Guest Blog Post: Frazzled, Frumpy, Fat, and Fatigued by Cindy Dupuie, CN, Functional Medicine Nutritionist

You’re nearing fifty, heading into uncharted territory of perimenopause and menopause. You’re feeling a bit depressed and/or anxious, you have no energy, you’re struggling with your weight, you’re losing hair, you would rather sleep than have sex, you have brain fog, and all of a sudden you’re suffering from IBS or acid reflux. In short, the vital, vibrant, charming, clear-headed, beautiful woman you used to know has been hijacked. A lady armed with the 4 F’s (Frazzled, Frumpy, Fat, and Fatigued) has moved in and taken over your body and mind.

You’ve gone to your doctor and were told that this is all part of the natural aging process. After spending ten to fifteen minutes with you, your doctor whips out his/her Rx pad and prescribes a sleep aid and an antidepressant or anti-anxiety medication to relieve your symptoms. Or he/she may have completed a series of tests and declared that everything is normal and sent you on your way. But you know what you’re feeling is anything but normal or good.

If you were given medication, you may have felt some relief, but that’s not getting closer to what’s really going on and why you’re still not feeling yourself. I compare this to giving someone a Tylenol to help the pain when they have a shard of glass in their foot. The Tylenol may take the edge off, but if you remove the glass, that would be treating the cause and be much more effective. The same is true for anyone suffering from depression, anxiety, sleeplessness, fatigue, weight gain, and IBS. There are underlying reasons and causes that are not being addressed.

So what could be the real cause of why you’re feeling pretty lousy? Well, it could be attributed to a number of things. It’s not just because you’re getting older. There’s often a perfect storm converging when we reach somewhere between the ages of 45-55.

Diet and lifestyle along with digestive health are the driving forces behind the perfect storm. Lesser players, but still very important, are our genetics and heavy metal toxicity load.

Most of us have spent years moving and grooving, getting it done, often overgiving and overdoing and not sleeping or eating well. As a result, our adrenal and thyroid glands have often been overworked and hit hard. These overworked glands start talking to us very loudly by affecting our moods, energy, bowels, hair, skin, and brain function. Mainstream medicine usually does not look closely at either thyroid or adrenal health and function.

Why are the adrenal and thyroid glands so important to our well-being? Let’s start with the thyroid gland. Every cell in our body has receptor sites for thyroid hormones. I think that tells us how important these hormones are. They’re responsible for the metabolism of each and every cell, which translates into the metabolism of our entire body. This means that our body temperature, energy, moods, and brain function are influenced by the level of our thyroid hormones. Depression is often not due to low serotonin levels but to a depressed thyroid and/or inflammation. Too little thyroid can make you feel tired, depressed, and anxious and can contribute to weight gain and IBS.

Over 30 million Americans suffer from a thyroid condition. Of the 30 million, 80% are women and 60% will go undiagnosed and suffer needlessly. They will be offered antidepressants, sleep aids, and antacids and be told that it’s all up in their heads. They will be told that they are not trying hard enough to lose the weight or that they’re lazy.

The 60% that go undetected are due to lack of proper screening. Many doctors will test only for TSH (thyroid-stimulating hormone) to determine thyroid health and not include T4, T3, reverse T3, or thyroid antibodies which rule out an autoimmune disease such as Hashimoto’s Thyroiditis. To effectively determine the health of the thyroid and the amount of circulating thyroid hormone, I recommend requesting a test to include all of the above.

The adrenal glands are responsible for the production of cortisol, adrenaline, sex hormones (progesterone, testosterone, estrogen), and aldosterone (regulates blood pressure). As we enter into perimenopause, the ovaries begin to shut down hormone production, and we start to rely more on the sex hormones produced from the adrenals for a smooth transition.

If our adrenal glands have become fatigued from years of excess stress, too little sleep, a poor diet, infection, or poor digestive health, cortisol production and levels will be low. Why is this a problem? We need cortisol for every change or stressor that we experience. Changes and stressors as seemingly mundane as blood sugar fluctuations, temperature changes, food sensitivities, IBS, and inflammation – to bigger stressors such as infection, injury, emotional trauma, losses, and even good change such as getting married, a new job, a new baby – all utilize cortisol.

Since we can survive without sex hormones (we may not feel great but we can survive) but cannot live without cortisol, the first responsibility of the adrenal glands when cortisol production is compromised is to make sure that they use all their resources to produce cortisol. The sex hormones that our adrenals could be making are put at the bottom of the priority list. That means the road into menopause can be a bit tougher for those with adrenal fatigue. By the way, adrenal health is closely tied to thyroid health and gut health.

So if you’re feeling the four F’s (Frazzled, Frumpy, Fat, and Fatigued) and maybe even depressed, it’s crucial to assess the health of your thyroid and adrenal glands and perhaps your gut function as well.

What if your doctor will not give you a complete thyroid workup? There are online labs such as Life Extensions that offer lab work without a prescription from a doctor.

Always request a copy of your lab work. If you’re told that your numbers are within the acceptable ranges, always check to make sure that your thyroid hormones are in the mid-range and not hugging the edges.

What can you do if you think you might have adrenal or thyroid dysfunction?

This is my checklist:

  1. Get proper testing: thyroid panel, salivary cortisol panel, including DHEA, and since digestive health or a leaky gut is often a source of tired adrenals or an autoimmune disease, consider completing a stool test to measure digestive function, good and bad bacteria, yeast overgrowth, and other pathogens.
  2. Take gluten, dairy, and sugar out for 3060 days and see how you feel
  3. Eat organic and grass-fed as much as possible
  4. Incorporate meditation and yoga 2-3 times a week
  5. Get out into nature
  6. Find a supportive community
  7. Do less


Resources for further information and help:

  • Cindy’s website, which features additional wellness articles and gluten-free and grain-free recipes:
  • To find other Functional Medicine practitioners: The Institute for Functional Medicine,
  • UltraMetabolism, Dr. Mark Hyman, MD
  • The Hormone Cure, Dr. Sara Gottfried, MD