Fatigue is a common complaint for many people. But did you know that one of the most common causes of fatigue is adrenal dysfunction?
Your adrenal glands—which sit atop your kidneys—release cortisol, epinephrine (adrenaline) and norepinephrine in response to stress. They also release other hormones such as testosterone, estrogen, dehydroepiandrosterone (DHEA), pregnenolone and progesterone as well as aldosterone, which works with the kidneys to balance sodium and potassium in the body.
Given its prominent role in so many hormone and neurotransmitter functions, it’s little wonder that adrenal dysfunction can wreak havoc with your health.
Your Adrenals at Work
When you’re stressed, the adrenal cortex (located on the outer edges of the adrenal glands) produces cortisol, while the adrenal medulla (tucked away in the center of the adrenal gland) produces epinephrine and norepinephrine to help you adapt to the stressor. This is a normal response to stress that puts the body into what’s called the “fight-or-flight” mode.
During this stage, heart rate and blood pressure increase and blood is diverted to the brain, heart and skeletal muscles. It’s a reaction our prehistoric ancestors were all too familiar with when they encountered a saber-toothed tiger. The problem is that in modern day society, our bodies can’t tell the difference between a saber-toothed tiger and that speech you need to give or the stress you’re feeling from having to meet deadlines at work.
Under normal circumstances, your cortisol, epinephrine and norepinephrine levels drop back down after the stressor goes away. In other words, your adrenals should adapt to the stress. However, our capacity for adaptation is limited. And if we’re experiencing chronic stress, our adrenal glands face a continual signal to enter the fight-or-flight response. The result? Continual production of excessive amounts of cortisol, epinephrine and norepinephrine.
Eventually, our adrenal glands may grow tired and lose their ability to produce these stress hormones. This drains our energy reserves and leads to fatigue or other symptoms or diseases. This is known as adrenal burnout or adrenal fatigue.
People who have adrenal burnout often find life overwhelming and suffer from exhaustion and are unable to concentrate. Other symptoms of adrenal fatigue include depression, poor memory, anxiety, nervousness, obesity and carbohydrate craving.
Any sort of imbalance in cortisol levels—high or low—can cause the body to become more vulnerable to many diseases.
Adrenal Dysfunction and Your Body
Both high cortisol levels and the depleted cortisol levels that occur after adrenal burnout can take a massive toll on the body. In fact, many seemingly unrelated health conditions are associated with this type of adrenal dysfunction.
Ongoing stress is linked to hair loss or hair thinning in both children and adults, as shown by several studies.1-3 The mechanism by which stress causes hair loss is likely due to an enzyme called 5-alpha reductase. Cortisol is metabolized by 5-alpha reductase, which also converts testosterone to dihydrotestosterone (DHT). DHT is the primary culprit behind male pattern baldness.4
In obese people, cortisol metabolism is altered. In addition, obese subjects have higher concentrations of cortisol in key tissues including the liver and visceral fat, which may account for the negative consequences of obesity.5
If your cortisol levels are imbalanced, you’re at risk for another adverse effect—an increased tendency toward insulin resistance, which also plays a role in weight gain. Adolescents with insulin resistance, for example, have reduced cortisol levels upon awakening.6
Plus, cortisol and other adrenal hormones increase appetite and levels of the hunger-modulating hormone leptin.7 As cortisol rises with stress, it also triggers an increase in ghrelin,8 another hormone related to food intake and weight gain.
Stress is linked to atherosclerosis, hypertension, stroke and hyperlipidemia. In fact, stress-related inflammation is blamed for 40 percent of the atherosclerosis that occurs in people who have no other known risk factors.9
Additionally, epinephrine also increases coagulation, leading to an increased risk of stroke in people who have atherosclerosis.10 Furthermore, if you participate in intense aerobic exercise, your norepinephrine levels may go up, increasing the tendency of your blood to clot excessively.11
One study published online in 2012 demonstrated that elderly high blood pressure patients had mean cortisol values greater than those of healthy people aged over 65 years. In fact, the higher the degree of high blood pressure, the higher the mean cortisol value.12
A connection between stress and cholesterol also may exist, as researchers have linked job stress to lipid problems.13
Another way in which adrenal dysfunction can affect your body is through disrupting your digestive system. Individuals with irritable bowel syndrome have elevated cortisol.14 There’s also an indication that, if you’re a woman with IBS, you may have a greater post-meal increase in plasma norepinephrine levels, along with an increase in systolic blood pressure.15
Finally, a study published in February/March 2012 found that female IBS patients with predominant diarrhea had substantially higher cortisol levels at awakening.16
Immune System Dysfunction
Stress-related cortisol imbalances suppress your immune system. Researchers demonstrated this in one study published in August 2011 in which they noted the immune system response of grieving adults 65 years and older. The bereaved group had a significantly higher cortisol:DHEAS ratio compared to controls. Additionally, neutrophil white blood cell superoxide production was significantly reduced among the bereaved, indicating lowered immune activity.17
In another earlier study published in March/April 2011, researchers studied volunteers performing a first-time bungee jump from an altitude of 60 meters. The study showed that the acute stress from bungee jumping suppressed immunity.18
The Complete Picture
If you are already on an adrenal support program, you know that it likely includes balancing levels of cortisol and DHEA. But it’s important to also consider other adrenal hormones such as norepinephrine and epinephrine.
The adrenal medulla needs sufficient quantities of the amino acids phenylalanine and tyrosine in order to produce epinephrine, which elevates heart rate, constricts blood vessels, widens air passages and is a star player in the fight-or-flight response.
Norepinephrine plays a similar role to epinephrine. It’s also involved in the fight-or-flight response, directly increases heart rate, encourages the release of glucose from energy stores and elevates blood flow to skeletal muscle as well as boosts the brain’s oxygen supply.
Balanced levels of aldosterone are also important. This hormone not only helps maintain fluid balance and blood pressure, it’s also an important component of your stress response process. When you’re suffering from adrenal fatigue, this aldosterone-controlled fluid-balancing system may be dysfunctional. If so, you’ll probably notice puffy hands and feet as the main symptom.
Another Important Gland
Next, look to correct any thyroid imbalances. The high levels of epinephrine and norepinephrine produced during stress may use up the body’s tyrosine stores. The thyroid needs tyrosine to function effectively because the thyroid hormones T3 and T4 are synthesized from both iodine and tyrosine.
If high stress levels deplete tyrosine stores, there’s not enough left for the thyroid. Furthermore, elevated cortisol levels can impair thyroid function by causing tissues to ignore the thyroid hormone signal.
Boost Your Energy
Okay, so your adrenals aren’t happy, now what? Here are some strategies you can use to help your adrenal glands cope with stress. If adrenal dysfunction is the cause of your fatigue, then these strategies will enhance your energy.
- Avoid sugar and refined fructose (table sugar is half fructose), which put a strain on the adrenal glands19—not including the fructose found in fruit, which comes with healthy doses of fiber.
- Get at least seven hours sleep per night, preferably eight. Sleep loss can disrupt cortisol levels, stressing your adrenals. In one study published in December 2011, getting more sleep protected older subjects from increases in cortisol secretion over time.20
- Stay away from all caffeine, which can raise epinephrine and cortisol levels in people with adrenal dysfunction.21-22
- Engage in moderate exercise daily. Although intense exercise raises cortisol levels, researchers have found that people feel more relaxed and less anxious after exercising.23-24
- Use stress-reduction techniques such as meditation. Researchers have found that meditation can balance your cortisol levels and improve sleep.25 Another great option is to listen to relaxation CDs. Listening to them before bed can help you fall asleep, relieving stress-related insomnia.26-27 And if you are looking for an excuse to get a massage, consider this your prescription to do so. Not only is massage the ultimate relaxation technique, it also strengthens the immune system.28
- Take adaptogens. If cortisol levels are high, a good approach is to use adaptogens that help balance adrenal function. Good choices include Eleuthero (Eleutherococcus senticosus) root,29-30 Japanese aralia (Aralia manchurica) root,31 astragalus (Astragalus membranaceus) root,32-34 ashwagandha (Withania somnifera) root,35 schisandra (Schisandra chinensis) fruit,36-37 Magnolia officinalis and Phellodendron amurense.38
- Support burned out adrenals further with nutrients such as Rhodiola rosea,39 Bacopa monnieri,40-42 glycyrrhizic acid43-44 and n-acetyl tyrosine.45
- Chu SY, et al. Br J Dermatol. 2012 Mar;166(3):525-31.
- Díaz-Atienza F, et al. J Psychosom Res. 2011 Aug;71(2):102-7.
- Willemsen R, et al. Acta Derm Venereol. 2011 Jan;91(1):35-9.
- Dušková M, et al. Physiol Res. 2011;60(2):253-61.
- Andrew R, et al. J Clin Endocrinol Metab. 1998 May;83(5):1806-9.
- Ursache A, et al. Psychoneuroendocrinology. 2012 Jan 20. [Epub ahead of print.]
- Dagogo-Jack S. Obes Res. 2003 Feb;11(2):232-37.
- Rouach V, et al. Psychoneuroendocrinology. 2007 Jul;32(6):693-702.
- Black PH, et al. J Psychosom Res. 2002 Jan;52(1):1-23.
- von Kanel R, et al. Eur J Haematol. 2000 Dec;65(6):357-369.
- Ikarugi H, et al. J Appl Physiol. 1999 Jan;86(1):133-138.
- Carstea D, et al. Int J Hypertens. 2012;2012:791412.
- Xu W, et al. J Occup Health. 2011 Oct 13;53(5):334-42.
- Dinan TG, et al. Gastroenterology. 2006 Feb;130(2):304-311.
- Elsenbruch S, et al. Am J Gastroenterol. 2004 April;99(4):703-710.
- Suárez-Hitz KA, et al. Psychosom Med. 2012 Feb-Mar;74(2):221-31.
- Khanfer R, et al. Brain Behav Immun. 2011 Aug;25(6):1182-6.
- van Westerloo DJ, et al. Mol Med. 2011 Mar-Apr;17(3-4):180-8.
- Collison KS, et al. Br J Nutr. 2011 Mar 24:1-10. Epub ahead of print.
- Rueggeberg R, et al. Psychoneuroendocrinology. 2011 Dec 22. Epub ahead of print.
- Renda G, et al. Am J Clin Nutr. 2012 Jan;95(1):241-8.
- Ping J, et al. Chem Biol Interact. 2012 Jan 5;195(1):68-75.
- Blacklock R, et al. Oncol Nurs Forum. 2010 Mar;37(2):206-12.
- Villaverde Gutiérrez C, et al. J Clin Nurs. 2012 Apr;21(7-8):923-928.
- Brand S, et al. Neuropsychobiology. 2012 Feb 24;65(3):109-118. Epub ahead of print.
- Tanyi RA, et al. Int J Psychiatry Med. 2011;42(2):151-66.
- Warnecke E, et al. Med Educ. 2011 Apr;45(4):381-8.
- Rapaport MH, et al. J Altern Complement Med. 2010 Sep 1. Epub ahead of print.
- Farnsworth NR, et al. In Economic and Medicinal Plant Research, vol 1, London: Academic Press. 1985;155-215.
- Asano K, et al. Planta Medica. 1986;37:175-7.
- Lupusoru CE, et al. Rev Med Chir Soc Med Nat Iasi. 2008 Oct-Dec;112(4):1092-7.
- Chu DT, et al. J Clin Lab Immunol. 1988;25:125-9.
- Yu L, et al. Chin Med J (Engl). 2002;115:923-7.
- Shi R, et al. J Tradit Chin Med. 2001;21:232-5.
- Bhattacharya SK, et al. Pharmacol Biochem Behav. 2003 Jun;75(3):547-55.
- Ip SP, et al. Planta Med 1995;61:398-401.
- Liu KT. Plenary lecture, World Health Organization (WHO) Seminar on the Use of Medicinal Plants in Health Care, Sept 1977, Tokyo, Japan. In: WHO Regional Office for the Western Pacific, Final Report. November 1977, Manila, 101-12.
- Garrison R, et al. Altern Ther Health Med. 2006 Jan-Feb;12(1):50-4.
- Fintelmann V, et al. Adv Ther. 2007 Jul-Aug;24(4):929-39.
- Ghosh T, et al. Planta Med. 2011 May;77(8):804-8.
- Morgan A, et al. J Altern Complement Med. 2010 Jul;16(7):753-9.
- Calabrese C, et al. J Altern Complement Med. 2008 Jul;14(6):707-13.
- Mills S, et al. Principles and Practice of Phytotherapy. Edinburgh:Churchill Livingstone; 2000.
- Blumenthal M (ed), et al. The ABC Clinical Guide to Herbs. New York: Theime; 2003.
- Deijen JB, et al. Brain Res Bull. 1999 Jan 15;48(2):203-9.