Overcoming Adrenal Fatigue

Overcoming Adrenal Fatigue

If ever there was a word that resonates on a global level and which applies to all our lives, virtually on a daily basis, it has to be stress. Every day we face the stress of getting up, going out, confronting others, getting from A to B, doing difficult or tedious jobs, shopping, making our way home, settling domestic disputes, cooking and then attempting to get some sleep.

• It’s a tough old world and that’s exactly how it’s going to stay for the foreseeable future. Even those of us lucky enough not to live in a war zone sometimes feel as if we do. You know there are people far worse off than yourself, but that doesn’t mitigate your own personal hardships and battles.

Read And Learn More: Health Problems And Dietary Solutions

• Chronic stress is emerging as a consequence of an unsustainable way of life in Britain today. The British work the longest hours in the EU, but all this productivity feeds a false economy when you consider that, according to the Health and Safety Executive, around half a million people in the UK are so stressed out by work alone that they believe it is making them ill.
• It is certainly keeping them awake. A study conducted by the Future Foundation for the British Association for Counselling and Psychotherapy found that almost a third of the population regularly suffers from lack of sleep, with anxiety as the most cited reason.
• Put that stressed-out, sleepless individual behind the wheel and you see why Britain holds the world title for road rage.
• It may be unwelcome but stress is the norm, and indeed can have a positive effect on human creativity and productivity. Who would really want to live a life devoid of challenges? The problem is that people are just not coping with life’s slings and arrows, and are therefore suffering the consequences.
• You may not think that diet plays much of a role in the body’s coping mechanisms, but think again. Your body is hard-wired to deal with stressful situations, given the right nutritional terrain. What you eat can have a profound effect on how your body deals with mental stressors, as we shall see.

Adrenal Fatigue Anatomy Of Stress

There is stress, and then there is stress. It was the world authority on the subject and author of The Stress of Life (1956), Hans Selye, who first identified a common response to stress which he called the ‘General Adaptation Syndrome’. According to Selye, humans and animals respond in three stages when under extreme stress. These are:

1. The alarm reaction is when your body goes on full alert. Stress is detected and the body reacts by producing adrenaline.
2. Adaptation, or resistance. You adapt to and learn to cope with the stressor.
3. Exhaustion. You are no longer able to deal with the stress and resistance has greatly declined

• The body’s response to stress is activated by what is called the hypothalamic-pituitary-adrenal (HPA) axis.
• The hypothalamus is a gland in the brain that stimulates and controls the pituitary gland jr in response to the changes it detects, and in turn the pituitary stimulates production of hormones by the adrenal glands.
• You are equipped with two adrenal glands, one on top of each kidney, and these produce hormones in response to stressful situations or thoughts.

Adrenal Fatigue Stage One The Beginning

During stage one, the hormones adrenaline and noradrenaline are released as a sort of ‘knee-jerk’ reaction to a given situation. This prepares you for ‘fight or flight’ and is short-term only. Stored glycogen is converted to glucose, so blood sugar rises and the flow of fatty acids into the bloodstream also increases, to give you more energy to fight or flee.

• The heart pumps faster to get more oxygen and nutrients to muscles, and energy is routed away from nonessential functions, such as digestion. The breathing rate increases and the respiratory passageways widen to accommodate more air, and therefore more oxygen.
• Even blood-clotting agents are mobilized, in case you are wounded. This alarm reaction is nothing less than a spectacular feat of biochemical engineering, and it is a pity that you are unable to appreciate its sublimity when in operation.
• We may be living in the 21st century as far as our external environment is concerned, but we still inhabit Stone Age bodies, with the same internal structures as our Neolithic forebears.
• Our nervous and hormonal systems do not distinguish between stress of the wild-beast-intent-on-devouring-us type or the vile-boss-making-unreasonable-demands type. The response is always the same.

Adrenal Fatigue Stage Two Stress Settles In

The adrenaline response works in the short term, but in the long term – stage two – the body uses other hormones to deal with prolonged, unrelenting stress, long after the effects of the alarm stage have dissipated. During the second, or adaptation stage, activation of the HPA axis stimulates the production of the hormone cortisol, and excessive cortisol production is a key feature of stage two of the stress response.

Normally, this hormone is produced cyclically in what is termed the circadian rhythm levels start to rise between 3 a.m. and 6 a.m. and gradually decrease throughout the day so that by night-time they are at their lowest. Like most essential things, cortisol is required in just the right amounts: too little, or too much, can disturb the homeostasis of the body. Why is cortisol so important? You need this hormone because of it:

1. Stimulates the conversion of protein and fat to glucose for energy, thus increasing blood-sugar levels
2. Stimulates the release of fatty acids from fat cells to be used as fuel for energy
3. Stimulates cellular repair
4. Increases mental and physical energy
5. Has a powerful anti-inflammatory effect
6. Improves mood
7. Reduces the allergic response
8. Controls the immune system – it prevents overreaction of white blood cells which could lead to autoimmune disease (where the body attacks its own cells and organs)
9. Maintains blood pressure by preventing sodium loss.

• During stage two the body produces cortisol in excess and, over a prolonged period, this surfeit can be detrimental to health.
• So too can excessive aldosterone, another adrenal hormone produced at this stage. Aldosterone raises blood pressure by retaining sodium in cells, which is why high blood pressure is often symptomatic of prolonged stress.
• The effects of elevated cortisol include raised blood-sugar levels and all the problems this can cause and weakened immunity – virtually all components of the immune response are inhibited by cortisol.
• This effect leaves you susceptible to colds, flu, and other immune-related disorders. Elevated cortisol suppresses the secretion of growth hormone – important because it carries out repair work when you are asleep.
• Headaches, sleep disorders, and heart disease can also result from excessive cortisol production, brought about by chronic activation of the HPA axis.
• Protein breakdown is increased, and this can lead to muscle wasting and osteoporosis. Cortisol is made from the female hormone progesterone so, not surprisingly, adrenal fatigue can disturb the menstrual cycle in women because prolonged stress can result in progesterone supplies being diverted to create cortisol.

And Another Thing

• Among the principal misdemeanors of unrestrained cortisol is, as we have seen, its ability to create hormonal havoc. This is particularly true when it comes to another important adrenal steroid hormone, dehydroepiandrosterone, or DHEA.
• DHEA is the most abundant steroid found in the blood and is a precursor to other hormones including testosterone and oestrogen. It is produced abundantly until around the age of 20 when levels start to decline. It is effectively the hormone that keeps you young and slim.
• It’s bad enough that secretion falls naturally as we age, without it being diminished even further by periods of unrelenting stress. Excessive cortisol diminishes the body’s level of DHEA. DHEA is essential because it:

1. Stimulates the immune system and counters the effects of excessive cortisol
2. Lowers LDL (‘bad’) cholesterol
3. Can help prevent osteoporosis by stimulating bone deposition
4. Can help slow down the ageing process
5. Stimulates metabolism
6. Reduces the symptoms of premenstrual syndrome
7. Stimulates the burning of fat for fuel
8. Increases vitality
9. Boosts sexual function
10. Regulates mood.

Adrenal Fatigue Stage Three Crash And Burn And Cry

Although the resistance stage can last as long as several years, the body’s capacity for adaptation has its limits, and if there is no let-up in the burden of mental trauma the exhaustion stage (also known as the adrenal maladaptation stage) is an inexorable fate. It is at this point that disproportionate cortisol output, which the adrenals can no longer sustain, starts to decline, falling to below-normal levels. Mental and physical exhaustion ensues.

• This is not the same as Addison’s disease, which is a rare, chronic, and life-threatening condition which may involve structural damage to the adrenal gland and requires the patient to take corticosteroid medication for life.
• Most cases of Addison’s are the result of tuberculosis infection or autoimmune disease, where the body attacks its own organs, leading to adrenal failure.
• Chronic fatigue syndrome (CFS) and fibromyalgia (a condition characterized by musculoskeletal pain and fatigue), weakness, and dizziness are all linked to cortisol insufficiency.
• Indeed, HPA axis dysfunction has been found to be present in the majority of patients with both CFS and fibromyalgia.
• Giving low doses of cortisol has been shown to treat both conditions effectively.
• Even so, adrenal exhaustion is still not widely recognized as a medical condition, despite increasing and compelling evidence that the adrenal glands can become underactive as a result of stress.
• People suffering from post-traumatic stress disorder (PTSD) have been found to under-secrete cortisol, as have ‘healthy’ individuals living under conditions of chronic stress.

Do You Have Adrenal Fatigue

The person best qualified to identify stress as a factor in your levels of health and well-being is you. That is why, whenever I suspect that adrenal fatigue (sometimes referred to as adrenal stress) may be aggravating a client’s symptoms,

• I ask: ‘Are you very stressed out? And if so, has the stress in your life been going on for a long time?’ If the client answers an unequivocal ‘Yes,’
• I follow up with: ‘Do you think stress is affecting your health, energy levels, and sense of well-being?’
• It is not uncommon, at this point, for my client to embark on a narrative of events, often starting in childhood.
• These stories are variously fascinating, heartbreaking, depressing, and shocking, but they are always unique and always serve as a reminder to me of the human ability to withstand enormous challenges and stresses. But stress does eventually take its toll on the mind and body, to varying degrees.
• The reason why some people are able to deal with punishing stress levels for so long, whilst others succumb early to the detrimental effects of endless pressure, may lie in how well their adrenals are functioning.
• As we have seen, adrenal fatigue is progressive. Stage one is normal – a fascinating display of the body’s autonomic defense system which swings into action without your having to do anything of your own volition. Stages two and three are much more of a concern. If you are at stage two, your symptoms are likely to include:
  • Frequent headaches
  • Insomnia (because cortisol is high at night when it should be low)
  • Menstrual irregularities
  • Frequent colds and infections
  • Signs of premature aging.
• If you are at stage three, your symptoms are likely to include:
  • Chronic fatigue
  • Painful muscles
  • Apathy
  • Weakness
  • Depression
  • Dizziness (especially on rising suddenly, because of low blood pressure).
• At any stage of adrenal fatigue, you are likely to be using stimulants such as caffeine and alcohol to prop yourself up. You are also likely to have abnormal blood-sugar levels and find yourself lurching from one cold or infection to another.
• You may find it difficult to get up in the morning and struggle with memory and concentration. Stressful situations become more difficult to handle and you find yourself becoming increasingly irascible. Despite this, you might be driving yourself forward, eating poorly and never taking the time to relax.

I know this doesn’t help right now, but you should be aware that you are also at increased risk of developing osteoporosis and heart disease later on, should the situation remain unresolved.

• If, by now, you suspect that suboptimal adrenal function may be behind your symptoms, you will hopefully be inspired by the knowledge that you can do something about it.
• You can start by following the advice below on how to stabilize adrenal function through diet and lifestyle changes. You may also wish to take a salivary hormonal test known as an adrenal stress index, or ASI, which examines cortisol and DHEA levels throughout the day and identifies any excesses or deficiencies.
• I have always made good use of the ASI test because it tells me not only if adrenal fatigue is a factor, but at what stage of adrenal stress my client has arrived.
• This test is very simple and can be performed at home – the laboratory posts a kit to you and you follow the instructions provided, which entail collecting four saliva samples at four different times of the day: 7-8 a.m., midday, 4-5 p.m. and 11 p.m-midnight.
• You then send off your four vials and wait for the results to be posted to you. See the Resources chapter for details of a laboratory that carries out this test.

Stabilizing Adrenal Output

Before embarking on a new dietary regime, you need to think seriously about the stress in your life and what you can do to minimize it. There is no one unique solution; the best approach embraces stress management, relaxation techniques, and, of course, dietary changes. Stress is one area where a truly holistic approach is imperative if you are to get effective results.

Stress Management

• There are stress-management techniques you can adopt yourself and techniques that require the help of others. Exercise is a good starting point because this is something you can initiate on your own.
• Exercise is important because it helps normalize levels of stress hormones in the blood, and improves circulation. It also stimulates the release of endorphins – ‘happy hormones’ – which can elicit a sense of well-being and positivity.
• Aerobic exercise stimulates the production of cortisol, so ideally should be carried out in the morning only, if cortisol is low. It is especially important that you do not engage in aerobic exercise in the evening, as normally cortisol levels should be falling at this time, in preparation for sleep.
• If you do not know if your cortisol is high or low, opt for gentle exercise only: daily walking, yoga, stretching, or swimming. Whatever you do, it has to be something you enjoy.

Relaxation

• In addition to exercise, there are other effective tools you can utilize to manage stress levels. Your method of choice is a matter of what you feel drawn towards. Possibilities include meditation, positive l imagery, and deep-breathing techniques.
• You might prefer a regular massage, aromatherapy, or reflexology. If you feel you need talking therapy, you might want to consider some professional help from a stress counselor.

Dietary Manipulation

• The dietary regime designed to help stabilize the adrenals is essentially the same, whatever stage of adrenal stress you have succumbed to. Therefore you can follow the advice below regardless of whether or not you have taken the ASI test.
• Dietary management of adrenal stress is fairly straightforward and manageable and you should not find it too difficult to follow.
• Your priority is stabilizing blood sugar. Achieving this takes the pressure off the adrenals and helps them normalize hormonal output.
• Fluctuations in blood sugar can stimulate cortisol output and are a stress on the body, but if you are not producing enough cortisol you are more likely to experience low blood sugar.
• Full details of dietary management of blood sugar are given. The most important dietary essential is the removal of all sugar and refined carbohydrates from the diet and the inclusion of fat and protein with every meal.
• If there’s one other dietary component you must have in your quest to normalize adrenal output, it’s the fatty acids commonly known as omega-3 fatty acids, of the type found in oily fish.
• You can read all about the role of fatty acids., but for now all you need to know is that these fats help stabilize HPA axis activity. Low levels of these fatty acids are associated with HPA axis overactivity, and supplemental omega-3 has been found to inhibit adrenal activation triggered by mental stress.
• The best omega-3 fish sources are sardines, salmon, herring, trout, mackerel, anchovies, and tuna (fresh, not tinned). If you do not take fish oil supplements, I suggest you eat oily fish at least twice a week.
• There are certain nutrients that are highly concentrated in the adrenals and which are essential for healthy adrenal function. In particular, the adrenals need vitamin C, B complex (especially B5) and the mineral magnesium.

Some Important Adrenal Nutrients, Their Sources, and Roles

• It is one thing to know which nutrients are helpful in assisting the adrenals, but quite another to translate that knowledge into practice. See the Meal Ideas chapter for some excellent suggestions.
• Hopefully, you can see what’s most important: protein in the form of meat, fish, dairy or eggs with each meal, with lots of fruits and vegetables. I have not included potatoes as they have a high glycaemic index which means they quickly elevate blood sugar levels.
• Some whole grains can be incorporated into this dietary regime, but I tend to restrict these to no more than one portion a day. I prefer to include beans and lentils rather than grains as they are more nutritious, higher in protein, and have a lower glycaemic index.
• All beans are good, but be wary of conventional tinned baked beans as these tend to be high in added sugar. Sugar-free varieties are available. To cook dried beans requires considerable commitment: they have to be soaked overnight and then boiled for several hours.
• This does have its advantages: dried beans are relatively cheap and you can make bean dishes in large quantities and then freeze them. However, most people, I find, would rather just open a tin. That’s fine, from a nutritional perspective, but just make sure that your beans of choice are sugar-free.
• Personal favorites include chickpeas, black-eyed beans, haricot, cannellini, adzuki, kidney, and butter beans. Lentils also make a good basis for a meal: green and brown lentils lend themselves particularly well to vegetable stir-fries with, say, chicken, beef, or fish. Red or green lentils can be used to make dhal. You can also grate some Cheddar cheese over cooked lentils for an excellent pro-adrenal meal.

Vegetarians and Vegans

• Balancing blood sugar and normalizing adrenal output can be a bit tricky if you do not eat meat, fish, or any other animal product. This is because animal foods are complete proteins which usually also contain fat. Both protein and fat delay and control the release of sugars into the bloodstream.
• Vegetarians may have to rely more on dairy products and eggs, and vegans more on soya produce, beans, and lentils, nuts, and seeds. See page 30 for a list of good protein foods, from both animal and plant sources.
• If you do not eat fish, or take fish oil supplements, getting the omega-3 fatty acids you need is also that much more challenging. Certain nuts and seeds, especially flaxseed (also known as linseed) and pumpkin seeds are rich in omega-3 fats, but these are different to the omega-3 fats found in fish.
• That is because the omega-3 fats in nuts and seeds have to be converted by the body into the fatty acids known as EPA and DHA, in order to be of any use, and the body does not do this efficiently – in fact, very little of the oil in nuts and seeds is converted to EPA or DHA.
• The advantage of fish oil is that it is a ready-made, plentiful source of both these fatty acids, so no conversion is necessary.

Dietary Supplements

• If you have decided to go ahead with a saliva test, I would urge that you do so via a nutritional therapist, or that you consult therapist once you have received the results. When it comes to taking supplements for adrenal stress, this is best done with professional guidance.
• Having said that, some supplements help balance adrenal output whether you have stage two or three adrenal fatigue.
• Other supplements can raise cortisol and others depress it, in which case it is obviously crucial that the right supplements are taken.
• Registered nutritional therapists are to be found on the website of the British Association for Applied Nutrition and Nutritional Therapy, details of which are found in the Resources chapter.
• The table below outlines a good basic support program which I tend to use whatever level of adrenal stress I am attempting to address. In addition to these, many people find the herbal remedies Siberian ginseng, Rhodiola, and ginger root to be very effective.
• These are considered to be ‘adaptogens’ in that they help the adrenals regulate normal hormonal output.

Basic Supplement Programme for Adrenal Support

How long will all this take? Most nutritional therapists will advise that you can expect to spend a minimum of two months normalizing adrenal function. You should, however, start to be aware of improvements in symptoms within a month.

Adrenal Case History

• Julie was an especially interesting case. At the age of 45 she came to see me with not only a long list of symptoms that suggested adrenal fatigue but lots of other problems, too, including poor digestion and painful, heavy periods.
• The symptoms she described which made me immediately suspect adrenal stress were total fatigue, poor sleep, depression and anxiety, joint pain, poor memory and concentration, and regular headaches. I asked Julie if she felt she was stressed, and her answer was an unequivocal Yes.
• Then I asked her how long she had been under excessive stress – and the answer was 25 years! It wasn’t difficult to conclude that adrenal stress might be contributing to her symptoms.
• On the digestion side, Julie regularly experienced bloating, diarrhea (alternating with constipation), bad breath, and flatulence.
• She also suffered from hay fever and asthma. It seemed I had my job cut out.
• A glance at her food diary revealed that it was heavily loaded with carbohydrates and was low in protein. It was quite normal for her to eat nothing but cereals and other carbohydrates throughout the day, without consuming any protein until the evening.

Fortunately, I was able to persuade her to take the ASI test. Whilst we waited for the test results, I got her to make significant changes to her diet, which were all about balancing blood-sugar levels: three meals a day with protein at each meal, lots of oily fish and dark leafy greens and snacking on nuts and seeds.

• I did suspect that she might have a wheat intolerance as she ate the stuff morning, noon L and night and had a lot of digestive symptoms. However, as she already had a lot of dietary changes to make in order to deal with the adrenal fatigue, I only asked her to reduce her wheat intake to once a day.
• Four weeks later, Julie returned for her follow-up consultation. Just by making the dietary changes suggested, her headaches had cleared up, which she described as Very unusual.
• Her digestive symptoms had all improved, though they had not gone away completely. Low energy and insomnia and other adrenal stress symptoms remained unchanged.
• By the time of this second appointment, Julie’s test results had arrived. They showed that she was, as I suspected, at the exhaustion stage. Both cortisol and DHEA levels were depressed throughout the day. No wonder she felt so awful.
• Diet alone wasn’t going to be enough: in this case, I was in no doubt that Julie required some quality supplements to, help bring up her adrenal output and restore homeostasis.
• I recommended a high-strength multivitamin and -mineral, vitamin C, fish oil, magnesium, and Siberian ginseng.
• I also persuaded Julie at this point to do the wheat exclusion test to deal with her digestive symptoms.
• Six weeks later, Julie returned. Her health had been transformed: she was sleeping well, cravings for sweet food had vanished, she had had no headaches and her energy was much better. On the digestion side, her bowels were regular, she had no diarrhea, bloating, or flatulence.
• She had also unexpectedly lost 5-6 lb in weight – and said she was ‘absolutely delighted’. The wheat exclusion test had been positive, and as a result, she had begun avoiding all wheat products. It was clear to me that the source of her health problems had been both wheat intolerance and adrenal fatigue.

Adrenal Fatigue Other Therapies

Reflexology is an excellent therapy in that it aids relaxation. Other relaxing therapies such as massage are to be highly recommended. I also favor acupuncture as a means of stimulating low-functioning glands and organs.