Adrenal Dysfunction: Part 1
Adrenal Dysfunction, often called Adrenal Fatigue, is all too common nowadays and something I’ve struggled personally with. I’ve had a chance to learn more about it and get a deeper understanding of it through the Functional Diagnostic Nutrition course I am currently taking. I’m going to do a series on adrenal dysfunction and break down what it is, what causes it, the different phases, what symptoms are associated with it, how to get tested for it and how to overcome it. First we need to understand what the adrenal glands are and what their purpose is.
The adrenal glands are an endocrine gland (meaning they secrete hormones) that sit on top of our kidneys. They are triangular in shape and contain two parts; the adrenal medulla and the adrenal cortex. The adrenal medulla is the inner portion of the gland and is responsible for producing epinephrine (adrenalin) and norepinephrine (noradrenalin). The Adrenal Cortex surrounds the medulla and produces steroid hormones including cortisol, aldosterone, DHEA (Dehydro-epiandrosterone) and other sex hormones (testosterone, estradiol, estriol, estrone and progesterone).
What are the adrenal glands and what is their purpose?
The adrenals are a part of the HPA (hypothalamic-pituitary-adrenal) axis, which is part of the neuroendocrine system that controls the stress response and many other functions in the body. Stress tells the hypothalamus, which is located in the brain, to release corticotropic releasing hormone (CRH). CRH tells the pituitary, which is located below the hypothalamus, to release adrenocotropic hormone (ACTH). ACTH stimulates the adrenal cortex to release cortisol to respond to the stressor. Therefore the more technical term for Adrenal Fatigue is HPA Axis Dysfunction, because the hypothalamus and pituitary are also involved.
What does cortisol do?
Cortisol has many affects on the body, including:
- Acts as a natural anti-inflammatory and pain killer
- Enhances epinephrine activity and lasts much longer
- Raises blood sugar through a process called, gluconeogenesis
- Suppresses the immune system by “muting” white blood cells and lowering SIgA
- Aids in fat, protein and carbohydrate metabolism
- Increases glucose utilization by the CNS (central nervous system)
- Suppresses gastric emptying, slows digestion
Cortisol normally follows a diurnal pattern that supports circadian regulation. Cortisol should be at it’s highest, first thing in the morning and drop throughout the day reaching it’s lowest point at night, usually 3-4 hours after falling asleep. This helps us feel our best and have energy to get out of bed in the morning while still being able to fall asleep and sleep throughout the whole night.
As you can see in the picture above, there is a normal pattern that cortisol should follow, with the red line being the highest end and the green being the lowest end. Stress can make your levels of cortisol rise above the red line as your body tries to adapt to stressors. Eventually cortisol levels can fall below the green line when your body fails to adapt from chronic stress. There are many forms of stress that can cause both high and low cortisol, including:
- mental/emotional, whether perceived or subconscious: fear, worry, excitement, anxiety, lack of self-love, lack of purpose
- physical/biochemical: trauma, fractures, muscle injuries, nerve compression, intense and prolonged exercise
- chemical/biochemical/physiological: inflammatory foods, food allergies/sensitivities, pesticides/herbicides/additives, drugs, alcohol, caffeine, blood sugar dysregulation, lack of sleep, chemicals, heavy metal toxicity, radiation and EMF exposure, medications, exogenous hormones, antibiotics, parasites, bacteria and fungi overgrowth.
In part 2 of this series I will discuss the symptoms associated with high cortisol and low cortisol as well as the different phases of adrenal dysfunction. In part 3 I discuss testing and how to overcome adrenal dysfunction using nutrition, lifestyle changes and helpful supplements.