Our adrenal glands sit on top of each kidney. Our overall hormonal health relies upon these glands. They play a huge function in the body: to help you cope with stress, and to survive. They also control hormones to fit with our natural circadian rhythms of the day, so that we are energised when we are supposed to be - (eg first thing in the morning to get us out of bed) The hormone that is needed to build our energy response is cortisol. Ideally, cortisol is at its high point in the early morning hours and follows a sharp curve where it lowers and reaches a low point at night. During sleep, cortisol then rises again to its high point in the morning.
The adrenals are known as the body’s “stress glands”, and they help you deal with every type of stress, ranging from physical stress such as exercise, to mental-emotional stress such as that related to relationships or work. They also detect the effects of dehydration and blood sugar imbalances and will react to both with a stress related action.
Fight or flight
In a stress response, our adrenals will produce adrenaline (epinephrine) in the immediate moment. This gives us that almighty stimulation to fight or flight away from the stressful situation. It is what makes our heart beat faster and our blood pressure rise. It makes our pupils dilate and encourages calcium and sodium to flood the cells in order for our muscles to spring into action. It halts our digestion and our reproduction in that immediate moment, as those two things are of the least importance when trying to run away from danger.
After the initial adrenaline hit, the adrenals secrete cortisol. Cortisol is a hormone that will help us to stabalise our response to the dangerous situation . It keeps us vigilant whilst at the same time not producing the same urgent effects as adrenaline. It is the same hormone that is responsible for the energy in the mornings mentioned earlier.
Think of a gazelle drinking at a water pool in the wild. It spies a tiger creeping up on it. It`s adrenaline helps it spring into action and run away. The tiger moves on to the next pond and the gazelle comes back to where it was before, and carries on drinking. Whilst the adrenaline response has gone, the cortisol is now flooding its system whilst it regains its composure. Whilst adrenaline is secreted by the glands for a short time, cortisol will be secreted for several hours.
We aren`t gazelles and the stresses we encounter aren`t tigers, but the response is the same. Whether it is a demanding boss, a nasty neighbour or busy traffic in rush hour that you are dealing with. Our adrenals - like the rest of our body - are amazing and resilient. They rise to the challenge in these situations and help protect us.
The problem lies when the demands are too frequent or have been going on for too long.
Cortisol is a great hormone in small doses and can be anti - inflammatory in the short term. Our bodies are not built for long term exposure to its effects though and it can cause a great deal of problems if it is constantly drip feeding our system due to chronic stress.
Cortisol is a catabolic hormone, which means that it breaks down tissue. In the long term it will actually cause inflammation, which can become systemic. Remember, inflammation is the route cause of most serious diseases. Long term cortisol release will also disrupt both the endocrine system and the immune system.
The three stages to adrenal fatigue.
This is the immediate problem that is causing the stress. It is the immediate reaction of fight or flight.
The resistance stage
This is often referred to as being tired and wired. We are feeling a drain on our energy but our mind is still stimulated. We may not be able to sleep at night because we have a lot on our mind. The cortisol is pumping out and we are trying to maintain our response to the stress. We can often get digestive upsets in this stage and notice our menstrual cycles becoming painful, heavy or going askew. We may get general inflammatory conditions. In this stage, we can keep plodding along to some extent. Some people can live most of their lives in this stage without moving on to stage 3. It all depends on our unique physiology. Ever known anyone who is a workaholic but as soon as they go on holiday the flop or get ill? It`s more than likely that they are living their life in stage 2. As soon as the adrenaline response is not needed, they flop!
At this point, our adrenals have very little cortisol left to give. We suffer from symptoms often put down to chronic fatigue or nervous breakdowns. Your GP may discuss antidepressants with you because you feel so flat and have so little left to give. Our body has very little energy to function properly. You can sleep for hours and hours and wake up feeling like you have just done a long-haul flight.
The long term requirements on the adrenals for cortisol have been so demanding that they just can`t keep up and start to refuse to make as much. It`s not that they don`t work, but they are fed up! They want to make you stop in your tracks and reassess the situation and make changes.
At the same time the hypothalamus (an area in the brain that is constantly detecting both the internal and external environment) notices that the adrenals have very little to give. It realises that it needs to turn down the demands on the body so goes to the central control system of our metabolism - the thyroid. It will often give the thyroid the demand to slow right down, causing what will eventually manifest as an underactive thyroid. A slower thyroid will also make you feel extremely fatigued and cause mood issues.
It is not a quick fix to recover from adrenal fatigue in any stage. Stage 1 can take 2 - 3 weeks to regain balance. Stage 2 requires a 6 - 12 month programme and stage 3 is more likely to take around 2 years. It requires nourishment from every angle possible.
It is so important to try to identify the route cause of your chronic stress and remove it. Without removing this trigger, you will go around in circles, trying to help yourself and not getting anywhere quickly. You are unlikely to escape the cycle. To some, this means getting a new job, to others, a new house, a new location or a change of relationship. Other sources of stress are far easier to sort out. It might be that a chronically bad diet has caused the condition or a smoking habit.
Whilst trying to recover from adrenal fatigue, it is vital that you follow an anti-inflammatory diet - see my handout on this. I t is essential that you eradicate all sugars, refined carbohydrates and stimulants (caffeine/ alcohol/ smoking) and that you are fully hydrated. Inflammatory foods, stimulants and dehydration cause the hypothalamus to feel stressed and it will then command the adrenals via the pituitary to secrete cortisol. You are trying to stop secreting cortisol all the time.
It is vital to get enough sleep as lack of sleep is another major cause of stress responses.
You need to schedule in time for mindfulness activities, whether you like to meditate or sit on a blanket in nature on a nice day, or read a good book. You need dedicated "Me time" away from the demands of the family. Massages and acupuncture are great for this.
You should avoid intense exercise as the body actually interprets heavy cardio exercise as a stress. It literally thinks you are running away from something and starts pumping out the cortisol to sustain you.
You need to feed your body the nutrients it needs to replenish and nourish the adrenals and establish any nutrient deficiencies. That`s where I come in to help.
Can my doctor help?
In a word - No.
Unfortunately, the way that allopathic medicine (your GP) tests the adrenals is in such a way that it will only look for reference ranges of cortisol in the danger zone. It will recognise levels that match Addisons disease - where there is so little cortisol it can not sustain life properly and requires steroid medication, (did you know JFK had this?!) or, the other extreme, where the body produces toxically too much (Cushings syndrome).
The levels that we identify with our functional medicine tests and by looking at your symptoms are sub-clinical levels. That means we can see that you are in a less than ideal range. Unfortunately, the way the UK health service works, it`s often too late to do anything by the time problems manifest.
Please look into the information on your protocol regarding the timings of your meal and the requirements of proteins over carbohydrates. You will help your adrenals by doing this.
There is a really good book called "Adrenal Fatigue, the 21st century stress syndrome" by James L. Wilson. I would highly recommend that you read this to understand the topic further.
On a personal note, I have been there, right in the depths of stage 3 exhaustion.
When my little girl was around 3 years old, this happened to me. I totally understand how bad it feels, but I am also an example of how you can recover and thrive again, so hang on in there!
The most important lesson that I personally learned from my experience was that I had to put myself first. In order to make any difference to anyone else, I had to be functioning the best possible way that I could and in order to do that, I had to focus on me. That meant changing my diet and my lifestyle. We are all much happier for it though. This doesn`t mean being selfish in any way, it means knowing you can only give so much because you only have so much in your tank, When you are done, you are done. Learn to say no.
It also means scheduling that all important "me - time". For me, I booked a back massage once a month and got into audio books. Every time I tried to actually read with my eyes, I would fall asleep! Comedies on Netflix, happy films... keep everything positive. Avoid the negative press and negative programmes. Keep away from negative people and energy vampires. There`s a really good book on this called "Dodging energy vampires" by Dr Christiane Northrup. I also immersed myself in health and wellness literature and audio books. Candle lit baths with bath salts and essential oils are good and always try to get to bed whilst there is a number 10 at the beginning of the clock. Whether it`s 10.15 or 10.40, Try to get to bed before 11pm. Make yourself get up in the morning. It`s important that your body tries to maintain it`s circadian rhythms.
But most importantly...
Put yourself first!
Thrive Clinical Nutrition and Naturopathic Health Eve Morley N.T AMNNA FNTP NFPTA