Adrenal Dysfunction—Is this YOUR Issue? 

A Day in the Life…

Your alarm goes off in the morning and you hit snooze one maybe two times struggling to get out of bed. You put your jeans on and can’t believe how tight they are starting to fit around your waist. You skip breakfast because you are trying to pack the kids lunch and get them to school. You grab coffee on the run because you need a boost. You head to the gym for high intensity interval training to help you lose the weight that doesn’t want to budge. You are trying to be healthy, so you grab a green juice for your mid-morning snack. You don’t have time to grab lunch, so you eat a protein bar. You can’t believe it’s already 2 p.m. and the kids are about to be home from school. You are exhausted, worn out, and craving something sweet. You grab some dark chocolate for an energy boost. You help the kids with homework and make a healthy dinner for your family. You watch some TV with your spouse and start heading to bed. Your spouse falls asleep as soon as his head hits the pillow, yet you feel like you just got an energy surge. You are feeling wired yet tired and watching the clock tick, becoming frustrated and anxious that you won’t get a good nights rest. Is this you? 

You may be suffering from adrenal dysfunction.

Patients often come to the practice with similar complaints of fatigue, abdominal weight gain, interrupted sleep cycles, food cravings, irritability, and anxiety. One of the core concepts I discuss with my patients is the importance of ensuring their adrenal glands are functioning optimally. As you can imagine, the first question everyone asks is “what are my adrenal glands and how can I make sure they are functioning well?”

Since adrenal glands are such an intricate component of our body’s complex hormonal web, understanding how they work and how you can improve their function is essential to overall hormone balance.

Where are your adrenal glands?

Adrenal glands are tiny pyramid-shaped glands that sit on top of your kidneys. Each gland measures about 1.5 inches in height and 3 inches in length. Although your adrenal glands serve a number of purposes, one of the most important functions of the adrenal glands is to help your body manage stress.

What is the role of the adrenal glands?

Without getting too scientific, here is a little pathophysiology lesson on how adrenal glands work:

• First, your brain must perceive something as stressful. This stressful event could be physical, such as an illness, high intensity exercise, inflammation from food allergies/sensitivities, or nutritional deficiencies (to name a few), or psychological, such as career-driven, financial, or relational stress.
• This stressful event causes they hypothalamus to produce a hormone called corticotropin releasing hormone (CRH)
• CRH sends a signal to the pituitary gland to stimulate the production of another hormone called adrenocorticotropin hormone (ACTH)
• ACTH makes its way down to the adrenal glands and stimulates the production of one of our main stress hormones, cortisol.
• Cortisol causes your heart to beat faster, your blood pressure to rise, your palms to get sweaty. This hormone gives you the extra push you need to make it through. They call this response your body’s “fight or flight” response.
• After the stressful event is over, your body balances cortisol with another hormone produced primarily by the adrenals called DHEA.
• This process is known as the HPA axis

This process is a normal and appropriate response to stress. As a matter of fact, we would not survive without this “fight or flight” stress response. The problem occurs when we live a stress-dominant lifestyle; always hurrying from one thing to another, trying to make unrealistic deadlines. Or maybe you are someone that does not perceive your life as stressful, but are training for marathons or endurance races. It is important to remember that both physical and psychological stress impacts our adrenal glands function.

Conventional vs Integrative approach

Conventionally, there are two dominant diagnosis related to your adrenal glands, Cushing’s or Addison’s disease. Addison’s disease is where your adrenal glands are not making enough cortisol and Cushing’s disease is where your adrenals are producing way too much cortisol. These two diseases are on complete opposite sides of what you could call the adrenal continuum.

In Integrative Medicine, we recognize the grey area or the middle ground on the adrenal continuum where you are not diagnosed with Cushing’s or Addison’s, yet you know something is off. As integrative medicine detectives, our goal is determine where you are along the continuum and to evaluate all possible causes of your symptoms including adrenal dysfunction.

So what are the symptoms of adrenal dysfunction

It is important to figure our what stage of adrenal function you are at. Han’s Selye, the founder of the term “stress,” describes three stages of adrenal function.

Stage 1: Arousal

Cortisol and DHEA rise appropriately in response to a stressful event. In this stage there are little symptoms, if any.

If you feel like you are in stage 1 without any symptoms, this is the time to add mind-body and stress management exercises into your lifestyle so you do not progress onto stage 2. 

Stage 2:  Resistance or Adaptation

Cortisol remains elevated longer than anticipated and DHEA gradually declines. Symptoms of this phase include anxiety, irritability, food cravings, abdominal weight gain, insulin resistance, immune system deficiencies (getting sick more frequently), brain fog, or interrupted sleep patterns.

If you are reading these symptoms and thinking, “Check, check, check—I have all of those symptoms,” our goal at CentreSpringMD is to help reduce your cortisol levels through stress management and supplements that support adrenal balance. Depending on your lab results, we may add a low dose DHEA to balance those levels.

Stage 3: Adrenal Exhaustion

You have burnt out your adrenals and they are no longer producing the appropriate amount of cortisol or DHEA. In this stage, you are exhausted, depressed, or maybe have a lack of motivation and drive.

If this is you, please make an appointment. We want to help rejuvenate and heal your adrenal glands. We want to partner with you to get your old life back!

How do we test adrenal function?

It is challenging to fully evaluate your adrenal function through conventional testing. You can have a serum (blood) cortisol and DHEA level drawn, but this is inaccurate because it only gives us a snap shot of how your hormones are functioning. Our adrenal glands secrete the most cortisol first thing in the morning. This is to help give us the energy we need to get out of bed and start our day. As the day progresses, cortisol gradually reduces and is the lowest at bedtime to help us a get a good nights rest. We test this cortisol trend and DHEA balance through saliva testing as shown below.

Quick recommendations to promote healthy adrenal glands today

In whatever stage of adrenal function or dysfunction you find yourself, you may benefit from some of these ten adrenal health tips.

1. Prioritize sleep. This is your body’s time to rest and recover. Aim for 5 hours of uninterrupted sleep
2. Limit caffeine to 4-6 oz. per day. (If you are in stage 2, consider tapering off)
3. Balance high impact exercises with mind-body exercises, such as yoga
4. Avoid large meals. Instead, eat smaller more frequent, high protein snacks/meals
5. Limit sugar to prevent insulin spikes and drops. (Low blood sugar increases cortisol levels—it is a stress on the body.)
6. Consider supplementing with a high-quality b-complex or magnesium.
   • B vitamins are co-factors in hormone production
   • Magnesium is known as the “relaxing mineral,” therefore deficiencies increase stress response.
7. Depending on your labs, you may benefit from an adaptogenic herb (balances cortisol: it lowers cortisol if high or increases cortisol if low) such as Ashwaghanda or Rhodiola.
8. Devote 10-15 minutes of quiet time DAILY. Find a routine that works for you and stay consistent
   • Deep breathing
   • Meditation
   • Prayer
   • Epsom baths
   • Journal

9. Evaluate your current relationships. Are any of them toxic and causing more stress in your life? Avoid unsupportive, negative relationships.
10. Shift perception. Focus on the aspects of your life you can control. Don’t dwell and stress about the areas of your life you cannot alter.