Last week I published a post in which I went into some detail on my current struggle with my health. I was shocked (though in retrospect I am certain I should not have been) to learn how many women empathize.
Today I want to go into a little bit more detail about what (by my best guess) is wrong with me and why. Hopefully this’ll help us start a conversation about recovering from stress, as well as raise some awareness about how prevalent stress-related health complications are.
The match at the bottom of the haystack: January 2011
To be clear: my “haystack” is very dry. Very, very dry. It has been for as long as I can remember. I have always been anxious. I have always been a poor sleeper – there is not one time in my life I can look back on and say ‘ah, yes, those were the glory days.’ I have always been a basketcase — if a tightly controlled and happy one — that’s just the fabric out of which me and my life are made. My haystack has always been dry and full of friction, ready to ignite.
January of 2011 was when the match was struck and everything “Stefani’s Health” sprinted to hell in a hurry.
Why? What happened? For one, I began taking T3 for my hypothyroidism, which upregulated my metabolism and therefore my heart rate. Worse, however, I began taking spironolactone, a usually fairly harmless drug (save for the rare occasion in which it can make you drop dead of hyperkalemia) often proscribed to women with hormonal acne.
I was so desperate to overcome my acne that I took drugs.
Almost immediately, I began having panic attacks.
Almost immediately, my previous insomnia problem which had always meant trouble falling asleep at night became an insomnia nightmare in which I was up until 4, 5, 6, sometimes 7am (and having to wake at 8 for class) anxious, sobbing, terrified, and with my heart racing.
I knew that spironolactone was supposed to reduce my testosterone levels, and I also knew it was a potassium-sparing diurectic. Neither of those things are known to cause anxiety in any statistically rigorous way. But hormones are hormones, and balance is important. More importantly, being a potassium-sparing diuretic means that other electrolytes – sodium, calcium, and magnesium – the electrolyte you need in order to feel calm – are flushed out of your system.
I quit the thyroid hormone, and that helped. It took me another month or two to work past my terror of going off the acne med (which, by the way, actually made my acne worse and my skin improved when I got off it… so… suck on that, Pfizer). When I did, it got better. I was no longer extremely clammy. Panicked. Palpitating. Wired. Incapable of falling asleep.
Not as extremely, anyway.
It never went away. In fact, in fairly short order, it got a lot worse.
Having been on this drug, I think I lost a significant portion of my already weak magnesium stores, which hurled me into the most painful and terrifying season of my life. I never slept. I didn’t know why. My heart always raced. My brain was out of control. Anxiety flooded every moment of my life, such that even tiny decisions like what color shirt to wear made my palms sweat and my heart race. I sought therapists. I sought psychiatric help in the form of the brilliant Dr Emily Deans (I never took anxiety meds, however, since I had anxiety about what they would do to me. Alas, the brilliant irony of mental health prescriptions.) I sought anything that might help – even acupuncture (which did). I contemplated giving up on living for the first time.
At the end of August it dawned on me that electrolytes might be an issue. You can actually die from an extreme electrolyte imbalance, so I checked myself into the ER. They ushered me in because my heartbeat was so fast. But they found nothing wrong with me.
And so – since then. It has been a full 24 months since I began taking spironolactone, and 18 months since I stopped. 15 months since I realized electrolytes were a part of my issue. 9 months since I realized that I needed to supplement with magnesium on a daily basis (my favorite one here). 9 months still in which I struggled to sleep, struggled to be calm, and struggled to have the sense of self I had before January 2011. 2 months since the most stressful period of my life.
Of course magnesium is not the only issue.
Adrenal fatigue: Do I believe in it?
No, and yes.
No, I do not believe in adrenal fatigue in the sense that your body gets too tired of making cortisol to keep doing so. That’s a bit far-fetched to me — cortisol is the hormone responsible for wakefulness, so of course it is a natural compound present throughout every moment of our lives.
What I do believe happens is that our bodies can become cortisol resistant, just as they can be insulin and leptin resistant.
Do I have it?
You bet your bottom dollar that I do. In the wake of those drugs, on top of an already stressful life, plus the stress of poor sleep and anxiety for two years plus the extraordinary culmination of four hours of sleep for two straight months –
Yes. My heart races at the drop of a hat, let alone at any kind of moderate stressor. Fights with my partners, important interviews, hell, even the idea of waking up early in the morning, all prevent me from being able to sleep throughout the entire night and give me anxiety. I used to be able to still fall asleep at some point during the night. Now, if there’s an issue, my body won’t calm down at all, and I might squeeze in 90 minutes somewhere between 8 and 10am.
Even if there’s not an issue, my eyes snap open with my heart thumping loudly in my chest exactly four hours after falling asleep nearly every night.
We’ll see how fun March is for me – a national book release. Hooray.
So what am I doing about it?
The absolute best thing I possibly can.
The reason I wanted to write this post was to share with you, again, the depths of my struggle with my physiological response to certain stressors.
I also wanted to emphasize how important it is to do everything you can for yourself.
Coming out of my period of stress, I knew that I needed a radical change. That lifestyle could not continue. I did not want it to. It was killing me, and I wasn’t having too much fun.
So I saved as much money as I could and I moved into a safe, quiet space away from my normal, hustle-and-bustle life. I do not make appointments before 2pm unless its Abel James Bascom and he’s dragging me out of bed for a crack-of-dawn podcast (more on which in a week or so). I go to sleep whenever my body allows it. I eat when I am hungry and I stop when I am full. I do not exercise unless I really feel like it (and it took me six weeks of serious rest before I felt like doing sprint workouts again.) I am “sugar detoxing” (using this plan) – by which I mean simply that I am attempting to reduce my addiction to and craving for sweet foods. I dance as often as I want to because that makes me happier than anything in the world.
I say no to obligations that might impede my healing.
As hard as it is, I know that what I need more than anything is to be slow. To stop trying. To not be perfect. To be calm. To weigh 130 pounds. To only spend time with people who energize and love me and make me feel safe.
This isn’t to say that I am incapable of life.
To the contrary. I am eminently capable. I have a lot of willpower. But willpower is what usually gets us into these messes in the first place. We push and push and push and push until there’s no muscle left to do the pushing anymore.
So we back up, and we repair, and we begin inching forward again.
This is the story of my tipped over physiology. Today I am healing. This morning I woke after seven hours of sleep with my heart beating peacefully, like it did so many years ago I can barely remember, and I looked at the sun streaming through my window with a smile. This morning I felt like I had enough energy to get up and work right away, and to exercise, and to forego naps. This morning I did not have insatiable sugar cravings. I am certain it is a long and winding road ahead. Today is one of the better days. But at least I am walking it, and gently.
Looking for more on the relationship between stress and health? I wrote even more about it in my bestselling book, Sexy By Nature.
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When your cortisol levels are too high for too long, your testosterone gets squashed! Then you get all kinds of physical and emotional symptoms. Adrenal fatigue – androgen hormones – not rocket science. But rocket fuel that you need to function right , especially as athletes. You won’t build bone density or strength without it. You’ll just burn the proverbial candle at both ends.
my testosterone levels are actually quite high thanks to PCOS
I am a big fan of l-theanine to deal with my form of insomnia, which is usually that my brain does not shut off, and instead races for most of the night. It shuts off the loop, if you will. It’s a GABA precursor, which I think my brain needs a little help with. I also take one in the event of a high stress situation, like an interview, and I find that I don’t freak out as much and therefore, I can speak more fluently when I need to.
Baaahahaha Oh Stef, sincere apologies for the “crack of dawn” podcast interview. You’re a champ! 😉
Excellent post – I’m so thankful you are sharing all of this… Here’s to many more 7+ hours of peaceful sleep to you!!
There are herbs that can help with adrenal fatigue, anxiety, insomnia. They have helped me, and several people I have come in contact with. They may help you. Elethero Root, Valerian, Kava Kava, etc. Cheers to you for keeping at it. =)
I take holy basil, which helps 🙂
As always, much appreciated Stefani – you’re an inspiration 🙂
Stefani! I was on spironolactone in high school (PCOS) which began my insomnia and need for magnesium. I had the epiphany that I had electrolyte imbalances too, I just didn’t know how deep it really ran.
I have had pretty terrible sleep recently as well. Having two nights in the past 6 months where irrational body anxiety kept me awake the ENTIRE night. And I also fall asleep poorly when I know i have to wake up early.
Sending healing vibes to you!
Wow. How long did it take you to recover from the spiro? I can’t believe I have a sister in this! Remarkable. Looks like we’ve both got some underlying permanent stuff going on there, too. Am I now forever susceptible to losing complete night’s sleep? Goodness I hope not, but it’ll be okay so long as it keeps getting less bad over time.
(The fuckit diet.. I like! 🙂 )
Thank you for these posts on your personal journey with anxiety and sleep issues. I, too, have been dealing with this state of being for most of my adult life as well. And I, too, have come to the conclusion that it has to be some kind of resistance because as I age (I am 43) my tolerance to stress seems to be less and less. I am currently in a place I would consider happy — raising 3 great kids, love my flexible-hours job, finally a pretty good place with diet, exercise and supplements (thanks to all the biggies — you, Jaminet, Sisson etc. But I still have these issues …so I am concluding it has to be a) the little, daily grind stuff in life (traffic, grocery lists, appointments, etc) has a bigger effect than I think and b) I have not yet found what is true, deep restoration. Still not sure how to translate this into a plan, but I look forward to your continued, important work … helping us all on our path toward some peace.
Yes! Thank you for sharing your story, too. I think both A and B are valid. Life is way harder than we give it credit for, even when we acknowledge that life is hard. There’s just so much responsibility and fear and accountability on our shoulders 24/7. It doesn’t go away. That’s something we need to be highly aware of and to care for and love and help relax as much as possible.
I also struggle with severe anxiety, I have my entire life. I am on T3 medication for hypothyroidism as well. I’m wondering if I should come off of it, but I’m terrified to (really afraid of weight gain and increased hypothyroid symptoms). Can you tell me about why/how you came off it and what symptoms you experienced if any? How did you deal with hypo after coming off the meds?
If you’ve had anxiety your entire life and if it’s remained roughly the same while on T3, it is quite possible that going off of the T3 won’t make much of a change. I couldn’t of course say for certain, however.
I also found at the time that it was more the spironolactone that was giving me the anxiety, not the T3, so coming off of it I was fine. My body felt like it calmed down a bit, but I didn’t experience weight gain or any negative symptoms when I stopped.
Thank you for this post, I am literally shocked to read your story. Your experience is similar to mine with spironolactone, especially the symptoms after stopping. My anxiety was so high for years after stopping the medication, that I felt like I was going crazy. I truly understand what you are going through and hope that you find relief soon!
So…I came across your site a few weeks ago, the first posts that you did on anxiety and magnesium. You inspired me to start taking my magnesium again (I’d never taken it on a regular enough basis to see any kind of improvement) It’s definitely improved my anxiety.
I was also inspired to go out looking for additional information, and came across a fb group called magnesium advocacy group. They talk about mag and how it relates to all the other minerals and vitamins, whether or not you’re taking enough, other metals that might be present that are blocking mag, or the other minerals (like copper blocking zinc).
I’m there specifically to learn how to get my anxiety under control and just in the last two weeks, I’ve learned a heck of a lot. And I plan on getting a hair analysis test to help me figure out my adrenals and doses of the other minerals/electrolytes. Just thought I’d mention the group in case you were interested.
This article talks about too much copper and how it relates to adrenals and anxiety – also connections with acne and insomnia.
Stefani! This post is so inspiring, and I am thrilled that you are seeing improvements now. I know how much hard work it is to put all of those lifestyle factors in line; I am in a major struggle with that (yes, letting Ed come before my adrenals). But hearing your commitment to, and success in, healing and getting rest gives me hope. Meeting you at WAPF 2012 (when I was in baaad relapse) was wonderful. Reading your doses of perspective, on both body image AND adrenal dysregulation, is equally great. Thanks so much!
Hi Stefani! I recently finished (April 2014) weening myself off spironolactone after taking if for 3-4 years. For the past couple of months I feel like I have been experiencing some PMDD symptoms for 3-4 days before my period and haven’t experienced this before. Do you think it could have something to do with going off spiro? A side note – I started Paleo in January of this year and adhere pretty strictly to it except for dark chocolate. Thanks for all that you do! I’ve learned so much from you.
I do. Unfortunately I have no advice other than to give it some time. If another sevearl months go by and it’s still the same, I’d get some bloodwork done perhaps and see if there’s any other hormonal imbalance going on.
What about staying hydrated?
I have had insomnia issues for the past two years… and often dread going to sleep at night because I think I won’t sleep at all. When I get anxious, I have these hours where I jump out of bed, feel weird in my digestive area… (hard to explain), I pace my apartment, and shake and cry. One friend had similar anxiety when she had bronchitis..and realized she was dehydrated. She keeps Gatorade on hand now and often a few sips of that will get her electrolytes back in balance and she can sleep.
I’ve tried magnesium oil on my feet (putting socks on over it), I’ve tried Be Calm, etc. I have almost a fear about being dehydrated..so I keep water with me all day at work..and try to drink a lot of it too when at home. I have this association between being dehydrated and having those anxious hours where I pace my apartment and get no sleep all night.
I want to get back to sleeping normally. I’m envious of a friend who goes to bed late, but she closes her eyes, sleeps, and then wakes up and it’s morning. I have no clue what that’s like!
I too suffer from Hypothalamus, Pituitary dysregulation and it’s many complexities!
Have seen 27 doctors!
Use caution with adaptagens, Ashwaganda made my issues soo much worse, after taking it for only 4 months and I NEVER went back to my abnormal normal 4 years later!
We just keep pushing forward!