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Season 2, Episode 13: Resolving Fatigue to Naturally Enhance Resilience with Evan Hirsch, MD

By Jodi Cohen

A promotional graphic for the "essential alchemy: the ancient art of healing" podcast, featuring an episode titled "resolving fatigue to naturally enhance resilience with evan hirsch," with portraits of the host jodi cohen, ntp, and guest evan hirsch.

With Evan Hirsch, you’ll learn more about addressing the 10 physical causes of fatigue, how thoughts drain energy, and turning self limiting beliefs into empowering and energizing beliefs.

  • Addressing the 10 Physical Causes of Fatigue
  • How Thoughts Drain Energy
  • Turning Self Limiting Beliefs into Empowering and Energizing Beliefs


About Evan Hirsch

Evan H. Hirsch, MD, is a World Renowned Fatigue Expert and is the Founder & CEO of the International Center for Fatigue. Through his best-selling book, podcast and online programs, he has helped thousands of people around the world optimize their energy naturally, and he is on a mission to help 1 million more.

If you’re enjoying the Essential Alchemy podcast, please leave Jodi a review on iTunes.


Jodi: Hi. I’m Jodi Cohen, your host. And I’m super honored to be joined by one of my favorite people ever, Evan Hirsch. Dr. Evan Hirsch is a worldrenowned fatigue expert and is the founder and CEO of the International Center for Fatigue.

Through his bestselling book, podcast, and online programs, he has helped thousands of people around the world optimize their energy naturally. And he’s on a mission to help a million more, which I’m sure you’re going to get to very quickly.

Dr. Hirsch: I sure hope so. Thanks for having me on, Jodi.

Jodi: Oh my God. It’s so fun to connect, even if it’s only online. So I ask everyone, what does resilience mean to you?

Dr. Hirsch: So, to me, resilience is your ability to bounce back from stress and challenges, simply put.

Jodi: Perfect succinct definition. And in order to bounce back, you need energy.

Dr. Hirsch: Absolutely.

Jodi: Which if you are suffering from fatigue, it’s a lot harder to be resilient. So I love that that is what you focus on. I know this story, but can you share kind of how you picked that area of focus after working with clients?

Dr. Hirsch: Absolutely. Well, and a lot of it had to do with my own story. So I graduated from medical school. I went to residency, and my first month in, I met my wife, Stacy, and we fell in love. And three months later, she couldn’t get out of bed because of her fatigue. And it lasted for three years.

And I was working 80 hours a week, and I had access– I was doing a family medicine residency, and I had access to a lot of really smart people, and they couldn’t help. She figured it out kind of on her own.

She found out that she had flatline cortisol, read Adrenal Fatigue by James Wilson, found a naturopath. Did saunas, took some adrenal support, worked mainly on her emotional health. That was probably the biggest thing that she did. She was mostly better after three years.

And it was incredibly hard on our relationship. Then we got married. We obviously fixed things. We worked things out. We got married, had a child. I graduated residency, started my own business.

And then three years later, I got chronic fatigue, and I was down for five years. And it just about destroyed our relationship, just about destroyed my business. Obviously, my health because I had to keep hiring people to do my job.

I had 4,000 square feet of office space and 10 employees at one point because I had to keep hiring more people to do the job that I couldn’t do because I couldn’t remember the person sitting in front of me because my brain fog was so bad. My body pain and my fatigue, where I could really only be upright for a couple of hours a day.

I would come home, and I’d lie on the couch. And my daughter would say, daddy, play with me. And I couldn’t. And then my wife said help out with the dishes, and I couldn’t. And I felt so much shame and guilt.

And so, part of my journey was not only about fixing my fatigue. And we can talk about how I did that, but it was also about fixing my mental state and my mindset and becoming more resilient around everything that entailed having fatigue.

Jodi: I love that. And you are my favorite kind of person. The person who fixes themselves understands why it worked and then helps other people. So if you can delve into some of the causes of fatigue, anyone who’s listening that’s like, that sounds like me. I wonder why.

Dr. Hirsch: Sure. So when we look at the causes of fatigue, we’re looking at 10 different categories, and those get broken up into deficiencies and toxicities. So deficiencies are things that aren’t in the body that are supposed to, and then there’s toxicities, which are things that are in the body that aren’t supposed to be there.

So when we’re looking at deficiencies, we’re looking at deficiencies in hormones like adrenals and thyroid and sex hormones. Deficiencies in nutrients like vitamins and minerals. Deficiencies in mitochondria, which is the energy center of every cell in the body and produces about 70% to 80% of our energy.

Deficiencies in lifestyle habits. So not enough sleep, not enough good food, not enough water, not enough movement. And deficiencies in neurotransmitters, like not enough serotonin, dopamine, GABA. And then the toxicities are things like heavy metals. A hundred thousand pounds of mercury are dumped into our oceans every year.

Things like chemicals—84,000 different chemicals we’re exposed to on a regular basis. Five hundred chemicals generally before we even leave the house in the morning. Talking about mold. About half of all the buildings in first-world countries have water damage. And most of those have mold. Talking about negative emotional patterns.

There’s the adverse childhood events, or I call them adverse life events, where if you had something happen to you, no matter what it is and you gave it meaning, it will change the way that you relate to the world. And it can increase stress on the human organism and affect you for the rest of your life.

So these are important things to work out. So we talked about heavy metals, chemicals, molds. Then there’s infections. The CDC recently changed their tune a couple of years ago. It’s not 30,000 new cases of Lyme per year. It’s actually 476, is the newest number. Sorry, 476,000.

Jodi: Oh, I’m like, wow.

Dr. Hirsch: 30,000 to 476,000. So there’s heaps more. And that doesn’t even include some of the Lyme co-infections like Babesia, Bartonella, things like Epstein-Barr virus, Anaplasma. And then there’s electromagnetic fields, but those are the toxicities.

And it just so happens that actually these deficiencies are caused by the toxicities because they damage all of these things, hormones and nutrients and mitochondria and all that. So those are the 10 categories.

Jodi: I love the way you simplify that. You make that so clean and clear, and you have a four-step protocol to kind of help people walk through it and understand it. Can you walk us through your protocol, please?

Dr. Hirsch: Absolutely. So the first step of this process is all about figuring out what causes an individual has. So of those 10 causes that we just talked about, everybody who has fatigue has something from every single one of those categories. Okay.

Now what’s interesting is that their causes are going to be different than Joe Schmoe’s causes over here. So somebody might have causes 2, 4, 6, 8, and 10, and somebody else might have causes 1, 3, 5, 7, and 9. So which means that their treatments are going to be different, which is really important because most people are focused on the treatment.

What is the supplement that I need to take in order to resolve my fatigue? Or how about IV vitamin C or ozone or whatever it is. So it’s really important to figure out what causes you have. So that’s step one. We look at symptoms. We look at history. We look at labs, and we figure out what causes an individual has.

And that’s the most important part of this talk, by the way, figure out your causes. Then step two is replacing the deficiencies. Now you’re going to say, wait a second, Dr. Evan. You just said this process is all about the toxicities. Why are we replacing the deficiencies?

And the reason why is because, in order to get rid of the toxicities, we have to be robust. We have to replace these deficiencies because everything works better when that happens.

And when we go into step four, we’re going to be a lot more successful if we are more robust. If we’ve got those adrenals, mitochondria, thyroid, all that stuff on board. Plus, also we want you to feel better as fast as possible, and replacing the deficiencies is the way to do it.

Jodi: Well, I just want to interject that all of those steps are outlined in your book for people to find them if they want to really land on that. And this is the thing that I really love about you early on as you were saying you’ve been doing this for a while, and you were noticing that people couldn’t heal when they didn’t have the energy to heal. And that’s why you really focused on this. So I really think this comes from personal experience. It comes from research, and it comes from success.

Dr. Hirsch: Absolutely. And what’s interesting too is that lifestyle habits are so incredibly important, but there’s a lot of people who join my program where they’re like, I can’t change my diet right now. I’m so overwhelmed. I’m not resilient.

And so, by replacing those deficiencies, that gives them that boost of energy and allows them to make the change in their life. It changes their mood. It changes their energy. It just makes a big difference.

Jodi: Yes.

Dr. Hirsch: So that’s step two. And then, step three is to open up the detoxification pathways. So this means opening up the intestines so that you’re pooping twice a day, liver, kidney, the lymph system, which is the garbage system of the body, the glymphatic system, so the lymph system in the brain because if you can’t dump things into these tubes and get them out of the body–

I just picture these pathways as like tubes. Then you’re not going to be able– when you grab your heavy metals and you pull them into the bloodstream, these tubes are clogged. You’re not going to be successful. The heavy metals are just going to go right back into a different compartment.

So that’s why step three is so important. And this is one of the challenges that a lot of people face who are having tons of die-off. In our program, we want you to have this much die-off, so we know what’s happening. And die-off is like when you’re killing a bug, or you’re removing a toxin, and you feel a little bit worse. The more open these detoxification pathways are, the more successful you’re going to be in a program.

Jodi: I 100% agree with that. And I think that that is everyone’s blind spot because if you can’t shepherd the toxins out of your body, it’s like Sisyphus. Your body is constantly trying to eliminate them. And that takes a lot of energy.

Dr. Hirsch: Absolutely. Yeah. And so then we remove the toxicities, the heavy metals, the chemicals, the molds, the infections, the allergies, the negative emotional patterns, the EMFs.

And I like to keep saying that list because it’s so important for people to get in their heads. Like if you still have fatigue, you haven’t gotten rid of all of these. You just haven’t found all of your causes because once you find your cause, I mean, it’s really a simple two-step process to kind of simplify it a little bit. But you figure out what causes you have, and then you fix them. But if you don’t know what causes you have, then you’re not going to be able to find the fix.

Jodi: Well, and people who just are kind of jumping to the, oh, what cortisol boosting supplement do I take? That’s only going to work if that’s your big issue. If you have other deficiencies, that’s not really going to help you.

Dr. Hirsch: Absolutely.

Jodi: First of all, that was really helpful and fabulous. And I’m curious. You kind of mentioned some of the emotional components that people– most people kind of get like, oh, I’m low and vitamin B or, oh, I need thyroid support. Can you speak to how emotions can contribute to fatigue?

Dr. Hirsch: Absolutely. They’re a huge part of fatigue. So you notice that we talked about negative emotional patterns as a significant cause, and this cannot be underestimated. There is something that happens when you experience a challenge in your life.

I don’t want to say trauma because it doesn’t necessarily have to be, as people term trauma. When you’re looking at adverse childhood events, the new definition is anything less than nurturing. Anything less than loving.

So it can be rejection. For me, one of the things was rejection from a peer group. I had some kids when I was 12 years old. I used to bike with them every day. For some reason, they rejected me. They went home. They called up my machine, and they called me a nerd a bunch of times. And that was devastating to me.

Jodi: That is devastating. That was mean.

Dr. Hirsch: Right. And it’s not sexual abuse or physical abuse, or emotional abuse by a parent. I didn’t grow up in a home with alcoholism, but it still had a significant effect on my life. And it informed all of my relationships moving forward.

So this is one of those things. And then the stress of trying to be cool throughout my life, trying to fit in. And so those are those things that are very stressful. And those negative emotional patterns weighed me down and didn’t allow me to achieve my best. So we have to look at that. Go ahead.

Jodi: No, it’s self-talk. I had parents that had ridiculously high standards. So if I got an A- (minus), that wasn’t good enough. I never got approval because the bar was too high.

Dr. Hirsch: Right. What happened to the other 10 points?

Jodi: Yeah, exactly. Yeah. But it does. It informs how you feel like you’re not good enough somehow because you’re not as perfect as other people want you to be.

Dr. Hirsch: Absolutely. And perfectionism is a big problem of mine. And so for me, some of the things that I’ve learned the last couple years that have really been helpful are retraining my mindset, retraining my brain, doing this neurosculpting or neuroplasticity, changing the way that the brain is actually thinking because, by default, our thoughts are 80% negative.

Jodi: Wow.

Dr. Hirsch: And so we all have to retrain. And if you say something enough to yourself, you will change the way that you think, and you will change what you believe.

So for me, as a perfectionist and feeling like there’s urgency on a regular basis as I have in the past, I am doing a lot better about it now. But I tell myself every day, there’s always enough time to get everything done. And if I didn’t get done today, I wasn’t supposed to get it done. With perfectionism, done is better than perfect.

Jodi: Yeah. I’ll work on that one. Is it a system? Can you talk more about that because that’s fascinating?

Dr. Hirsch: Absolutely. So what we teach in our program is what I call the daily mindset practice. And the first part of this is gratitude. So there’s lots of really great research on gratitude—one study in particular at Harvard, where they did on their students. Three gratitudes a day decreased anxiety and depression by 60%. And that’s repeated time and time again.

And they can be the same three gratitudes every day. So for me, it’s I’m grateful for my wife and my daughter for them to be happy and healthy and for my job and being able to help people and take care of my family and my parents. And then you can just go on from there.

But the more that you express gratitude, the more you will actually see gratitude around you. And then the next step within that gratitude is actually to start being grateful for things that haven’t happened yet. I’m grateful for my amazing summit that’s going to be launched in mid-June where we’re going to help–

Jodi: I’m grateful for all the people you’re going to help with this talk.

Dr. Hirsch: Yes, exactly. So you’re retraining the brain once again to think in a different way about what’s happening because the brain doesn’t know the difference between reality and fantasy or reality and imagination.

There was another Harvard study where they took pianists. So people who played the piano and they had some of them just do it mentally. And some of them who did it sitting down at the piano and their performances were just as good minus the muscle memory.

This has been proven time and time again as well. And this is one of those things. I’m actually reading the book The Success Principles right now, which is wonderful by Jack Canfield. But this is one of those things that people who are successful, they envision. And so one of the properties, one of the principles that we do in the program is we actually take people through a process of envisioning their perfect day. What does your perfect day look like? Who do you wake up next to? Where are you? What does your day look like? What is the flow of your day? What does your work look like? What do your relationships look like?

Because that ends up imprinting on your brain and changing your reality, and I’ve seen this time and time work for myself as well as for other people. So that’s gratitude, visioning. The next step is looking at the limiting beliefs and flipping them into empowering beliefs.

Jodi: Okay. I love that. Let’s really hover here. This is an important topic. Can you explain to people what limiting beliefs are?

Dr. Hirsch: Absolutely. So limit beliefs are things that you think are keeping you limited, that are not allowing you to achieve your best in life.

Jodi: I’m not good at that. Oh, I’m a terrible cook. Oh, I’m really uncomfortable in social situations. Oh, I can never make a lot of money—all of those things.

Dr. Hirsch: Perfect. Absolutely. That’s exactly right. And so what we want to do for each one of those is that we flip them on their head and we do the opposite, and we say the opposite to ourselves.

Jodi: I’m a great cook.

Dr. Hirsch: Exactly.

Jodi: Maybe my daughter will believe that.

Dr. Hirsch: Cooking comes easy to me. I can figure out how to make great meals that are easy and effortless. It’s very easy to make money. Money is flowing to me very easily.

So it’s just figuring out what your limiting beliefs are. And you can Google limiting beliefs online, and you can get a list. Figure out which ones you have and then flip it on its head. Do the opposite and say the opposite every single day.

So that’s step three of the process is creating those empowering beliefs because those are decisions in your life. You are deciding when you are making those beliefs. And then the last one is changing disempowering questions into empowering questions. So for most people, they have one main question that they ask themselves every day. And for people who are ill or have fatigue, they may be saying, why is this happening to me?

Jodi: Oh, so it’s the victim mentality.

Dr. Hirsch: It is the victim mentality. Absolutely. And the brain is the goalachieving machine. It’s like Google. Any question that you put in, guess what? You’re going to get an answer back. So if you ask a bad question, you’re going to get a bad answer or an answer that is disempowering.

So if you ask, why is this happening to me? The brain is going to say because you’re a slob, because of this, because your life sucks, because of whatever. So you need to ask yourself a better question. What can I do today to advance my health? What can I do today to love myself even more?

And when you stick in, even more, it reminds your body– it kind of tricks your brain a little bit that you’re already doing it, that you’re already loving yourself. How do I love myself even more today? If you want to work on your relationships, how can I show the people in my life how much I love them even more?

Jodi: The power of even more. I love that. So I’m curious because you have a clinic. When you started adding in mindset, how did that affect fatigue? What was mindset doing to energy?

Dr. Hirsch: Well, it first started with me, and a lot of people don’t realize how much their thoughts are draining their energy. And so I start started with myself. I actually learned this from my wife. And interestingly enough, my wife, Stacy, right now, is taking people through a resilience course. She’s a mindfulness teacher and meditator, trauma-informed.

And so I learned from her a lot of this stuff. And when I started applying it to myself because when I first started in functional medicine, I was all about the biology, all about physical medicine. Let’s replace these deficiencies and remove these toxicities and all that.

It wasn’t until I tried it on myself and then I started experimenting with other people, and I noticed that they had so much more improvement, and the quality of their lives improved significantly just by changing their minds. It was remarkable.

Jodi: Wow. It’s funny I interviewed Dr. Perlmutter for my Parasympathetic Summit, and I always ask at the end, is there anything else you want to talk about? And he said mindset is everything. I really do think– especially, I mean, you’re kind of hitting fatigue from all angles. You’re looking at the deficiencies. You’re looking at the toxicities, and then you’re looking at the mindset.

And for somebody who’s listening who’s like, I love all of this, how can they learn more? How can they get started with you on all levels?

Dr. Hirsch: So they can come to our website. We’re at fixyourfatigue.com, F-IX-Y-O-U-R-F-A-T-I-G-U-E.com. And there’s a lot of free information there. You can take the infection quiz to see if you’ve got a particular infection that might be affecting your fatigue. And then you can click on the learn button and download the ebook and a whole bunch of things.

And then, if you feel like you want to explore with us whether or not you’re a good fit for our program, you can jump on a free call with us. And that’s really putting yourself in the driver’s seat and putting that mindset where, okay, I’m ready to fix my fatigue. I’m not just going to sit in the background anymore. I’m actually going to take action, which is something that a lot of people don’t do for some reason or another.

Maybe it’s their limiting beliefs. This is just going to be another rodeo. I’m not going to be successful in this one as well, but you don’t know until you actually get on a call and learn. And so you have to make sure you’re constantly learning, constantly evolving and taking those steps and being in action.

Jodi: I love that. And is there anything else related to resilience that we didn’t touch that you’d like to add?

Dr. Hirsch: So I think what’s really at the root of a lot of resilience issues is a lack of mindfulness because when– and to define mindfulness, I’m talking about being able to see your thoughts as they are being made and how you are feeling, what your feelings are inside from a moment to moment basis.

Because when you’re able to see when you feel good and when you feel resilient, then you’re actually able to say, okay, I’m resilient right now because I’m playing guitar every day, and I’m singing every day, and I’m laughing every, and I’m walking, or I’m exercising every day. And those things make me resilient. And I realize that now. And so, when I’m not feeling resilient, I just need to do those things.

Jodi: That is great. Like figuring out what makes you happy is basically what you’re– that is fantastic. Well, thank you for your time and all of your brilliance. You are such a blessing.

Dr. Hirsch: It’s always a pleasure.

Jodi: Thank you.

Dr. Hirsch: Thank you, Jodi.

About The Author

Jodi Cohen

Jodi Sternoff Cohen is the founder of Vibrant Blue Oils. An author, speaker, nutritional therapist, and a leading international authority on essential oils, Jodi has helped over 50,000 individuals support their health with essential oils.