What I Learnt This Week – The Significance Adrenal Fatigue

On their deathbed, no one ever said they wished they had spent more time in the office. Indeed, over-work and stress can result in a quick downward spiral of health. This week I came across a fascinating article by Dr Jeoff Drobot, which highlights the significant effects that poor adrenal health can have. I’ve paraphrased, shopped, summarised as follows:

The adrenals sit on top of your kidneys and produce stress hormones and Adrenaline. They are your glands for survival, but overload them, and you’ll be relying heavily on your nervous system as the last line of defense. There are increasingly cases where elite business people are found to have a hormonal and nervous system running purely on Adrenaline. The article cites that the following symptoms are indicative of adrenal fatigue:

1. Anxiety with a tendency to tremble when under pressure.
2. Reduced sex drive.
3. Lightheaded when rising from a lying down position.
4. Unable to remember things.
5. Lack of energy in the mornings and also in the afternoon between 3 to 5 PM.
6. Feeling better suddenly for a brief period after a meal.
7. Feeling tired between 9 and 10 PM, but can’t get to bed.
8. Need coffee or stimulants to get going in the morning.
9. A craving for salty, fatty, and high-protein food such as meat and cheese.
10. Increased symptoms of PMS for women.
11. Pain in the upper back or neck with no apparent reasons.
12. Feeling better when stress is relieved, such as on a vacation.
13. Tendency to gain weight and inability to lose it, especially around the waist.
14. High frequency of getting the flu and other respiratory diseases and these symptoms tend to last longer than usual.
15. Chronic pain.
16. Irritable Bowel Syndrome.
17. Depression.
18. Craving sugar as the day goes on.
19. Insomnia.

The Players:

The adrenal glands are two small glands, each about the size of a large grape. Their purpose is to help the body cope with stress and survival. Each adrenal gland has two compartments. The inner compartment, or medulla, modulate the sympathetic nervous system through secretion and regulation of two hormones (which are also neurotransmitters) called Epinephrine and Norepinephrine that are responsible for the “Fight or Flight Response.” You know these hormones collectively as Adrenaline. The outer adrenal cortex comprises 80 percent of the adrenal gland and is responsible for producing over 50 different types of hormones. The most important are Cortisol and DHEA. Let’s break these components down:

Cortisol: A catabolic hormone that has many systemic effects. You can think of it as the hormonal “gas pedal”. It increases blood sugar to provide fuel, reduces inflammation, suppresses the immune system and constricts blood vessels. It does these things for one reason; to allow you to survive when faced with immediate stress. Cortisol is secreted at its highest levels around 6 AM, after which there is a gradual decline throughout the day with its lowest levels occurring between midnight and 4 AM. It is viciously effective at enabling you to perform under stress, but does so with the high price of tearing down tissue (namely the digestive tract), suppressing inflammation and the immune system. All of these are ideal if you’re running for your life, as longevity is an afterthought. However, when you call on it repeatedly in response to chronic stress you’re continually breaking down your immune, digestive, nervous and hormonal systems.

Keeping Cortisol high for a prolonged period of time can lead to a loss of bone density, muscle wasting, thinning of the skin, decreased ability to build protein, fluid retention, elevated blood sugars, weight gain, and increased vulnerability to bacteria, viruses, fungi, yeasts, allergies, parasites, and even cancer.

Dehydroepiandrosterone (DHEA): This is the adrenal gland’s anabolic hormone. It is the “brake pedal”. DHEA, with Testosterone, is assigned to repair what Cortisol breaks during the day. When your body perceives you are safe, it will go to work and rebuild what Cortisol has “borrowed” for survival. DHEA helps to neutralize Cortisol’s immune-suppressant effect, thereby improving resistance to disease.
Cortisol and DHEA are inversely proportional to each other. When one is up, the other goes down. DHEA also helps to protect and increase bone density, guards cardiovascular health by keeping "bad" cholesterol (LDL) levels under control, provides vitality and energy, sharpens the mind, and helps maintain normal sleep patterns. It is known as the “Anti-aging Hormone.”

Epinephrine and Norepinephrine: These two hormones are commonly known as Adrenaline – the “Fight-or-Flight” hormones. Adrenaline is produced when something is (or you think it is) threatening. Its main function is to get you away from danger. Like Cortisol, it does so by breaking down body tissue to mobilize energy. It increases heart rate, floods the muscles in your legs and arms with blood, dilates your pupils, sharpens your thinking and allows you to tolerate pain, all in an attempt to either run or fight. However, it was intended for survival, not red-eye flights and meeting deadlines.
When you organically start running low on this hormone, you reach for caffeine to stimulate more or increase the intensity of your morning workout to give you a “boost”. As you can see, there are more ways to break your body down than there are to repair it. Survival is king with longevity a distant second.

The Process:

Adrenal Fatigue begins very subtly and innocently. With increased work hours and increased demands you start the cycle of chronic stress. Your body perceives the workload as a threat to survival and you start the downward spiral of borrowing more than you replace. This can be outlined in four predictable phases:

1. Normal: You’re walking along and a lion jumps out. Your body responds immediately by increasing Adrenaline to increase heart rate, blood flow and blood pressure to run or fight. Cortisol responds next to suppress pain and inflammation and mobilizes blood sugars to keep you running, while impeding digestion and metabolism as they will mean nothing if you don’t get away. Cortisol ensures that Adrenaline can’t stimulate you out of control. That is the normal response. Under stress, you call on the stress hormones as a “gas pedal” to move you to safety. The key is that the threat is supposed to be short-lived, real, and an immediate threat to survival. Once you are safe, DHEA will elevate repairing the tissue you’ve broken down, quieting your mind, relaxing your tissues and stimulating metabolism. What is lost will be regained and physiology will be restored.

2. Adaptation: With continual stress, your body starts producing more of all of the adrenal hormones. Increased Adrenaline and stimulants throughout the day lead to heightened states of Cortisol for prolonged periods in the day. Your adrenals respond by producing more DHEA in an attempt to offset the increased breakdown that higher levels of Cortisol and Adrenaline are causing. Depending on genetics and your current lifestyle practices you may be able to exist in this phase for years. You feel good, powerful, don’t need a lot of sleep, don’t need a lot of food and can seemingly conquer the world. It’s like an infusion of funds into a start-up company…you just spend.

3. Imbalanced: With prolonged periods of stress, your body starts running out of resources. It makes the choice to use the hormones it has left to produce more Cortisol and Adrenaline and can’t spare any for DHEA and repair. Cortisol, normally only high in the morning, is now elevated all day. There is no period in the day when you’re conserving. You are simply spending. You’re starting to show the signs: you need coffee to get up, alcohol to calm down, you’re getting sick more frequently and recovering less, your thought process seems more laborious, your metabolism is slowing down and your sex drive is diminishing. Your adrenals are “all-in” hoping soon you’ll make it to the safety of your cave where you can hibernate, heal and repair.

4. Exhaustive: You’re hormonally bankrupt. Your adrenals can’t produce sufficient Cortisol and certainly DHEA production is a distant memory. All you have left is what you came into the world with—Adrenaline. But Adrenaline takes no prisoners and has no regard for normal biological functioning. Without Cortisol and DHEA to keep it in check, Adrenaline tears you down in one last attempt to drive you to safety. You can’t think, tremble easily, have periods of anxiety with periods of depression, your digestion is terrible, sleep is a nightmare and you’re struggling to make it through every day. It may have taken months or even years but once you’re here you’re in real trouble. Chronic diseases like heart disease, cancer and diabetes result as inflammation flares systemically without repair. Your quality of life is gone.