In this episode of the Feel Good Effect, we’re joined by Dana Monsees, MS, CNS, LDN. If you are looking for some very simple habits that you can use to manage stress, beat burnout, and address adrenal fatigue – this episode is for you.
These basic habits are around stress management and whole health are important for all of us (whether you think you may be struggling with adrenal fatigue or not). Listen in to the episode or read the article for all our made-for-real-life tips!
4 simple habits to manage stress, beat burnout & address adrenal fatigue with dana monsees, MS, CNS, LDN
meet the guest: dana monsees
Dana started her brand at Real Food with Dana as a food-only blog while she was in school to become a dietitian nutritionist. Once she got her credentials and started working with people though, she wanted to transform her business into something more clinical, specifically working with adrenal fatigue, gut health, thyroid conditions, and how people’s relationship with food and body image can play into clinical manifestations of symptoms and illness.
Day to day, Dana works with patients and clients under a naturopathic doctor in her practice as well as in her own practice where she focuses on helping women with body image and relationships with food issues who also have symptoms of gut problems. The people attracted to her practice tend to be Type A, perfectionist, over exercisers, with a history of either chronic dieting or eating disorders.
please note: this podcast is for informational and empowerment purposes only, we’re not providing medical advice and always encourage you to seek advice from your trusted health professionals.
“the main symptom is an overwhelming crushing fatigue…basically what’s really happening when adrenal fatigue is going on is the body can no longer meet the needs of the various stressors – so physiologically the body starts to compensate”
Dana Monsees, MS, CNS, LDN
what is adrenal fatigue?
Adrenal fatigue is a term that was not recognized by the western medicine, allopathic community for a long time because it is a misnomer. It is not that your adrenal is getting tired and stopping producing cortisol (which is actually a different, autoimmune, medically diagnosable disease called Cushing’s or Addison’s disease).
Adrenal fatigue is a collection of symptoms named for the main symptom, which is overwhelming fatigue. Really it is HPA-axis dysregulation. HPA axis is the hypothalamus-pituitary-adrenal axis tied in with the thyroid, all being very interconnected between hormone signaling and releasing. This synergistic nature between all these different structures is why so many with adrenal issues also have thyroid issues, sex hormone issues, and gut issues.
What’s really going on in adrenal fatigue is that the body can no longer meet the demands of the chronic stressors or very intense acute stressors that we’ve put on our bodies. Most of the chemical compounds that we are talking about here are hormones, which fluctuate and are cyclical in nature. Every time the body is exposed to a stressor (whether you think of it as a stressor or not) – physical, mental, emotional, or spiritual – your sympathetic nervous system is activated & you go into “fight or flight mode”.
what is “fight or flight mode”?
Fight or flight mode feels like the shock your body temporarily goes into when you have to temporarily swerve in traffic. Your muscles tense up, your heart rate goes up, among other physiological changes to get your body ready to fight or flee. Conversely, in rest or digest mode, we are resting, recovering, digesting, and where we want to be for most of the time. If you are continually in fight or flight, your body is not producing digestive enzymes, allowing your muscles to recover, or sex hormone regulation.
Fight or flight is adaptive in keeping us safe, but adrenal fatigue comes in when this is activated too much, too often. It’s not that the adrenals are getting tired, what happens in the body is really similar to what happens in the pancreas in insulin resistance which leads to metabolic syndrome and diabetes. If you are stressed all the time and your body is constantly producing cortisol, you’re hypothalamus and pituitary stop signaling the adrenals to send out more because there is already so much in the bloodstream. Instead, they conserve their resources to make other hormones or signaling hormones. It’s a protective mechanism by the body. The problem is that when you start to have cortisol in your bloodstream all the time, you’re never in rest and digest. Your blood sugar & pressure are all over the place and your immunity is compromised.
Similar to the manifestations of some autoimmune diseases, adrenal fatigue has symptoms all over the body, so symptom management does not get at the root cause. Trying to manage symptoms independently doesn’t get to the root cause, and does not allow you to heal from the adrenal fatigue because we so often cannot figure out where it is coming from.
talking to your western practitioner about your symptoms
Dana’s answer is – it really depends on the practitioner. A good thing that came out of 2020 is that more people are talking about burnout. If you were to go to your primary care and say, “I think I am having some cortisol issues, I’m really tired all time, and I am feeling completely burned out”, that would put them in the right direction of wanting to test your hormones. You may have more luck in the functional medicine world, though. Like with an integrative nutritionist or a dietitian, someone who can do cortisol testing, or the Dutch test (which tests all your adrenal hormones and methylation factors).
“It’s really important to get to the root cause of what’s going on”.
Dana Monsees, MS, CNS, LDN
If you are burned out and feel like something is wrong:
- Advocate for yourself. If a medical professional dismisses your concerns, do what you need to do to get them to listen or find another doctor.
- Remember that this might not be the thing that’s going on. This cluster of symptoms could be a product of a number of things. Keep an open mind when you talk to a medical professional to make sure you look at other potential issues.
So many have gone to their primary care provider and gotten labs back that don’t show concerns. If you’re having symptoms, though, your labs probably aren’t fine. Getting a second opinion is always great. On the other hand, some people will read about adrenal fatigue and self-diagnose, jumping into a diet for adrenal fatigue.
some signs of hormonal dysregulation
- If you are exhausted all day and wired at night
- Stuck “on” and struggling to relax
- Missed periods, crazy PMS that differs from your normal
- Feeling like you can’t function without coffee
- Worsening anxiety and/or depression
- Sugar and salt cravings
- Hair falling out
- Fluid retention, bloating, feeding puffy
- Waking up feeling hungover, even when you haven’t been drinking
It’s an interesting time, so many of us probably being able to nod “yes”‘ to a few of those, but it’s really about knowing yourself and your baseline.
“When we are talking about hormonal dysregulation, stress, doing a diet… trying to put your body in a deficit is another form of stress that will not allow you to get out of adrenal fatigue.”
Dana Monsees, MS, CNS, LDN
steps to take to try to figure out a root cause for symptoms
Dana can typically tell where someone is at with their progression of adrenal fatigue based on responses to questionnaires she administers. You can think about these through a self-assessment, too:
- Hopped up on coffee, go-go-go-lifestyle, perfectionist, stressed out to the max
- Higher cortisol most of the day and night
- Tired and wired, tired during the day, awake at night
- Low cortisol in the morning, high at night
- Tired all the time, when someone asks you something you are ready to break down crying or feeling like people are just too much
- Overall cortisol is constantly low
Cortisol has an inverse relationship with melatonin (cortisol is high = melatonin is low) The optimal cortisol high is at noon, slowly decreasing through the day so you can fall asleep naturally at night without having to take extra melatonin
which tests to prioritize
You don’t have to spend the money on getting tests done for your provider to make recommendations about nutrition and lifestyle.
If you can prioritize getting tests done, Dana recommends a dried urine panel called the Dutch test. This comprehensive test covers cortisol, DHEA, sex hormones, and methylation factors. This is different than a blood cortisol test you might get with your annual bloodwork. With the blood test, you get one marker from one point in the day. What really matters when we’re talking about adrenal fatigue is how your DHEA and cortisol fluctuate throughout the day. Functional medicine testing gives us an accurate representation of how your levels are changing throughout the day.
Another one you can likely get through your regular primary care or endocrinologist is getting your thyroid levels checked. A lot of symptoms of adrenal fatigue do overlap with hypothyroidism or Hashimoto’s (because of the adrenals and thyroid being so connected).
“When we talk about self-love and self-care, understanding stress is really important and something most of us have not been equipped to do”
Robyn Conley Downs
assessing your stress with the stress bucket practice
If you think that adrenal fatigue or hypothyroidism or any of these things discussed above might be an issue for you – the best thing you can start doing is assess where it is coming from. Think about all the things that are stressing you out, demands in your life, and all things you have to do.
Take stock of your stress with a Stress Bucket practice. Write down every single thing that you think could be filling up your bucket. This includes stress related to body image, your relationship with food, time spent trying to figure out your health, overexercising, etc.
It’s probably not best to do more cortisol-dependant activity at that point since it’s probably filling up your stress bucket more.
Ask yourself how can you reduce the number of things in your stress bucket? And how can you make that sustainable for the long term?
sources of stress to consider
A lot of high-performing clients are used to having tons of things on their plate at the same time; they’re good at managing stress.
But stress isn’t just what “stresses you out”, like living in a global pandemic is an obvious stressor. But also think about the things that are going on in your day-to-day life that put demands on yourself or your body. Exercise is something we are asking our bodies to do for us. It can be hard to tease these things out, because some, like exercise, are things people use for stress management. But if you notice that after a hard workout, you’re still tired hours later and you wake up the next morning with less energy than you had the day before, something you did the previous day was too much. If the demands you are asking your body to do are too much and it keeps being like this over time, it will not end well.
Keep in mind that all of our thresholds are lower than they used to be. Just the experience of living through last year has impacted us on individual levels. In addition to operating on a lower threshold, we are putting additional demands on top of it.
Don’t start with quitting your job. Start with asking, where are the things where I can give my body a break? There are some stressors that we can’t get rid of. We can’t get rid of the fact that we live in a pandemic and you might not be able to get rid of a less than ideal work situation with no other option.
“If you don’t fix where the problem came from in the first place, it doesn’t matter what protocol you’re doing. As soon as you’re done with that protocol, if you haven’t fixed the lifestyle stuff it’s all going to come back.”
Dana Monsees, MS, CNS, LDN
what do we do to step out of this burnout point?
Aside from not taking on new routines and habits that add stress to your bucket, the next step is choosing things that fill your cup up. Think about things mentally, emotionally, physically, spiritually- what fills your cup? Frontline workers are living in a survival mode state right now and there isn’t anything that can be done to change that. What you can do, though, is try to get restorative sleep, take a few minutes longer in the shower, ask someone for help with something, do things that are more restorative for you.
Dana is recommending that we get back into things that we loved during our childhood. We spend so much time on screens, both at work or during the day, and often to relax in the evening; all of that blue light can disrupt our circadian rhythms or cortisol sleep-wake cycle. Thnk about playing board games, fun reading.
Also, acting on the ideas of the Feel Good Effect is also going to help you lessen the stressors in your bucket. Perfectionism can certainly lead to burnout, perhaps one of the leading causes. People pleasing & trying to “should” yourself through your day, everyday – these take away from your cup and are not restorative. Choosing more restorative activities so that the minimal time you do have off from your stressful job is even more important to think about. Get away from the all-or-nothing mentality and choose restoration that works for you; it does not have to be a 12-step self-care routine.
Don’t pour fuel on the fire.
The answer is not always food. There is no diet alone that is going to cure adrenal fatigue.
“Diet alone isn’t the only thing that got us to where we are, so diet alone can’t be the only thing that gets us out of it”.
Dana Monsees, MS, CNS, LDN
steps to take
1. Try to get at the root cause
2. Do some assessments and evaluations (if you can)
3. Start by stopping the fuel on the fire
4. Add in restorative practices
If you want to learn more about the physiology of the adrenals or what cortisol resistance really is, listen to Real Talk with Dana.
It’s important to remember, don’t beat yourself up if you are in this place. It’s really easy to blame ourselves when it seems like a lot of the things you are hearing are around self-blame. You can’t heal in a blaming mindset. Give yourself a little bit of a break and think about practical steps to take. “You can’t heal in the same environment where you got sick”. And moving forward, you can have more compassion, less “shoulding”, the tools for awareness, and ways to get out of the situation.
what it really means to be healthy
“When I think of being healthy, I think of feeling vibrant and well from the inside out and that encompasses physical, mental, emotional, social, spiritual, whatever the buckets that you really prioritize. It’s not about sacrificing one or three of those for another one; it’s a balance of all of them… really finding whatever your unique balance of… health looks like. Having not only yourself feeling food, but a community of support around you that supports your ideas and beliefs and whatever those are to help you feel good”
Dana Monsees, MS, CNS, LDN
what is a CNS?
A CNS is a certified nutritionist specialist, the closest you can get to a registered dietitian credential. Not wanting to go back to school for another bachelor’s, Dana went for a master’s degree and became a CNS. There is not a lot of enforcement of laws around licensure for nutritionists and dietitians, so almost anyone could call themselves a nutritionist in most states in the U.S., regardless of whether they completed really intense credentials or took a 3-week nutrition course online. More specifically, among several different titles and background combinations out there, Dana is a dietitian nutritionist.
Dana Monsees, MS, CNS, LDN is a Dietitian-Nutritionist and Body Image Coach who helps women with gut issues, hormonal imbalances, and burnout. By starting with their relationship with food and their bodies, Dana helps women heal their chronic symptoms and get out of the elimination diet yo-yo cycle for good. She is the creator of Real Food with Dana and the host of the Real Talk with Dana podcast, where she and her guests break down no-BS nutrition science, body image, health inclusivity and reclaiming your power.
Listen to Dana’s podcast, Real Talk with Dana
Listen to Dana’s podcast episode with Robyn