Embrace Joy With Vorfreude

  • Joy is one of the most powerful metrics for making decisions that empower and enrich your life

  • Improving mitochondrial health boosts cellular energy, which is crucial for making empowered decisions and aligning with your authentic self. Effective decision-making is energy-intensive, requiring robust cellular energy to function optimally, underscoring the link between health and mental clarity

  • Recognizing and altering negative thought patterns is also crucial for fostering a more joyful mindset and embracing life’s opportunities

  • The concept of “vorfreude,” or anticipatory joy, significantly improves happiness and well-being by allowing you to savor the anticipation of future pleasures

  • Strategies to enhance joy include consciously appreciating the brief moments just before experiencing something pleasurable, treating yourself, writing down your plans, unleashing your creativity and much more

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Joy and health share a deep and intricate connection, which is why I am now starting to shift my focus toward the weak link in this relationship, namely Joy or, more accurately, the lack of Joy that most people experience.

What many fail to realize is that Joy is one of the most powerful metrics for making decisions that empower and enrich our lives. “Joy” is capitalized here to emphasize the deeper, more profound state of contentment that I want to convey. It’s a type of fulfillment that transcends fleeting moments of happiness.

While Joy and happiness may seem synonymous, their essence diverges significantly. Happiness often manifests as a passive state, fleeting and dependent on external circumstances. Joy, on the other hand, emanates from within, transcending the realm of sensory gratification.

Unlike pleasure, which is ephemeral and tied to immediate sensory stimuli, Joy represents a deeper, enduring fulfillment — the ultimate pursuit and realization of life’s purpose. Joy gives you the confidence to know that all is well, regardless of external circumstances.

There are many ways to increase Joy in your life, but as I’ve mentioned in previous articles, optimizing your mitochondrial energy production is a central factor, as the energy produced by your mitochondria is virtually identical to the energy that created the material universe.

When you increase your mitochondrial health, you automatically augment your ability to connect with the Source of your own Self, which is where true Joy resides. It’s also the storehouse of your intuition and inner knowing, which is always nudging you along in the direction of your authentic self and, hence, that which brings you the most Joy.

“When you trust your instantaneous knowing and prioritize Joy in your decision-making, you align yourself with your authentic Self, and pave the way for a life filled with purpose and fulfillment.”

When you trust your instantaneous knowing and prioritize Joy in your decision-making, you align yourself with your authentic Self, and pave the way for a life filled with purpose and fulfillment. Ashley Armstrong, cofounder of Angel Acres Egg Co. and the Nourish Cooperative is a perfect example of this.

In the video above, she describes her journey to reclaim her Joy. By setting aside the advice of others she discovered her own truths. Ashley embodies the essence of courage and the resulting success such decisions offer.

Choosing to walk away from years of academic pursuits that were influenced by the expectations of others, she was able to identify her own unique path to Joy, and in the process created something that now benefits thousands of people.

It is my sincere desire and hope that you will consider allowing her journey to inspire and empower you to make similar choices in your own life to reclaim the Joy that you deserve.

Ralph Waldo Emerson famously said, “Once you make a decision, the universe conspires to make it happen.” This expression encapsulates the power of your decisions, implying that the universe aligns itself to facilitate and realize your dreams once you’ve committed to them. Indeed, your decisions wield immense power to reshape your reality — and the reality of others.

It’s crucial to realize that your body prioritizes energy for essential tasks, and decision-making requires significant energy. Your brain consumes about 20% of your body’s energy despite being only 2% of its weight.

Ashley simply would not have had enough cellular energy to supply her brain to make a decision like she did unless she improved her health. Factors like excess linoleic acid, estrogen and endotoxins were depleting her cellular energy, which is crucial for making energy-intensive decisions.

Her transformation underscores the power of nurturing your health to gain the energy necessary for making significant life changes. Avoiding dietary pitfalls like seed oils played a key role in this journey, enabling her to tap into a newfound capacity for brave decisions — a testament to the profound impact of regaining cellular energy on her ability to navigate life’s choices.

All of that said, learning new mental habits is also important, which is where the central topic of this article comes in.

“Vorfreude” is a German noun that describes the joyful, intense anticipation that comes from imagining future pleasures. It translates directly to “pre-joy” or “anticipation joy” in English. This concept is often associated with the emotions experienced before positive events, be it a vacation, a holiday, a reunion with loved ones or simply a delicious meal.

Unlike the English counterpart “anticipation,” “Vorfreude” specifically captures a sense of delightful expectation. If you can’t remember the last time you felt this way, read on, because vorfreude is something you can cultivate. In an April 9, 2024, article1 in The Guardian, Rachel Dixon explored the concept of vorfreude and the ways in which you can learn to anticipate and savor Joy.

Rory Platt from The School of Life and Karen Neil, a health coach and founder of Mindful Medicine, both of whom were interviewed by Dixon for her article, note that intentionally creating small moments of anticipation can significantly enhance your overall happiness. A 2017 study2 also confirmed that anticipating positive events activates your brain’s medial prefrontal cortex, which improves wellbeing.

“Doesn’t getting your hopes up risk disappointment? Perhaps it’s safer to keep expectations low,” Dixon writes.3 “Emma Mills, a mindfulness expert and the author of Inhale Exhale Repeat, begs to differ.

‘There is a saying: ‘If you worry, you suffer twice.’ Anticipatory joy is the opposite of that.’ Even if an anticipated event turns out to be a letdown, vorfreude helps people bounce back. ‘Optimists have improved coping abilities when dealing with unplanned distress and they tend to recover far faster,’ says Tania Taylor, a psychotherapist and vorfreude advocate …

[V]orfreude … shouldn’t feel like a chore. ‘Mostly, it will involve exploring what you already have in your life that you look forward to,’ says Taylor. Willem Kuyken, a professor of mindfulness at the University of Oxford, has researched the benefits of cultivating joy.

In his book Mindfulness for Life, he writes: ‘It takes only a small step out of habit and into awareness to enjoy the people we love around us, to savor food or to dance to music in our kitchen while cooking. These moments are available to us all the time.’”

In her article, Dixon lists 30 different ways to boost your vorfreude quotient with minimal effort.4 First of all, start small. If you’re not used to thinking positively and are prone to fret over everything that could go wrong rather than what could go right, begin by taking note of one joyful thing each day.

As suggested by Neil, frame it as a photo challenge. “Spend a little time every day looking for one beautiful flower, interesting sight or cute dog to photograph.” A morning affirmation, such as “Today, I will actively seek out and welcome the joy that life offers,” can also help set you on the right track.

Ritualizing routines, such as enjoying your morning cup of coffee and/or establish a special greeting ritual to connect with loved ones when you come home from work, is another technique that can bring great rewards. If you live alone, identify a small, enjoyable activity to look forward to each day and making it a part of your homecoming routine. Other strategies suggested by the experts in Dixon’s article include:5

  • Anticipate everyday occurrences — Identify three things you look forward to tomorrow. Examples could include taking a stroll through a park, listening to a favorite podcast during your commute or taking a hot bath before bed.

  • Break out of automatic mode — As Karen Atkinson, CEO of Mindfulness UK told Dixon, “Perhaps you have a hobby such as gardening, or a pet to spend time with. Coming out of autopilot and consciously looking forward to these moments is an achievable way for anyone to experience vorfreude.”

  • Avoid mental pitfalls — Atkinson also emphasizes the importance of recognizing and altering negative thought patterns to foster a more joyful mindset. She identifies “mind traps” like catastrophizing and focusing on the negative, suggesting a shift in perspective to appreciate small joys and social opportunities.


    For instance, rather than minimizing an overnight trip, view it as a delightful break. She also warns against the trap of comparison. Appreciate and relish occasional outings without succumbing to the stress of FOMO (fear of missing out).

  • Savor moments of anticipation — Consciously focus on appreciating the brief moments just before experiencing something pleasurable. This will train you to begin to recognize imminent joys. Savor these instants and reflect on your good fortune.

  • Treat yourself — Platt suggests planning short outings and treats, such as leaving work early on Fridays for dinner, visiting an art gallery, or going to the movies alone. Don’t feel guilty about these indulgences. Allowing yourself to anticipate these pleasures enhances the enjoyment of them.

  • Write down your plans — “Even the simple act of putting pen to paper can make plans feel more real and increase excitement,” Dixon notes.

  • Keep a Joy journal in which you write down what has brought you joy that day, week, or month. Over time, a theme will emerge, which will provide you with valuable clues about how to bring even more Joy into your life.

  • Schedule physical movement — Whether you have a regular exercise routine or not (and I encourage you to have one!), schedule some kind of physical movement into your day, such as a daily walk after lunch.

  • Try meal planning — Taylor recommends meal planning as a way to anticipate and enjoy upcoming meals throughout the week.

  • Make a date with a friend.

  • Cherish the beauty of nature — Taylor emphasizes the benefits of finding joy in nature, supported by research highlighting its value. She illustrates this with a personal anecdote, describing a moment of appreciation in her own garden where she noticed daffodils beautifully intertwined with a fallen leaf, demonstrating that one doesn’t need to venture far to experience nature’s wonders.

  • Unleash your creativity — Set aside time to engage in creative activities. You don’t need to be a skilled artist to benefit. Painting by numbers, making collages from magazine images, writing poems or short stories, and learning origami from YouTube tutorials are all accessible ways to explore your creativity.

  • Expand your horizons — Enrolling in a new dance class or craft workshop is a way to inject excitement into the week through the thrill of learning. Sometimes, such experiences can be truly transformative.

  • Find happiness in the joy of others — Neil discusses the concept of “sympathetic joy,” which is finding happiness in the joy of others. She mentions that even small acts can generate anticipatory joy, or vorfreude. Taylor exemplifies this by describing how she looked forward to hiding Easter eggs for her adult children, enjoying both the preparation and the pleasure of seeing their reactions to the fun activity.

  • Make time for silence — Even a few minutes of meditative silence can rewire your brain towards positivity and alter your perspective. Create peaceful moments by lighting a candle and embracing stillness, looking forward to the tranquility each session brings. Platt also emphasizes the importance of taking breaks from negative news to focus on the positive and hopeful aspects of the present.

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Migraine Triggers and Helpful Treatments

  • Migraine is the third most prevalent illness in the world, yet researchers still struggle to understand exactly how and why migraines occur. Adding to the complexity, there are several different types of migraine

  • Migraine is thought to be a disorder of your nervous system, most likely originating in your brain stem. Evidence also suggests migraines are strongly related to mitochondrial dysfunction

  • One of the primary causes of mitochondrial dysfunction is excess linoleic acid (LA) consumption, so radically reducing your intake should be at the top of your list if you struggle with migraines

  • Nutrient deficiencies also appear to play a role. Of particular importance for prevention and treatment of migraine are vitamin D, magnesium, Coenzyme Q10 (CoQ10) and riboflavin (vitamin B2)

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Migraines affect an estimated 12% of the American population and is the second leading cause of disability worldwide.1 They can strike both young and old, but a majority of sufferers are women. According to research,2 “Its prevalence increases in puberty but continues to increase until 35 to 39 years of age, decreasing later in life, especially after menopause.”

Worldwide, as many as 1 billion people are affected,3 making migraine the third most prevalent illness in the world. Yet, despite its prevalence, researchers still struggle to understand exactly how and why migraines occur. Adding to the complexity, there are several different types of migraines, including:4 5

  • Cluster

  • Chronic

  • Episodic

  • Basilar

  • Hemiplegic

  • Retinal

  • Abdominal

  • Optical

  • With aura

  • Without aura

  • Status migrainous

  • Transformed

  • Menstrual

  • Vestibular

Migraine attacks are typically recurring, of moderate to severe intensity, many times occurring only on one side of your head. Along with throbbing, piercing or “burning” pain, other common symptoms include nausea, visual disturbances, dizziness, numbness in your extremities or face, and extreme sensitivity to light, sound, smell and touch.6

An attack may last from a couple of hours to as long as three days, often requiring bed rest in complete darkness and silence. In a 2017 Greatist article, migraine sufferers were asked to describe their pain. Here are some of their answers:7

  • “My head feels like it’s in a vise” — Triggers often include stress,8 weather changes, physical exertion, lack of sleep and/or eating the wrong foods. Artificial sweeteners9 such as aspartame are also known to commonly trigger migraine.


    Doctors suggest keeping a food diary to track the emergence of symptoms to pin down certain food triggers. You could do the same for weather and stress if you believe such factors may play a role.

  • It’s “like when a light fixture starts to go out” — This patient is describing the effects of ocular migraine, the onset of which often starts with flickering or flashing light phenomena, or zigzagging lines in the peripheral vision, which can eventually take over the entire field of vision.


    These visual disturbances are referred to as an “aura.” Other common auras include blind spots, blurry, wavy or kaleidoscope vision. Auras can also involve other senses.


    For example, you may experience paresthesia (tingling or numbness), aphasia (trouble speaking), auditory hallucinations or smelling something that isn’t there. Approximately one-quarter of all migraines are accompanied by aura, which is thought to be caused by a chemical or electrical wave in the brain region that processes sensory signals.10

  • “It’s like I’ve been staring at the sun” — Oftentimes, the entire head, from the neck up, can feel overworked, “battered and bruised,” or like your brain has been pounded with a hammer. Post-symptoms can also include a stiff neck for up to a day after the headache ends.

  • “Like I’m on a ship during a storm” — Nausea and a feeling of being in motion is also common.

Generally speaking, migraine is thought to be a disorder of your central nervous system, most likely originating in your brain stem.11 While most brain regions do not register or transmit pain signals, the trigeminal nerve network does.

Pain is relayed through the trigeminal network to an area in your brain stem called the trigeminal nucleus. From there, it is conveyed to the sensory cortex in your brain that is involved in awareness of pain and other senses. Interestingly, estrogen appears to be a major factor in this chain of events.

The late Ray Peat, a pioneer in bioenergetic medicine, argued that estrogen is a major cause of migraines, and in 2018, research was published that offered fresh support for that view. Researchers found that estrogen sensitizes cells around the trigeminal nerve and connected blood vessels in the head, thereby augmenting pain signals.

Estrogen, of course, is at its highest during women’s’ reproductive years, which also helps explain not only the gender difference in prevalence but also the age range at which migraines are most common. As noted by bioenergetic researcher Georgi Dinkov, a student of Peat, in 2018:12

“After more than 80 years of claiming estrogen protected women from migraines and mood disorders (and prescribing HRT as prevention/treatment) modern medicine seems to be finally recognizing the causative role of estrogen in migraines. Peat has been saying this for years …

The fact that stress also causes and/or exacerbates migraines is another ‘obvious’ sign for the role of estrogen (and serotonin/cortisol) in migraines.

In addition to implicating estrogen as a facilitator and cause of migraines, [a] study13 14 [in Frontiers of Molecular Biosciences] … also states that progesterone and testosterone are protective.

I have personally noticed that all men who complained of migraines have quite obvious signs of hypogonadism and hyperestrogenism — low muscle mass, gyno, irritability, depression, etc.”

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An even more foundational cause of migraines is mitochondrial dysfunction. As such, any strategy that helps improve your mitochondrial function is likely to be helpful. The most important of these strategies is to limit your intake of linoleic acid (LA), as this omega-3 fat acts as a mitochondrial toxin when consumed in excess. I published a paper together with Christopher D’Adamo on the detrimental health effects of LA in July 2023, which you can read for free.15

Ideally, you’d want to keep your intake below 2% of your daily calories, but even 5% would be a significant improvement since most people consume far more than that. Seed oils, and hence most processed foods and restaurant foods, are the primary sources of LA and need to be radically limited. I’ll expound on this further below.

The main reason why excess LA causes so many health problems — from migraines to heart disease and cancer — is that it prevents your mitochondria from working properly. Mitochondria are subcellular organelles responsible for producing most of your cellular energy in the form of ATP, and without ATP, your cells cannot function and repair themselves normally.

PUFAs such as LA are easily damaged by oxygen in a process called oxidation,16 which triggers the creation damaging free radicals.17 These, in turn, give rise to advanced lipoxidation end-products (ALEs)18 and oxidized linoleic acid metabolites (OXLAMs).19 20

These ALEs and OXLAMs then go on to cause mitochondrial dysfunction, which is a hallmark of most all chronic disease, including migraines. In addition to oxidation, inflammation and mitochondrial dysfunction, processed seed oils can also:

  • Damage the cells lining your blood vessels

  • Cause memory impairment and increase your risk of Alzheimer’s disease (canola oil, in particular, has been linked to Alzheimer’s)

  • Strip your liver of glutathione thereby lowering your antioxidant defenses

  • Inhibit delta-6 desaturase (delta-6), an enzyme involved in the conversion of short-chained omega-3s to longer chained omega-3s in your liver

  • Impair your immune function and increase mortality

  • Make your fat cells more insulin sensitive, thereby causing insulin resistance

  • Inhibit cardiolipin, an important fat in the inner membrane of your mitochondria

The inhibition of cardiolipin in the inner membrane of your mitochondria explains much of the damage caused by LA. You have about 40 quadrillion to 100 quadrillion mitochondria throughout the cells of your body. The cristae of the inner membrane of the mitochondria contains a fat called cardiolipin,21 and its function is dependent on the type of fat you get from your diet.

Cardiolipin is important, because it influences the structure of the cristae inside your mitochondria, which is the area where energy production occurs. If cardiolipin is damaged, then the complexes will not be close enough together to form supercomplexes and thus the mitochondrial energy production will be impaired.

Cardiolipin also works like a cellular alarm system that triggers apoptosis (cell death) by signaling caspase-3 when something goes wrong with the cell. If the cardiolipin is damaged from oxidative stress due to having too much LA, it cannot signal caspase-3, and hence apoptosis does not occur.

As a result, dysfunctional cells are allowed to continue to grow, which can turn into a cancerous cell. The type of dietary fat that promotes healthy cardiolipin is omega-3 fat, and the type that destroys it is omega-6, especially LA.

The good news is that dietary changes can improve the composition of fats in your cardiolipin in a matter of weeks, or even days. So, even though it will take years to lower your total body burden of LA, you will likely notice improvements well before then.

Primary sources of LA include seed oils used in cooking, processed foods and restaurant foods made with seed oils, condiments, seeds and nuts, most olive oils and avocado oils (due to the high prevalence of adulteration with cheaper seed oils), and animal foods raised on grains such as conventional chicken and pork.

Ideally, consider cutting LA down to below 5 grams per day. If you’re not sure how much you’re eating, enter your food intake into Cronometer — a free online nutrition tracker — and it will provide you with your total LA intake.

Cronometer will tell you how much omega-6 you’re getting from your food down to the 10th of a gram, and you can assume 90% of that is LA. Anything over 10 grams of LA is likely to cause problems. Healthy fat replacements include tallow, butter or ghee, all of which are excellent for cooking.

The table below provides a relatively comprehensive list of the most commonly consumed oils and their approximate LA content.22 23 24 In general, the lowest LA-containing fats — butter and beef tallow — would be the fats of choice.

These excellent cooking fats would not only be the lowest in LA but will also provide the fat-soluble vitamins, A, D, and K2. Coconut oil is also very low in LA but doesn’t provide the important fat-soluble vitamins that tallow and butter contain.

One long-held theory was that a migraine is caused by vascular changes in your brain, from initial blood vessel constriction and a drop in blood flow, followed by dilation and stretching of blood vessels, which activates pain-signaling neurons.

Newer studies have negated this theory, however, as researchers determined migraines are not actually preceded by constriction and decrease in blood flow, but rather by a blood flow increase of nearly 300 percent. Despite that, circulation appears normal, or even slightly reduced, once the attack is in full swing. The question remains: Why?

One small observational study25 found that migraineurs tend to have a different blood vessel structure in their brains compared to those who do not get migraines. Using magnetic resonance angiography, the researchers examined the structure of blood vessels and the changes in cerebral blood flow, focusing on a system of arteries that deliver blood to the brain called “circle of Willis.”

They found that an incomplete circle of Willis was significantly more common in those who get migraines, with or without aura, compared to the control group (73% and 67% versus 51%, respectively). As a result, compared to those with a complete circle of Willis, those with an incomplete circle had greater asymmetry in hemispheric cerebral blood flow.

According to one of the authors of the study, Dr. John Detre, a professor of neurology and radiology:26

“Abnormalities in both the circle of Willis and blood flow were most prominent in the back of the brain, where the visual cortex is located. This may help explain why the most common migraine auras consist of visual symptoms such as seeing distortions, spots or wavy lines.”

Other research27 suggests some migraines — primarily migraines without aura — may be caused by a tear in your neck artery (arterial dissection), which raises your risk of stroke.

Compared to people who had migraine with aura, those without aura were 1.7 times more likely to have an arterial tear. Arterial dissection and stroke was also more likely in men and those under the age of 39. Overall, your probability of having this problem is very low, but it may be worth getting it checked out if you fall into a high-risk category.

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Nutritional deficiencies can also contribute to or cause a number of different health problems, including migraines. In the video above, “America’s pharmacist” Suzy Cohen discusses drug-free solutions for migraine and headache relief, including nutritional supplements. Nutrients of particular importance here are vitamin D,28 magnesium, coenzyme Q10 (CoQ10) and riboflavin (vitamin B2), and deficiencies in one or more of these is quite common.

In a migraine study29 involving more than 7,400 children, teens and young adults, 16% to 51% of participants had below average levels of vitamins depending on the vitamin tested.30 Those suffering from chronic migraines were overall more likely to have CoQ10 and riboflavin deficiency compared to those with episodic migraines.

Unfortunately, many of the patients in this study were prescribed preventive therapy and too few were given supplements alone for the researchers to determine if supplementation was enough to actually prevent migraines.31 However, other research suggests they can.

For example, research using vitamin D supplementation demonstrated a reduction in C-reactive protein (CRP) and a statistically significant reduction in headache frequency.32 Another more study by Finnish researchers found that men with the lowest vitamin D levels were twice more likely to suffer frequent headaches than those with the highest levels.

Overall, the lower the men’s blood level of vitamin D, the more frequent their headaches. Those with a vitamin D blood level of 15.3 nanograms per milliliter (ng/mL) or lower typically had one or more headaches per week, while those with a level of 11.6 ng/mL or lower reported up to seven headaches per week. Ideally, your vitamin D level should be in the 60 to 80 ng/mL range, so both groups were severely deficient. As reported by Deming Headlight:33

“The researchers theorized that vitamin D has anti-inflammatory properties that prevent swelling in the sensory neurons and the microglial cells in the brain and is essential for proper brain function. In the study information, they also note that previous studies show vitamin D prevents musculoskeletal pain, a major cause of tension headaches.”

According to research presented at the 50th Annual Meeting of the American Headache Society34 in 2010, nearly 42% of patients with chronic migraine were deficient in vitamin D. The study also showed that the longer you suffered from chronic migraines, the more likely you are to be vitamin D deficient.

Magnesium — which can affect both serotonin receptor function and the production and use of neurotransmitters — has also been shown to play an important role in the prevention and treatment of migraines, and migraine sufferers are more likely to suffer from magnesium deficiency than non-migraineurs.35

Researchers theorize that migraine sufferers may develop magnesium deficiency from a variety of reasons, including poor absorption, renal wasting, increased excretion due to stress or low nutritional intake. Since magnesium administration is both easy and safe, researchers have noted that empiric treatment with a magnesium supplement is justified for all migraine sufferers.36

As a prophylactic, be prepared to boost your magnesium intake for at least three months to experience results, ideally in combination with CoQ10.

In many cases, receiving a high dose of magnesium can also abort an attack in progress. The most effective way to administer magnesium for migraine would be to get an intravenous (IV) infusion. I used to regularly administer magnesium IVs for those with acute migraines and it seemed to work for most patients to abort the headache.

Barring that option, magnesium threonate may be your best option for an oral supplement. It has superior absorbability compared to other forms of magnesium, and since its ability to cross the blood-brain barrier makes it more likely to have a beneficial effect on your brain.

Besides CoQ10, magnesium and vitamin D, other vitamin deficiencies linked to migraines include riboflavin (B2), B6, B12 and folic acid. One 2009 study37 evaluated the effect of 2 mg of folic acid, 25 mg vitamin B6 and 400 micrograms (mcg) of vitamin B12 in 52 patients diagnosed with migraine with aura.

Compared to the placebo group, those receiving these supplements experienced a 50% reduction in migraine disability over a six-month period. Previous studies38 have also reported that high doses of riboflavin can help prevent migraine attacks. For example, in one study patients who received 400 mg of riboflavin per day experienced a 50% reduction in migraine frequency after three months.

Although supplements are convenient, it’s important you get as many nutrients from your diet as possible, as your body can metabolize and absorb vitamins and minerals from your diet more effectively and efficiently than from most supplements.

In addition to adding foods rich in magnesium, riboflavin and CoQ10 to your daily diet, look for organic, grass fed products to reduce your exposure to toxins and additional stressors. As for vitamin D, sensible sun exposure is your best bet. If you opt for a vitamin D3 supplement, be sure to increase your vitamin K2 and magnesium as well.

  • Foods Rich in Magnesium:39

    • Dark leafy greens

    • Wild Alaskan salmon

    • Yogurt made from organic and/or grass fed milk with no added sugars

  • Foods Rich in Riboflavin:40

    • Beet greens

    • Tempeh

    • Crimini Mushrooms

    • Organic low-PUFA eggs

    • Asparagus

    • Broccoli

    • Cauliflower

The fact that nutritional deficiencies worsen migraine and supplementation can ease it lends additional support to the theory that migraines are a mitochondrial disorder.41 Ubiquinol — the reduced form of CoQ10 — plays a vital role in ATP production, which is the basic fuel for your mitochondria.

Your body does produce ubiquinol naturally; in fact, it is the predominant form in most healthy cells, tissues and organs. However, with rampant pollution and poor diet, mitochondrial dysfunction has become increasingly common, warranting supplementation with either ubiquinol or CoQ10.

One study published in the journal Neurology42 found that CoQ10 was superior to a placebo in preventing migraines and reducing severity. Of the patients who received 100 mg of CoQ10 three times a day, 50% reported significantly reduced frequency of headaches compared to only 14% of those who took the placebo.

That said, while ubiquinol may be beneficial, for long-term migraine relief you really need to address your diet in a more comprehensive manner, as detailed above.

Last but not least, it’s also useful to keep a diary of your migraines to identify potentially triggers. That way, you can avoid them. While there are many (and what triggers a migraine for one might not trigger it in another), the following are some of the most common.

  • Food and drink, especially wheat and gluten, dairy, cane sugar, yeast, corn, citrus, eggs, artificial preservatives or chemical additives, cured or processed meats, alcohol (especially red wine and beer), aspartame, caffeine and MSG.43 44

  • Allergies, including food allergies45 and food sensitivities and chemical sensitivities. Research published in the journal Lancet in 197946 showed migraineurs with food antigen immunoreactivity experienced profound relief when put on an elimination diet.


    Another randomized, double-blind, cross-over study published in 201047 found that a six-week-long diet restriction produced a statistically significant reduction in migraines in those diagnosed with migraine without aura.


    If you suspect you might have a food allergy, I suggest doing a diet elimination challenge to see if your symptoms improve. Keep in mind that depending on your typical migraine frequency, you may need to avoid the suspected food for a few weeks in order to evaluate whether it had an effect or not.

    To confirm the results, reintroduce the food or drink on an empty stomach. If the suspected food is the culprit, you will generally be able to feel the symptoms return within an hour, although migraines can sometimes have a longer lag time than, say, bloating or drowsiness.
  • Hormones — Some women experience migraines before or during their periods, during pregnancy or during menopause. Others may get migraines from hormonal medications like birth control pills or hormone replacement therapy.

  • External stimuli — Bright lights, fluorescent lights, loud noises and strong smells (even pleasant ones) can trigger and/or exacerbate a migraine.


    Blue light in particular can be problematic. Many digital devices and LED light sources emit mostly blue light. Research has found that this light increases your migraine pain and activates your trigeminal nerve, associated with the pain of migraines.48 Meanwhile, green light may help ease migraine pain and photosensitivity.49

  • Changes in sleeping cycle, either missing sleep and oversleeping.

  • Stress/post-stress — Any kind of emotional trauma can trigger a migraine, even after the stress has passed.

  • Dehydration and/or hunger — Skipping meals or fasting are also common triggers.

  • Physical exertion — Extremely intense exercise, or even sex, has been known to bring on migraines.

  • Weather changes, and/or changes in altitude.

Acupuncture may also be a helpful adjunct therapy. Research has found that getting regular acupuncture treatments can help reduce the frequency and severity of migraine attacks in those suffering from migraine without aura.50 51 52

In all, 249 adult migraineurs who reported two to eight migraine attacks per month were included in the study. They were randomly assigned to receive either 20 real acupuncture treatments or 20 sham treatments over four months. Among those receiving the real treatment, migraine frequency declined by about three episodes per month, while the sham group had two attacks less per month. According to the authors:

“Acupuncture should be considered as one option for migraine prophylaxis in light of our findings.”

It’s interesting to note that even sham treatment had a significant response. Indeed, previous research has shown the placebo effect can be a potent tool in the prevention and treatment of migraines and other types of pain. As noted by neurologist Dr. Amy Gelfand, while the placebo response is troublesome for researchers, it can be a very beneficial effect for patients, especially when the treatment is otherwise safe, be it acupuncture or sugar pills.53

Chiropractic adjustments have also helped many patients, but not all chiropractors are skilled with the techniques to address migraine, so before you schedule an appointment it is important to confirm that your chiropractor has significant experience in helping people treat their migraines.

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Disclaimer: The entire contents of this website are based upon the opinions of Dr. Mercola, unless otherwise noted. Individual articles are based upon the opinions of the respective author, who retains copyright as marked.

The information on this website is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice. It is intended as a sharing of knowledge and information from the research and experience of Dr. Mercola and his community. Dr. Mercola encourages you to make your own health care decisions based upon your research and in partnership with a qualified health care professional. The subscription fee being requested is for access to the articles and information posted on this site, and is not being paid for any individual medical advice.

If you are pregnant, nursing, taking medication, or have a medical condition, consult your health care professional before using products based on this content.

Why You Want to Avoid Hot Drinks When Flying

  • Clean, pure water is one of the most important foundations for optimal health, but is becoming more difficult to come by with environmental policy changes, agricultural runoff and water treatment plant failures reducing water quality

  • The EPA is attempting to regulate tap water supply on airlines to reduce your risk of coliform bacteria contamination; this pollutant may indicate fecal contamination of the water supply

  • Consider bringing bottled water with you when you fly, purchased after the security checkpoint, as the airlines will sometimes run short of bottled water and it may not be advisable to drink the tap water

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Editor’s Note: This article is a reprint. It was originally published July 5, 2017.

Clean, pure water — in sufficient amounts — is one of the most important foundations for optimal health, but is becoming far more difficult to come by with each passing year.

Environmental policy changes ensure ground water will suffer greater contamination with chemical pollution;1 water treatment plants don’t have the resources to remove drugs and other small particles from the water before dumping into rivers and oceans;2 and in some cases, sewage is dumped directly into the environment.3 4

Most tap water is far from pure, containing a vast array of disinfection byproducts, fluoride, radiation, heavy metals, agricultural runoff, pharmaceutical drugs and perfluorooctanoic acid (PFOA), a chemical used in the production of Teflon and flame retardants.5 And that’s the short list. What’s worse, more than half of the 300-plus chemicals detected in U.S. drinking water are not even regulated.6

Every year new stories are released about toxic drinking water across the U.S. The World Health Organization estimates nearly 25% of all global deaths result from an unhealthy environment.7 The 1972 Clean Water Act8 regulates discharges of pollutants into U.S. waterways and sets quality standards for surface waters.

It was supposed to ensure clean water for swimming and fishing, yet after more than four decades of clean water regulation, our waterways are in serious jeopardy. It should come as no surprise, then, that you may want to carefully consider avoiding any drink that comes from the tap while flying.

Early morning flights and traveling from west to east, when jet lag is tougher on your body,9 makes it more difficult to stay awake and function when you land. Sometimes all you want is a nice warm cup of coffee or tea to wake you up and help you feel refreshed.

The featured video shows you why, before you ask the flight attendant to serve that coffee, you may want to wait until you land and are safely off the plane. According to a flight attendant, there is a self-imposed ban on warm beverages by flight crew. One attendant stated:10 “Flight attendants will not drink hot water on the plane. They will not drink plain coffee, and they will not drink plain tea.”

Unfortunately, even cold drinks may be a problem as the attendants use tap water when the bottled water runs out. The same attendant confirmed that while the water tanks are cleaned, it isn’t very often.11 The tap water on your plane is first delivered to the airport via a water tanker truck where it is stored in a facility.

Another truck is then filled from the storage tank and delivers the water to the plane. Tap water on your flight may be contaminated at any point during transport from the original source to your plane.

This water has tested positive for coliform bacterial contamination, bacteria that indicate human fecal waste is present. Coliform bacteria are considered “indicator” bacteria, as they come from the same sources as pathogenic organisms like E. coli.12

Water supplies are tested for indicator bacteria since the concentrations of pathogens from fecal contamination may be small and the number of possible pathogens is large, making testing for each pathogen impractical. Testing for coliform bacteria is therefore more practical.

Over 15 years ago the Association of Flight Attendants-CWA13 (AFA) pushed for regulation of tap water on air flights. After an Environmental Protection Agency (EPA) study found 1 of every 8 planes in 158 tested had contaminated water,14 the airline industry agreed to a two-year plan during which they would test the water from each plane every year and disinfect the plane’s water tanks every three months.

However, the tanks agreed to be disinfected in this accord were the plane’s tanks and not the storage or transportation tanks. Bacteria may infect the water on the plane from the storage tanks or from hoses that are routinely found in filthy condition.15

Twelve airlines agreed to the initial solution in 2004 proposed by the EPA. Within a year the EPA went on to develop drinking water agreements with 24 domestic airlines.16 After a round of testing, the results showed Southwest had the best test results with less than 3% of its planes testing positive for coliform and none for E. coli.17

The testing in 2004 by the EPA eventually led to the Aircraft Drinking Water Rule18 in 2009, after more testing continued to identify coliform contamination in aircraft tap water.19 Further study results, requested in 2012 by an investigation by NBC5 through a Freedom of Information Act Request, showed 12% of tests on commercial flights had at least one plane that tested positive for coliform bacteria.

Bill Honker, director of the water division, EPA Region 6 in Dallas, calls this a “high percentage” of planes and believes the industry could do a better job of protecting their customers.20

The bacteria found in the planes’ water tanks may not all be killed at the temperatures used to brew tea and coffee on the plane, and in some instances the maximum brewing temperature is not reached.21 Southwest Airlines routinely uses ozone to disinfect their tanks and the faucets in the galley and lavatories, contributing to their low bacterial rates on testing.

However disgusting it is that water from the plane’s tank may have coliform bacteria, the water originates from a source awash with fluoride, chloride and other pollutants. Drinking bottled water from plastic bottles has its own set of concerns, as it may contain bisphenol-a (BPA), an endocrine disrupting chemical linked to altered immune function, obesity, reduced sperm production and hyperactivity.22

When water bottles are not stored in climate controlled environments, leakage of BPA into the water increases. If the plastic bottles are BPA-free, the chemical has likely been replaced with another form of bisphenol with a similar chemical structure and function.

However, it is also important to be drinking while you fly. The air in the plane has little humidity. According to Aviation International News, a dripping wet terry cloth hand towel will be bone dry after 1.5 hours of flight,23 as the water is absorbed into the air quickly. The same happens to you as water evaporates more quickly from your skin and lungs in the low humidity, dehydrating you more quickly.

Although plastic bottles of water have their health concerns, it’s a far safer choice than drinking tap water from the plane, and you do need to rehydrate while flying. If you are traveling for longer periods and are concerned the airline will run out of bottled water, you may carry on as many bottles as you like, as long as they are purchased after the security checkpoint.24

Similar problems have been reported onboard Cathay Pacific Airways when Hong Kong’s Port Authority Office collected samples from 22 planes as part of a routine inspection and found 10% had tainted drinking water.25 Following the inspection, the airline issued a warning to passengers to avoid brushing their teeth in the lavatories and issued all passengers bottled water.

This airline also cleans and disinfects its tanks every three months and tests every six months. Brenda Wiles manages a lab in Fort Worth, Texas, that is certified to test the drinking water from aircraft. She commented:26

“There’s poop in the water if there’s E. coli in the water, and that’s not a good thing. [Heating] might kill some of the organisms, the more susceptible ones, but it’s not going to kill the majority of them.”

According to a statement from the AFA, which first made the push to have water safety onboard planes regulated:27 “The regulation gives broad discretion to airlines on how often they must test the water and flush the tanks. AFA does not believe this regulation goes far enough or is sufficiently enforced.”

It appears from this statement that the AFA is not satisfied with the regulations currently in place, or the attempts by the airlines to ensure the health and safety of the passengers and crew from water contamination. As with water from your tap at home, you may consider precautions that will help you avoid contamination from bacteria, toxic chemicals, drugs, fluoride and chlorine.

To be certain you are using the purest water at home, consider filtering at both the point of entry to the house and the point of use. Unfiltered water may expose you to dangerous chlorine vapors and chloroform gas.

A whole house filter helps eliminate the potential for vaporized chlorine from your toilets, washing machine and showers. Chloroform gas, chlorine vapors and the associated detergent byproducts may increase your risk of asthma, airway inflammation and respiratory allergies.

If you don’t have a whole house filter, open your windows on opposing sides of your home to achieve cross ventilation for between five and 10 minutes each day to remove the gasses, no matter the temperature outside.

Although purification is important, I also believe it’s important to drink living water. During my interview with Dr. Gerald Pollack, author of “The Fourth Phase of Water: Beyond Solid, Liquid, and Vapor,” we discussed “structured water,” which is the type of water found in your cells.

This type of water is energized to recharge your mitochondria. You can find structured water from a deep spring, and the deeper and more pressurized the better. You can find a spring in your area using the website FindaSpring.com.28 Just be sure to evaluate the site you choose based on any surrounding industrial or agricultural facilities that may pollute the water.

Two options you may try at home are vortexing or cooling the water to 39 degrees F. By creating a vortex in a glass of water by stirring it with a spoon, you’re putting more energy into it, thereby increasing the structure of the water. According to Pollack, virtually any energy put into the water seems to create or build structured water.

Disclaimer: The entire contents of this website are based upon the opinions of Dr. Mercola, unless otherwise noted. Individual articles are based upon the opinions of the respective author, who retains copyright as marked.

The information on this website is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice. It is intended as a sharing of knowledge and information from the research and experience of Dr. Mercola and his community. Dr. Mercola encourages you to make your own health care decisions based upon your research and in partnership with a qualified health care professional. The subscription fee being requested is for access to the articles and information posted on this site, and is not being paid for any individual medical advice.

If you are pregnant, nursing, taking medication, or have a medical condition, consult your health care professional before using products based on this content.

How Your Microbiome Influences Your Dietary Recommendations

Download Interview Transcript | Download my FREE Podcast

  • Contrary to popular belief among followers, Ray Peat, Ph.D., did not advocate for high consumption of sugar. While sugar is acceptable in moderation, refined sugar, particularly in large amounts, can be problematic due to its impact on the microbiome. There’s also a debate over the best source of carbohydrates. Fruit is traditionally favored over starch. However, starch is likely superior, provided you have a healthy gut microbiome, which most people lack

  • Efficient mitochondrial function is crucial as it provides the energy needed to maintain an optimal gut environment. Poor mitochondrial function can lead to an imbalance in gut microbiota, favoring pathogenic over beneficial bacteria

  • Akkermansia, a highly beneficial bacteria in your large intestine, plays a crucial role in maintaining gut health and should constitute about 10% of the gut microbiome. However, it is absent in many individuals, likely due to inadequate mitochondrial function and resultant oxygen leakage in the gut. Widespread use of antibiotics can also disrupt the microbiome by killing both beneficial and harmful bacteria, leading to a dominance of pathogenic bacteria which produce harmful endotoxins

  • Collagen supports skin health, joint strength, and gut health due to its amino acid profile. Collagen should ideally comprise about 5% of your daily calorie intake. Avoid going above 10% as it can be problematic

  • Investigators using a pro-metabolic (energy-enhancing) approach are currently experimenting with vitamins and an aspirin analog to target cancer metabolism by inducing apoptosis through lowering intracellular pH. Preliminary studies show promising results in stopping tumor growth and even regressing tumors

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In the ever-evolving field of bioenergetic medicine, the relationship between our diet, microbiome, and overall health continues to unveil complex and intriguing connections. At the heart of this exploration is the legacy of Ray Peat, Ph.D., whose theories on sugar intake and metabolic function have sparked widespread debate and interest among researchers and health enthusiasts alike.

In this interview, repeat guest Georgi Dinkov, a bioenergetic medicine researcher and I delve into the nuanced understanding of how our microbiome influences dietary choices, particularly the contentious decision between starch and fruit as preferable sources of carbohydrates. Dinkov also reviews groundbreaking research and innovative treatments that aim to manipulate cellular energy pathways to combat cancer.

Many of Peat’s followers believe that he advocated large amounts of sugar, but that’s not the case. Sugar, or glucose more specifically, is necessary for cellular health. Refined sugar can be a problem, especially in large amounts.

The issue really boils down to your microbiome, which Peat didn’t really understand as many technical advances have been made since he was actively learning. He certainly warned about the hazards of endotoxin, but I suspect he may not have fully appreciated the power of the microbiome.

The contention within the bioenergetic medicine community is that it’s wise to avoid starch and replace it with ripe fruit. They mostly believe fruit is the ultimate carbohydrate, but I now suspect starch may be the ideal type of carb, but only if your gut microbiome is optimal.

Since most people have poor gut health they don’t do well when eating a significant amount of starch. Most also have dysfunctional mitochondria, and if you don’t have enough mitochondria, you can’t create cellular energy efficiently enough to ensure a healthy gastrointestinal tract.

Your gut contains primarily two types of gram-negative bacteria: beneficial and pathogenic. The beneficial ones include obligate anaerobes, which cannot survive in the presence of oxygen and are essential for health. They do not produce harmful endotoxins and contribute positively by producing short-chain fatty acids, like butyrate, propionate, and glucagon-like peptide-1 (GLP-1).

Proper gut function requires energy to maintain an oxygen-free environment in the large intestine, where 99% of gut microbes reside. Insufficient energy leads to oxygen leakage, which harms obligate anaerobes while not impacting the facultative anaerobes, thereby disrupting the balance of the microbiome.

Pathogenic bacteria, or facultative anaerobes, can survive in oxygen and are harmful, as they possess endotoxins in their cell walls. Feeding these bacteria with starch can exacerbate their growth, leading to health issues.

The only carbohydrate that does not promote these bacteria is fruit juice, which some people may tolerate better than whole fruit. Polyphenols, found in high amounts in fruits but not starches, also has beneficial effects on the gut microbiome.

In short, enhancing mitochondrial energy production is crucial for maintaining a healthy gut environment. When you do that, it helps suppress the growth of pathogenic bacteria and support beneficial microbial populations.

The bacterium Akkermansia is particularly beneficial and should ideally constitute about 10% of your gut microbiome. However, DNA analyses suggest about one-third of people have few to no Akkermansia at all, and I suspect this is due to insufficient energy production (low metabolism) and resulting oxygen leakage in the gut.

As noted by Dinkov, the high prevalence of antibiotics in our food supply also has a detrimental effect on the microbiome by indiscriminately killing off both good and bad bacteria. Pathogenic bacteria tend to rebound faster, resulting in a predominance of endotoxin-producing bacteria that destroy the intestinal barrier.

A robust intestinal barrier can prevent bacterial fragments from entering the bloodstream, whereas a compromised barrier allows these harmful fragments through while blocking beneficial compounds like short-chain fatty acids (SCFAs).

The overall health impact of the microbiome, therefore, significantly depends on the integrity of the intestinal barrier, and the strength and function of the intestinal barrier, in turn, is determined by the presence or absence of endotoxins.

Considering the adverse effects of antibiotics on gut health, I do not support Peat’s recommendation to use antibiotics to kill off pathogenic bacteria. It’s not an ideal solution. What you need to do is restructure your microbiome, and the most effective way to do that, I believe, is through eating foods that support Akkermansia and other beneficial bacteria, and avoid foods like linoleic acid that destroy these bacteria.

One of the reasons akkermansia is so important is because it produces mucin, a thick, protective gel-like substance that lines various parts of the body, including the gastrointestinal tract. Mucin forms a protective barrier on the gut lining, shielding the epithelial cells of the intestinal wall from mechanical damage, chemical irritation from stomach acids and digestive enzymes, and pathogenic organisms like bacteria and viruses.

Mucin also supports the immune system by trapping potential pathogens and other foreign particles, which are then expelled from the body through the digestive process. It also contains antibodies and antimicrobial peptides that help fight off infections.

Lastly, mucin serves as a food source for other beneficial gut bacteria. This relationship is essential for digestive health, as the bacteria fed by akkermansia aid in digestion, produce essential nutrients, and help maintain an overall balance of gut flora.

As noted by Dinkov, there’s also a tight relationship between intestinal motility — the frequency and quality of bowel movements — and metabolic rate, particularly in relation to thyroid function. Historically, frequent bowel movements (nearly after every meal) were considered normal and were used as a diagnostic indicator of thyroid health.

Currently, however, the accepted norm for bowel movements has shifted to once a day or even once every two days without concern, unless constipation extends beyond a week. Ideally, you should have at least one or two bowel movements per day.

The composition of your stool can also provide insights into your hydration status and gut fermentation processes, which are indicative of the overall health of the colon and reflect your metabolic rate. Patterns in urination and bowel movements can also serve as indicators of metabolic health, with infrequent bowel movements and excessive urination suggesting a low metabolic rate.

Another one of Peat’s recommendations that I don’t think he stressed enough is the value of collagen (or gelatin). Collagen and gelatin are related substances, but they differ in structure and uses due to how they are processed and prepared. Gelatin, I think, is an inferior form of collagen.

They contain the same amino acids, and are known to support skin health, strengthen joints and bones, and improve digestive health. However, because collagen peptides are smaller and more bioavailable, they may be more efficiently absorbed by the body than gelatin.

About 30% of your bone is collagen, making it an essential dietary component to prevent osteoporosis (age-related bone loss). Your muscle fibers also contain loads of collagen, not to mention your tendons and ligaments, so you can’t build muscle if you don’t have enough collagen. Collagen intake can also help lower your risk of insulin resistance. As noted by Dinkov:

“Several studies have demonstrated that if you ingest collagen with a very large amount of glucose, it doesn’t trigger nearly the same insulin response because the collagen can fill in for a lot of the insulin. Some of the peptides are very similar in structure. So, it’s like you’re ingesting insulin and you don’t have to trigger your pancreas to produce as much. So, you directly improve your insulin sensitivity with every meal.”

Unfortunately, many who are following a carnivore diet fail to realize that most of the protein should be in the form of collagen, NOT red meat. An all-meat diet will only accelerate your demise, as most of the amino acids in muscle meat — methionine, histidine, tryptophan and cysteine — promote inflammation and suppress thyroid function and metabolism.1

According to Dinkov, tryptophan is also directly carcinogenic. Collagen, meanwhile, contains radically higher levels of glycine, proline, hydroxyproline and alanine, which are essential for health. Dinkov comments:

“Glycine is an actual neurotransmitter. It’s the major inhibitory neurotransmitter in the spinal cord and one of the major neurotransmitters that regulates gastrointestinal motility. So, without sufficient amounts of glycine in the body, you’ll have problems with digestion even if you don’t have an inflamed gastrointestinal tract.”

The best source of collagen is homemade bone broth, which you can whip up in four hours using a pressure cooker, such as the Instant Pot. Simply place the bones in the pressure cooker, fill the pot with pure, filtered water — just enough to cover the bones — add salt and other spices to taste, then set it to cook on high for two hours if the bones are CAFO (from animals raised in a concentrated animal feeding operation), and four hours if organic and grass fed.

Organic grass fed beef bones are the best. Using bones from CAFO beef can be problematic due to potential heavy metal contamination. When cooking these bones in a pressure cooker, it’s best to limit the time to two hours to avoid introducing heavy metals into your broth.

If you’re using beef bones from grass fed organic sources, you can safely cook them for four hours. I recommend chilling the bone broth before you eat it. This will allow the fat to rise to the top so you can skim it off. While some beef fat is good, excess can be problematic.

On a side note, if you have a dog, you can carve off the loose cartilage around the joints after two hours and feed the cartilage to your pet. If you cook the bones for four hours or longer, most of the collagen will be dissolved in the broth, so there won’t be anything left to pick off. More importantly, you never want to give your dog cooked bones as they can splinter during chewing and cause great damage to the esophagus.

Another delicious way to get more collagen into your diet is to make homemade ice cream. My homemade healthy ice cream recipe done in a Ninja Creami includes one scoop of my collagen protein powder, three tablespoons of maple syrup, two egg yolks, and a cup of goat milk. It tastes almost identical to store-bought ice cream but is much healthier.

So, just how much collagen do you need? As noted by Dinkov, in studies conducted on rodents, researchers have discovered that adding 1% to 2% collagen to the diet can effectively mimic the life-extending effects observed from the depletion of certain amino acids such as cysteine, tryptophan and methionine.

This finding is particularly intriguing as it suggests a possible direct translation of these benefits to humans due to the metabolic nature of the intervention. When considering overall dietary protein, the consensus among nutritionists is that it should ideally comprise about 15% of your total daily calories.

Approximately one-third of this protein, or about 5%, should ideally be collagen. This recommendation is based on achieving the optimal balance for health benefits without adverse effects. It’s probably safe to increase the proportion of collagen up to 10% of total calorie intake.

A similar ratio — 5% to 30% — applies to dietary fat as well. That range is probably ideal. The remainder of your daily calories would then come from healthy carbs, mostly fresh fruits (if you can tolerate them) and fruit juice if you’re mitochondrially impaired, or starches like white rice and cooked potatoes if your metabolism is high (which is indicative of healthy mitochondrial energy production).

Interestingly, cheese is also high in tryptophan, significantly more than egg white. However, according to Dinkov, the casein in the cheese basically acts as a tryptophan blocker. Calcium also has tryptophan-buffering effects. He also goes on to explain how different types of amino acids interact in the body, particularly in relation to brain function and fatigue.

A key point to remember though is that most cheeses today are made with genetically modified rennet, so make sure you’re buying cheese made from raw, organic, grass fed milk and natural animal-based rennet only.

Amino acids are building blocks of proteins that have various functions in the body. Among them, branched-chain amino acids (BCAAs) and aromatic amino acids like L-tyrosine and phenylalanine are important. BCAAs include leucine, isoleucine, and valine. The blood-brain barrier is a filter that controls what substances can enter the brain from the bloodstream.

BCAAs and aromatic amino acids such as L-tyrosine and tryptophan compete to cross this barrier, and if you consume large amounts of BCAAs alone, they outcompete L-tyrosine and tryptophan at the blood-brain barrier. This results in lower levels of L-tyrosine and tryptophan in the brain, which in turn can decrease the levels of neurotransmitters like serotonin.

Dinkov cites animal research showing that fatigue during exhaustive exercise isn’t primarily caused by a lack of energy but rather by an increase in serotonin in the brain. Administering BCAAs and L-tyrosine seemed to mitigate this type of fatigue without significantly adding calories, suggesting the importance of amino acid balance over sheer energy intake.

He also reviews some of the natural ways to influence amino acid absorption and serotonin levels, such as consuming foods rich in BCAAs, aspirin, cheese, and fruits containing salicylic acid, such as blackberries and apricots. All of these have an inhibitory effect on the absorption of inflammatory amino acids from food.

Biomolecular biologist Brad Marshall, whom I recently interviewed, argues that starches are a more ideal carb than fruit, but again, the caveat is that you must have a healthy microbiome. If you don’t, starches can pose problems.

Since my gut health is good and my metabolism high, I make 6 cups of white rice cooked in bone broth for my dog and I each day, along with an egg yolk or two. I think these three foods — bone broth, white rice and low-linoleic acid egg yolk — make for a close to optimal meal, both for humans and dogs. I also eat about half a pound of organic, grass fed cheese each day.

After eating this amount of cheese, rice and bone broth for one month, I did a SICA test to assess my bone mass and body fat percentage. I’d grown half an inch in height, gained 4 pounds in total body weight yet my body fat decreased from 8.5% to 5.3%. Basically, I gained 4 pounds of pure muscle.

The increase in height is explained by improved structural integrity of my vertebral discs. They get crushed with time, which is why you tend to shrink with age. The bone broth supplies loads of collagen, which strengthens those vertebra. An increase in connective tissue also increases intracellular water, and at the time that I did this test, my intracellular water had increased by half a liter.

Dinkov also discusses the findings of experimental studies he’s involved in, in which they’re using vitamins and pharmaceutical agents to target the metabolism of cancer cells. Vitamins studied include B1 (thiamine), B3 (niacinamide), and B7 (biotin). These vitamins were chosen based on historical studies, some nearly a century old, that connect them to cancer metabolism.

As explained by Dinkov, thiamine (B1) acts as a cofactor for pyruvate dehydrogenase, a crucial enzyme in cellular energy production. Thiamine also inhibits pyruvate dehydrogenase kinase (PDK), which itself inhibits pyruvate dehydrogenase (PDH). Thus, B1 indirectly supports energy production by keeping PDH active.

Niacinamide (B3) converts to NAD+ in your body, thereby affecting the NAD+ to NADH ratio, which is vital for metabolic processes like the functioning of another enzyme, alpha-ketoglutarate dehydrogenase. NAD+ also inhibits lipolysis, reducing fat availability to cancer cells which can use fat as fuel.

Biotin (B7), meanwhile, is noted for significant effects in human studies involving neurological disorders like multiple sclerosis and Huntington’s disease.

High doses of biotin (300 mg) have been observed to halt the progression of primary progressive multiple sclerosis, with the proposed mechanism being an improvement in mitochondrial function. It also appears to enhance the Krebs cycle, a key component of cellular respiration, as shown by increased carbon dioxide production in cell cultures.

A combination of all three were found to completely stop tumor growth but didn’t trigger regression. The research used the JEKO-1 cell line, which is a type of human mantle cell lymphoma.

This cell line is described as being highly malignant and fatal when transplanted into immunocompromised animals, showing a 100% mortality rate and 0% chance of tumor regression, whether through treatment or spontaneously. This indicates the aggressive nature of the tumor and the challenge it presents for therapeutic intervention.

Seeking additional treatment options, the researcher then added aspirin at a dose of approximately 1.5 grams per day, which is high but below toxic levels typically associated with treatments for conditions like rheumatoid arthritis. This dosage successfully led to the full regression of tumors in three experimental mice.

After the tumors regressed, the mice were monitored for recurrence. One mouse showed signs of potential tumor recurrence, but this subsided, and after 70 days — a significantly extended period compared to the usual two-week lifespan due to the lethality of the tumors — all mice remained tumor-free.

With the success of aspirin, the focus shifted to a more potent analog, 2,6-dihydroxy benzoic acid, known for its stronger acidic properties and better lipophilicity, which can potentially lower the intracellular pH of cancer cells more effectively. This shift in pH is crucial because cancer cells typically avoid apoptosis (programmed cell death) by maintaining an alkaline internal environment. Lowering the pH is thought to trigger apoptosis.

This compound, 2,6-dihydroxy benzoic acid, which was used in the past to treat rheumatoid arthritis at doses significantly lower than those required for aspirin, showed promising results in further lowering the dose required for treatment compared to aspirin. The initial results from using this compound in conjunction with vitamins showed that tumors not only regressed but the treatment was effective at much lower doses.

So, in summary, a combination of vitamins and an aspirin analog may be a potent cancer treatment, minimizing side effects related to high doses of conventional aspirin. This shows how a combination of dietary supplements and pharmaceutical agents can target the metabolic vulnerabilities of cancer cells, specifically through the manipulation of intracellular pH to induce apoptosis.

Dinkov also reviews other experimental approaches aimed at understanding and manipulating cancer cell behavior through dietary and pharmacological means. In a fascinating dietary experiment, mice were fed a fat-free diet for two weeks prior to tumor implantation attempts.

Remarkably, these mice exhibited resistance to tumor growth, suggesting that a deficiency in essential fatty acids, particularly polyunsaturated fats (PUFAs), could prevent cancer formation. This finding radically challenges existing theories on the benefits of ketosis and the use of high-fat diets as a way to manage cancer.

Dinkov’s team is now working on the transition from animal models to human cancer protocols. He’s confident this will happen because the pharmacokinetics — how the body absorbs, distributes, metabolizes, and excretes a drug — of the involved chemicals are well-understood.

This includes the acidic analog of aspirin (2,6-dihydroxy benzoic acid), which, although less familiar, has some historical human data supporting its use. The process involves translating dosage from mice to humans based on body surface area and metabolic differences, which are generally well-documented and allow for relatively straightforward adjustments.

He also notes that in the 1950s and 1960s, they used high doses of natural desiccated thyroid for terminal cancer cases, which aligns with Otto Warburg’s theories on cancer metabolism. Warburg hypothesized that cancer growth is caused by the energy generated from glucose fermentation; hence, a pro-metabolic (energy-enhancing) approach such as what Dinkov’s team is working on, rather than an anti-metabolic (energy-reducing) therapy, might be more effective.

For more details on the topics summarized here, be sure to listen to the interview in its entirety. Also check out Georgi’s blog at haidut.me or follow him on Twitter. He also has hundreds of videos on YouTube on a plethora of topics.

Disclaimer: The entire contents of this website are based upon the opinions of Dr. Mercola, unless otherwise noted. Individual articles are based upon the opinions of the respective author, who retains copyright as marked.

The information on this website is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice. It is intended as a sharing of knowledge and information from the research and experience of Dr. Mercola and his community. Dr. Mercola encourages you to make your own health care decisions based upon your research and in partnership with a qualified health care professional. The subscription fee being requested is for access to the articles and information posted on this site, and is not being paid for any individual medical advice.

If you are pregnant, nursing, taking medication, or have a medical condition, consult your health care professional before using products based on this content.

Improve Your Physical and Psychological Health With This Simple Lymphatic Drainage Routine

  • Your lymphatic system, integral to immune function and waste removal, significantly influences overall health, including physical, mental and emotional aspects

  • The “Big 6” routine developed by chiropractor Perry Nickelston involves stimulating six key lymphatic points to enhance blood flow, nerve response and the clearance of toxins. The “Big 6” lymphatic drainage points are: above and below the collarbone, jawline, chest, abdomen, hip area and back of the knees

  • A lymphatic drainage routine helps reduce swelling, facilitates detoxification, helps prevent disease by boosting immune function, and improves digestion and nutrient absorption

  • Understanding the lymphatic system’s unique pressure system is essential; drainage should start at low-pressure areas (above and below the collarbone) and move towards higher-pressure areas to prevent swelling, especially in extremities

  • Enhanced proprioception, resulting from a well-functioning lymphatic system, translates into a feeling of safety by allowing the brain to accurately sense joint positions and movements, thus reducing injury risk and boosting confidence and psychological well-being

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The lymphatic system is a crucial part of your body’s immune and waste removal systems, and as such play a significant role in your overall health and well-being. Its proper functioning affects physical, mental, and emotional health through its network of vessels and nodes that transport lymph, a fluid containing white blood cells and waste products.

As explained by Perry Nickelston, a practicing chiropractor, in the video above, maintaining a healthy lymphatic system is important for preventing health issues like infections, joint pain, fatigue, and more serious conditions such as lymphedema and cancer.

Your lymphatic system helps remove toxins and waste, supports the immune system, and aids in the absorption and transport of fats and vitamins. The lymphatic system of your brain is called the glymphatic system, and it’s essential for removing waste products from your brain.

When either of these systems gets congested, sluggish or blocked, it can have severe effects on your physical and mental/neurological health.

Regular exercise, a healthy diet, adequate hydration and stress management are essential for supporting lymphatic function. Eastern practices such as Ayurveda and Traditional Chinese Medicine (TCM) have long recognized the lymphatic system’s importance, using methods like lymphatic massage, yoga and herbal remedies to support the free flow of lymph.

To support the health of your lymphatic system, Nickelston has developed a six-step routine called the Big 6, which he describes in the featured video. The routine involves stimulating key lymphatic points in your body by rubbing, tapping and massaging them.

While the routine may appear deceptively simple, it can have a profound effect, as stimulating these lymphatic spots will boost blood flow to and from various tissues, change how your nerves respond to tightness in the tissues, and encourage the clearance of toxins from your body through your sweat, urine and feces.

As a result of this detoxifying process, you may experience a period of increased fatigue, lethargy, pain, headache, general malaise or illness-like symptoms. This is a sign that toxins are being expelled. As noted by Nickelston, “that is normal.” To aid the detox process, make sure you drink some water before and/or after doing the routine.

The lymphatic system operates on a unique pressure system that is pivotal for its efficient functioning. This system’s design ensures the effective drainage of lymph back into the bloodstream.

Understanding the pressure gradients within the lymphatic system is crucial for promoting optimal lymph flow and preventing the accumulation of fluids, which can lead to swelling, especially in the extremities like the hands and feet.

The areas around and above the collarbone represent the points of lowest lymphatic pressure. It is here that the lymphatic fluid drains back into the venous blood system, completing its circuit around the body. Because these points are the final destination for lymph being cleared from the body, they are crucial in the lymphatic drainage process.

Conversely, your hands and feet are the farthest from these low-pressure points, making them more prone to swelling due to the accumulation of lymph fluid, as gravity and distance impede the fluid’s return flow.

“By starting at the collarbone — where the pressure is lowest — and working outward and upward, ensures that these low-pressure pathways remain open and able to receive lymph from other parts of the body.”

To effectively encourage the movement of lymph through its vessels and nodes, it is essential to clear the lymphatic system from areas of low pressure toward those of high pressure.

This means that any lymphatic drainage technique or routine should never start with the extremities, where pressure is higher and fluid accumulation is more common. Instead, starting at the collarbone — where the pressure is lowest — and working outward and upward, ensures that these low-pressure pathways remain open and able to receive lymph from other parts of the body.

The six key points for effective lymphatic drainage are as follows. In the video above, Tim Boettner of Think Flow Grow does a full demonstration of Nickelston’s routine so you can follow along. Again, make sure to do them in the correct order, as listed. Use whatever pressure and speed that feels good. You’re not seeking to cause pain.

The whole routine can be completed in just a few minutes and can be done any time of the day. Getting into the habit of doing it once a day, perhaps during your morning shower, is the best way to reap maximum benefits.

  1. Above and below your collarbone — Initiating drainage here facilitates the clearance of lymph back into the circulatory system. Begin by lightly rubbing above, over and below your collarbone on one side for several seconds. Next, lightly tap the area with open hand, and then rub the area in a circular motion clockwise and counterclockwise. Repeat on the other side.

  2. Jawline — Rubbing and massaging your jawline helps drain lymph from your head and neck. The spot you’re working is located at the top of your neck, directly behind the angle of your jawbone just below your earlobe. Using two or three fingers, rub that area in an up and down motion on one side. Then, lightly tap and do some circular rubbing. Repeat on the other side.

  3. Chest — Clearing the chest area supports the drainage of lymph from the upper torso and arms. The spot you’re looking for is where your shoulder attaches to your pectoral muscle. Perform the same rubbing, tapping massaging motions as before on each side.

  4. Abdomen — The abdomen is a central hub for lymphatic activity, influencing digestion and lower body lymph flow. To locate the correct spot, place one hand over your belly button and the other hand directly above that. Using both hands, rub your belly up and down. Then, tap your belly with both hands, then stack your hands one atop the other, press your hands into your abdomen and rub in circles.

  5. Front of the hip — Stimulating this area encourages the movement of lymph from the lower extremities toward your core. Place your hands over the crease of your groin and rub up and down, then tap and rub in circles.

  6. Back of the knees — Finally, the area behind the knees is critical for draining lymph from the lower legs, reducing the risk of swelling in the feet and ankles. Simply place your hands behind your knees and rub above and below the crease of your knees in an up and down motion. Then tap the crease and rub in a circular motion.

When done with all six areas, stand up, lift your heels off the floor and lightly bounce up and down on the balls of your feet for 20 to 30 seconds and shake out your hands and arms.

Adhering to this order is paramount for maintaining an efficient lymphatic system. By starting at the points of lowest pressure and methodically working toward areas of higher pressure, it’s possible to enhance lymph flow throughout the body, bolstering immune function, reducing swelling and promoting overall health.

As explained by Nickelston, this lymphatic drainage routine can also have significant benefits for your emotional and mental health. The reason for this is because when your brain can accurately sense where your body’s joints are in space — a faculty known as proprioception — it significantly contributes to a feeling of safety and security.

Proprioception is part of your body’s sensory system, providing continuous feedback about the position of limbs, the tension in muscles, and the state of joint movement. This sensory information is crucial for maintaining balance, coordinating movements, and performing daily activities confidently and efficiently.

The link between proprioception and feelings of safety lies in your brain’s ability to predict and control bodily movements. When proprioceptive feedback is clear and accurate, your brain can effectively anticipate the outcome of movements, reducing the risk of injury and enhancing physical autonomy. This predictability and control are foundational to a sense of safety, as they enable you to navigate your environment with assurance.

Additionally, clearing the lymphatic system reduces swelling and inflammation around joints, which can otherwise impede the flow of sensory information. Swelling can distort the signals sent by proprioceptors (sensory receptors that detect motion and position) located in muscles, tendons, and joint capsules, leading to decreased proprioceptive accuracy.

As the lymphatic system is optimized and fluid balance is restored, proprioceptors can function more effectively, sending clearer, more precise signals to your brain. As you become more attuned to your body’s positions and movements, you develop a heightened sense of spatial awareness and body control.

This improvement not only aids in physical performance but also reinforces the neural pathways responsible for proprioceptive processing, making your brain more adept at interpreting and utilizing this information.

The culmination of these effects — a well-functioning lymphatic system and enhanced proprioception — contributes to a greater sense of bodily integrity and safety.

When your brain can reliably know where your body is in space, it reduces the perceived risk of falling or suffering an injury, which in turn diminishes anxiety and enhances confidence in your physical capabilities. This assurance extends beyond mere physical safety, influencing psychological well-being by fostering a sense of control and competence in interacting with the world.

Disclaimer: The entire contents of this website are based upon the opinions of Dr. Mercola, unless otherwise noted. Individual articles are based upon the opinions of the respective author, who retains copyright as marked.

The information on this website is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice. It is intended as a sharing of knowledge and information from the research and experience of Dr. Mercola and his community. Dr. Mercola encourages you to make your own health care decisions based upon your research and in partnership with a qualified health care professional. The subscription fee being requested is for access to the articles and information posted on this site, and is not being paid for any individual medical advice.

If you are pregnant, nursing, taking medication, or have a medical condition, consult your health care professional before using products based on this content.

Adrenal Fatigue: What It Is and How to Treat It

  • Adrenal fatigue describes a collection of symptoms such as body aches, fatigue, nervousness, sleep disturbances and digestive problems

  • The theory is that chronic stress can overtax the adrenal glands, resulting in their functional decline and an inability to produce adequate hormones

  • It’s long been assumed that if you have low cortisol, you’re suffering from “adrenal fatigue,” but we now know that this is not an accurate concept

  • When adrenal function changes, what’s really going on has to do with the signaling between your brain and your adrenal gland in response to stress — not to adrenal gland function alone

  • HPA axis dysfunction, which can be identified using the DUTCH test, may better describe where symptoms come from after prolonged exposure to stress

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Adrenal fatigue describes a collection of symptoms such as body aches, fatigue, nervousness, sleep disturbances and digestive problems. The concept is based on the idea that your adrenal glands, which are small glands located on top of each kidney that produce hormones like cortisol, can become overworked.

The theory is that chronic stress can overtax the adrenal glands, resulting in their functional decline and an inability to produce adequate hormones necessary for optimal function. In other words, adrenal fatigue is the idea that your adrenal output of cortisol can become insufficient from long-term stress.

It’s important to note, however, that some experts do not believe adrenal fatigue is an actual medical syndrome.1 While the symptoms often attributed to adrenal fatigue are very real, their underlying causes may be something else entirely.

Your adrenal glands are two triangular-shaped endocrine glands located atop each kidney. They produce over 50 hormones, such as cortisol, aldosterone and adrenaline. Like thyroid hormones, adrenal hormones are crucial for your metabolism.

Adrenal hormones primarily regulate your physical and mental stress responses and influence your metabolism, mood, immune function and blood pressure, but testing their function is complex.

As noted by Dr. Michael Greger in the NutritionFacts.org video above, “Saliva tests for adrenal hormone levels are not reliable, with studies showing so-called ‘adrenal fatigue’ patients having higher levels than controls, similar levels or lower levels, ‘an almost systematic finding of conflicting results.’”2

Further, although blood tests can assess many bodily systems, they do not provide a clear picture of adrenal function. Cortisol is frequently tested using blood, but what’s being measured is your total cortisol, which includes both free and bound cortisol.

Since most cortisol in your body is bound to proteins and inactive, “high cortisol” levels in blood tests may not be informative. Free cortisol, which is biologically active, is what’s important. One of the most effective tests for this is the Dried Urine Test for Comprehensive Hormones, or DUTCH test, performed multiple times over a 24-hour period.

Cortisol levels can vary significantly throughout the day, typically peaking in the morning and decreasing by evening, which is referred to as the diurnal rhythm. A single measurement like a blood draw cannot reveal if your diurnal pattern is dysfunctional. By taking multiple samples throughout the day, you can get a more accurate measure of your cortisol pattern.

Further, the DUTCH test evaluates levels of free cortisol, cortisone and their metabolites, alpha-tetrahydrocortisol (a-THF), beta-tetrahydrocortisol (b-THS), and tetrahydrocortisone (THE). These metabolites are important for assessing adrenal output and can help you understand what the underlying pathology is. While saliva tests allow you to check free cortisol, they still won’t show you the metabolites of cortisol. DUTCH, on the other hand, shows both.

It’s long been assumed that if you have low cortisol, you’re suffering from “adrenal fatigue,” but we now know that this is not an accurate term or concept. When adrenal function changes, what’s really going on has to do with the signaling between your brain and your adrenal gland in response to stress — not to adrenal gland function alone.

Addison’s disease, or adrenal insufficiency, however, is a medical condition that occurs when your body doesn’t make enough cortisol. “The only situation in which low cortisol becomes problematic is probably Addison’s disease, which is adrenal failure. And that’s very rare,” says Georgi Dinkov, an expert on the work of the late Ray Peat, Ph.D., an author and pioneer in nutrition, bioenergetic medicine, environmental factors and regenerative processes.

“If you have adrenal failure, unless you take cortisol shots you will die from hypoglycemia or Addison’s disease. So, it’s lethal,” Dinkov notes. Many doctors use an ACTH (adrenocorticotropic hormone) test to check for problems with your adrenal glands. However, the ACTH test only recognizes extreme underproduction or overproduction of hormone levels. Greger explains:3

“There is an actual disease of adrenal insufficiency known as Addison’s disease, which is diagnosed with an ACTH stimulation test. You inject people with adrenocorticotropic hormone, the signal your brain uses to get your adrenal glands to pump out the stress hormone cortisol, and if your adrenals don’t respond, that shows your adrenal glands must be in trouble.

But inject those presumed to be suffering from chronic stress and fatigue with ACTH, and sometimes you even get a greater rise in cortisol, disproving the notion that stress causes the adrenals to ‘burn out.’”

Even if your free cortisol is low, adrenal fatigue is rarely the cause, according to Dr. Peter Attia. In reality, cortisol production is often normal, but the cortisol is either a) being degraded, b) too much of it is being converted into inactive cortisone, or c) instead of converting back to cortisol, the cortisone is metabolized into THE.

Enzymes called reductases regulate the conversion of cortisol and cortisone into their respective metabolites. Inflammation, obesity and other factors associated with poor health accelerate these conversions.

So, if you’re feeling lousy and have no energy but your cortisol and cortisone metabolites indicate that production of these hormones is normal, then you need to address the underlying factors, i.e., the obesity, insulin and leptin resistance, and inflammation.

Corticosteroids are often prescribed to people with adrenal fatigue — and it may make you feel better temporarily — but the boost they provide isn’t a sign that you needed more cortisol, and exposes you to another set of health risks. Greger said:4

“But wait, you were diagnosed with ‘AF,’ [adrenal fatigue] given corticosteroids, and now you feel great, so it must have been real. That’s the thing about corticosteroids, though. One of the side effects is a euphoric sense of well-being. The problem is that even low doses can increase the risk of osteoporosis, psychiatric and metabolic disorders, muscle damage, glaucoma, sleep disturbances, and cardiovascular diseases.”

While both primary and secondary adrenal insufficiency can be diagnosed with a lab test, more subtle abnormalities in the hypothalamus-pituitary-axis (HPA) are more difficult to diagnose, as there’s no accepted medical test for it. The HPA axis is the primary stress response system. As described in the Journal of Undergraduate Neuroscience Education:5

“It [the HPA axis] is the neuroendocrine link between perceived stress and physiological reactions to stress. The primary function of the activated HPA axis is to release glucocorticoids that activate short-term physiological responses to stress.

While some stress is necessary for salubrious development and aging, when an individual exists in a chronic state of stress their ability to cope is compromised by dysregulation of HPA-axis and other peripheral physiological functions.”

To better describe where symptoms come from after prolonged exposure to stress, it’s important to look at the bigger picture of HPA axis dysfunction. This is the more accurate term describing what is happening here. According to Mark Newman, the founder of Precision Analytical Laboratory in Oregon, makers of the DUTCH test:6

“If a patient has low cortisol, we see many providers label that as ‘adrenal fatigue’ and work to try to increase cortisol. What we find when we look at the metabolites of cortisol in these patients (which is a better marker for overall cortisol production), is that about half of the patients with low free cortisol are making more than average amounts of cortisol.

They may be processing it more quickly. As in obesity, you get these huge productions of cortisol (metabolites), but when you only focus on the free cortisol, you can call someone ‘stage 3 adrenal fatigue’ who is literally making more cortisol than 90%, 95%, or 99% of the population in some situations (because obesity results in more cortisol production, but not more free cortisol). So it’s a more complex situation than that.”

Evaluation of free hormone plus metabolites gives a more complete picture and can prevent practitioners from misunderstanding what is wrong with a patient. As mentioned, the ACTH test only recognizes extremes, as shown by the top and bottom 2% of a bell curve.

This means your adrenal cortisol production could be functioning 20% below the mean, and your body experiencing symptoms of HPA dysfunction, yet the test will not recognize it. To identify HPA dysfunction, a comprehensive hormone panel like the DUTCH test is recommended.

Thyroid function is another variable in cases of “adrenal fatigue,” as dysfunction in one can affect the other. For example, if you have low thyroid function and your adrenals aren’t producing enough cortisol, it can worsen your symptoms. Since both are involved in metabolism, dysfunction in either your thyroid or adrenals can also produce very similar symptoms, such as fatigue, memory impairment and low mood.

Dr. Jinaan Jawad, a specialist in chiropractic and functional medicine, describes your adrenals as the “battery backup” for your thyroid. If your adrenals are overtaxed, your thyroid function will suffer.7 If you’re hypothyroid and on hormone replacement therapy, yet still experience symptoms of low thyroid function, you could be shutting down too much cortisol. To address this, Jawad recommends avoiding adrenal stimulators, such as:

  • Coffee, soda, energy drinks and other caffeinated and/or stimulating beverages

  • Refined sugars, high fructose corn syrup and artificial sweeteners

  • Nicotine

  • Alcohol

  • Any food you have an allergy or sensitivity to (example: dairy, wheat, corn, gluten or shellfish), as these foods will cause a release of histamine and inflammatory chemicals that active your fight-or-flight response

  • Seed oils (partially hydrogenated fats high in omega-6 linoleic acid) and any food made with them, which includes most processed and fast food. Examples include cottonseed oil, corn oil and canola oil. All of these oils inhibit adrenal hormone synthesis

  • Excessive exercise, as this keeps your body locked in fight-or-flight response

If chronic stress is taxing your body, adaptogenic herbs can help your body become more resilient to stress. They work, in part, via hormone regulation and immune function support. Five adaptogenic herbs for adrenal support include the following:

  1. Ashwagandha, which helps your body adapt to stress by balancing your immune system, metabolism and hormonal systems. The root contains the highest concentration of active ingredients that modulate hormones, including thyroid hormone, estrogen, progesterone and testosterone.

  2. Rhodiola, which has been shown to be particularly beneficial for your nervous system. It has antidepressant and anti-anxiety benefits, and may help reduce symptoms of burnout associated with work stress. Its energy and vitality-boosting effects can have clear benefits for those struggling with chronic fatigue. As an added boon, it tends to be fast-acting.

  3. Asian (Panax) ginseng — Like ashwagandha, Asian ginseng impacts thyroid hormones. More specifically, it contains properties that block production of excessive amounts of rT3. A study looking at the impact of ginseng injections found it produced healthy increases of T3 and T4 and a reduction in rT3.8

  4. Siberian ginseng (Eleutherococcus senticosus) — Its active components are called eleutherosides, which are thought to stimulate your immune system. Like Asian ginseng, Siberian ginseng is an adaptogen that’s traditionally been used to increase energy, stimulate the immune system and increase longevity.


    It also has mild antidepressive effects and is useful for insomnia, behavioral and memory problems, and has been shown to improve exercise endurance by improving oxygen utilization in your body.

  5. Tulsi — Highly revered in India for over 5,000 years, tulsi, also known as holy basil, has been valued for its many health-promoting properties. This herb is said to purify the mind, body and spirit, and has been cherished for its protective and uplifting nature.


    Tulsi tea is an antioxidant-rich beverage with a complex and unique chemistry. It contains hundreds of beneficial phytochemicals. Working together, these compounds have adaptogenic and immune-enhancing properties that combat stress, bolster your immune system and promote healthy metabolism, including helping your body maintain an optimal level of blood sugar.

Disclaimer: The entire contents of this website are based upon the opinions of Dr. Mercola, unless otherwise noted. Individual articles are based upon the opinions of the respective author, who retains copyright as marked.

The information on this website is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice. It is intended as a sharing of knowledge and information from the research and experience of Dr. Mercola and his community. Dr. Mercola encourages you to make your own health care decisions based upon your research and in partnership with a qualified health care professional. The subscription fee being requested is for access to the articles and information posted on this site, and is not being paid for any individual medical advice.

If you are pregnant, nursing, taking medication, or have a medical condition, consult your health care professional before using products based on this content.