What’s one of the fastest growing mental health conditions? Burnout. It seems many of us have grown weary and fatigued while adapting to a new normal amidst a long-haul pandemic. Going forward with inspiration and innovation might feel impossible if you’re burnt out.

Burnout often falls into three categories:

  • You aren’t aware that you are burnt out.
  • You’re aware that you’re feeling burnt out but unsure how to help yourself.
  • You’ve been burnt out before and rebounded, but this time you notice yourself heading down the same path again, toward a re-lapse…and you practise what you’ve learned to prevent another burnout phase.

Personally, I have been through each one of these stages of burnout, and being human, I am now prone to re-lapsing. I hover between feeling like I can handle things—I am engaged and present and feel in control of all that lies on my professional and personal radar and to-do lists—and feeling like I am falling behind daily and taking everything far too seriously.

But here’s the thing, burnout is not strictly a mental health condition. Our physical health—things like our iron and thyroid levels, our blood sugar levels, and our adrenal health—also affect our experience of burnout.

Repeated episodes of heart-pounding, adrenaline driven frenzies can become a coping mechanism. Sometimes, these episodes are driven by things like looming deadlines, a lack of support, and/or a general feeling of inadequacy about how you’re stacking up. Regardless the cause, they raise your stress hormone, cortisol, which can have negative effects on your blood sugar and thyroid hormones, key determinants in your overall energy levels!

But once burnout happens, there are many factors to address to find your root cause, and often, there’s more than just one thing.

Rhonda is a 38-year-old woman who has a professional career, two young children, and a husband. She booked an appointment because she knew she was not coping well and felt her usual resilience was lost.

I did a lifestyle review, curious what might be contributing to Rhonda’s fatigue and feelings of burnout. I was looking for things like premade and packaged foods, sugar and coffee cravings, and using alcohol at night to relax, which could all be causing big swings in her blood sugar. I found her diet was remarkably unprocessed and nutritious, and she was avoiding alcohol and sweetened beverages.

She went to bed and woke up at the same time every day. Her sleep quality was decent, but she never felt refreshed.

Rhonda stopped attending her anaerobic boot camp workouts because she just felt too exhausted. That cued me to check her blood work—if her mood wasn’t prohibiting her from exercising, perhaps her iron stores, adrenals, or thyroid were suffering.

She felt on purpose with her career and felt connected (versus alone) with her husband and children.

So, what was going on with Rhonda?

The other half of treating burnout is assessing one’s health data. Rhonda’s story illustrates how important it is to know your numbers and consider your adrenal health.

Anemia/low iron stores

Iron deficiency is the most common mineral deficiency worldwide in women. It’s not uncommon for women to have low iron stores, even women who eat animal products and do not have heavy menses. Low iron stores are the norm when I check ferritin levels (our storage form of iron) on women in my practise.

The ideal level of ferritin for women is 70 – 80 ug/L (micrograms per litre). In conventional medicine, doctors diagnose and treat iron deficiency once ferritin is below 15. You can see how large this range is, and the benefit of acting sooner means that it will take less time to raise your ferritin to the ideal range. If your iron stores are less than ideal, this can be a major contributor to feeling fatigued, having difficulty with basic and vigorous physical activity, and can even affect your focus and concentration.


Your thyroid controls your metabolism and can impact your level of alertness and the energy you bring to each day. Generally, a basic thyroid-stimulating hormone test (TSH) is performed, but the “normal” range is wide: 0.34 – 5.60 mIU/L (milli-international units per litre). A hypothyroidism diagnosis generally occurs when your TSH is above 5.6 and thyroid antibodies are present. But ideally, your TSH should be nowhere near 5. Additionally, two other thyroid hormones, free T3 and free T4, need to be tested to understand the amount of active thyroid hormone in our body. Sometimes, reverse T3 also needs to be tested.

Blood glucose

Highs and lows in our blood glucose can take us from feeling “wired” and “hyper” to feeling sweaty-palmed, weak, nauseous, and faint. During burnout, the stress hormone, cortisol, is released, and this tells our body to release even more glucose into our blood, so we are ready to sprint away from impending disaster. Cortisol can result in elevated blood sugar levels, cravings for sugar, and more adrenaline release, which results in dips after the spikes in blood glucose. A one-off, random reading of your blood sugar won’t reveal much, but you can track your hemoglobin using an A1C test, which reflects the past three months of your day-to-day blood sugar control. If your A1C level is increasing—even a few points from 5.3 to 5.5—it’s time to learn how you can lower your blood glucose and address your burnout.

Adrenal Health

Summing it up in one sentence, your adrenals are small glands on top of your kidneys, and they respond to stress. So, they are a stress response organ, and they are essential for life. And if I had to summarize the adrenals most basic functions, I would say stress response, usually in the form of the hormone called cortisol, and energy production.

One of the most frustrating things for many people when the adrenals are overproducing or underproducing hormones is fat storage. Cortisol is made to help us through famine times, allowing us to store fat for a time when we may not be able to eat as much when we’re under stress. This has a lot to do with weight gain, especially central weight gain (abdominal obesity) and the fat around the organs, which we call visceral fat. This is one of the most dangerous types of fats!

So, why was Rhonda feeling so depleted?

Her ferritin was 20ug/L. Since this wasn’t diagnostic for iron deficiency, she wasn’t aware it was so low.
Her adrenal symptom questionnaire indicated her adrenals were compensating heavily, and she was beyond being wired…she was flat out tired.
Her thyroid function was OK—her TSH had crept up from 2.0 to 4.0 over the past twelve months—but I needed to treat her adrenals first. Sometimes, when the adrenals are supported and cortisol levels normalize, thyroid hormones will return to optimal ranges.
We weren’t sure about her blood glucose but since she does feel an energy dip a few hours after she has sugary foods and starchy meals, she wanted to try a continuous glucose monitor (CGM).

Often, when the adrenals are supported and ferritin levels are optimized, a recharged feeling of energy and eagerness for physical activity resumes. In Rhonda’s case, if I didn’t look ‘under the hood’ at her health data, I would have merely been guessing why she was feeling burnt out.

So, if you’re feeling depleted and burnt out or feel you’re heading in that direction, it’s wise to consider the many factors included under lifestyle medicine and health data. I summarize lifestyle medicine as choices related to your five core pillars of health: food, sleep, movement, purpose, and connection. The health data you will want to check are your ferritin, blood sugar, a comprehensive thyroid panel, your hemoglobin A1C, and adrenal fatigue symptoms.