WHERE ARE THE ADRENALS

An adrenal gland sits on top of each of your kidneys, located on either side of your lower back.

The adrenal glands (via signals from the HPA-axis) secrete a number of hormones that help our bodies respond to stress, in addition to other important functions. These hormones include adrenalin (epinephrine), noradrenalin (norepinephrine), cortisol and cortisone. These hormones activate the body's fight-or-flight response. They increase the amount of glucose in the blood, raise blood pressure and increase energy production in response to threats to our life.

The adrenal glands also produce aldosterone, estrogen, testosterone, progesterone, pregnenolone and DHEA.

HPA-AXIS

The stress response is primarily governed by the hypothalamic–pituitary–adrenal (HPA) axis. Stress activates the HPA axis and sets off a cascade of neuroendocrine signals that ultimately leads to the release of hormones and neurotransmitters like cortisol, norepinephrine (noradrenaline), and epinephrine (adrenaline).

Over time, the chronic activation of our stress–response system erodes resilience and depletes metabolic reserve, creating a change in our hormone production (often leading to cortisol resistance), which in turns affects nearly every organ and system of the body, including the gut, brain, thyroid, metabolism, catabolism, and male and female reproductive system.

Adrenal fatigue is a term that has been popularised to describe what happens when your body is under more stress that it can handle, for a long period for time. HPA Axis dysregulation is a more accurate term to describe what actually happens in the body.

CAUSES OF ADRENAL / HPA AXIS DYSFUNTION

High Sugar Diet: A diet high in sugar and carbohydrates will cause blood sugar imbalances, spikes in insulin and cortisol, which is stressful on the body, and can lead to adrenal dysfunctions.

Low Fat Diet : This can lead to a deficiency in saturated fats and cholesterol.

The adrenal glands produce steroid hormones. As the raw materials used to make these hormones are saturated fats and cholesterol, a deficiency in those nutrients can lead to a reduction in hormone production.

Stress: Stress, either physical (a chronic infection/injury), mental or emotional, leads to the production of cortisol and other stress hormones. In the short term, this is a good thing. However, when this persists for a long period, it can eventually lead to adrenal dysfunction (more on this below).

Common situations that can lead to chronic stress: high stress job, divorce, financial troubles, having a baby (for some people, especially if lack of sleep and no help available), moving country, difficult relationship/abuse.

Nutrient deficiencies: Caused by a poor diet or malabsorption due to poor gut health.

Poor gut health/ food sensitivities: The overload of toxins and immune system over-stimulation will eventually lead to adrenal dysfunction (often over many years).

Overexercising: A lot of emphasis has been put on the benefits of exercising. However, too much exercise (the cross-fit culture) can be just as damaging on the body. Putting too much demand on the body without appropriate rest can eventually lead to adrenal dysfunction.

Toxins: Exposure to heavy metal, mold, endotoxins from poor gut health, is a constant source of stress on the body.

INITIAL PHASE OF ADRENAL /HPA AXIS DYSFUNCTION

At first, the stress (either physical or emotional) causes abnormally high cortisol levels. A lot of people actually report feeling good during this phase, as the high cortisol gives them a ‘high’, allowing them to get a lot done. Mums with young children with a full time job will often be in this category.

However, if the stress level remains high for too long, the level of other hormones (like DHEA and progesterone) will start to drop as the energy is put into making cortisol (often called pregnenolone steal). DHEA is converted into other hormones such as estrogen and testosterone, so high cortisol (caused by excessive stress and poor diet) causes a hormonal deficiency cascade of other sex hormones such as oestrogen, progesterone and testosterone. Low levels of these hormones leads to a variety of other problems such as PMS, peri-menopause/ hot flushes, hypothyroidism and general poor health.

Other symptoms include:

• High blood pressure
• Tendency to put on weight, sugar craving, muscle wasting
• Worsening insulin resistance / diabetes
• Altered brain chemistry causing irritability, depression and anxiety.
• Disrupted metabolism
• Difficulty getting to sleep
• Sweating / perspiration is excessive, even when inactive or at normal temperatures
• Waking up feeling tired
• Frequent infections

LATE PHASE OF ADRENAL / HPA AXIS DYSFUNCTION

We used to think that the symptoms of long term stress were caused by low cortisol. However, as mentioned above, it might be more accurate to say that the issue is a dysregulation in the signalling between the hypothalamus, the pituitary gland, and the adrenals (the HPA axis). Another way to describe the issue is that the body becomes resistant to cortisol (similar to insulin resistance), and even if there might be enough cortisol, there is symptoms of cortisol deficiency.

Symptoms include:

• Fatigue, exhaustion, low energy level, low stamina, poor recovery after exercise. It's an effort just to get through the day.
• Irritability, anxiety, inability to handle stress, nervous disposition, mood swings, low self-esteem, loss of interest in friends, family and work. Relationships suffer.
• Reduced production of gastric hydrochloric acid and digestive hormones, causing a variety of digestive and gut problems and weak digestion. This causes malabsorption, mineral and other nutritional deficiencies.
• Low blood pressure and dizziness when you stand up too quickly.
• Low body temperature. Red fingertips. Poor circulation, cold hands. Decreased cold tolerance.
• Insomnia, trouble sleeping (it's common to wake up with an adrenaline rush in the middle of the night, caused by low blood sugar... low cortisol means that your body struggles to keep your blood sugar stable)
• Low libido
• Menopause from hell and female hormonal imbalances such as hot flushes and PMS.
• Hypoglycaemia (low blood sugar level).
• Weak immune system. Prone to colds, flu and other infections.
• Skin - dry, thin, scaly.
• Little perspiration. It takes a lot of heat and exercise to get sweating.
• At first, weight gain, inability to lose weight. However, the classic long term body shape is thin with muscle wasting.
• Salt or sweet craving.
• Headaches, especially with stress or exertion, or in the afternoon.
• Allergies
• Aches and pains in joints and muscles.

PREVENTION & TREATMENT

It can take a couple of years to fully recover from severe adrenal dysfunction. With milder forms of adrenal dysfunction, you can have good improvements fairly quickly.

Eliminate reactive foods. We'll do that in Phase 1 of the program with the Reset Diet and Low Trigger Diet)

Optimise digestion. All the work you'll do during this program will greatly help optimise your digestion, which will take a load of your body and allow for a lot of healing to happen.

Optimise your diet.

• Avoid processed food and refined sugar.
• Focus on eating nutrient rich foods.
• Eat plenty of saturated fats and cholesterol, the building materials for steroid hormones.
• Have some proteins with every meals (20 to 25g is a good quantity for most people).
• Eat foods that provide sufficient vitamin B complex (especially B5) and vitamin C. It's a good idea to supplements with those vitamins at first to give the body a boost.

Balancing blood sugar. Avoid the blood sugar roller coaster. To avoid low blood sugar, it's better to eat of bit more frequently (every 2 hours) until your energy improves. Read more about balancing blood sugar.

Reduce the level of stress in your life. Be gentle on yourself, physically, mentally and emotionally. The recommendations in each phase of the program in 'Show Your Body Some Love' and 'Light Up Your Spirit' will be really helpful to help you better cope with stress.

Enjoy gentle and pleasant exercise such as walks and gardening, but avoid vigorous or sustained exercise while you are trying to heal.

Reduce toxic exposure. Read more here.

Get plenty of sleep. Read more about optimising your sleep.

HELPFUL SUPPLEMENTS

1- Licorice: Licorice can be very effective, although you do have to be careful not to overdo it. We recommend a Licorice extract, although for some people, a licorice tea (very tasty) a few times per day can be enough.

It shouldn't be taken for more than 4-6 weeks at a time (take a break of 2 weeks and than see if you still need it).

People with high blood pressure should NOT take licorice.

2- Adrenal Cortex (we recommend Seeking Health or Thorne Research): This is safe to take for most people, although a very small number of people have a negative reaction to it (usually feeling jittery). We recommend starting with 1 in the morning, and increasing the dose until you feel an effect. A lot of people will need 3 in the morning and 3 at lunchtime to feel better when taking it. Some people with severe adrenal dysfunction will need even more. A lot of people get increased energy when taking it, and some also feel a better ability to cope with stress.

3- Ashwagandha: One of the best known adaptogen, which are powerful herb and plant medicines that help the body adapt to stress and regain balance. It is used a lot in Ayurveda to relieve stress and increase energy. Research shows significant reduction in cortisol levels and significant reduction in self-reported stress and anxiety symptoms in those taking ashwagandha. It can also improve sleep.

* Important note: Since ashwagandha is part of the nightshade family, it can be a potential trigger and cause negative reaction. If you react negatively to foods in the nightshade family, such as tomatoes, eggplant, peppers, and potatoes, we recommend avoiding ashwaghanda. Common reactions to the nightshade family is joint pain, but it can be anything.