What are your adrenal glands?

Your adrenals are tiny glands that sit on top of your kidneys (literally ad+renals), but don’t judge these little guys based on their size. They pack a mighty punch when it comes to energy, hormones, blood sugar, inflammation, metabolism, blood pressure and sleep. Your adrenals produce hormones like cortisol, DHEA and aldosterone as well as the neurotransmitters adrenaline (epinephrine) and noradrenaline (noradrenaline).

Adrenaline (Epinephrine): Secreted quickly by the adrenal glands during a stressor and released into the blood through activation of the sympathetic nerves that communicate with the adrenal glands. Adrenaline is fast acting and responsible for shunting blood to our tissues/muscles to help the body deal with a stressor, converse to the more timed released of cortisol. Norepinephrine is another important neurotransmitter that regulates the central nervous system.

Cortisol: One of your main steroid hormones made in the adrenal cortex (the outer layer). Cortisol normally follows a diurnal rhythm and is highest in the morning then slopes off over the course of the day into the evening when melatonin starts to rise to support restful sleep and repair. Cortisol supports inflammation, maintains blood sugar and improves fat burning when working properly. It gets a bad rap, but it is so important to a healthy stress response! The trouble arises when we activate the stress response too often as you’ll read below.

DHEA: DHEA is the pre hormone to testosterone (50% of a women’s testosterone comes from conversion of the androgens DHEA and androstenedione). It is released during the activation of the HPA Axis and is thought to help moderate the negative impact of cortisol on the body and the brain. DHEA is known as the anti-aging hormone which decreases naturally as we get older. DHEA is sometimes called the antiaging hormone since it has a role in energy metabolism, memory, how much body fat we store and our libido.

Aldosterone: Made in the adrenal medulla, aldosterone is responsible for keeping electrolytes like potassium and sodium in balance which are important players in the regulation of cellular fluid balance and blood pressure.

While all of these hormones are crucial, let’s focus our attention on imbalances in cortisol.

Cortisol’s role in chronic disease

When we activate the HPA Axis too often, it upsets our normal cortisol balance. Normally, cortisol is highest in the morning then slopes off to its lowest point in the evening, when melatonin becomes the star of the show to aid in restful sleep and cellular repair. When we undergo a stressful event (whether its infection, running from a predator or worrying about a work or school deadline), we activate the HPA axis.

The chain of command starts in your hypothalamus which tells the pituitary gland to tell the adrenals to start producing your stress hormones cortisol and adrenaline. Adrenaline is released into circulation in minutes and is responsible for the sweaty palms and rise in blood pressure to get nutrients to our muscles quickly in case we have to run. Cortisol takes a bit longer and also takes longer to clear from the blood once the stressor is over. Normally, things then return to homeostasis. Cue our modern lifestyle: we have short intermittent stressors all.day.long meaning that cortisol may not clear from the blood before the next stressor hits. Chronic activation of the HPA Axis is bad news bears for your health.

Here are some things that are linked to inappropriately high levels of cortisol:

• High blood pressure
• Sugar cravings/Increased appetite
• High blood sugar/Diabetes
• Mid-section weight gain
• Immune dysfunction (At first, high levels of cortisol activate the immune system which is why stress can seem to worsen or trigger autoimmune conditions. Repeated intermittent stressors (lots of ups and downs) also seem to do this. However, the longer a stressor goes on the opposite occurs and the immune system becomes suppressed 40-70% below baseline making it hard to fight off infections or threats.)
• Poor sleep/Insomnia
• Underactive thyroid
• PMS/Hormonal imbalances

The Science of “Adrenal Fatigue”

While some suffer from having too much cortisol throughout the day, the opposite issue of not having enough cortisol can also cause bothersome symptoms. This is often called “adrenal fatigue” which is a bit of a misnomer since the adrenals are not too tired to make their hormones. A better term is adrenal dysfunction which simply means there is a disconnect occurring from the brain to the adrenal glands and they are no longer getting the message to make their hormones.

Possible reasons for this are mitochondrial dysfunction, nutrient deficiencies or chronic inflammation (the molecule TNF-alpha may block ACTH from binding to adrenal receptors). Another possible reason for low cortisol is Addison’s Disease, which is a rare and serious autoimmune condition when the immune system attacks the adrenal glands.

Here are symptoms of having low levels of cortisol:

• Low energy
• Difficulty sleeping
• Low blood pressure
• Difficulty recovering from exercise
• Lack of resilience under stress

Both too high and too low cortisol can exist at the same time as well making this a complicated issue.

Adrenal/Hormone Connection

What your adrenals are doing has a big impact on the rest of your hormones, and especially your thyroid hormones. High levels of cortisol reduces the conversion of T4 (inactive thyroid hormone) to T3 (your active thyroid hormone), and since your body is in a state of stress it drives conversion of T3 to RT3 (a storage form of the hormone that is unusable). Additionally, high levels of cortisol can also cause gut dysfunction and dysbiosis (20% conversion of thyroid hormone happens in the presence of healthy gut bacteria).

Adrenal dysfunction will also impact your sex hormones like testosterone, estrogen and progesterone. A state of stress is not conducive to reproduction, so ovarian or testicular production of our sex hormones may diminish, impacting fertility and hormone balance.

How to eat for your HPA Axis

• Focus on colorful fruits and veggies, especially foods high in Vitamin C like oranges, peppers, broccoli, spinach, and strawberries.
• Support your mitochondria (the powerhouse of your cells) – Eat foods rich in the B vitamins (good quality animal proteins), CoQ10 (eggs, olive oil and fatty fish), zinc (pumpkin seeds, cashews, oysters and beef) and magnesium (leafy greens, fiber rich whole grains, dark chocolate, nuts/seeds)
• Eat lots of healthy fats like avocado, nuts/seeds, olive oil, wild caught fatty fish, dark chocolate, and eggs
• Focus on good quality lean proteins like fish, poultry, eggs and moderate amounts of grass-fed red meats and pastured pork
• Eat for good blood sugar regulation – Eating fiber, protein and healthy fats together prevents spikes and dips in blood sugar which are viewed as stressors on the body and can impact adrenal health

Lifestyle Tips for Adrenal Health

• Exercise is like goldilocks and the three bears: you want not too much, not too little but just enough. Exercise is a good stress on the body, but when it goes on too long or you feel fatigued/exhausted and push through anyway, you might be doing more harm than good. Do some self reflection on if your exercise routine feels good for your body. If not, check out other options!
• Get 7-9 hours of sleep every night. NOT JOKING! This is important. Do what you have to do to prioritize your sleep above almost everything else. Check back on last week’s blog about sleep here.
• Practice stress management techniques through the day like deep breathing, journaling or guided meditations. Being in a constant state of rushing around or feeling overwhelmed is not good for your adrenal health.
• Say no more often. Too much on your plate? Learn to say no to things that aren’t serving you.

Test, Don’t Guess

When it comes to your hormones and the stress response, symptoms can be a good indicator of dysfunction (Listen to your body!). However, we suggest working with a practitioner to assess hormone levels (Cortisol, Estrogen, DHEA, Testosterone and Progesterone) to get a complete picture before starting any kind of treatment protocol.