Adrenal health in women
We’re all familiar with stress — it’s a constant element in women’s busy lives. But what we aren’t so familiar with is the body’s response to stress and the ways in which the stress we face today goes far beyond the kind of stress we faced as we evolved — and ends up depleting our energy and health.
When faced with a stressful situation, our bodies rely on the adrenal glands sitting atop our kidneys to monitor our “fight or flight” response. For the most part, our stress response evolved from short-term events — crises that came and went. If we had to run from a predator, for example, our healthy adrenal glands responded by releasing adrenaline, which makes us more alert and focused, and cortisol, which converts protein to energy and releases our stored sugar, glycogen, so our bodies have the fuel needed to respond quickly. In concert, the adrenal response rapidly increases our heart and respiratory rates and blood pressure while releasing energy, tensing our muscles, sharpening our senses, and slowing our digestion so we are primed to escape or fight back, whichever is needed. When the threat is gone, the body returns to normal — quickly with respect to adrenaline levels, less quickly with respect to cortisol.
But in today’s society, women are inundated with stress — stress that doesn’t let up. And when chronic stress repeatedly forces the adrenal glands to sustain high levels of cortisol, two things happen: first, the adrenals can’t attend to their broader role in hormonal regulation because the same resources they use to make hormones like estrogen are required to make cortisol, and second, cortisol starts to damage healthy tissues. Eventually, adrenal fatigue sets in, and many women experience symptoms such as weight gain, fatigue, insomnia, fuzzy thinking, depression, cravings and mood swings. Once the adrenals become depleted, it can lead to adrenal exhaustion and much more serious health concerns.
The following articles will aid you in identifying symptoms of adrenal fatigue early and provide steps to restoring and supporting your adrenal glands. From finding new strategies to manage stress to learning which foods are best to eat and when — there are many ways to replenish adrenal health naturally. One thing I can promise you is that when you heal your adrenal glands, you’ll see results on every physical and emotional level, and your whole body will thank you for it!
The effects of adrenal dysfunction can be profound: fatigue and weakness, suppression of the immune system, muscle and bone loss, moodiness or depression, hormonal imbalance, skin problems, autoimmune disorders, and dozens of other symptoms.
The good news is that adrenal fatigue can almost always be relieved. Let’s look at the relationships between stress, high cortisol levels and adrenal fatigue, and then we’ll look at how you can give your adrenals more support.
To understand how adrenal fatigue develops, it is important to understand the original, evolutionary function of the adrenal glands. The adrenals are walnut-sized glands located on top of each kidney, and are important control centers for many of the body’s hormones. The outer layer of the gland, called the adrenal cortex, produces hormones including cortisol, DHEA, estrogen and testosterone. The centers of the glands produce adrenaline, the hormone named after them.
The basic task of your adrenal glands is to rush all your body’s resources into "fight or flight" mode by increasing production of adrenaline and other hormones. When healthy, your adrenals can instantly increase your heart rate and blood pressure, release your energy stores for immediate use, slow your digestion and other secondary functions, and sharpen your senses.
Let’s emphasize two points about this healthy stress response. First, it takes priority over all other metabolic functions. Second, it wasn’t designed to last very long.
Stress and the adrenal glands
Unlike our ancestors, we live with constant stress. Instead of occasional, acute demands followed by rest, we’re constantly over-worked, under-nourished, exposed to environmental toxins, worrying about others — with no let-up.
Every challenge to the mind and body creates a demand on the adrenal glands. And the list of challenges is endless: lack of sleep, a demanding boss, the threat of losing your job, financial pressures, personality conflicts, yo-yo dieting, relationship turmoil, death or illness of a loved one, skipping meals, reliance on stimulants like caffeine and carbs, digestive problems, over-exercise, illness or infection, unresolved emotional issues from our past or present and more. The result is adrenal glands that are constantly on high alert.
What is cortisol? In its normal function, cortisol helps us meet these challenges by converting proteins into energy, releasing glycogen and counteracting inflammation. For a short time, that’s okay. But at sustained high levels, cortisol gradually tears your body down.
Sustained high cortisol levels destroy healthy muscle and bone, slow down healing and normal cell regeneration, co-opt biochemicals needed to make other vital hormones, impair digestion, metabolism and mental function, interfere with healthy endocrine function; and weaken your immune system.
Adrenal fatigue may be a factor in many related conditions, including fibromyalgia, hypothyroidism chronic fatigue syndrome, arthritis, premature menopause and others. It may also produce a host of other unpleasant symptoms, from acne to hair loss. (Please click here to see a list of adrenal fatigue and related conditions.)
The loss of DHEA production
When the adrenals are chronically overworked and straining to maintain high cortisol levels, they lose the capacity to produce DHEA in sufficient amounts. DHEA (the full name is dehydroepiandrosterone) is a precursor hormone to estrogen, progesterone, and testosterone, and is necessary to moderate the balance of hormones in your body. Insufficient DHEA contributes to fatigue, bone loss, loss of muscle mass, depression, aching joints, decreased sex drive, and impaired immune function. (For more information, read our article on DHEA.)
Conventional medicine is truly wonderful at treating disease-state conditions. Unfortunately its focus on drugs also tends to suppress early-stage symptoms rather than treat their underlying causes. This can have the effect of delaying treatment until a disease state has developed. This is true in the case of adrenal fatigue cortisol testing. In the conventional standard of care, any cortisol level within a very broad range is considered normal, and anything outside that range indicates disease.
In our practice, we measure cortisol levels at several points in the day to track the adrenals’ day–night pattern (called the “diurnal rhythm”) using a panel of simple saliva tests. We hope to see cortisol elevated in the morning to help you get going, lower but steady throughout the day to sustain energy, then fall in the evening to support restful sleep.
In the early stages of adrenal dysfunction, cortisol levels are too high during the day and continue rising in the evening. This is called “hyperadrenia.” In the middle stages, cortisol may rise and fall unevenly as the body struggles to balance itself despite the disruptions of caffeine, carbs and other factors, but levels are not normal and are typically too high at night. In advanced stages, when the adrenals are exhausted from overwork, cortisol will never reach normal levels (“hypoadrenia”).
Conventional medicine will detect only the extremes of these conditions, when damage to the adrenals has already occurred (Cushing’s disease and Addison’s disease). Within those extremes, you can feel miserable and still be told your cortisol levels are normal. But by responding to early-stage symptoms of adrenal fatigue, we can reverse the developing dysfunction.
Should you get an adrenal test?
In general, if you feel happy and well, have steady energy and emotions, sleep soundly seven to nine hours a night, wake up feeling rested, recover well from stress, and maintain a healthy weight without dieting, then your adrenals are probably doing well.
On the other hand, if your energy lags during the day, you feel emotionally unbalanced much of the time, you sleep poorly or less than seven hours a night, can’t lose excess weight even while dieting, use caffeine or carbohydrates as “pick-me-ups” — these are all red flags indicating adrenal insufficiency.
