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Adrenal Fatigue

Adrenal issues are on the rise in our fast-paced, deadline oriented, stressful, economy riddled lifestyle. The signs are easily recognized, and can be reversed!  

The adrenal glands are two small endocrine glands that sit on top of your kidneys. They release the adrenal hormones cortisol, DHEA, and aldosterone. These hormones are best known for helping us deal with stress: psychological or physiological. Although DHEA has numerous functions in the body, for our purposes, we will focus on the cortisol/DHEA ratios that are needed to maintain a healthy response to stress.

Cortisol is released from the adrenal glands in relation to stress. This can be any stressful event: the intense phone call, the car that cuts you off in traffic, or the mood swings caused by PMS, or issues in your metabolism, such as hot flashes, diabetes, etc. Cortisol is a stimulant to our nervous systems, and a certain amount is needed for a healthy response to stress.

The problems result when there has been too much stress for too long. I see this in my silicon valley practice when people are too busy to exercise, running a startup operation, eating poorly, or not having enough family/relaxation time in general. The cortisol levels that remain too high throw off feedback loops to the pituitary gland in the brain. Here's how that works: the pituitary gland puts out stimulating hormones to the thyroid, adrenals, ovaries, testes, liver, etc. The pituitary hormones jumpstart these various organs and glands to produce their own hormones. When hormone levels are sufficiently produced in the glands, the pituitary gets a message back, and adjusts the levels of it's stimulation.

With the adrenal glands, the pituitary stimulation is ACTH, adrenocorticotrophin hormone. This tells the adrenals to produce more cortisol. When the cortisol levels remain chronically high from the above mentioned factors, the pituitary feedback loop can become out of balance.The body continues to produce too much cortisol, and symptoms occur. Here's the classic examples:

  • sleep issues (inability to get to sleep, or stay asleep)
  • anxiety
  • high blood pressure
  • orthostatic hypotension (dizziness on standing)
  • sleep apnea
  • sweet cravings
  • increasing fatigue
  • weight gain
  • mood, cognition, memory problems
  • dysbiosis
  • ulcers
  • yeast infections
  • decreased immunity
  • PMS
  • decreased libido
  • water retention
  • irritable bowel

On a systemic level, high cortisol levels and surges will effect many systems. It will create hypothalamic-pituitary dysregulation, lutenizing hormone imbalance, decreased DHEA, decreased T3 (thyroid), decreased progesterone in women, decreased testosterone in men, increased estrogen in women, increased estrogen conversion in men, decreased thymus function, decreased growth hormone, effect blood sugar balance creating insulin surges, insulin resistance or lead to diabetes. If adrenal imbalance continues for too long, there is a tendency for genetic predispositions to be expressed (thyroid, autoimmune conditions, diabetes, arthritis, cancers, heart conditions).

The adrenal glands have a circadian rhythm throughout the day. Healthy levels are highest on awakening in the morning, consistent throughout the day, and drop off at night, allowing us to go to sleep easily. When the levels are off, often one of the first signs is inability to get to sleep, that second wind that hits at 10:30 to 11:00 at night and has you on email until 2 am. Or up at 1:30 in the morning regularly.

The most efficient way to test for adrenal imbalance is through a saliva test. Four samples are taken during the course of an average day, one on awakening, one at noon, one mid afternoon, and one before sleep. The report will contain information re: the rhythm and levels throughout the day, the DHEA/cortisol ratio, the gut immune health, gliadin sensitivity.

It is very helpful to see exactly where you are in terms of adrenal markers. The adrenal imbalance progresses in stages,

and can be reversed with a comprehensive program including: diet, appropriate exercise, nutritional supplementation, lifestyle changes (most commonly self care: ie massage, acupuncture, chiropractic, etc.) The various stages of adrenal imbalance must be properly evaluated and the treatment plan customized for accurate results. There are currently nutritional supplements formulated specifically for adrenal support

The other issues that parallel adrenal imbalance closely are blood sugar handling and insulin resistance. That is the subject of another article... stay tuned!

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