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Supporting the different phases of stress
Modern chronic stress, most often psychological and with no return to balance, lastingly disrupts your patients' adrenal axis and autonomic nervous system, to the point of sustaining digestive, hormonal, immune or metabolic disorders for which it is the deep cause. This training gives you a precise physiological and…
15 lessons · Lifetime access · Online
These trainings are delivered in French. This page is translated for your convenience; the course videos and materials remain in French.
Overview
Modern chronic stress, most often psychological and with no return to balance, lastingly disrupts your patients' adrenal axis and autonomic nervous system, to the point of sustaining digestive, hormonal, immune or metabolic disorders for which it is the deep cause. This training gives you a precise physiological and pathophysiological reading of the different phases of stress, so you can identify where the person you support stands and offer genuinely tailored support, from biochemical reasoning to hands-on protocols.
What you will learn
- Distinguish ancestral stress from modern stress and understand why our physiology remains ill-suited to a chronic stress of a psychological nature
- Master the physiology of stress, the balance between the sympathetic and parasympathetic nervous systems, the hypothalamic-pituitary-adrenal axis, steroidogenesis, the role of pregnenolone, DHEA, cortisol and catecholamines
- Identify the alarm, resistance and exhaustion phases (burn-in, burn-out, adrenal exhaustion) through clinical assessment, functional and validated questionnaires, and functional biology (salivary cortisol cycle, pregnenolone, DHEA, urinary 17-hydroxysteroids)
- Build adrenal support tailored to each phase, optimising steroidogenesis and magnesium status, then using adaptogenic plants, liquorice, blackcurrant, mycotherapy, organotherapy or allopathy depending on the context
- Deploy a systemic approach linking stress to sexual, thyroid, digestive, immuno-inflammatory, neuropsychic and metabolic dysfunctions
- Integrate lifestyle levers, head, plate and movement, with the chronobiology of nutrition, the optimisation of proteins and lipids, the management of carbohydrates and salt, and physical activity adjusted to the phase of stress
On the programme
- Introduction: ancestral versus modern stress, the three primary responses and the challenges of chronic stress
- Physiology of stress: organisation of the nervous system, hypothalamic-pituitary axis, signalling pathways, catecholamine synthesis, steroidogenesis, pregnenolone, DHEA and cortisol
- Pathophysiology: alarm, resistance and exhaustion phases, cortisol-to-DHEA ratio, cortico-resistance, burn-in and burn-out
- Clinical and biological identification: functional signs, questionnaires (including PSS, MBI, CBI), functional biological assessments and markers to measure
- Management of the phases of stress at the adrenal level: optimising steroidogenesis, magnesium, adaptogenic plants, adrenal support, organotherapy and bio-identical hormones
- Systemic management: sex hormones, thyroid, gut ecosystem, immuno-inflammatory function, neurotransmitters, sleep and metabolic function
- Integrative management head, plate, movement: dietary model, proteins, lipids, carbohydrates, salt, coffee, physical activity and mental management tools
- Mini clinical cases and an expert clinical case with Dr Stéphane Résimont, followed by the commented correction of the assessment quiz
Who it is for
This training is for healthcare professionals oriented towards micronutrition and functional medicine who support patients in chronic stress, pre-burnout or exhaustion, and who wish to anchor their protocols in a rigorous physiological understanding.
At the end of the training
You will be able to place a patient in their phase of stress from the clinical interview, the questionnaires and functional biology, then adapt your support accordingly. You will be able to build personalised and justified protocols, combining micronutrition, phytotherapy, dietary hygiene, physical activity and mental management, while keeping a systemic view of the associated functions. You will thus have concrete tools, usable in consultation, to support the different phases of stress without losing sight of the search for the deepest cause.
Programme
Total video duration: 10 h 35 min
Accompagnement des différentes phases du stress
- WELCOME3 min
- INTRODUCTION25 min
- QUIZ DE PRE-FORMATION
- PHYSIOLOGIE1 h 25 min
- PHYSIOPATHOLOGIE29 min
- OUTILS EVALUATION STRESS1 h 13 min
- PRISE EN CHARGE SURRENALES50 min
- PRISE EN CHARGE SYSTEMIQUE1 h 27 min
- PRISE EN CHARGE INTEGRATIVE ASSIETTE1 h 31 min
- PRISE EN CHARGE INTEGRATIVE BASKET22 min
- PRISE EN CHARGE INTEGRATIVE TETE1 h 04 min
- CAS CLINIQUES MINI25 min
- CAS CLINIQUE EXPERT DR RESIMONT43 min
- QUIZ POST-FORMATION
- QUIZ CORRECTION40 min
Video Audio PDF handout
Frequently asked questions
Why must management differ depending on the phase of stress?
Each phase corresponds to a distinct hormonal profile: in the resistance phase, cortisol is elevated and needs to be modulated downward; in the exhaustion phase, the adrenal glands can no longer synthesize it and a support strategy becomes necessary. Offering the same approach in both cases can worsen the situation. Prior clinical and biological assessment is therefore essential.
Why should the adrenal glands be treated before starting thyroid hormone treatment?
In adrenal exhaustion, thyroid hormones will be poorly tolerated if the adrenal glands are not supported first, and they can even worsen pre-existing adrenal fatigue. Dr Anne Lucas, PharmD, recommends waiting at least two to three weeks of adrenal recovery support before introducing thyroid substitution. Later, as adrenal fatigue improves, thyroid hormone requirements can decrease and the dosage will need to be adjusted downward.
Why is adrenal fatigue syndrome not recognized in conventional medicine while burnout is?
Dr Anne Lucas, PharmD, points out a paradox: the pathophysiological mechanisms of adrenal fatigue syndrome are exactly the same as those of burnout, yet the former is not recognized in allopathic medicine. Conventional management of burnout, moreover, does not match the actual pathophysiological mechanisms, which is likewise problematic.
Why does chronic stress so often cause digestive disorders and reduced immunity?
In chronic stress, the sympathetic nervous system is permanently overactivated at the expense of the parasympathetic nervous system, which digestion and immune regulation depend on. Noradrenaline and adrenaline inhibit intestinal peristalsis and deprioritize the immune response in favor of muscular action. Rebalancing parasympathetic tone, particularly via the vagus nerve, is therefore a central goal of management.
Why optimize total cholesterol before supplementing the adrenal glands?
Cholesterol is the precursor of all steroid hormones. A level below 1.5 g/L compromises the entry of cholesterol into the mitochondria via the StAR protein and thus the whole of steroidogenesis. Dr Anne Lucas, PharmD, recommends reintroducing quality fats (eggs, butter, offal, oily fish) before any targeted supplementation.
How does the nutritional chronobiology model support neurotransmitter synthesis under stress?
The model splits the day into two periods: protein and fat in the morning to promote the passage of tyrosine and phenylalanine (precursors of dopamine and noradrenaline), and a carbohydrate snack around 4-6 pm to allow tryptophan to pass through and stimulate the synthesis of serotonin and then melatonin. The key is to avoid any insulin spike in the morning, since insulin blocks tyrosine's passage across the blood-brain barrier. This model also supports thyroid and adrenal activity by delivering nutrients at the right time.
Why is it essential to rule out an organic adrenal disorder before starting micronutrition support?
Functional hypercortisolism linked to chronic stress must not be confused with Cushing's syndrome, nor adrenal exhaustion with Addison's disease. These organic conditions require conventional endocrinology management. Confirming their absence allows work to proceed confidently within the scope of micronutrition, as a complement to allopathic medicine rather than a substitute for it.
Why should the same exercise recommendations not be given to every patient with chronic stress?
Dr Anne Lucas, PharmD, stresses two cumulative criteria: the phase of stress (alarm, resistance, exhaustion) and the patient's baseline level of physical activity. An elite athlete in the resistance phase will not receive the same advice as a sedentary person in the same phase. Fine-tuning these two parameters is essential to avoid worsening the patient's condition.
What is the level of this training on stress?
Dr Anne Lucas, PharmD, explains that she spent several months creating this training, with a level of rigor higher than her previous courses. She aims for an approach that is both theoretical and highly practical, covering physiology, pathophysiology, clinical/biological evidence and management.
Which micronutritional cofactors are essential for the synthesis of noradrenaline and adrenaline?
Noradrenaline is synthesized from tyrosine through several enzymatic steps requiring BH4, vitamin B6, copper, vitamin C and iron. The conversion of noradrenaline into adrenaline involves a methyltransferase (PNMT) that uses SAMe as a methyl donor. A good methylation status is therefore essential, and in chronic stress the accumulation of homocysteine linked to adrenaline overproduction should be monitored.
What is the difference between chrononutrition and nutritional chronobiology?
Chrononutrition is a calorie-restricted weight-loss method created by Dr Delabos, inspired by the concepts of nutritional chronobiology. Nutritional chronobiology, developed notably by Professor Jean-Robert Rapin (Dijon Faculty), is a functional approach aimed at delivering foods at the right time to support biorhythms and neurotransmitter synthesis. Dr Anne Lucas, PharmD, teaches the latter, which is not a diet but a model for structuring meals.
What physical activity should be suggested in the alarm phase?
In the alarm phase, cortisol generates chronic hyperglycemia whose glucose is not being used up. Dr Anne Lucas, PharmD, recommends high-intensity activities such as HIIT or CrossFit to use up this energy substrate and prevent it from being stored as triglycerides. She notes, however, the importance of listening to the body's signals: difficult recovery over several days signals that the intensity is too high.
What are the three primal stress responses and how are they expressed?
The three primary responses are fight (actively defending one's territory), flight (fleeing to escape danger) and freeze (inhibition or paralysis in the face of a threat perceived as insurmountable). In the wild, each is followed by a rapid return to balance once the danger has passed.
Which mechanisms explain functional hypothyroidism in the context of chronic stress?
In the resistance phase (hypercortisolism), excess cortisol shifts T4 conversion toward reverse T3, which antagonizes active T3. In the exhaustion phase (hypocortisolism), the compensatory rise in CRH stimulates somatostatin, which inhibits TSH and creates central hypothyroidism. These two distinct mechanisms call for a full workup: ultrasensitive TSH, free T4, free T3, reverse T3, ideally supplemented by a 24-hour urinary thyroid hormone assay.
What is iron's role in steroidogenesis, and when should it be supplemented?
The cytochrome P450 family enzymes involved in steroidogenesis (desmolase, 17-alpha-hydroxylase, 21-hydroxylase, etc.) are all iron-dependent. An iron deficiency therefore slows the production of all steroid hormones. Dr Anne Lucas, PharmD, insists on never supplementing without a prior iron panel, and recommends iron bisglycinate, possibly combined with lactoferrin.
How many modules does the training include and how are they organized?
The training includes 10 modules: an introduction, physiology, pathophysiology, evidence (clinical and biological), adrenal management (module 5), systemic management (module 6), integrative mind, diet and exercise management (module 7), two mini clinical cases, an expert clinical case module with Dr Stéphane Résimont, and the post-training quiz with its answer key (module 10).
What clinical signs suggest a pregnenolone or DHEA deficiency?
Pregnenolone deficiency presents as chronic fatigue, orthostatic dizziness, thin dry skin, cycle disorders, decreased libido and neurocognitive signs such as brain fog and memory problems. DHEA deficiency presents as loss of muscle mass, dry skin, mood disorders, reduced stress resilience and sleep disturbances. These signs are nonspecific and must be cross-checked with the biological workup.
What is magnesium's central role in the pathophysiology of stress?
Magnesium is the most heavily consumed micronutrient from the alarm phase onward, due to the strong synthesis of adrenaline. This overconsumption worsens in the resistance phase as cortisol rises. Dr Anne Lucas, PharmD, stresses a daily magnesium intake, not a one-off course but a continuous supply, with particular attention to the form and dosage used.
How should one choose between rhodiola and ashwagandha as adaptogenic herbs in the burn-in phase?
Both plants modulate cortisol secretion downward and improve adaptation to stress. The main distinction according to Dr Anne Lucas, PharmD: in the presence of associated hypothyroidism, ashwagandha (KSM-66, 300-600 mg/day standardized to 5% withanolides) is preferable as it normalizes TSH. Rhodiola (standardized to 3-5% rosavins and 1-2% salidrosides) is indicated in the absence of hypothyroidism; it also reduces cortisol resistance.
Which physiological mechanisms are activated during the stress response?
Perceiving stress triggers a hormonal and nervous cascade: stimulation of the hypothalamic-pituitary-adrenal axis (cortisol secretion) and activation of the sympathetic nervous system (noradrenaline and adrenaline secretion). This leads to an increase in heart rate, alertness and muscle tension, with rapid mobilization of glucose to enable fight or flight.
How can a phase of functional hypercortisolism be clinically distinguished from cortisol deficiency?
Functional hypercortisolism (resistance phase) is recognized by agitation, a permanent state of alertness, abdominal weight gain, fragile skin, a puffy face and buffalo neck. Conversely, cortisol deficiency (exhaustion phase) presents as intense morning fatigue, orthostatic hypotension, sweet and salty cravings, marked brain fog and immune-inflammatory hyperreactivity. These two pictures can succeed one another in the same patient.
How should physical activity be adjusted in the resistance phase for an already active patient?
The goal is not to stop the activity, since it is often the patient's release valve. Dr Anne Lucas, PharmD, advises reducing frequency (e.g. from 5 sessions to 3) and intensity (lighter loads, fewer HIIT rounds), while adding 2 yoga or Pilates sessions per week to stimulate the parasympathetic nervous system. Bikram yoga should be avoided as the excessive heat raises cortisol.
How does chronic stress disrupt the intestinal ecosystem, and through which mechanisms?
Chronic stress inhibits the parasympathetic nervous system and thus the vagus nerve, which reduces intestinal motility, decreases digestive juice secretion (hypochlorhydria, enzyme insufficiency) and promotes dysbiosis and intestinal hyperpermeability. In the exhaustion phase, the rise in somatostatin also inhibits cholecystokinin (CCK), compromising bile secretion and lipid digestion, with a risk of deficiency in the fat-soluble vitamins A, D and E. These dysfunctions create fertile ground for SIBO, autoimmune diseases and chronic inflammation.
What is the difference between burnout and adrenal fatigue syndrome?
Burnout is recognized by the WHO in a professional context, but the underlying pathophysiology (exhaustion of the hypothalamic-pituitary-adrenal axis) can occur outside a work setting, for example in caregivers or overwhelmed parents. The term "adrenal fatigue syndrome" is more precise because it reflects the biological reality regardless of the source of chronic stress.
What protein intake should be recommended to a patient with chronic stress, and how should it be distributed?
The target is 1.5 to 2.2 g of protein per kg of healthy body weight per day (based on Gabriel Lyon's recommendations), with a minimum of 30 g per main meal, going up to 50 g. In case of overweight, the calculation is based on estimated ideal body weight. Priority sources are animal proteins (eggs, meat, oily fish, offal), since their essential amino acid profile and high biological value activate muscle protein synthesis (MPS) without adding carbohydrates at breakfast.
Why is it necessary to increase protein intake in a patient with chronic stress?
Excess cortisol activates muscle proteolysis to fuel hepatic gluconeogenesis. To offset this catabolic effect of functional hypercortisolism, Dr Anne Lucas, PharmD, recommends increasing protein intake up to 2 g per kg of body weight. This recommendation is directly justified by cortisol physiology rather than by an arbitrary rule.
Should the quiz be done before starting the videos?
Yes, Dr Anne Lucas, PharmD, recommends starting with the full 40-MCQ quiz (rather than the 20-question mini-quiz) in order to assess one's baseline knowledge before going through the modules. A second post-training quiz will then measure progress.
Who is the guest expert for the clinical case module?Full answer inside the training →
Why is modern psychological stress more harmful than ancestral stress?Full answer inside the training →
Why can collagen not replace complete protein intake?Full answer inside the training →
What is "cortisol steal", and how is it managed?Full answer inside the training →
What should be recommended to a burnout patient who cannot get out of bed?Full answer inside the training →
What is cortisol resistance, and why can it lead to a diagnostic error?Full answer inside the training →
What is the Queen functional questionnaire, and how is it used in consultation?Full answer inside the training →
What is the difference in immune impact between functional hypercortisolism and adrenal exhaustion?Full answer inside the training →
What is the role of the StAR protein in steroidogenesis, and why is it a rate-limiting step?Full answer inside the training →
What functions does pregnenolone have beyond its role as a hormone precursor?Full answer inside the training →
Which organ dysfunctions are induced by chronic stress?Full answer inside the training →
How should carbohydrate intake be adjusted based on ApoE polymorphism and metabolic status?Full answer inside the training →
How should the cortisol/DHEA ratio be interpreted, and why is it particularly important in older patients?Full answer inside the training →
What is the difference between the PSS, the MBI and the CBI for assessing exhaustion in a patient?Full answer inside the training →
How can learners share their quiz results and get feedback from Dr Anne Lucas, PharmD?Full answer inside the training →
How can the link between physical activity and mental health be explained to patients?Full answer inside the training →
What is the 3-tier management strategy for adrenal burnout?Full answer inside the training →
Why is nutritional intervention on membrane phospholipid composition central to managing inflammation?Full answer inside the training →
How does chronic stress disrupt the synthesis of the neurotransmitters dopamine and serotonin?Full answer inside the training →
What practical tool does Dr Anne Lucas, PharmD, recommend for progressively adjusting exercise in burnout?Full answer inside the training →
Why does Dr Anne Lucas, PharmD, prefer the CBI over the MBI in her daily practice?Full answer inside the training →
Why can chronic stress produce symptoms resembling depression?Full answer inside the training →
What differences in salt recommendations exist between the burning phase and the burnout phase?Full answer inside the training →
Why is DHEA described as an anti-catabolic hormone, and what is its relationship with cortisol?Full answer inside the training →
When should 7-keto-DHEA be used instead of standard DHEA?Full answer inside the training →
Is stress always harmful to the body?Full answer inside the training →
What is the impact of stress on digestion, and how should this be explained to a patient?Full answer inside the training →
Why is magnesium essential from the baseline phase onward, and at what doses?Full answer inside the training →
What is the golden rule to communicate to hyperactive patients still in the alarm phase?Full answer inside the training →
Should coffee be discouraged for all stressed patients?Full answer inside the training →
What overall approach does this training propose for managing stress?Full answer inside the training →
What is the link between the FUT2 gene and managing intestinal mucus in a stressed patient?Full answer inside the training →
Which forms should be measured for pregnenolone and DHEA in preventive investigative biology, and what precautions should be taken before the blood draw?Full answer inside the training →
How does individual chronobiology influence the interpretation of a cortisol test?Full answer inside the training →
Why is the salivary cortisol cycle the reference workup in functional medicine for assessing chronic stress?Full answer inside the training →
Why should time-restricted eating skip the last meal rather than breakfast?Full answer inside the training →
Why do official burnout guidelines leave room for micronutrition?Full answer inside the training →
How should management of thyroid dysfunction be prioritized amid multiple systemic dysfunctions?Full answer inside the training →
What does cordyceps contribute to the management of adrenal burnout?Full answer inside the training →
What is cortisol resistance, and how is it distinguished from cortisol insufficiency?Full answer inside the training →
What is the value of licorice in managing the cortisol pool?Full answer inside the training →
What is the mechanism by which chronically elevated cortisol leads to insulin resistance?Full answer inside the training →
How should one choose between whey isolate and plant protein to stimulate MPS in the context of chronic stress?Full answer inside the training →
What is the value of 24-hour urinary adrenal hormone testing relative to the salivary cycle?Full answer inside the training →
In which cases is it relevant to add an androgen profile or a thyroid panel to the adrenal workup?Full answer inside the training →
How are the two stress signaling pathways interdependent?Full answer inside the training →
Why is classic sodium restriction unsuitable as the sole measure against hypertension?Full answer inside the training →
What are the priority active ingredients for supporting regulatory T lymphocytes and modulating the autoimmune response in adrenal exhaustion?Full answer inside the training →