Ade Akindipe, DNP (00:25)
Welcome back to the Modern Midlife Collective. So today we're going to talk about fatigue. So if you have been struggling with dragging through your days and wondering why eight hours of sleep is not enough for you, then this episode is for you.
Jillian Woodruff, MD (00:40)
That's right. We're here to tell you that chronic fatigue in your 40s or 50s or beyond is not just part of normal aging. It's your body waving the red flag. Say, help me. Let's decode this.
Ade Akindipe, DNP (00:56)
Absolutely. So we're going to talk all about why you're always tired and then break down what the top causes of this that sometimes gets overlooked, especially for women in midlife. So let's get into it.
Jillian Woodruff, MD (01:08)
Yeah, absolutely. It is overlooked or I guess we should say not validated or dismissed. Fatigue is the most common but least validated complaint we hear. I'm sure we both hear from women that are in perimenopause and beyond. And it's often dismissed just saying, you're doing too much or you just need to spend more time on yourself when this issue is really multifactorial.
I will say in my practice, the typical woman that comes in is in her, let's say 40s or 50s, and she's not sleeping well. So even if she knows she needs rest and she has time for it, she is not sleeping well. She is also very busy. So she's caring for her kids. She's probably caring for aging parents or family members. She's working and she probably doesn't even have time to
eat well, you know, eat well and eat the right food. She probably doesn't even have time to do that sort of thing, but she doesn't necessarily eat poorly either. And despite not eating poorly, she is putting on weight. So she is either not feeling motivated enough to exercise or she's exercising probably too much because of this weight gain that she's putting on. And then when she does try to sleep, she may be having night sweats that wake her up.
And then her bed is wet and she has to cover it with a towel. Or maybe she just, you know, wakes up because she's warm and so she's just throwing off some cover. She's not sweating, but even though she's waking up, that's still disrupting her sleep. And then during the day, she can't remember where she put the keys or she walks into a room and doesn't remember, what did I come in this room for? So she just has this like brain fog. Is it due to...
not sleeping? Is it due to perimenopause? These are the questions she's asking, but unsure if this is just a normal part of getting older. And then let's say that she is trying to fall asleep and she's done all the perfect sleep hygiene that you can do. She's anxious. She's thinking, what do I need to do tomorrow? What did I do today? Or what happened at this meeting? And so then her brain is just like going and going and going, and she can't even
relax herself enough to get into sleep, never mind deep restorative sleep, which is what she really needs. What do we need to do? We need to get to the root cause of this. Does this sound like a pretty typical picture of a Harry Menopausal or Menopausal woman to you?
Ade Akindipe, DNP (03:49)
yeah, you just basically described the exact woman that typically walks into the clinic, usually over 40, with all of the above that you just explained. And a lot of the times they'll walk in really frustrated. They've probably told some provider somewhere everything that you just described. And maybe they have been prescribed medication for depression or they've been told
Well, this is just part of aging. Unfortunately, there's not much you can do about it or just sleep more or eat less and move more, you know, the usual typical things that you get. So by the time they get to us, it's like, help me. So yes, that's pretty typical.
Jillian Woodruff, MD (04:28)
Yes.
Well, I think we can probably brainstorm. I'm thinking of five top or most common physiological causes of fatigue. The first one, of course, we have to start with because for the modern midlife collective, when we talk about hormones, let's talk about hormonal imbalances. Yes, specifically like our sex hormones, right? So estrogen, I guess, would be number one when we're talking about our sex hormone imbalance.
Ade Akindipe, DNP (04:48)
Let's talk about the hormones.
Jillian Woodruff, MD (05:01)
and estrogen drops, your serotonin also drops, another hormone, and then your mood dips. So you already brought up the depression and people getting their depression medications. And the depression medications are typically medications that will keep your serotonin working. So it prevents your, the reuptake, they're called selective serotonin reuptake inhibitors. So it prevents the serotonin from being removed.
And the problem is, that great, we are taking care of that problem, but not the root of the problem, which is the estrogen going down leading to the serotonin going down. And then the mood dips and then your sleep suffers and then your energy takes, right? Another one is progesterone. Progesterone is our, you know, feel good, calming hormone.
Ade Akindipe, DNP (05:44)
And everything else goes with it.
Jillian Woodruff, MD (05:54)
So when that kind of starts to decline, our sleep suffers. We are going to feel more anxiety. Our brain or our mind will wander more. We're not able to kind of turn it off. It's like someone flipped off their relaxation switch and now you're up in the middle of the night. And even when you are sleeping, you're not getting deep restorative sleep. There's specific types of sleep that we need each night. And if we don't get that, then there are
Ade Akindipe, DNP (05:54)
Yeah.
Jillian Woodruff, MD (06:22)
lasting consequences.
Ade Akindipe, DNP (06:24)
Absolutely. I mean, I just, can think of just a couple of people on my mind right now who would say they had something close to maybe anxiety, even as extreme sometimes as panic attacks where, you know, when, especially if they've been on hormone therapy and they're kind of at the tail end, they'll say, oh yeah, those, some of those symptoms start to come back.
because that big drop in hormones, like progesterone, exactly what you just mentioned, is it calming, helps your mood, helps with sleep. Imagine just going from a nice normal level to going to zero if you're hitting the point where you're no longer producing these hormones. So it can impact women so much. And of course, we've talked about testosterone in another episode, but this is so important also.
for energy levels, know, for muscle tone, metabolism, and if your metabolism isn't that great, of course, you're going to, you know, have that weight gain. Women usually gain that weight around the midsection. Even our motivation to want to do anything. So it all is connected, right? So many people don't realize, you know, the reason it's so hard to recover from exercise. Sometimes when they'll say, I went to the gym, and of course, you're working out, like you mentioned earlier, you're working out so hard, you're trying to lose all that weight.
And then you can't work out for like a week because you're trying to recover from the exercise episode that you just had because your testosterone is so low. you know, they feel so sore. They're, you know, they're not as the recovery takes so much longer. Maybe they used to run marathons and it's just, you know, they can't do it. So when testosterone is low, your get up and go gets up and goes literally. So.
Jillian Woodruff, MD (08:07)
I love that it is, it's funny, but also not funny. I love it. love it. my gosh. Okay. Going back to estrogen, it's tanking and you're waking up three times a night with night sweats or with anxiety from the low progesterone and your testosterone is so low that you either have no motivation.
Ade Akindipe, DNP (08:11)
It's not funny, you know, but that's exactly what happens.
Jillian Woodruff, MD (08:31)
to do anything to exercise or like you said, you can't recover from the exercise that you've done. And then if you're not recovering, you're having higher cortisol levels, which that's another one we have to talk about. You're not going to be able to even think straight. So of course you're going to feel exhausted.
Ade Akindipe, DNP (08:50)
it's just so much. so that's one, you we talked about hormones and the next thing we should talk about is thyroid dysfunction, which you know, that basically is your master gland for your metabolism. So imagine if you're not having, I don't want to use the word normal, optimal functioning thyroid during midlife. You know, it's your internal thermostat. So it controls how fast or how slow your metabolism runs.
Imagine if that declines, that also impacts your energy levels, your recovery as well. So you can get sluggish, even your labs, even when your labs say normal. I think this is something we should expand a lot on because you probably know that when somebody says, I've had my labs checked and you'll see just a TSH and because the TSH or your thyroid stimulating hormone is just part of the picture. I'll let you expand on that little bit.
Jillian Woodruff, MD (09:44)
yeah, that's the pet peeve of mine. ⁓ I hate that when I say, I think we're going to check your thyroid and they're like, no, my thyroid is always normal. Okay, let me see the results. they checked the TSH. That's not a hormone produced by your thyroid. That is produced in your brain and your pituitary gland. So it stimulates your thyroid to produce hormone. But we all know there are lots of...
Ade Akindipe, DNP (09:48)
you
Jillian Woodruff, MD (10:10)
steps to doing something and you could have a disruption at any of those steps. So checking the top doesn't mean you're going to get your optimal outcome at the bottom. I mean, that just makes sense to me. I don't know why it doesn't ring true for everybody, you know, that everybody wouldn't make that same conclusion that we have to actually check those hormones because there are many clogs and the drains and it hurt, right? Yeah.
Ade Akindipe, DNP (10:20)
Right.
Right?
There are so many. Absolutely. Absolutely.
Yeah. If your thyroid isn't, if you're just checking the TSH like you talked about that's produced in the brain and you're not seeing what's happening at the organ level and where it actually is supposed to be functioning so that your tissues are getting the benefit is where the problem is. So like if your T4, which is one of your hormones that converts into the active T3, that is the
T3 is actually what your tissues really need. So if that's missing, you know, maybe because you have some minerals that are not available for your hormones to convert from T4 to T3, that could be the problem. You may not necessarily need the active thyroid T3, but maybe you just need to optimize your nutrition or maybe you need to get some supplements to help, you know, like selenium and zinc. These are really important for hormone conversion. So.
It's like having a full tank of gas, but no key. There's no ignition. There's nothing to help it go. So all of those things can really make it really hard for your metabolism to really get that jumpstart. So it's more than just, yeah, I'm eating well, but what is optimal for you at this stage of life?
Jillian Woodruff, MD (11:30)
Yes!
Yeah, I really like that analogy that you have this full tank of gas, you have this hormone there, but you have no key in the ignition. So the fuel's there, but your cells can't use it. Why is that? We have to look into that. So your metabolism isn't working efficiently. Thyroid hormone, especially active thyroid hormone, T3, that gives you energy. And so if you're either not converting the T4 to T3 or
Ade Akindipe, DNP (11:57)
Can't use it.
Jillian Woodruff, MD (12:13)
you don't have enough T4 to convert to T3 or your T3 even there's reverse T3 where it can go backwards and become T4 again or you don't have those nutrients that you discussed that you need to actually make thyroid hormone, that's a problem. So it's not enough to just have it. You have to have the tools to use it as well. so optimizing your thyroid can give
Ade Akindipe, DNP (12:31)
Yeah.
Jillian Woodruff, MD (12:40)
you more of that energy that you desire, even if it's normal. Even if you do have a normal right, a normal range, maybe you feel better when your levels are at the higher end of the normal range. Some people don't. Some people may feel too revved up at the high end of the normal range. And others really thrive at that point, really thrive.
Ade Akindipe, DNP (12:46)
Even if it's within a normal range. Yeah.
Yeah,
yeah, absolutely. I think there was one lady that showed up with a T3 that was high and she had walked into a provider's office and just for follow up, think she just moved out of town and they were gonna mess with her. And she said, she put up such a fight and says, you better not touch that. This is where I'm at. I'm physiologically doing well. I don't have any palpitations. I'm not anxious. I'm not.
You know, so it's really frustrating if you go to someone that doesn't get it and they literally want to call your provider and say, are you trying to kill? You know, that's just what we're trying to say. It's not that, you know, you have to be within a box or you have to be between two and three. Maybe you do better at 3.5 because you are getting the symptoms of optimal thyroid function. You have energy, your metabolism is functioning okay.
of course just continuing to monitor because your levels can change so that needs to constantly be monitored.
Jillian Woodruff, MD (13:59)
And then note, even your TSH, you can't monitor just your TSH when you're on thyroid medication, right? It's a whole feedback loop. And so your brain doesn't necessarily need to send out signals that it needs more if it's already getting what it needs. So even if those levels are way low, know, lower than the reference range,
Ade Akindipe, DNP (14:07)
Exactly.
Jillian Woodruff, MD (14:26)
When this signal is whispering, like don't say more, but you're on medication, it's because the medication is doing what it needs to be doing. You have to look at the actual hormones themselves.
Ade Akindipe, DNP (14:39)
Love that. I
love how you said, because some people get freaked out when they see the TSH go really low. It's like, is that normal? Well, yeah, because now you have great amounts. So we don't need to send that loop to the brain or to the thyroid gland to produce more because there's enough in the bloodstream that's making your tissues function. So that's what we want. It's a good thing. Yeah.
Jillian Woodruff, MD (14:46)
Mm-hmm. Mm-hmm.
Right, right, exactly. Okay, let's
go on to number three, cortisol. And the stress fatigue spiral, ugh, yes. So can't skip cortisol. Cortisol is very important. It's the hormone that kind of wakes you up in the morning. You should have high levels in the morning to get you through your day, helps you handle life, you're doing life with your cortisol level.
Ade Akindipe, DNP (15:08)
Stress hormone, yeah.
Jillian Woodruff, MD (15:26)
Cortisol is there to support you. It's there when you are having to go through a situation that's scary, right? Like you're fleeing from a bear. Well, I shouldn't say that because some bear you don't run from, others you do. So I don't know. Right? No, there's some, you have to play dead. the, oh my goodness, I didn't go to elementary school in Alaska, so I should call my daughter and then ask her. But like, so the black.
Ade Akindipe, DNP (15:37)
Mm-hmm.
Wait, which bears don't you run from?
Jillian Woodruff, MD (15:56)
bear, one of them you have to be like overpowering and dominating and like, and then the other one, yeah, I don't think you're supposed to run away. Okay, we need to study this and come back with this because no, you cannot run from all of the bear. I know, especially when we're like out there running, right? Moose, can run from them. Go ahead and run away. Don't run through them. Just turn around. A bear, no.
Ade Akindipe, DNP (16:01)
Okay, I haven't figured this all out yet. My instincts will say run from everybody, from everywhere.
Apparently we need some bear safety training.
⁓ gosh.
Jillian Woodruff, MD (16:23)
Either you're playing dead or you're being dominant. How about we just stay away? You know, just stay away.
Ade Akindipe, DNP (16:28)
noted.
How about just,
yeah, stay away, know, stay far away. Don't go looking for trouble. Yeah.
Jillian Woodruff, MD (16:35)
Right? But if we
encounter them, then what's going to happen is our cortisol levels are going to shoot up so that we can... I know, we're going to come back. Cortisol spike, that's the important thing to take away from this. Please do not get your bear safety from us. But yeah, cortisol goes up to manage your stress, but it gets thrown off because if you have...
Ade Akindipe, DNP (16:41)
I bet our audience is not going to forget this now. They're like, what are they talking about? So bears just think cortisol spikes.
Jillian Woodruff, MD (17:02)
chronic stress. if a bear is in your life every single day, your cortisol is going to be like, you know what, I couldn't help you the first 20 days. So I'm done. You know, I'm, I'm retiring from this situation. And then you don't have cortisol, um, cortisol and it's thrown off. also have poor sleep. Your body also, especially if you have like these long periods of high cortisol levels, you have such high inflammation in your body, which causes a lot of other problems. And then
Hormonal changes also affects our cortisol. So as our estrogen levels go down, that affects the production of our cortisol. It can get too high, if you're wired and anxious. And then at other times, if your cortisol crashes too low, then you're like feeling blah, you're dragging, you're not feeling energized.
Ade Akindipe, DNP (17:49)
Yeah.
Absolutely, and this is where women will say they've slept for six to eight hours and they still feel tired. You know, they're not really sleeping well. They think they're sleeping, but they're not. You're stuck. Your cortisol levels are not high because maybe you're chronically fatigued. They're actually super low because it's tired of producing. It's like, I'm trying to protect you, but I guess it's not working. So we're just going to give up. So your body's constantly spending energy just trying to keep up.
So you may wake up wired at 3 a.m. or mid afternoon, you might crash with zero energy. So it's not you necessarily, or maybe there's some lifestyle things that need to really be adjusted. You know, your adrenal glands produce this cortisol, and so they're crying out for help. So those are the signals when you just feel like nothing, you're trying, maybe you have all these supplements that you take every day, but it's not working. This might be a sign of chronic stress.
Jillian Woodruff, MD (18:50)
Yes, yeah. Your body's always in fight or flight mode. That just doesn't work. This is also something that I find pretty controversial in the medical community, especially amongst people who maybe just practice more traditional Western medicine. The adrenal fatigue diagnosis. I don't know if you've like encountered this controversy. Yeah, I, so there's, right, people think it doesn't exist.
Ade Akindipe, DNP (18:55)
Hmm.
Mm-hmm. Yeah, I've heard that. Yes. That it doesn't exist. It's no such thing.
Jillian Woodruff, MD (19:19)
But in all things, if something's overworked, then there starts to be an introduction of dysfunction, and that's gonna what happens with the overworking of your adrenal glands.
Ade Akindipe, DNP (19:26)
Correct.
Yeah, I absolutely agree. know, those symptoms of chronic stress, maybe we don't have to call it adrenal fatigue, but the symptoms are real. And once that those, the root cause is reversed and you can start to make normal cortisol levels again and you have energy and you have sleep. Yeah, it does. You know, it is definitely something that you can fix. So when you, if you are having those symptoms, it's definitely time to reach out and get your hormones checked.
Get your lifestyle checked. All of the above checked.
Jillian Woodruff, MD (20:03)
And it's not a quick fix either with that. It takes dedication,
Ade Akindipe, DNP (20:05)
Mm-mm. It takes time. Mm-hmm.
Yeah, absolutely. So let's talk about nutrition. So this is something that I think a lot of women struggle with because we are so busy with work, life, everything, and we are not the best at making sure that we are optimized nutrition. I mean, we have women coming in with super low vitamin D levels, especially those that are here in Alaska.
B12, magnesium, these are all elements that are needed for thyroid conversion, for iron, for blood, for all these things are missing. So it's nice to have them, but they're really important for energy, for mitochondria. Your mitochondria is the powerhouse of your cells, so if you don't have these nutrients, then of course you're gonna be exhausted, right?
Jillian Woodruff, MD (20:53)
Right, right. So if you've had chronic stress or let's say you're losing blood because of heavy periods or you have poor digestion, ⁓ gut issues, that will affect the absorption of the nutrients. So even if our food was more nutrient dense, which it's not, our food today is just not as nutrient dense as it was. But even if you're eating perfectly, if you're having absorption issues, gut issues,
Ade Akindipe, DNP (21:00)
yeah.
Jillian Woodruff, MD (21:19)
then you're not going to be absorbing those nutrients that you need, even from food or supplements or vitamins that you take. You may not be absorbing them from that way either. There's even medications that can interfere with the absorption of nutrients. So if you're taking medications like for reflux, back-embroidery absorption, even good things like metformin that we give for insulin resistance, that can interfere with the absorption of the vitamins that you need from
Ade Akindipe, DNP (21:22)
Yeah.
Right.
Mm.
Yeah,
absolutely. Absolutely. And I think even when your labs are in the normal range, you may notice that maybe if you're optimized a little bit, maybe if you do get a few injections to help out to optimize and elevate that, you might feel better. So just because your B12 is in the normal range, maybe you can optimize that a little bit.
Jillian Woodruff, MD (21:48)
food.
Ade Akindipe, DNP (22:11)
So if your cells are trying to power up but you don't have the tools, it's really frustrating. So your body really needs the fuel and it can't run on empty for so long, right?
Jillian Woodruff, MD (22:21)
Right, right. And speaking of running on empty or your energy crashing, this can happen after meals or after the wrong meals, let's say, or ⁓ thinking about if you're getting hangry between your meals, then you may not have had the best meal for you to fuel your day. You're probably on a blood sugar roller coaster. You think about that.
you know, you're eating a high carb breakfast and then your sugar crashes a couple hours later and you're feeling super tired. You didn't, weren't given the fuel that you needed to get through your morning. Um, and not eating the foods that give you a sense of satiety, like make you feel full, like you're, that you could last several hours. Um, also from hormone changes, you know, estrogen declining that can lead to
less sensitivity to insulin. So insulin is carrying glucose, the sugar, into your cells. But if those cells aren't opening the door and letting insulin in, then you're not able to use the fuel. So then it just sits in your bloodstream causing all sorts of problems, that blood sugar. So we need cells to be more sensitive.
sensitive to insulin so that you can use your food as an energy source. But in midlife, things change thanks to lowering up your hormone levels. Then you have more spikes and crashes in your blood sugar, which itself makes you feel...
Ade Akindipe, DNP (23:58)
Yeah.
Yeah, speaking of those ups, spikes and crashes, there's a lot of that, right? So it's never it's even more important now. it's, you know, let's be real, it's difficult because you're we're constantly running like like we said before. So most of the time we're grabbing coffee and we're out the door and there's no energy source. We're relying on caffeine and to kind of get through the day. I get it. Totally get it. I have those days. I tell you. But then you get hungry. Right.
Jillian Woodruff, MD (24:03)
There's a lot of feeling. What a shame.
⁓ no, yes.
Ade Akindipe, DNP (24:29)
around 12 or one and then you eat and then you have crash and you're in your blood sugar after that. That's that afternoon fatigue that women will feel like you just feel like I'm done for the day. So what's happening? You have this either a high carb breakfast or no breakfast or you have a high carb meal because you're super hungry and usually most times I would say not heavy on protein. So you reach for that muffin or whatever it is that you feel like you can quickly grab and then you're crashing after that. most of times you're not
fueling yourself with fiber, which is really great at stabilizing your blood sugar throughout the day. If you take the time to wear, I'm sure, Jillian, you've done that before, where you wear your CGM, your continuous glucose monitor, and you can tell what's happening really quickly because those blood sugars are doing all sorts of crazy things. I mean, that was a huge game changer when I wore that. And I was like, you know, told a nutritionist, yep, I am a believer and I will never go back.
So on days when you're really busy, grabbing even just a bar that is high in protein can really help balance out that blood sugar so you're not having that afternoon crash where you're just really, you're done, you can't focus, you can't do anything else because your blood sugars are either really high or they're low, just kind of all over the place.
Jillian Woodruff, MD (25:49)
So you're saying a grande caramel latte for breakfast isn't a good idea?
Ade Akindipe, DNP (25:52)
You
Hey, listen, I love my coffee. Don't get me wrong. I love my coffee, but I feel like we really, we could do better, you know? Your body digest those carbs quickly. It's a quick source of fuel for your body, right? So imagine you take it, your blood sugars go up and your cells use them and it's like, okay, what's next? And the more you do that, especially when there's a lot of stress,
That's where we start to get into trouble if this is chronically what we do because your body starts to get less sensitive to the work of insulin. That's when we start to develop insulin resistance and pre-diabetes where your blood sugars just kind of sit there. Your body's just kind of like, you know, we don't need to do any more of this. And that's where you start to store a lot of sugar as fat. And that's where we start to get belly fat. you know, it just leads to more problems. So the best thing to do...
Jillian Woodruff, MD (26:39)
Hmm... Mm-hmm.
Ade Akindipe, DNP (26:46)
is to yes, you can have your coffee, but make sure that you're balancing it. Don't make it a daily routine where you're surviving just on caffeine. I think that's where the problem is. So yes, you can have your coffee, just make sure that you're balancing, especially now during midlife, that nutrition is so key. Healthy fats, even if you're busy taking the time to fuel yourself or if you have a desk job.
Finding things that you can easily reach that are not high in sugar. Make sure that you're not fueling yourself with things that have, you know, those fructose and sucrose, they're supposed to be healthy, but they're hiding something in there that's making you want those things to keep going back. Yeah. They could be sneaky.
Jillian Woodruff, MD (27:21)
⁓ yes. Yes. Yeah, they stimulate that center. Like the yes, they sure do the same like the
cocaine center. Right? Like a in it needs you want more? huh. Yep. Yep.
Ade Akindipe, DNP (27:30)
huh, it can be very sneaky. It makes you want more. yeah, that healthy
thing that I brought from Costco. So yeah, just read the labels, watching for those extra grams of sugar. That should help.
Jillian Woodruff, MD (27:37)
Hmm.
Yeah, I get it. So the stabilized energy, we have to eat with our blood sugar in mind. And you're right, those continuous glucose monitors can really give you really valuable information on what causes spikes in your blood sugar for you, because it's not going to be the same for everyone. You don't want your blood sugar to spike more than I think 30 points. So, you know, that's significant.
Ade Akindipe, DNP (28:02)
Yeah.
Jillian Woodruff, MD (28:08)
to look out for. And then just changing how we're eating our meals, I've found helpful, making sure that I have protein with each of the meals. And so eating that protein first can make a difference on how the other nutrients in your food are being utilized. So have your protein, also your fiber, and then fats, know, healthy fats, right? And then just avoiding the carbs like your, your native carbs like toast and.
Ade Akindipe, DNP (28:30)
Absolutely.
Jillian Woodruff, MD (28:36)
even fruit by itself, you know, have protein with your fruit.
Ade Akindipe, DNP (28:36)
Yeah.
Yeah, even movement. mean, if you have to grab a muffin, I mean, let's be real, life, life sometimes, but getting some movement in after work, I think helps me out. I know I've been sitting at my desk for hours. I need to get up and move, take the stairs, walk around a little bit just to kind of get your body to use up some of the sugar. That helps kind of restore that energy so you're not in that slump from having such high blood sugars too. Just another tip.
Jillian Woodruff, MD (28:45)
Thank
Let's zoom out then and talk about how energy, know, how your body makes and uses energy, starting with the mitochondria, which you mentioned, the tiny powerhouses that are inside all of our cells, have your mitochondria. And so you're eating your food or you're breathing in oxygen and your body is converting it into ATP. And this is your body's usable energy.
Ade Akindipe, DNP (29:37)
Yeah.
Jillian Woodruff, MD (29:39)
But your mitochondria needs support too.
Ade Akindipe, DNP (29:39)
So
it definitely does. So this is, I feel like the mitochondria is like really, what's the word? I want to say bougie. It's like, it doesn't want just any kind of energy. It needs the good stuff. It needs vitamins, B vitamins, magnesium, CoQ10, L-Cart. I mean, there's so many different vitamins that it needs. So these are...
Jillian Woodruff, MD (29:50)
Yeah, that's right. Yes.
Ade Akindipe, DNP (30:05)
they need it for steady fuel. So that's why when you rely heavily on carbs, it's not sustainable, right? Because it's just empty calories. So it needs vitamins, yes, but it also needs low, it doesn't thrive on high cortisol, low inflammation. So as Dr. mentioned, where you're constantly stressed out, you're in a constant inflammatory state.
whether that's in your gut or whatever. it really needs a balance of all of this for it to function. So that's what I mean that it can be very selective. if you want, you know, hydration even, making sure that you're staying very hydrated, your cells need that.
Jillian Woodruff, MD (30:48)
This just brings up so many other things that we could talk about. would take so long to make it each be a separate program because really that does bear repeating is that the energy production systems that we have, they thrive in low stress environments, low inflammation environments, low blood sugar environments. But in midlife, our life is anything but.
Ade Akindipe, DNP (30:57)
Yeah.
Jillian Woodruff, MD (31:16)
You know, we often have nutrient deficiencies. And like we said, it could be from medications that you're taking. It could be from a lot of gut issues that people are struggling with. It could be because you're not eating the right foods or you're not taking supplements. So many things, right? And then our bodies are often flooded with stress just because we're life-ing. You know, our sleep is broken. So we're not having that time that we need to recover. Like during sleep, your body is very active.
your body is working to restore, to fix things. And so we're not getting sleep. We're not able to do that. We also have a lot of inflammation that happens, whether it's from nutrients being low or not having enough sleep or not having the hormones. This is all sounding really depressing, as I'm saying. But it's not. There's hope. There's hope. We can fix all these things. really can. Yes. So...
Ade Akindipe, DNP (32:08)
There is hope! That's why we're here!
Jillian Woodruff, MD (32:13)
Yeah, when our mitochondria start to slow down, we can speed it up again. Like we have so much power in ourselves, even without, you know, medications and things to fix these problems that occur or start to occur. So antioxidants, right? Just helping to clear our body from toxins, using our food as fuel, using our food to detox our environment, eating things like
berries and leafy green vegetables, anti-inflammatory foods make a huge difference. But we don't see like changes right away. You you start to feel better. You start to notice maybe you have less bloating after meals or maybe you do have a better sleep that evening. But the changes are so gradual that sometimes people may give up thinking it's not helping before they actually get to like the promised land really.
Ade Akindipe, DNP (33:10)
Yeah, absolutely true. And that's why, you know, when you go on an elimination diet, for example, you ever tried an elimination diet where you kind of eliminate certain things that may be triggering? It's amazing how your body starts to kind of feel really bad from not, you know, from eliminating those things, whether it's caffeine, whether it's ⁓ maybe an offending food that's causing inflammation. And once those things are removed,
It's almost like a detox process. And I'll have some clients say, I just feel awful. But then I start to feel better because you're getting rid of all of those things that are causing you to feel sick and tired. And once you remove those things, your body starts to feel better, your energy's better, your mood is better, your brain fog clears. So there's just so many things that you talked about, environmental things, know, that whether it's...
Jillian Woodruff, MD (33:50)
Yes.
Ade Akindipe, DNP (34:05)
Perfumes whether it's plastics all this toxic things that are burdening our immune system our gut Can really wreak havoc so once you know poor diet emotional stress even just stress alone can cause problems, right? So it sends messages to your mitochondria to slow it down essentially So it's your body's way of protecting itself. So it's it's ⁓ it sounds depressing But it's really important for you to really be cognizant to understand how
different things in our environment can cause illness. Even with midlife changes, know, there's hormonal changes, but there are also things in our environment, in our lifestyle that can really cause energy, brain fog, and all those other things. So, you know, I'm just hoping that you're stopping and you're thinking about how I can change, whether it's writing things down. At this time of the day, I feel X, Y, Z.
Is it because of what I'm eating? Is it because of stress? Is it work? Is it stress in the family? That's what functional medicine really is about is looking at the whole picture and how all of these things can create problems, illness, starting all the way back from when you were a child to now. Some of the stresses, the trauma can cause stress, chronic stress. So anyway, that's a whole other topic that we're diving into.
Jillian Woodruff, MD (35:29)
Yeah, I think we do have to come back
to that. I think we should do, we need to talk about like inflammation in general. ⁓ If we haven't already, I don't think we have specifically. So I think that's a great idea. I've never done a food elimination diet, to be honest, Dr. Adai, I did at food testing so I could see specifically what affected me.
Ade Akindipe, DNP (35:32)
huh
Yeah.
Yeah, I don't think so. Yeah.
Jillian Woodruff, MD (35:53)
in a good way, what caused inflammation, like it was green, eat these foods, yellow, it's like, these are a little bit inflammatory and red is highly inflammatory, do not eat. I'm impatient, so that was just so much easier for me. And then it just told me, don't eat these things or you're not gonna feel good. And I can do that, so you know, I like data. Yes.
Ade Akindipe, DNP (35:59)
Yeah.
Right.
Right, right, ⁓ it was enlightening. It definitely was enlightening to do it. I decided
to try it as part of my functional medicine course. And at first I was like, well, I don't know if I want to do that. Well, if I'm going to teach my patients to do it, then I should probably do it. But definitely makes a huge, you realize how much things really do cause problems when you eliminate them. And you may not need to eliminate it forever.
Jillian Woodruff, MD (36:19)
I don't know.
Ade Akindipe, DNP (36:33)
but just taking a break can really actually help improve things out. So you can go back and maybe start to take it, but moderate and not every day.
Jillian Woodruff, MD (36:42)
Right? Well, big picture here today is fatigue is not about just being too busy. It's not about, oh, you have poor sleep hygiene and you just need to go to bed earlier. It is a multi-system issue. Hormones, nutrients, thyroid hormones, stress and inflammation, sleep, yes, metabolism, all of these things interact.
Ade Akindipe, DNP (36:56)
Hmm.
Jillian Woodruff, MD (37:11)
and can lead to fatigue, right? And so if one of those systems is out of sync, your energy takes a hit.
Ade Akindipe, DNP (37:12)
Yeah.
Absolutely. here is your gentle nudge. You know, look at all these different areas that we mentioned. We talked about a lot of different things. Maybe it's your blood sugar, maybe it's your sleep, maybe, you know, your diet. So give it some thought. Maybe it might be time to maybe journal and, you know, track what's happening. You know, your energy didn't just crash overnight and we can't fix everything overnight. So but you can start to rebuild it. You can start from somewhere, right?
Jillian Woodruff, MD (37:47)
That's right. And you deserve to feel good. You deserve to feel like yourself, even better than you have before. So not just functional, not just getting by, but really truly energized and optimal and alive in your own body. So you're made to thrive. We are all made to thrive and to feel our best. If we have shared something that resonated with you or that you liked, please share this episode with a friend.
Invite them to join us here on the Modern Midlife Collective.
Ade Akindipe, DNP (38:21)
Thank you so much for joining us. This is it for the Modern Midlake Collective and we'll see you next time.