Laura Schoenfeld: Good question, Angel. I actually see a lot of blood sugar issues in people that aren’t eating enough carbs if they have adrenal fatigue. And when we say “adrenal fatigue,” just for future reference, Chris doesn’t really like the term “adrenal fatigue.” He likes to use the term “HPA axis dysregulation” just because “adrenal fatigue” is a little bit misleading as far as what the actual process is that’s happening. That’s just a future reference. He likes the acronym HPA-D. But we can call it adrenal fatigue. I don’t mind calling it adrenal fatigue.
Anyway, somebody who needs to have some carbs but has blood sugar issues, I would say doing a moderate-carb approach, so not super-high carb, not a lot of sugar, not having them have a Coke every time they feel like they’re having blood sugar issues, but also not entirely avoiding carbs or doing a super-low-carb diet. That’s usually going to be the best approach.
Kelsey Marksteiner and I put together a program on adrenal fatigue, and our starting recommendations for carb amount is about 30 percent of calories, which is kind of right in the middle of … a little lower than a typical American diet, but higher than a low-carb diet, and that provides adequate carbohydrates for maintaining good blood sugar, reducing stress hormones, and just making sure that they’re not having swings between low blood sugar and then a release of cortisol to bring that sugar up and then perhaps having high blood sugar. I’d say always making sure that carbs are combined with protein and fat is really important, so try to have your patient not just have carbs on their own. If they’re going to have fruit, maybe have some nuts or an egg or some meat or something with protein and fat in it on the side of the carb. And trying to have carbs in a meal as opposed to snacking all day is going to help with maintaining good blood sugar. And again, maybe having a moderate portion at each meal, not having a ton, not having something that’s super-high glycemic index and is going to shoot their blood sugar up so then they have perhaps a reactive hypoglycemic episode. But they have a meal that has some meat or fish or something and some of starch, like a potato, sweet potato, rice, plantains, something that’s a starchier carb. Maybe they have a half a cup to a cup total at that meal, and then they also have adequate fat, so maybe a couple of tablespoons of fat added, as well as some vegetables. Then that should be a pretty well-balanced meal that keeps their blood sugar from either spiking or dropping.
Then the last thing you want to make sure you’re paying attention to is just total calorie intake. A lot of our clients with adrenal fatigue tend to be undereating. If they’re undereating calories, they’re going to probably have worse blood sugar issues than if they’re eating enough food regularly, so that might be something to look at as well. It’s pretty stressful on the body if they’re in a constant calorie deficit, so just ensuring that they’re eating enough food and eating regularly enough and not skipping meals, not snacking all day on high-sugar foods or high-carb, low-fat, low-protein foods, and combining carbs with meals and other macronutrients at the same time. That will help keep their blood sugar steady and get the carbs that they need to have their adrenals function well.