 Hi, this is Dr. Ruscio, and let's discuss one, if not the most commonly overlooked cause of fatigue, your gut. I've been saying this for a while, and I think this is a concept that's finally really starting to get the appreciation that it deserves. But if you're fatigued, one of the most common causes of fatigue or adrenal fatigue or however you want to term it may be your gut. And we see a recent study published that supports this. So I'll put the abstract up here on the screen and read you a few quotes from the study. This study was entitled Fatigue, A Distressing Symptom for Patients with Irritable Bowel Syndrome. And in the study, what they did was they took a total of 160 patients with IBS and they completed a questionnaire assessing fatigue and digestive distress, psychological distress, and sense of coherence or mental acuity, sometimes a lack of this is known as brain fog, and their conclusion, and I'll quote here. Fatigue is a distressing symptom which occurs in the sizable portion of patients with IBS. It affects life in multidimensional ways, with poor bodily stamina being the most prominent feature or fatigue. Fatigue along with a sense of coherence, brain fog, inability to think, depression and anxiety needs to be assessed, confirmed, and targeted for interventions. So like I said a moment ago, in my observation, one of the most common causes of fatigue or adrenal fatigue or however you want to term it is or are problems in the gut. And I can't tell you the number of patients that I've seen who have spent a decent amount of time and money on adrenal testing and trying to quantify what they thought was the cause of their fatigue, looking at cortisol levels with a four point saliva, cortisol tests as an example, spun their wheels there and only when they improved the health of their gut did they see their fatigue and their brain fog as this study is suggesting improved. Now in my book, Healthy Gut, Healthy You, there's a whole section dedicated to the adrenal gut connection and the gut adrenal connection and we talk about how there is this bi-directional relationship. So if you have fatigue that can be driven from your gut but also you can have stress and lifestyle factors that can cause problems with fatigue or termed another way adrenal fatigue. We want to look at this from both ends, lifestyle, exercise, sleep, nutrition, diet, but also from the other end, gut health and again in my observation just making this practical in terms of what I see in my interaction with patients here in the clinic is the most commonly overlooked cause of fatigue or adrenal fatigue are problems in the gut and if you can take some time to optimize your gut health then you have the chance to see fatigue improve, brain fog improve and your mood and we're seeing some literature published to support this connection and I've certainly seen a number of these cases in the clinic. I talk about it in the book, I share a case study about that in the book and so if you're struggling with fatigue instead of chasing down testing to quantify that from a hormonal perspective like adrenal testing I would recommend you invest some time and money into optimizing your gut health and I think you'll be very happy with the results that that produces. Okay this is Dr. Ruscio and hopefully this helps you get healthy and get back to your life. Thanks.