Page 10 - Spring 16

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Adrenal Fatigue
Do you need a caffeine boost to get going in the mornings? And another at about 10 am with a biscuit or three? Does it go on like that all day, with a slump at about 3-4 pm, some wine at home in the evening, then you collapse, exhausted into bed, if you don’t fall asleep in front of the telly or in the bath first? If any of this sounds vaguely familiar, you are probably suffering some degree of adrenal fatigue.
When exposed to a stressful situation, the adrenal glands are stimulated to produce adrenalin and noradrenalin, cortisol, aldosterone, DHEA, pregnenolone and sex hormones as the main hormonal messengers, orchestrating the well known ‘fight or flight’ response. The cortisol level is regulated by the negative feedback loop of the HPA axis involving the production of Corticotrophic Releasing Factor (CRF) by the Hypothalamus, AdrenoCorticoTrophic Hormone (ACTH) by the Pituitary gland and a range of hormonal messengers including Cortisol and Adrenalin (epinephrine) by the Adrenal glands. All the adrenal hormones are made from cholesterol, which is converted to pregnenolone, the first hormone in the series of hormones created by the various different zones of the adrenal glands. Our current obsession with cholesterol levels, fat free foods and the overuse of statins and other cholesterol reducing drugs is bound to have an adverse effect on our body’s ability to respond
appropriately to stress.
Cortisol is one of the most important hormones used by the
hypothalamus to balance body chemistry. It helps to prevent the body from over-reacting to stressors and is the most vulnerable to underproduction in chronic stress and adrenal fatigue, resulting in auto- immune diseases and unnecessarily violent reactions to insect bites, for example. The hypothalamus constantly measures the amount of circulating cortisol and relates this to the information it receives from both external (e.g. the sensory organs of sight, sound, smell, touch and taste) and internal (e.g. energy requirements) sources. The amount of the various hormones released varies minute by minute. It is a very finely tuned homoeostatic mechanism upon which our life depends.
In a stress-free environment, cortisol is released in tune with the circadian rhythms of all species. In humans, cortisol production increases from 6 am to reach its peak at 8 am, waking us up, subsiding and rising repeatedly throughout the day in a series of peaks and troughs, the peaks stimulated by exercise, eating and stress. Cortisol levels are naturally at their lowest in humans during the night, between midnight and 4 am. This circadian rhythm is reversed for nocturnal animals; for people working at night, it takes the body days to weeks to adjust its circadian rhythm to suit, so the shift worker’s cortisol levels are chaotic with disastrous health consequences.
What does cortisol do?
• Cortisol protects our cells from stress throughout all the body systems.
• Cortisol normalises blood glucose levels by stimulating gluconeogenesis in the liver when required and protecting the cells from excess insulin. During times of stress (good and bad), cortisol levels increase to regulate blood sugar levels and insulin levels increase to allow the cells to access the much needed glucose so they can respond appropriately to the stressor (e.g. running or fighting). Hypoglycaemia results from low cortisol (mostly due to lack of gluconeogenesis in the presence of high levels of insulin), which further stresses the adrenals and exacerbates Adrenal Fatigue, with feelings of muscular weakness, brain fog and slow reactions. People reverse these symptoms with stimulants like caffeine and sugar. As their blood sugar suddenly rises, more insulin is produced so blood sugar drops, but overshoots in the absence of the protecting influence of cortisol, dropping further than it was before, so more sugar and caffeine are consumed creating an erratic rising and falling of blood sugar every hour or two, completely
exhausting for the homoeostatic systems to deal with. Over-eating often results from hypoglycaemia, with the excess glucose being stored as fat. With low cortisol levels, conversion from fat to glucose (gluconeogenesis) is slow resulting in an inexorable weight gain. Prevent this by snacking on healthy whole foods every couple of hours to maintain relatively stable blood sugar levels and completely avoiding stimulants and empty calories (e.g. biscuits, cakes, donuts).
• Cortisol damps down the effect of the immune system, reducing inflammation and preventing life threatening over reactions and autoimmune reactions. During times of stress, before the onset of adrenal fatigue, the high circulation cortisol renders the body vulnerable to infections and other ailments as the level of circulating lymphocytes is vastly reduced, which is why chronically stressed individuals often succumb to diseases (e.g. infections, cancers). Once the adrenals are exhausted and their production of cortisol impaired, the stress messengers circulating can result in an over-reactive immune system, with auto-immune diseases, inflammation, allergic reactions, tissue destruction (is this
the basis of the tissue necrosis seen in MRSA I wonder?) as there is insufficient cortisol to protect the cells.
• Cortisol regulates blood pressure by stimulating the midsized arteries to contract and increasing the strength of contraction of heart muscle, thereby increasing blood pressure. Aldosterone also contributes to maintaining blood pressure by regulating sodium, potassium and fluid levels. Unresponsive low blood pressure and dizzy spells result from low cortisol levels seen in Adrenal Fatigue.
• Cortisol influences mood, behaviour, excitability and neuronal electrical activity. Cortisol deficiency can result in sleep disorders, poor memory, intolerance and inability to think clearly.
No matter what the sources of the stress, the resulting effects on the body are the same, stimulating the HPA axis to produce more adrenaline, cortisol and other adrenal hormones. When the adrenal glands are exhausted, they cannot produce enough of these hormones to induce the body to respond appropriately. The more extreme the difference between the level of stress and the lack of cortisol, the more significant the consequences, ranging from death to feeling exhausted and
emotionally drained.
Our adrenal glands and the HPA system
were designed to keep us alive during occasional stressful events. The amount of stress we subject ourselves to these days in a year is probably what we are designed to cope with in our entire lifetime. We need to give our adrenals time to rest and recover, rather than expecting them to work flat out full time, constantly flogging a dying horse!
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