Stress and Adrenal Fatigue

Your body is hard-wired to react to stress in ways meant to protect you against threats from predators and other aggressors. For example, think of a prehistoric caveman with a boar coming at him. These kinds of threats are rare today, but that doesn’t mean that life is free of stress.

On the contrary, you face multiple demands each day, such as taking on a huge workload, paying the bills and taking care of your family, and these days, additionally all the stressors related to COVID-19. Your body treats these so-called minor hassles as threats. As a result, you might feel as if you’re constantly under attack. But what actually happens physiologically when you feel stressed?

When you encounter a perceived threat, your hypothalamus, a tiny region at your brain’s base, sets off an alarm system. Through a combination of nerve and hormonal signals, this system causes your adrenal glands, located atop your kidneys, to release a surge of hormones, including adrenaline and cortisol. Going back to our prehistoric caveman, when the boar comes at him, the cortisol rises, and after the boar is no longer a threat, the cortisol should go down.

Adrenaline increases your heart rate, elevates your blood pressure and boosts energy supplies. Cortisol, the primary stress hormone, increases sugars (glucose) in the bloodstream, enhances your brain’s use of glucose, and increases the availability of substances that repair tissues.

Cortisol also curbs functions that would be nonessential or detrimental in a fight-or-flight situation. It changes immune system responses and suppresses the digestive system, the reproductive system and growth processes. This complex natural alarm system also communicates with the brain regions that control mood, motivation and fear.

The body's stress-response system is usually self-limiting, meaning once a perceived threat has passed, hormone levels return to normal. As adrenaline and cortisol levels drop, your heart rate and blood pressure return to baseline levels, and other systems resume their regular activities.

But when stressors are always present and you constantly feel under attack, that fight-or-flight reaction stays turned on. This is what we’re seeing in epidemic proportions these days.

The long-term activation of the stress-response system and the overexposure to cortisol and other stress hormones that follow can disrupt almost all of your body's processes. This puts you at increased risk of many health problems, including anxiety, depression, digestive problems, headaches, heart disease, sleep problems, weight gain and memory deficits.

Whether you call it adrenal fatigue, adrenal dysfunction, or adrenal insufficiency, there are lots of terms used out there to describe what happens to your adrenals when you are exposed to chronic stress.

It’s not a term readily accepted in traditional medicine, but there was an article in the New England Journal of Medicine in the late-1990s that discussed the range of dysfunction you can see with our adrenal glands from chronic stress.

We are well aware of conditions like Addison’s disease, an extreme case of adrenal insufficiency when you don’t produce enough cortisol, or Cushing’s disease when you produce too much cortisol, but then modern medicine assumes you’re normal if you’re not either of those. There is a continuum between those extremes, and this is where the disconnect lies: This isn’t black or white; you can still be on that continuum and have significant symptoms from adrenal dysfunction.

What kind of stressors are we talking about? They can be physical – like an infection or toxin – or they could be mental or emotional.

The concern is that all of these stressors, which can include lack of sleep, a poor diet, chronic unremitting stress, or even environmental toxins, all of these affect our adrenal function. Really, the best term for what is happening, is adrenal dysfunction. And another problem is that most people don’t even realize that it is occurring.

This can cause a number of symptoms such as trouble sleeping, feeling tired and wired. People find themselves exhausted but unable to sleep. They’re often sleepy mid-morning and/or mid-afternoon. Maybe they get cravings for salty foods, but sometimes also sugary foods because they’re exhausted. Some patients get brain fog and bags under their eyes. Over time, clients can see weight gain, traditionally in the belly region, that’s tough to get rid of.

The first step to getting rid of these symptoms is to actually start with relaxation since your body is begging you to slow down and reset. Engaging in activities like yoga, meditation, hot baths, using a sauna, gentle exercise and naps can all help to reset.

The next thing is to eat a diet that helps you to balance your adrenal glands. Foods to avoid are sugar, caffeine, processed foods, and alcohol. Foods like sugar and caffeine push your adrenals to release cortisol and adrenaline. Sugar also causes release of insulin. Alcohol, which makes you feel relaxed in the moment but actually causes problems with cortisol, poor immunity, increases inflammation, and causes sleep issues, is something to avoid.

Try to eat a whole-foods diet, mostly plant-based, with a lot of healthy fats and high-quality proteins. It’s important not to skip any meals. This is a bad habit for a lot of people with adrenal dysfunction because it makes symptoms worse.

It’s important to exercise daily but to make sure it’s gentle exercise and not physically taxing. In our medical practice, we see that patients who overexert themselves physically often have abnormal cortisol levels.

Make sure you have enough B5, B6, vitamin C and magnesium. Herbs called adaptogens, such as ashwagandha, rhodiola and ginseng, help modulate your body’s response to cortisol. Ideally, you want to have your vitamins and micronutrients tested, as sub-optimal levels cause stress in the body.

Lastly, it’s necessary to incorporate some mindfulness and meditation into the daily routine, as these lower cortisol levels. Find a quiet place in your home and make it part of your day to do some deep breathing or meditation every morning and night. This will help you sleep better as well.

If you incorporate these changes, you will start to feel better, but it takes time. If your symptoms don’t improve, reach out to a functional medicine specialist who is well versed in treatment of adrenal dysfunction.

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