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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

Click image for larger version

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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Gluten-Free Side Dishes: Three Quick and Tasty Recipes


Green Beans with Garlic Butter Sauce

sauteed green beans by Flickr user pongGreen beans contain a wide range of vitamins and minerals, and this dish is a tasty change-up from steamed or boiled green beans. If you want, you can substitute spinach or watercress for the green beans.


  • 1 tablespoon butter
  • 1 tablespoon olive oil
  • 4-5 cloves of fresh garlic, peeled and sliced
  • 1 pound green beans, washed and with ends removed
  • 1/4 cup grated Parmesan cheese (optional)
  • salt and pepper to taste, if desired


  1. Bring a pot with water (enough to cover green beans) to a boil. Add green beans, and let them boil for 4-5 minutes.
  2. Drain green beans and place aside in an ice bath.
  3. Put a large skillet over medium heat. Melt butter with the olive oil, and add the garlic. Cook garlic until lightly brown, stirring often.
  4. Add the green beans, with any salt and pepper. Cook for 3-5 minutes, or until tender. Stir the beans every so often.
  5. Remove from heat, plate and sprinkle with Parmesan cheese, if desired.

Roasted Brussels Sprouts

Brussels sprouts by Flickr user johnsu01Brussels sprouts are a nutrient-dense vegetable, but many people, not just children, can’t get over the taste. Roasting these miniature cabbages is a great way to make them more palatable.


  • 1 and 1/2 pounds of Brussels sprouts, ends trimmed and yellow outer leaves removed
  • 3 tablespoons olive oil
  • 1 teaspoon sea, Celtic or Himalayan salt
  • 1/2 teaspoon freshly ground pepper


  1. Preheat oven to 400* F (205* C).
  2. Add Brussels sprouts, olive oil, salt and pepper to a large plastic bag or mixing bowl, and gently mix together.
  3. Spread Brussels sprouts onto a baking sheet, large enough to prevent crowding. Roast for 30-46 minutes, shaking the pan every 7 minutes or so for even browning. Lower the heat if necessary.
  4. When done, Brussels sprouts will be dark brown and crispy on the outside and tender on the inside.

Baked Parmesan Tomatoes

Parmesan baked tomatoes by Flickr user MigleThis is a simple, blissful dish that can be eaten on its own or as an accompaniment, like between slices of your favorite gluten-free bread. Enjoy these for breakfast, lunch or dinner, hot or cold. You can add just about any fresh herb as a topping, like oregano, basil or rosemary.


  • 4 (or as many as you like) medium-sized tomatoes, sliced horizontally in halves.
  • 1/4 cup grated Parmesan cheese
  • 1 teaspoon chopped fresh oregano
  • salt and pepper to season
  • 4 teaspoons extra virgin olive oil


  1. Preheat oven to 350* F (180* C).
  2. Place tomatoes cut side up on a baking sheet. Top with Parmesan, oregano (and/or any other herb you wish to use), salt and pepper.
  3. Drizzle with oil and bake for about 15 minutes, or until tomatoes are tender.

More gluten-free recipes are available on Dr. Eric Bakker’s website here: http://www.naturopath.co.nz/Recipes/Gluten+Free+Recipes.html

Image Credits: Green beans by Flickr user pong; Brussels sprouts by Flickr user johnsu01; Tomatoes by Flickr user Migle

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Yeast Infections: Frequently Asked Questions with Answers

Warner's Safe Yeast ad by Flickr user boston_public_libraryYeast Infections: Frequently Asked Questions with Answers

What Are Yeast Infections?

Candida albicans, a yeast-like fungus, naturally lives inside most people. Since it’s not a foreign object or invader this fungus is not inherently bad; problems arise when too much of this fungus is created. Molds and yeasts spread and reproduce by releasing millions of microscopic spores into the air, where they eventually settle on a favorable surface. Yeasts and molds prefer warm, dark and moist environments, which means there are many places in your body conducive for mold and yeast growth.

Who Gets Yeast Infections?

Anyone from birth to old age and from any race or culture can develop and suffer from a yeast infection. People vary greatly in their ability to develop and maintain a yeast infection in their bodies. A high stress lifestyle, a life crisis or a continuing difficult situation can cause a yeast infection in even the healthiest person because these factors will lower a person’s resistance and increase their susceptibility.

However, there are certain factors that increase susceptibility to yeast infections. These include a diet high in take-out foods; alcohol consumption; too little sleep and rest; taking an antibiotic or the oral contraceptive pill; a diet high in refined sugars and simple carbohydrates like pasta and bread; and a mother with a yeast infection during gestation and birth. Unfortunately many of these factors are common in modern life.

What Causes Yeast Infections?

The adrenal glands mobilize the body’s response to every kind of physical, emotional and psychological stress through hormones that regulate energy production and storage, heart rate, muscle tone, immune function and other processes that deal with stress. Adrenal fatigue is produced when the output of regulatory adrenal hormones is diminished through over-stimulation of the adrenals by severe, chronic or repeated stress, or because of adrenals weakened by poor nutrition, congenital factors or other causes. In adrenal fatigue the adrenal glands function, but not well enough to adequately meet the demands of stress. The causes of adrenal fatigue usually stem from one of four common sources that overwhelm the glands:

1) Disease states such as severe or recurrent pneumonia, bronchitis or flu, cancer, AIDS, auto-immune and other illnesses.

2) Physical stress such as surgery, poor nutrition, addiction, injury, and exhaustion.

3) Emotional/psychological stress from relationships, work or other unavoidable life situations.

4) Continual and/or severe environmental stress from toxic chemicals and pollutants in the air, water, clothing or food.

What are the Common Symptoms of a Yeast Infection?

A candida yeast infection overgrowth can potentially cause many symptoms. The most common in my experience are:

  • Fatigue, tiredness and general weakness or malaise
  • Bloating and flatulence (gas)
  • Food allergies and sensitivities
  • Itching skin near areas such as the scalp, ear, groin, armpit or vagina
  • Strong cravings for carbs and/or sweet foods like candy, ice cream, chocolate
  • Vaginitis (vaginal thrush) accompanied often by a vaginal discharge
  • Anxiety and depression
  • Impaired memory, poor concentration
  • A foggy brain, feeling spaced out

What are the Less Common Symptoms of a Yeast Infection?

Additionally, numerous other less common symptoms may be exhibited. Of these, those I see most frequently in the clinic include:

  • Cystitis/urethritis (urinary tract infection–painful, burning or “stinging” sensations when trying to urinate)
  • Menstrual irregularities
  • Loss of libido
  • Stiff, creaking and painful joints, muscle pain
  • Indigestion or heartburn
  • Diarrhea or constipation
  • Inhalant allergies and multiple chemical sensitivities
  • Mucus or catarrh, hay fever, sinusitis or a persistent cough
  • Heart arrhythmia, fast heartbeat
  • Discolored nails, acne and other skin eruptions, especially when itching
  • Earaches, headaches, and dizziness

Can People Recover From a Yeast Infection?

Although a yeast infection may only last a short while, especially if it was caused by one transient stressful event such as one round of antibiotic, it can debilitating and last for many years–even a lifetime–without proper treatment. However, with proper treatment, most people can fully recover from a yeast infection.

Can a Yeast Infection Become Chronic?

Yes, in some people the digestive and immune systems do not return to normal levels of function without help, either because their diet and lifestyle remained poor, their stress levels were too great or too prolonged, or because their general health is poor. However, when a yeast infection becomes chronic, it is almost always because of the ignorance of factors that can be changed through the correct modification in lifestyle and diet.

I want to prevent a Yeast Infection from returning. How do I stay healthy?

The guidelines for keeping healthy and preventing the recurrence of a yeast infection are very similar to the overall principles of good health. A moderate lifestyle with good quality food, regular exercise and adequate rest, combined with a healthy mental attitude to the stresses of life goes a long way towards keeping your body strong and resilient. However, because modern life can be so stressful and diets can be so compromised, certain nutritional supplements specially designed to counter a yeast infection and help restore the digestive microbial balance and maintain a healthy digestive system.

For more on yeast infection prevention and support, visit my website www.yeastinfection.org

Image Credit: Warner Yeast ad by Flickr user Boston Public Library

Dr Eric Bakker, NZ naturopathic physicianAbout the Author: Eric Bakker B.H.Sc. (Comp.Med), N.D, R.Hom. is a highly experienced naturopathic physician who has been in clinical practice for 25 years. Eric is passionate about improving people’s lives through proven wellness and lifestyle principles, natural medicine practice as well as public and professional practitioner education. Eric specialises in candida yeast infections, as well as adrenal fatigue, and thyroid disorders. Dr. Bakker has written one of the most comprehensive books on yeast infections called Candida Crusher. Website:  candidacrusher.com  You can complete his online survey to determine if you have a yeast infection here, or link through to his many YouTube videos: www.yeastinfection.org  Dr. Bakker’s Blog:  www.ericbakker.com


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Not All Food Allergies are the Same: Type 1 and Type 3 Responses


A true food allergy is not as common as you may actually think. Food sensitivities/reactions, which are much more common in my experience, are often mistaken for allergies. A true allergy to food is mediated by the immune system, and involves an antibody reaction to a specific food or drink. Food allergies are categorized into groups, and for this purpose I’m focusing on two of those: Type 1 immediate response (IgE) and Type 3 delayed response (IgG).

Type 1 or IgE Response (Immediate Food Allergy)

allergic reaction-hives on man's back

Hives are a common symptom of a food allergy

The best known and most studied form of food allergies is called a Type 1 immune reaction, or IgE mediated response. An IgE reaction occurs immediately after exposure to the allergen. With this allergy, the immune system creates an antibody called IgE (Immunoglobulin E) that attacks certain foods, causing a reaction. Type 1 food allergies occur in less than 5 percent of the population, and mostly in children. These type of allergies usually occur in the genetically predisposed individual (one or both parents have an allergy).

Since this pathway occurs immediately, it is often easy to recognize a Type 1 allergy. This is the immunological pathway behind seasonal allergies such as hay fever. The most common test for this type of reaction is the RAST (radioallergosorbent) or “scratch” test which is performed by doctors or specialists. This involves scratching the skin and applying a test substance and then waiting for a “wheal and flare response,” often a skin reaction.

The problem I find with this test is that it’s not always a reliable indication of an allergy, with many patients showing a “false negative” test and at times even an exaggerated positive response. The test substance may be too old to invoke a reaction or the test substance may not specific enough to the particular person and therefore does not invoke the reaction. There are simply too many reasons why this test can fail.

Type 1 Food Allergy Symptoms

The allergen and resulting symptoms are unique to the individual, so symptoms can vary by person. However, some people don’t have any idea that they have a food allergy. Not long after the response, allergy symptoms become apparent, including swollen hands, itchy and swollen eyes, sensations of the lungs, and in severe cases closing of the larynx or throat. Anaphylaxis is the most alarming response (difficulty breathing, fast heart rate, panic) and other symptoms may include stomach cramping, diarrhea, hives, swelling, itching and skin rashes.

Type 1 Food Allergy (IgE) Summary

grilled shellfish platter

Shellfish: Tasty, but one of the most common food allergens

-Generally no more than one or two foods are involved in causing these allergic symptoms.

-Even the tiniest trace amounts of food can trigger this intense allergic reaction.

-Allergic symptoms commonly appear within 2 hours after consumption, but may occur within minutes.

-Primarily affects the skin, airway and digestive tract manifesting in conditions such as asthma, rhinitis, urticaria, angioedema, eczema, vomiting, diarrhea and anaphylaxis.

-This type of allergy is usually a permanent, fixed food allergy.

-Frequently IgE responses show as positive on “RAST” and skin tests, but this is not always the case. Variables include the experience of the person doing the testing, the conditions the test was performed under, and if the patient was taking drugs (like antihistamines) beforehand.

-Although mixed immediate/delayed onset allergic reactions have been reported (e.g., eczema), the IgG antibody is not characteristically involved in IgE responses.

-Mast cells, basophils, histamine and tryptase release are all commonly involved in this type of reaction.

Type 3 or IgG Response (Delayed Food Allergy)

Non-IgE-mediated allergies involve antibodies like IgG (Immunoglobulin G). Symptoms of an IgG-dependent reaction may occur hours–even days–following exposure to the allergen. When foods are involved, these are often referred to as “delayed food reactions”. The IgG antibody may bind to the food antigen and form an immune complex, and these complexes may deposit in various tissues and trigger inflammatory reactions. It is most unfortunate, but conventional medicine often does not recognize these types of immune responses.

Delayed Food Allergy (IgG) Summary

-Anywhere from 3 to 10 food allergens may be involved, and in some cases up to 20 foods have been reported.

-It is more rare for a person in this category to be only allergic to one or two foods.

-Unlike IgE allergies, larger amounts of food often in multiple feedings are commonly needed to provoke these types of allergic reactions. Reactions may not occur after a single food challenge.

-Virtually any tissue, organ, or system of the human body can be affected, making it difficult to distinguish between an IgE and IgG response.

-It has been estimated that addictive cravings and withdrawal symptoms can be clinically significant in 20-30% of patients suffering from this type of allergy.

-The offending foods are rarely self-diagnosed. Multiple doctor visits involving different physicians are often the rule, not the exception, before proper diagnosis and treatment is provided.

-Allergic foods are commonly favorite foods, eaten often and in larger amounts.

-Unlike IgE responses, IgG responses are often alleviated or reversed.

-IgG responses typically show as negative on RAST and skin tests.

-Sensitized lymphocytes, eosinophils, platelets, release of PAF and leukotrienes may be more prevalent.

For more on food allergies, check out our blog on Food Allergies, Sensitivities and Adrenal Fatigue and Making Sense of Food Allergies, Sensitivities and Intolerances

Image Credits: Hives on back by DLdoubleE (Own work) [Public domain], via Wikimedia Commons

Dr Eric Bakker, NZ naturopathic physicianAbout the Author: Eric Bakker B.H.Sc. (Comp.Med), N.D, R.Hom. is a highly experienced naturopathic physician who has been in clinical practice for 25 years. Eric is passionate about improving people’s lives through proven wellness and lifestyle principles, natural medicine practice as well as public and professional practitioner education. Eric specialises in candida yeast infections, as well as adrenal fatigue, and thyroid disorders. Dr. Bakker has written one of the most comprehensive books on yeast infections called Candida Crusher. Website:  candidacrusher.com  You can complete his online survey to determine if you have a yeast infection here, or link through to his many YouTube videos: www.yeastinfection.org  Dr. Bakker’s Blog:  www.ericbakker.com

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Progesterone and Pregnenolone: Two Ps in a Pod

Progesterone and Pregnenolone: Two Ps in a Pod

peas and podProgesterone and pregnenolone are steroid hormones manufactured in several areas of the body: the adrenal cascade, ovaries and testicles. Progesterone is made from pregnenolone and both are metabolized into DHEA. In the adrenal cascade, pregnenolone is the first hormone to be made from cholesterol and progesterone is the second. Besides DHEA both can be converted into several other adrenal hormones, including the sex hormones, aldosterone and cortisol. Hormones like pregnenolone and progesterone are incredibly versatile, letting your body’s wisdom choose which other hormones it will make from them based on your individual needs.

With adrenal fatigue, sex hormone levels often fall because your adrenal glands are not able to manufacture adequate amounts. One key function sex hormones serve is to act as antioxidants that help prevent the damage caused by cortisol. The lower the levels of sex hormones, the more damage there is to tissues, especially when stress levels are high. This oxidative damage is one of the key factors contributing to rapid aging.

Both progesterone and pregnenolone have been used with success to ease premenstrual syndrome (PMS). This is not surprising considering that the most common cause of PMS seems to be too little progesterone and/or too little magnesium. The addition of oral pregnenolone or natural progesterone cream is often used as relief for the side effects and symptoms of PMS. Both pregnenolone tablets and progesterone cream are available from many health food stores and some pharmacies.

It is important to note that we are speaking of natural progesterone and not the synthetic tablet-form progestins typically prescribed by a doctor. Synthetic progestins can have many side effects and should be avoided. The reason most progestins have side effects is that none of them are exactly like the natural progesterone your body makes. The progesterone contained in progesterone cream, however, is usually a naturally-derived plant progesterone (phytoprogesterone) that has been converted into the same molecule as the progesterone in your body. In my experience, this form can be used safely by most women.

Use of progesterone cream for PMS typically involves rubbing 1/4 to 1/2 teaspoon cream into the tender areas of your skin (swimsuit areas plus the inside of thighs and arms) each morning and evening. Premenopausal women should apply it from the 12th day of the menstrual cycle to the 26th day (the first day of bleeding is counted as the 1st day). Post-menopausal women can use it for 21 days each month. A great resource for more information on this topic is What Your Doctor May Not Tell You About Menopause by Dr. John Lee.

smiling HCP with patientBoth pregnenolone and progesterone can be used to raise the hormonal levels in both men and women, and decrease some aspects of adrenal fatigue. Bypassing the very complex and energy consuming steps required to make pregnenolone or progesterone from cholesterol means fatigued adrenals do not have to work nearly so hard to keep hormone levels adequate. Using hormone replacement therapy for adrenal fatigue is an area that requires skill. Although some of the hormones mentioned here can be purchased without a prescription, I highly recommend using a physician familiar with hormone replacement in cases of adrenal fatigue. If you cannot find one in your area, try our Find a Practitioner section to see if we have someone near you.

Hormones work together in symphony to perform in the concert of life. To throw in a hormone here and another there in a haphazard way is like having a heavy metal band thrown in with an orchestra. Hormones are powerful engineers of body processes and balancing them calls for delicate precision. The timing, the quantity and the form of hormone used are all critical. It is best to work with an expert who will monitor your progress using laboratory tests. If you do embark upon this yourself, use caution: start low and go slow.

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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Insomnia! Ungh! What is it? And What is it Good For?

insomnia collage by Flickr user narghee-laWhat is Insomnia?

Insomnia is a word that gets used a lot to describe every type of sleep problem imaginable, but what is it exactly? By definition, insomnia is a sleep condition characterized by difficulty falling and/or staying asleep. Typically, insomnia exists when one or more of the following complaints are experienced:

  • Difficulty falling asleep
  • Waking up frequently during the night with difficulty returning to sleep
  • Waking up too early in the morning
  • Unrefreshing sleep

There are three different types of insomnia people experience: transient (short term), intermittent (on and off), and chronic (constant). Regardless of type, insomnia can have quite the effect on your health and daily life. Lack of quality sleep can cause many daily problems like tiredness, lack of energy, difficulty concentrating, and irritability.

What Causes Insomnia?

There are many causes of insomnia. Transient and intermittent insomnia generally occur in people who are temporarily experiencing one or more of the following:

  • Stress
  • Environmental noise
  • Extreme temperatures
  • Change in your surrounding environment (work and/or home)
  • Sleep/wake schedule problems such as those due to jet lag and alternate shift work
  • Side effect from a medication

Chronic insomnia is more complex and often results from a combination of factors, including underlying physical or mental disorders. One of the most common causes of chronic insomnia is depression. Other underlying causes include arthritis, kidney disease, heart failure, asthma, sleep apnea, narcolepsy, restless legs syndrome, Parkinson’s disease, and hyperthyroidism. However, chronic insomnia may also be due to behavioral factors, including the misuse of caffeine, alcohol, or other substances; disrupted sleep/wake cycles as may occur with shift work or other nighttime activity schedules; and chronic stress.

Here are some more behaviors that have been shown to cause insomnia:

  • The expectation and worry over sleep/sleep difficulties
  • Excessive caffeine intake
  • Alcohol or tobacco consumption close to bedtime
  • Excessive napping during the day
  • Irregular or continually disrupted sleep/wake schedules

These behaviors may prolong existing insomnia, and they can also be responsible for causing the sleeping problem in the first place. Stopping these behaviors may eliminate the insomnia altogether.

How is Insomnia Treated?

Transient and intermittent insomnia may not require treatment since episodes last only a few days at a time. For example, if insomnia is due to a temporary change in the sleep/wake schedule, as with jet lag, the person’s biological clock will often return to normal on its own. If you suffer from chronic insomnia, speak with your healthcare practitioner. Chronic loss of sleep can have detrimental effects on your daily life, and can even lead to severe health conditions.

Here are some natural methods used to help insomnia:

Relaxation Therapy: There are specific and effective techniques that can reduce or eliminate anxiety and body tension. As a result, the person’s mind is able to stop “racing,” the muscles can relax, and restful sleep can occur. It usually takes much practice to learn these techniques and to achieve effective relaxation.

Sleep Restriction: Some people suffering from insomnia spend too much time in bed unsuccessfully trying to sleep. They may benefit from a sleep restriction program that at first allows only a few hours of sleep during the night. Gradually, the time is increased until a more normal night’s sleep is achieved.

Reconditioning: Another treatment that may help some people is to recondition them to associate the bed and bedtime with sleep. For most people, this means not using their beds for any activities other than sleep and sex. As part of the reconditioning process, the person is usually advised to go to bed only when sleepy. If unable to fall asleep, the person is told to get up, stay up until sleepy, and then return to bed. Throughout this process, the person should avoid naps and wake up and go to bed at the same time each day. Eventually, the person’s body will be conditioned to associate the bed and bedtime with sleep.

More information on insomnia can be found at the National Heart, Lung and Blood Institute website: http://www.nhlbi.nih.gov/health/health-topics/topics/inso/

Image Credits: Insomnia collage by Flickr user narghee-la

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Much Ado About Aldosterone: Electrolyte Imbalance and the Craving for Salt

Much Ado About Aldosterone: Electrolyte Imbalance and the Craving for Salt

macro shot of salt grains by Flickr user pagedooleyAldosterone is responsible for the maintenance of fluid (water) and the concentration of certain minerals (sodium, potassium, magnesium and chloride) in the blood, the interstitial fluid (area between the cells) and inside the cells. In the blood, sodium is the most dominant of the four minerals. Inside the cells, potassium has the highest concentration. These minerals are called electrolytes because they carry minute electrical charges. These electrolytes are very important for proper cell function and fluid properties and they must remain in a relatively constant ratio to each other. Small deviations in ratio  or to concentration means alterations in the properties of the fluid, the cell membrane and the biochemical reactions within the cell. In fact, most of the physiological reactions in the body depend in some way on the flow or concentration of electrolytes.

In times of stress, aldosterone is the major director of these relationships by its influence on sodium and water concentrations. As the concentration of aldosterone rises, the concentration of sodium rises in the blood and interstitial fluid. As mentioned above, aldosterone controls sodium, potassium and fluid volumes in your body. When aldosterone secretions are normal, potassium, sodium and fluid levels are also normal. When aldosterone is high, sodium is kept high in the fluids circulating in your body.

However, as circulating aldosterone levels fall, sodium is removed from your bloodstream as it passes through the kidneys and is excreted in the urine. When sodium is excreted it takes water along. Initially, there is some loss of volume of your body fluids but it does not become severe until your circulating sodium level drops to about 50% of its original concentration in body fluids. At this point, even a small loss of sodium begins to have severe consequences.

dry cracked dirtWhen the blood’s sodium supply is not replenished by eating salt-containing foods or liquids, sodium and water is pulled from your interstitial fluids into the blood to keep levels from getting too low. If too much salt or fluid is pulled from the interstitial fluids, the small amount of sodium in the cells begins to migrate out of the cells into the interstitial fluid. The cell does not keep a great reserve of sodium in order to maintain its 15:1 ratio of potassium to sodium. As the sodium is pulled from the cell, water escapes as well. This leaves the cell dehydrated and sodium deficient. In order to keep the sodium/potassium ratio constant inside the cell, potassium begins to migrate out in small quantities. However, each cell has minimum requirements for the absolute amounts of sodium, potassium and water necessary for its proper function. Cell function suffers when these requirements are not met, even if the proper ratio is maintained.

If you have an electrolyte imbalance, you must be careful how you rehydrate yourself. Drinking lots of water or liquid without adequate sodium replacement can make you feel worse because it further dilutes the amount of sodium in your blood. Moreover, your cells need salt to absorb fluids. When you are already low on body fluids and electrolytes, try adding salt to your water (about 1/4 teaspoon). Sea salt is a better choice than regular table salt because it contains trace amounts of minerals in addition to the sodium.

rows of sports drinks by Flickr user pbemjestesWhen your aldosterone levels are low and you are dehydrated and sodium deficient, you may also crave potassium because your body is sending you the message that your cells are low on potassium as well as sodium and water. However, after consuming only a small amount of potassium containing foods or beverages, you will probably feel worse because the potassium/sodium ratio will be further disrupted. Avoid soft drinks or electrolyte-rich sports drinks because they are high in potassium and low in sodium, which only add to the imbalance. Further, most ‘hydration’ drinks and sodas contain artificial colors, additives, and unhealthy sweeteners. You are much better off having a glass of water with salt in it, or eating something salty with water to help replenish both sodium and fluid volume.

Image Credits: Rows of sports drinks by Flickr user pbemjestes

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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Sleep Facts and Fiction: The Counting Sheep Myth and Others

Sleep Facts and Fiction: The Counting Sheep Myth and Others

When it comes to sleep advice, it’s important to know what works and what doesn’t. For example: did you know that counting sheep can actually make you less sleepy and more alert? Read on for better alternatives to counting sheep, and for more sleep facts and fiction.

1. If I don’t get enough sleep tonight, I can make it up later.

man sleeping on a benchSleep, unlike money, can’t be saved up and moved around when necessary (though how wonderful would that be?). Perhaps more valuable than money, sleep is essential for good health, daily energy and mental clarity. When you’re not sleeping well or enough (7-9 hours a night is ideal for adults), you accrue a ‘sleep debt’ that is quite difficult to pay back. Stuck in catch-up mode, your tired body and mind pay the price, leaving you feeling flat, groggy and mentally foggy.

2. Being tired during the day is caused by lack of sleep.

Are you sleeping 7-9 hours a night and still feeling tired during the day? Aside from dietary issues, there could be another problem causing your fatigue. Chronic and excessive daytime fatigue can stem from narcolepsy, sleep apnea, thyroid issues, adrenal hormone imbalance(s), and viruses, among others. Chances are the condition can be treated, so speak with your physician about options so you can start getting your energy back.

blood pressure monitor3. Conditions like diabetes, depression and hypertension have nothing to do with quality of sleep.

Poor sleep is linked to many health conditions, physical and mental. For example: lack of sleep is linked to inadequate hormone production; as the amount of hormones released decreases, the chance for weight gain increases. Your blood pressure is typically lower when you’re asleep. Poor sleep can cause higher blood pressure at night, which can lead to cardiovascular issues. It’s also been shown that poor sleep interferes with the body’s ability to manage and control blood sugar, which can lead to hypoglycemia and even diabetes.

4. The older you get, the less sleep you need.

As you get older you may notice you sleep less or find it harder to stay asleep, though your need for sleep (7-9 hours nightly) hasn’t changed. Since older people tend to sleep less at night, they tend to sleep more during the day. And this isn’t a bad thing; in fact, regular naps can be beneficial in promoting alertness and maintaining energy levels.

5. When you’re asleep, your brain turns off.

Your body is at rest during sleep, but your brain remains very active, even while resting. When you sleep, your mind drifts between two states: REM (the deepest, most relaxing sleep) and non-REM. REM sleep is also where dreams happen, breath and heart rates increase and fluctuate, and muscles relax. The brain is the conductor of all these activities, so needless to say it remains quite active while you’re snoozing away.

flock of sheep6. If you can’t fall back asleep, lie in bed and count sheep.

It turns out that counting sheep and other such mental activities can be more distracting than relaxing. Instead, imagine a calm, peaceful scene. Regardless of your technique, most experts agree that if you fall back asleep within 20 minutes, try something else. Go to another room and do something relaxing, like reading or listening to soft music. Avoid watching the time; it can make you feel anxious and unable to rest.

7. Snoring isn’t harmful; it’s just an annoying habit of my significant other.

Sometimes snoring is just snoring, but it can be caused by something like sleep apnea, a condition that inhibits airflow while sleeping. This irregular breathing pattern lowers blood oxygen, which puts a strain on the heart. This is one way frequent and chronic snoring has been linked to hypertension. There are treatment options available for sleep apnea. If you or someone in your home snores regularly, speak to your physician about it.

8. Insomnia means you can’t fall asleep.

Though technically true, difficulty falling asleep is only one of four symptoms generally associated with insomnia. Symptoms also include frequent awakenings, inability to fall back asleep and waking up feeling unrested. When insomnia symptoms occur frequently or hamper your ability to function on a daily basis, it’s time to speak to a professional. Fortunately, the root cause of the insomnia can often be treated.

For more, visit the National Sleep Foundation website: sleepfoundation.org

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Sleep Disruptions Can Be Caused by Stress and Adrenal Function

Sleep Disruptions Can Be Caused by Stress and Adrenal Function

One major thing I have gained from Dr. Wilson’s vast understanding of the role of hypopthalmic, pituitary and adrenal function (the HPA axis) is that an excellent night’s sleep is very much the result of a balanced HPA axis. If you suffer from a cortisol imbalance, you will not only have energy disturbances, you will have sleep disturbances! Do you have an issue with sleep? Then please read this article. I know it may seem a bit top heavy on the technical side, but if you slowly go through the material it will make a lot of sense. You can gain a great amount of understanding about stress, insomnia and energy by understanding Dr. Wilson’s work. Here is an excellent article from Dr. Wilson regarding sleep and cortisol. -Eric Bakker, ND

insomnia by Flickr user alyssafilmmakerStress and adrenal function affect sleep, particularly the circadian pattern of cortisol secretion by the adrenal glands. Circulating cortisol normally rises and falls throughout the 24 hour daily cycle, and is typically highest at around 8 AM and lowest between midnight and 4 AM. Both high and low nighttime cortisol levels can interrupt sound sleep. Stress normally causes a surge in adrenal hormones like adrenaline and cortisol that increase alertness, making it more difficult to relax into sound sleep–especially when they remain high or rise and fall irregularly through the night. Frequent or constant stress can chronically elevate these hormone levels, resulting in a hyper-vigilant state incompatible with restful sleep.

If this is the reason for poor sleep, anything that reduces stress and enhances the ability to handle stress may improve sleep. This can include relaxation, breathing and/or meditation techniques, certain yoga postures, healthy lifestyle changes, and stress-relieving life alterations. Refraining from vigorous exercise in the evening and taking time to consciously relax before going to bed may calm the adrenals and help lower cortisol and adrenaline levels.

When the adrenals fatigue, adrenal hormone levels may become low, leading to another possible source of nighttime sleep disruption–low blood sugar. Cortisol plays an important role in maintaining blood sugar (glucose) levels around the clock. Although blood glucose is normally low by the early morning hours, during adrenal fatigue cortisol levels may not stay sufficient to adequately sustain blood glucose. Low glucose signals an internal alarm (glucose is the main fuel for all cells, including brain cells) that disrupts sleep so the person can wake up and refuel.

Low nighttime blood glucose can also result from inadequate glycogen reserves in the liver. Cortisol causes these reserves to be broken down into glucose that is then available to the cells. When low cortisol and low glycogen reserves coincide, blood glucose will most likely drop, disrupting sleep. Waking between 1 AM and 3 AM may indicate low blood sugar resulting from inadequate glycogen reserves in the liver, low adrenal function and cortisol, or both. This is often the culprit when panic or anxiety attacks, nightmares, or fitful, restless sleep occur between 1 and 4 AM.

If low blood sugar is disrupting sound sleep, supporting healthy adrenal function and dealing with the adrenal fatigue may contribute long term to sound sleep. Also having a healthy snack before bed can help fortify the body’s nighttime energy reserves. The snack should be one or two bites of food that contains protein, unrefined carbohydrate, and high quality fat, such as half a slice of whole grain toast with peanut butter or a slice of cheese on a whole grain cracker. Eating or drinking sugary, refined foods will only aggravate the problem. Sometimes exercising before bed can help, since exercise tends to raise cortisol levels. (more on blood sugar and adrenal function)

Lack of sleep can be a significant body burden that, in itself, can contribute to adrenal fatigue. Every time the wake/sleep cycle is altered, it takes several days to weeks for the body and cortisol levels to adjust. In fact, sleep ranks with diet and regular exercise as an essential component of a healthy life. People on alternating shifts with less than three weeks between shift changes are continually hammering their adrenal glands and may become very susceptible to adrenal fatigue.

Chronic lack of sleep is now regarded as a health hazard and has been associated with several possible health consequences. These include lowered immunity with increased susceptibility to infections, impaired glucose tolerance, low morning cortisol levels, and increased carbohydrate cravings. Lack of sleep can also elevate circulating estrogen levels, upset hormonal balance, and slow healing and prolong the recovery period. These are in addition to the decreased alertness and concentration that most people experience when missing an inordinate amount of sleep.

The consensus from research and clinical observation is that it is necessary to sleep an average of eight hours per day. Some people need even more in the beginning phases of recovery from adrenal fatigue. A saliva cortisol test done at night and compared with daytime levels and with the test standards for those times will help determine if either high or low cortisol may be interfering with sound sleep. If cortisol is a likely culprit, cortisol levels will be significantly higher or lower than normal for those times.

Image Credits: Woman with insomnia by Flickr user alyssafilmmaker

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Metabolic Syndrome: Symptoms, Causes and Tips for Support

Metabolic Syndrome: Symptoms, Causes and Tips for Support

measuring tape around a large stomachMetabolic syndrome (also known as syndrome X and prediabetes) is a progressive disorder that can lead to heart disease, stroke and diabetes. With obesity on the rise, it is estimated that around 30% of the U.S. population has metabolic syndrome. This syndrome occurs when three of the following conditions are experienced concurrently:

  • High blood pressure
  • High fasting glucose
  • High levels of serum triglycerides (bad cholesterol)
  • Low HDL (the good cholesterol) levels
  • Weight gain in the stomach or abdominal area

Causes of Metabolic Syndrome

In addition to aging and genetic predisposition, many factors, such as daily consumption of foods high in sugar and fat combined with lack of exercise, can contribute to the development of metabolic syndrome. The pervasive stress of modern life is a powerful common denominator that, when added to these unhealthy lifestyles, accelerates their adverse effects on health and greatly increases the likelihood they will result in metabolic syndrome.

Modern Stress

The modern stress overload from economic, environmental, social and psychological factors can rarely be resolved by physical action. However, because human physiology has not changed much in the past 100,000 years, your stress response system is designed for the kind of physical threats to survival experienced by early man that required a physical “fight or flight” reaction. Every stress you experience, whether it’s a sleepless night or an overdue bill, triggers a chain reaction that prepares you to physically respond to the stressor. Without physical action in response to stress, these HPA axis-regulated adjustments can disrupt metabolic balance over time, as well as lower stress tolerance.

Stress, Cortisol and Insulin Resistance

insulin needle by Flickr user feathy123The adrenal stress hormone cortisol is the primary instigator of the physiological changes that occur with stress, and in the process it interacts with other hormones like insulin. Cortisol and insulin work together to increase energy, but have opposite effects on blood sugar. Cortisol raises blood sugar by triggering the conversion of stored energy (glycogen) into glucose (blood sugar). Glucose is the source of energy used by most cells in the body. Insulin helps move the glucose from the blood stream into the cells, thus lowering blood sugar. When cortisol goes up (as it does during stress), blood sugar goes up; and when blood sugar goes up, insulin does too. However, when insulin is high too often or for too long, the cells develop insulin resistance. This means they become less sensitive to the effects of insulin in order to protect themselves from the harmful effects of too much glucose.

With less glucose getting into the cells, the resulting elevated blood sugar triggers increased insulin, further aggravating insulin resistance. In addition, less glucose in the cells triggers hunger, which often translates into cravings for carbohydrates. Both a diet high in refined carbohydrates and the elevated cortisol levels from frequent stress can produce a vicious cycle of insulin resistance. When chronic stress and poor diet combine with a sedentary lifestyle, they become an irresistible force driving the body, over time, towards metabolic syndrome and a variety of related health problems, including cardiovascular disease and diabetes.

Weight Gain, Insulin Resistance and Stress

A prolonged cycle of stress and insulin resistance usually leads to weight gain, particularly belly fat. Although the reasons are not fully understood why this weight tends to accumulate in the chest and abdomen (visceral fat), several physiological mechanisms conspire to create this spare tire. Rising cortisol from stress increases blood sugar and causes hunger which may lead to overeating. Both cortisol and insulin play complex roles in storing any excess energy (like blood glucose) as visceral fat to meet future needs. Compared to other fat cells, deep abdominal fat cells have greater blood flow, more cortisol receptors and higher levels of an enzyme that increase cortisol’s fat-storing activity within these cells. All of these factors contribute to further belly fat accumulation. In addition, rising insulin inhibits fat burning hormones, like growth hormone, and signals the body not to release any stored fat. This chain reaction both encourages visceral weight gain and makes it more difficult to lose weight, especially when there is little physical activity.

Metabolic Syndrome Prevention and Support Tips

The three keys to managing metabolic balance are: maintaining a healthy weight; managing stress; and exercising regularly. Together these factors provide the best long-term solutions to moderating blood pressure and blood sugar, promoting normal fat and carbohydrate metabolism, and maintaining a healthy cardiovascular system.

Dietary Guidelines for Weight Management

fresh vegetables by Flickr user OlearysHave small regular meals and chew well. Here are some tips on foods to include:

  • Low carb (low glycemic), unrefined foods
  • Oils high in Omega 3
  • White meat, fish, legumes, nuts and seeds
  • Plenty of vegetables (5-6 servings a day)
  • High potassium foods (most seeds, vegetables and fruit)

And foods to avoid:

  • Caffeine (stimulates cortisol)
  • Sugar and refined carbs (stimulates insulin)
  • Partially hydrogenated oils (disrupts healthy fat metabolism)
  • Reduce calories, fat and sodium

Lifestyle Tips for Stress Management

  • closeup of man meditating on yoga matEliminate as many sources of stress as you can
  • Limit contact with energy robbers (people, environments
    and activities that leave you feeling drained)
  • See the stressors you can’t get rid of in a more positive light
  • Laugh more
  • Make time to just relax (even if it’s only for 10 minutes a day)
  • Practice some simple breathing and meditation techniques daily
  • Don’t do anything else while eating (no TV, work, or texting)
  • Prioritize
  • Learn to say no

Exercise for Weight & Stress Management

Exercising 30-40 minutes a day helps normalize cortisol, insulin and blood sugar, and reduces belly fat. Combine the following:

      • Aerobic (vigorous walking, jogging, swimming,
        dancing, Zoomba)
      • Anaerobic (weights, isotonic, Pilates)
      • Flexibility (yoga, stretching, tai chi)

Dietary Supplements for Stress and Metabolic Balance

Having the right kind of supplemental support in addition to following the dietary, lifestyle and exercise guidelines described can significantly enhance your ability to handle stress and maintain metabolic balance. These supplements should:

      • Promote balanced HPA axis function and blood sugar metabolism
      • Replenish the nutrients used up by stress
      • Support adrenal function
      • Provide extra vitamin C and antioxidants
      • Supply fish oil high in Omega 3

Image Credits: Insulin needles by Flickr user feathy123; Vegetables by Flickr user Olearys


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