Interview with Dr. Angela Agrios, ND
The Adrenal Glands and Stress
The adrenal glands are part of your endocrine system. Endocrine is a medical term that just means hormone system. Your adrenal glands anatomically live on top of your kidneys on both sides and make hormones like cortisol and DHEA, aldosterone. Cortisol is a really important hormone—it has lots of jobs in the body. One of them that we’re really familiar with is helping you deal with stress that comes your way. So when you hear about that “fight or flight” type of reaction, that’s actually mediated by cortisol. So if you don’t have enough cortisol, you actually can’t motivate and address that situation really adequately.
Adrenal Glands and Cortisol
Another thing that’s really important that cortisol does is it helps someone maintain blood sugar regularities: we’d all love to eat every few hours if we could, but sometimes there’s situation where we just don’t eat for more hours, you know, five or six hours—and so it’s the cortisol during that time that signals your liver to release your stored sugar, called glycogen, so that you can maintain blood sugar regularity. Lastly, cortisol is really important for helping you maintain inflammation appropriately in your body. So if you don’t have adequate cortisol levels, you’ll tend to see over-reactivity in your immune system, and so that’s a problem you’ll see. It manifests as allergies, and sometimes, in a severe condition, as an autoimmune case.
Adrenal Fatigue Symptoms
Adrenal fatigue is something that’s actually very common in our society. I don’t think people know, though, the term very well, but the symptom profile is very common, and it comes about because of chronic stress essentially. This can be mental and emotional stress from chronic studying as a student; it can be very high career stress for years and years; it can be having physical disability, so someone who has a physical condition, a health problem, for years—that will often tax the adrenals. And another one that’s huge in our society is diet: coffee pushes, so to speak, the adrenal glands to make more hormone, and they get tired. And sugar’s another big one—a lot of the refined carbohydrates in sugar really stress out our adrenal glands.
By Derrick Garwood, Freelance Medical Writer and Editor
In today’s fervently age-conscious society, where maturity is widely regarded as a social handicap on a par with halitosis, why should women hoping to maintain their youthful good looks spend their days at sea level? And what could this possibly have to do with the adrenal gland? The answer is that women who live at high altitudes appear to age more quickly, because of lower levels of the adrenal hormones DHEA and DHEAS (dehydroepiandrosterone and dehydroepiandrosterone sulphate). However, a healthy adrenal gland does much more than act as endogenous botox…
This diagram shows the adrenal glands positioned at the upper pole of each kidney. Each one is buried in fat, as can be seen in this photograph, and is composed of an outer cortex and inner medulla. The cortex uses cholesterol to manufacture three types of steroid hormones: glucocorticoids, mineralocorticoids and androgens. Glucocorticoids have a potent anti-inflammatory effect on the body and depress the immune response, the most abundant example being hydrocortisone or cortisol, while the important mineralocorticoid aldosterone promotes the re absorption of sodium ions by the kidney, to help maintain normal blood pressure. Microscopic examination reveals that the cortex has three concentric zones with different cellular arrangements. The medulla consists of neurons which form part of the sympathetic nervous system and release adrenaline and noradrenaline into the bloodstream, in preparation for ‘fight or flight’.
Those who suffer its effects say treating it brought them renewed energy, while most doctors say the disorder doesn’t exist
By Julie Deardorff, Chicago Tribune
“Adrenal fatigue” is the sort of diagnosis that might hit home during a late-night Internet search. Do you, for example, have trouble waking up in the morning without caffeine? Do you crave salty foods? Do people seem a lot more irritating than in the past?
If so, it could mean your adrenal glands are underperforming because of illness or constant emotional or physical stress, according to some medical practitioners who suggest patients make dietary and lifestyle changes in response — as well as take supplements they frequently sell.
But those who diagnose adrenal fatigue or exhaustion are fighting an uphill battle for legitimacy, even as the terms gain traction in alternative health circles and among Americans seeking a solution for chronic and unexplained fatigue, depression, weight gain and malaise.
The disorder is not recognized by most conventional endocrinologists or internists, major medical associations and even integrative medicine pioneers such as Dr. Andrew Weil, who reject the idea that excessive stress weakens the adrenals and causes health issues.
“Adrenal fatigue is a worthless diagnosis, and lavish testimonials and anecdotal claims of marked improvement following some intervention are most likely fraudulent or transient placebo effects,” said Dr. Paul Rosch, president of the American Institute of Stress and a clinical professor of medicine and psychiatry at New York Medical College.
Other critics say there is room for further study. Endocrinologist Seymour Reichlin, an expert on the brain-endocrine system and stress, doesn’t believe in adrenal fatigue but says “it’s not unreasonable to carry out lab tests because the symptoms of adrenal fatigue overlap with true adrenal insufficiency.”
According to the adrenal fatigue theory, modern life is so relentlessly stressful that the walnut-size adrenal glands, which produce hormones needed to cope with stress, get overworked and peter out. If you’re tired for no reason, get lightheaded when you stand up quickly, can’t shake colds or infections and feel as if you’re constantly walking uphill, you may have something going on at the adrenal level, proponents say.
by Diane from Balanced Bites
You hear the expression thrown around a lot if you’re in the health and fitness community or reading books, blogs and listening to podcasts on health-related topics. It’s very common that we, as everyday Americans and athletes/CrossFitters even moreso, experience varying levels of restful sleep, energy, digestive function, immunity and the ability to recover from exercise. With so many stressors in our daily lives, not to mention the things we add on top as pleasure that are actually stressors, it’s no wonder we’re in a bit of a pickle when it comes to achieving healthy endocrine balance.
I have a close relationship with the condition of adrenal fatigue as I have suffered from it, at varying levels, over the last four years. While training for my first half-marathon here in San Francisco in July of 2007, I was experiencing what seemed to be very mysterious changes in my energy and moods. I was following a low-fat diet for the duration of my training under the nutrition advice of a Registered Dietitian who specialized in sports nutrition. The program included plenty of whole grains, dairy, some nut butter, very lean meats, vegetables and fruit – and would add up to as much as around 2,500 calories per day. Without eating much fat, that’s a LOT of food. I was eating at least six times a day. At the time, I was training anywhere from 60-120 minutes, primarily performing steady-state cardio exercise or sometimes interval training with minimal strength training included. This was a pretty far departure from the training I had done most of my life prior to beginning the half-marathon training. Needless to say, this was not a smart choice for my body.
While completing training runs adding up to around 20-25 miles per week, I would also attend three or four cardio kickboxing classes per week on top of that. I distinctly remember attending a couple of those classes, which I had always done for the fun of it, and not being able to smile. My energy was just flat. It was like the air in my tires was gone and I couldn’t even muster up the gusto to finish the classes anymore. And these were classes I was even certified to teach, that’s how much I loved them. As if that wasn’t enough, I would frequently pick up a second cup of coffee for the day either before or after the kickboxing class (we’re talking 6/7pm here folks) to go home after the gym and work late into the evening on side-projects from my day job. Talk about burning the candle at both ends! I was very lean and felt amazing when I looked in the mirror and saw 6-pack abs for the first (and possibly only) time in my life, but my body was telling me that it wasn’t happy. And I wasn’t listening. I didn’t know that what I was experiencing was something real that was a direct result of the diet and lifestyle I was choosing to lead – thinking it was making me healthier!
What I finally learned after my exhaustion:
- People who train hard and look lean are not always healthy.
- Eating fat will not make me fat
- Working out smarter, not harder is often the way to achieve performance and aesthetic goals.
- Sleep is the cornerstone of being able to eat well, train well and to allow the body to re-set stress levels and lose body fat.
I felt like I had discovered The Holy Grail. Creating a lean healthy body actually required a lot less effort than I thought.
What is stress?
Stress is a specific response by the body to a stimulus, such as fear or pain, that disturbs or interferes with normal physiological equilibrium. Stress can be physical, mental or emotional strain or tension and can be an occurrence (chronic or acute) or a causative factor in a state of dis-ease.
Key players in the endocrine game of stress & adrenal function:
Two, triangular shaped glands that sit on top of your kidneys, consisting of an inner medulla and an outer cortex. The adrenal medulla produces and secretes epinephrine (adrenaline, a fast-acting hormone), norepinephrine (noradrenaline), and a small amount of dopamine in response to stimulation by sympathetic preganglionic neurons. The adrenal cortex mediates the stress response through the production of steroid hormones: mineralocorticoids and glucocorticoids, including aldosterone and cortisol respectively as well as DHEA and sex hormone precursors.
By Dr. James Wilson
What are the Adrenal Glands?
No bigger than a walnut and weighing less than a grape, each of your two adrenal function glands sits like a tiny pyramid on top of a kidney (“ad” “renal” means “over” the “kidneys”). But don’t let their small size fool you; these powerful little hormone producing glands manufacture and secrete almost 50 different hormones, including steroid hormones such as adrenalin, cortisol, aldosterone, estrogen and testosterone that are absolutely essential to your health and vitality. They not only significantly affect the functioning of every single tissue, organ and gland in your body; they also have important effects on the fluid balance control and blood sugar regulation. They even regulate how you think and feel and determine how effective your immune system functions. Without the hormones the adrenals produce you would die very quickly, and when out of balance the quality of your health and wellbeing becomes severely compromised. Does it not make sense therefore to optimise the functioning of these tiny glands? Of course it does.
by Vicki Wade, PharmD
Have you recently experienced a major stress in your life, be it illness, job, death, children, etc? After this stress, have you felt as though you just cannot seem to get yourself together, or at least back to where you used to be? Are you usually tired when you wake up, but still “too wired” to fall asleep at night? Is it hard for you to relax or to get exercise? Do you find that you get sick more often and take a long time to get well? If so, then you, like many other Americans may be experiencing symptoms of Adrenal Fatigue.
Adrenal fatigue is not a new condition. People have been experiencing this condition for years. Although there is increasing physician awareness, many are not familiar with adrenal fatigue as a distinct syndrome. Because of this lack of knowledge, patients suffer because they are not properly diagnosed or treated.
Adrenal fatigue is a condition in which the adrenal glands function at a sub-optimal level when patients are at rest, under stress, or in response to consistent, intermittent, or sporadic demands. The adrenal glands are two small glands that sit over the kidneys and are responsible for secreting over 50 different hormones—including epinephrine, cortisol, progesterone, DHEA, estrogen, and testosterone. Over the past century, adrenal fatigue has been recognized as Non-Addison’s hypoadrenia, subclinical hypoadrenia, neurasthenia, adrenal neurasthenia, and adrenal apathy.
Generally patients who present with adrenal fatigue can often be heard saying, “After______, I was never the same.” The onset of adrenal fatigue often occurs because of financial pressures, infections, emotional stress, smoking, drugs, poor eating habits, sugar and white flour products, unemployment and several other stressors. After experiencing many of these events over a long period of time, the adrenal glands tend to produce less cortisol, the body’s master stress hormone. Cortisol’s main role in the body is to enable us to handle stress and maintain our immune systems. The adrenal gland’s struggle to meet the high demands of cortisol production eventually leads to adrenal fatigue.
Thousands of people suffer from constant fatigue that is not relieved by rest and sleep. This is the main symptom of adrenal weakness or adrenal burnout syndrome. This article examines this extremely common syndrome – its causes, symptoms and the process of recovery of vibrant health with a nutritional balancing program.
I hear from many people who are still suffering from adrenal exhaustion, adrenal fatigue or adrenal burnout after 3, 5 or even 10 years. This is not necessary! Nor is it helpful or necessary to take hormones, obtain a lot of tests, or do chelation therapy at all. I owe a great debt to Dr. Paul Eck, whose deep interest in the adrenal glands inspired this article.
WHAT ARE THE ADRENAL GLANDS?
The adrenal glands are rounded, disc-shaped glands about 3-4 inches across. One sits atop each kidney, located on either side of your lower back, just above where the ribs end. You may at times feel a sensation of pressure in this area when under stress. However, muscular tension and other factors also commonly cause pain or a sensation of pressure in this area.
The adrenal glands are essential for life. They secrete a number of hormones that prepare our bodies to respond to stress. These include adrenalin, also called epinephrine, noradrenalin, also called norepinephrine, cortisol and cortisone. The adrenal glands also produce aldosterone, estrogens, testosterone, progesterone, pregnenelone and DHEA.
These hormones regulate many body activities. Of greatest importance for this article is that the adrenal hormones, particularly adrenalin and cortisol, activate the body’s fight-or-flight response.
This consists of increasing the amount of glucose or sugar in the blood, raising blood pressure, and promoting increased energy production. There are many other effects of the adrenal hormones, but we will focus on these effects for now.
Of great importance to our discussion is that the adrenal glands are innervated and stimulated by activity of the sympathetic branch of the autonomic or automatic nervous system of the body. This is the part of our nervous system that activates when we must respond to threats to our life.
WARNING: ADRENAL EXHAUSTION AND INSUFFICIENCY ARE NOT COMMONLY RECOGNIZED MEDICAL DIAGNOSES
The medical profession is far behind when it comes to understanding adrenal gland problems. In 2011, many still do not recognize adrenal insufficiency, adrenal exhaustion or adrenal burnout as real health conditions. This is very sad, as the situation is so common. The official allopathic medical beliefs about the adrenal glands are:
1. Either the adrenals work fine or they do not work at all. This is the prevailing viewpoint, even though it makes no sense. Doctors are well aware, for example, that most other glands such as the thyroid, pancreas, pituitary, ovaries, and testes can have many degrees of dysfunctions. Why should the same not be true of the adrenal glands?
(When the adrenals don’t function well at all, doctors call it Addison’s disease, for which they give cortisol or cortisone for life. With a nutritional balancing program, so far all of them have responded well, and did not need to stay on the cortisone therapy. I do not know whether this will occur in all cases, but I am just reporting what I have observed so far.)
2. If you are tired, depressed, or have low blood sugar, the best idea is to take anti-depressants, anti-anxiety drugs or other drugs. This is also ridiculous. The first course of action should be to assess and then heal your adrenal glands, in most cases.
3. Serum, urine or saliva hormone tests for the adrenals are adequate tests. This is also totally incorrect, from my experience.
I find that a properly performed and properly interpreted hair mineral analysis is just as good, and usually far better than any hormone tests. The hormone tests are not sensitive enough, and do not give the same information as a correctly interpreted hair mineral analysis. The mineral analysis not only tells a great deal about the status of the adrenal glands with mathematical precision, but it often tells us why the adrenals are not functioning properly. The test also tells a lot about the sympathetic nervous system, which is intimately connected to the adrenal glands and their functioning.
4. The medical answer for adrenal problems is usually a drug. This is unfortunate. Usually, we find, the answer is not any drug, but elimination of all the drugs one has taken for one’s entire lifetime. In addition, one must remove many toxic metals, toxic chemicals, and renourish the entire body. Then the adrenals begin to function normally and one’s energy returns.
5. Doctors ignore a simple adrenal test they could do in their offices called the Ragland Test or Ragland Sign. This is a very simple test in which the doctor takes your blood pressure while you are lying down and relaxed. Then the patient suddenly stands up and the doctor or assistant takes your blood pressure again. The pressure should go up. In those with weak adrenals, it often goes down and the patient feels weak, shaky and/or a little dizzy. It is a crude test, but it would be better than doing nothing , and putting people on more drugs that do not address adrenal insufficiency at all.
Several other simple tests can be done to check your adrenals in a crude way. One is to look in the mirror and shine a strong light like a flashlight in one eye. The pupil of the eye (the black part in the middle) should contract quickly. If it does not, the adrenals are most likely fairly weak. Another crude test you can do at home is to gently run the tines or spikes of a fork or similar object across the inside of your forearm. They should leave little lines on your forearm that should turn red quickly. If they do not turn red within about 10 seconds, this is another crude indicator of weak adrenals. These tests are not that accurate, but can be done safely at home with no formal instruction or training.
A DEFINITION OF ADRENAL BURNOUT
The adrenal glands may develop various types of problems. Before we define adrenal burnout, let us briefly discuss these rarer conditions.
Cushing’s disease. Severe overactivity or hyperfunction of the glands is called Cushing’s syndrome or Cushing’s disease. It is characterized by a ‘moon face’, obesity in the trunk, muscle weakness, poor wound healing, kidney stones and often psychological symptoms.
This condition is relatively rare and usually caused by a tumor of the adrenal glands that secretes cortisol or cortisone, two of the important adrenal hormones.
Addison’s disease. Extremely low adrenal activity is known as Addison’s disease. It is characterized by weakness, fatigue, low blood pressure, changes in skin color, dehydration, anorexia, nausea, decreased cold tolerance and dizziness. It is also a fairly rare condition, though I have met people who say they have Addison’s disease when they really are just in adrenal burnout, which is very different.
Addison’s disease is also caused at times by a tumor on the adrenal glands that shuts down the glands completely. It may also be caused by a severe shock to the system, as happened in the famous case of John F. Kennedy.
Mr. Kennedy developed Addison’s disease when his small patrol boat was suddenly rammed by a Japanese destroyer on a dark night during World War II. Most of the crew was killed instantly. He survived, but the shock damaged his body severely.
Adrenal burnout syndrome. Adrenal burnout syndrome is basically a mild form of Addison’s disease. It is a low functioning or underactivity of the adrenal glands. It may also be termed adrenal insufficiency or adrenal exhaustion. It differs from Addison’s disease in several important ways:
1. In most cases, it can be corrected using natural methods. We do not like using cortisone therapy or any bio-identical hormone therapy for this condition. Most often it is not needed and just slows true recovery of the adrenal glands.
2. In most cases, the cause is not a single shock to the system, as with Addison’s disease. Instead, it is usually a slow decline in adrenal activity due to nutritional deficiencies and the accumulation of toxic metals and chemicals in the body. As these causes are removed, the adrenal glands easily recover.
3. Unlike Addison’s disease, adrenal insufficiency or burnout is very, very common today, especially among adults. However, few physicians are prepared to diagnose it.
Fatigue versus adrenal burnout. Adrenal burnout syndrome differs from simple fatigue in that burnout is not relieved by getting a few good nights sleep, as is the case with fatigue.
This is the case because adrenal exhaustion is not just a sleep deficit, although that may be an aspect of the syndrome. Burnout is a deeper derangement of the body’s energy-producing system, of which fatigue is one symptom.
DETECTING ADRENAL BURNOUT
Unfortunately, when a patient complains of fatigue, depression or other symptoms that are often related to the adrenal glands, most of the time the doctor does not ask the right questions and does not run tests of the adrenal glands.
Instead, patients are told to take a vacation, or given an anti-depressant, or told it is “in their head”.
The right questions, however, would often be enough to assess the condition fairly accurately. These would include “How many hours of sleep are you getting?” , “Do you use caffeine or other stimulants” and “What other symptoms are you having?”. Let us examine how this can often identify adrenal burnout, even without other testing.
Signs and symptoms. A simple and quite reliable way to assess adrenal burnout in a general sense is with signs and symptoms. A common sign, for example, is a low blood pressure in the absence of other obvious causes.
Usually, the person will also often feel fatigued, even though one sleeps well. If one is not sleeping, the problem may simply be a sleep deficit. One may not feel tired, however, if you drink coffee, other caffeinated beverages or use other stimulants.
Another common symptom is depression. Others include joint pain, cravings for sweets, pain in the low back area and perhaps excessive thirst or craving for sweet and salty foods. Together these symptoms can help one decide if one needs further testing.
HAIR MINERAL ANALYSIS AND ADRENAL BURNOUT
Hair mineral analysis is a very exciting, cost-effective and non-invasive test. I have used hair tissue mineral analysis to help assess the condition of the adrenal glands for almost 30 years with more than 25,000 clients. I am very satisfied with the results using hair analysis for adrenal assessment and to guide the correction of all types of adrenal imbalances.
Hair analysis indicators for adrenal insufficiency or burnout on a hair mineral test. To be accurate, the hair sample must not be washed at the laboratory. For each of the adrenal burnout mineral patterns below, there is an article on this website that describes it in more detail. The patterns are:
- A slow oxidation rate. The slower the oxidation rate, the more likely one is in adrenal burnout or exhaustion.
- A sodium/potassium ratio less than about 2.5:1. The lower the ratio, the worse the adrenal condition, in general.
- A double low ratio pattern. This consists of a sodium/potassium ratio less than 2.5 plus a calcium/magnesium ratio less than about 4.
Adrenal Fatigue occurs when your adrenal glands – 2 small glands that sit on top of your kidneys – become overworked and depleted. Your adrenal glands are responsible for handling the stresses of your daily life, whether that be physical stress, emotional stress, or psychological stress.
When your adrenal glands become overworked, they cannot keep up with the stresses of your everyday life. You then start to manifest the symptoms of adrenal fatigue.
Note that just because you have one or two of the symptoms of adrenal insufficiency does not mean that you have adrenal fatigue. However if you find you have the majority of these symptoms then you may want to investigate further.
You’ll want to learn some of the common causes of adrenal fatigue to see if you can identify with any of these causes in your own life. You’ll also want to see your doctor for a full medical workup and diagnosis of adrenal fatigue.
Here are the key symptoms of adrenal fatigue:
You’re Tired For No Explainable Reason
People with adrenal fatigue experience extreme physical exhaustion and they don’t have an explanation as to why (such as a strenuous workout). This isn’t just everyday tiredness it is extreme exhaustion.
A normal, healthy response to stress is when you feel alarmed, your heart races and you are alerted, after which your body returns to a baseline state soon after the excitement is over. However, if your adrenals are fatigued due to relentless exposure to stress, elevations in cortisol become entrained, habitual and chronic leading to hypertrophy of your adrenal cortex. Long term this may result in adrenal failure symptoms. In addition, if your adrenals are fatigued, you may experience a loss of normal circadian rhythm, resulting in insomnia, morning fatigue and exhaustion, agitation, weight gain, hypertension, racing heart, mood swings, anxiety and immune disregulation due to elevated cortisol levels. If you have adrenals fatigue, your adrenal failure symptoms may appear as general loss of adaptability to stress, more mood swings, depression, fatigue, PMS, disturbed sleep, sugar cravings, and hypertension eventually leading to postural hypotension.
As far as testing for adrenal fatigue, one way in which you can tell if you have adrenals fatigue, is by comparing your systolic blood pressures between two different readings. One blood pressure is taken in the recumbent position and another taken in a standing position. You would lie in a recumbent position for five minutes and take your blood pressure. Then stand up and immediately take your blood pressure again. If your adrenals are healthy, your systolic blood pressure would be 4 to 10 mm higher in the standing position than it is in the recumbent or lying down position. If, however, the blood pressure is lower in the standing position, hypoadrenia or adrenals fatigue may be suspected.
Many people with Hashimoto’s Thyroiditis have adrenal fatigue. My goal is to not only explain how this develops, but to give you some tips that will help to restore the health of your adrenal glands. In addition to being a licensed healthcare professional that has helped patients with adrenal fatigue, I personally was diagnosed with an autoimmune thyroid disorder, had stressed out adrenals, and successfully restored the health of my adrenal glands.
While many people are aware of the common symptoms associated with adrenal fatigue (a constant feeling of exhaustion, sleeping difficulties, difficulty concentrating, etc.), what many people don’t realize is that stressed out adrenal glands can actually cause an autoimmune disease such as Hashimoto’s Thyroiditis to develop. The reason for this is because chronic adrenal fatigue can compromise the immune system. So over a long period of time, this weakened immune system can make someone susceptible to an autoimmune thyroid disorder, such as Hashimoto’s Thyroiditis.
The good news is that most cases of adrenal fatigue can be reversed. The problem is that most people don’t know how to do this, as many simply go out and purchase some nutritional supplements from their local health food store, hoping this will help. Some will consult with a medical or holistic doctor, but the fact remains that most doctors don’t know how to properly treat this common problem. I too was guilty of this when I first began practicing, as my first few years of practicing I would also simply tell many of my patients to eat healthy, tell them to take some supplements, etc.
3 Primary Common Causes Of Adrenal Fatigue
The truth is that eating well and proper nutritional supplementation can help, but doing this alone will not be enough. To understand this better, let’s look at three of the major causes of adrenal fatigue:
Cause #1: Chronic stress. This is a major cause of adrenal fatigue, as while the adrenal glands were meant to deal with acute stress situations, they cannot effectively deal with chronic, prolonged stress. Unfortunately, we live in a society where the majority of people have some type of chronic stress in their life, which over a period of months and years will take its toll on the adrenal glands, resulting in adrenal fatigue.
Cause #2: Poor eating habits. Eating poorly can definitely affect the health of your adrenal glands and eventually contribute to adrenal fatigue. This is especially true for those that frequently eat refined carbohydrates, in which many people fit under this category. The reason this can affect the adrenal glands is because refined foods removes both the nutrients and the fiber from the whole food source. While the manufacturers do replace some of the removed nutrients, these refined foods no longer have the fiber component to help slow down the absorption. What this means is that when you eat a refined food, it absorbs quickly into the blood stream, and spikes up the blood sugar levels.