The human body is exquisitely clever. We possess intricate mechanisms to cope with all sorts of regular or irregular situations. We don’t instruct our body to run any particular program, it intuitively knows which one to select depending on the coding received from our senses.
During times of stress – a number of areas of the brain receive a call to action. In the first instance, the amygdala, the area of the brain that can process emotional signals, sends out a distress call to our command centre, the hypothalmus. The hypothalmus is the part of the brain that generates a fight or flight response. It determines the size of the lion, whether to run or stay still, or the speed at which we need to run to flee from danger.
The hypothalmus signals the adrenal glands at the top of our kidneys to release epinephrine (adrenaline). This type of response is perfect for times of short-term stress when we need a quick fuel injection or burst of energy. It is often called fight-or-flight or alarm reaction. Australian surfing legend Mick Fanning demonstrated this mechanism most skilfully in 2015 when he was attacked by a shark during the finals of a world championship title. He jumped from his board, punched the shark in the back, started to swim to shore before stopping and turning to face the enemy, knowing he had better chance of survival if he could see the danger. Mick’s short-term stress response was working well that day as he miraculously escaped unharmed!
But what happens during times of long-term stress?
This is the stage of resistance and this is where cortisol comes into play. Cortisol helps the body respond to stress or danger by increasing the metabolism of glucose. If a person is starving for example, the body signals the adrenals to release cortisol to stimulate the conversion of stored protein, fats and carbohydrates to energy by way of gluconeogenesis. Long-term stress response can stimulate the hypothalamus to begin a chain reaction of hormones including cortisol, causing sodium and fluid retention, and leading to increased blood volume and blood pressure.
Chronic stress response
If the stress continues for a longer term, the body responds with symptoms quite different than the fight-or-flight response. During this stage of exhaustion, individuals may begin to suffer depression, the suppression of their immune response, severe fatigue, or cardiovascular repercussions. These symptoms are mediated by the hormones of the adrenal cortex, especially cortisol, released as a result of signals from the HPA Axis.
What are the Risk Factors of Adrenal Fatigue?
- Lifestyle
- Lack of sleep
- Poor food choices
- Food and drink stimulants when tired
- Staying up late even when tired
- Lack of work/life balance
- Perfectionism
- Repeated or overwhelming chemical exposure – drug and alcohol abuse included
- Life Events
- Death of family or close friend, isolation
- Surgery
- Moving house
- Job loss
- Sudden changes to financial status
- And most currently, elongated lockdowns during a pandemic
Signs and Symptoms of Adrenal Fatigue
- Difficulty getting up in the morning
- Continued fatigue not relieved by quality night’s sleep
- Salt or salty food cravings
- Lethargy
- Increased effort to perform normal day to day tasks
- Decreased sex drive
- Decreased ability to handle stress
- Increased time to recover from illness, injury or trauma
- Orthostatic or postural hypotension (dizziness when standing up)
- Increased PMS
- Symptoms increases if meals are skipped or inadequate
- Brain fog
- Memory loss
- Decreased tolerance
- Afternoon energy slumps
- Evening energy peaks after dinner
- Decreased productivity
- Mild depression
- Less enjoyment / happiness with life
Disease and Health Conditions associated with Adrenal Fatigue
Most chronic disease is stressful. These place great demand on the adrenals. Chronic fatigue often precedes Chronic Fatigue Syndrome, Fibromyalgia, Alcoholism, Ischemic heart disease, Hypoglycaemia, Rheumatoid Arthritis, Chronic and reoccurring respiratory infections.
There are certain herbs and compounds that can help the adrenal glands in times of stress by reducing cortisol levels in the body. This include Withania Somnifera (winter cherry), Magnolia officinalis (magnolia), Phellodendron amurense (phellodendron), Ocimum sanctum (holy basil), Panax quinquefolium (American ginseng) and Pana ginseng (Korean ginseng).
Testing for Adrenal Fatigue
Saliva Hormone Testing
This test measures the amounts of various hormones in saliva rather than blood or urine. Above blood and urine, saliva hormone testing is the most accurate test for detecting adrenal fatigue as it is more indicative of the hormone levels inside cells where hormone reactions are occurring. DHEA-S levels are a direct indicator of the functioning of the area within the adrenal gland that produces sex hormones. Decreased Testosterone, DHEA-S and cortisol levels together indicate chronically-decreased adrenal function.
Recovering from Adrenal Fatigue
Recovery is reliant on how you spend your energy, how you create your energy and how you conserve your energy. The key aspects to recovery are lifestyle, diet, rest and body-mind techniques, and in many cases where diet is insufficient, dietary supplementation. With adrenal fatigue, the cells have used up much of the body’s stored nutrients, creating a nutritional void. Good quality food is the best source for replenishing these nutrients.
Lifestyle
The primary goal is to remove the cause and aggravating factors of the illness:
- Determine which things in life are contributing to health and which things are detracting from it
- Identify the ‘energy robbers’
- Change the stressors that are being internalised. This can be assisted with many techniques, such as counselling, NLP (neurolinguistics programming) and relaxation techniques
- Habits for quality sleep – healthy sleep environment, no technology after a certain time, relaxation before retiring, going to bed when tired. Sleep quality is imperative to adrenal recovery.
- Exercise – increased blood flow, detoxification, normalisation of cortisol, insulin, blood glucose, growth hormone, thyroid hormone, acceleration of CO2, O2 and nutrient exchange.
- Eat ‘Real’, fresh food. Avoid pre-made/processed foods which are often loaded with artificial flavours/preservatives/fillers
- Do not limit your salt intake when you have adrenal fatigue, especially if you are craving salty foods. Sodium is critical for adrenal function, and is usually low when adrenals are depleted. Avoid sodium chloride. Celtic sea salt is a naturally healthier choice.
- Limit starchy vegetables and fruits high in simple carbohydrates (especially bananas – high in potassium, which levels are already high in adrenal fatigue)
- Quality protein – grass fed beef, organic chicken, eggs, oily fish
- Quality fats – coconut oil, extra virgin olive oil, avocado, nuts & seeds, flaxseed oil
- Eliminate alcohol
- Eliminate Caffeine
- Combine fats, carbohydrates and proteins at every meal – carbohydrates should be the last item to your plate
- Avoid fruit in the morning – particularly with severe adrenal fatigue
- Eat in a relaxed environment and slowly – chew every bite at least 30 times
- Avoid refined grains, sugar, fats and their products – sweets, chocolate, white flour, pies, cakes, deep fried foods etc.
- Drink filtered water and herbal teas
- Eat as much fresh above the ground veggies as you can – this will create a less acidic state in the body
Food Allergies, Sensitivities and the Adrenal Function
As histamine and pro-inflammatory substances are released cortisol is required to control the inflammatory response which puts the adrenal glands under pressure. The harder the adrenals have to work in producing cortisol, the more fatigued they become. As a result, less cortisol is produced allowing histamine to inflame the body. This viscous cycle leads to further adrenal fatigue, increased sensitivity and more systemic allergic responses all over the body.
Eliminating allergic or sensitive foods from the diet decreases the demand on the adrenals, allowing them opportunity to recover. A food reflection or reaction diary is a good method of tracking any symptoms after eating certain foods. Allergy and sensitivity lab testing can also be done to confirm sensitivities.
Supplementation
- Vitamin C
This is one of the most important supplements for adrenal fatigue. The more cortisol that’s produced, the greater the Vitamin C required. This important vitamin is essential to the adrenal hormone cascade as it acts as an antioxidant within the adrenal cortex itself. Not only does it increase adrenal function but it stimulates the immune system.
A bioflavonoid:ascorbic acid complex in 1:2 ratio is most beneficial as the bioflavonoid will enhance the bioavailability of the ascorbic acid on what your practitioner prescribes. Caution should be made with blood thinning medication. Vitamin C decreases blood clotting and coagulation. Blood thinning/anti-coagulation medication may need to be lowered.
- Vitamin E
An essential vitamin for indirect enzymatic reactions in the adrenal cascade, high amounts are necessary in to maintain high levels of steroid production and recover adequately. Vitamin E absorbs and neutralises the free radicals generated as a result of adrenal hormone manufacturing. It works in synergy with Vitamin C – vitamin C enhances the activity of Vitamin E inside the cells by regenerating the capacity of vitamin E to sequester the free radicals.
Mixed tocopherols, particularly ones high in beta-tocopherols are most beneficial for adrenal regeneration. Caution should be made with blood thinning medication. Vitamin E decreases blood clotting and coagulation. Blood thinning/anti-coagulation medication may need to be lowered.
- B Vitamins
Pantothenic Acid (B5)
Is an essential contributor to the adrenal cascade and is important for energy production. Pantothenic Acid is found throughout living cells in the form of Coenzyme A (CoA), a vital coenzyme in numerous chemical reactions It is present in high quantities in the adrenals.
Niacin (B3)
Is one of the most important B vitamins to the adrenal cascade. Large amounts are necessary to form the molecular structure of certain niacin dependant coenzymes critical for several steps in the adrenal cascade
Niacin tends to make people ‘flush’.
Magnesium
Mg is essential to the production of the enzymes and the energy necessary for the adrenal hormone cascade.
The presence of magnesium in adrenal cells is specific for adrenal recovery. Magnesium glycinate is easily absorbed by the body, does not cause diarrhoea and assists with sleep, among other functions. It can be taken up to 3 times/day
- Calcium
This important mineral helps to settle the nervous system and is best absorbed after 8pm, but should not be taken at the same time as magnesium. It can be taken on alternate evenings to magnesium or take magnesium closest to bedtime.
- Trace Minerals
There are many helpful trace minerals that assist with renal function - manganese, selenium, molybdenum, chromium, copper, zinc and iodine. These minerals have a range of functions, including immune and antioxidant support. They typically have a calming effect on the body especially in people who are jittery, nervous, easily upset or anxious. Supplements are best taken with a meal.
Specific dietary inclusions
Fibre
Mild constipation is common in adrenal fatigue. Increasing fibre will improve bowl motion and re-establish normal bowl function whilst strengthening adrenal function. As the adrenals begin to heal, the liver will begin to detoxify more rapidly, therefore there are more toxic constituents in the bile secreted by the liver. Fibre prevents bile from becoming toxic in the large intestine by binding to it and moving it through the digestive tract
Psyllium husk, nashi pear, berries, avocado, coconut, peas, beans, legumes, flax seeds, chia seeds are all excellent sources of soluble and insoluble fibre as well as an excellent source of vitamins, minerals and antioxidants.
Adrenal Recovery Soup
The following vegetable soup recipe is rich in minerals and alkalinizing to help balance the acidity that usually occurs in people experiencing adrenal fatigue and stress.
- 450g green beans
- 1 cup chopped celery
- 1 zucchini, sliced
- 1 medium onion, chopped
- 1 cup tomato juice
- 1 cup spring water
- 2 tbsp. raw honey
- 1 tsp. paprika
- 1 cup chicken broth
Combine ingredients and simmer for one hour until vegetables are tender. Pepper to taste.
Our wholistic pharmacists at Synergy Compounding can help you find supportive supplements during times of stress. Some of our options include:
- Synergy Unwind with GABA, Magnesium Glycinate, Taurine and L-Theanine
- Synergy Calm with GABA, inositol, taurine, glycine
- Magnesium Glycinate