The Programme, week 4: Nutritionist's comments on Rachel

Antony Haynes: Rachel's teaching course has all but finished. This has not only led to difficulty in following the dietary advice but has also tired Rachel out! We measured her blood pressure and it was low at 89/52 - an ideal may be somewhere around 120/80. This generally reflects inadequate adrenals, the hormones which maintain blood pressure.

Interestingly, the guidelines for Rachel were already supportive of adrenal health, with frequent intake of food, avoidance of sugar and stimulants (which tax the adrenals). However, this finding - which could readily be explained by the hard and long work Rachel has put into the teaching course - requires express adherence to the guidelines. Since protein supports adrenal hormone levels and blood glucose balance too, it is important to consume a high-class protein at breakfast, lunch and dinner. A complex carbohydrate meal may be the next best thing, such as porridge oats.

Low blood pressure may pose a reduced risk of stroke and cardiovascular problems, but it increases the likelihood of brain fatigue, lethargy, sugar craving and even dizziness upon standing. It may be associated with hypoglycemic (low blood glucose) symptoms too. Large meals can often result in sleep since more blood moves to the digestive tract and not enough reaches the brain.

Exercise can usually help to balance the levels of stress hormones in the body, although you do need to be careful not to over-exert yourself since this can tire the adrenals even more.

In Rachel's case, it may not be wise to avoid caffeine all at once, but rather reduce slowly. Otherwise her blood pressure may be too low for everyday functioning. I am hoping that in a few days her blood pressure will return to a more normal level and with it her energy levels too.

Alcohol is one of the major enemies of adrenal health; it depletes vitamin C and vitamin B5 which are vital for adrenal function. Rachel would do well to maintain her reduced intake. Already she has noticed improvements through alcohol avoidance or reduction, including loss of weight, improved general wellbeing, and less grogginess.