Are you over 40 years old and distressed to be gaining weight and "getting a gut" even though you are trying to eat less and exercise more? Guess what? Stress, not calories, may be the culprit.

Who isn't stressed out in this action-filled and responsibility laden world in which we live? Let's examine the science behind how your midlife stress may be upsetting your hormones and, as a result, causing you to pack on even more pounds.

In the last few newsletters I have focused on the role of the three sex hormones produced by the ovaries and testes, e.g. estrogen, progesterone and testosterone. I have also emphasized the lock-step relationship between estrogen dominance and weight gain. (To read a previous newsletter about swimsuit season and estrogen dominance, click here). Now, in the next several newsletters, I will be discussing how stress impacts the production of five other hormones that can cause you to pack on those pounds.

Three of the five hormones are produced by the walnut-sized adrenal glands located on top of each kidney. They are adrenaline, cortisol, and dehydroepiandrosterone (DHEA). The other two hormones are ghrelin and leptin which are produced by a small area in the middle of the brain called the hypothalamus. If stress has disrupted the balance of one or more of these five hormones, you will tend to always be hungry and never feel full no matter how much you eat. The result? More fat stored around your middle.

Stress, Hormones and Hunger

For years I have observed how my patients' midlife stressors seemed to directly contribute to their weight gain. Recent medical research now validates my clinical observations. According to Tene T. Lewis, Ph.D. a health psychologist and lead researcher at Rush University Medical Center in Chicago, "typical midlife pressures stimulate some bodies to conserve more fat." Dr. Lewis's team of researchers has found that, the more stressors reported, the more weight gained over four years. This weight gain was not attributable to other variables like diet or exercise.

What are midlife stressors? The list of "bad things" that my middle-age patients often cite include being laid off or fired, experiencing major money worries, losing a parent, going through a divorce or dealing with difficult or angry teenagers. Can you identify?

What does stress do to your hormone levels? When the brain perceives some form of danger, it signals the adrenal glands to pump out more of the hormone adrenaline, often referred to as the flight-or-fight hormone. The sudden surge in adrenaline levels signal fat cells to quickly release energy. This energy rush stimulates flight, or running away.

Once the body is out of danger, the brain continues to signal the adrenal glands that there is a temporary need to keep adrenaline levels elevated. Higher than normal adrenaline levels cause an increase in appetite which is needed to encourage the body to eat more calories and replenish fat stores. Under acute stress situations, adrenaline levels will soon return to normal once the immediate appetite has been satisfied.

Now this brain-body hormone stimulating phenomenon served human beings very well in times when people were trying to avoid acute, or immediate, dangers like the threat of being eaten by wolves or minced up by invading armies. Today, however, the modern person in the United States in not frequently subjected to such immediate dangers. Contemporary stressors tend to be more chronic, or long term, like worrying about paying the mortgage, doing the jobs of three people, dealing with an unhappy marriage or grappling with ongoing parenting issues.

A life stressor can be considered chronic if it persists for three or more months. Instead of pumping out more adrenaline, chronic stress causes the adrenal glands to secrete more of the hormone cortisol. Because chronic stress is ongoing, high cortisol levels do not subside until the stress is removed or the adrenal glands are exhausted.

Over time, elevated cortisol levels can wreak havoc on the body. Sustained high cortisol levels destroy healthy muscle and bone, slow down healing and normal cell regeneration, co-op biochemicals needed to make other vital hormones, impair digestion, dull mental processes, interfere with healthy endocrine function, and weaken your immune system. If you are stressed out, high cortisol levels will also compromise your metabolism and cement more pounds around your middle.

In addition, when the adrenals are chronically overworked and straining to maintain high cortisol levels, they lose the capacity to produce DHEA in sufficient amounts. DHEA is a precursor hormone to estrogen, progesterone, and testosterone, and is necessary to moderate the balance of hormones in your body. When DHEA is produced at optimal levels, it functions to promote the loss of body fat. Double- blind clinical trials have found 100 mg per day of DHEA to be effective in decreasing body fat in older men. Insufficient DHEA also contributes to fatigue, bone loss, loss of muscle mass, depression, aching joints, decreased sex drive, and impaired immune function.

"Often, our response to stress today is to sit and stew in our frustration and anger, without expending any of the calories or food stores that we would if we were physically fighting our way out of stress or danger," says Shawn Talbott, PhD, an associate professor in the Department of Nutrition at the University of Utah and author of The Cortisol Connection. Moreover, Pamela Peeke, M.D., author of Body For Life tells us that, "Chronic stress can cause the body's cortisol levels to remain persistently elevated. This then causes a feeling of being constantly hungry."

More bad news: stress has been directly linked to more belly fat. Deep abdominal fat tissue has been found to have up to four times the number of receptors for cortisol as does superficial fat elsewhere in the body. This means that, when you are stressed out, the cells in your belly work harder to store fat. In addition to your distaste for the looks of that unseemly gut suddenly find yourself carrying around, those extra pounds around your middle can negatively impact your health as well as your vanity. Extra abdominal fat has been linked to a greater risk of heart disease and stroke.

How Stressed Are You?

I use the Life Event Profile, based on the work of mental health experts Thomas H. Holmes and Richard H. Rahe, to identify the sources and amount of stress in my patient's lives. I know from experience that, if a patient is suffering from moderate to severe life stress, that stress is adding pressure to their hormone production. Take the Life Event Profile self assessment now, click here... then continue reading below.

Little Steps That Can Help You Lose Big

If you completed the Life Event Profile and are still reading this newsletter, my guess is that your score indicated that you are experiencing borderline to high stress levels in your life. What do you think that I am going to recommend you do about it? Take up another identity? Move to another planet? Win the lottery? Get another life? My answer: None of the above.

Here's what I do recommend: choose your battles. If you are trying to fight three battles simultaneously, e.g. one against stress, one against hormone imbalance and one against your weight, the odds are stacked against you. I suggest you forget about your weight for awhile and focus instead on what you steps you can take to better manage your stress and restore your hormone balance. The good news is that, if you are anything like the thousands of stressed out men and women I have treated over the years (and I bet you are), these same steps will simultaneously start slimming you down.

Step 1: Stop living on automatic pilot and put "YOU" back in your life. Start with carving out one 20-30 minute ritual per day that is all about bringing YOU joy, fun, pleasure and/or peace of mind. Some ideas: walking, yoga, meditation, mindful bathing, reading, playing with children or pets, working on a craft, eating an ice cream cone in the sun, hitting golf balls in the back yard... The trick is to make sure that YOU are the primary beneficiary of this activity. Typically it is best to find an activity that you can do alone and don't have to explain, ask permission or tell anyone about if you don't want to.

Step 2: Move your buns more everyday. I am sure that the idea that "exercise is good for you" is not new to you. Still, for most busy and stressed out people, a regular exercise commitment is the first thing to fall off their to-do list. I recommend that, in order to not let yourself down, you set realistic time slots for doing an exercise of you enjoy. Write your exercise time on your calendar and/or set aside the same time everyday. Regard this time as non- negotiable. Don't be afraid to start with a commitment as small as 10 minutes a day. Think outside of the box: you can walk, run, stretching, do pilates, dance to Frank Sinatra or reggae. Just don't let yourself down by not doing it. Oh, and don't exercise right before going to bed because it can impede your getting a good night's sleep.

Step 3: Address Your Underlying Condition of Estrogen Dominance. If at least three of the following descriptors apply to you, then you it is almost certain that you are estrogen dominant.

• You are a man over 40 or a woman over 35 years of age,
• You have 10 to 30 to 40 extra pounds around your middle,
• You have two or more persistent symptoms of hormone imbalance (hormone symptom quiz), and/or
• Your current life situation is moderately to highly stressful.

• Add bio-identical progesterone back into your system. Try Dr. Randolph's Natural Progesterone Cream.
• Supplement your system with Calcium D-Glucarate. This particular supplement helps the body excrete excess estrogen through the bowel.

Step 5: Support Your Body and Mind With Vitamins and Supplements. The adrenal glands play a role in almost all of the body's processes, and are the main sites of stress damage in the body. My Adrenal Boost formulation nourishes depleted adrenal glands while encouraging adrenal cortex secretions. Addressing an underlying condition of adrenal fatigue is a critical first step to neutralizing the havoc that stress can wreak on your health and your weight. You may also want to read "Adrenal Fatigue: the 21st Century Stress Syndrome" by James Wilson, N.D., D.C., Ph.D..

A number of medical studies have shown that stress can deplete important nutrients -- particularly the B complex and C vitamins, and sometimes the minerals calcium and magnesium. Because these nutrients are needed to balance the effects of stress hormones like cortisol, and may even play a role in helping us burn fat, it's important to keep levels high.

Diindolylmethane is a phytonutrient found in vegetables including broccoli, brussel sprouts, cabbage, cauliflower and kale. Unlike other plant nutrients such soy isoflavones, diindolylmethane has unique hormonal benefits. It supports the activity of enzymes that improve estrogen metabolism. When taken as part of a healthy diet, DIM-Plus may help to support PMS symptoms, fat loss and healthy estrogen metabolism.

Finally, while eating good diet is essential, taking a high potency multi-vitamin supplement can insure that you give your body what it needs to not only deal with the stress, but also burn fat and lose weight. As a multi- vitamin, I also recommend Dr. Randolph's Meno-Support to support a woman's health changes that may occur in association with peri-menopause or menopause. This dietary supplement is specifically formulated to help ease many of the uncomfortable symptoms associated with shifts in hormone production, e.g. hot flashes, night sweats, insomnia, irritability, heart palpitations and headaches. To support optimal cognitive performance, I recommend Dr. Randolph's Brain Flex as a premier formulation to support superior cognitive enhancement. This natural product is for individuals who want to improve or maintain cognitive performance and reduce the effects of stress and aging on memory and mental functioning.

Read about Tammy: A Real Life Stressed-Out Patient
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It is my privilege to be a resource to you,
C.W. Randolph, Jr., M.D., R.Ph.

I am currently working with Genie James, M.M.SC. to develop the complete protocol and food plan for Dr. Randolph's "Waist Away" Hormone Balance Diet. If you are interested in knowing more about my diet program, please email your name and address to: CWR@HormoneWell.com.

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