Adrenal Health – Understanding the Role of the Adrenal Glands
The adrenal glands are walnut-shaped glands positioned just over each kidneys and are the body’s main terminals for regulating certain hormonal activity. The adrenal glands’ various layers are responsible for producing the specific hormones that circulate and fluctuate around and within our bodies. The outer layer or the adrenal cortex is responsible for producing cortisol, the sex hormones, estrogen testosterone and DHEA while the inner portion of the gland regulates the production of adrenaline.
The adrenal gland’s primary role is to command all of your body’s resources into “fight or flight” mode by increasing production of adrenaline and other hormones. If your adrenals are healthy, they will instantly increase your heart rate and blood pressure, release your energy stores for immediate use, slow your digestion, and sharpen your senses.
But there are two things we need to remember about this healthy stress response:
- It takes priority over all other metabolic functions.
- It’s not designed to last for an extended amount of time.
The Modern Stress Syndrome
Have you ever witnessed the meltdown of an overtired child? It starts out as hyperactivity and then progresses to erratic behavior and inattentiveness. She may become clingy, and if her needs aren’t met, she’ll start whining, and then inconsolably crying. If this goes on for long enough, she’ll eventually cry herself to sleep. Now imagine handing this exhausted child a donut and a triple espresso and telling her to get a grip and get back to work! Then, when she’s so totally cracked out on sugar and caffeine that she can’t sleep at all, imagine handing her a double Martini or a sleeping pill to knock her out so that she can get up and do it all over again in 4 to 6 hours! “No way!” You say, “That’s child abuse!”
Sadly, that’s what many of us do to ourselves on a daily basis, and then we wonder why we’re sick. We shouldn’t be mystified by the epidemics of stress-related chronic illness in Western society. We live on borrowed energy, never pay it back with rest, and wind up depleted and sick.
I call adrenal fatigue a “splinter” in The Thyroid Cure because I feel that it’s a major underlying trigger in all chronic illness. Adrenal fatigue is similar to an autoimmune condition because it is both the symptom and consequence of a life out of balance.
Adrenal Exhaustion, Adrenal Fatigue and Adrenal Burnout are All Names for the Same Condition: Too Much Stress in All its Forms!
Most Western medical doctors do not recognize adrenal fatigue or adrenal exhaustion. They believe that either your adrenals work fine, or they don’t work at all. Unless you have a diagnosis of Cushing’s or Addison’s disease, they will chalk up your symptoms to depression, anxiety or some other ill-defined mechanism and then prescribe a pharmaceutical drug to mask your symptoms. This is like closing the windows and turning up the radio when your car starts smoking and making a banging sound.
Practitioners who work with patients who have adrenal fatigue will tell you it’s a real condition all right. They will also tell you that it’s difficult to correct, but not because the body can’t heal, but because the sick, toxic, stressed out and exhausted person can’t or won’t slow down for long enough and make the necessary lifestyle changes to heal.
Too Much Stress!
Our bodies are designed to handle a healthy amount of stress, and the flight-or-fight response can save our lives when we are in danger. But stress becomes chronic when the stressful situations don’t end, and we are forced to sustain an unnatural fight-or-flight response.
Over time, our adrenals can become overworked and exhausted, which can cause us to feel fatigued, depressed, and sick. If the stress goes on for too long, we can experience a condition called “burnout,” which makes our bodies begin to break down on a cellular level.
Chronic stress in all of its forms can cause chronically increased levels of the adrenal hormones adrenalin and cortisol, which have an impact on all your body’s functions. Stress out too often and you’ll experience the effects of adrenal fatigue or burnout.
Effects of Elevated Stress Hormones
- Blood sugar imbalances, dysglycemia, and insulin resistance
- Redistribution of fat in the body—typically weight gain around the middle
- Decreased DNA repair
- Inhibition of pro-inflammatory interleukins39
- Impaired cognitive function and damage to a part of your brain called the hippocampus, which is involved in memory
- Inhibited conversion of thyroid hormones T4 into T3, suppression of TSH, and blockage of thyroid hormone receptors—a measure your body takes so that you don’t just completely burn out!
- Negative effects on the cells of the immune system—elevated cortisol will reduce the amount of secretory immunoglobulin A (IgA), which is your body’s first line of defense against bacteria and viruses. (This is why you get sick more easily when you are stressed.)
- Feeling wired but tired, with disrupted sleep patterns—these are the hormones that wake you up at 3 a.m.
- Inhibited skin regeneration while you are sleeping, resulting in premature wrinkles and aging
- Decreased bone density
- Elevated blood pressure
- Decreased muscle mass
Causes of Adrenal Fatigue
Adrenal fatigue is caused by stress in all its forms. Everything we’ve been discussing—emotional, psychological, infectious, toxic, allergic, and environmental factors—have an effect on the adrenal glands. All of these stresses are enough on their own, but most of us find ourselves bombarded by multiple types of stress, and over time, these accumulate and become chronic. The condition of constant, unrelenting stress leaves the adrenals working overtime, and without a rest, they eventually give out. After a while, you begin to feel like you’re “beating a dead horse,” and your body simply says, “No!”
Symptoms of Adrenal Fatigue
• Suppressed thyroid function—poor conversion of T4 to T3
• Waking up in the middle of the night and being unable to get back to sleep
• Trouble falling and staying asleep
• Difficulty waking up in the morning
• Not feeling rested after a full night’s sleep
• Needing caffeine to start the day
• Being lightheaded upon standing up
• Feeling wired but tired
• Lack of energy
• Being easily startled by loud noises
• Cold hands and cold feet
• Panic attacks
• Feeling shaky and weak
• Craving salt
• Craving sweets
• Mental fogginess
• Memory problems
• Needing increased time to recover from illness, injury, or trauma
• Feeling that little things put you over the edge
• Feeling depressed
• Lack of interest in the things that used to bring you joy
• Decreased libido
• Increased PMS symptoms
• “Hitting the wall” at 3-4 p.m. only to feel “up” again after 6 or 7 p.m.
• Feeling tired but resisting going to bed before 11 p.m.
Adrenal Fatigue is Not:
- It’s not “just being tired.” Many times a person is told to simply “rest.” While that may help, it doesn’t correct the underlying functional imbalances. What is making that person tired and stressed-out? A toxin? An infection? A crazy lifestyle? All of the above? Because each of us is unique, we each have different issues; it can be challenging to find all the causes of stress.
- It’s not a hormone deficiency. A person with adrenal fatigue may be deficient in adrenal hormones, but it’s important to correct why that person is deficient, instead of just giving them more adrenal hormones. Imagine your car has an oil leak and uses up a quart of oil per day. Do you just add a quart of oil everyday and keep driving, or do you add the quart of oil and then try to find the leak? If you don’t fix the leak, there will come a time when adding oil won’t help anymore.
- It’s not an herbal deficiency. There are wonderful herbs that can support your adrenals and help you feel more comfortable while you heal, but if you don’t take out the splinters and reduce your stress, you’re not correcting the core issue.
What you need to know: Healing is about slowing down and learning to nurture your body and soul. Have the same compassion for yourself as you would have for the tired little child who needs rest. Believe me, there is no supplement, herbal formula or hormone available that will make you immune to running yourself into the ground. I encourage you to develop this kind of self-love because your body is crying out for help. Take this time to listen. Take this time to heal.
There are tests available that assess adrenal function, some may be paid for by your insurance, others may not. There are blood tests that measure the adrenal hormone DHEA, and saliva tests that measure your cortisol levels over a 24-hour period. DHEA-sulfate is included in my baseline lab test suggestions. Most insurance companies will pay for this test.
Saliva testing for adrenal function measures your diurnal (24-hour) cortisol levels. Cortisol is integral to your body’s stress response. Some saliva tests include other hormones such as DHEA, testosterone, progesterone, estradiol and estriol. This testing may or may not be covered by your insurance. Many integrative and functional practitioners feel that cortisol is the only one of these hormones that can be measured accurately in the saliva. Only you and your practitioner can determine which testing is right for you.
I feel there is a place for cortisol saliva testing, as it can help you and your practitioner assess your stage of adrenal fatigue and where you need the most support. If you scored high on my Adrenal Stress Assessment, this test may be worthwhile, and will help your practitioner design a healing program for you.
If you did not score high on the Adrenal Stress Assessment, you may not really need an adrenal function test.
Before considering adrenal saliva testing, ask yourself the following questions:
- Do I really need a test to tell me that I’m too stressed out?
- If a medical test confirms that I am too stressed out, will I be more willing to make the lifestyle changes necessary to heal?
If you answered yes to both of the above questions, then go ahead and spend your money on an adrenal function test!
Now let’s say the test comes back and it shows that your adrenals are “ok,” but you know deep down inside that you’re too stressed. What then?
The whole point of an adrenal stress profile is to find out if your adrenals are stressed, and to determine your stage of adrenal fatigue. The results can help your practitioner prescribe the right support, as well as inspire you to make the necessary lifestyle changes to heal.
What You can Do on Your Own to Heal Your Adrenals
- Try Eating for Your Good Genes! Replace junk foods and stimulants with nutrient rich foods. Eat healing proteins and healing fats with every meal.
- Follow my Sensitivity Discovery Program to uncover food sensitivities.
- Don’t skip meals—Try to eat within 90 minutes of waking.
- Take a good multivitamin and B complex supplement like my Empowerment Formula
- Slow down and get some rest.
- Try adaptogenic herbs. An adaptogen is a compound that increases one’s ability to adapt to environmental factors, including physical and emotional stress.
- Cut unnecessary stress from your life!
- Do something that brings you joy!
Herbs for Adrenal Support
There are herbal formulas that have been used for centuries to help support the body during times of stress.
- Ashwaganda—This is a powerful herb from the Ayurvedic tradition that is particularly helpful with sleep problems. It has been shown to improve DHEA-S and testosterone levels. It is available in tablet, liquid and capsule form. Standard dose is 500 mg per day or as directed by your healthcare provider. A note of caution is in order: Ashwaganda is a nightshade and some people are sensitive to it. If you take it and you notice symptoms such as sore joints, rash etc., discontinue use.
- Rhodiola—This herb also has a long tradition of use for the management of fatigue, reducing mild depression, and facilitating mental clarity. Look for formulas that contain 2-3% rosavin and 0.8-1% salidroside. Standard beginning dose is 100 mg per day and can be increased by 100 mg per week up to 400 mg.
- Siberian ginseng (Eleutherococcus senticosus)—This herb is famous in traditional Chinese medicine for increasing vitality and longevity. Western herbalists favor it to treat stress, fatigue and exhaustion, and to restore immune function. This herb is available as liquid extracts, solid extracts, powders, capsules and tablets; and as dried or cut root for tea. Because it is energizing, it’s better to take earlier in the day so it doesn’t interfere with sleep. Look for formulas standardized to contain 0.8% eleutheroside E & B. Standard dose is 100 to 500 mg per day. Warning: Siberian ginseng may boost the immune system and may interact with immunosuppressive drugs commonly prescribed for autoimmune conditions. Please consult your healthcare provider before taking this herb.
Note: It’s important to remember that just because something is natural, doesn’t necessarily mean it’s safe or right for you. Herbs can be powerful medicines and have side effects and interactions with pharmaceutical drugs. If you take medication, please talk to your health care provider before self-prescribing these herbs. At the very least, do your own research on the side effects and interactions.
When You May Need a Practitioner
The suggestions in The Thyroid Cure and on this website are designed to help you reduce stress and bring the core systems of your body into balance. If you scored high on my Adrenal Stress Assessment, or if you have chronic fatigue syndrome (CFS) or a more serious autoimmune condition, you will very likely need to support your adrenals in order to heal. You may benefit from working directly with a qualified functional or integrative practitioner in addition to following the steps outlined in this chapter. A practitioner can help you uncover the splinters underlying your adrenal fatigue and help you feel better while you heal.
When looking for a practitioner be sure to ask if they have experience with advanced functional medical testing and adrenal fatigue. Many chiropractors, doctors of oriental medicine and certified nutritionists are also skilled in evaluating and uncovering the roots of adrenal fatigue.
Functional Testing for Adrenal Stress
I feel it’s best to consult with an integrative or functional practitioner to obtain an adrenal saliva test because self-diagnosing can be complicated and the results are not always easy to interpret. Working with a qualified practitioner can save you time and money by removing the guesswork and thus avoiding unneeded treatments or supplements.
There are several labs that offer saliva testing for adrenal hormones. Here are two tests that I have used with my clients:
- Adrenal Stress Profile by Genova/Metamerix (two labs that have recently merged)
- Diurnal Cortisol (Saliva) – 4x ZRT Laboratory
You’ll find more tips about how to reduce stress and live a vibrant life on this website and in my book, The Thyroid Cure. If you need more help, please consider joining my practice or attending a teleseries!
Michelle Corey, C.N.W.C., F.M.C., is a Functional Medical Practioner, Nutritionist and Author. She studied holistic nutrition at Clayton College of Natural Health and completed a comprehensive 2-year practical program at Academy of Functional Medicine and Genomics. Michelle is an advisor to the Academy of Functional Medicine and Genomics and the Functional Medical University, and a member of the Institute of Functional Medicine and the National Association of Healthcare Advocacy Consultants.
In her groundbreaking book The Thyroid Cure, The Functional Mind-Body Approach to Reversing Your Autoimmune Condition and Reclaiming Your Health, (Vibrant Way Press) Michelle presents readers with the keys to reversing the full spectrum of autoimmune conditions such as Hashimoto’s, Graves’ Disease, Lupus, Celiac, Rheumatoid Arthritis, Fibromyalgia and Chronic Fatigue.
Michelle offers Total Recovery Programs for patients who suffer from complex autoimmune and inflammatory conditions. These Functional Mind-Body programs are designed to guide people to recover wellness by balancing the core systems of the body through optimizing nutrition and detoxification, practices to release stress, let go of the past, and connect more fully to a life of spirit.