"If I could somehow have the energy to function, have more energy in the morning to start my day, that would be great because I already feel like I'm starting at the bottom of the hill and trying to climb up as the day goes on.”
These are the words of a real-life health coaching client, Carl who sought help for his low testosterone levels. (Case Study Credit: Functional Medicine Coaching Academy)
A tax lawyer, with a wife and young baby at home, Carl felt he had no energy for his family when he got home at night. He adored them though and really wanted this to change, not least because he wanted to have another baby!
His initial view was that if he could take a supplement then surely that would solve everything.
There was a little more to it than that though as you will see below…
Carl’s analytical brain needed concrete evidence to connect the impact his lifestyle was having on his health though so sharing some research papers initially gave him the confidence to continue with the health coaching.
Over six sessions, the health coach worked with him on the following areas:
Understanding why improving his energy levels was important to him, and the difference it would make at home AND at work. Our WHY enables us to tap into intrinsic motivation which is potent!
Sharing the Functional Medicine Tree to understand the interconnections.
Looking at antecedents, triggers and mediators: these are the inherited or early life factors which might have caused any health issues, the stressful events or major illnesses which could have been triggers and the factors that have been perpetuating the health issues (diet, stress, lack of exercise etc).
Functional Medicine really excels in helping people with chronic health issues which have been going on for a very long time, where conventional medicine may not have the answers. If we can work on the mediators (factors that mean health issues continue), often actually chronic health issues that are no longer chronic.
Getting a sleep monitor (an Oura Ring in this case) to understand what the quality as well as the quantity of his sleep was like.
When people are getting good quality sleep, it tends to improve their body composition. They have an easier time losing weight or maintaining weight, better blood sugar control throughout the day and even things like, of course, energy and mood. Why not read our blog on Sleep & Chronic Illness here.
Recognising that Carl would be less reliant on coffee (7-8 cups/day) if he slept better and woke with more energy. Reviewing Carl’s sleep hygiene was therefore a key step.
What would enable better sleep? For him it was establishing a set time to go to bed each night, not taking the laptop with him and implementing a more mindful wind down.
Explaining Heart Rate Variability (HRV) and how the alcohol and cannabis gummies Carl was reaching for to destress impacted his HRV.
HRV stands for heart rate variability. What that is, in a nutshell, is a way of measuring the stress state of our body. Say your heartbeat is beating 60 times per minute, or whatever it may be. When we're stressed, our heartbeat becomes very regular: like a metronome. When we're more relaxed what we find is that there's a little bit of a change between each successive heartbeat.
It looks regular from a high level, but if you were to measure at a very granular level, you'd see little differences between each successive heartbeat, and that's called heart rate variability. HRV then is the measurement of how much variability you have between heartbeats. When you're stressed, the HRV tends to stay low. When you're able to do things that help you destress or feel more relaxed, you'll notice your HRV may start to go up.
Introduction of the cardio metabolic food plan as advised by his Functional Medic.
As the name suggests, this food plan is all about supporting cardiometabolic health. It’s designed, first, to help manage blood sugar levels and also in relation to that, insulin levels.
It's a diet that basically is lower in the simple sugars that can elevate blood sugar very quickly, and it's higher in complex carbohydrates like fruits and vegetables and also higher in some healthy fats. At the same time, it's also a food plan that can help with regulating blood pressure.
Introduction of a continuous glucose monitor (CGM)
Tapping into Carl’s desire for data to help him see the direct linkages between the changes he was making and his health. Clients like to measure things like when they eat a certain fruit or a certain meal, what happens to their blood sugar for the next couple of hours. With blood sugar, it will definitely go up when you eat some food, but then what's important is how quickly it comes back to normal and then stays within our normal range.
Keeping a food journal including noting any exercise as well as what his mood and energy levels were like.
This would help Carl directly map his device results to what he’d eaten and done that day. At first he was resistant as he thought it would take time and he would only commit to two days. He soon realised the value of it though and that by jotting things on a sticky note throughout the day, he could quickly complete the journal in the evenings. You can read more about the benefits of journalling in our blog, '6 Benefits of adding journalling to your routine', here.
Carl soon noticed that the usual fruit and yoghurt breakfast was spiking his blood sugars and not suited to his body’s particular needs so, with the coach’s guidance, he brainstormed other breakfast ideas which would give a slower energy release and settled on vegetable omelettes – something quick and tasty which he’d enjoy. Adding avocado meant healthy fats were included.
Noticing the impact on blood sugar on the days when Carl reached for lots of caffeine.
Carl noticed that on high caffeine days his blood sugar was going up and then down. That’s called rebound hypoglycaemia - basically, your blood sugar goes way up and then basically your body has to release a whole bunch of insulin; it overcompensates, and your blood sugar goes way down. It's a vicious cycle up and down which is why we feel a crash.
Exploring intermittent fasting and who it is suitable for.
If you're metabolically flexible, you can have a second fuel source called ketones. With somebody who is very good at fasting, they've probably adapted their diet so it's a bit lower in sugars and glucose. They're often eating the healthier fats in their diet. The cardiometabolic food plan recommended to Carl is designed around balancing blood sugar and allowing you to switch between burning sugar or perhaps burning ketones.
If you'd like to know more on intermittent fasting, read our blog here.
Carl learned that when you have a poor night's sleep, you generally have poor glucose control and that will in turn perhaps make you a little bit more irritable or emotional.
Understanding the link between stress and low testosterone
The coach described to Carl that somebody who's very highly stressed all the time will likely see a correlation with having low testosterone. So, by managing your stress, you will impact your testosterone levels. Things like alcohol and marijuana use can also impact your testosterone.
Exploring strategies for impacting stress
We’re all different in what works for us; Carl decided on gratitude journaling as the research was so solid behind it.
Finally, on session five, the coach and Carl looked back at what his motivators were and how far he’d come since their first session together.
Carl’s parting words were:
“I'm a big believer now of like, "I don't need to take a pill." Because even when I did get a prescription from a doctor and then you take it for a headache and stuff, it doesn't go away. I feel a lot more energized and not having to put more things into my body, more foreign things. Food is natural.
That has been probably the biggest takeaway, is just while the progress, it takes a little bit more effort, the benefits are much more rewarding, I think. Just feeling all the changes and knowing that I don't need another prescription, another pill to do it. Even though it seems like it would be an easy fix, it's not a fix.”
Interested in reading more? Ross Tomkins shares his own story of low testosterone and the impact on his life, which led him to create a service which supports men going through a similar experience: Read more