Adrenal Dysfunction: Part 2

Adrenal Dysfunction: part 2

As you’ve learned from part 1 of this series, there are many types of stressors that can lead to Adrenal Dysfunction.  Depending on what phase you’re in, you will have elevated or low cortisol and your symptoms will vary.

Symptoms of Elevated Cortisol:

  • Abdominal weight gain, inflammatory hormonal fat.
  • Increased blood sugar, which leads to increased insulin and causes stressful blood sugar fluctuations, increased appetite and cravings.
  • Decreased TSH (thyroid stimulating hormone), which blocks conversion of T4 to T3, you’re active thyroid hormone.
  • Decreased melatonin and sleep disturbances.
  • Suppressed bone formation and bone loss.
  • Decreased mood and will-power as there is decreased frontal lobe capacity.
  • Decreased memory from decreased hippocampus function.
  • Loss of muscle mass.
  • Immune system imbalances, which puts you at increased risk for illness.
  • Increased risk for GI infection/infestation because of suppressed Secretory IgA.
  • Decreased sex hormones leading to low libido, infertility, low energy and poor muscle tone.

Symptoms of Lowered Cortisol:

  • Hypoglycemia; blood sugar control gets worse and you start to experience shakiness, lightheadedness and sleep issues.
  • Increased higher risk for infections.
  • Sugar cravings, feel like you need to eat often.
  • Involved in SAD (seasonal affective disorder), chronic fatigue syndrome and fibromyalgia.
  • Low blood pressure, postural hypotension: you experience a quick drop in blood pressure that makes you dizzy when you stand up or sit up quickly.
  • Allergies and chemical sensitivities.
  • Stressed out feelings, depression, unable to handle stressful situations like before.
  • Cold body temperature.
  • Fatigue that doesn’t improve with more sleep.
  • Decreased ability to recover from workouts.

Adrenal dysfunction affects our steroid hormone balance and is connected to our health in so many ways, as you can see by the symptoms associated with elevated or low cortisol.  I’ve discussed the steroid hormone metabolic pathway in another post here, but I’m going to tie it in with the different phases of adrenal fatigue as well.

Steroid Hormone Metabolic Pathways

Simplyfied pregnenolone steal


As you can see from the above picture, cholesterol is the building block for pregnenolone, a hormone produced in the adrenal glands.  Normally you will have a healthy balance of pregnenolone going into the production of progesterone to cortisol and DHEA to the other sex hormones (testosterone, estradiol, estriol and estrone).  When you experience chronic stress, the body begins to shunt pregnenolone towards the cortisol pathway to support the bodies need for increased cortisol output.  The DHEA pathway looses viability and the cortisol pathway becomes the preferred pathway of pregnenolone.  This is known as the pregnenolone steal.

Acute Phase of HPA Axis (Adenal) Dysfunction

The Acute Phase occurs when there is an elevated daily cortisol output in response to stressors.  For example this could mean just elevated morning cortisol, morning and afternoon cortisol or it could be elevated throughout the whole day.  At least one cortisol measurement will be elevated and DHEA will generally be low.  During the Acute Phase, the body is adapting appropriately and the person may still feel good because they’re in fight or flight mode.  So even if they aren’t sleeping well they can feel wired and full of energy during the day.  This phase can last for years or only a couple of months depending on the person’s genetic potential and what type of stress they’re dealing with.  The person will begin to experience all the symptoms associated with elevated cortisol levels including blood sugar and sleep issues, weight gain, inability to fall asleep, feeling unrested in the morning and “tired and wired.”  They may also feel like their hormones are out of whack.

Compensatory Phase of HPA Axis (Adrenal) Dysfunction

In the Compensatory Phase, the daily cortisol output is “in range” because adaptation is beginning to fail.  The stress level is the same as in phase 1 but cortisol output is diminished.  The Pregnenolone steal is occurring in phase 2 leading to steroid hormone imbalances.   The person will have some low or borderline low cortisol readings, most commonly being a drop in the afternoon cortisol.  These people will have more symptoms as the cells, organs and systems are no longer adapting well, which leads to lowered resistance.  They can experience a mix of symptoms relating to both elevated and low cortisol including low libido, sugar and salt cravings, low energy, inability to lose weight, urgency and increased frequency to urinate and hypothyroidism.

Exhaustion Phase of HPA Axis (Adrenal) Dysfunction

In the Exhaustion Phase, the daily cortisol output is low and the person will be struggling, especially with fatigue.  The adaptive reserve is becoming depleted, leading to low adrenal output.  DHEA is usually low and the pregnenolone steal is still present.  This puts the body in a catabolic state that leads to loss of muscle and bone mass.  Multiple malfunctions and imbalances will be present, likely with chronic symptoms.  They will experience symptoms of low cortisol with hypoglycaemia and depression, anxiety and other mood issues being some of their main complaints.

In part 3 I will discuss testing and how to overcome HPA Axis Dysfunction using nutrition, lifestyle changes and helpful supplements.

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