11 Signs You’re Not As Healthy As You Think You Are

TiredYou could be the picture of health to everyone who beholds you, feel generally “okay” on a daily basis without any real complaints, and never really feel compelled to visit the doctor for any specific issue. Plus, you’re Primal, so what could possibly go wrong? Except that many of us, if we stop to think about it, have little niggling symptoms that annoy us. And some of them could portend more serious conditions. I don’t want to worry anyone or freak you guys out. I just want you to be aware of seemingly inconsequential symptoms before they become more serious.

I’ve omitted the obvious signs that people don’t ignore, like blood in the toilet or the sudden inability to bear weight on one leg, to focus on the subtler symptoms that many of us take for granted.

You drag through every day.

Maybe it’s your job boring you to tears. Maybe it’s the long commute robbing you of valuable sleep. Maybe man wasn’t meant to sit in a cubicle during the best hours of the day. Maybe you’ve just had a bad week. Maybe you’re still on a high-carb diet, or you’re transitioning to a low-carb one. Those are all reasonable reasons to be tired throughout the day, but it could be something else. If you find yourself nodding off on a consistent basis all day, every day, and the aforementioned causes don’t apply, consider conditions like hypothyroidism, diabetes, hypothalamic pituitary axis (HPA) insufficiency, or chronic fatigue syndrome (CFS).

See a doc or health professional experienced with CFS or HPA insufficiency. Get thyroid and blood sugar tests.

You sleep poorly.

Good sleep is a pillar of good health. It’s really, really hard – bordering on impossible – to be healthy, lean, and fit without a solid 7-8 hours of sleep a night. Many people think they’re getting away with it, tossing around pithy quotes like “sleep is for the dead,” but they’re really just getting by. And not for long. Eventually, it catches up. Inadequate sleep is linked to early mortality from all causes, while partial sleep deprivation directly leads to insulin resistance, overeating, and body fat gain.

Manufacture a great night’s sleep.

You snore consistently.

One health risk associated with consistent snoring is being smothered in your sleep by whoever has to listen to it. Another is sleep apnea. Regular snorers may have obstructive sleep apnea (OSA), a disease that involves obstruction of the upper airway, frequent (but unbeknownst to the sleeper) awakenings, and 20-40 second long pauses of breathing during sleep. Yes, if you snore all the time, you might be holding your breath while you sleep. People with OSA are often inexplicably tired during the day (because of the awakenings and poor sleep). OSA is also linked to metabolic syndrome, cardiovascular disease, hypertension, cancer, and diabetes.

Get checked out by your doctor. A sleep study may be in order.

You can’t drag yourself out of bed in the mornings.

Beds are hard to leave. I get that. They’re soft, warm, inviting. But you should be able to get out of bed if you really need to get on with your day. You shouldn’t languish daily against your better judgment. If you are, something’s wrong and needs fixing. Remember, that same study showing a link between low sleep duration and early mortality also found a link with long sleep duration (although a later study found that sleeping for a long time only increased mortality in sedentary people). A common culprit (assuming you’re not getting to bed too late or sleeping poorly in general, which I’ve already covered) is low morning cortisol, which has been shown to be an accurate predictor of hypothalamic pituitary axis insufficiency.

Test your diurnal cortisol rhythm. Get plenty of bright, natural light in the morning and during the day, but not at night.

You injure yourself frequently.

Frequent injuries can mean several things: you’re training too much or too hard, you’re not giving yourself enough time or food to recover from your workouts, you’re using poor form, you’re wearing the wrong shoes, you’re moving the wrong way, you’re deficient in key micronutrients. Whatever the cause or causes, someone who’s always injured, or always getting injured, is not a healthy person. You should be able to to move relatively pain-free.

Watch out for overtraining, shore up your micronutrient intake, sleep adequately, and eat an anti-inflammatory, anti-arthritis diet.

Normal physical exertion leaves you winded.

You can be lean, ripped to shreds, and strong as an ox, but if you can’t walk up a flight of stairs without getting winded or go for a hike and enjoy it, you should probably rectify that. Human beings should be strong, yes, and the presence of good amounts of lean mass is one of the most important health markers we have. It’s not everything, though. Humans should also be able to move their body around the environment, to ambulate and crawl and climb and even run if we have to without wanting to die. I’m not suggesting we all become triathletes or CrossFit champions. I’m not advocating chronic cardio. I’m not even advocating running or “cardio” at all; you can absolutely improve your conditioning using strength training movements done quickly with minimal rest. I’m just saying that cardiovascular fitness matters, too, and if you don’t have any, you’re not as healthy as you think.

Work on sprints and high intensity circuit workouts, not just weights. Be sure to walk every day.

You can run a marathon but struggle with pullups.

Don’t be the person they use in sprinter/marathoner comparison pics. Don’t neglect your lean muscle mass for the sake of a few seconds shaved off your time. Take it from a guy who’s been there, who’s read the literature proving the importance of muscle in health: we all need a decent amount of it. Besides, even the top endurance guys are incorporating strength training these days. Chances are lifting heavy things will only improve your endurance performance, not hinder it. It will also make you more resistant to injury.

Lift heavy things.

You have no libido.

We’re sexual beings. And not necessarily in a tantric, creepy guru with an open shirt, hairy chest, long greasy hair, and extensive selection of oils kind of way. On a base level, we exist to reproduce and so the ability and drive to do it – or at least perform the act – is pretty central to our health. And if we’re just not interested in sex, there’s usually something going on that needs addressing. Hypothyroidism and depression are two potential causes, as are low testosterone in men and low estrogen in women.

Support a healthy sex drive.

You have acne.

For many people, teenage acne is part of growing up. Acne as an adult could mean something different. And yeah, check in with a dermatologist if you want, but I doubt the creams, ointments, balms, salves, and other superficial skin treatments will get to the root of the issue if it’s a serious one. There’s a growing amount of evidence that gut health is linked to acne: gut permeability is elevated in many disorders, acne rosacea patients are more likely to suffer GI dysbiosis, and acne vulgaris patients tend to have altered gut flora.

Fix your gut. Eat probiotic-rich foods, consume prebiotic fiber (like resistant starch). Self-experiment.

You have dark circles under the eyes.

Most dark circles under the eyes are caused by poor sleep and/or thinning skin. But dark circles can indicate a few other, more serious issues. You could have food intolerances or undiscovered food/seasonal allergies, which could in turn indicate other issues (see below). They might also indicate anemia or elevated liver enzymes, both of which simple blood work can uncover. It’s probably nothing too serious, but be certain.

Get a complete blood count (for anemia) and/or a liver enzyme test. Try an elimination diet to identify food intolerances or allergies.

You have sudden intolerances to foods.

Have you ever experienced it? Maybe you sit down to your favorite post workout meal of steak and broccoli only to wake up later that night with horrible gas and horribler stomach pain. Or it’s cherry season and you come home from the farmer’s market with a big five pound bag of them, but eating more than a handful gives you the runs and really bad bloating. When there’s a sudden food intolerance, whether it’s to FODMAPs or dairy or anything else, it may indicate imbalanced gut flora, leaky gut, or both. Even if a food you already avoid, like wheat, is giving you more trouble than it usually does, that should be a warning sign to address the health of your gut.

See the recommendations for acne.

This is by no means an exhaustive list. There are more, and I may even get to them in the future. It’s just a list of signs and symptoms that in my experience people tend to ignore or downplay. You may well be justified in doing that, but it’s good to find out for sure so that small problems don’t become larger ones.

Thanks for reading, everyone. Got any other symptoms that people should watch out for? Let us know in the comment section!

About the Author

Mark Sisson is the founder of Mark’s Daily Apple, godfather to the Primal food and lifestyle movement, and the New York Times bestselling author of The Keto Reset Diet. His latest book is Keto for Life, where he discusses how he combines the keto diet with a Primal lifestyle for optimal health and longevity. Mark is the author of numerous other books as well, including The Primal Blueprint, which was credited with turbocharging the growth of the primal/paleo movement back in 2009. After spending three decades researching and educating folks on why food is the key component to achieving and maintaining optimal wellness, Mark launched Primal Kitchen, a real-food company that creates Primal/paleo, keto, and Whole30-friendly kitchen staples.

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137 thoughts on “11 Signs You’re Not As Healthy As You Think You Are”

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  1. I’m a marathoner trying to get better with upper body strength! I’m making it a point to do at least a dozen push-ups after every run (6x a week) and upper body/core focused strength training 2x a week.

    1. Good, but its better to put the strength training ahead of the cardio. Much better. I used to train a few distance runners, and when they performed strength training either before or better on a different day , they improved much faster. Give it a try.

    2. Cut back on the volume of running to 2-3 days per week and do 2-3 days of strength training. Take 1-2 days per week for rest and recuperation. Muscles will have a difficult time growing (hypertrophy) with so much volume of exercise and calorie burning and not enough rest.

  2. I think lots of people can benefit from knowing their blood sugar readings. Do not wait for a doctor to tell you, you can monitor that yourself. There is testing equipment available at Walmart that doesn’t cost a lot. Take your own readings on a typical day, before and an hour after meals, and see where you are. I am a T2 diabetic and have found LOTS of people whose blood sugar is consistently higher than mine. This is a very valuable tool to let you know that high blood sugar (and resulting drops that make you hungry) might be causing you problems. If your blood sugar is higher than you’d like, you can do something about it early. Low carb DOES work.

    1. So true Janice!! People should take charge of their own health and be proactive. Don’t wait for a doctor to tell you you need medicine!

      1. When it comes to health and wellbeing nowadays, the power is in our hands. There is no excuse. The lazy one shall suffer!

      2. I agree! My doctor, following common protocol, waited until I was into neuropathy range before he disgnosed me and put me on medication. I have been med-free since I found low carb; about ten years now.

    2. ABSOLUTELY, amazing I don’t feel so alone know, it is funny how my numbers are so much lower. And those people really feel it is no big deal if they have high readings. Many feel that anything under 180 is good. My mom died from complications of being a childhood diabetic at the young age of 57, being told to eat a low fat high carb diet, which she followed and lead to her early death. Anyone that has witnessed a loved one suffer from this would take extreme measures to prevent it from happening to them, it is not a path that anyone wants to witness or die from, and it is very preventable.

    3. The blood glucose readers are cheap but the test strips require a doctor’s prescription!

      1. No prescription required. As I noted under this main comment, the best two meters are the Nova Max Plus and Abbott Precision Xtra. Strips for both are available without prescription.

        http://www.americandiabeteswholesale.com is a good source for strips for the Nova Max Plus.

        http://www.ebay.com is is a good source for strips for the Abbott Precision Xtra.

      2. No, they can be purchased without a prescription (at least in my state, NC), but they are certainly costly without insurance coverage!

        1. Blood glucose strips can be purchased on Amazon, relatively inexpensive.

      3. You can get blood glucose meters at Walgreens, CVS or whatever pharmacy you decide to use. Then head on over to Amazon, the test strips for the meters are very inexpensive. No prescription needed.

        Be well.

      4. You can get the Walmart brand strips online without a prescription. I did. I think it would be totally stupid that anyone would need a prescription for test strips, it’s not like you can overdose on them as you might with some prescription drugs. If you’re paying for them yourself, what would be the problem?

      5. Glucose meters can be purchased inexpensively at Walgreens, CVS or whatever pharmacy you choose, the test strips can be purchased on Amazon, very inexpensively.

    4. Right on. The two best meters at this time are:
      – Nova Max Plus
      – Abbott Precision Xtra

      Both measure glucose and ketones (important for LCHF/ketogenic diets). The Nova Max Plus has much cheaper strips (especially for ketones), but the Abbott Precision Xtra is far superior for ketones. Often times the Nova Max Plus will read “lo” for ketones whereas the Abbott Precision Xtra so far has always returned ketone levels including 0.1 mmol/L.

      You can also find a post from Jimmy Moore where he compares the two. These are pretty much the only two meters out there for glucose and ketones. If accurate ketone measurements are important to you, go for the Abbott Precision Xtra even though the strips cost more. Once you know what you are doing, you really don’t need to measure ketones often.

    5. I had ALL of those symptoms. I really did. Then, one day I decided that my issues stemmed from my weight. Now, I’m not sure if it was the cause but, I know I couldn’t get through my day without a nap, then I couldn’t sleep at night when I got home. Some foods didn’t agree with me and I would throw up. How could I not have circles under my eyes, I didn’t get enough sleep. I knew my iron was low but, taking iron pills did little to help. I went to the doctor but, I didn’t feel any better.

      I changed all of that. I started doing Green Smoothies and I haven’t stopped yet. I feel so much better, my skin is clearing up, I sleep better and I’m losing weight. I’m still AMAZED how I survived the way I did. I’m also AMAZED at how it all turned around for me. I literally don’t have circles under my eyes any longer. I don’t take naps at work for my lunch hour. Green Smoothies helped me a lot and I changed my lifestyle completely.

      So, let these be warning signs and make a change — ANY change. Don’t continue on this way.

      I hope this helps someone!

      1. Didn’t you gain a lot of weight drinking those green smoothes?

        1. Did you gain weight drinking green smoothies (made mostly with veggies, not fruit)??? I drink green juice (not smoothies) all the time as meal replacements and my experieince is that I’ve lost a lot of weight doing so and feel healthier.

  3. “And not necessarily in a tantric, creepy guru with an open shirt, hairy chest, long greasy hair, and extensive selection of oils kind of way.”

    Um, maybe I’M creepy, but I’d kinda like to meet this guy… 😉

  4. The title of this post scared me, but luckily there were no big surprises once I read through it! Since transitioning my diet my sleep, energy, strength, and digestive symptoms have all improved, but there is definitely still work for me to do on my overall self care. I am an anxious type who has trouble resting so that will always be the weak link for me. I have to get more serious about slowing down, giving up twice yearly marathons and resting/sleeping more. Good list!

  5. I am guilty of not being able to do a pullup. I could benefit from more strength training. But dark circles? Isn’t that sometimes just genetic?

    1. I thought my dark circles were genetic, too. All my siblings have them and my dad too.
      But very slowly, after switching to a paleo/primal diet, my dark circles have all but disappeared. It took months before they started to fade, and almost a year before they were completely gone. I suspect there was an underlying food sensitivity that I have unknowingly addressed by cleaning up my diet.
      Between my primal weight loss (45 pounds) and the disappearance of the dark circles, I look 15 years younger and feel great.

      1. Do you eat dairy? I’ve been primal for 2 1/2 years, but still eat dairy, and sometimes I wonder if giving that up would help any last issues that I have. I also still have dark circles – maybe not super dark, but dark enough that I like to cover with concealer.

        1. I cut way back on dairy a year ago and finally cut it completely out about a month ago. I feel better having done that, but the circles were mostly gone by then, anyway.

      2. I was about to reply in the ‘yes, it’s genetic’ camp because I have had very pronounced dark circles my entire life, but reading your comment gives me hope. I just started following a primal lifestyle a few months ago and while I try to abide by the 80/20 rule, I’m still having a hard time staying as primal as I would like (my husband is the poster-child for sugar burners… and he is also the cook in the family). Anyway, this was great to see and I’ll use it as motivation to keep going and keep improving.

        1. When I started noticing that the circles were going away, I tried to find information on it, but was not very successful. I think the allergy answer makes the most sense. I hope it works for you. It was always something I had always been resigned too — just a minor concern — but I have to say, I’m very happy they are gone.
          It’s difficult when there are some in the family who are primal and some are not. I’ve got my two daughters on board (17 and 26), and they love it, but their dad and brother don’t want to give up bread. I’m the cook at home, so they are a lot more primal then they would be if they were cooking their own food. (I make them buy their own bread pasta.) Primal food is delicious, so who needs grains?
          Good luck!

    2. Dark circles under the eyes of kids can also be a sign of intestinal parasites. Don’t know about adults.

  6. I have suspected for a while that poor sleep is the root cause of many of my issues. Primarily, I am having issues losing weight regardless of how healthy I eat and how active I am. Think I need to do something with the mattress. Always wake up with a stiff lower back and hips.

    1. Hey simple suggestion:
      A pass of foam roller in the morning makes wonders!
      Only 5 minutes makes a difference. 10 minutes you start the day a new person

  7. Mark – you missed the big one! A disease that is little known yet has most of these symptoms. A disease that kills more people than Breast or Prostate Cancer – 40,000 per year. One that has another 50,000 added each year and the symptoms are shortness of breath, persistent cough, fatigue, unexplained loss of weight. A disease that most Doctors see as either Asthma or Bronchitis. I have this killer disease and the average person lives 3 to 5 years after diagnoses. It called Idiopathic Pulmonary Fibrosis or IPF and I credit going Primal three years ago with my stabilization and became the first diagnosed patient – ever – to enter, run and win an age group 5K and constantly refer people to both you and this web site. Going primal has saved, not just changed, my life and if you reading this and have any of the symptoms please, please, please insist on getting a High Resolution CT Scan to diagnose it. An X-Ray won’t do.

    1. I, like Mark, was a healthy paleo lifestyle who struggled only slightly with thyroid issues. I had regular exercise with cardio intervals and was a healthy stable weight. Then things started going awry. I chalked the back muscle ache to too much heavy work in the garden. The interval fatigue to lack of fluids ( it is August in Houston after all). My weight has been uncontrollable for several months. I just thought I needed more activity and smaller portions. Then the chest pain sent me to the ER where they found Renal Cell Carcinoma. I was soooo surprised. On the upside, my healthy lifestyle has done wonders for my recovery!!! Staying strong!

      1. Lynn, congratulations – your story give us all hope who have life threatening terminal diseases and it appears you are recovering from yours. Just one additional comment… some of us have underlying conditions that create symptoms that are not the disease… they are the result of the underlying condition… this is something no one seems to be willing to talk about. Toxic heavy metal poisoning presents all the symptoms of diabetes, high blood pressure, high cholesterol, asthma, neuropathy, IRB, obesity, leaky gut, autoimmune symptoms, low to no hormone levels. I have seen a major improvement in all the symptoms and the underlying condition because of Primal Living, to whatever extent I have been able to do it and encourage all humans to do so for creating a quality of life, regardless of duration, that is exceptional.

        1. Sonya – you hit the nail on the head. I too have had and seen great improvement in almost every one of the underlying conditions you mentioned. My, and your, point being, even with Paleo, bad things happen, and Paleo is a wonderful lifestyle not only for healing but for health maintenance when things do go wrong – as you stated – to fully create a quality lifestyle that is maintainable and exceptional for a lifetime. Be well and well nourished!!!

  8. Sleep is a big one and often an overlooked source of health problems. I have personal experience with this. I know if I go a few days without good rest, I start to feel terrible, and feel like something is wrong with me. It literally affects every aspect of your life. Once I get a long sleep, though, I feel great again. Sometimes ya just gotta out everything else aside and let yourself get some zzzzzs.

  9. For “normal exertion leaves you winded,” I would also recommend checking iron and ferritin levels. Low iron/ferritin can have this effect.

  10. For some of us, blood in the toilet isn’t really that alarming. Just sayin’.

    1. And always remember to ask yourself, “Did I eat beets yesterday?”

      1. I’ve been wanting to try beets because I’ve heard it can help with endurance. Glad I read this or else I might’ve freaked out the next time I was in the crapper.

      2. Same thing happened to me. Asked my doctor about red urine, “Did you eat something unusual lately”. “A big mess beets.” “Don’t worry about it.”

  11. I think women with low libido should have estrogen, progesterone AND testosterone checked. Of the three it least likely to be estrogen that is the problem.

      1. DHEA is the precursor to the androgens and estrogens. In adrenal fatique, the prenenalone that is responsible for creating DHEA often gets “taken” to create extra cortisol. This is called the prenenalone steal. When this happens, you don’t have enough DHEA to create the androgens and the estrogens, hence you present with the myriad of symptoms related to low testosterone, such as low libido.

  12. I had another sign I may not be as healthy as I think:

    A guy showed up at my front door from the medical center to which I have donated my body to science.

    He said they wanted it now!

      1. I am donating my body to the Neptune Society. They provide cadavers to medical students in other countries and provide ashes to your heirs for comfort.

  13. Ironically, I have MS and Chronic Lyme but can do unassisted pullups, don’t get winded, have no acne, great libido, sleep well and no eye circles. I do struggle with food intolerances though.

  14. My sleep is really weird… I always sleep a solid 5-6 hours. Then I wake up and my brain gets busy and I feel the need to do something. If I’m in relaxed mode I get up, get on my laptop and work on my stories for a while. Typically an hour, two or three if I feel like it. Then I go back to sleep. And if I feel the need I’ll often have a nap on my lunch break. I work from home. XD That works well. However… for this summer I’ve been watching my sister’s kids three days a week. Starting at 7:30 AM and my work shifts are typically 2-10. I try desperately to get the whole 7 hrs but I just. Keep. Waking. Up! Argh. Can you say caffeine addiction?

    I also have adult acne. Not much but a bit. Hmm. Might want to keep working on the resistant starch thing I guess.

    1. Are you eating really low carb? Waking up and being fully alert is a sign your liver has run out of glycogen, and your system dumps a bunch of cortisol 8 to your blood stream to get you up and looking for something to eat.

      1. No, I’m not super low carb. And I’m not HUNGRY when I wake up like that. I typically drink some water on the computer before going back to bed. I think it might actually be a natural way of sleeping… segmented sleep? It works fine normally, it’s this 7:30 AM stuff that’s just killing me.

        1. Years ago I read an article to the effect that segmented sleep is a natural rhythm – it’s how the medieval monks survived midnight prayers… You might be able to find some references avec le bon Doctor Google.

      2. I have had a cortisol rush at 4-5 AM for a couple of years. When I have a tbs of powdered gelatin (glycine) in a cup of herb tea or hot broth I sleep well and dream. I think that’s a good sign. I do have a couple cups of coffee every morning. The cortisol translates to my brain as anxiety and ruins sleep for 2-3 hours.

    2. I am fairly certain that Mark has written a post about segmented sleep.

    3. Your sleep sounds a bit like mine prior to finding out I was gluten intolerant. I struggled with weird sleep for 32 years before I realised it wasn’t normal to sleep so lightly all night that waking up several times was normal, to have to pee once, twice, sometimes THREE times through the night EVERY night, and to wake up with such an enormous burst of adrenaline/anxiety each morning that once I woke up (usually far too early) I simply couldn’t choose to “sleep in” afterwards, no matter how exhausted I felt. And I really did need to sleep in, because I spent 32 years in a constant state of exhaustion, mistakenly thinking I was for some reason “just different” from everyone else. If you haven’t already tried, do an elimination diet. I went cold turkey, and haven’t looked back. Acne is also a very immediate symptom of gluten consumption for me. Never could get to the bottom of my skin problems til I got rid of it from my diet, now my skin is wonderful.

      1. That’s interesting… I avoid gluten but I haven’t completely eliminated it from my diet. I sometimes indulge and see no real side effects, but maybe it is a problem. I do wake up quite a bit although my first five hours is pretty solid. Hmm. Unfortunately I live with my parents right now, but I’ll be getting a condo in a year. I might try an elimination diet then.

  15. Also check any side effects of any meds you’re still on. Right now, I’m willing to trade off poor sleep and 12-14 hours a day of drowsiness for the ability to actually get up and enjoy life. There’s no reason to avoid modern medicine if that’s the catalyst it takes to help you clean up your lifestyle.

  16. I had been humming along pretty well with diet and lifestyle for a while, with a few minor pesky things still unresolved. I had been having food sensitivities to dairy and nightshades, and some occasional digestive variability. My sleep was not the greatest at times, but that’s been a lifelong issue for me anyway. But overall, I thought I was doing pretty well, as long as I avoided the foods that bothered me.

    Then I started experimenting with the whole resistant starch thing, and lately supplementing with some of the recommended fiber supplements (like LAG, Inulin, FOS, etc). It has been very interesting. Overall, my digestion and sleep seem to have improved quite a bit. But I’ve also dealt with some other strange symptoms that I think are mostly related to bad gut organisms dying off. I realize this is still a wide-open area of ongoing research, and we are guinea-pigging ourselves out without really knowing exactly what we are doing.

    I’m genuinely hopeful that I will be able to heal my gut to the point of having at least some dairy and nightshades included again. I consider my problems with these to be “sensitivities” and not allergies. The whole experiment seems very promising so far, as long as I don’t try to go too fast with it.

    Compared to my SAD lifestyle days, I’m doing fantastic. Lean, strong, healthy, energetic. Just fine-tuning my beast mode at this point. 🙂

  17. The comment on sex drive and sexual desire is too general and not entirely accurate. Some people such as asexuals have no interest in sex, with or without a sex drive (there is a big difference), and there is nothing wrong with them. I know it wasn’t intended as such but it came off a as bit insulting. If someone normally experienced either or both and then didn’t, then obviously that is more of a concern that should be looked into.

    1. I beg to differ. Mother Nature considers procreation of the species a high priority, which is why sexual activity is rewarded with pleasure. If no pleasure then something is wrong, physically or mentally.

    2. “and there is nothing wrong with them” as a person or individual BUT genetically something is amiss because we are built to genetically pro-create.

      1. Individuals don’t have to, if their relatives do. See all the eusocial species.

    3. I always thought ‘asexual’ meant a creature that can reproduce by itself without a need for a mate, such as amoebas and other single celled organisms…

  18. One thing to point out on the low libido, regarding low estrogen- this is actually -normal- for mothers exclusively breastfeeding, especially to natural duration. Estrogen levels can be very low when doing so and it would seem to be a beneficial thing- to prevent another pregnancy while the mother’s body is focusing on recovering from child birth and nourishing the current nursling.

  19. Does it matter how late you got to bed like 1:00 AM BUT getting a good 7 to 9 hours of deep sleep ?

    1. I can’t see how it would matter. Congrats if you’re getting good sleep! 🙂

      1. well how much of the circadian rhythm is affected. our organ runs on cycles too.

  20. Regarding sudden food intolerance, there are other reasons than those listed which I found out the hard way and that took literally months to discover and understand. I started getting lactose intolerance in my late 50’s. It got progressively worse to the point that one day on a mountain bike ride I was incapacitated by stomach cramps so sever, I had to stop riding due to dizziness and pain.

    About a month after that I came down with the flu and whooping cough and could not shake them. I went to the M.D. after about a month who put me on antibiotics which lessened the flu symptoms but left me with diarrhea.

    With seemingly nothing to lose, I tried a Chinese Medicine practitioner who helped me feel much better but still with the lactose intolerance and now milder respiratory issues. Only because the schedule dictated it, my dentist did the 5 year full mouth x-rays which i had contemplated canceling due to them always being a waste of money and just exposing me to more rays. She found I had an abscessed tooth from a previous root canal gone bad.

    The abscess had not progressed to the point of causing pain or swelling, but it was real. After a trip to new endodontist, and retreatment of the root, all my symptoms cleared up including the lactose intolerance. And, coincidentally in Chinese Medicine the abscessed tooth is related to the lower intestine and stomach.

    Just to be sure because the endodontist told me there was not way this tooth would cause all these problems I had a battery of tests run including liver, kidney, glucose, cancer markers, all type of infectious disease markers, etc, etc, too many to list here but about $600 worth which all came back negative.

    Three months later, I am completely back to normal other than I lost muscle tone and am building my strength mack up. I thought this was important to pass on because figuring out what ails you can be a long and difficult road and sometimes not very obvious.

  21. I am a senior woman, menopause is long past done. I believe that lack of sexual desire is a natural part of life, and don’t see any reason to put my life at risk by jumping on the estrogen bandwagon. We have a long family history of various “female” cancers….my husband hasn’t jumped on the viagra bandwagon, either. There are plenty of ways to stay close & connected without needing to “exchange fluids”. I’m disappointed that there is always this usual get some hormones as the answer to everything. I’m not willing to take the chance with pills, shots, creams, “bio-identical”, or any of it. Luckily, my partner prefers to have me around for a lot more years, rather than one more orgasm. I mean more than that – I am more than that. I am more than a vessel to him. I expect to get lots of criticism for this opinion, but we’re comfortable with our choice. Don’t assume you can’t be a healthy 70 year old without traditional sex. I trust nature.

    1. I don’t believe his audience was for your age group… but you do make a good point, as time goes on the lack of female hormones often leads to a lack of libido.

      1. We’re all here reading this, so we’re all the audience. Jean’s comment is a great reminder of how broad our community is!

      2. Really? What exact age group is this audience for? People in their 70s who have never experienced excellent health can benefit from this method of life! Perhaps most menopausal women over 65 may not benefit from HRT (btw I totally agree with Jean’s assessment of the need for it)…however Primal Man and Woman rarely lived this long…health and quality of life is the right of any human willing to pursue the methods to create it, regardless of their “exact age group”. Go Jean.

    2. I find your comment interesting as I find this topic (menopause and post-menopause issues) given little attention in the paleo/primal communities.

    3. I am a 73 year old male with a normal libido. I can assure you that if my female partner did not reciprocate in that regard I’d be looking for a different female partner. Life is too short to give up one of the few pleasures we have.

      1. I am happy for you John. However there are many men your age who apparently do not have your virility but their female partners stick with them because of other reasons, including when the female libido has not declined. Perspective is everything. If sex is one of your few pleasures… there are some things in life you have obviously missed. Glad I am not the woman you will dump because of lack of a comparable libido. Life is never too short, it is just what it is… so many heartbeats, so many breaths, so many experiences, and then there is that obstinate thing. Primal Living makes it all so much better. Why are you still here?

      2. I’ve got to say that’s pretty piss-weak, telling another woman what you would effectively do to her. I bet you haven’t even told your own partner, how they’d be replaced, if they didn’t put out for you?

        Thankfully I’ve known some older guys who died being faithful to their sweethearts, come hell or high water. But then they were a cut above the average man.

        1. We all have our own assessment of the value of people in relationships, don’t we? Those who can still love – more so than those who no longer can. The physical and mental benefits of participating in a relationship, are undeniable.

      3. You’d really dump your female partner if for some reason she was no longer interested in sex? To me, that’s pretty sad. My husband had prostate cancer surgery and became impotent. By your logic, I should dump him and find a new guy because I have a normal libido. Luckily, I’m just glad my husband is still alive so I’m sticking with him. My relationship with him is much more than just sex.

    4. +1 Jean.
      It’s back to that whole litany of operations and prescription drugs to fix/change things that are probably not broken. Not feeling horny? Take this pill. Peeing too much? Take this pill. Losing your hair? Get replants. Boobs too small? Put silicone in there to make ’em hard and unnatural. Personally, one of the joys of ageing is to not think about sex 24-7 like I did in my 20’s to 40’s. I can actually get a lot done and enjoy life more now without that constant sexual urge lurking underneath everything.

    5. I’ve got grandparents and so does my partner, who knew pleasure was a simple cup of tea, with your loved one in the morning. And of course, having a sense of humour. When you had that, you had everything.

      But then these were people who experienced war and buried loved ones. Learning to live with change and appreciating what they had, became a lifestyle.

  22. Between traveling full time, homeschooling, and taking care of our 5 month old baby I don’t feel like I’ll ever sleep again. Maybe you can write a post in your primal parenting about getting infants to sleep better that doesn’t involve crying it out. 🙂

    1. At five months, sleep interruptions are normal i.e. biologically appropriate so going against biology is always a tough thing to do for both parties… I never wanted to use the cry it out methods either. I found the best way to improve both your sleep during that first year is to sleep next to one another (if not in same bed, then bed/crib next to one another) and in no time you will begin to synchronize your sleep cycle with the baby’s. James McKenna does some amazing research on sleep within the mother/baby dyad, his concepts helped me so much when my kids were infants – look him up, hopefully his info will help you too!

  23. I have the misfortune of working a rotating shift which I try to mitigate with melatonin etc. The job is mainly sitting, and there are no breaks, so I end up doing exercise/stretches in several 10-15 minute bouts through-out the day, whichever shift I happen to be on. I hope it’s helping me to stay healthier than otherwise.
    Any advice on how to minimize the bad effects of working 6 days on first, 7 days on second and 7 days on third shift ad infinitum?
    I do get tired and draggy on third. There’s not much use in trying to do anything that requires oomph. There are always obligations of one sort or another to bust up sleep.

    1. I don’t know how to mitigate those hours for you to become better balanced. I’d rather live in a tent without a job than be subjected to those hours. I think that constitutes torture. I worked in Alaska for 11 years working 18-20 hour days in the summer, but at least they were not rotating shifts. Still, if I knew Primal back then, I would of quit much sooner. Good luck (and I hope you are young). Shift workers die younger than other workers.

      1. Small world. I worked in Big Creek and also on a factory trawler, though not for more than a few months at a time. 18 hour days are killer.
        I hope I’m not rotating for too much longer, but for as long as I am I guess I will have to do what I can to mitigate the harm. Sometimes it helps to break third shift sleep into two parts. Also helpful: Exercise and movement of all varieties in little bits many times a day most days. Good food. Self expression. Affection. Realistic expectations.

  24. The injury point is huge. Many of my patients resolve a lot of nagging injuries by changing their diet (and typically learning how to move better).

  25. Sleeping more than 8 hours: wasn’t there a link to an article here on MDA about many people sleeping much longer hours and getting good benefits from it, as in a famous professional athlete?

  26. Regarding most items on the list in the article, I’d say STAY AWAY FROM SUGAR!

    Sugar is one of the most addictive substances on Earth. I don’t know many people who have been able to complete kick sugar and stay off it completely for life.

  27. Re: you can run a marathon but can’t do a pull-up: I am student at the University of Connecticut studying Exercise Science and yesterday in my Fundamentals of Resistance Training lecture,taught by leading strength and conditioning expert Dr William Kramer, he kept hammering home how long distance runners need to lift heavy for the joint and skeletal adaptations. Figured this would be worth passing along to the community.

  28. If you have IBS you should be tested for Coeliac Disease before you go Primal. To get a true diagnosis you need to be eating the grains containing gluten though otherwise you will get a false negative. Doctors in the UK are becoming more clued up now and realize that most people don’t get as sick as the text books say. Some of the vague symptoms I had before diagnosis were feeling tired all the time, terrible heartburn and indigestion, being very irritable, not much colour in my face, the occasional uncontrollable bowel movements. I wasn’t anaemic, probably because I was taking multivitamins. If you are a diagnosed Coeliac, then you need to be aware you are at higher risk from Type 1 diabetes, autoimmune thyroid and osteoporosis and should have the appropriate blood tests each year. If you are over 50 then you should get at least one bone scan to assess the state of your bones. I’ve been a Coeliac for over 20 years, and going primal two years ago has been very beneficial.

    1. Easier solution – get tested for heavy metal toxicity – which will produce all of the same conditions and is the underlying cause for most human existence exacerbation of life. Primal Living combats the effect of this and most non terminal diseases of today’s health situations. However, the effort has to be primary to be effective.

  29. I noticed the mention of dark circles under the eyes, and that’s right on the money! My friend Andy had really dark circles all the time I knew him…till he went grain free. Amazing…

  30. Hi Mark

    Any ideas on sensitivities to chemicals. Chemicals are not really the best for anyone but some are more tolerant than others to them. Any ideas as to why this could be the case. Chemicals is a broad term so I will narrow it down a little and specify them as organic solvents such as petrol, paint, perfumes etc. I notice when I’m exposed to something I often feel really fatigued and nausea’s the following day. If its a particularly strong dose of something I may get headaches or light headed. Usually though the symptoms I get are delayed and usually the next day. Often I will feel the symptoms and have to think back to the day before to remember that, “oh yeah I filled up with petrol, or I walked into that room that had been freshly painted” for example.

    1. I’d like to know about this too. I have a pretty strong chemical sensitivity – can’t breathe near someone wearing too much perfume, have to buy fragrance free soaps and make my own hairspray, deodorant, etc. because even the “unscented” ones still smell. I’m having a terrible time right now because I had to buy a new washer and dryer last weekend and they are still off-gassing. Most people don’t understand what this is like, but it can be quite depressing and even debilitating at times.

      1. I fully understand. I’m having the same trouble with a new computer. Its difficult for others to understand. Shoots 15 years ago doing my chemistry degree I didn’t understand either. I had a flatmate who said she was sensitive to the chemical products we were using to clean the flat. We all thought she was exaggerating. I understand now it affects me. No one can really understand it unless they experience it themselves. I just hope they accept it. Some do some don’t.

  31. This article made me consider a few things I hadn’t thought about before – both of my parents struggle with thyroid issues and it is something I should keep in mind!

  32. I think quality of sleep is more important than amount of sleep. I’m 57 years old and with job and family obligations I get 4 to 5 hours of sleep a night and feel phenomenal!! I have no symptoms that Mark writes about. I follow a low carb/paleo diet and do intermediate daily fasting which gives me more than enough energy for HIT type of exerciseing two to three times a week. Perhaps all this will eventually “catch up with me” put when I feel better than i did in my 40s, or 30s I’m maintaining quality over quantity.

  33. Watch out for getting a lack of pump in the gym when you used to get one frequently. I also see digestion issues come up and simply keeping track of your heart rate and blood pressure each morning can show you if things are outbid balance.
    Take your heart rate first thing each morning to find your true resting heart rate. If you are getting a consistent number then some days are finding it’s 3 beats or so higher is a good sign something is off due to over training or improper recovery

    1. there is a lot of science done that HRV rather than HR is a better measurement of over training

  34. MCS can be related to adrenal fatigue. Low cortisol can lead to increased startle response and heightened sense of smell. Maybe this great post (which touches on adrenal fatigue) can lead to another on how to deal with chemical sensitivities. Not much research done on this topic in general.

    1. Ok, I feel really intrigued. Can you elaborate more? Do you have links I could read or anything to help me understand it better?

      You absolutely can’t talk about increased startle response and heightened sense of smell without describing me so closely I’m actually stunned.

  35. hi Mark 🙂 i do a mixture of strength and endurance training using functional training and weight training.. I carry on functional training using small nominal weights. Is that fine? I can do upto 55 repetitions of pull ups. Also i have an apple as my pre workout diet but sometimes i have this gassy and acidic burping feeling which makes me uneasy.. It happens like 6 out of 10 times. My another problem is that i feel too fatigue after a rigorous functional workout as i do big five 55. Do u suggest me to take a day’s break after the training and continue working out after a day? 🙂 Thanx a lot Mark

  36. I don’t think you mentioned recurring migraines & constant low-grade joint pain, the two most unpleasant symptoms of my undiagnosed celiac disease that vanished the soonest after going gluten-free!

  37. I’m as healthy as I think I am… sick. Either that or high standards!

  38. Great article Mark,
    I often come across this working in the fitness industry. Sometimes pushing too hard will leave us even more unhealthy than we were to begin with and often our appearance is not the best indicator of our health. The low sex drive is a dead give away, when I talk with a young male especially and they have minimal sex drive I know something is up! One guy I got to start eating only a slight bit more as he was trying to get so lean and his sex drive returned.

    I would add that no drive for anything ‘primal’ can be a good indication of not being as healthy as you could be. Hunger, adventure, fun, relationships etc all of these drives can become limited when we are not in optimal health.

  39. I would add constipation and seasonal allergies to the lot.

    After I went dairy free, my chronic constipation cleared up and after I went grain free, my seasonal allergies are so much better, I can’t believe we are in september and it saves me so many dollars in paper tissues it’s ridiculous! Just yesterday, I did a really big clean up with lots of dust and I only sneezed once!

  40. Dragging yourself through every day and being unable to drag yourself out of bed may also be signs of a sleep disorder like idiopathic hypersomnia. Its not super well known, but its out there, and excessive sleepiness, even when you’re getting plenty of sleep and are sleeping otherwise well, is one of the biggest symptoms.

  41. When I improved my diet my Acne Rosacea went away. Completely. No cure ha!

  42. So I was having significant trouble getting out of bed in the morning. And exhausted all day. I was taking Lexapro for anxiety and found it actually made me depressed (when I had no depression before) and more anxious about certain things. My MD said “you’re depressed!” and doubled my dosage. I quit it instead, and feel tons better. I want to get out of bed again! I now take a gaba supplement to deal with the occasional anxiety, with no side effects.

  43. If I may be so bold and add #12.

    Obsessing over the notion of Absolute Optimal health. (AOH)

    Which is often indicated by reading thru the hundreds of similar articles posted everyday all over the the ‘Net. A nagging worry that somewhere there’s a secret just being revealed that will put us, me, over that imaginary line of Absolute Optimal Health. A sleep disturbing tendency to micro-analyze every rep, every ounce of food, every negative thought, etc – that keeps us from the Nirvana of AOH. A tendency to keep reworking my schedule, my workouts, my intake of food, seeking new food and supplements, carelessly spending money them, or time and brain effort on the research being poured out onto the ‘Net on a hourly basis.

    Like a religious zealot, or pilgrim on a quest to reach absolute enlightenment.

    AOH is unattainable…its the carrot that dangles just out of reach…put there by our own self doubt and the tendency as a species to seek messiahs.

  44. I don’t post often, but this is the timely type of topicality that I am compelled to salute. I’m Primal but admittedly, only in spirit. It’s just too easy to slide (back) into the convenient and sometimes comfortable realm of processed foods. That, in conjunction with summertime libations and a social smoking “preference” (as opposed to “habit”), probably qualifies me as a typical subject of this post. My semi-robust health is something that I attribute to the Paleo/Primal leanings of the last couple of years as well as a normally uninterrupted exercise regimen. Still, while it may hold the fort for a while, it adds up to treading water in place. After all, compared to many, I’m fairly confident that I am outpacing them health wise but compared to how I used to feel, I am not placing so well.

    “It’s only bad to let yourself go if you can’t get back.” – Mick Jagger

  45. Great list. You are so right about cardiovascular training. I ignored it for years and did not realize how unfit I had become. So now some regular sprints and the occasional jog are an essential part of my routine.

  46. Joint pain and injuries- don’t forget Lyme disease. I didn’t take this one seriously and kept trying to heal my recurrent pain myself with acupuncture and suffered for a year before getting tested. Being primal can improve your health but you still have to know when to go to the doctor ( which I hate). After a few courses of treatment and and a month of iv antibiotics I have learned my lesson….

  47. What kind of doctor should I check my symptoms with to see if I have Leaky Gut? Homeopathic? Acupuncture? Any suggestions?? Thanks 🙂

  48. I am late riser. I never can get up at early morning. Is it the sign of that I am not much healthy ?

  49. This post is/was a picture of me: I had been Paleo for 4 years, have worked out consistently my entire adult life, so I look fit, but I felt awful. The first time I met Mark at PrimalCon, he wanted to know if I felt great…..the truth was, no, I did not feel great. I was often exhausted, and felt worn out. Fast forward a few years, last fall my signs and symptoms just got worse. Here I was, eating very clean, working out, strength training, doing my HIIT one to two times a week,…I LOOKED the picture of health, but constantly exhausted, holding on to 5-7lbs that I could not get off, hair was falling out, no libido, anxiety, unable to stay asleep all night, gut dysbiosis, etc. I went to a doctor, she ran the standard labs……I was “fine.” Just getting old, and going through menopause……oh, and I had nodules on my thyroid which she wanted to “watch” but other then that, healthy as a horse, according to her “labs.”
    Thankfully, I was not satisfied with her diagnosis. I found Reed Davis and Functional Diagnostic Nutrition and started to investigate my issues. Through FDN, I’ve discovered that I had Stage 3 Adrenal Dysfunction. This means that my stress response is in the toilet. My adrenals are hardly shooting out any cortisol. My melatonin was pitifully low…..hence not being able to stay asleep. My sex hormones were way off…..my testosterone was nil. BTW, testosterone is responsible for libido in both men AND women. Next, I tested for gut function. My mucosal lining was gone……this points to leaky gut. The investigation continued…….tested for food sensitivities. I am highly reactive to parsley (cilantro in parsley family, which I eat a ton of), pistachios (cashews in this family), broccoli (ate a ton of this), banana’s, leeks, lemons, dairy, grapes,…..basically things one would NEVER in a million years suspect. The investigation continued: test for pathogens in my gut. Result: I have an H. Pylori overgrowth, as well as a little yeast in there and an undergrowth of E.Coli (a natural flora in the gut).
    I am now on a healing protocol. Luckily, the body will heal itself if given the right tools and the opportunity. I would encourage anyone who is not feeling GREAT, to investigate. Don’t listen to the standard medical community whose response is to give you a pill that will just help give you symptom relief. You want to find the root cause of why you feel like caca. If you don’t find the root cause, the dysfunction will continue and get worse over time……this is why our nation is in the state of health that it is in. FDN is all over the world and is a great resource for helping you to investigate your health issues. To hear podcasts by Reed Davis, you can go to Underground Wellness with Sean Croxten, and search: Reed Davis, if you want an idea of how FDN works.

    1. +1

      Candida albicans overgrowth due to a lifetime of prescribed antibiotics, including during/after surgery, can also cause extreme fatigue symptoms.

      So can MTHFR. It’s criminal that the medical industry doesn’t do genetic screening on all of us. Thankfully it only costs $99 and we can do it ourselves.

  50. Yeh, I do every thing healthy and feel like the healthiest unhealthy person there is. Had many of the 11 things listed. Found I had gut issues, gave up gluten, then found I had Hashimoto’s, and have tried to treat that and not really any better…then found out my cortisol is high at night, low in morning….all pointing to adrenal fatigue…

    So many things to figure out and all of this can take so many months to heal. Not many Doctors know about it. Hopefully the HPA dysfunction will keep getting more and more recognized as an illness.

  51. This definitely shocked me! I’ve been eating healthy and is a marathon runner. But I can relate to some of those symptoms mentioned, especially dark circles! I’ve always been struggling with that. What i know about dark circles is that it is an indication of the health of your liver. Hence, you’ll get darker circles if you sleep late or after 10pm. What do you think?

  52. This shocked me! I eat healthy and is a marathon runner. Nonetheless, i can relate to some of the symptoms mentioned, especially dark circles! What i know about dark circles is that it tells us the health of our liver. Hence, we get dark circles if we sleep late(after 10pm). What do you think?

  53. I am guilty of not being able to do a pullup. I could benefit from more strength training. But dark circles? Isn’t that sometimes just genetic?

  54. Regarding dark circles under your eyes: what has helped mine a lot- they have disappeared completely, I have to admit- was some real Vitamin A:

    I seem to belong to the bunch of people (40%) that cannot convert the plant form of Vitamin A (Betacarotine) into the Retinol form of Vitamin A. Vit A is a prohormone and one of the signs of defiency are those dark circles.

    When start eating liver and pastured (!) butter they’ve receded and after a few weeks those circles, thar had accompanied me for a life, disappeared at all. Wow!