Our ABC station (KEYT, and former CNN editor Shirin Rafaee) asked me about Dr Oz’ 4 Secret Reasons Women Are Exhausted (previously, we spoke about belly fat). Here they are:

1. Carb Coma: a catchy way to sum up the sharp drop in blood sugar and shunting of blood to your stomach (not to your brain!) when you have a breakfast of pastry, or just high sugar fruit.  To gain energy, Oz reminds us to eat oatmeal and one fruit, not two, and to eat a hardboiled egg before leaving the house, and add vegetables to keep feeling full.

This is good advice, generally. Too many of us just have cereal or nothing for breakfast, and skip the protein. I’d add nuts and avocado, and make the oats steel-cut. I like my patients to aim for 30% of their daily calories at breakfast, and 60% by 2 pm.

2. Hormone Hell: Oz tests for high levels of cortisol and low levels of testosterone, which is suppressed by too high cortisol. Cortisol keeps spiking during the day in stressed and exhausted people, instead of its normal pattern; women need (and make) testosterone too.

In men, I think that testosterone actually is the weight loss hormone (even more than leptin), and knowing that, women can make a huge difference for men who need to lose weight.

In women, it depends on age:  women over 65 who have insulin resistance and metabolic syndrome often have high (not low) testosterone levels. In other women, testosterone gradually declines. One (unaccepted) theory is that their adrenal glands can’t keep up with chronic fight-or-flight arousal of chronic stress, and don’t produce enough of the hormones needed, including testosterone.

To help, Oz suggests getting 8 hours of sleep and 18 minutes of exercise daily, a balanced diet, and taking supplements, including Tongkat Ali (a Malaysian herb, now a protected species from overharvesting, made into a tea which improves sexual performance in male rats and mice), also available as a powder and an extract.  Claims about Tongkat Ali are sensational: I could find no studies of effectiveness in women, and only one in men (for infertility).

3. OTC Pain Meds can cause sleepiness.  Yes, they can–between 3 and 9% of people taking naproxen, for example, report just that. Oz suggests taking them just once weekly, and trying peppermint oil compresses instead.  I think less reliance on medication is a good thing. Sharecare and HealthTap are leading the way online in providing better DIY and DIT advice f.

4. Don’t sleep with your pets.  I think this is good advice: Oz notes that if a pet is restless at bedtime, they might need more exercise during the day, and might be keeping you up at night. Oz suggests giving a pet her own bed, and making the transition if you’ve slept (or tossed and turned) that way for years.