ADRENAL DYSFUNCTION, STRESS, CORTISOL, AND ALL THINGS IN BETWEEN
LONG TIME, NO TALK!
I know I said I’d try and post on here about once every 7-10 days…so it looks like I’m a bit overdue. Life has been a little full, and a little stressful. The blog has kind of been put on the back burner!
Speaking of stress, have you ever wondered or heard about how it affects your adrenal glands? Have you ever even heard of your adrenal glands? If you have, did you know they’re directly linked to your blood sugar balance, insulin response, and mood? I’d like to talk about all of the above in the blog today covering the adrenal glands and include how they work synergistically with blood sugar balance in next week’s post (and yes, that means I’ll be posting again!).
ANATOMY AND PHYSIOLOGY OF THE WHOLE ADRENAL SHEBANG
We shall begin with ~yet another~ anatomy and physiology lesson.
Stop 1: the nervous system. Our nervous system is composed of two “main” divisions: the central nervous system and the peripheral nervous system. The central nervous system is composed of the brain and the spinal cord; the peripheral nervous system is composed of all nerves that are not the brain or spinal cord. This means all cranial nerves, sensory organs, and spinal nerves projecting from the spinal cord (2).
Within the peripheral nervous system, we have the somatic nervous system which is in charge of all voluntary movements. It uses sensory organs to elicit such movements of skeletal muscles. We also have the autonomic nervous system, which is in charge of all involuntary muscles within the body that perform their duties without conscious thought (you can think “automatic”). This autonomic nervous system is broken into the parasympathetic and the sympathetic nervous systems (2).
These words may seem big and scary, but maybe you’ve heard about them before? The sympathetic nervous system also refers to the “fight or flight” response, and the parasympathetic nervous system is often referred to as the “rest and digest” response. Both exist complementary to one another. A good explanation of the balance between the parasympathetic and sympathetic nervous systems is the balance between war and peacetime. I hope you’ll begin to see why...
THE PARASYMPATHETIC NERVOUS SYSTEM
The parasympathetic nervous system is responsible for a wide variety of functions: digestion, peristaltic movements to facilitate digestion, immune function, pupil relaxation, normalized heart rate, and normalized blood pressure (3). We are (supposed to be) in the parasympathetic nervous system more of the time than we are in the sympathetic nervous system (I’ve read~80% parasympathetic to 20% sympathetic, but was unable to find a source). Why? When the parasympathetic nervous system is active, we are able to digest and absorb our food, reproduce and have a libido, grow, and our immune system is able to “clean house” and to take care of itself. Blood flow is kept proximal to the body, and the organ systems are able to perform their rightful duties. Think of this as “peacetime”.
THE SYMPATHETIC NERVOUS SYSTEM
Now, imagine that we’re gearing up for war. Our main focus is no longer on internal (domestic) maintenance. Our bodies’ stress responses have been triggered, and we’re gearing up for survival (war, in the analogy). The sympathetic nervous system’s purpose is to keep us alive and was thought to have been developed in our response to escape predation and near-death experiences—like falling off of a cliff.
As an immediate response—I’d liken this to slamming on your breaks as someone cuts you off—our adrenal glands begin releasing stress hormones norepinephrine and epinephrine (1). When in a period of perceived survival (note I said perceived, we’ll touch on this below), muscles require a steady supply of blood flow for glucose and oxygen supply to distal parts of the body (2). This fuels muscle activity, cognition response, increased heart rate, vasoconstriction for increased blood pressure, bronchi dilation of the lungs, and increased respiration. The liver’s conversion of glycogen to glucose also expedites fuel metabolic needs (remember this tidbit for next week!) (2). During the activation of the sympathetic nervous system, digestion and immune function are inhibited to perform these other necessary bodily functions to keep you alive and to get you out of immediate danger.
In order to keep the sympathetic nervous system activity, the body signals up top to the brain that this “danger” is going to take a little while. The amygdala—or the part of the brain responsible for fear—signals to the hypothalamus to release a hormone known as corticotropin-releasing hormone (CRH). This signals to the pituitary gland to release adrenocorticotropic hormone (ACTH). This tells the adrenals to release the well-known, highly discussed, super popular hormone known as CORTISOL (2)!
SO, TO RECAP AND SPARKNOTES…
Perceived Acute Stress > Release of Norepinephrine, Adrenaline > Stress Lasting More Than a Few Seconds > Amygdala Signals to Hypothalamus > Hypothalamus Signals Pituitary (CRH) > Pituitary Signals Adrenals (ACTH) > Adrenals Release Cortisol
Talk about passing the baton!
The release of cortisol in this situation—like I mentioned earlier—is a product of evolution to get us out of imminent danger like climbing back over a cliff, escaping a predator, or going to battle. It was (and still is) life-saving. However, our stresses of today are not the same as they were when we developed this response. Stress is much more… chronic. Toxicities from heavy metals, environmental chemicals, mold, and infections are becoming more rampant and invasive. We also have more “mental factors” that may be perceived as survival stress by the body like with a relationship, workplace, or academic demands. All aforementioned stressors are not immediately resolved, and therefore pull cortisol for extended amounts of time.
YOU’RE RUNNING ON E!
Now, try and picture running a car for weeks on end. It has to stop and be refueled! It also needs a break. Otherwise, the engine overheats. The car is your body, cortisol is the fuel, and your adrenals are the tank itself. Over prolonged periods of stress, this really starts to become draining on your adrenals and maintenance of cortisol reserves. Maybe your adrenals have started to talk to you and tell you they need a break, and you’re seeing…
Slow starter in the morning;
Unable to sleep soundly, or unable to sleep and awaken rested;
Weight loss (middle stage) or weight gain (late-stage);
Hunger fluctuations (no hunger at all, or bingeing);
Poor immunity, sick all of the time;
Wounds slow to heal;
Low libido, loss of menses in females;
Poor digestion, constipation, diarrhea;
Stunted or delayed growth (in children);
High blood pressure and high resting pulse (earlier stage);
Low blood pressure, low resting pulse (later stage);
Orthostatic hypotension (dizziness when standing);
“Tired and wired”;
Tendency to be a night person;
Clenched or grinding teeth;
Edema;
Edginess, internal anxiety, inner unrest;
Sweaty palms;
Need to wear sunglasses;
Low sodium levels;
Low blood sugar (we’ll talk more about this next week!);
Weight gain around the midsection;
Loss of muscle tone (4)
It’s important to note that these symptoms are not criteria to diagnose, cure, or treat. Rather, they are helpful indicators to help gain insight into where dysfunction lies.
Cortisol might sound like the enemy at this point. But… we DO need it to keep us alive (3)! Cortisol is responsible for our sleep/wake cycle and inherently helps to set our circadian rhythm, heart rate, blood pressure, and dilation of our pupils.
THE RHYTHMS OF CORTISOL
In a healthy person, cortisol is at its highest in the morning—its spike wakes us up (5). It continues to decline throughout the day and reaches its lowest point at about 12 AM-1 AM. Its decline allows us to go to sleep (5). Now, in someone who has dysfunctional cortisol levels, we may see two scenarios:
1. Cortisol is inverted, which can be common in more developed stages of insufficiency. The body is still able to keep up with early-onset adrenal stress (hypernatremia) and is matching the demand for cortisol. Here, cortisol may be below in the morning. It might remain low until mid-afternoon when it starts to climb, which could explain symptoms like “slow starter in the AM”, “night owl”, and “tired but wired”. It can be referred to as “cortisol flip” or “cortisol reversal”, and is indicative that the sympathetic nervous system’s switch is in the “on” position. Western medicine might give this exhibition of symptoms the designation of Cushing’s Syndrome (7).
2. Cortisol is depleted, and release is quite low. This means your body is not waking you up naturally (you might be reliant on an alarm). You may find it hard to remain awake or to remain stimulated. Minimal exercise may leave you fatigued for days, and sleep doesn’t do much to resolve your fatigue. This is most common in “adrenal exhaustion”, or the “exhaustion phase”. Heart rate and blood pressure can also be low in this stage, as the body is unable to keep up with the demands of cortisol (hypoadrenia) (6, 7).
Keep in mind, adrenal exhaustion and insufficiency are often not medically recognized conditions. This article is not meant to diagnose, cure, or treat any hypothesized condition. It’s best to talk to your medical doctor about any cumbersome symptoms.
If these symptoms or scenarios above describe you, it might be an indicator your adrenals are in need of some relief. Now, this might sound like it’s just something that you can deal with and stifle. But, like anything, you can actually do more damage if you shove it under the rug!
A long-term presence in the “exhaustion” phase can result in an adrenal “crisis” or an adrenal “crash”, which can be life-threatening. When the body no longer can produce sufficient amounts of cortisol to maintain normal bodily functions that sustain life—like heart rate and blood pressure—one can put themselves in large amounts of danger from long-term stresses. Oftentimes the inability to produce sufficient stress hormones will generate the named condition of “Addisio’s Disease” by western medicine. While this is extreme and often takes a compilation of stressors over years to take place, it is a danger to be aware of (7).
Remember the parasympathetic (rest and digest) and the sympathetic (fight or flight) nervous systems are balancing systems. When we’re in one we can’t be in the other, meaning when we’re locked in the sympathetic nervous system for prolonged amounts of time we’re not executing the functions that the parasympathetic nervous system is responsible for.
SO WHAT’S SO BAD ABOUT THIS?
Long-term sympathetic activation and high-cortisol output mean we’re:
* NOT digesting and emulsifying our foods contributing to deficiency, irritable bowel, indigestion, low HCL acidity, dysbiosis, and constipation/diarrhea (you can read more about digestive dysfunction here). This also means we’re inefficiently and ineffectively absorbing our foods, which can contribute to deficiency in neurotransmitter production that can contribute to anxiety and depression.
* NOT able to produce a consistent immune response, allowing our bodies to be invaded by pathogens such as fungi, bacteria, parasites, molds, and viruses. Over time, this can contribute to cancers and autoimmunity.
* NOT able to have healthy reproductive health. Cortisol is a steroid hormone and is synthesized down the same pathway as sex hormones like estrogen, progesterone, and testosterone. When we’re demanding “Cortisol! Cortisol! Cortisol!” all of the time, we’re sacrificing the production of our reproductive hormones resulting in infertility, low libido, loss of menses (in females), and delayed puberty in growing adolescents.
* NOT able to grow or properly develop, as human growth hormone is inhibited by chronically high cortisol demand and output.
* NOT able to regulate our cardiovascular function, which could contribute to consistently high blood pressure and resting pulse, or the abnormally low resting pulse and blood pressure (overtime as cortisol becomes more and more depleted).
WHAT’S TO BLAME?
Now that I have your attention that some of these symptoms might be a little bit noteworthy, we can talk about some potential contributing culprits:
Chronic heavy metal toxicity
Mold exposure
Viral, bacterial, or fungal overloads
Toxin inundation
Excess EMF exposure
EXACERBATED BY…
Mineral deficiency
Vitamin deficiency
Insufficient fatty acid and amino acid intake (#1-3 poor diet!)
Excessive demands and expectations that are prolonged in the workplace
Equally high demands in academia
Trouble in close relationships, with a parent, relative, friend, or partner
Death or illness in a loved one
Prolonged worry (financial, health status, etc.)
Excessive exercise or performance, as this requires cortisol produce the desired muscular function
Traumas (mental, emotional, physical) that have remained unresolved and still continue to trouble the subconscious
Large consumption of alcohol and/or recreational drugs
Caffeine, and excess stimulant production from recreational stimulants
Long-term use of adrenal-stimulating pharmaceuticals like Adderall, Ritalin, and steroids
Chronic pain, from an unresolved injury or illness
Some hypothesize that the immune system is weakened by factors within the first list, and is thrown “over the edge” into symptom exhibition by the second list (7).
Eliminating the stressful factors that we have control over and learning to healthily manage those we cannot all can help with our cortisol output. Looking to support our bodies with nutrient-dense, properly prepared foods rich in vitamins, minerals, amino acids, and healthy fats will help with the toxic burden. Giving our bodies rest and focusing on parasympathetic-activating behaviors can also be beneficial. Stay tuned next week (and yes, I’ll follow through on this one!) for part two, covering the relationship between blood glucose imbalance and adrenal stress.
CITATIONS
1. Klein, S. (2013, April 19). Adrenaline, Cortisol, Norepinephrine: The Three Major Stress Hormones, Explained. Retrieved February 6, 2020, from https://www.huffpost.com/entry/adrenaline-cortisol-stress-hormones_n_3112800?guccounter=1&guce_referrer=aHR0cHM6Ly93d3cuZ29vZ2xlLmNvbS8&guce_referrer_sig=AQAAADOxTkNr2Pmyr8LtT5j4xJf-jkgXMrsrQ8WYdb03Q7m41FIqHqYxyWcxWulciddPqXUAPU2JnT4uPYQGtLAtcksxcfdkAz2iM16rwLIh7Jpnx2JEOkibGuXunDcV9tXnxio3BSQZZFfWTOWxcMwN_PdsPmquYqetTIlveqgOqbyR
2. Portage Learning BIOD 152.
3. Tortora, Gerard J., Derrickson, Bryan H. Introduction to the Human Body.
4. Weatherby, D. (2004). Signs and Symptoms Analysis from a Functional Perspective (2nd ed.). Emperors Group LLC.
5. Chan, M., & Debono, M. (June 2010). Replication of cortisol circadian rhythm: new advances in hydrocortisone replacement therapy. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3475279/
6. Common Patterns of Cortisol Imbalance Patient Handout. (n.d.). Retrieved February 5, 2020, from https://www.zrtlab.com/media/1488/pho-common-cortisol.pdf
7. Wilson, L. (2019, February). Adrenal Burnout Syndrome. Retrieved February 6, 2020, from https://www.drlwilson.com/articles/ADRENAL_BURNOUT.htm
8. http://biology.kenyon.edu/courses/biol10/110pdfs/13Nervous.pdf
