Interview with DR. Michael Galitzer

Dr. Michael Galitzer is another of this country’s leading physicians. His specialty is natural hormone replacement and anti-aging medicine, and he treats men and women of all ages who are looking for an edge relative to their health.

SS: Thank you for giving me this time. I know how busy you are. Especially since I interviewed you for my book, “The Sexy Years”, I know that you hardly have time to breathe. But I think people resonated with you and the other doctors in my book as the ‘new thinking’, cutting-edged doctors, and frankly, who doesn’t want to be in on that?

MG: Well thank you. It’s a pleasure to speak with you again.

SS: I’d like to get right into it,…. I don’t think any of us ever realized the importance of the functioning of the adrenals. We’ve all heard of an ‘adrenaline rush, but most of us never have understood just how relevant adrenal balance is to our health, and the effect it has on our body and it’s ability to function properly. Let’s talk about decreased adrenal function and why it’s important to understand this major endocrine gland.

MG: I have to start by saying that adrenal burn-out is epidemic in our country. In traditional medical practices adrenal failure is recognized as a disease called Addison’s disease. In fact JFK had Addison’s disease and treated it with Cortisone for years. We’re not talking here about adrenal failure, but about adrenal fatigue which occurs when the adrenals are depleted. This is definitely not being detected in most medical practices. Physicians don’t look for it. They don’t properly diagnose it, and they don’t treat it correctly. When people are under enormous and prolonged stress, they will experience adrenal fatigue.

SS: Where are the adrenals located, and how does stress affect them?

MG: The adrenals are two small glands that sit on top of the kidneys. The adrenals are highly affected by different forms of stress. You can have emotional stress from marital problems, or you may not like your job or your employer. You can have chemical stress resulting from mercury leakage from silver dental fillings, chronic exposure to other heavy metals and pesticides, and food allergies. And you can have physical stress from over-training, working 60+ hour weeks, or having an infected root canal.

The first stage of stress is called the alarm reaction. At this stage, there is increased secretion of the hormone cortisol, in order to adapt to the stress. High cortisol causes insulin resistance, and insulin resistance causes high cortisol. When you have insulin resistance, you gain weight, crave sugar, and are constantly hungry, You also get fatigued after eating a high carbohydrate meal because lots of insulin has been secreted, while the cells are no longer responsive to insulin. The body converts carbohydrates into fat, which requires energy, and which accounts for the fatigue after meals.

Another symptom of high cortisol is that people are unable to fall asleep. They also frequently have symptoms of low thyroid function. When you have low thyroid, your hair falls out, you are constipated, your skin feels very dry, and you feel cold most of the time.

Increased cortisol contributes to high blood pressure. For men high cortisol will cause him to lose his testosterone down the road, because cortisol will block testosterone from working at the cell receptor sites. A man will lose his sex drive and be 30 pounds overweight. He will frequently have high cholesterol and high triglycerides. It’s a perfect set-up for a heart attack.

SS: So there is a domino effect starting with adrenal burnout.

MG: Yes, but there’s even more. The brain becomes less sensitive to estrogen when there is high cortisol, resulting in hot flashes in women who had previously been in perfect hormonal balance. Whenever a major stressor occurs, a woman will call and ask me, “Why am I having hot flashes?” The reason is that the stressor causes the cortisol to go up, which makes the cells less sensitive to estrogen.

Increased cortisol also occurs as a result of chronic inflammation, and chronic pain. The liver has a reduced ability to detoxify, promoting a leaky gut, with consequent auto-immune reactions within the body. Increased cortisol can cause ulcers in both the stomach and small intestine. Bone density can go down.

Additionally, high cortisol will suppress the pituitary’s ability to release LH. LH is essential for ovulation. So if cortisol suppresses ovulation, you’re going to get infertility and no progesterone.

Students who pull all-nighters who study, study, study, and do great on tests often find that 2 days later they get an upper respiratory infection. That’s because there’s no more cortisol around to protect them, and therefore they get sick. Cortisol is a major player in our health.

Older people are in a more difficult position because they have additional stressors associated with aging, that make it more difficult for them to achieve balance. They sleep less, they drink more alcohol, and they take more prescription drugs. There is a greater incidence of death among their friends and relatives. They have a greater sense of helplessness, and they often become caregivers to their spouses who may be sick.

SS: So stress, produces high cortisol, which starts a chain reaction of bodily malfunctions, all of which have serious effects on our bodies’ ability to operate and function properly. Sounds like high cortisol is not where we want to be.

MG: You are correct because as a result of prolonged stress, this person is at the second stage of adrenal fatigue ( the resistance stage). Left unchecked you will quickly progress to the third stage when the effects of cumulative stress are so great that the adrenals are completely burnt out, and this is called the exhaustion stage. At this point the adrenals are unable to respond to any stressor, and you will see low levels of cortisol and DHEA in the body. You don’t want to be here.

SS: So how can a person know how to fix this problem? We live in a society where stress is part and parcel of our daily lives. If a person comes into your office and says, “I want to live a perfect life and avoid the diseases that seem to automatically accompany our everyday lives”. What do you do for this person?

MG: Changing ones’ lifestyle is number one. You can’t be drinking six cups of coffee during the day. You can’t be drinking 3 glasses of wine every night. You can’t be smoking cigarettes. You can’t be drinking several 12 oz. colas a day.

This person has got to get in touch with his/her purpose in life. Why am I on this planet? You’ve got to let that purpose guide you as opposed to anything else. Find out why it’s important for you to be here. We all need purpose.

Frequently, when I talk with patients, they say their purpose is their children, and that is fine. There isn’t only one right answer, the key is for that person to align themselves with that purpose, and let that purpose guide them. I think that’s the most important thing that anybody can do. Then you have to stay on top of it. Pay attention to your body. If women and men would follow everything you are telling them to do in this book, from supplements to nutrition, to exercise, to relaxation to meditation, and then balance their hormones bioidentically, everyone would be in much better shape.

The best thing you can do for a woman or man with burnt out adrenals is to balance their hormones. Then I question them about sleep. If you have too much cortisol you can’t fall asleep. High cortisol turns off melatonin, so consequently you toss and turn to no avail.

If you wake up in the middle of night, and can’t get back to sleep, that’s a sign that your adrenals are fried, burnt out. You see, when we are sleeping our cells are working. Our cells need glucose to live. That’s the job of cortisol, to tell the liver to keep glucose going to the cells. If the cortisol isn’t working, the body says ‘hey guys we need sugar”. Well if your cortisol levels are very low, your body will go into the emergency mode, and go to the adrenal medulla ( the inner adrenal ), which secretes epinephrine and norepinephrine. It’s like the fireman breaking the glass to get to the fire extinguisher. When that gets secreted your blood sugar goes up, you wake up, and now you have an adrenaline rush. You can’t go back to sleep. This is what happens in third degree adrenal stress, adrenal burn out and adrenal fatigue.

SS: What do you do for this person?

MG: I would give them B complex injections, 1000 mg of Vitamin B5 daily, 25,000 mg of intravenous Vitamin C weekly, and put them on 4,000 mg of Vitamin C daily.

I would give them adrenal cortex extract injected deep into the muscle. The herb licorice root increases the half-life of cortisol. Licorice is also an anti-viral, and great for respiratory infections in those who have adrenal fatigue. The hormone, Pregnenolone which is produced in the adrenals and the brain, is the precursor of all the adrenal hormones, and also improves memory. DHEA helps with third degree adrenal fatigue. Lastly, Bio-identical Progesterone strengthens the adrenals.

SS: Yet, is it at this stage that most people are usually given a sleeping pill and/or an anti-depressant.?

MG: Yes, this does not fix the root of the problem. Also, sleeping pills like Ambien can become highly addictive. There are certain things that are critical for the adrenal fatigue people to do to get better. They have got to avoid refined sugar. They must avoid caffeine because it raises your blood sugar. When your blood sugar is raised your insulin gets triggered to drive your blood sugar down. When the blood sugar goes down, cortisol is supposed to bring it back up, but since these adrenal fatigue people don’t have enough cortisol, they become very hypoglycemic. So drinking caffeine is probably the worst thing they can possibly do.

SS: How does all of this affect weight gain or loss?

MG: The people who are adrenal fatigued are usually pretty thin. The people with high cortisol are the ones who gain the weight.

Adrenal fatigued people must have protein at each meal. It’s mandatory that they don’t skip breakfast. A muffin and a piece of fruit would be the worst possible thing for breakfast. If they are going to snack, they should snack with low glycemic foods like seeds and nuts. Fruit juices should be avoided because of the sugar, and if you’re going to eat high glycemic foods, always have protein with it.

SS: What about exercise when you are adrenal fatigued?

MG: The general rule is any exercise that makes them feel okay 1- 1 ½ hours later, and they don’t feel worse the next day. Walking, slow jogging, slow cycling is okay. Running quickly on a treadmill would the the worst thing for an adrenal fatigued person.

SS: When the adrenals are shot like this, how does it affect all the other hormones?

MG: Nothing works right. They really need to take it easy because there isn’t enough cortisol to normalize blood sugar.

SS: It seems crazy that as a society we have chosen to live such stressful lives that we are putting this kind of stress on our bodies’ ability to function properly. How do we get back on track?

MG: We need to look inside of ourselves and realize that there are three main causes of chronic streSS:

When we have long-term unhealthy beliefs that cause us to perceive life events as “dangers,” and thus trigger an alarm response.

When we have persistent deprivation of our emotional need for ‘bonding’ or closeness.

When we don’t get enough of our psychological needs met in our daily lives, that which unique to our specific personality. Some of us need to have fun and excitement; others need acknowledgement of our values; others need acknowledgement of our ability to think clearly and logically; other people need solitude; and some of us need to be richly stimulated.

Instead, we work too much. People are driven by this desire to make more and more money. That puts us in a defense mode. One of the things we have to do is slow down. I try and tell my patients to breathe deeply, to try meditation, to do yoga, to take vacations. Laughter is important as a de-stresssor. Rest. Go to bed early. All of these things are very simple but at present, antithetical to the way we are living our lives. I think people work because it’s an area where you can define yourself and you can find satisfaction. It’s great to do something you are really good at doing. It gives you a feeling of worthiness. But at the same time, over-working is not honoring your body. In the end, you don’t win because it keeps you in a very closed locked-out mode that is ultimately not in your best interest. The goal in life, in every aspect, is balance. And always remember that life is not measured by the number of breaths we take, but by the moments that take our breath away.

SS: Thank you for this fine information.

MG: Again, my pleasure.