circadian rhythm disruption
  • Multi-tasking
  • Blood sugar disorders
  • Low-calorie diets

These things trigger a chronic stress response in the body too.

So even if you don’t feel stressed emotionally, if your body is burdened with any of the above, that intricate dance between the hypothalamus, pituitary and the adrenals becomes sloppy like that drunk uncle dancing at the wedding afterparty at 2am. They aren’t working in harmony to reduce stress hormones and the subsequent inflammation that comes with exposure to those stress hormones long-term. 

And the more of these stressors you have at one time, the more it burdened your body becomes. 

That’s why you can’t just rely on a basic diet and exercise routine to stay mentally, emotionally, and physically healthy. You must also address chronic infections, dial in your gut health, balance your blood sugar, and do daily stress management.

It’s also why doing HITT and intermittent fasting during a stressful time of your life may be overburdening your body.

So if you’re doing “everything” to stay healthy and still feel you’re a hot mess on the verge of a physical or emotional breakdown, it’s time to examine your daily habits and see where you can make a change.



Let’s break down how that ‘day-in-the-life’ I described above is wreaking havoc upon your health…


You jolt awake to your alarm clock blaring, feeling like you barely slept.

Being suddenly woken up by a loud and stressful alarm sound in the morning can trigger the HPA axis and increase your cortisol and adrenaline levels. This can feel even more jarring if you are in a deep stage of sleep, causing an increase in heart rate and blood pressure, and leading to the secretion of adrenaline.

On the other hand, waking up naturally without an alarm clock allows you to gradually ease into wakefulness without the sudden surge of stress hormones. This can help you feel more relaxed throughout the day.

To achieve quality sleep and wake up naturally, it’s essential to get adequate sunlight exposure during the day and avoid light exposure at night. You can also improve your sleep quality by going to bed ideally around 9-10pm and using daily stress management techniques such as journaling before bed or practicing daily meditation to quiet your mind.

Sleep deprivation can activate the stress response and lead to increased cortisol levels, which can create a cycle of stress-insomnia-stress-insomnia. Therefore, getting enough quality sleep is absolutely essential for maintaining overall physical and mental health.


You quickly get ready for the gym, chugging a preworkout or cup of coffee as you make your way to do a HIIT workout.  You skip breakfast altogether by practicing intermittent fasting or opting for a smoothie or bowl of oatmeal and fruit.

How you start your day is crucial for overall energy and mindset throughout the day.

Many Americans start their day with breakfast options that are high in sugar and/or carbohydrates but low in nutrients. This can include foods like bread, croissants, and cereals, as well as seemingly healthy options like smoothies, fruit, and oatmeal.

This can cause spikes and crashes in blood sugar levels, leading to an increase in cortisol and blood sugar dysregulation. These imbalances can contribute to anxiety, poor stress management, hanger, cold extremities, brain fog, afternoon energy slumps, poor digestion, and other health problems.

Even more is every time blood sugar drops, it’s an emergency signal to the body and the HPA axis (stress response) is activated. Ongoing blood sugar imbalances create systemic inflammation, imbalanced hormones, and other serious issues.

Opting for warm and savory breakfast options that are rich in protein and essential nutrients can assist in regulating blood sugar levels and offer us sustained energy throughout the day. Choosing protein-rich ingredients such as bacon, steak, sausage, chicken, eggs, and vegetables, coupled with nourishing fats like avocado or olive oil, helps in maintaining stable blood sugar levels and keeps us satiated until lunchtime.

Eating on-the-go means you aren’t chewing your food as well and aren’t eating in a relaxed state which decreases acid and enzyme production. This hinders digestion and allows large particles of food to make their way past the stomach and into the small intestine which can lead to inflammation, SIBO or leaky gut. An inflamed gut can increase the risk of developing autoimmune disorders, food sensitivities, allergies, and other health issues.

Intermittent fasting is a prime example of where the one-size-fits-all approach fails. IF can be amazing for people trying to lose weight but if you are already under a lot of stress, are underweight, have thyroid or hormone issues, or already have blood sugar dysregulation, it may not be the best choice for you. 

Fasting can be stressful on the body and if you’re already having a lot of perceived stress (from your job, family, or other areas of your life), or physiological stress (gut infection, chronic illness or PTSD), it’s better for your nervous system to eat consistent, nourishing meals to keep your blood sugar regulated and additional stress to a minimum. 

If you do choose to intermittent fast, I recommend doing a fasting window where you eat both dinner and breakfast early, between 5-7pm and 7-9am respectively. This allows your digestive system to rest while sleeping at night and provide fuel in the morning for stable energy all day. 

For those doing keto, it’s important to note that a consistently low carb diet can be another layer of stress on the body. Couple that with intense exercise like spin or a HIIT workout on top of a super stressful week and you may start pushing your body to the brink of burnout.

During intense exercise, the body requires a significant amount of energy to perform, and this energy is usually obtained from glucose stored in the muscles and liver. 

However, in a low carb diet like keto, the body is forced to use alternative sources of fuel, such as ketones, to power the muscles. This can result in an increased demand on the HPA axis, which can lead to hormonal imbalances and increased stress levels.

The most important part of all of this is to listen to your body’s signals and find a balance that works for your body and goals. 

Obviously regular exercise is vital for good health and none of these things listed above are ‘bad’ by themselves. However when they are combined they can create imbalances that put too much strain on the body.

If you’re feeling burnt out, exhausted or plateaued in your workouts, it may be time to make some adjustments to your workout and eating habits.  

These adjustments may vary from week to week depending on how your body is feeling, but it’s essential to be aware of how your body is responding to these stressors and make changes accordingly.


You head to work but find yourself stuck in traffic.

When we engage in aggressive driving behaviors like getting cut off, cursing, or speeding, we activate the HPA axis and trigger our stress response. While it’s difficult to completely avoid this kind of stress, there are small changes we can make to minimize the impact on our nervous system.

For example, listening to a podcast, relaxing music, or practicing meditation while commuting can help keep us in a happier and calmer state. These small tweaks can make a big difference in our overall well-being.


You arrive late and your boss lays into you for it. You have meetings that should have been emails and feel like none of your co-workers can do their jobs. You get wrapped up in thoughts of how you’re not getting paid enough or that you hate your job.

Work and finances are the two biggest emotional stressors for modern Americans, unlike our ancestors who faced more acute stressors such as fleeing from a predator. These continuous emotional stressors keep us in a state of fight-flight-free by consistently activating the HPA axis, which can take a significant toll on our health.

Sometimes it can be tough to find joy in our day-to-day lives, especially when it comes to work. However, it’s important to remember that chronic stress can take a toll on both our mental and physical well-being. While quitting your job may not be the solution, there are still ways to address the stressors in your life.

If you find yourself in a job that you hate or doing something that doesn’t bring you joy, take a step back and see how you can make changes. This could mean asking for a raise, taking on different tasks within your company, or simply finding ways to make your workday more enjoyable. It’s easy to get stuck in a negative mindset, but it’s important to remember that happiness is ultimately a choice.

By taking control of the things you can change and shifting your perspective about the things you can’t, you can start to create a more fulfilling life for yourself. Remember, it’s never too late to start making positive changes and finding joy in the little things.


You eat lunch at your desk or skip it all together…

Eating while multitasking causes us to chew poorly, eat more than intended and become largely out of touch with our food. This causes poor digestion and has us eating in a stressed state. When we eat while stressed or distracted, we produce less stomach acid and food sits in the gut for longer, causing fermentation which results in gas and bloating. 

Furthermore, inadequate chewing allows larger food chunks to reach the gut, creating extra work for the stomach and increasing the likelihood of leaky gut or intestinal permeability. 

It’s essential to make mealtimes a moment of relaxation and reflection. Take time to savor each bite, connect with the flavors and textures of your food, and enjoy the nourishment it provides.

As we discussed above, while intermittent fasting can be helpful in certain situations, it’s not suitable for everyone, particularly those already experiencing stress, hormone imbalances, or low blood sugar. Skipping meals can create additional stress on the body, which can cause more harm than good in the long run.

You sit at the computer for 4-5 hours a day. 

We all know that exercise is important and many health-conscious people get in an hour workout at least a few times a week.

But what you may not know is that too much sitting is harmful even if you are getting ‘enough’ exercise.

This means you could be meeting the recommended guidelines for exercise (i.e., 30 minutes of moderate to vigorous activity, five days a week), but still be at higher risk of disease if you sit for long periods each day.

In fact, a large study involving over 100,000 U.S. adults found that those who sat for 6+ hours a day had up to a 40% greater risk of death over the next 15 years than those who sat for less than three hours a day. 

It’s absolutely vital that you break up your ‘sitting’ time with walks, stretching, or even doing exercise breaks if you work from home. Setting a timer every 30-60min helps you to break it up and move your body, even if it’s just taking a stroll to the water cooler or getting up to stretch. 


When you get home from work you eat dinner in front of the TV and scroll on your phone until it’s time to drag yourself into bed at 11pm. You scroll until you fall asleep. Or maybe you need to take a xanax or other sleeping med to be able to sleep through the night.

We already discussed distracted eating and TV is another common example of this.

The blue light that is emitted from your tv, phone and computer screen mimics daylight and creates stress/stimulation in the body. This can lead to insomnia or disrupted sleep. 

Maybe you already do turn off all the devices and still have a hard time sleeping, finding yourself worrying about upcoming deadlines, things you need to do or conversations that happened earlier in the day. 

Instead of turning to sedatives that numb the body and have groggy next morning side-effects, try journaling or meditating before bed to regulate your stress response. 

Wine, sugary CBD gummies or edibles, and THC all increase the load of toxins and substances our livers have to breakdown and detox which puts more stress on the body.  Using these temporary band-aid solutions creates a vicious cycle that creates more toxicity in the body, which produces more stimulation of the HPA-axis and results in a more dysregulated nervous system. 


On the weekends you treat yourself with brunch and later get dinner and drinks with friends. You stay up late because it’s the weekend and you want to let loose and have some fun. You wake up hungover and get the Sunday scaries knowing that tomorrow the grind starts all over again.

I think it’s pretty clear as to why this can become an issue. If we’re stressed all week and use alcohol and late-nights to unwind and have fun, we add insult to injury on an over-stressed system. We aren’t giving the body time to rest and recover. 

Sleep is when the time when the body recovers and repairs and if we are staying up late, we miss out on that vital recovery time. Imagine if the garbage truck didn’t come for a few weeks. Cellular trash and debris begins to build up within the body and leaves us feeling moody, tired, inflamed and drained.

Throw alcohol into the mix and we have a hot, flaming dumpster fire! Alcohol is a toxin (think about it, we use alcohol to clean and disinfect) so putting that into our systems and conjunction with all the sugary mixers and lack of sleep is just beating our bodies into total, exhausted submission. 

You start back on Monday with an inflamed, irritated body that is barely handling the basics of modern life. How are you supposed to thrive when you start your week with an empty tank?


So what are things you can focus on to balance out your HPA-axis and avoid burnout?

  • Eat a warm, savory breakfast
  • Take breaks from the screen, getting up to walk every 30-60 minutes
  • Get outside within an hour of waking to regulate cortisol
  • Train yourself to wake up naturally or use a sunrise alarm clock that uses light instead of sound
  • Meditate DAILY (not just in SOS moments)
  • Journal 2-3 pages each day to get the chatter out of your head.
    • Writing it out allows you to organize your thoughts and process feelings more efficiently than simply ‘thinking’ through them
  • Use the weekend to rest and recover or pour back into your cup with activities that light you up
  • Use meals as a meditation and time to focus only on your food.
    • Pay attention to the taste, texture and temperature of each bite.
    • Chew every bite until it’s liquified.
    • Avoid phones, tv, computers or reading for best digestion.
  • Aim for 8000 steps a day to have a goal to help you get outside and move more
  • Get a standing or treadmill desk to increase movement and activity throughout the day
  • Address underlying health issues (gut infections, heavy metals, parasites, blood sugar dysregulation, etc) that cause chronic stress
  • Limit blue light and artificial lights at night
    • Keep lights dim and to a minimum as the sun goes down.
    • Avoid screens 2 hours before bed.
    • Read instead of watch TV or scroll.
  • Improve sleep hygiene and create a routine.
    • Our bodies love routine and doing one before bed helps keep things consistent and prime the body for sleep.
  • Minimize alcohol consumption by either reducing the number of days you drink during the week or the number of drinks you have.
    • Contrary to that one cherry-picked study that says wine is actually healthy for you… there is no safe limit of alcohol and if you are feeling run-down, alcohol puts more stress and strain on the body
  • During times of emotional stress, limit other stressful activities.
    • This includes fasting, HIIT or intense workouts, sleep deprivation
  • Get acupuncture!
    • It rebalances the nervous system and helps get your body into rest-and-digest mode and out of fight-or-flight. It relieves inflammation, pain and helps to heal the gut
  • Get Functional Medicine testing for your basic vitamin levels and gut health.
    • I use the GI Effects Stool Test by Genova Diagnostics for gut testing which assesses malabsorption, inflammation, infections, dysbiosis, and metabolic health of your gut!

While diet and exercise are an incredibly important aspect of health, stress management is just as vital for you to feel happy and healthy. Achieving optimal health is about more than simply eating well and exercising regularly. True wellness requires a holistic approach that takes into account all of your micro-habits and actions during the day that add up to make a big difference.  


If you want personalized recommendations and help fine-tuning your routine and habits, schedule a Functional Medicine Consultation. In addition to doing comprehensive bloodwork and other specialized labs (stool, breath, DUTCH, etc), we will go over your diet and routine to figure out how we can dial in and upgrade your health.


Book this 30 min virtual consultation today!