Overcoming Fatigue with Ari Whitten

Dr. Cates: Hi there. I’m Dr Trevor Cates. Welcome to The Spa Dr. Podcast. On today’s podcast work covering the science of overcoming fatigue and getting real energy back. And I know many of you probably are using energy drinks, caffeine, sugar to boost your energy, but we all know that that is not sustainable energy. That’s gonna wear off, that’s going to be a problem in the short and long term. So let’s get to the root cause of why your energy is low and come up with some real solutions in this podcast today. My guest is Ari Whitten. He is a bestselling author and the founder of the energy blueprint. He has been studying and teaching health science for over 20 years and for the last five years he’s teamed up with world renowned scientists and physicians to help with an evident to create, an evidence based system for overcoming fatigue and increasing energy levels. Today we talk about whether or not adrenal fatigue is the real cause of low energy and what Ari shares about? The research on fatigue syndromes will probably surprise you. And in the end of the podcast we discuss one thing we know for sure affects our energy levels and what you can do about it. So stay til the end of find out what that is. And I hope you enjoy this podcast.

Dr. Cates: Ari, welcome to my podcast. It’s great to have you here.

Ari Whitten: Yeah. Thank you so much for having me.

Dr. Cates: Yeah, so I know what we’re talking about fatigue today cause it’s such a big topic and everybody’s reaching for coffee and energy drinks and that quick fix to boost their energy. And it is, it is definitely something that everybody has struggled with, right? We’ve all been tired and you’ve got kind of a unique angle on this and you’ve done a lot of research. So I wanted to have you on and so you could share some of this.

Ari Whitten: Yeah, it would be my pleasure.

Dr. Cates: Yeah. So, you’ve done a lot of the research and looking at adrenal fatigue in particular. And so what are some of the things you noticed about adrenal fatigue in the literature

Ari Whitten: Before we get there, if you don’t mind, I’d love to comment on what you said a minute ago, just about the quick fixes. And the stimulants and energy drinks and all that. I think it’s a huge issue and I’m glad that you brought that up because, they are really insidious things, you know, a lot of these stimulant and sugar based energy pills and energy drinks. Because they, they give the illusion of being the fix to the problem. They actually work in the sense that, you know, if you take those things within half an hour or an hour, you feel more energy and you function better for a few hours. And so it makes you feel like it works. And then people start relying on it on a daily basis. And as a result of that, in long term, they end up actually subtly eroding away at their body’s ability to produce energy the real way, real energy. And, and then they become addicted to the substances and their body is dependent on them just to do, to function normally. And it’s a really, really insidious process again, because it appears to be working and helping while it’s simultaneously actually making you worse over time. So these things are really big issue and I’m not into any of that stuff. I’m not into stimulants and sugar pills. I mean, it would be very easy for me to create a supplement that’s a stimulant based energy supplement and, and sell it. And I could make a lot of money doing that, but I don’t do it because that’s not what I’m into. I’m into teaching people how to build real energy. And you know, caffeine is an interesting subject. The same thing actually happens with coffee and people can become dependent on that to function in the same way. And a lot of people are unaware of how that works. But basically caffeine works by blocking, by plugging up a certain receptor in the brain called an adenosine receptor. Adenosine is a type of neurotransmitter that’s normally an inhibitory neurotransmitter. So it’s a neurotransmitter that essentially calms down the brain and makes you tired and sleepy. And by blocking, by plugging that receptor up, caffeine creates a stimulant and energizing effect. And it works really well in the short term. If you take people who don’t normally consume caffeine, you give them caffeine, you see a really nice boost to their mood and their energy levels and their performance. The problem is over time, when you do that on a daily basis, the brain basically says, Hey, I’m being overstimulated here. Let’s get back into balance. So it creates more adenosine receptors and more adenosine in the brain. So that does a couple things. One is that once the caffeine leaves your system, you crash harder. It also creates a higher tolerance to caffeine meaning you need more caffeine to get the same buzz effect. And that’s why people end up drinking two, three, four, five, six cups of coffee a day. But the third thing that most insidious thing is that if this is somebody who’s normal energy levels and performance, what people think is happening when they consume caffeine is that they’re going like this. They’re going above what’s their normal and then back down what’s actually happening over time because of those negative neurotransmitter adaptations with the adenosine receptors and the adenosine is you go from here as your normal baseline performance and energy levels to here. And then the, that you feel, that subjective increase in energy levels actually is just taking you back up to normal, what used to be your normal level of function and then you go back down. So that’s why people who are dependent on caffeine wake up groggy. It’s like there’s zombies and then they need their caffeine and then as soon as they have their caffeine now, now things turn on. So that is not where you want to be. You don’t want to be in a state of drug dependence just to function. Normally. You want to be in a state of vitality and energy and then using caffeine or coffee. I’m not opposed to it to the use of coffee, but I am a, I am a proponent of using it in an intelligent systematic way, um, not becoming dependent on it to function on a daily basis. And then when you use it that way, you do actually get a genuine boost. So anyway, that was a little spiel on the whole quick fixes.

Dr. Cates: Yeah. And that’s great. And also there’s the physical, a chemical addiction to sugar and coffee to that, those withdraw symptoms that with people that are addicted to caffeine and I’ll get the headaches. And so it’s a real thing and people that have sugar withdraws, their mood changes. The cravings, there are changes in person that there are behavioral changes. A lot of this stuff can change because of the addiction that people can develop if they become so dependent upon these as energy boosters. So definitely not the way we want to go

Ari Whitten: 100%. And also since you brought up the withdrawal symptoms, um, this is an interesting way of thinking about it because a lot of the research actually explicitly talks about it like this. So one thing that’s kind of hard to make sense for a lot of people is, you know, I’m saying, Hey, caffeine is not actually giving you the boost that it’s, you think it’s giving you, but then their day to day experiences, like while I drink caffeine and I obviously feel a boost, so it’s real. What do you mean you’re, you’re telling me it’s not real? Well, it is real. But what they’ve shown is that, and the many studies have tested us, the benefits, the boost that you’re feeling is what they call just withdrawal reversal. So in other words, literally just going 15-18 hours without coffee is enough to cause withdrawal symptoms. So you’re already starting to get to the symptoms of the drug withdrawal at that point. By the time you wake up in the morning, the following day. Okay. And that’s, that’s what I’m talking about with that grogginess the brain’s not functioning well. You’re not in a good mood, your brain’s not performing, you’re not energetic. That is, those are withdrawal symptoms. And then you drink the coffee and it’s, the boost that you think you’re getting is actually just withdrawal reversal. It’s just taking it back to normal. So it’s the same thing as somebody, uh, who drinks alcohol and gets a hangover and then you can cure the hangover by drinking more alcohol the following day. So the same exact thing is going on here, just it’s become so prevalent our world. So normal and typical that people don’t realize that this is what’s going on.

Dr. Cates: Yeah. Interesting. Okay. So let’s shift back to adrenal fatigue and what you found about that when you’re looking in the research, because I think some, a lot of, it’s a term that’s used frequently in the public to just talk about fatigue in general. Like you know, you’re tired and though it’s adrenal fatigue and so it’s, it’s not actually a medical diagnosis. So I kind of struggle with this. I’ve always kind of struggled with the term, but I know that my patients will sometimes come into me and say, I think I’ll have a drain off fatigue. And I’m like, okay, well this isn’t actually a diagnosis, so let’s test and see what’s going on. But now I’m interested in what you’ve learned, what you’ve discovered in the research that you’ve looked at.

Ari Whitten: Yeah. Well there’s, there’s a lot of layers to this story and I’ve done actually five hours of video on this topic alone, kind of picking apart the research. This was six months of my life, actually considerably more than that to dig in to all these layers of the research. What I found is fascinating. I’ll back up and kind of tell my story a little bit of how I came to, to discover what I’m about to tell people. So I first want to say that I, I’ve been in, you know, studying natural health for over 20 years now, basically since I was like 14 years old. And, this has been a lifelong passion and obsession of mine and very hardcore natural health, holistic health. And I started reading about adrenal fatigue back in, I believe it was coined, the term was coined in 2001 James Wilson wrote a book, called Adrenal fatigue, 21st century Stress Syndrome. And that’s when the term was actually first coin. Um, and I’ve been reading about it since then and I’ve read dozens of books on it, hundreds if not thousands of articles online about it. And a, I was a hardcore proponent of it. I used to do cortisol testing for people. I used to be, you know, telling people they had adrenal fatigue, treating their adrenals. And I was absolutely convinced that the whole thing was very real. And then a few years ago I discovered something kind of bizarre, which is, that would seem to me as bizarre, um, which is that all of conventional medicine doesn’t actually believe in adrenal fatigue at all. They do not recognize it as a legitimate medical condition. And I mean, there’s even, you know, for example, quotes from, uh, the, the Institute of, I forget exactly what it’s called, but it’s an institute of endocrinology that that represents like 14,000 endocrinologists, which are entities that, that study hormones that specialize in hormones of which cortisol is one. And, uh, they said there are no facts to support. Adrenal fatigue is not a real medical condition. There are no facts to support the idea that chronic stress wears out the adrenals and results in many chronic symptoms. And that’s almost a word for word quote. So I was really annoyed by this coming from the natural health community and, and um, being a proponent of adrenal fatigue. So I actually had an idea to write a book like called the evidence based guide to adrenal fatigue. And my goal was to go into the scientific literature and basically prove that adrenal fatigue is a real thing. That’s, that’s how this all started. Um, so the first layer of things as far as how I got shocked was when I went into pub med, which is like Google for scientific research. And I did a search for adrenal fatigue. Basically nothing came up like zero studies. Now this is a for people that have never done this, just to, to emphasize this point, if you go look up any medical condition, even if it’s some obscure super rare thing, go type it in pub med, you’ll find at least dozens of studies but more like hundreds or thousands of studies for any medical condition. Type in adrenal fatigue. Nothing. Okay. So it was just kind of bizarre to think why are dozens of books being written about this thousands of articles online. So many people in the natural health community are talking about this diagnosing with people with this. And yet there isn’t a single study in existence on this topic. So my plan to write a book, the evidence-based guide to adrenal fatigue kind of stalled. And then, uh, you know, over the course of months and what turned into years, I started to realize that there were other recognized fatigue syndromes, like burnout syndrome or clinical burnout on these go by a few different names. So burnout syndrome, clinical burnout. Another one’s called vital exhaustion. Another one’s called stress-related exhaustion disorder. And then arguably you can lump in chronic fatigue syndrome and fibromyalgia as well, or leave them out depending on, some people say that they’re similar enough to adrenal fatigue. Other people say they’re not. Anyway, the point is there’s several recognize fatigue syndromes. And what’s interesting is this, the basic idea of adrenal dysfunction or cortisol levels being a factor in these fatigue syndromes has actually been around for many, many decades. There was a guy even before James Wilson back in the 1970s who was injecting people with, um, with cortisone a as a way to try and treat their fatigue. His name was I think Jeffrey Smith or something like that, and he wrote a book back in the 70s or 80s. So the basic idea that the adrenals and cortisol levels are playing a role in these conditions. It’s actually been around for a very long time. And even going further back to Hunseliay’s research in the 1930s, 1950s. Um, so because the idea has been around a long time, lots of researchers all over all over the world for over 25 years have actually tested this idea to see the link between adrenal function and cortisol levels and these various fatigue syndromes that I just mentioned. So I decided to dig into those studies and I thought, well maybe I can look there and see that there is this very clear link between low cortisol levels and people with these conditions. I started to find some studies and some studies found very slightly elevated cortisol levels in people with these conditions. Other studies found slightly lower cortisol levels and a lot of studies found no difference in cortisol levels whatsoever. So I was kind of baffled by the whole thing for like a year. I didn’t know what to do with it. And at a certain point I decided that I’m just going to dig through the whole body of literature and find literally every study in existence on this whole topic and just compile it all and just count, just put the data together. You know, starting in 1995, which was when I found the first study through 2018 and literally just list them all off. What’s the conclusion from the researchers? What’s the actual data? What’s the screenshot of the cortisol levels between people with those fatigue syndromes versus normal healthy people? And basically at the end of that, what I have is 79 studies, um, 20 of which are literature reviews and then 59 of which are individual studies. Okay. Literature review, systematic literature reviews are where researchers themselves go and compile, let’s say all the studies on burnout syndrome specifically, or all of the studies on stress-related exhaustion disorder or all the studies on chronic fatigue syndrome, etc. What I did is I compiled all of them in one very, very long list and it basically turned into a short book and I basically just counted, what did all the studies say? And here’s what it comes down to. 13 of the 59 studies found slightly higher cortisol levels in people with these fatigue syndromes versus normal healthy people. We’re not talking about massive Lehigh or we’re talking about very slightly significantly but significantly higher. Okay. Another 15 of the 59 studies found slightly lower cortisol levels. Again, not talking about massively lower cortisol levels or anything indicative of the adrenals not able to function or produce enough cortisol. We’re talking about just a slight trend towards a lower average number, in morning cortisol levels specifically for people with these fatigue syndromes versus normal healthy people. And then the vast majority of the studies, 33 of the 59 studies found zero difference, no detectable difference at all in adrenal function, HPA axis function or cortisol levels between people with these fatigue syndromes and normal healthy people without any of these symptoms. So in other words, to make that point even more. If you were to take a thousand, let’s say a hundred blood tests or a hundred salivary cortisol test, 50 of which were from people with full blown fatigue or burnout or stress related exhaustion and 50 of which are from normal healthy people without any symptoms. And you handed those hundred cortisol tests to somebody who is a proponent of adrenal fatigue and said, tell me which of these people has fatigue and other symptoms, the symptoms that you would call adrenal fatigue. Tell me which of these 50 people based on these cortisol tests has the fatigue and which do not, they would have the same chance at getting that question right as flipping a coin. That’s, that’s how, how strong the data is as far as showing that cortisol is just very clearly not the key causal factor in these fatigue syndromes. If the majority of people with these fatigue syndromes have no detectable difference in their cortisol levels or adrenal function, that the argument that Cortisol is, or adrenal function is the key causal factor of the symptoms is just you have to throw it out at that point. If, if you’re intellectually honest and you’re not, you don’t have some kind of agenda or you haven’t built a business around selling adrenal fatigue, adrenal support supplements or something like that. So that’s basically the quick summary of a very long period of my life to dig into a lot of research.

Dr. Cates: Yeah, it’s fascinating. I mean, I did my thesis in medical school on chronic fatigue syndrome on a patient that I was seeing through it while, you know, during several years that I was in school and, and so, and that was 20 years ago, 20 maybe 21 years ago that I started looking at that. And you know, definitely one of the things, I’m curious about what the literature is, how they looked at these. Like, you know, there’s good research and there’s bad research and then there’s everything in between. Right? And so it’s important when you look at research, so look at the details of the studies, right? And so what, what I know about cortisol is that when you look at blood cortisol levels, when you do a blood test, when patients do a blood test on cortisol, that can really vary depending upon the time of day. Because Cortisol levels change throughout the day. And we do know that that’s definitely something we know about cortisal. Oftentimes in the morning to help get us up and get us going. And then it drops off later in the day. And with that lowering of cortisol helps us sleep at night. So what I’ve found with, with many of my patients, what I ended up doing was, was doing salivary cortisol levels and so that you could collect it throughout the day. And so I’m wondering with these, with these studies that you looked at were they looking at blood and saliva or, or one or the other?

Ari Whitten: Yeah, so the truth is it’s actually a range. Not all of them tested in the exact same way. The vast majority of them tested salivary cortisol levels and they usually tested pretty much all of them tested multiple points over the morning. Many of them tested many, many points over the course of 24 hours. And then there’s also, I would say much fewer studies, maybe less than 12, that have tested either blood or urinary cortisol. But the vast majority of them tests saliva cortisol and they usually do it over at least four points over the morning. But most of them tested over the course of 24 hours of the day.

Dr. Cates: Yeah, it would be, I mean, I would be interesting to kind of divide out that research and does take out anything that doesn’t specifically look at those times a day because it it, yeah, it would be interesting to kind of look at it if the research that showed the correlation between those conditions was more with the salivary. I mean I’d be interested to see that.

Ari Whitten: Yeah. Actually so I actually have done that. And the, the, what I explained before is basically a little slight oversimplification just so that I don’t introduce too much complexity like of the diurnal cortisol curve. I tried not to introduce that layer of complexity just so I don’t confuse people. But you’re absolutely correct. There is this diurnal cortisol curve. We get lots of it in the morning and then it declines over the rest of the day into much lower levels in the evening and night. So the results that I talked about before are specifically for the morning cortisol rise in cortisol. So, basically over the course of the morning you get this, you get this peak or what’s called the cortisol awakening response and they measure at specific time points across that cortisol awakening response. Usually it is done for like four hours. So that’s specifically where the difference shows up. If there is any difference at all, it’s it shows up there. So that’s where you see maybe a slight decrease in the cortisol awakening response or a slight increase in the cortisol awakening response. And then when you check the rest of the time points in the afternoon, the evening and the night, almost all of those cortisol responses are identical. Even in the studies where they showed some difference in morning cortisol levels, cortisol levels, the rest of the day are perfectly normal. So, anyway, I hope that answers your question. Yeah. There’s one other layer to the story as far as like what, you know, am I saying that low cortisol levels, low morning cortisol levels do not exist? No, I’m not. They do exist. They’re just not the cause of fatigue. Um, but they can be a contributing factor to certain kinds of symptoms. And it’s another question do then, you know, once you know that that’s not the central cause of fatigue, then you can say, okay, well what is causing those, those low morning cortisol levels and um, and how do we fix it and so on. And that’s kind of a separate discussion.

Dr. Cates: Okay. And it’s not the cause of the fatigue syndromes, right? It could be. I mean, if someone has low cortisol in the morning, that could potentially make them feel tired. No?

Ari Whitten: it can be a contributing factor. Yeah. So here’s, here’s what it amounts to. What are the other layers to the story is basically that like, after I did all that and I figured out why, why the heck, you know, I, I figured out that basically, uh, there’s no case, there’s the evidence. Does not support the idea that poor adrenal function or low cortisol levels are, are the cause or a primary cause of these fatigue syndromes. So there’s like two questions that come out of that. One is what are the real causes of fatigue, if not this whole story of adrenal fatigue. If that’s not true, then what’s really going on and causing this problem and causing these symptoms? Cause I want to be clear, I’m not saying your symptoms are not real, your symptoms are absolutely real. I’m just saying that they’re not actually caused by what a lot of people have told you that your adrenals and your cortisol. So what are the real causes? The second thing is, what the heck causes low morning cortisol levels, you know, you know, and so those are two potential avenues. And I’ve gone, I spent many years of my life going down.

Dr. Cates: What’s the root cause? What’s really behind it? So if it’s not, you know, like what, what really is behind those low cortisol levels? And the idea that we’re just being overly stressed is, I mean I understand that there, that probably or may not be the only, cause certainly it’s, and people who are stressed are oftentimes not eating well. They’re exposed to environmental toxins. So there could be a number of different things that are causing someone’s fatigue. Right. So that’s, I think this is the topic today is to what, what really is going on, what are the things that we can do to boost energy and really addressing the various root causes that are associated with it. Right?
Ari Whitten: Yeah. Let’s, um, there’s two things there and what you said. So, let’s maybe address the low, what are the real causes of low cortisol? Just cause some people are probably thinking, well, I, you know, I got my salad salivary cortisol tested and I do have low morning cortisol levels. Um, and so what’s, what’s causing that? If that’s not adrenal fatigue, what’s really going on? Um, so I’ll answer that very quickly. This is another podcast actually that I’m about. I’ve already recorded it all. I’m about up to release it. It’s like two and a half hours of video on this topic alone, but it’ll give you the quick like two minutes summary. So I dug really extensively into the literature to kind of answer that question cause I didn’t really know the answer. I mean basically the theory of adrenal fatigue suggests chronic stress over time just sort of wears out the adrenals and then that causes low cortisol levels. So the first thing I did is find all the literature that looks at various kinds of chronic stressors and looks at cortisol levels. And there’s lots of research on that subject. So you can have various kinds of stressors, various kinds of psychological or emotional stressors, um, and specific things like stress from work, stress from being overworked, stressed from, from being out of work and unemployment, stress from relationships, stress from financial stress. And then you can look at like physical and metabolic stressors and you can look at what our cortisol levels in chronic smokers and um, you know, heavy smokers versus moderate smokers versus light smokers and versus nonsmokers versus heavy drinkers and moderate drinkers versus non drinkers. And, you know, there’s lots and lots of ways you can look at this evidence and then you can even look at chronic disease. So arguably like something like diabetes or cardiovascular disease or neurological diseases or a lot of these other chronic diseases would be characterized by most people in the natural health community as you know, a higher total body stress load or allostatic load. And so you can kind of see if somebody has diabetes and they have chronically high blood sugar, that’s very clearly a metabolic stressor, you know, that’s causing damage at the cellular level. And you can look at people who have had diabetes for years or decades and you can look at severe diabetes versus less severe diabetes. And all those studies exist, testing cortisol levels in those people versus normal, healthy people. All the studies exist. So what those studies find in virtually all cases, I would say 98% of the time those studies find slightly higher cortisol levels in people who are, have any kind of stress in their life or uh, who have various kinds of diseases. You’d almost never finds lower cortisol levels. And even when there is a link with lower cortisol levels, again, it’s slight and it’s usually slightly lowered morning cortisol levels, not suggestive of any loss of ability to have the adrenals to produce cortisol. As is the case with like for example, a true Addison’s disease or adrenal insufficiency, which is a real rare condition where there’s a genuine ability, inability of the adrenals to produce enough cortisol. So in general, chronic stresses associated with slightly increased cortisol levels are sometimes significant, very, very significantly increased, almost never lowered cortisol levels. The one exception that is consistently associated with lowered morning cortisol levels or lowered cortisol levels in general, still normal, no inability of the adrenals to produce enough cortisol, but lower is PTSD post traumatic stress. So past trauma or childhood trauma seems to have some ability to reset the way our stress response system operates to some kind of, you know, I think what most researchers believe it to be as some kind of protection mode where it’s sort of like the stress system gets, gets reset to a less sensitive level. Like it’s almost maybe like it’s numbing you from life as a way, as a, as a way to sort of protect you from future trauma. But that’s one thing that is consistently associated with lower cortisol levels. Almost every other type of chronic stress or chronic disease you could imagine a is associated with either normal or more likely slightly elevated cortisol levels. So again, the question is what the heck causes low morning cortisol levels, which we sometimes see. Um, here’s the main factors that cause it. The Big One is circadian rhythm disruption. If somebody has circadian rhythm or sleep disruption, that in itself can cause a cortisol pattern that is massively lower than what is typical. Um, and can cause a cortisol pattern that an adrenal fatigue proponent would say, hey, this is adrenal fatigue. You know, if they saw that, that cortisol test, this very clearly that chronic stress has worn out this person’s adrenals. And that’s why you know, they have this, well if you just sleep a few hours less night and take your cortisol levels tomorrow morning, you will have adrenal fatigue. You will have cortisol levels that mimic what people think is adrenal fatigue. But more commonly are our world is almost perfectly designed to disrupt our circadian rhythms. Circadian clock in the brain that controls lots of different neurotransmitters and hormones, one of which is cortisol. So we talked before about this diurnal curve, the fact that it goes up in the morning and down at night, that’s because it’s controlled by the circadian clock. You disrupt the circadian clock and you blunt the cortisol rhythm, which means you get lower morning cortisol levels and oftentimes higher evening cortisol levels, which is also called a flattened diurnal curve. And that’s the most common finding that you see in people with abnormal cortisol levels. So anything that disrupts circadian rhythm, our sleep will cause that lack of morning light exposure, lack of light exposure during the day working indoors, which most people do. And most people do not get that morning light exposure, too much artificial light at night before bedtime, which almost everybody does because they have screens in their face. All of those things disrupt the circadian clock and cause that Cortisol abnormality. In addition, sleep deprivation itself, or poor sleep will also cause that. So, um, we, we also have an epidemic of chronic slight sleep deprivation. People are consistently sleeping an hour or two hours less than their body actually needs. That causes that cortisol abnormality. Then the other big one, this is a cool one. There’s a few other ones. So like there’s some indication, not strong research, but there’s some indication of a few types of toxins to potentially disturb cortisol levels. And then severe inflammation. So for example, mold exposures or chronic infections may also be able to cause that. And then there’s a few other ones that are not that strong. A just being sedentary, just being physically inactive can also cause a flattened diurnal curve of cortisol levels. But what probably the most interesting one to me is Kronotype, which is again kind of related to the circadian clock, but it is whether you’re more of a morning person or a night person. So the, the really interesting thing here is there’s like, there’s really good studies on this. So there’s like six studies on it and they’re all super consistent in their findings and the findings are massive. So a lot of these other factors that I talked about, you look at smoking or drinking or this disease or that disease or this kind of chronic stress or that kind of chronic stress, all very, very slight differences in cortisol levels. You look at fatigue syndromes, very slight differences in cortisol levels. You look at Kronotype massive differences in cortisol levels. So just take somebody who is a morning person or a group of morning people versus a group of night people, night owls and you measure their morning cortisol levels at night, owls have literally half of the morning cortisol levels that the morning people do. Okay. And this is the important part. Um, the, there are studies where they’ve taken morning people and night people who have no symptoms, no fatigue, no symptoms, perfectly normal, healthy people, just morning people versus night people. The night owls have a cortisol pattern that if they went to go see somebody who believes in adrenal fatigue, they would get diagnosed with adrenal fatigue because their cortisol levels are so low. It’s not because they have fatigue and they have adrenal exhaustion. It’s just because they’re night owls. And that’s how it rewires the circadian clock and, and the secretion of Cortisol. So, that’s probably in my opinion, as far as why most people have a flattened diurnal curve or low morning cortisol levels, I’d say 90% of the time it’s just circadian rhythm disruption or sleep deprivation.

Dr. Cates: You know, it’s Kinda one of those things, it’s like, is it the chicken or the egg? Right? So is it, is it because somebody has these sleep patterns that causes it or did the low cost, you know, the changes in cortisol and caused them to, uh, to have difficulties? Um, were they having adrenal issue is, you know, it’s, it’s, I mean, I think that it could happen both ways and I know it is really interesting to see that. And then when we look at ways to help people, you know, clinical practice, a lot of naturopathic doctors and functional medicine doctors will do adaptogenic herbs to help with, um, you know, adrenal insufficiency or adrenal. Uh, you know, when we see those different changes throughout the day that are not ideal, right? When you do the salivary adrenal a task, and a lot of times people that aren’t sleeping well are the ones that are tired, right? So we’re, we’re seeing, we’re already seeing the people that they can’t sleep there, they can’t get going in the morning and they’re staying up Atlanta night. Those are the people that really more extreme adrenal insufficiencies. And so doing things like the adaptogenic herbs is the idea of the APP adaptogenic is that they, they will help either there, they help the body adapts right there. They do either way. So whether it’s higher or whether it’s slow, it’s, it’s helping the body function more optimally. So it’s interesting with what you were talking about with the research and tying all this in. And then another thing that really helps with people with low energy and um, what you know when you see these, these little cortisol levels I think is, is B vitamins. But you know, when we look at B vitamins are multiple reasons why B vitamins can help boost energy. Right? So what are some of the things that you recommend or that you find from the research that are particularly helpful for helping people boost our energy?

Ari Whitten: Yeah, great question. So I think one of the things we just talked about, circadian rhythm is a great place to start. Circadian rhythm is one of the biggest factors in why we have an epidemic of fatigue. And we also have an epidemic of people struggling what their sleep. So sleep and energy levels are two sides of the same coin and they’re linked by the circadian clock in the brain, which is, which is really, it’s, it’s literally a 24 hour clock in the brain. It’s a part of the brain called the super charismatic nucleus. And in response to certain signals, mainly light exposure, but also meal timing and movement can can also affect it. Even temperature can affect it. In response to those cues, what are called Zeitgebers, they use a German word for some reason. I don’t know why, but, um, in response to those, the circadian clock then figures out what, when it’s daytime and when it’s nighttime. So in response to those cues of, hey, it’s daytime, the time to be awake, alert, active, and energetic, it then produces and regulates the production and synthesis of lots and lots of different neurotransmitters and hormones that control things like our energy levels in our wakefulness and our mood and so on, or our tiredness and our sleepiness and, and lots and lots of different things. So it’s not, cortisol is just one of the many hormones and neurotransmitters that are affected by the circadian clock. And, you know, to give you an idea, one of the neurotransmitters that’s affected is called Orexin. Orexin is probably our primary wakefulness neurotransmitter. So for people to get this, um, in people with narcolepsy. That is actually when the orexins accreting neurons in the brain are dysfunctional and are not able to produce enough orexin. So you get chronic sleepiness, and sort of start falling asleep randomly. Orexin is a critically important wakefulness neurotransmitter directly impacted by the circadian clock in the brain. So if, if you don’t have good Circadian Rhythm Habits, you’re going to get lower orexin levels, you’re going to be sleepy throughout the day, or slightly more tired and fatigued and you should be, in addition, it also impacts serotonin. It also impacts dopamine, which affect our mood and our energy levels and our motivation or drive. And it also impacts a Gaba, which is another neurotransmitter in the evening that helps, makes us make us tired and sleepy and, and go into rest and rejuvenation mode. So there’s widespread effects on lots of different pathways that all impact on our energy levels. And then again, if, if, if you sleep well, which is largely a function of training that circadian clock, um, that in itself is going to allow your system to repair itself properly. So another few mechanisms we could talk about still with the circadian rhythm and sleep theme. One is the brain actually has what’s called the glymphatic system. This is a very recently, a recent scientific discovery just in the last couple of years where it’s basically a lymph system that drains the brain of waste products and toxins. That specifically happens during the nighttime while we’re sleeping. So if you don’t sleep as deeply or as well, or you’re not sleeping as long as you should, which a lot of those depend on having a strong circadian rhythm. Then every night your system doesn’t clear toxins and waste products. And some of these things like Tau Proteins and Beta amyloid plaques that debt are, that are building up in the brain on a daily basis. You know, a lot of people associate the Beta amyloid plaques with Alzheimer’s and they think, oh, that’s something that accumulates over years and it’s only in people with Alzheimer’s, those that Beta amyloid protein accumulates in our brain every day to some degree in every person, healthy people, and then it needs to be cleared out every night. And that depends on the quality and quantity and depth of your sleep, which depends on your circadian rhythm. So that clearing out the toxins and the waste products and the damage cells, critically important. And that’s another mechanism of how we can sort of chronically develop fatigue as a result of poor circadian rhythm. One more that I’ll mention, there’s several more that we could talk about, but um, one more. That’s a cool one to mention is Melatonin. So people know of Melatonin and people say, Oh, you know, Melatonin promotes sleep onset. It’s a hormone produced by our pineal gland that produces, that promotes sleep onset. Totally true. But what people, well don’t know is that Melatonin actually goes into our mitochondrial membranes an is one of the most important mitochondria stabilizers that protects, that protect our mitochondria from damage, from oxidative stress. So our Mitochondria, again, are the cellular energy generators. That’s literally what virtually all of the trillions of cells of our body, our brain our heart our muscles are depending on for their energy. If your mitochondria aren’t using lots of energy, you don’t feel very energetic. So melatonin stabilizes and protects those mitochondria from damage and keeps them strong and healthy every night. Well, here’s the thing. If you have a poor circadian rhythm, if you have lots of artificial light learning into your eyes every night from artificial, you know, from, from phones and computers and TV’s and indoor lighting, that light is directly suppressing melatonin production from, from your Peniel Glen. So what happens if you are chronically on a daily basis for months, for years, for decades, suppressing your brain’s ability to produce this critical hormone that protects your mind, Andrea, for damage? Well, you accumulate lots of mitochondrial damage over the course of years. So, I’m a big believer that the circadian rhythm is a critically important piece of having high energy levels and protecting ourselves from mood fatigue. So I, that’s where I start. People that’s kind of a foundation, strengthen your circadian rhythm and your sleep. Everything else is built on top of that foundation.
Dr. Cates: Yeah, it’s true that are about circadian rhythm is getting so disrupted by people today. Our lifestyles today. And, and so we, we talk about how, um, you know, how important it is to get a good night’s sleep. It’s so many things are in our way, right? That’s all the artificial lights and the technology and the sounds and everything that that prevents us from sleep. So I think it’s great. We’re talking about this and, and Melatonin is so important and for our health and stuff and a lot of different ways and sleep helps restore our skin too. So if you’re not getting a good night’s sleep, that’s your body’s opportunity to really heal and recover and restore and, and, and, and all the different organs, including the skin and um, in addition to having that energy. So let’s get back to getting that.

Ari Whitten: Can I add one point on to that? What’s crazy for people to think about? If they’re sleep deprived for one night, one single night, you get four hours of sleep or five hours of sleep instead of your normal eight, let’s say. Okay. The people who know you, they can literally see that in your face the following day. They can see it in how your face is presented. So there’s literally such a profound effect even just in the span of one night that it’s literally manifesting in how you look. You know, tjat’s kind of crazy. So imagine what chronically being slightly sleep deprived for years or decades is doing.

Dr. Cates: Yeah. And there’s some interesting research coming out about Melatonin and skin and the protection that, um, that it does provide as well. So, so much we could cover art, we can just keep going and going on fatigue and sleep and all these different things. But it’s been fascinating hearing about the research and all the work you’ve done. So thanks for coming on today. I really appreciate it and tell us, so tell everybody where they can find you.

Ari Whitten: So my website is called theenergyblueprint.com. And we can set up a, a little link for your people. We can put below this on, on your page for people to opt in for what I have is a free masterclass training. I call it a double your energy masterclass. And it’s basically four videos covering everything from circadian rhythms, neurotransmitters, nutritional factors and how to, how to build up the strength of your mitochondria and several other really cool things in, in a span of four videos. So we’ll set up a link for your people to opt in for that.

Dr. Cates: Perfect. Well thank you. Thanks again for coming in today.

Ari Whitten: Yeah, it was my pleasure. Thanks so much for having me.

Dr. Cates: I hope you enjoyed this interview today with Ari and enjoyed our discussion about the research. I know it might’ve gotten a little technical for some of you, but hopefully you got to follow through and get to the end and understand what we know is one of the foundational important things for helping with sustainable energy. So I’m curious to see what you thought about this interview and what you think about adrenal and, and the causes of fatigue and the importance of things like sleep. So Post your comments below the podcast interview and if you want to learn more about Ari, you can go to the Spa Dr Com, go to the podcast page with his interview and you’ll find all the information in the links that he was talking about during the interview. Also, I encourage you to get your customized skin report at theseskinquiz.com just takes it just a few moments of answering a few questions. You can get information explaining what your skin might be trained to tell you about your health and what you can do about it. Just go to these skin quiz.com also, I invite a join me on social media, on Facebook, Pinterest, Twitter, Instagram, and Youtube and join the conversation and I’ll see you next time on The Spa Dr. Podcast.