Q&A with Dr. Aviva Romm on Women’s Health and Hormones

My friend and colleague, Dr. Aviva Romm started her career as a midwife and an herbalist and ended up as a Yale-trained, board-certified family physician with a specialty in women’s health and obstetrics. The author of seven books, Dr. Romm is an expert in hormonal health and natural medicine. Dr. Romm’s new book, The Adrenal Thyroid Revolution, offers a powerful program to help women heal their overwhelmed, overloaded systems, and prevent and reverse a myriad of symptoms including weight gain, fatigue, brain fog, hormonal imbalances, and autoimmune conditions.

Dr. Romm and I both understand how a well-functioning thyroid and strong adrenal system are crucial to good health. Below, I share key excerpts from our recent discussion about improving both adrenal and thyroid health.

What are the adrenals and why should we know about them?

The adrenal glands are the final messengers in an emergency signaling system called the HPA Axis that begins in your brain. The tiny but mighty adrenals are responsible for producing adrenaline, which gives us focus, motivation, excitement, and the ability to respond quickly and effectively in an emergency, and cortisol, which controls the synchronization of your brain with every cell in your body—the immune, hormonal, detoxification, cardiac, energy-producing, and digestive systems, and also provides important emergency responses.  

Here’s how that process works:

  • We perceive danger in the amygdala, an area of the brain that keeps a catalogue of all possible threats—real and perceived.
  • The amygdala sends an alarm to the hypothalamus, which passes the message along to the pituitary gland that something’s not right, which in turn signals the adrenal glands to kick out adrenaline and cortisol.
  • Adrenaline gets your heart rate up, dilates your pupils, and makes you hyper-alert— you are now primed inside and out to escape, subdue, and/or survive a mortal threat.
  • Cortisol also takes action to protect your body; it elevates blood pressure, so that if you bleed copiously you won’t go into shock. It mobilizes your immune system to fight infection or withstand infection. It dumps sugar into the bloodstream for immediate energy, and insulin from the pancreas to mop up that sugar once the crisis is over.

It’s a fantastic response system. The problem is that in our modern lives, most of us are rarely out of survival mode.

Why does the medical establishment dismiss adrenal issues?

Unfortunately, conventional medicine has a tendency to dismiss dysfunction and to only recognize disease once it’s become obvious, which is terrible, because it keeps millions of people from getting help for common symptoms when they are still merely imbalances rather than full-blown medical conditions. This is the case for adrenal imbalances.

In your book, The Adrenal Thyroid Revolution, you introduce a term you call “SOS” or Survival Overdrive Syndrome. What is  it?

SOS stands for Survival Overdrive Syndrome and it’s a term I coined to describe what my patients were telling me they were experiencing—feeling that they were constantly in overdrive, in survival mode, or “stuck in the ‘on’ position.” It’s also what was actually happening in their bodies. When we’re overwhelmed, our brain picks this up as a state of constant emergency. We feel we can’t keep up, can’t do enough, aren’t good enough, or that things are going to fall apart if we let even one ball drop. Furthermore, chronic inflammation, environmental triggers, and a number of foods can send our body into overwhelm, also triggering SOS. As a result, our stress response is chronically activated and before long, we’re in SOS. Their survival response system—their HPA Axis—was indeed stuck in overdrive, or had been for so long that now that response system was exhausted and they were, too.

What are the consequences of SOS? How does someone know that she might have it?  

When you get stuck in survival overdrive, the cascade of events described above, which is intended to protect you, backfires. It’s a case of too much of a good thing and here’s what happens and how you might know you’re in SOS.

  • Excess adrenaline and cortisol result in anxiety, trouble falling asleep, and even when you do sleep, you’re not rested when you wake.
  • You’re likely to feel irritable, blue, or depressed.
  • Cortisol causes us to crave sugar and carbs; we then store excess energy in the form of fat predominantly as cholesterol and belly fat, a toxic form of fat that produces harmful inflammatory chemicals, and we can develop metabolic syndrome and even diabetes.
  • Chronic cortisol derails your brain, impairing willpower, focus, and memory, potentially creating “brain fog.”
  • You can develop high blood pressure.
  • Hormone problems including PCOS, endometriosis, PMS, infertility, higher risk of miscarriage, thyroid problems, and annoying menopausal symptoms are more common.
  • Digestive problems can result including IBS, constipation, leaky gut and microbiome imbalances.
  • Increased immune system activation can lower your resistance to infections and you also have an increased risk of developing autoimmune disease.

You might also find yourself irritable and overly sensitive, with a negative outlook on life, believing that nothing ever goes right for you, that you are bound for failure, or perhaps feeling overly judgmental of others—this is called a negativity bias, and it’s part of survival mode.

Can you explain more about the relationship between adrenal and thyroid problems?

Your thyroid is your body’s thermostat, and determines how much energy you burn or conserve. When you are in chronic survival mode, your brain is getting the message that it’s time to conserve, not spend energy, in order to protect your resources. As a result, your thyroid function slows down and you can develop hypothyroidism. Additionally, over a prolonged period of time, months for example, SOS can lead your immune system to become disoriented, and cause it to start to attack your own cells—a process called autoimmunity, and the most common form of autoimmune disease is Hashimoto’s disease, or autoimmune hypothyroidism, which affects nearly 30 million Americans that we know of, mostly women.

What is the revolution you’re suggesting in your book, “The Adrenal Thyroid Revolution”?

For far too long, the medical community has overlooked, dismissed, and marginalized women’s symptoms, often insisting that very real problems are in “women’s heads.” The modern way of saying this is to call it depression, stress, or anxiety. The first revolution this book suggests is that the medical community wake up and start listening to women, and not just give a pill for every ill, or wait for symptoms to become diseases, but really understand the root causes that lead to disease. The other revolution is for women. There’s a proverb I open my book with that says, “When sleeping women wake, mountains move.” Too many women feel they are sleeping, that their symptoms are keeping them from living their lives fully. Can you imaging the revolution if the millions of women who are tired were able to wake up not only their health, but their inner gifts and potential, as well, and have the energy to bring these to the world? It’s phenomenal to consider.

What can we do to break the cycle and heal the HPA axis?

The first step is to recognize when we’re in SOS. The next step is to hit the pause button, take a few breaths, and take stock of why this might be happening. Taking back our health requires that we start by taking back our lives—learning what’s affecting us and making a commitment to turning that around. In my book, The Adrenal Thyroid Revolution, I give women a blueprint for figuring out what your personal root causes are, and I give you the tools to reverse these. And I do it in as easy a way as possible—because we’re already overwhelmed, and healthy shouldn’t have to be hard!

Thousands of women have already experienced more energy, fantastic mood improvements, dramatic and sustainable weight loss, the disappearance of sugar and carb cravings, better sleep and digestion, and improvement in chronic diseases that even allow some to come off of a number of different medications and reverse their disease diagnoses as a result. And this isn’t miraculous or rocket science. It’s using strategies that are easily within all of our hands.