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Key Steps to Beating Adrenal Fatigue Naturally

Key Steps to Beating Adrenal Fatigue Naturally

stressed man on bench by Flickr user ranoushSimple fact: adrenal fatigue stinks. It robs you of your well-being, makes you feel terrible, and for a lot of people can cause alienation and loss of work. On top of that, many practitioners do not recognize adrenal fatigue, and end up turning people away or offering solutions that can be harmful if unneeded (antidepressants are a popular patch).

Hope should not be lost with adrenal fatigue. There are many things you can do on your own that will help. Changes in your diet, lifestyle and added supplementation can do wonders. It will take time and effort, but every bit will be worth the progress. Dr. James L. Wilson has spent much of his professional career helping people with adrenal fatigue, from those with mild cases to those who are practically bedridden. In the video below, Dr. Wilson outlines what you can do to beat adrenal fatigue naturally.

More on adrenal fatigue and food

More on adrenal fatigue and lifestyle

More on adrenal fatigue and supplements

Questions? Please feel free to post them as comments.

Image credit: Stressed man on bench by Flickr user ranoush

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The Role of DHEA in Adrenal Fatigue and Loss of Libido

The Role of DHEA in Adrenal Fatigue and Loss of Libido

saliva test vialsDHEA is one of the androgen hormones secreted by the adrenal glands and is the precursor to several other sex hormones. DHEA levels often become depressed during adrenal fatigue. A saliva test can determine whether your DHEA levels are below normal. I usually recommend measuring DHEA-S levels with the saliva test as well because the adrenals are the primary source of DHEA-S (but not necessarily DHEA). Adrenal fatigue syndrome often involves decreased DHEA-S. The DHEA-S level is a direct indicator of the functioning of the area within the adrenal glands that produces sex hormones (the zona reticularis).

Saliva tests for testosterone, the estrogens, progesterone and other hormones can also be done, if needed, and may be of value in working with adrenal fatigue. Testosterone and DHEA-S levels are two of the most reliable indicators of biological age. Testosterone and DHEA-S levels below the reference range for the person’s age may be indicators of increased aging. If the cortisol levels are also decreased, the three tests together further indicate chronically decreased adrenal function.

Although the sex hormones are made primarily by the gonads (ovaries and testes), the adrenal zona reticularis manufactures an ancillary portion of sex hormones for each sex and also produces male hormones in women and female hormones in men to keep the effects of the dominant sex hormones in balance. DHEA and its relatively inactive precursor, DHEA-S, are two other major hormones that are manufactured and secreted by the zona reticularis. Nearly all of the DHEA-S in circulation is manufactured by the adrenals, which is why DHEA-S blood or saliva levels are excellent indicators of adrenal function.

The adrenal sex hormones and their immediate precursors such as DHEA, pregnenolone and androstenedione do more than add to or balance other sex hormones. They also help balance the effects of cortisol and act as cellular anti-oxidants. Thus, the sex hormones and DHEA both limit cortisol’s possible detrimental effects on cells and at the same time facilitate its actions by functioning as hormonal anti-oxidants. These precursors have their own actions as well as serving as raw material from which the sex hormones are made. For example, DHEA is exported to most cells and once inside the cells, it often becomes the resource material from which small amounts of local hormones can be created to carry out various specific tasks.

The Physiological Effects of Stress and Aging on Adrenal Sex Hormones

two ladybugs mating on a branchThe more the adrenals are stimulated by stress and internal demands, the less responsive the zona reticularis becomes. Consequently, the adrenal output of sex hormones and their precursors decreases with chronic stress and adrenal fatigue. When less DHEA-S is manufactured in the zona reticularis, less DHEA-S and DHEA is available for export and use by other cells. This diminishes your ability to respond adequately to the demands placed on your body for increased DHEA-S and DHEA, thus, in turn, increasing the negative effects of chronic stress.

Loss of libido is commonly associated with adrenal fatigue, probably due in large part (in both men and women) to a drop in testosterone production by the adrenals. From your body’s point of view, when you are in the midst of having to fight tigers and run for your life (i.e. when you are under a lot of stress), it is not a good time to feel amorous because your energy must be used for survival.

Output of adrenal sex hormones and their precursors also decreases with age. A decline in DHEA and testosterone levels accounts for many of the degenerative processes of aging. In fact, the levels of these two hormones in males track the progression of biological aging more closely than do any other markers. As we lose the available DHEA and testosterone, we become less able to counter the intense effects of cortisol in the cells. With age, cortisol levels remain relatively steady, while DHEA and testosterone decline and the other hormones range somewhere in between. In general as the levels of sex hormones and their precursors such as DHEA and testosterone decrease because of age, stress and adrenal fatigue, their many and varied beneficial effects decrease as well.

Dr. James L. WilsonAbout the Author: With a researcher’s grasp of science and a clinician’s understanding of its human impact, Dr. Wilson has helped many physicians understand the physiology behind and treatment of various health conditions. He is acknowledged as an expert on alternative medicine, especially in the area of stress and adrenal function. Dr. Wilson is a respected and sought after lecturer and consultant in the medical and alternative healthcare communities in the United States and abroad. His popular book Adrenal Fatigue: The 21st Century Stress Syndrome has been received enthusiastically by physicians and the public alike, and has sold over 400,000 copies. Dr. Wilson resides with his family in sunny Tucson, Arizona.

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Do You Need Caffeine to Keep Going? Keep Reading

Do You Need Caffeine to Keep Going? Keep Reading

Do you feel like a zombie until you’ve had your coffee? Do you count down the hours until your next caffeine break? Your body (or mind) may be reliant on ‘go-go juice’ to keep going. But, you’re not alone; in fact, caffeine addiction is quite commonplace. Whether the addiction is psychological or brought on by a body burden (like adrenal fatigue), dependence on caffeine can be bad news.

How do you know if you’re addicted to caffeine?

cup of coffeeHave you tried going a full day without coffee or any caffeinated drinks? Did you find yourself feeling worse (headache, fatigue, irritability)? You could have experienced symptoms of caffeine withdraw. The good news about caffeine withdraw is that the symptoms are short-lived, typically lasting a few days at most.

You can also gauge dependency by your mentality on caffeine. Do you feel like the day is doomed if you don’t have that first cup? Or think of clever ways to time travel back home to retrieve the thermos you left on the counter? Maybe consider sneaking a sip from your coworker’s mug? As ridiculous as it may sound, caffeine dependency can make us do silly things to get our fix.

What’s so bad about caffeine?

Caffeine, a natural alkaloid, is not inherently evil. What makes it dangerous is the amount and type consumed. Generally, authorities agree that 300-400 mg of caffeine per day is safe for most adults. (There are about 95 mg of caffeine in an 8-ounce cup of coffee.) Not all caffeinated drinks are created equal; there are big differences between a cup of green tea, a can of diet soda and a Starbucks peppermint mocha.

Caffeine can be especially detrimental to those with certain conditions, like adrenal fatigue and chronic high stress. Additives like creamer and sugar can make matters even worse. The short pick-me-up feels good at first, but leads to a crash that makes you feel worse than before. In addition to the harm it can do to already exhausted adrenal glands, here are some negative side effects of frequent caffeine use:

  • insomnia by Flickr user petitefoxSleep disturbances – Coffee consumption can make you groggier in the morning.
  • Digestive issues – Caffeine irritates the stomach lining, causing excessive production of stomach acid, which can lead to a variety of digestive disorders. Moreover, research has shown a definite link between coffee drinking and ulcers and heartburn.
  • Neurological disturbances – Headaches are one of the most common symptoms of excess caffeine and also of fluctuating caffeine levels throughout the day.
  • Nutritional deficiencies – Frequent coffee intake can cause a significant loss of several vitamins and minerals, including vitamins B and C, calcium, iron, and zinc.

 How can I be less reliant on caffeine?

Cutting back on or eliminating coffee and other detrimental caffeinated products isn’t easy, but it can be done. Many people think they need caffeine to keep going, and without it they’ll be a pile of useless mush on the floor. In fact, the opposite is true: eliminating your dependence on caffeine can lead to positive changes in energy levels, mood, sleep quality, and overall health. Here’s some tips on cutting out the caffeine:

  • Cut back slowly – Quitting a caffeine addiction cold turkey can lead to undesirable side effects. Try reducing the amount first. Cut back to one cup per day, or have smaller servings.
  • Stick to decaf – For many, the need for coffee is psychological. Try switching to decaf. Your body may not even realize the difference!
  • Drink more water – Dehydration and lack of water can lead to fatigue and lethargy. If you’re thirsty, have some water first. Staying hydrated can do wonders for energy levels.
  • Get off the crutch – If you feel like you need coffee to survive, there are other problems to be addressed. Your body doesn’t need caffeine like it does vitamins and minerals. A reliance on caffeine is a sign of an underlying issue, be it psychological or physical. Adrenal fatigue is one such example of an underlying issue.

What are safer alternatives to coffee and soda?

In addition to the tips above, there are safer alternatives to harmful caffeinated drinks. Here are some healthier options:

  • Green tea – Green tea has about one-fourth the caffeine of coffee, and is the best food source of catechins, a powerful antioxidant that can reduce the risk of heart disease.
  • Water – We don’t need to tell you that you need water to survive, but you may not know how much water, or lack thereof, can affect energy levels. Plus, the energy benefits of water are not short-lived and there’s no crash afterward.
  • Nut milks – Not all nut milks are created equal, but good ol’ natural nut milks are easy to make yourself with some nuts, water and a blender. Nut milks have the health benefits of raw nuts, namely essential fatty acids.
  • Vegetable juices/smoothies – The juicing craze is in full-swing, but it’s not all hype. Natural vegetable juices and smoothies can be very beneficial for their vitamin and mineral content. Plus, it’s easy to make your own if you own a juicer.

Image Credits: Insomnia by Flickr user petitefox

Sources:

Harvard Health Publications. Benefit of Drinking Green Tea. Harvard Health Services, Sept. 2004. Web. 15 Oct. 2014.

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Reframing: How to Manage Unavoidable Stress

Reframing: How to Manage Unavoidable Stress

stereogram by Flickr user fdecomite

Can you see the hidden image? Click picture for larger version.

Have you ever looked at one of those pictures containing a hidden image? At first you look and look from every angle, but all you can see is the regular picture. Then suddenly your focus shifts, the hidden image appears and you see it so differently that it becomes impossible not to see it that way. Reframing is a similar process of changing focus in which new information and/or a new point of view alters the way you see something. When you change how you see something, you also change how your body responds. That is why one of the most effective ways to lessen the stressful effects of an unavoidable, difficult situation is to reframe or refocus your perception of the situation. This often allows you to adapt yourself to the situation in a more positive way or gives you a key to changing the situation for the better.

lifesaver by Flickr user emdot

Reframing can literally be a lifesaver

It takes some imagination and effort but reframing can literally be a lifesaver. Sometimes, the way circumstances unfold allows us to reframe miserable experiences into beneficial ones (like finding out that a negative lab test result was an error). However, it is usually up to us to “turn lemons into lemonade” by consciously altering how we see our difficulties in order to experience them as something better. If we wait around hoping life will present us with a series of happy endings we will probably be disappointed. However when we choose to use reframing techniques to shift our perceptions about situations that have been wearing us out with stress, we empower ourselves to stay healthy. We change how our bodies actually experience and respond to these situations. The psychological changes produce physiological changes that directly affect our health.

Many times, changing the impact of a situation is not as difficult as you might imagine. If you look at a situation from a different angle or allow your attitudes or beliefs about it to change, quite often the stress and tension that the situation provokes will begin to diminish. For example, if you go to work every day and think your boss hates you, or you dread going because of the unpleasant people you work with, you are really seeing yourself as the victim in this situation. Instead, you could decide that this is really a master’s training course on how to handle difficult people that you are taking while looking for another job. This way you can benefit from studying these people and your reactions to them. Changing your responses puts you back in control of the situation.

You can then pick one reaction each week that you want to change, or somehow diffuse, and continually work at mastering yourself so you are no longer a victim. In other words, turn it into an opportunity for getting something you want or need instead of allowing it to be an obstacle to what you want or need. Each time you lose your temper or get uptight, instead of blaming or criticizing yourself, realize that you need more practice in deflecting other people’s negativity and maintaining a positive emphasis on your own perceptions and goals.

The positive changes you make will give you more confidence that you can actually find a work situation that you would enjoy–something you might have thought was impossible a few months before. Remember: we are not required to sell our souls in order to work. That is a belief that some of us hold and, as a result, we find ourselves working for companies that demand it.

It surprises many people to discover that not only is it possible to change a belief about something, but that changing the belief often changes the situation. If, for example, you believe you must exhaust yourself at work in order to get ahead, then you are in a real bind. The only way you can win is to lose. If you win at your job, you lose with your health and if you are not exhausted, you must not be doing your job.

equations on chalkboardA belief is like an internal equation you live by. In this example if you can replace your equation that job success=exhaustion with an equation like job success=focus with relaxation, then new possibilities can arise for you. In the first equation you have a sense of powerlessness and your job controls you; in the second equation you are empowered to have much more control over yourself and your job experience.

What you believe (your equation) about success in this case governs your freedom to choose work attitudes and behavior that either lead to health or to debilitation, and possibly to actual success or failure. For example: if you have to work late some evenings, you can set a limit on how much is reasonable for you to finish and how many extra hours you are willing to put in to meet your job goals. Then while doing the work you can use techniques like deep breathing to stay focused and relaxed. In a relaxed state, you will usually work more effectively than you do when you put yourself under the gun, so you might even get the job done faster. The important result for your health is that you can do whatever you have to do with less stress.

Image Credits: Stereogram image by Flickr user fedecomite; Lifesaver by Flickr user emdot

Dr. James L. WilsonAbout the Author: With a researcher’s grasp of science and a clinician’s understanding of its human impact, Dr. Wilson has helped many physicians understand the physiology behind and treatment of various health conditions. He is acknowledged as an expert on alternative medicine, especially in the area of stress and adrenal function. Dr. Wilson is a respected and sought after lecturer and consultant in the medical and alternative healthcare communities in the United States and abroad. His popular book Adrenal Fatigue: The 21st Century Stress Syndrome has been received enthusiastically by physicians and the public alike, and has sold over 400,000 copies. Dr. Wilson resides with his family in sunny Tucson, Arizona.

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Stress, Cortisol and the Immune System: What Makes Us Get Sick?

The Case of the Poor Student: Sick after Exams
It’s happened to all of us, in some form. Here’s how it happened to Tom: he was staying up late for the last two weeks cramming for his barrage of final exams, and finally his last exam was over. After one more late night—this time partying—he woke up with that all-too-familiar soreness in his throat, along with that annoying stuffy nose. “Great,” he thought. “I’m sick in time just for Christmas shopping. Must be that pesky cold bug going around again.”

What is Psychoneuroimmunology?
Just how exactly stress affects our immune system has long been debated, but the field of psychoneuroimmunology is still relatively new. Coming from the Latin roots psych- (meaning mind), neur- (meaning nerve or nervous system), and immuno- (meaning immune), psychoneuroimmunology is the study of how the mind can affect immune system functioning. Drawing upon many disciplines of science including immunology, psychology, and physiology, psychoneuroimmunology is a very integrative field with scientists studying a wide variety of things. Although many discoveries have been made, not many people are aware of just how significant they are. In order to understand just how stress can affect our immune system, you must first understand how the immune system responds under normal circumstances to invading pathogens.

Pathogens? You Shall Not Pass!
You Shall Not Pass sign by Flickr user Tar Sands BlockadePathogens, defined as disease producing agents (such as viruses and bacteria), are pesky organisms that cause our immune system to mobilize into action. In response to pathogens present in the body, the immune system induces the inflammatory response. Even though the bodily mechanics behind the inflammatory response are complicated, for many people it causes symptoms like stuffy nose, sore throat, and even fever. What many people don’t seem to understand is that the inflammatory response is a result of the body’s immune system trying to “get rid” of invading pathogens; it’s not the pathogens themselves that cause things like sore throat and runny nose. More importantly, pathogens themselves aren’t the only causes of the inflammatory response; hormones have also been identified as a regulator of the inflammatory response as well.

Hormones—Not Just for Sex
Hormones, better known as the “chemical messengers of the body”, are released by specialized organs (called glands) during certain events. Although their “reputation” in the general public is that they deal with sex-specific behaviours, hormones have several roles in the body. One of the best known hormones is insulin, which is released by the pancreas into the blood; it acts as a messenger, telling the cells in your body to start taking in glucose (a type of simple sugar). One of the chief hormones released under stressful conditions is cortisol. Released by the kidneys, it helps mobilize the body into a “fight-or-flight” mode by causing increased blood pressure, heart rate, and sugar breakdown. Think of the last time you were in a stressful or nervous situation; can you remember your heart racing? Another interesting property of cortisol is that it acts as an anti-inflammatory signal, meaning that it acts as an “off switch” for your immune system, helping prevent the inflammatory response described earlier.

Cortisol, a Stress Hormone
Dr Hans SelyeSince its initial discovery by Hans Selye in 1907, cortisol has been the subject of many studies, yielding several different conclusions. Initially, it was found that elevated levels of cortisol were associated with elevated levels of stress, and it was thought that cortisol was released as a cause of stress, as described earlier. However, later studies showed a negative relationship between stress and cortisol levels; they found lower cortisol levels in people living under highly stressful circumstances. How could this be?

When the results of these experiments were further analyzed, scientists found startling relationship. With experiments where participants were subjected to conditions of acute stress (shorter duration), like speaking in public, or being suddenly startled, cortisol was found to be in elevated levels. However, when participants were under conditions of chronic stress (longer duration), like divorce or unemployment, scientists found lower levels of cortisol. This caused them to believe that maybe the relationship between stress and cortisol levels wasn’t so simple. More evidence continued to support the claim that acute stress caused sudden elevation in cortisol levels; if this stress continued, cortisol levels would decline. What implications does this have for Tom’s situation described earlier?

How Cortisol Affects our Immune System: The Traditional Theory
As mentioned earlier, stress is thought to have an immunosuppressive impact on the immune system, mediated through cortisol. Thus, if someone is subjected to a certain stressor, their immune system would be temporarily “shocked”, and pathogens would have a relatively easier time entering and proliferating (growing) within the body. This would result in that person having a greater chance of getting “sick”. Although this theory explains how stress may affect our immune system, perhaps it’s not so simple. It doesn’t explain how for most people, it’s not until the stressor is removed that symptoms of the inflammatory response begin to manifest. Growing evidence is showing support for an alternative theory—one that suggests that inflammation is a result of cortisol dysregulation.

How Cortisol Affects our Immune System: An Alternative Theory
People on subway wearing germ masks by Flickr user Eneas de TroyaPerhaps the symptoms experienced by Tom described earlier weren’t a result of pathogen presence, but rather a result of faulty cortisol regulation? Note that in his case, Tom didn’t get sick while studying for exams, but rather after his last exam was finished–not until his stressor was removed. Since he was placed in a stressful situation, his kidneys were constantly releasing cortisol, suppressing his immune cells (so he’d see no signs of the inflammatory response). Over the course of his exams, his immune cells would constantly be receiving this anti-inflammatory signal, but what happened the stress was suddenly removed, cortisol levels suddenly dropped, and the anti-inflammatory signal went away? Maybe the sudden drop in cortisol’s anti-inflammatory signaling is enough to manifest the inflammatory response?

What happened to Tom may have been a combination of things. The stress onset may have caused his cortisol levels to rise, suppressing his immune system. In its weakened state, he may have been exposed to a variety of pathogens, which were then able to enter and proliferate within his body. Although this pathogen may have been present, his immune system was also constantly being signaled by cortisol to suppress inflammation, explaining why he didn’t see any symptoms during his exams. However, after his exams were over, the combination of pathogens living in his body along with absence of the anti-inflammatory signal may together have caused him to experience symptoms of the inflammatory response—sore throat, stuffy nose, and fever. It may very well be that a combination of both Tom’s mental state of stress along with exposure to pathogenic agents that caused Tom to “get sick.”

A Problem in Science: Lack of Integration
Pathogenic mediation of the inflammatory response is a widely understood principle, but hormonal—specifically hormones pertaining to mental state—control of bodily processes is still not completely understood. Perhaps this is because of the nature of the field. The traditional science disciplines generally tend to be reductionistic, focusing on certain reactions or mechanisms. However, there are many phenomena that cannot be explained within the context of one scientific field in isolation; like how your mental state influence your immune system functioning. In the field of psychoneuroimmunology, questions cannot be answered by looking specifically at immunology or specifically at psychology, but require people to integrate over a variety of scientific disciplines, which may explain why the field is still relatively new.

Implications—What Does this Mean for Me?
From an evolutionary standpoint, the delayed inflammatory response caused by cortisol’s immunosuppressive properties would be advantageous over those without this delayed response, even in the context of Tom’s case. Which would you rather happen? Would you rather combat sickness amidst tackling a barrage of exams? Or would you rather be able to study for exams without showing any signs of being sick, and deal with it after exams are over? If your life depended on getting good grades, the choice would be obvious.

The impacts of stress on our health have been widely studied, and these data give us more concrete evidence, into the adverse affects of stress on health. Perhaps now the question isn’t whether or not stress affects us negatively, but rather how we can effectively remove stress, or at least learn techniques to reduce the impacts of stress.

Image Credits: You Shall Not Pass sign by Flickr user Tar Sands Blockade; Dr. Hans Selye image courtesy of Library and Archives Canada/PA-11671; People on subway wearing germ masks by Flickr user Eneas de Troya

*This piece was originally published by Alvin Lim in The Science Creative Quarterly. Accessed 9/23/14 http://www.scq.ubc.ca/stress-cortisol-and-the-immune-system-what-makes-us-get-sick/

References
Anisman, H., Griffiths, J., Matheson, K., Ravindran, A., & Merali, Z. Posttraumatic stress symptoms and salivary cortisol levels. American Journal of Psychiatry. 2001. 158, 1509–1511.

Bauer, ME. Stress, glucocorticoids and ageing of the immune system. Stress. 2005 Mar;8(1):69-83.

Kaufmann I, et al. Stress doses of hydrocortisone in septic shock: beneficial effects on opsonization-dependent neutrophil functions. Intensive Care Med. 2007 Sep 29

Leonord, B. Stress, depression and the activation of the immune system. World J Biol Psychiatry. 2000 Jan;1(1):17-25.

Miller, G.E., Chen, E., & Zhou, E.S. (2007). If it goes up, must it come down? Chronic stress and the hypothalamic-pituitary-adrenocortical axis in humans. Psychological Bulletin, 133, 25-45

Prignet et al. 2004. Clinical review: Corticotherapy in sepsis. Critical Care, 2, 122-129.

 

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Who Suffers From Adrenal Fatigue?

Who Suffers From Adrenal Fatigue?

Anyone who does not get enough rest and relaxation to enjoy life, who drives him/herself constantly, who is never satisfied or is a perfectionist, who is under constant pressure (especially with few outlets for emotional release), who feels trapped or helpless, who feels overwhelmed by repeated or continuous difficulties, or who has experienced severe or chronic emotional or physical trauma or illness is probably already suffering from some degree of adrenal fatigue.

Adrenal Fatigue Doesn’t Discriminate

People from every walk of life, every culture, and every age can suffer from adrenal fatigue. The political leader, the university student, the homeless person, the farmer, the villager in a war torn country, the Hollywood director, the factory worker on a swing shift, the medical doctor with an HMO, and the single parent with little support probably all have the factors in their lives that can lead to adrenal dysfunction, even though they lead very different lifestyles. The cost is untold in the loss of productive hours, creative ideas, sound business decisions, and other intangibles such as happiness, not to mention good health and longevity.

Your Job May Be a Factor

stressed doctor by Flickr user Celestine ChuaSome professions are harder on the adrenal glands than others. If you look at insurance company actuarial tables of the mortality rates, drug abuse, and number of sick days in different professions, what you are seeing–barring physically dangerous jobs–is largely the amount of adrenal fatigue experienced in those jobs. The medical profession is a good example of a profession prone to adrenal fatigue. Physicians, on average, die approximately 10 years younger, have higher rates of alcoholism and several times the drug addiction rates of the rest of the population.

Typically medical students go directly to medical school from an undergraduate program. During the first two years of medical school they learn approximately 25,000 new words, staying up many late nights to do so. At the end of the four years of study, they graduate and become residents in a specialized area of study, working between 80 and 110 hours per week, sometimes under a great deal of pressure from superiors and other students. By the time they graduate and finish their residency, they are often burdened with heavy debt and feel emotionally isolated.

Over two-thirds of those who are married end up divorced by the end of their residency. Because of their experiences during their training they may feel they can trust no one. This makes work and home unsafe places to be. After residency, most new doctors move immediately into a practice. Once in practice, they frequently work long hours with little rest, sometimes resorting to amphetamines or other stimulants in order to keep going. They often have little home life because they are working most of the time, which leads to marital dissatisfaction. Although this is a generalization and is certainly not true for every doctor, it is a description that fits many of the medical students, residents and young doctors I have worked with recently in practice. In fact, I know one doctor who, after collapsing at the end of her residency, decided to make a career of teaching professionals how to deal with stress.

police officer directing traffic by Flickr user James RussoThe police force is another profession that is very hard on the adrenals. I have counseled many policemen who are on the verge of collapse because of the stress involved in their job. You might think that it is the danger these people live with day in and day out that produces the stress, but much of their stress comes from the demands placed upon them by their commanding officers. If these people are also involved in a weekly rotating shift, the stress is magnified because their bodies never have a chance to adjust to the new circadian rhythm produced by each sleep change. People on alternating shifts with less than three weeks between shift changes are continually hammering their adrenal glands. Every time the wake/sleep cycle is altered, it takes several days to weeks to establish a normal hormonal pattern for the new wake/sleep cycle.

Middle executives, secretaries, and teachers are examples of professionals who suffer from “sandwich stress.” This is stress that comes from having to meet the demands and expectations from above and below without the power or authority to make the necessary changes or to do their job effectively. It is frequently the person in the middle who takes the blame when things go wrong, but not the credit when things go right.

People in this position commonly have more than their share of health problems. They often suffer from metabolic syndrome (a complex of signs and symptoms that includes glucose intolerance, increased triglycerides, low HDL cholesterol, insulin resistance, hypertension, central obesity, and accelerated atherosclerosis). These disorders reflect the effects of stresses that produce elevated cortisol levels. However, sometimes this phase is followed in time by a drop in cortisol levels to below normal, as the adrenals are less able to respond to the stress.

An important factor to remember is the ability to withstand stress varies by person. One person may withstand a stress quite easily and be ready for more, but another person, or that same person at another time, may find the same stress overwhelming and impossible to bear. It is important to understand that the onset and continuation of adrenal fatigue has great individual variation.

Image Credits: Stressed doctor by Flickr user Celestine Chua; Police officer directing traffic by Flickr user James Russo

Dr. James L. WilsonAbout the Author: With a researcher’s grasp of science and a clinician’s understanding of its human impact, Dr. Wilson has helped many physicians understand the physiology behind and treatment of various health conditions. He is acknowledged as an expert on alternative medicine, especially in the area of stress and adrenal function. Dr. Wilson is a respected and sought after lecturer and consultant in the medical and alternative healthcare communities in the United States and abroad. His popular book Adrenal Fatigue: The 21st Century Stress Syndrome has been received enthusiastically by physicians and the public alike, and has sold over 400,000 copies. Dr. Wilson resides with his family in sunny Tucson, Arizona.

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The Anti-Inflammatory Effects of Cortisol

 

The Anti-Inflammatory Effects of Cortisol

mosquito on skin

Among many other jobs, cortisol helps keep insect bite swelling under control

Cortisol is a powerful anti-inflammatory, even when secreted at normal levels. It acts quickly to remove and prevent redness and swelling of nearly all tissues. These anti-inflammatory actions keep mosquito bites from flaring into giant lumps, bronchial tubes and eyes from swelling shut from allergens, and mild scratches from looking like you have just had a close call with a mountain lion.

Cortisol maintains the balance through the unwritten law that “for any physical body to remain in homeostatic equilibrium every inflammatory reaction must have an opposite and equal anti-inflammatory reaction.” Although there are other anti-inflammatory responses occurring at local sites, cortisol is the main anti-inflammatory agent circulating naturally in your body. You can assume that almost any time you have an inappropriate amount of redness and/or swelling, there is too little cortisol in circulation.

Cortisol has similar anti-inflammatory control over auto-immune reactions. In auto-immune reactions, white blood cells attack parts of your body as if they were the enemy. These reactions can range from mild to life threatening. In most auto-immune reactions, cortisol levels are inadequate for the degree of reaction taking place in particular tissues or locations in the body.

This is one of the reasons why strong corticosteroids (prednisone, prednisolone, etc.) are used with all diseases involving inflammatory processes, including auto-immune diseases. These hormones imitate the anti-inflammatory effects of cortisol, although often with serious undesirable side effects. Cortisol not only affects the redness and swelling but also the actions of the white blood cells, as described in the next section.

The Effects of Cortisol on White Blood Cells

Cortisol influences most cells that participate in immune reactions and/or inflammatory reactions, especially white blood cells. It specifically regulates lymphocytes, the commanders of the white blood cells. Cortisol and corticoids (cortisol like substances) also affect the actions of other white blood cells with names such as natural killer (NK) cells, monocytes, macrophages, eosinophils, neutrophils, mast cells and basophils. These white blood cells gather in defense of the body at places of injury or perceived invasion and some flood the area with very powerful chemicals to attack the invaders.

firefighters spraying a fire

Cortisol rushes to put out the “fire” started by white blood cells’ reaction to invaders

Although they are a great defense, these chemicals irritate the surrounding tissues, causing redness and swelling. Cortisol reacts like a crew of firefighters, rushing to the site to put out the fire made by the lymphocytes and other white blood cells. It keeps the local white blood cells from sticking to the site and releasing their chemicals and also controls the number of circulating lymphocytes and other white blood cells, so there are fewer white blood cells available. This prevents an overreaction by the immune system and controls the irritation and tissue destruction that takes place at the site of congregating white blood cells.

Cortisol also reduces the rate at which lymphocytes multiply and accelerates their programmed cell death to further protect the body from this overreaction. In fact, when cortisol is elevated during the alarm reaction, there is almost a complete disappearance of lymphocytes from the blood. That is why your immune system is suppressed when you are under stress or taking corticosteroids. On the other hand, when circulating cortisol is low its moderating effect on immune reactions is lost and lymphocytes circulate in excess. In this situation inflammation is greater with more redness and swelling, and it takes a longer time for the inflamed tissue to return to normal. So, directly and indirectly cortisol dramatically influences most aspects of immune function.

Dr. James L. WilsonAbout the Author: With a researcher’s grasp of science and a clinician’s understanding of its human impact, Dr. Wilson has helped many physicians understand the physiology behind and treatment of various health conditions. He is acknowledged as an expert on alternative medicine, especially in the area of stress and adrenal function. Dr. Wilson is a respected and sought after lecturer and consultant in the medical and alternative healthcare communities in the United States and abroad. His popular book Adrenal Fatigue: The 21st Century Stress Syndrome has been received enthusiastically by physicians and the public alike, and has sold over 400,000 copies. Dr. Wilson resides with his family in sunny Tucson, Arizona.

References:

Collip J, Anderson, Evelyn M. Thyrotrophic Hormone of Anterior Pituitary.
J.A.M.A. 104 (12): 965-969, 1935.

Duncan WC, Jr. Circadian Rhythms and the Pharmacology of Affective Illness.
Pharmacol. Ther. 71 (1): 253-312, 1996.

Hartman F, Brownell, KA., & Hartman, WE. The Hormone of the Adrenal Cortex.
Am. J. Physiol. 72: 76, 1930.

Mortensen RMW, Gordon H. Aldosterone Action. Physiology 3rd edition:
1668-1710, 1995.

 

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Chronic Diseases and Adrenal Function

 

Chronic Diseases and Adrenal Function

vial of hydrocortisone

Hydrocortisone, a corticosteroid, is used to imitate the actions of cortisol

Because the adrenals are the glands of stress, they are a big factor in the process of and recovery from most chronic diseases. The reason for this is simple: most chronic disease is stressful. The processes that take place in chronic diseases, from arthritis to cancer, pull on the adrenals as more and more demand is made upon the body by the disease. Therefore, if someone is suffering from a chronic disease and morning fatigue is one of their symptoms, the adrenals are likely involved.

In any disease or disease process in which treatment includes the use of corticosteroids, diminished adrenal function is most likely a component of that disease process. All corticosteroids are designed to imitate the actions of cortisol, a hormone secreted by the adrenals, and so the need for them arises primarily when the adrenals are not providing the required amounts of cortisol. If the cortisol response is appropriate, there is little need for the external synthetic drugs that imitate its action, except in extreme instances.

With that said, there are a few diseases that particularly stand out as having an adrenal component: chronic fatigue syndrome, fibromyalgia, alcoholism, ischemic heart disease, hypoglycemia, rheumatoid arthritis and chronic and recurrent respiratory infections. In the cases of chronic fatigue syndrome and fibromyalgia, substantial evidence is now emerging that these syndromes may result from unusual infectious microorganisms that are not detected by the typical laboratory tests. A growing number of peer reviewed papers are now confirming the presence of these microorganisms in these particular illnesses. These pathogenic microorganisms act as a tremendous body burden, draining adrenal resources.

glass of whiskeyAdrenal fatigue often precedes a syndrome such as chronic fatigue, fibromyalgia and some cases of alcoholism. The immune weakness that results from altered adrenal function sets the stage for easier infection or greater debilitation. In many alcoholics, adrenal fatigue and the resulting hypoglycemia predispose the person to a compulsive desire for alcohol. In other cases of alcoholism, the adrenals become fatigued by the continual use of alcohol. In either case, adrenal fatigue is an intimate component of most alcoholism. Adrenal support greatly enhances the treatment protocol for alcoholism.

Chronic and recurrent bronchitis, pneumonia and other chronic lung and bronchial diseases typically have an adrenal fatigue component. This includes many cases of asthma, influenza and allergies. This relationship appears to be both causal and resultant, meaning frequent respiratory ailments can lead to adrenal fatigue and adrenal fatigue can leave a predilection toward developing respiratory problems. The association between adrenal function and respiratory infection was first written about in 1898, but by the mid 1930’s physicians apprised of the importance of the adrenals in resistance to infection and to overall health were also aware of the relationship of the adrenals to chronic and recurrent respiratory problems.

Later it became known that even the proper development of the lungs in the fetus is dependent upon an adequate amount of adrenal hormones, especially cortisol. If there is a lack of cortisol from the adrenals in the fetus during development, the lungs don’t develop properly and early problems in the lungs are more frequent and more serious. The tip-off that there is a low adrenal component to any of these illnesses is a longer than normal recovery period with decreased stamina and excess fatigue. When these symptoms are present, adrenal fatigue is likely a component of the symptom picture, no matter the cause.

Image Credits: Vial of hydrocortisone by LHcheM via Wikimedia Commons

Dr. James L. WilsonAbout the Author: With a researcher’s grasp of science and a clinician’s understanding of its human impact, Dr. Wilson has helped many physicians understand the physiology behind and treatment of various health conditions. He is acknowledged as an expert on alternative medicine, especially in the area of stress and adrenal function. Dr. Wilson is a respected and sought after lecturer and consultant in the medical and alternative healthcare communities in the United States and abroad. His popular book Adrenal Fatigue: The 21st Century Stress Syndrome has been received enthusiastically by physicians and the public alike, and has sold over 400,000 copies. Dr. Wilson resides with his family in sunny Tucson, Arizona.

References:

Back JC, Casey, John, Solomon, S., Hoffman, MM. The Response of the Adrenal
Cortex to Chronic Disease. In: GEW Wolstenholme aRP, ed. The Human
Adrenal Cortex: Its function throughout life. Boston: Little, Brown and
Company. pp. 94-119, 1967.

Bellometti SG, L. Function of the hypothalamic adrenal axis in patients with
fibromyalgia syndrome undergoing mud-pack treatment. Int J Clin Pharmacol
Res 19 (1): 27-33, 1999.

Bourne I. Local corticosteroid injection therapy. Acupuncture in Medicine 16 (2):
95-102, 1998.

De Becker P, De Meirleir, K., Joos, E., Campine, I., Van Steenberge, E., Smitz,
J., Velkeniers B. Dehydroepiandrosterone (DHEA) response to i.v. ACTH in
patients with chronic fatigue syndrome. Hormone & Metabolic Research. 31 (1):
18-21, 1999.

Dessein P, Shipton, EA., Joffe, BI., Hadebe, DP., Stanwix, AE., Van der Merwe, BA.
Hyposecretion of adrenal androgens and the relation of serum adrenal steroids,
serotonin and insulin-like growth factor-1 to clinical features in women with
fibromyalgia. Pain 83 (2): 313-319, 1999.

Feher I. Secretory function of adrenal cortex in chronic alcoholis. Med Pregl 52
(6-8): 221-225, 1999.

Harrower HR. Arthritis, p. 288, 1932.

Kuratsune H, Yamaguti, K., Sawada, M., Kodate, S., Machii, T., Kanakura, Y.,
Kitani, T. Dehydroepiandrosterone sulfate deficiency in chronic fatigue
syndrome. Bioorganic & Medicinal Chemistry Letters. 1 (1): 143-146, 1998.

Lee S, Schmidt, ED., Tilders, FJ., Rivier, C. Effect of repeated exposure to alcohol
on the response of the hypothalamic-pituitary-adrenal axis of the rat: I. Role of
changes in hypothalamic neuronal activity. Alcohol Clin Exp Res 25 (1): 98-105,
2001.

Neeck G, Riedel, W. Hormonal pertubations in fibromyalgia syndrome. Ann N Y
Acad Sci 876: 325-338; discussion 339, 1999.

Rivier CL, S. Effect of repeated exposure to alcohol on the response of the
hypothalamic-pituitary-adrenal axis of the rat: II. Role of the length and regimen
of alcohol treatment. Alcohol Clin Exp Res 25 (1): 106-111, 2001.

Scott L, Teh, J., Reznek, R., Martin, A., Sohaib, A., Dinan, TG. Small adrenal
glands in chronic fatigue syndrome: a preliminary computer tomography study.
Psychoneuroendocrinology 24(7): 759-68, 1999.

Straub RC, M. Involvement of the hypothalamic—pituitary—adrenal/gonadal axis
and the peripheral nervous system in rheumatoid arthritis: viewpoint based on a
systemic pathogenetic role. Arthritis Rheum 44 (3): 493-507, 2001.

Watterberg K, Scott, SM., Backstrom, C., Gifford, KL., Cook, KL. Links between
early adrenal function and respiratory outcome in preterm infants: airway
inflammation and patent ductus arteriosus. Pediatrics 105 (2): 320-324, 2000.

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How Adrenal Function Affects Your Everyday Life

How Adrenal Function Affects Your Everyday Life

The purpose of your adrenal glands is to help your body cope with stresses and survive. In fact, the adrenals are known as “the glands of stress.” It is their job to enable your body to deal with stress from every possible source, ranging from injury and disease to work and relationship problems. Your resiliency, energy, endurance and your very life all depend on their proper functioning.

Napoleon Bonaparte on horseback

Like Napoleon, the adrenal glands are small but mighty.

Just as Napoleon, a small man with great power, mobilized huge forces to make his presence felt in every part of his world, so your adrenal glands command powerful hormones to extend their influence throughout your body and your life. No bigger than a walnut and weighing less than a grape, each of your two adrenal glands sit like a tiny pyramid on top of each kidney. From this central location they not only significantly affect the functioning of every tissue, organ and gland in your body, but they also have important effects on the way you think and feel. The forces that these two little Napoleons mobilize largely determine the energy of your responses to every change in your internal and external environment. Whether they signal attack, retreat or surrender, every cell responds accordingly, and you feel the results.

One way to get an overview of the far-reaching extent, variety and depth of the effects of your adrenal hormones is to take a look at the wide range of medical conditions treated with drugs that imitate the actions of the adrenal hormone cortisol (synthetic corticosteroids). The uses of hydrocortisone (a corticosteroid) listed in The Physicians’ Desk Reference will give you the story. They include treatment of diseases and disorders of the joint mucus membranes, the heart, the blood, the respiratory tract and lungs, the gastrointestinal tract, the skin, the eyes, and the nervous system.

Hydrocortisone is also used to control swelling and inflammation as well as symptoms of allergies, cancer, viral infection, and immune and auto-immune disorders. However, the effects of your body’s own adrenal hormones on your health and bodily functions are even more varied, profound and extensive.

diagram of kidneys and adrenal glandsThe hormones secreted by your adrenals influence all of the major physiological processes in your body. They closely affect the utilization of carbohydrates and fats, the conversion of fats and proteins into energy, the distribution of stored fat (especially around your waist and at the sides of your face), normal blood sugar regulation, and proper cardiovascular and gastrointestinal function. The protective activity of anti-inflammatory and anti-oxidant hormones secreted by the adrenals helps to minimize negative and allergic reactions to alcohol, drugs, foods and environmental allergens. After mid-life (menopause in women), the adrenal glands gradually become the major source of the sex hormones circulating throughout the body in both men and women.

These hormones themselves have a whole host of physical, emotional and psychological effects, from the level of your sex drive to the tendency to gain weight. Every athlete knows that muscular strength and stamina are acutely affected by the adrenal hormones, more commonly known as steroids. Even your propensity to develop certain kinds of diseases and your ability to respond to chronic illness is influenced significantly by the adrenal glands. The more chronic the illness, the more critical the adrenal response becomes. You cannot live without your adrenal hormones and, as you can see from this brief overview, how well you live depends a great deal on how well your adrenal glands function.

Dr. James L. WilsonAbout the Author: With a researcher’s grasp of science and a clinician’s understanding of its human impact, Dr. Wilson has helped many physicians understand the physiology behind and treatment of various health conditions. He is acknowledged as an expert on alternative medicine, especially in the area of stress and adrenal function. Dr. Wilson is a respected and sought after lecturer and consultant in the medical and alternative healthcare communities in the United States and abroad. His popular book Adrenal Fatigue: The 21st Century Stress Syndrome has been received enthusiastically by physicians and the public alike, and has sold over 400,000 copies. Dr. Wilson resides with his family in sunny Tucson, Arizona.

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The Regulation of Cortisol, the Stress Hormone

The Regulation of Cortisol, the Stress Hormone

Cortisol is responsible for many of the life sustaining functions attributed to the adrenal glands. Although cortisol is secreted by the zona fasciculata in the adrenal glands, it is regulated primarily from the brain. The amount of cortisol circulating at any particular moment is regulated by a complex interaction between the hypothalamus, the pituitary gland, and the adrenal glands. This regulatory trio, often referred to as the HPA axis, operates through a negative feedback system.

the regulation of cortisol illustration

Click image for larger version

A negative feedback system works like the thermostat in a house or apartment. The thermostat senses the heat in the room and compares it with the desired temperature at which it has been set. When the heat gets too low, the thermostat signals the relay switch to tell the furnace to ignite, sending out hot air into the room and raising the heat. When the heat has risen to the desired level, the thermostat signals the furnace to quit until more heat is needed. This cycle is called a negative feedback system because when enough heat is released, a negative signal is sent to slow or stop the input.

In your body, your hypothalamus is analogous to the thermostat, your pituitary to the relay switch, your adrenals to the furnace, and your body to the room (see the illustration “The Regulation of Cortisol”). The amount of cortisol released is comparable to the heat released from the furnace. To a large extent you control the thermostat through the demands you place on your body. These demands arise from the physical situations your body has to deal with (diet, exercise, work, climate, etc.) and your reactions (emotional and physiological) to them. This negative feedback system is described below in the language of physiology.

The Physiology of Cortisol Regulation  

The HPA Axis is one of the most important elements of the whole body process known as homeostasis, the process that maintains a steady internal biochemical and physiological balance in your body. The HPA Axis adjusts cortisol levels according to the needs of the body, under normal and stressed conditions, via a hormone called the Adrenal Corticotrophic Hormone (ACTH). ACTH is secreted from the pituitary gland in response to orders from the hypothalamus and travels in the bloodstream to the adrenal cortex. There it activates cells in all three (or four) zones to produce their various hormones.

illustration of the HPA axis

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Each zone generates different hormones as end products, but the process of making all hormones in all zones begins with ACTH binding to the walls of the adrenal cells. This initiates a chain reaction of intracellular enzymes that release cholesterol within the cell. The cholesterol is then used inside the adrenal cells to manufacture pregnenolone, the first hormone in the adrenal cascade. No matter which adrenal hormone is being produced, pregnenolone is the first hormone formed in the series.

In the zona fasciculata, pregnenolone is processed to form cortisone and then cortisol. Cortisol, once manufactured, is released into circulation. It takes less than a minute after the initial stimulation by ACTH for newly synthesized cortisol to be circulating through your blood to every part of your body, including to your hypothalamus where the concentration of cortisol is being constantly measured. Your hypothalamus, in its regulatory function, analyzes and integrates input from many different external and internal sources.

This input includes information from brain centers about overall excitability, energy requirements of your body, and sensory data from your brain centers for hearing, seeing, smelling, touch and taste. Based on this information, your hypothalamus determines how much cortisol your body requires and subsequently releases its own hormones as messengers.

The primary hormone messenger from the hypothalamus is corticotrophin releasing factor (CRF) which signals the pituitary gland to secrete a specific amount of ACTH. Thus ACTH is sent from the pituitary to your adrenal glands to begin the process described above all over again. Alterations in ACTH levels, and hence cortisol levels, are made minute by minute using this negative feedback loop, modulated by other information received by the hypothalamus as shown in the illustration.

Dr. James L. WilsonAbout the Author: With a researcher’s grasp of science and a clinician’s understanding of its human impact, Dr. Wilson has helped many physicians understand the physiology behind and treatment of various health conditions. He is acknowledged as an expert on alternative medicine, especially in the area of stress and adrenal function. Dr. Wilson is a respected and sought after lecturer and consultant in the medical and alternative healthcare communities in the United States and abroad. His popular book Adrenal Fatigue: The 21st Century Stress Syndrome has been received enthusiastically by physicians and the public alike, and has sold over 400,000 copies. Dr. Wilson resides with his family in sunny Tucson, Arizona.

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