May 1, 2011

What Everyone Needs To Know About The Adrenal Glands (The Stress Glands)

What are the adrenal glands?
The adrenal glands are part of the endocrine system (system of glands within the body responsible for secreting different hormones into the bloodstream to regulate the body) and are primarily responsible for managing stress, being that they are our ‘stress glands’. Our energy, endurance, resiliency and life are dependent on their proper function, and the ability to build muscle, burn fat, live healthy and perform at our best in whatever it is we choose to do, are acutely affected by the adrenals.

What is adrenal fatigue?
When your adrenals are fatigued or worn out, a condition referred to as adrenal fatigue develops and your entire body feels it, which in turn affects all aspects of your life. Fatigue occurs when the amount of stress overextends the capacity of the body to compensate and recover.

How many people are affected by adrenal fatigue?
Some literature suggests that roughly 80% of the adult population is affected by adrenal fatigue, but I wouldn’t be surprised if the actual number was much higher.

What do the adrenals do?
The adrenal glands are located above the kidneys and they’re purpose is to help us cope with stress and survive. Each gland has two compartments – the inner compartment, which modulates the sympathetic nervous system (pumps you up) through secretion and regulation of two hormones, epinephrine and norepinephrine, which are responsible for the fight or flight response. And the outer adrenal cortex, which makes up 80% of the adrenal gland itself and manufactures the steroid hormones like testosterone, estrogen, cortisone, hydrocortisone, cholesterol, progesterone, DHEA, pregnenolone and over 50 total hormones that are essential for life. These 50+ hormones are separated into three different classifications: ADRENALINE, MINERALCORTICOIDS, and GLUCOCORTICOIDS.

What is adrenaline?
Adrenaline (epinephrine) is a hormone that is responsible for increasing your heart rate in an attempt to physically prepare you for a fight or flight scenario, as well as controlling blood flow to your muscles and the brain, and helping with the conversion of glycogen to glucose in the blood.

Adrenaline also:
1. Causes the pupils of eyes to dilate (for better awareness in fight or flight scenario)
2. Increases heart rate, force of contraction, and blood pressure (to provide the muscles with greater ability to fight or flight)
3. Constricts the blood vessels of nonessential organs such as the skin
4. Dilates blood vessels to increases blood flow to organs, skeletal muscle, cardiac muscle, liver and adipose tissue
5. Increases the rate and depth of breathing and dilates the bronchioles to allow faster movement of air in and out of the lungs
6. Raises blood sugar as the liver glycogen is converted into glucose
7. Slows down or even stops processes that are not essential for meeting the stress situation, such as muscular movements of the gastrointestinal tract and digestive secretions (ever notice that if you need to go to the bathroom, and then something scares the crap out of you, all of a sudden you don’t have to go to the bathroom? It’s because of the adrenaline pumping through your body)

What are mineralcorticoids?
Mineralcorticoids such as aldosterone, help keep your blood pressure and blood volume regulated by maintaining an ideal balance of potassium, sodium and water in the body. Stress increases the release of aldosterone, causing sodium retention, which therefore increases water retention as well as blood pressure, and also depletes potassium and magnesium.

What are glucocorticoids?
Glucocorticoids such as cortisol and hydrocortisone, assist your body in converting food into energy, normalize blood sugar, respond to stress and also maintain your immune system’s inflammatory response. Cortisol is the main stress response hormone in the body and is a bit of a double edged sword.

Cortisol levels vary throughout the day based on current demands, commonly rising between 6 and 8 am, and peaking around 9 and 11 am, then steadily declining throughout the day. Think of it like this: cortisol rises with the sun, and sets with the sun. The reason for this is simple. For millions of years, we did our hunting and gathering between sunrise and noon. The body adapted to this lifestyle, and is why things are the way they are for us now. When you exercise, the body triggers the release of cortisol, and the body thinks it’s somewhere between sunrise and noon, and it is for this reason that workouts are probably best done in the morning. Working out at night will disrupt the body’s natural sleep patterns and thus stress the adrenal glands. People that work out after noon, and think they get good sleep, are not some sort of special exception, they just have fatigued adrenal glands. If you get good sleep after working out at night, it’s probably because excercising brought your depleted cortisol levels up to baseline levels. Working out at night to help with sleep provides a band aid effect which fails to address the real problem.

What does cortisol do?
1. It’s a stimulating natural hormone that elevates our metabolism and body temperature and prepares our body to work
2. An anti-inflammatory hormone, aiding in the control of inflammation, a natural precursor to tissue healing
3. An activating hormone stimulating us to wake from sleep if released due to light exposure, low blood sugar levels, stressful dreams, or because we have parasites eating into our tissues when we sleep at night
4. Mobilizes and increases amino acids, the building blocks of protein, in the blood and liver
5. Stimulates the liver to convert amino acids to glucose, the primary fuel for energy production
6. Stimulates increased glycogen in the liver. Glycogen is the stored form of glucose
7. Mobilizes and increases fatty acids in the blood (from fat cells) to be used as fuel for energy production
8. Counteracts inflammation and allergies
9. Prevents the loss of sodium in urine and thus helps maintain blood volume and blood pressure
10. Maintains resistance to stress (ex. infections, physical trauma, emotional trauma, temperature extremes etc.)
11. Maintains mood and emotional stability
What if excess cortisol is needed and secreted?
1. Stimulates fat deposits and can result in weight gain
3. Accelerates ageing
4. Increases blood pressure
5. Diminishes cellular utilization of glucose
6. Increases blood sugar levels which leads to reduced insulin sensitivity and eventually diabetes
7. Decreases protein synthesis
8. Increases protein breakdown that can lead to muscle wasting
9. Causes demineralization of bone that can lead to osteoporosis
10. Interferes with skin regeneration and healing
11. Causes shrinking of lymphatic tissue
12. Diminishes lymphocyte numbers and functions
13. Suppresses immune system and can lead to increased susceptibility to allergies, infections, and degenerative disease
14. Estrogen dominance leading to PMS, uterine fibrosis and breast cancer
15. Decreased liver detoxification
16. Decreased immune system function, leading to increased risk of infection
Symptoms of elevated levels of cortisol:
1. Fatigue/low energy
2. Impaired memory
3. Impaired concentration
4. Insomnia
5. Anxiety
6. Crying
7. Restlessness
8. Feeling of hopelessness

Depleted levels of cortisol, which happens if the adrenals are fatigued, also have negative side effects as well.

Side effects of depleted cortisol levels:
1. Suppressed immune system
2. Increased inflammation
3. Hypoglycemic tendencies, fluctuations in blood sugar and insulin spikes

What is DHEA?
DHEA, along with testosterone and estrogen, is another important anti-ageing hormone manufactured by the adrenals in both sexes by pregnenolone.

What does DHEA do?
1. Functions as an androgen (male hormone) with anabolic (building or synthesis of tissues) activity
2. Is a precursor that is converted to testosterone (male hormone). Is a precursor to estrogen (a female anabolic hormone)
3. Reverses immune suppression caused by excess cortisol levels, thereby improving resistance against viruses, bacteria, and Candida albicans, parasites, allergies, and cancer
4. Stimulates bone deposition and remodelling to prevent osteoporosis
5. Improves cardiovascular status by lowering total cholesterol and LDL levels, thereby lessening incidences of heart attack
6. Involved in the thyroid glands conversion of the less active T4 to the more active T3
7. Reverses the many of the unfavourable effects of excess cortisol, creating subsequent improvement in energy, vitality, sleep, premenstrual symptoms, and mental clarity
8. Accelerates recovery from any kind of acute stress (ex. excessive exercise, insufficient sleep, mental stress)
9. Increases muscle mass, therefore decreases percentage of bodyfat
Together these hormones control several body functions including:
1. Manage blood sugar levels
2. Regulate inflammation
3. Regulate the balance of salt and water in the body
4. Regulate blood pressure
5. Burn calories (lose fat!)
6. Control the response to stress
7. Maintain pregnancy
8. Control sexual maturation during puberty
9. Produce testosterone and estrogen
Is it possible for the "stress glands" to become stressed?

Even though the adrenals are there to help you cope with stress, they too can become stressed, and too much will cause them to break down.

Basically they are intended to get your body ready for a rare fight or flight situation. When you feel threatened the adrenals bump up the secretion of adrenalin and other hormones and as part of this response your heart rate and blood pressure increase, your digestion slows down and you are prepared physically to make the decision to stay and fight, or run as fast as you can to avoid dangerous circumstances.

While a response like this is good and necessary when the time comes, a huge amount of the population faces CONSTANT stressors.

Constant stressors we face regularly are:
1. Work – Physical, Mental, Emotional
2. Excessive Exercise
3. Environment/Toxins (Pollution, Smoking etc...)
4. Lack of Sleep and Light Cycle Disruption (staying up late, working night shift etc...)
5. Emotions - Worry/Fear/Anger/Anxiety/Guilt/Depression/ANY NEGATIVITE EMOTION!
6. Relationship Issues (Spouse/Boyfriend/Girlfriend)
7. Financial Issues (Bills/Paycheck)
8. Children
9. Skipping Meals
10. Excessive caffeine intake
11. Excessive sugar/carb intake
12. Surgery/Trauma/Injury
13. Inflammation (carbs elevate insulin which increases inflammation which is a contributor as well as result of stressed adrenals), Infection, Illness, Pain
14. Extreme Temperatures
15. Nutritional Deficiencies (malabsorption/maldigestion) and Mineral Deficiencies (having an acidic pH level)
16. Hypoglycemia – low blood sugar (is a contributor as well as result of stressed adrenals)
17. Pretty much ANYTHING negative that happens to you

It is these constant stressors that put you, and keep you, in fight or flight mode for far longer than was ever intended from a biological standpoint.

This results in the adrenals becoming overworked and fatigued. When this happens it leads to a decrease in certain hormones, particularly cortisol. Other hormone deficiencies will vary from person to person, from mild to severe.

How bad can adrenal fatigue become?
The most extreme form of adrenal fatigue is known as Addison’s disease, which can be life threatening, but is more commonly associated with muscular weakness, weight loss, low blood pressure and low blood sugar.

Addison’s disease (when the adrenal glands are not functioning what so ever, aka adrenal failure) is very rare and only about 1 out of 25,000 will develop it, due to an auto immune disease but can also develop from very severe stress.

Adrenal fatigue, also known as hypoadrenia, is less severe but can also be debilitating. In some cases people can’t even muster up the strength to get out of bed for a few hours after waking. We don’t ever hear about it because modern medicine does not recognize it as a distinct syndrome. As the adrenals become more and more stressed, every organ and system in the body is profoundly affected.

Signs and symptoms of adrenal fatigue are:
1. Tendency to gain weight and inability to lose weight after extensive efforts, especially around the abdominals (how many people do we all know that have this issue?)
2. Dizziness/light headedness after standing up from sitting/laying down (possibly due to low blood pressure as a result of stressed adrenals)
3. Craving foods high in salt (due to low aldosterone levels, the body will crave salt to regulate blood pressure)
4. Craving foods high in sugar (due to low energy as well as low cortisol which is needed to help the liver release glycogen and give you energy)
5. Craving foods high in fat
6. Fatigue and weakness upon waking and throughout the afternoon
7. Trouble waking up despite a full night’s sleep
8. Depression
9. Hormonal imbalance
10. Increased PMS or menopausal symptoms (periods are heavy and then stop, or are almost stopped on the 4th day and then start again on the 5th or 6th day)
11. Low sex drive
12. Poor memory
13. Skin problems
14. Autoimmune disorders
15. Autoimmune diseases
16. Increased allergies
17. Muscle and bone degeneration
18. Muscular weakness
19. Decreased ability to handle stress
20. Low body temperature
21. Low blood pressure
22. Random hair loss
23. Nervousness, tendency to tremble while under pressure
24. Difficulty building muscle
25. Irritability
26. Apprehension (expecting the worst)
27. Hypoglycemia – low blood sugar (is a contributor as well as result of stressed adrenals)
28. Inability to concentrate, moments of confusion, poor memory
29. Always hungry
30. Inflammation (carbs elevate insulin which increases inflammation which is a contributor as well as result of stressed adrenals)
31. Indigestion
32. Feelings of frustration
33. Palpitations (could also be due to a magnesium deficiency)
34. Insomnia
35. Dry and thin skin
36. Osteoporosis
37. Alcohol intolerance
38. Frequently complains of “needing a vacation”

How do you know if you have adrenal fatigue:
Here is an extremely common pattern you’ll recognize in people that suffer from adrenal fatigue: they’ll wake up sluggish, barely get out of bed, struggle to get through the day, get a burst of energy around 6pm (which they tell themselves is due to eating a meal or something like that, as they try to convince themselves that there is nothing wrong with them for peace of mind), followed by tiredness again around 9 or 10pm which they’ll resist, then get a second wind around 11pm and stay up past midnight, even though they know they should be asleep by then. This is a VERY common pattern for people suffering from adrenal fatigue.

Other common symptoms associated with adrenal fatigue are high blood sugar levels and mental disturbances, like fear and anxiety, and also people that rely on coffee to get them going in the morning, and other sources of caffeine to keep them going throughout the day.

Unrelenting fatigue, or a feeling of not being able to keep up with daily demands due to feeling run down, is the most common symptom of adrenal fatigue. Because nearly everyone deals with fatigue on different levels, it makes it very difficult to diagnose.

How to replenish the adrenal glands:
For those dealing with adrenal fatigue, there is hope, but as you can imagine it took time to burnout your adrenal glands, and therefore it will take time for them to recover. Depending on the severity, it can take from 6-9 months to recover from minor fatigue, and up to 2 years for those dealing with severe fatigue.

The biggest and most influential step in the recovery process is addressing current and past emotional issues. Other steps you can take to help replenish your burnt adrenal glands are:

1. Eat frequently (within first hour of waking up, every three hours at the latest and also before bed. YES, BEFORE BED, but obviously not something like a cheeseburger, pizza or pasta). If you get hungry, you waited too long (blood sugar has dropped and that indirectly stresses the adrenals). As far as eating is concerned, to stabilize blood sugar you must maintain a balance between glucagon and insulin, two hormones produced by the pancreas. Protein increases glucagon, carbohydrates increase insulin. If you remember my article on basic nutrition, you may remember that insulin is a storing hormone. When excess carbs are eaten, insulin is elevated while glucagon is not, which results in more fat being formed and stored. When insulin is high and glucagon is low, you will experience intervals of hypoglycemia, and in an attempt to normalize blood sugar the adrenal glands have to pick up the slack by secreting excess cortisol from the adrenal glands to help raise blood sugar in the absence of glucagon. Excess intake of carbs leads to excessive secretion of cortisol which contributes to chronic cortisol depletion and consequently adrenal exhaustion. You basically force the adrenal glands to do work that would normally be done by the pancreas if only you had a balanced amount of protein with your carbs. On a side note, the brain uses mostly sugar, so when blood sugar drops due to high insulin levels as a result of a high carb meal, you get tired. On another side note, have you ever noticed when you are very hungry (blood sugar has dropped), and for whatever reason you don’t eat something and after enough time passes you aren’t hungry anymore? That’s cortisol doing its job.

2. Avoid stimulants like coffee and other products with caffeine as they further stress the adrenals. They deplete important B vitamins and alter pH levels. COFFEE does not give you energy! It gives you the illusion of energy. It actually drains the body of energy and makes you more tired due to vitamin and adrenal depletion. Caffeine prevents the adrenals from producing the right level of energy naturally. Even stimulants like ephedrine can cause an over secretion of cortisol, thus provide further stress to the adrenal glands.

3. Excess alcohol consumption reduces the immune and energy production systems. When you drink to relax it inhibits the adrenals from performing the task on their own.

4. Foods high in potassium make adrenal fatigue worse, especially in people deficient in sodium (bananas, all melons, oranges, grapefruit, raisins)

5. Exercise, but don’t overdo it. I see people in the gym for hours, probably because they think more is better, not knowing that they are wreaking havoc on their adrenal glands. Keep workouts under an hour. When I say workouts, I mean the total time from when you start, after you’ve warmed up, until the time you finish your last set, prior to your cool down or stretching, if you choose to. Another tip to prevent wearing out your adrenals is to avoid training to failure! Training to failure suppresses proper adrenal function. Remember that next time you decide to do triple drop sets for an entire hour, thinking it makes you look hardcore.

6. REST! Do not underestimate the power of rest. This means sleeping in when you can as cortisol levels rise between 6 and 8 am, going to bed when you know you should, and listening to your body. If you need a nap mid day, take one.

7. LAUGH! Laughter increases parasympathetic supply to the adrenals. A lot of people are attracted to others that make them laugh subconsciously without knowing or caring why. One of the reasons we crave to be around those people is because they have positive physiological effects on our health.

8. TAKE MAGNESIUM! A magnesium deficiency creates a stressful environment within the body.

9. TAKE FISH OIL! The adrenals thrive on essential fatty acids, that’s why they’re called essential. Healthy fats like fish oil, lower the insulin response during and after a meal as well as reduce cortisol when it gets too high, thus sparing the adrenal glands.

Treating adrenal fatigue requires a whole body approach that addresses lifestyle habits and excess stresses that wore out your adrenals in the first place.

On a side note, to treat imbalanced sex hormones, whether it be male or female, the first step is to address the adrenal glands. Attempting to treat hormone imbalances with bioidentical hormone therapy will fail over the long haul because the fatigued adrenals would never allow the hormones to equilibrate properly.

If you have any questions about stress and adrenal function, feel free to contact me at I'm available for online consulting and personalized program design, as well as one on one training if you are located in the Greater Toronto Area (GTA).

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