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Ellen Brown L.Ac. DACM

Adrenal fatigue, stress and modern life


In the world we live in today, many influences strive to pull us away from the healthy life we want to lead. But none are more insidious than stress. Short periods of stress can actually be beneficial, sharpening our thinking to keep us alert or heightening our physical performance to excel in athletic competition. But stress can quickly turn negative when a person faces continuous pressure without relief. When individuals are relentlessly under assault — over money, relationships, career pressures, childcare, long-term illness, or even a long, daily commute — chronic stress can wreak havoc on your health and life.


Our bodies have been hard-wired since pre-historic times to react to stress in ways meant to protect us from predators and other threats. When faced with a perceived threat or stressor, the hypothalamus – a tiny region at the base of your brain – sets off an alarm system in your body. This prompts the adrenal glands, located atop the kidneys, to release a surge of hormones that include adrenaline and cortisol. Adrenaline increases your heart rate, elevates your blood pressure and boosts your energy (all very helpful when you’re running from a saber-toothed tiger). Cortisol, the primary stress hormone, increases sugar in the bloodstream, enhances your brain’s use of glucose, and increases the availability of substances that repair tissues. Cortisol also curbs functions that would be non-essential (or even detrimental) in a fight-or-flight situation. It alters immune system responses and suppresses the digestive system, as well as the reproductive system and growth processes. This complex natural alarm system also communicates with regions of the brain that control mood and motivation.


Under “normal” conditions, the body’s stress-response system is self limiting, meaning that once the perceived threat has stopped, hormone levels re-set and return to normal. For too many people, however, stress has become “chronic” and the body’s fight-or-flight mode remains permanently turned-on. It’s the on-going activation of the body’s stress-response system – and the resultant excess supply of cortisol and other stress hormones – that damages the adrenals and significantly damages your health.


The adrenal glands mobilize the body’s response to every kind of stress – be it physical, mental or emotional – through hormones that regulate energy production and storage, immune function, heart rate, muscle tone, and other processes that enable you to cope with stress. Whether its an emotional crisis such as the death of a loved one, a physical crisis such as major surgery or any type of emotional stress in your life, the adrenals respond in the attempt to maintain homeostasis. A long-term illness, on-going life crisis or a continuing difficult situation at home or work can ultimately drain the adrenal resources of even the healthiest person. When the adrenal glands remain over stimulated for a long period of time, they begin to weaken. On top of that, lifestyle choices (poor diet, substance abuse, inadequate sleep, excessive caffeine and other stimulants, external and self-imposed pressures) can make a bad condition worse.


Adrenal fatigue sets in when your adrenal glands, hypothalamus and pituitary gland (together, called the HPA axis) can no longer meet the demands of stress and begin functioning below optimal level. Because adrenal fatigue is actually a collection of signs and symptoms, it is known as a syndrome. As the name suggests, its primary symptom is fatigue that is not relieved with sleep.

Adrenal fatigue is a huge issue in our over-scheduled, fast-paced society where people wear their stress like a badge of honor. For many people, adrenal fatigue starts subtly as one’s energy gradually drains away. They will have trouble sleeping and wake up feeling as worn-down as when they first went to bed. Often, people find they lose the motivation and enthusiasm to do the things they once loved. Cravings for salt and/or sugar increase, as does weight. They feel easily overwhelmed by their emotions in response to even minor stress and find that the littlest things can set them off and cause stress out-of-proportion to the situation. Sleeping longer doesn't help and caffeinated drinks and other stimulants are often needed to get through the day. The symptoms of adrenal fatigue are so prevalent in our stressed-out society that people accept them as the new “normal” way they feel.


To understand the effect of stress on the adrenals, it’s important to understand the important role that cortisol, also known as the “stress hormone,” plays in a number of physiological processes, not least of which is determining your body’s ability to cope with stress. In addition, cortisol regulates how your body metabolizes fats, proteins and carbohydrates for energy. Cortisol also impacts blood pressure and cardiovascular health. When hormones are balanced, cortisol is protective and burns fat. When cortisol and other hormones are out of whack, changes start to occur in our carbohydrate, protein and fat metabolism, fluid and electrolyte balance, heart and cardiovascular health and even our sex drive. Still more changes occur at the biochemical and cellular level in response to (and to compensate for) the decrease in adrenal hormones that occur with adrenal fatigue.


Ultimately, there is a limit to how much stress our bodies can handle. When life’s various pressures add up, or become chronic, the adrenals are forced to work overtime to mobilize our body’s response to physical and/or emotional stress by secreting more and more cortisol into the system. Eventually, the adrenal glands become depleted from pumping out cortisol continuously and symptoms of fatigue start to set in. Besides being unable to stabilize blood-glucose levels, the body will have more difficulty fighting inflammation, mounting an immune response and maintaining a healthy metabolism.


Our bodies continue to rely on the same systems today to battle modern-day stress as our caveman ancestors did to fight the woolly mammoth. What has changed, however, is our stress load. While most of us do not experience life-threatening stress, we do carry the chronic accumulations of a thousand minor stressors from work, family, communication overload, environmental toxins, overeating and even over-training. As a result, we have become less facile in our ability to physically deal with the mounting stress that defines our lives. The danger is that our modern lifestyle will eventually lead to “burnout” – leaving us susceptible to disease as well as damaging our quality of life.


Many doctors are reluctant to diagnose adrenal fatigue since it often manifests quite differently in every person. Some doctors argue that adrenal fatigue is not an illness per se, but a collection of fatigue-related symptoms. In reality, this profound state of depletion is difficult to detect with lab tests until the condition becomes severe. Indeed, adrenal dysfunction is not recognized by modern medicine until it becomes life-threatening – when the adrenal glands virtually shut down and an autoimmune condition known as Addison’s Disease develops.


I have found that the best treatment plan for adrenal fatigue includes acupuncture, herbal medicine and nutrition aimed at improving strength for lasting energy. Any treatment strategy for adrenal fatigue must also include a plan to change the myriad lifestyle habits that contribute to modern-day stress. Treating the adrenals does not help unless you also fix the condition’ s underlying root cause.


To proactively manage emotional stress, it is crucial to honestly assess the stresses that have the most impact on your life. This will surely include taking a hard look at your life-work balance and the people you surround yourself with. Meditation, walking outdoors in nature and yoga are all activities that can prompt calm-inducing chemical shifts in both the brain and body.


For active, athletic people healing demands not training too hard during the adrenal fatigue recovery period, which may take several months. It is important to remain active, but avoid over exertion, which further stresses the adrenals and makes recovery difficult. For runners, this might mean replacing part of your routine with yoga and meditation.Changing your diet will also be critical to recovery. In particular, this includes cutting out coffee and other caffeinated drinks. A clean diet of whole or minimally processed foods must be part of any adrenal restoration program. Finally, acupuncture and herbal medicine can help address both the root stress response in your body as well as help tonify the adrenals for greater, more enduring energy.


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