Book Review – Are You Tired and Wired? by Marcelle Pick, OB/GYN NP

are you tired and wiredMarcelle Pick is a nurse practitioner and co-founder of a medical clinic called Women to Women in Yarmouth, Maine. This pioneering practice provides functional medicine to prevent and treat a variety of health disorders. In her practice and in her book Are You Tired and Wired? Pick weaves the physical aspects of health disorders together with the emotional ties that often accompany them.

The primary focus of the book is a comprehensive review of “adrenal dysfunction.” However, Pick doesn’t just define the problem medically. Because she holds a bachelor’s degree in psychology, she is also able to outline a program that readers can use for emotional self-help or to seek out a practitioner to coach them in solving their problems.

We are all familiar with the adrenal “fight or flight” response. In the presence of perceived danger, the adrenal glands pump out extra hormones that enable us to deal with the challenge. However, Pick contends that we have reached a point in human evolution where, for some of us, the stress of challenges does not stop. This unremitting outpouring of adrenal hormones has consequences to both our physical and emotional health. Researchers are now attempting to measure the consequences of these changes, and gauge how these measurements can predict our long-term health and even our lifespan, referred to as “allostatic load” or “allostatic overload.”

Types of Adrenal Dysfunction

Pick identifies three dysfunctional types associated with adrenal dysfunction:

The Racehorse

The Racehorse is in a constant state of stress and may even be an “adrenaline junkie,” feeling speedy all day long. The constant high cortisol levels lead to weight gain and obesity, even without feeling hungry or eating very much. The high cortisol also tends to wreak havoc with sex hormones, leading to PMS or perimenopausal symptoms and a lack of sexual interest. The high adrenaline may also cause problems with digestion, blood pressure, anxiety and tension. The Racehorse may be emotionally programmed that she is not good enough and therefore refuses to let up even while feeling exhausted.

The Workhorse

The Workhorse has trouble getting up in the morning and is fueled throughout the day by copious amounts of caffeine and carbohydrates. By nighttime, the adrenals are so revved up and producing stress hormones that sleep is nearly impossible. But, even revved up, adrenal hormone production is already failing. The Workhorse puts herself in service to others ahead of taking the time to look after herself.

The Flatliner

The Flatliner is totally exhausted and has trouble completing even daily chores. She struggles with low blood pressure and low blood sugar. She craves salt and sugar. She is worn out, and doesn’t even want to leave the house. Any small issue can be an unbearable stress. She tends to have problems with weak thyroid function, autoimmune diseases, and insulin resistance.


Marcelle Pick presents a detailed program designed for each of these types of adrenal dysfunction. She begins with diet and even addresses the timing of meals.  She discusses suggested nutrients and herbal support. She identifies toxin loads and ways to avoid them, including resources for alternative cleaning and healthcare products.

However, perhaps more importantly, a good third of Are You Tired and Wired? is dedicated to helping people reprogram the emotional overload they carry. Pick explains that we carry many events from our childhood, and throughout our lifetime, that keep us on stress alert. She describes a patient who had a father who became loud and boisterous whenever he became drunk, sometimes hitting her while in that condition. Now, as an adult, she is married to a very kind and loving man, who sometimes raises his voice and become boisterous. This emotional trigger causes her body to react by going into high alert, even though there is no longer anything to fear.

Are You Tired and Wired? offers many techniques to help break this type of emotional programming. Pick also points out that we have a choice about how we perceive and react to events. A particular set of circumstances can become a very stressful situation or, with a change in our interpretation, we can learn to have no reaction at all.

Pick emphasizes the importance of this awareness because high cortisol levels produced by stress can have a profound impact on the quality of life, even shortening our lives. In simple terms, she educates us about how critical the adrenals are to our daily lives, such as:

  • At a cellular level, the enzyme telomerase protects cells that are dividing from becoming shorter and from aging. With allostatic overload, the immune cells that produce telomerase become weakened and therefore do not produce the enzyme as well.
  • With adrenal dysfunction, thyroid and growth hormone (both of which affect our metabolism, mood, and energy) are also impaired.
  • The adrenals take up the slack of declining ovarian function during perimenopause. When adrenals function is inadequate, menopausal symptoms become more severe.
  • When cortisol is high, aldosterone production is impaired, leading to low blood pressure, fatigue, muscle weakness, and a craving for salt.

Marcelle Pick believes that because the medical profession has been taught only to diagnose the extremes of too much or too little adrenal function rather than recognize it as a range of dysfunction, many people struggle with the kinds of symptoms described here. Are You Tired and Wired? offers clear explanations for typical causes of the variety of symptoms presented by adrenal dysfunction. Reading this book and absorbing some of its valuable insight may be an important first step for those who feel “tired and wired” all the time.

  • Pick M. Are You Tired and Wired? Your Proven 30-Day Program for Overcoming Adrenal Fatigue and Feeling Fantastic. 2nd Ed. Carlsbad, CA: Hay House; 2012.
Written by Carol Petersen, RPh, CNP – Women’s International Pharmacy
Edited by Michelle Violi, PharmD – Women’s International Pharmacy
© Women’s International Pharmacy
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