Leigh, update and question regarding client with severe damage

Mandy Polk · 03-02-2009, 09:54 AM

Her tests show she has high cortisol, which I suspect would be positive because at least she's not producing zero cortisol.

I don't think gastritis is an issue because she absorbs her anxiety meds. However she still has terrible chronic constipation, despite dietary changes per our suggestions to her.

She used to respond well to progesterone (mood/period) but doesn't repond at all anymore in either respect.

Like many folks with adrenal fatigue she isn't able to manage her mood or really "wake up" until late evening.

Where should she go from here, or is this all in the hands of her physicians at this point?

LaraT · 03-02-2009, 12:28 PM

If she has high cortisol than I don't think she can have adrenal fatigue? That is marked by LOW cortisol. They symptoms can be similar (low energy, feeling tried, irritable, etc) How was her cortisol tested?

UConnJulie · 03-02-2009, 04:58 PM

Mmm ... high cortisol is sort of like the calm before the storm. It shows that her adrenals are working harder than they should because her stress is too high. If she doesn't change things, then her levels will likely start to drop and she will crash and burn.

strongchick · 03-02-2009, 05:06 PM

high cortisol is typical in women with AN. As is constipation, gastric problems, and not responding to progesterone.

She could just still need a LOT of rest and refeeding.

Mandy Polk · 03-02-2009, 09:50 PM

She's been resting and refeeding since last August

UConnJulie · 03-02-2009, 10:10 PM

What are her other stressors like?

High cortisol indicates that there is a stress issue somewhere.

It can be a chronic infection.
It can be a stressful job.
It can be training stress.
It can be a busy mom lifestyle.
It can be a food intolerance.

There is a stress on her body somewhere that her body is not happy with.

Rest and refeed are only part of the equation.
Eliminating the stress -- or at least her response to it, is the other part.

Mandy Polk · 03-02-2009, 10:44 PM

She has major constipation issues, so that's a stress, maybe food intolerance for sure, but she's eliminated so many food groups I think to continue to eliminate would be a mistake because then her body's accustomed to like, 3 foods.

She stresses about her situation CONSTANTLY

Crying, panic attacks, not getting out of bed.

So her reaction to it worsens it.

She was pre-med and way too stressed about school, and then she started a figure prep that was never ending, and all this madness started.

She is taking time off school but the stress continues.

strongchick · 03-03-2009, 06:14 AM

if she's still stressing, she isn't resting. resting is more than time off from the gym.

is she in therapy?

UConnJulie · 03-03-2009, 07:29 AM

Ha! That was going to be my next question!

Sounds like she needs to learn to meditate ... and that she needs counseling!!

LaraT · 03-03-2009, 07:40 AM

sounds like therapy and most likely medications to help her deal with the anxiety are in order.

Leigh P. · 03-03-2009, 10:11 AM

To be honest I think while perhaps there could be nutrition and training that can help, this seems like a complete mental disorder leading issue. As a trainer, sometimes you have to refer people and send them to a better place for them. In short, this sounds like it is completely out of your hands.

Zoey Patrick · 03-03-2009, 10:15 AM

Quote:

Originally Posted by UConnJulie

Mmm ... high cortisol is sort of like the calm before the storm. It shows that her adrenals are working harder than they should because her stress is too high. If she doesn't change things, then her levels will likely start to drop and she will crash and burn.

Ditto. A lot of people miss this one and think they're doing 'fine' because their cortisol is high...it's really a sign that your body is stressed and in overdrive...and how long can that go on?

I understand all of the comments regarding therapy (couldn't hurt) and medications, but I'll say from personal experience, that if the situation is physical in it's origin, none of that is really going to help significantly. You can't 'learn to relax' when your body is going crazy, which it sounds to me like it is.

Constipation can be a serious gut issue; it can interfere with absorption and can lead to bacterial overgrowth, all of which can interfere with thyroid functioning (labs come back 'normal' because the body is producing enough thyroid, but there's a breakdown in the metabolism of the thyroid hormones in the body). I hope she has a really good doc, or GI specialist continuing to work with her on this...

LaraT · 03-03-2009, 10:25 AM

Oh I see now that she is already on anxiety medications. Hopefully the person giving her those meds is conducting therapy as well?

As someone else mentioned, high cortisol is very common in people with eating disorders. Even though she might no longer be in the midst of the disorder, the fact that she had one within the recent past could very well be causing the high cortisol. And mental stress can cause high cortisol too, it is not necessarily a sign that somethign is physically wrong in the body as Zooey mentioned. Of course we don't know her whole story like you do as her trainer but it sounds like she has had thorough medical workups and this is really more of a mental health issue.