Adrenal Health

Do you ever feel frazzled or stressed out? Have you been dealing with allergies or asthma? How about mood swings? Do you feel fatigued, experience headaches, suffer from insomnia, or find it hard to lose weight? What about cravings for salty or sugary foods? Believe it or not, the little glands that sit atop your kidneys, called adrenals, may be at the root of all these issues. If you answered yes to any of the above questions, you can be fairly sure your adrenals could use a little extra tender love and care. In fact, up to 80% of the population suffers from a certain level of adrenal fatigue at some time during their life.(1)Even more surprising, up to 90% of all visits to primary care physicians are now due to stress related problems.(2,3)

Adrenals 101

All stressors trigger the same cascade of powerful biochemical events, and it all begins in the two small adrenal glands, which have been rightly bestowed the nickname "stress-regulators." Stressors can come in many shapes and sizes, including over-exercising, poor food choices, environmental chemicals, and a lack of sleep, as well as the "stuff" of day-to-day life. The problem is that our bodies were not designed to deal with the stresses with which we are confronted in today's world. The stress response system we are genetically equipped with is designed to help us flee from the occasional wild animal, but this response is mostly inefficient for the modern kinds of multiple, nagging, and continual pressures many people endure today.(4)

The adrenals produce from 30 to 60 different hormones, which influence nearly every bodily function. When confronted with a stressful situation, the adrenals immediately increase the production of two hormones – first adrenaline (also called epinephrine) and then cortisol. The adrenaline surge alerts the body to imminent danger and prepares it to fight or flee, and is meant to be a short-lived response. This hormone is needed for short blasts of energy, such as when someone is approached by a mugger.(5) After the initial shot of adrenaline, the adrenals pump out cortisol, a hormone that helps subdue adrenaline and provide strength and stamina. This is the hormone that allows one to persevere and conquer adversity,(4) such as with the flu or a job change. This hormone also helps the body metabolize sugar, protein, and fat, as well as influencing mood, immune function, and inflammation.(6)

This fight or flee hormonal response is meant to only be used on rare occasions. When levels of any of these hormones exceed a certain amount for a significant length of time, problems occur. When it is constant, the body starts to break down.(6)

How Fatigued Are Your Adrenals?

If adrenals are continuously overworked, the levels of adrenaline and cortisol can elevate too high, too often, and keep one feeling chronically wired and strained. Whatever the cause of these chronically elevated hormones, this hyper-stressed state can lead to many physical symptoms, including weight gain, depressed moods, pronounced PMS, memory loss, and heart disease.(4,6) Insomnia is common because hormone levels may be high at night, which is when they should be winding down. As this state of adrenal alarm progresses, other systems try to assist and compensate. For example, the thyroid, which controls metabolism, may turn down its hormonal activity in an attempt to reverse the adrenal overdrive. Immune function is compromised due to the extra stress, thus sickness is more frequent. Finally, cortisol's backup hormone, DHEA, often referred to as the body's age-slowing hormone, will become worn down to subnormal levels.(7)

The second stage of adrenal fatigue is when one's supply of stress-fighting hormones has finally run low, but not completely out. For a year or so, at most, hormones will hover in the low-to-normal range, leaving a person tired and stressed, but functional.(7) This is often when individuals start to become reliant on artificial ways of elevating hormone levels, such as excessive exercising, caffeine or alcohol consumption, undereating, or pushing oneself too hard. There is a limit to what the adrenals can endure. Eventually, chronic stress can start to wear out the adrenals and diminish their ability to produce all stress-coping hormones in the final stage. The "I just can't take it anymore" feeling it is a sign that the adrenals are no longer producing enough stress-fighting hormones. When this occurs, one's energy will be low and it will be easy to become overwhelmed by the smallest stressor – like a phone ringing or a child crying.(4,7)

What Causes Adrenal Fatigue?

Adrenal exhaustion, in any stage, is caused by some form of stress, which can be physical, emotional, psychological, environmental, infectious, or any combination.(1) Remember, the adrenals respond to every kind of stress the same, whatever the source. Our society tends to encourage people to become overly busy multitaskers, and discourage rest, relaxation, and time to nourish onesself.(4) The typical American diet is extremely stressful. Ironically, over 70% of us eat junk foods in order to relieve our emotional stress,(4) which ultimately backfires and worsens already-overworked adrenals. Furthermore, if the many nutrients needed to make the adrenals function are not provided through a nutrient-dense diet, the adrenals will not be able to respond correctly or produce the appropriate types and amounts of hormones.(1) Stressful dietary choices include excess sugar, caffeine,(25) and alcohol(7) as well as skipping meals, eating too few calories, and not enough fat.(5)

The adrenals are on constant alert for body irritants. They are easily stressed by foods or substances one is allergic or sensitive to. The adrenals and the hormones they produce, especially cortisol, are the forerunners in dealing with the inflammation associated with allergic reactions. This is the reason it becomes necessary for people with severe allergies (e.g. asthmatics) to use powerful synthetic cortisol steroids like prednisone.(4) Finally, moderate exercise is a stress-fighter, but overexercising strains the adrenals.(25) If exercise leaves you feeling tired instead of invigorated, your adrenals are probably in need of extra support.(4) Be gentle with yourself and exercise at a pace that works best for you. Ultimately, working toward removing the underlying causes of adrenal burnout is one of the first steps to healing.

Feeding Your Adrenals

The adrenals need adequate nutritional support for functioning and to produce their many hormones. The most important dietary foundation is to focus on the choice of simple, natural, clean, whole foods. This includes (preferably organic) brightly-colored vegetables, nuts and seeds, wild cold-water fish, whole grains, legumes, unrefined oils, organic eggs, grass-fed meats, game meats, free-range and chemical-free poultry, and dairy products (preferably fermented and only if they are well-tolerated). Everyone's ideal balance is different. Find what balance of nutrients works best for you.

Blood sugar balance and fat consumption are two primary concerns when considering the adrenals. Cortisol helps keep blood sugar balanced to meet the body's demands for energy. However, when the adrenals are fatigued, cortisol levels drop lower than normal. This makes it more difficult for the body to maintain normal blood sugar levels. As a result, those suffering with adrenal fatigue tend to also have low blood sugar (hypoglycemia) episodes of fogginess and fatigue.(1) The best way to avoid blood sugar instability is to consume a healthy source of protein, like grass-fed beef or eggs, along with a good amount of quality fat and fiber, in each meal.(4)

Quality fats and oils, such as those found in butter, coconut oil, avocadoes, and olive oil, are particularly important for adrenal health.(5,8) Dr. Hanley, author of Tired of Being Tired states, "Eating a low-fat diet is a surefire way to put your adrenals into red alert that your body is in a dangerous famine. It is the way to increase body fat, malnutrition, and risk of heart attacks and chronic disease, and is clearly a major stressor for your body."(5) Cholesterol, found in eggs, butter, whole-fat dairy, and animal products, is actually necessary for all adrenal hormones to be produced.9 It is also the body's repair substance and important for adrenal support.(5)

Why do those with compromised adrenals crave salt? This happens because the adrenals are in charge of keeping body levels of salt in balance.(7) Salt can actually support adrenal recovery because it helps restore functions related to sodium loss within the cells.(1) However, the type of salt is important. Sea salt is the best choice due to a higher mineral content and minimal processing. Foods high in sodium include ocean veggies like kelp and dulse, as well as olives and Swiss chard.(1)

Adrenal-Supportive Nutrients

In addition to a nourishing diet, supplements are usually needed for extra healing support. One or more of the nutrients discussed below can be added on top of a high quality multiple vitamin and mineral supplement.

Vitamin C is necessary for cortisol production. This vitamin is involved in every step of the adrenal cascade and acts as an antioxidant within the adrenal gland itself.(1) Need for this nutrient increases during times of stress, and it is necessary for proper adrenal gland function.(10) A general recommendation is between 1000 to 4000 mg per day.(11) The amount is based on an individual's need, stress level, and bowel tolerance.

B Vitamins have a sedative effect on the nerves, help maintain brain neurotransmitters, and are important for adrenal function. Stress causes B vitamins to be quickly depleted.(4,12) A B complex formula with 25 mg of each B vitamin(4) on top of a multiple is a good place to start. The B vitamins that are most specifically suited for adrenal support include thiamin (B1), which helps to regulate cortisol levels. It can lower cortisol excess in the earlier stages of adrenal fatigue, as well as raise levels that are too low in the later stages.(7) Pantothenic acid (B5) is important for energy production1 and allows the adrenals to make more of their anti-stress hormones.(7) Additionally, pyridoxine (B6) deficiency may alter nerve function.(13) Avoid taking B vitamins close to bedtime, since they can be stimulatory.(4)

Omega-3 fatty acids play an important role in the maintenance of cellular membrane fluidity and insulin responsiveness.(14,15,16,17) This is important when controlling blood sugar balance and encouraging overall body function.(18) First, focus on getting the preformed DHA and EPA fatty acids from fresh, wild cold- water fish, like salmon, sardines, and halibut, then consider adding a fish or cod liver oil supplement.

GABA is an amino acid that works to relax the body by helping deactivate stress hormones. A good starting amount is 100 mg, which can increase to 500 mg if more is needed, especially at bedtime.(7) Licorice is the best known adrenal-supportive herb. It naturally fortifies hormone levels by slowing their breakdown in the liver. This allows adrenal hormones to not be depleted as quickly. It also helps decrease symptoms of low blood sugar, which is often experienced by those with adrenal fatigue.

Licorice products that include glycyrrhizin may increase blood pressure and cause water retention;(19) some people are more sensitive to this effect than others. Furthermore, it usually takes extended use (more than two or three weeks) and large amounts (more than 1 gram of glycyrrhizin - the amount in 10 grams of root) daily for this to result. Moreover, many people who have malfunctioning adrenals have low blood pressure. Licorice supplementation is most appropriate for the later stages of adrenal exhaustion.(7) Consider 10 to 40 mg, 2 hours before cortisol is to drop (such as during the evening).(7)

Panax ginseng is an adaptogenic herb that helps protect against mental and physical fatigue, increase vitality, counter the effects of stress, and support the adrenal glands.(20) The best-researched form of this herb is the standardized herbal extracts that supply approximately five to seven percent ginsenosides, the primary group of active components.(21) People often find 100 to 200 mg per day useful for combating stress and fatigue. When used in the recommended amounts, ginseng is generally safe. This herb is used continuously for two to three weeks, followed by a one to two week "rest" period before resuming.

Theanine is the predominant amino acid in tea. It causes several chemical changes in the brain that can induce relaxation, such as encouraging the release of GABA.(22) It also limits nerve cell activity in those areas of the brain associated with anxiety.(23) Theanine has been shown to increase alpha brain waves, which are considered an index of relaxation.(24) Based on clinical studies, it has been established that theanine is effective in single doses ranging from 50 mg to 200 mg.

Adrenal cell extract/glandulars support, fortify, and restore normal adrenal function, thus accelerating recovery. Glandular therapy refers to the use of animal tissues to try to enhance the function of, or mimic the effect of, the corresponding human tissue. This glandular also provides the nutritional components needed for the adrenals to repair and normalize.(1)

As the saying goes, "don't sweat the small stuff; and, it's all small stuff." Although this is easier to say than actually believe, it does ring true. While you are working on a more relaxed, laid-back attitude, providing the adrenals with extra support will help you respond to stress in a more healthful way and make a less-stressful, symptom-free way of life become a reality.

Side Bar:

Common Symptoms Associated with Adrenal Burnout: (1,4, 25)

Difficulty getting up in the morning Fatigue (not relieved by sleep) Cravings for salt or sweets Increased effort to do everyday tasks Decreased sex drive Decreased ability to handle stress Light-headed/dizzy when standing up quickly Low blood pressure Mild depression Increased PMS Memory problems Experience an afternoon low around 3 or 4 in the afternoon Sensitivity to fumes (smoke, smog, exhaust) Inability to tolerate much exercise or feel worse after exercising Rapid mood swings Dark circles under the eyes Lack of mental alertness Headaches Insomnia Need for caffeine Food or respiratory allergies Frequent infections Allergies Arthritis Asthma Candida

References:

1 Wilson, James, N.D., D.C. PhD. Adrenal Fatigue. The 21st Century Stress Syndrome. Smart Publications. 2002.

2 American Institute of Stress Statistics, Posted in 2000.

3 Ross, Julia, M.A. The Mood Cure. Viking. 2002

4 Ross, Julia, M.A. The Mood Cure. Viking. 2002

5 Hanley, Jesse Lynn, M.D. Tired of Being Tired. G.P. Putman's Sons. 2001.

6 Talbott, Shawn, PhD. The Cortisol Connection. Hunter House. 2002.

7 Ross, Julia. The Diet Cure. Penguin Books. 1999.

8 Ingram, Cass Dr. Supermarket Remedies. Knowledge House. 1998.

9 Engelberg, Hyman, Lancet, Mar 21, 1992, 339:727-728; Wood, W G, et al, Lipids, Mar 1999, 34(3):225-234

10 Cheraskin E: Vitamin C – Who Needs it? Arlington Press, Birmingham, AL, 1993

11 Murray, Michael, Stress, Anxiety and Insomnia, Prima Publishing, Rocklin, CA, Copyright 1995

12 Somer, Elizabeth, M.A, R.D. Food and Mood. An Owl Book, NY. 1999.

13 Garrison, Robert, M.A., R. Ph. and Elizabeth Somer, M.D., R.D. The Nutrition Desk Reference. Second Edition. Keats Publishing, Inc. New Canaan, Connecticut. 1990.

14 Storlein LH, Pan DA, Kriketos AD, et al. Skeletal muscle membrane lipids and insulin resistance. Lipids 1996; 31: S261- S265

15 Luo J, Rizkalla SW, Boillet J, et al. Dietary (n-3) polyunsaturated fatty acids improve adipocyte insulin and glucose metabolism in insulin-resistant rats. Relation to membrane fatty acids. J Nutr 1996; 126: 1951-1958

16 Popp-Snijders C, Schouten J, et al. Dietary supplementation of omega-3 fatty acids improves insulin sensitivity in noninsulin dependent diabetes. Neth J Med 1985;28:531–2.

17 Popp-Snijders C, Schouten JA, Heine RJ, et al. Dietary supplementation of omega-3 polyunsaturated fatty acids improves insulin sensitivity in non-insulin-dependent diabetes. Diabetes Res 1987;4:141–7.

18 Dutta-Roy AK. Insulin mediated processes in platelets, erythrocytes and monocytes/macrophages: Effects of essential fatty acid metabolism. Prostaglandins Leukot Essent Fatty Acids 1994;51:385-99.

19 Blumenthal M, Busse WR, Goldberg A, et al, eds. The Complete Commission E Monographs: Therapeutic Guide to Herbal Medicines. Boston, MA: Integrative Medicine Communications, 1998, 161–2.

20 Michael Murray, ND. & Pizzorno, Joseph, ND. Encyclopedia of Natural Medicine. Prima Publishing. 1998.

21 Brown DJ. Herbal Prescriptions for Better Health. Rocklin, CA: Prima Publishing, 1996, 129–38.

22 Ross, Julia M.A. The Mood Cure. Viking. 2002.

23 Abe Y, et al. 1995. Effect of green tea rich in gamma-aminobutyric acid on blood pressure of Dahl salt-sensitive rats. Am J Hypertens 8:74-9.

24 Ito K, et al. Effects of L-theanine on the release of alpha brain waves in human volunteers. Nippon Nogeikagaku Kaishi 1998;72:153-7

25 Schwarzbein, Diana, M.D. The Schwarzbein Principle II. Health Communications, Inc. 2002.