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Fatigue

I am a 52-year-old man who has been experiencing various symptoms like chronic fatigue, a significant drop in energy levels, muscular pains, weight gain, low mood, shortness of breath, palpitations, bloating and difficulty sleeping. I was finding managing my stressful job of working as a financial advisor to be a real challenge. I had gone to several doctors and specialists, been through a gamut of tests but there was no diagnosis or relief for my symptoms. I had begun to feel hopeless, depressed and angry. Frustrated and desperate for answers, I turned to functional medicine. One of my friends recommended Dr Menka Gupta and I approached her in desperation.

Even before my first consultation with her, Dr Menka Gupta sent a very comprehensive questionnaire which had detailed questions about both my physical state as well as life events such as family circumstances, stressors, childhood etc. This was followed by a very thorough initial consultation, where she focussed on the relevant part of my history to ascertain what brought about my health issues in the first place. 

I had lost close family members in the past 12 months and was stressed at work. This took its toll and I was no longer exercising and was sleeping poorly. The combination of ongoing stress, worries about family members, and poor sleep led to me feeling lethargic and unable to focus. This complicated things further as I was worried not only about my health but about my job security.

I approached my GP and got referred to a bunch of specialists including cardiologists and a lung specialist. Besides ECG and spirometry, a number of blood tests followed, which tested me for various hormones and vitamin/ mineral levels. All my test results were normal, the doctors could not find anything wrong with me.

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After listening to my history, Dr Gupta recommended a couple of tests  – the DUTCH hormone test and a food sensitivity test. She suspected that a combination of recent stressors and poor sleep may have led to adrenal stress that could have been causing my symptoms. When the body is under chronic stress there is a high demand for adrenals to produce stress hormones which can affect the sex hormones like testosterone as well. High stress and poor sleeping habits cause disruption in diurnal variations of cortisol (stress hormone) levels.  When these issues become chronic they cause a phenomenon called `pregnenolone steal.` Pregnenolone is a byproduct of cholesterol metabolism that is necessary to produce both cortisol and DHEA.

When we are under chronic stress it creates an alteration in the HPA axis which reduces the body’s ability to adapt to new stressors.  This condition is called HPA axis dysfunction, which can also progress further to adrenal exhaustion.  This process of stress and poor adaptation can lead to a vicious cycle of chronic inflammation, tissue breakdown and accelerated ageing.

My food sensitivity test revealed that I am allergic to dairy, cashew nuts and camomile tea(!). This was an eye-opener as I was using whey protein shakes to supplement protein and camomile tea for its calming properties. Dr Gupta explained that sensitive foods act as internal stressors and can cause hormonal dysfunction.


She removed the food sensitivities from my diet and created an anti-inflammatory nutrition plan for me. This meant removing refined sugars, refined oils, sugary drinks, alcohol and processed foods from my diet. She recommended eating a lot of green vegetables, clean proteins from wild-caught fish, grass-fed meats, antibiotic-free, hormone-free organic chicken, nuts (besides cashew nuts), seeds, olive oil, herbs and spices like turmeric. This helped in reducing chronic inflammation in the body which was useful for healing my adrenal glands

The Dutch Hormone Test is a comprehensive hormone panel that measures the levels of various hormones in the body, including diurnal variation in cortisol, estrogen, progesterone, testosterone, and DHEA and their metabolites. Unlike traditional blood tests that measure hormone levels at a single point in time, the Dutch test provides a more comprehensive picture of hormone levels throughout the day and night.

My results showed that I had a hormonal imbalance, with low levels of DHEA and low levels of cortisol. It also showed that I had low levels of melatonin. DHEA is a hormone produced by the adrenal glands that play a crucial role in maintaining energy levels, reducing stress, and promoting overall health. Cortisol, on the other hand, is a stress hormone that, when produced in abnormal amounts, can lead to various health problems.

One of the first things Dr Gupta did to bring my hormones into balance was to focus on my sleep. She recommended “trimag supreme night” and insomnitol and some breathing techniques. While I was earlier sleeping less than 6 hours a day and waking up several times in the night, following her recommendations I started to sleep much better. In the first couple of weeks of starting on her protocol, my sleep was longer (7-8 hours), more restful and uninterrupted (I woke up once a couple of nights but was able to go back to sleep quickly). 

With Dr Gupta’s plan, I was able to address my hormonal imbalances and improve my overall health. I was prescribed supplements to increase my DHEA levels and improve cortisol production, as well as other lifestyle changes such as stress reduction techniques with Dr Deepika Gopalan and better sleep habits.

I am now able to focus on my work again, without fatigue or brain fog interfering with my job. I am enjoying my work, my moods and anxiety have stabilized, and I am able to find new levels of calm, happiness and confidence. My muscular pains have gone and I have been able to go back to my exercise routine, which I really enjoy. 

A big thanks to Dr Menka and NutraNourish team!

– A Grateful Patient

Dr Menka Gupta

IFMCP, MSc, MBBS

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