Are you prone to fatigue? Do you suffer from insomnia? Is anxiety interfering with your life? Do you suffer from feelings of mental fog? Is getting your coffee in the morning the best part of your day? Do allergies or asthma bother you? Ever feel like you have drops in blood sugar that seem sudden or unexplainable? Do you feel like you have a lack of vitality that keeps you from working out effectively? Low libido? You are not alone! Adrenal-related issues are incredibly common and are one of the primary reasons why people seek help at our practice.
As the sun moves South and the long, lazy days of summer begin to fade, busy school schedules resume, workloads shift back into gear, and the holidays loom in the foreground. As stress levels start to rise with these increased demands in your schedule, protecting your adrenal health should be one of your primary fall health goals. Read on for a discussion on how your adrenal glands function, how they impact your health, and what you can do to keep them functioning well.
Symptoms Of Adrenal Problems
Adrenal problems often pop up after either physical stress–such as a chronic infection or a busy schedule–or after emotional stress such as the death of a loved one or a break up. After prolonged physical or emotional stress, eventually a person will end up with either symptoms reflecting adrenal imbalances or other health syndromes and diagnoses that are related to adrenal fatigue.
Here are some common symptoms and physical indicators that you having disruptions in your adrenal function. You only need one or two for us to suspect an adrenal imbalance:
- Chronic sense of fatigue
- Unexplained headaches
- Feeling tired in the morning even after a “good” nights sleep
- Loss of libido
- Weight gain
- Feelings of exhaustion
- Unable to cope with stressors
- Feelings of overwhelm
- Insomnia or deranged sleep patterns
- Feeling rundown
- You may feel most energetic in the evening
- Low stamina, poor to recover from exercise
- Difficulty concentrating or frequent “brain fog”
- Consistent low blood pressure
- Unexplained anxiety
Health problems and diagnoses associated with adrenal imbalances:
- Food sensitivities or environmental allergies
- Chronic allergies or asthma
- Frequent infections such as sinusitis, bronchitis or pneumonia
- Irritable Bowel Syndrome
- Chronic gut infections and inflammation
- PMS and other debilitating menstrual symptoms such as severe cramping
- Frequent dizzy spells
- Low immune function
- Sensitivity to cold
- Joint pain and muscle pain
- A diagnosis of “fibromyalgia” or chronic fatigue syndrome
- Feeling drawn to adrenal stimulants such as coffee, tea, sodas, sugar, nicotine and alcohol
- Anxiety disorder or depression
- Any type of tick-borne illness or disease such as Lyme disease or Bartonella
Obviously, adrenal complaints are no laughing matter and many of these signs and symptoms can impact not only your physical health and personal well being, but your work performance and relationships. If you have any of these infections, signs or symptoms, you would be wise to consider testing.
What Are Your Adrenal Glands?
Your adrenal glands are tiny, triangular shaped glands that sit on top of your kidneys. They are responsible for creating and releasing hormones that help you cope with stress, reduce inflammation in the body, regulate sodium and potassium levels in the blood, and stabilize blood sugars. Most people are familiar with cortisol and epinephrine (or “adrenaline”) as they relate to stress, but most people are not aware that these hormones impact your blood sugars and glucose metabolism as well. Additionally, cortisol reduces inflammation, helps fight infections, and is critical at optimal levels for creating a sense of vitality and well being.
When you become stressed for any reason whether it be a difficult conversation with someone, a car accident, a stressful day at work or a situation where you may be in danger, your adrenals release epinephrine (adrenaline.) The adrenaline hormone quickly increases your heart rate, contracts blood vessels, and dilates air passages to give you what’s commonly described as a “fight or flight reaction.” You may experience this as feeling “super charged” ready for muscular strength or quick thinking. Your body, in response to this hormone, will quickly burn through any available energy stores, lowering your blood sugar. Shortly after the adrenaline release, your body will produce cortisol to increase your blood sugar in order to help your body return to homeostasis.
Of course, if you are river rafting and fall off the raft and this reaction occurs, it sets up the perfect environment for you to quickly harness energy and respond to the emergency. However, if you are garnering this hormonal response multiple times a day due to emotional stress from family responsibilities, emotional turmoil from family dysfunctions or break ups with a partner, work stress, traffic, death of a loved one, or prolonged health problems or social crises, your adrenal glands and entire physical body will soon become exhausted. This fight or flight reaction was not intended by mother nature to be an all day, everyday event, but intended only for use during true survival emergencies.
Modern day life and pressures set up the perfect opportunity for many people to feel chronically fatigued and “burned out.” In fact, they are indeed in a form of burn out we diagnose as adrenal fatigue.
How do I get tested?
Testing for your adrenal health is fairly simple, but it is important that you get the correct tests. There are 3 ways of collecting information about your adrenal glands:
1. Salivary Testing
2. 24 Hour Urine Testing
3. Blood Work
Salivary testing: Salivary testing is considered “The Gold Standard” with regards to adrenal testing, and we will recommend this test to anyone whom we feel may have an adrenal issue underlying their health complaints. During the salivary test, you will collect your spit into tubes at specific times throughout the day. Because science knows that healthy adrenals produce a reliable pattern of hormonal output during specific times of the day, this test allows us to measure how well your adrenals are functioning against a healthy standard.
Oftentimes, we can identify the reasons for insomnia or decreased energy levels during specific time periods of the day reflecting the timing of patients’ complaints. We can also see if you are in a severe state of adrenal fatigue where cortisol levels are bottoming out throughout the day alerting us that there may be other issues going on such as a chronic infection draining the system.
It is critical on the day of the test that you do not have any caffeine and you may not use any other sublingual medications or hormones (such as melatonin, pregnenalone etc) several days prior to and of the testing. Caffeine and sublingual medications and hormones can disrupt your test results. It is also important that you choose a day off where you do not have to go to work or deal with any other additional stressors.
24 Hour Urine Test: The 24 hour urine test is another test that will give us detailed information about your adrenal health. For this test, you will literally collect all of your urine for a 24 hour time period and send a portion of it to a lab for analysis. Similar to the salivary test, it is best to do this test on a day where you do not have to work or deal with stressful events that may alter your test results. Additionally, caffeine use may disrupt the test results.
The 24 hour urine test will give us 24 hour totals of your adrenal hormone derivatives, but will not tell us functional patterns of your cortisol output at specific times during the day. For most patients, we will recommend the salivary testing first. The 24 hour urine test is one of the best ways for assessing hormonal imbalances and we often recommend it to assess for a variety of hormonal issues.
Bloodwork: Bloodwork is the least reliable way to check your adrenals. Nonetheless, there are some very specific tests that can be done via serum labs that cannot be done on the salivary test. We may add some adrenal blood tests to confirm or match with the results from your salivary test.
Please call the office for any questions regarding testing.
Treatment of Adrenal Issues, Dietary Guidelines, and Supplements
Get More Sleep and Rest: Too little sleep causes your adrenal glands to over produce cortisol and adrenaline just to maintain normal bodily functions and energy levels that should be rejuvenated during sleep. By resting whenever you feel tired, your body will recharge energy levels naturally rather than relying on cortisol and adrenaline to keep you going. This would include creating a sleep schedule. Try getting to sleep around the same time every night. Having erratic sleep schedules that change everyday will quickly tire out your adrenals. It is also said that sleeping between the hours of 7-9 a.m. can be particularly healing. Whenever you get the chance, sleep in! Sleep and rest are a critical component of healing. You MUST figure out a way to find more time to sleep and relax.
Avoid Intense Exercise: Intense exercise requires large amounts of adrenaline and cortisol. Many people experiencing adrenal fatigue notice that after their work outs they feel a dramatic sense of fatigue instead of feeling energized. If you are in adrenal fatigue, you must tone down your work outs to things like quiet walking, yoga, and gentle swims. Intense exercise may be something you can go back to doing once you have healed.
Avoid Chemicals, Toxins, and Pesticides: All of these things will drain your adrenals as your adrenals will attempt to reduce inflammation caused by these products. Food must be organic, you must avoid chemical inhalents such as paint fumes, and body care products such as toothpaste and shampoos should be organic and made of natural products. Start looking at labels and buying products that are created without chemicals.
Treat All Chronic Infections: If you suspect that you have any chronic infection whether it be a virus like Epstein Barr, bacterial like chronic sinusitis, or a long term gut problem like candida or H Pylori, these infections must be correctly treated before you will ever recover. Because your adrenal glands also function to reduce inflammation and improve immune function, hosting an infectious agent chronically will eventually weaken your adrenals and cause extreme fatigue. You can take adrenal supplements, sleep, eat the perfect adrenal diet, and reduce all other external stress, but you will not heal until the infection is managed correctly. Please come see us for testing if you suspect any type of infection.
Avoid Caffeine and Other Stimulants: Caffeine and other stimulants such as nicotine will artificially spike your cortisol and adrenalin hormones adding an extra work-load for your adrenal glands. This will contribute to fatigue. Taper off slowly. If you find that you truly cannot stop caffeine completely, reduce it to the lowest possible amount! Your adrenals will thank you!
Avoid Alcohol, Refined Sugars and Grains: When you drink alcohol or eat refined sugars and grains, your blood sugars rise quickly. This prompts your pancreas to release insulin to reduce your blood sugars. When your blood sugar drops too low, your adrenals are forced to produce cortisol to bring blood sugar levels back up to normal. This blood sugar merry-go-round is one of the contributing factors to adrenal fatigue. To heal, your diet must eliminate most sugars, breads, grains, and packaged carbohydrates. Alcohol is metabolized in the body and cells just like sugar, so alcohol is best eliminated for healing as well.
Include Small Amounts of Complex Carbohydrates: While the Paleo diet is definitely a diet we recommend for many patients, people who are already in adrenal fatigue will feel miserable in the initial stages of treatment on a strict paleo diet that eliminates all carbohydrates. Instead, people with weak adrenals will need to include a small amount of complex carbohydrates in each of their meals that are low glycemic.
Low glycemic carbohydrates will not spike blood sugars. Instead, complex carbohydrates will slowly release a steady amount of sugar into the blood stream over several hours as the stomach breaks down the long chained food and chemical bonds. These carbohydrates when eaten with meat, vegetables, and some healthy fat will help stabilize your blood sugars and eliminate surges and drops in sugar levels so your adrenals won’t have to work so hard at maintaining them. Our favorite recommendations are small amounts of yams or quinoa with your meals both for their low glycemic index and for their anti-inflammatory properties.
Eat More Healthy Fats: Including healthy fats in your diet will be very important for adrenal healing. In fact, healthy fats—not carbohydrates–should be your primary energy source. In particular, you may want to include coconut oil in every meal. Coconut oil is a medium chained fatty acid and has the very unusual property of being the only fat that your liver can turn into useable energy in the bloodstream instead of going straight to fat storage. Therefore, while you eliminate your sugars and grains, coconut oil will help keep you from feeling fatigued. Including healthy fats in your meals will help stabilize blood sugars, even out moods, and keep you feeling satiated. Many experts are now concluding that having larger amounts of healthy fats in your diets and far less carbohydrates are a key to optimal health. Adrenal health is included. Pour on the olive oil, use coconut oil, add some avocado to your meals, and make sure all meats and poultry are organic and grass fed to avoid toxins and chemicals that will also weaken your adrenals.
Eat Lots of Greens and Healthy Salt: Your adrenal glands produce a hormone called aldosterone that regulates sodium and potassium levels. Many of the minerals found in deep leafy greens and in a healthy salt (such as Himalayan or sea salt) will help support your adrenal glands by avoiding highs and lows in these important nutrients. Having healthy levels of salt is actually critical to adrenal recovery with some experts recommending having warm water with a teaspoon of sea salt 2-3 times per day as part of their adrenal treatment plan. Cook up your greens and heap on the salt!
Supplements and Support: There are a wide variety of bio-identical hormones and supplements that may help you overcome adrenal fatigue—too many to fully discuss here. After testing, we can prescribe the correct dose and combination of supplements that fit your health needs. Please click HERE to log into your account with our office. Once you log in you can set up an appointment to discuss which one’s might be right for you, or call the office at (415)383-9903.
Stress management will be a crucial piece to your healing, and it is something we cannot do for you. While we can certainly recommend lifestyle changes, medications and supplements to support your adrenal glands, in the end, learning to handle stress effectively and arranging your life to be less stressful may be the central task for long-term wellness and healing.
Meditation and Breathing: Research has shown us that meditation and breathing exercises can greatly improve stress responses and common health problems such as anxiety, insomnia, and fatigue. They do not have to take up huge amounts of time in your day to be effective. For example, the simple exercise of taking 3 deep, slow belly breaths can change your day right in that moment. Learning to get in touch with some of these techniques will be very important as you learn to control your emotional and stress responses.
Dr. Andrew Weil MD, whom you may be familiar with, has been a pioneer in integrative health for decades. He has long been a proponent of teaching patients (and their healthcare providers) breathing exercises to improve health and is emphatic that food, sleep, and supplements are not enough to stay healthy. In fact, meditation and breath work are mandatory for the Physicians and Nurse Practitioners he trains at his integrative medical school in Arizona. Here is a link to his introduction to breathing exercises from his website: http://www.drweil.com/drw/u/ART00520/breathing-basics.html
Dr. Deepak Chopra, also likely someone you are familiar with, stands at the forefront of bringing meditation practices to the masses. You may have heard of his and Oprah’s “21 Day Meditation Challenges” which are short, free, and intended to bring beginning meditators “into the fold” by creating 12-15 minute daily guided meditations that anyone can do. To register so that you will be alerted to their next 21 day challenge, click this link: www.chopracentermeditation.com and click “register” at the top right.
There are thousands of internet sites devoted to meditation and spiritual practices. We are fortunate in the Bay Area to have multiple Buddhist and Zen centers dedicated to teaching meditation that often offer free weekly meditations and meditation trainings to the public. Spirit Rock is one in Woodacre: www.spiritrock.org. For other places closer to you, enter in your google search tool “zen center” and any city, and multiple centers with calendars and events will show in your browser.
We recommend everyone start to integrate breath work or a meditation practice into your health regimen even if for just a few minutes or even seconds each day!
Reducing Stress and Anxiety: While breathing exercises and/or meditation will be helpful, other things you may need to revise to heal are your work schedules, your living spaces and your relationships. You will not fully heal until you manage the physical and emotional realities causing your adrenal fatigue.
For example, is your apartment full of mold? This physical stressor demands a move. You may never feel well regardless of supplements, food and breathing techniques if you are constantly exposed to this physical toxin.
Are you fighting with your partner? Maybe some marriage counseling is something that is finally necessary. Chronic emotional stress such as this will keep your adrenals weak.
Are you having problems at work? What can you do to make it tolerable?
We literally have had patients that have had to change jobs, move to a different location, or get a divorce to get healthy. These are extreme cases. For most of you, there will be strategies and ways you can reduce stress in your day to day life without taking such extreme measures.
Start today by taking a pen and paper and writing down all the things impacting your adrenal glands and nervous system. Brainstorm solutions and start implementing whichever ones you can.
Adrenal fatigue is one of the most common health problems we see in the office. If you are undergoing a stressful time in your life or are having some of the symptoms we have listed in this article, please do not wait for the fatigue or other related health problems to get worse. We can help. If you feel that you need testing, retesting, or an assessment, please do not hesitate to call us for a full analysis! Stop suffering and waiting for your health to get worse. Get the help that you need. Moreover, whether you are well or feeling fatigued, implement some of these adrenal supporting strategies today and protect your vitality!
Written by Marya Grosse, FNP
Nurse Practitioner at Morgan Camp, MD & Associates