Spring 2015: Chronic Hypervigilance - Your Worn Out Adrenals
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Summary: How do people get adrenal fatigue and what can we do about it?

How You Get to Adrenal Fatigue

In today’s fast life, the norm for most people is chronic hypervigilance. This means that your adrenals think you are being chased by a hungry tiger day in and day out without any rest. Your body does not know the difference between a real hungry tiger or a virtual hungry tiger, which may just be fighting traffic to get to work on time, rushing to meet one deadline after another, worrying about the economy, striving to keep up with a demanding job, too much homework and studying for exams while working full time, current news media stress, family stress, late nights, the busyness of keeping up with after-school activities for your children, and the continual juggling of everything that vies for your time which leads to poor sleep, little to no down-time during the day and poor nutrient intake.

In this chronic state of stress, the adrenals are overworked as your body tries to cope with one acutely stressful event after another. The result of constant stress is a cycle of events within the body that begins with stimulation of the adrenal glands to release more epinephrine and cortisol than should normally be required. The nonstop circulation of epinephrine and cortisol in the blood stream disrupts the normal circadian rhythm creating high blood sugars, blood pressure, and heart rate and reduced digestion and blood flow to the organs. This disruption in the circadian rhythm lasts longer than the stress itself. Despite adequate daily rest after a stressful event, it takes almost a week for the adrenals to recover. 1

Sixty to 80% of people suffer from adrenal fatigue and symptoms of stress are the number one reason for doctor visits. 2 If you wake up with the need to indulge in sodas, coffee, caffeinated teas, high sugar foods, sugary juices, chocolate, processed carbohydrates or any of an assortment of quick-fix foods or beverages to get and keep you going through the day, you may have adrenal fatigue. A healthy individual bounces out of bed in the morning with vigor and life, full of vitality and energy without the need of outside stimulants.

Two Tiny Organs with Big Responsibilities

We have two tiny adrenal glands, one sitting on top of each kidney. Each adrenal gland looks like a threesided hat, measuring only a few inches. Despite their tiny size, they have one of the richest blood supplies of all the organs and they store and use more vitamin C than any other organ or tissue in your body. 3

The adrenal glands have a huge responsibility. Each adrenal has two divisions: a smaller, inner medulla and a larger, outer cortex. Each part secretes separate stress hormones. The medulla secretes the “fight or flight” hormones which are the front-line first responders to stress or unrest of any kind. The medulla works quickly and efficiently, instantly producing the steroidal hormones adrenalin, noradrenalin and androgens as needed. The adrenals produce a surge of power by triggering the release of temporarily stored energy for fight or flight.4 The adrenal medulla hormones are the ones that allow a frantic mother to lift a car off her trapped two year old child and allow a hiker to walk out of the woods despite a painfully fractured hip. In an instant, the adrenalin quickens the pulse and constricts the blood vessels in order to raise the blood pressure, dilate the pupils for visual acuity, increase muscle contraction for activity, and the raise blood sugar for immediate energy.

If the acute stressors continue and become chronic, the adrenal cortex kicks in and produces cortisol5, which is the second responder. Cortisol is longer acting than adrenalin. Cortisol does not produce the typical jitters or shaking that comes with a rush of adrenalin because it gets its energy from protein stores, resulting in a slower conversion of energy which is more sustaining but over the long term is eventually damaging. Chronic stress fatigues the adrenals, lessening our ability to handle more stressors and uses larger than normal amounts of vitamin C, leaving the rest of the body without.3

Adrenal Fatigue Creates Hormone Imbalances

The adrenal hormones are manufactured in an algorithm fashion starting with cholesterol at the top. Cholesterol gets converted to pregnenolone, the precursor or raw material for all the other adrenal hormones 6. Pregnenolone then gets converted to either progesterone, cortisol, or DHEA, depending on what the body needs. DHEA leads to the production of sex hormones and is converted into estrone, estriol, testosterone, estradiol and others, again depending on what the body needs. But in times of stress pregnenolone is not converted to DHEA because cortisol is grabbing it all to manage the stress. DHEA is only manufactured in times of calmness.

If DHEA is not being manufactured, then neither are the sex hormones and you may experience a low sex drive, premenstrual syndrome, and menopausal symptoms. Other signs of the underproduction of DHEA include:

• sleep disturbances due to high cortisol,

• sleeplessness at 3 a.m.,

• fatigue,

• irritable bowels,

• dizziness upon standing,

• salt cravings,

• excessive thirst and urination,

• difficulty gaining muscle and losing belly fat,

• depression,

• light sensitivity,

• dark circles under your eyes,

• thin, dry, falling out hair,

• cold intolerance,

• frequent illness,

• anxiety, and

• a wired-and-tired energy pattern which makes you want to go to bed at 9 p.m. but you are still up at 11 p.m.

If you have sex hormone problems, the key may be to take low doses of pregnenolone and allow your body to manufacture what it needs from the raw material, but talk to your functional medicine doctor or other root-cause practitioner for a blood work up.

Testing for Adrenal Fatigue

Testing for adrenal fatigue is a simple non-invasive saliva test and can be done with a health care provider’s order at Diagnos-Techs, Inc. if you are in the USA. Cortisol levels change throughout the day so it is necessary to provide a saliva sample four times throughout the day at 6:00-8:00 a.m., 11:00 a.m.- 1:00 p.m., 4:00-5:00 p.m., and 10:00 p.m.–midnight. Cortisol should be highest around 6-8 a.m. to get you going in the morning, then as the day continues the levels should drop off by evening time so you are able to sleep well. The saliva test shows which of the seven phases you are in, though typically, in the literature, there are three stages: alarm, resistance, and exhaustion. There are also adrenal assessments that ask several pages of questions, with each question being assigned a numerical value and you end up with a score. That score gives you your level of adrenal fatigue.

Big Changes, Big Results: The Restorative Lifestyle

In addition to managing stress and having a healthy peace of mind, changing your lifestyle and dietary habits are key in restoring healthy adrenals. Your attitude toward a healthy lifestyle should not be “all-ornone” but consider it a process and a journey rather than a destination. From the list of adrenal support recommendations below, choose all the ones that you can change immediately and make those a part of your daily routine. Once you’ve incorporated these changes into your routine, start to look at other items and change those things that are next easiest until they become routine and so on, until you have accomplished the list within a reasonable amount of time. Of course, the further along you are in the disease process, the faster changes ought to be made.

Healing is in the causes. Our body has a hierarchical way of healing itself and the proper course of healing needs to be taken, so you cannot jump into healing the adrenals without first addressing other higher-priority issues. There are foundational lifestyle principles that must be incorporated to help the body jumpstart the healing process regardless of which disease you have or are trying to prevent. These principles are timeless.

Foundational Principles

The foundational principles of the restorative lifestyle include:

• A whole-foods, plant-based, vegan diet with 50-80% raw foods;

• Daily exercise;

• Drinking 6-8 glasses of clean, fresh water;

• 20 minutes of sunshine per day;

• Temperance in all things that are healthful and abstaining from those things that are hurtful;

• Getting outside to take in the fresh air;

• Taking moments of rest during the day;

• A day of rest each week;

• 7-9 hours of sleep every night;

• Getting to bed no later than 10 p.m. (9 p.m. is ideal);

• Trusting in God for our daily needs;

• Wearing proper clothing; and

• Having a positive outlook.

Once the foundational principles are in place, you can start digging deeper into what additionally may be hurting the adrenals. Obesity, poor quality and quantity of sleep, poor nutritional intake, injuries, toxins, and stress all hurt the adrenals.

The Toxic Environment

The adrenals are sensitive to toxins of all kinds.7 Beyond the foundational lifestyle principles, the next step is to remove the barrage of toxins in, on and around the body, which includes standard lotions, cleaning supplies, hair products, environmental toxins, detergents, air fresheners, soaps, stale indoor air, toxic and processed foods, toxic thoughts, and dental amalgams 6. Look for healthier non-toxic cleaning and personal care products at your local health food store or make your own. Do not put anything on your skin that you would not eat.

To heal the adrenals, it is also necessary to get the toxic foods out of your diet. That includes artificial sweeteners (such as aspartame, Ace-K, saccharin, sugar alcohols); trans fats; ingredients with names that you can’t pronounce; ingredients you can’t purchase as whole foods; processed sugars; gluten; dairy; meat; products made from refined flour; foods with pesticides, preservatives, and plasticizers, which are endocrine disruptors; vegetable oils; regular table salt; coffee; tea; alcohol; tobacco, and too much cooked food. Start inching your way up to a minimum of 50% raw diet and if you are already at 50%, inch your way up to at least 80%. There are a myriad of delicious, fresh, raw food recipes online and in recipe books, filled with life-giving enzymes to take the place of enzymeless cooked and dead processed foods.

Healing Your Digestion to Heal the Adrenals

The next rung on the hierarchical healing pyramid is digestion, a foundational source of all ill health. We are not only what we eat but what we assimilate. Digestion-related problems include allergies, food intolerances, candida, parasites, inflammation anywhere in the body, hay fever, and any autoimmune disease, Crohn’s disease, colitis, diverticular disease, indigestion, constipation, diarrhea, and flatulence. During the hectic, stressful day of the average person, the digestion works sub-optimally so it is necessary for you to reboot and relearn how to structure your day to include moments of relaxation, even if only for a minute or two several times a day.

Digestive imbalances also come from improper chewing and consuming foods you may be allergic to or have an intolerance to. The top food allergens and intolerances are gluten, dairy, chocolate, peanuts, tree nuts, wheat, soy, corn, eggs, strawberries, citrus, and shellfish.8 Genetically modified (GM) foods are also known to cause gastrointestinal problems 9 and in a position paper, the American Academy of Environmental Medicine called on “physicians to educate their patients, the medical community, and the public to avoid GM food…and to consider the possible role of GM foods in the disease processes of the patients they treat”.10 To date, unless certified as organic or otherwise labelled as not GM, you may assume the following crops to be genetically modified: alfalfa, corn, sugar beets, soy, canola and cottonseed, papaya from Hawaii or China, zucchini and yellow crookneck squash 9. Other GM foods are on their way as well, like GM salmon, meat and potatoes. Some produce, such as tomatoes have also been experimented on and may be in your grocery store. Eliminating these foods will be good medicine for your adrenals and the rest of your body.

Controlling Blood Sugars to Heal Your Adrenals

If you have adrenal problems then you most likely have blood sugar imbalances, which is the next rung on the hierarchical healing pyramid. You may not even realize you have blood sugar problems, especially if you eat a vegan diet, are of normal weight, drink plenty of clean water, and exercise. If you are not on a vegan diet, are overweight, don’t drink enough water or get enough exercise, the chances are even greater that you will have insulin resistance. To check for blood sugar abnormalities, you may want to purchase an inexpensive glucometer and start checking your blood sugars. Check them first thing in the morning and at 15 minute intervals for up to 2 hours after eating. Your blood sugar should not go above 120, 100-110 is even better. 11

Keep a food and blood sugar journal and see which foods increase your sugars. Be especially careful to note blood sugar levels after consuming grains (especially gluten-containing grains), dairy, processed foods (even the “healthy” ones), starches and fruit. Temporarily eliminate anything that increases your blood sugars above 120 until you eliminate the toxins in your life and your gut and your adrenals are healed. If you have adrenal problems, most likely you have thyroid problems too, as they often go hand in hand.

Foods that Hurt the Adrenals

Eliminate things that hurt the adrenals. Not surprisingly, coffee, non-herbal tea, caffeine, sugar, and alcohol are adrenal stressors and create a similar effect in the body as outside stress does. Eliminate gluten and the top food allergens: milk, eggs, peanuts, tree nuts, fish, shellfish, soy, wheat, sesame seeds, soy, and sulfites. 12 Gluten intolerance is not a fad; it is a real issue. If you have any health problems at all and already bypass dairy products, gluten may be the next suspect as there are over 200 symptoms associated with gluten sensitivity or gluten intolerance.

Foods that Heal the Adrenals

Hippocrates said, “Let food be thy medicine and thy medicine food,” which is good advice for relieving adrenal fatigue. The foods we choose to eat play a very important role in giving the adrenals and the rest of the body what it needs for restoration. The more nutrient dense and alkaline the food, the more restorative it will be for the body. The more nutrient depleted, the more damaging its effect will be. It is as simple as that. Ideally, your goal should be to eat 50-80% fresh, raw foods, the more the better and 80% alkaline. After all, the original diet in the Garden of Eden was fresh, raw, local, in-season food.

Foods specific to adrenal restoration include omega-3 rich foods such as flax seeds, hemp seeds, chia seeds, and walnuts and probiotic foods such as homemade sauerkraut and cultured nut, seed and coconut yogurts, kefir and rejuvelac 13. These are inexpensive and very simple to make. Other highly recommended foods for the andrenals are adaptogenic mushrooms such as cordycepts, chaga, shiitake and reishi and sea vegetables such as kelp, bladderwrack, nori, and dulse. Adaptogenic herbs and foods create homeostasis, peace and calmness. Green leafy vegetables and fresh sprouts are loaded with protein and they contain the micronutrients so often missed in the mainstream diet. The goal would be between a half pound and 2 pounds of leafy greens and sprouts per day. 13 Onions, garlic, lecithin, Brazil nuts, coconut, vegetables and low-glycemic fruits (that is, cherries, grapefruit, pears, plums, green apples and berries) are also excellent for daily eating, but check your blood sugar to make sure it remains normal. If any of these raise your blood sugar levels, they will need to be eliminated for a time until further healing occurs.

Adaptogens and Other Support

Once on a clean diet and lifestyle, additional support with vitamins and herbs to help heal the adrenals may be needed. Find a local naturopath, functional medicine doctor or lifestyle practitioner who can help you on your path. Following are some further suggestions. At the top of the “additional support” list would be vitamin C. The adrenals use more vitamin C than any other organ and when under constant pressure and stress, they use even more to the point of depleting the body of vitamin C. You may need to take 2-6 grams per day, depending on bowel tolerance. You may also want to add high quality liquid vitamin B5, B6, trace minerals and magnesium.

You can also make smoothies, an elixir drink, or tea with ashwagandha, astragalus, maca, holy basil, shilajit, Korean ginseng, Siberian ginseng, rhodiola rosea, the adaptogenic mushrooms, the above-sea vegetables, chamomile, eleuthero root and others . 14 When a combination of adaptogens is used, significant improvements are seen in the reduction of fatigue and stress 14. To make an elixir, start with a teaspoon of herbal healing tea such as holy basil and steep it in 2 cups boiled water for 10-30 minutes, or overnight for maximum benefit. Pour the tea into the jar of a high-speed blender. Then add ½-1 teaspoon of each adaptogen and sea vegetable, 4 Brazil nuts, 1 tablespoon of walnuts and 1 tablespoon coconut butter or dried coconut 13. Add carob powder for a pleasant chocolaty, richer flavor. To make a smoothie, simply add low glycemic fruits and some greens to the above listed ingredients and blend till smooth. Experiment with different combinations and maybe even have 2 or 3 recipes that you can change up each day.

At first it may seem overwhelming to make so many changes, and in the beginning it is more work. But after a while it just becomes your natural lifestyle and the benefits are well worth the effort.

1. Opstad, K. (1994). Circadian rhythm of hormones is extinguished during prolonged physical stress, sleep and energy deficiency in young men. Eur J Endocrinol, 131:55-66.

2. Head, K. & Kelly G. (2009). Nutrients and botanicals for treatment of stress: Adrenal fatigue, neurotransmitter imbalance, anxiety, and restless sleep. Alternative Medicine Review, 14(2), 114-140.

3. Patak, P., Willenberg, H., & Bornstein, S. (2004). Vitamin C is an important cofactor for both adrenal cortex and adrenal medulla. Endocrine Research, 30(4), 871-875.

4. Wikipedia.org. Epinephrine. http://en.wikipedia.org/wiki/Epinephrine

5. Wikipedia.org. Cortisol. http://en.wikipedia.org/wiki/Cortisol

6. Lam, M., Schmitt, W., Wilson, J. The Adrenal Glands: Endocrine support products. http://tuberose.com/Adrenal_Glands.html

7. Food and Nutrition Information Center. National Agricultural Library USDA. (2010). Food allergies and intolerances resource list for consumers, December 2010. www.nal.usda.gov/fnic/pubs/bibs/allergy.pdf

8. Samsel, A., & Seneff, S. (2013). Glyphosate, pathways to modern diseases II: Celiac sprue and gluten intolerance. Interdiscip Toxicol, 6(4): 159-184.

9. Institute for Responsible Technology. (nd). GMO Education: Health Risks. http://www.responsibletechnology.org/health-risks

10. Dean, A. & Armstrong, J. (2009). Genetically modified foods. American Academy of Environmental Medicine. http://www.aaemonline.org/gmopost.html

11. Christiansen, J. S. (Sept 13, 2006). What is normal glucose? Continuous glucose monitoring data from healthy subjects. Diabetes Management: From Today’s Standards to Tomorrow’s. Presented at the Annual Meeting of the EASD, Copenhagen, Denmark.

12. Food & Drug Administration. (January 2009). Food allergies: Reducing the risks. Consumer Health Information. http://www.fda.gov/downloads/ForConsumers/ConsumerUpdates/UCM170952.pdf

13. Loscalzo, Ritamarie. (nd). Correcting Adrenal Fatigue and Exhaustion. http://www.vibrantlivingmembers.com/cafe/part3/

14. Stansbury, J., Saunders, P., Winston, D. (2012). Journal of Restorative Medicine, 1, 1. pp76-82(7). Supporting adrenal function with adaptogenic herbs. http://www.restorativeformulations.com/Library-Adrenal-Metabolism/Supporting-Adrenal-Function-with-Adaptogenic-Herbs

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