The relationship between adrenal fatigue and hormone balance
If I had a dollar for every woman who told me they hate having to menstruate because of their terrible symptoms of heavy bleeding, PMT and pain, I would probably not be that rich in today’s inflated economy, but it would make a nice contribution anyway! Ask each of those women whether she also feels constantly exhausted, having to crack the whip at themselves just to get through each day, and it’s likely that we become aware of a relatively silent epidemic – that of underlying adrenal fatigue.
Today’s lifestyle seems to have a destabilizing effect on women’s hormones and energy systems. Many of these women go from doctor to doctor and are told they’re just tired and to get more sleep. They may walk out the door with a prescription for the oral contraceptive pill, or thyroid medication. Occasionally the doctor will order certain tests, and if the doctor is enlightened there may even be a recommendation for an iron supplement, or even a referral to someone who might be able to support them at a deeper level.
I am often seeing women in my practice who tell me that they were fine until they had kids, and then all their symptoms started. I also see this in younger women without kids who have been through an emotionally traumatic time, only for their cycle to change for the worse and their energy levels plummet. I’m not going to tell you I have all of the answers for everyone suffering from these issues, because it’s all so complex and everyone is different. What I can do is give a little bit of background in this blog as to why these things might be happening.
It all starts with adrenal fatigue
I think we can all agree that conventional medicine is fantastic for saving lives in an emergency. The medical term adrenal insufficiency is the name for a condition that is extremely debilitating and must be treated very differently to adrenal fatigue, which is not widely recognised in conventional medical literature.
Most of us, thankfully, don’t end up with clinical adrenal insufficiency. But many of us end up adrenally fatigued after too many late nights, juggling work and family, eating crappy food on a regular basis and ignoring the signals of our bodies telling us we need to slow down and rest. Those of us who have had multiple pregnancies are particularly prone to adrenal fatigue, as it can take years for our bodies to recover from the rigours of pregnancy, birth and breastfeeding.
It is very difficult to test for adrenal fatigue, which might be why it hasn’t been acknowledged by most doctors, but then neither have many other women’s complaints such as endometriosis, vulvodynia and of course the many complaints of menopause.
Here is an article that goes into more detail about testing, which is beyond the scope of today’s blog. What we are dealing with in adrenal fatigue is low grade, chronic and subclinical (meaning it doesn’t show up on standard adrenal testing) depletion of the adrenal glands, which means that testing isn’t necessarily going to give you a cut and dried answer.
What do the adrenal glands do?
Our adrenal glands are like our power-houses of energy. Sitting just above the kidneys, they synthesise hormones that stimulate us to wake up in the morning and sustain our energy throughout the day. When our adrenals are in a healthy state, we sleep well and wake up refreshed at a reasonable hour every morning. When depleted, we are, ironically, often faced with difficulties sleeping, poor sleep quality and a constant feeling of underlying irritability and exhaustion. Drinking coffee or other caffeinated beverages to boost us up so we can function is a little like taking out an ever increasing bank loan, as caffeine forces the adrenals to pump those hormones out regardless of how much in the way of reserves we have.
Given that no one system in the body works in isolation of the others, exhaustion and issues with sleep are only two of a wide variety of possible types of fallout accompanying adrenal fatigue. Others are symptoms associated with chronic, low grade inflammation and hormone imbalance (more on that later) such as joint pain, weight gain, blood sugar imbalance and issues with female reproductive hormones. We will go into some of these in more detail later.
The main hormones that the adrenals synthesise are adrenaline, cortisol and DHEA. There are others but we are going to keep it simple, and the others assist in the actions of these main three. We all know something about adrenaline (called epinephrine in some literature), which can be stimulated by drinking caffeinated beverages, exercise and of course states of fear or stress. Most of us would have experienced the adrenaline shakes when our body is overloaded with the stuff. Some people even develop an addiction to it and are known as adrenaline junkies.
Adrenaline causes your heart rate to increase rapidly, sending a rush of blood to your muscles and certain parts of the brain involved with more primitive responses such as those involved in “fight/flight” reactions. In doing this, blood is diverted from your digestive organs and higher functioning parts of the brain such as your rational mind.
Adrenaline also causes stored sugars in the liver to break down into readily available glucose in the blood for the muscles to use when you run from that woolly mammoth or sabre-toothed tiger. Unfortunately, these days, many of our stresses are ones that are not fixed by running away or fighting in the physical way, which would use up all the increased nutrients so intelligently made available for our body to ensure its own survival in the wild. So, all of those sugars floating around in the blood are then having to be broken down again. Unfortunately, if we are suffering from chronic stress, it can cause so many blood glucose spikes that it’s too difficult for the body to deal with, which can over the longer term be incredibly damaging for our health and lead to chronic diseases like type 2 diabetes.
When you combine adrenaline with cortisol in a constant way over a long time, it further compounds the issues. Cortisol also raises blood glucose. It suppresses the immune system and inflammation. You might think that suppressing inflammation is good, but actually physiologic inflammation (or the body’s natural inflammatory response to a genuine issue), is a vital part of healing.
In fact, chronic, long term stress actually contributes to chronic underlying inflammation which is the type you really don’t want. As for immune system suppression, many of us know someone who has undergone a major trauma, only to develop a chronic disease a few months later.
Unfortunately, the reality is that our bodies are not coping well with this lifestyle of ours which tends to ignore the natural cycles of day and night, rest and action, and lack of exercise.
Blood pressure, cardiovascular disease and cortisol
Cortisol also increases blood pressure. Anyone who is under chronic and severe stress will notice an increase in blood pressure, which combined with chronically high blood glucose levels, increased chronic inflammation and suppressed immunity is a disaster waiting to happen.
To add insult to injury, cortisol also causes the breakdown of fats, which might be great if your stress is short term and you need ready nutrients. But when your cortisol levels are chronically high it makes your body deposit fat in places where we would rather it not go, like the abdominal region. Part of this is also as a result of elevated blood glucose levels as well.
The damage caused by a prolonged stress response also has special significance for those practicing extreme sports and extreme diets. Did you know that if you consistently eat far less than what your body needs, and/or over exercise, you are putting yourself into a high stress state and your body will conserve calories, as well as increase blood cortisol levels, which will increase your chances of depositing fat in the belly region? Moderate dieting and exercise have been shown to be more effective at reducing weight and while there are no quick fixes, you’re better off going slow, especially if you are suffering from adrenal fatigue.
Another issue here is that cortisol and adrenaline channel blood away from the digestive organs, reducing stomach acid and other digestive secretions. This means that if you are under chronic stress you won’t be digesting well, which can lead to chronic inflammation of the gut, damage of the gut membrane, issues with absorption of foods, less than desirable changes to bowel habits and weird cravings that might give a temporary boost but don’t do your long term health any favours. When under stress we tend to head towards high carbohydrate foods which are easy to eat and quick to digest. We crave substances that help us distance ourselves from our stress such as low quality chocolate and alcohol (all the better if it’s high carb like wine). Those foods might make us feel better for a short time, but in the long term they can be a disaster for our gut function, blood sugar balance, hormone function and moods.
Then there’s DHEA, which is a hormone that acts in a similar way to cortisol, allowing our bodies to deal with stress. DHEA is also a precursor to estrogen and testosterone. If cortisol levels are chronically high, it can suppress DHEA, which can be just one of the factors that can throw our reproductive hormones out of balance.
Before I go on to explain any more, I want to say a quick word about the thyroid gland. Actually, the thyroid deserves a whole lot more than a quick word, but for the sake of this blog we will touch on it briefly, in relation to the effect adrenal fatigue has on thyroid function.
Most people, when they feel cold all the time, put on weight, are prone to constipation, and feel tired and depressed are told to get their thyroid tested. It’s still very important to go to your doc to get thyroid testing if you have these symptoms. But it’s also vital to know that a low functioning thyroid can be as a result of reduced adrenal function. This link is a great resource for understanding more about the connection between adrenal function and thyroid function.
Most doctors will put patients with reduced thyroid function on supplemental thyroid hormones without checking adrenal status. It is likely to work for a while, but in a similar way to coffee, where thyroid hormone flogs the adrenals to secrete more stress hormones. Eventually the treatment will stop working if the underlying issues haven’t been addressed, and supporting the adrenals can make huge differences in thyroid function if there is underlying adrenal fatigue.
Adrenal fatigue and reproductive hormones
As we saw above, DHEA is a precursor to many of the sex hormones (and just out of interest, cholesterol is a precursor to DHEA). Low estrogen is less common than too much, but a lack of estrogen can also cause all kinds of issues as well, especially in menopause. There is the situation of increased androgens and blood sugar in the case of polycystic ovarian syndrome, but that’s adding even more complication to the issue so we’ll focus on the more common excessive estrogen.
We are bombarded by estrogenic substances from the environment in the form of plastics and other chemicals. We struggle to break down these artificial estrogens (called xeno-estrogens), especially if our liver isn’t working at its full potential.
Estrogen and progesterone, in a healthy woman, are in a delicate state of balance. If we have all of our cortisol and DHEA going into the stress pathway, there won’t be enough left to make progesterone which is sometimes referred to as our happy hormone. To put things into a very oversimplified nutshell, progesterone opposes or balances out the action of estrogen. If we don’t have enough progesterone to balance out estrogen, we are left with the see-saw tipping too much in estrogen’s favour which can lead to bloating, weight gain, water retention, moodiness, heavy periods, and encouragement of all kinds of growths to grow. These can be benign such as fibroids and polyps etc, but high estrogen levels have also been linked to certain types of cancers. And given the amount of artificial estrogens in our environments, as well as in contraceptive medications, most of us really don’t need any more estrogens.
If the liver is not functioning well, which can occur as a result of high chronic stress (as well as all of the other insults we heap upon it from alcohol, crappy food and trans fats etc), we are even more unlikely to be able to break down the excess estrogen, which then builds up in our bodies and causes havoc.
Another issue with excessive estrogens is that they tend to increase a substance called thyroxin binding globulin, which grabs onto thyroid hormone and renders it unable to be used, therefore further slowing down the thyroid.
We haven’t even mentioned libido yet, but after reading the above complex mess, I can imagine the last thing you’re thinking about right now is sex. And if you’re adrenally fatigued you won’t exactly be tapping your partner on the shoulder in a hurry either. Due to the imbalance of reproductive hormones, exhaustion and general snappishness, it’s likely that anything not considered necessary for basic survival is off the list.
How to address adrenal fatigue
So, now that we understand a bit more about our bodies, what can we do about the problem? Well, more coffee definitely won’t help. In fact, it’s likely your natural therapist will advise you to stay away from caffeinated beverages, at least in the beginning, so that you don’t get a false burst of energy that will drain your adrenals further.
It is vital to follow sleep hygiene to the letter, especially if you’re suffering from poor sleep quality or insomnia. Here’s a blog I wrote earlier about how to improve your sleep.
Sooooo, I will confess something very un-nutritionist-like here. I am actually an ex sugar addict, but don’t tell anyone! My addiction was a direct result of a very stressful situation early on in my life, switching on the chronic fight/flight pathway, so I have some experience with all of the above issues.
I ended up having to stop eating anything containing sugar because sucrose and fructose can cause quite extensive nerve damage due to hyperstimulation of the nervous system. In plain English, it means that sugar acts in a similar way to caffeine and can contribute to insomnia, mood disorders and can also disrupt hormones. It is imperative that if you want to support your adrenals, you absolutely must stop eating sugary foods.
Eating the rainbow of fresh veggies is also super important. I know it’s the last thing we feel like after a stressful day, to spend ages chopping things up (unless we imagine that we are chopping up the object of our stress while we’re doing it), but I cannot say it enough. Our body needs nutrients. Sugar, stress, alcohol, processed foods and tea/coffee all leech our bodies of nutrients, meaning we are constantly running below par.
Getting enough quality protein is also vital. Lean, grass fed meats, eggs, wild caught fish, organic chicken and good quality legumes prepared in the correct way are essentials in a good diet. For vegetarians and vegans, they need to work harder to ensure they get the right amount of protein, but you can achieve a great balance of nutrients without meat.
Quality fats, such as omega 3 (in quality deep sea wild caught fish), and unprocessed oils are also incredibly important. It turns out that fats are not the bad guys we’ve been told to fear and avoid at all costs. Lashings of quality, grassfed butter are NOT unhealthy in a balanced diet, and the low fat way of eating has been shown to increase sugar cravings and carb intake, which then of course can lead to increases in the “bad” cholesterol. Once we have a diet with enough quality fats and protein and veges, you may also be surprised to see cravings reduce. After all, cravings are often signs that our bodies are out of balance in some way.
You might even find that find your energy levels increase with an improvement in your diet alone.
Most of us are chronically depleted in magnesium, especially if we have been breastfeeding or in a state of long term stress. The body finds it hard to hold on to magnesium when under stress. Adults typically need around 400mg per day. A good magnesium supplement can go a long way towards supporting better sleep, improving muscle function, balancing blood sugar, assisting in moods and hormone balance, among many other benefits.
The adrenals use up lots of vitamin C, especially when we are under stress. Vitamin C also reduces damage at the cellular level and boosts our immune function. Taking 2-5g of vitamin C daily is a win-win for all.
A good quality iron supplement can work wonders if you suffer from exhaustion, heavy periods, or feel easily winded during exercise. Iron deficiency anaemia is very common and many women don’t know that they have it. And just to remind you, the lower the iron the heavier the period, ironically! A quick test is to stretch out your palm. If the creases are pale, then it’s likely you’re running low. A blood test will give you a better idea and is more accurate if you feel you might be exhausted because of low iron.
A quality B complex is essential for assisting with so many bodily functions I cannot even begin to list them. For those under extreme stress, our bodies churn through all the B’s at a much faster rate. Make sure you know that you don’t have any methylation issues, because most B vitamins are made for people who do not have MTHFR, and folic acid can cause issues for some people.
Zinc is also vital to support not only the nervous system, but also is a super important nutrient that helps the conversion of many different hormones, as well as being absolutely necessary for effective immune function. Zinc is also essential for helping in gut and wound healing, and can also oppose many toxic metals. Conversely, if there are toxic heavy metals in the system, zinc supplementation is needed to ensure your stores are sufficient as these toxins, especially lead and mercury, can stop zinc from being absorbed or utilised in the body. Zinc is also essential in pyrrole, which seems to be becoming more and more common as a result of our lifestyle and environment.
Tissue salts can be found at most health food shops and pharmacies. These little powerhouses of awesome-ness can help the body better absorb and utilize various minerals, bringing gentle support to many underlying metabolic imbalances. It’s important to know that while tissue salts can be slow to work (you need to persist for over 12 weeks), they can have a very powerful positive effect on your health.
Tissue salts that can be of fantastic support for adrenal fatigue include Ferrum Phos, Mag-Phos, Kali-Phos, Nat-Phos and Nat Sulph. Try putting a pill of each into your drink bottle each day to sip on.
Other nutrients can also make an enormous difference, such as iodine, vitamin D and Vitamin K, although this section would be a mile long if I went into all of them and it can get quite complicated when you try put them all together in an individual regime appropriate for your specific issues… But I guess that’s what a nutritionist is for 🙂
Homeopathic remedies for supporting adrenal fatigue and hormone balance
It is recommended that you see a registered homeopathic practitioner for a specifically tailored homeopathic remedy or group of remedies that match your symptoms. There are many homeopathic remedies that can be very useful for assisting in recovery from adrenal fatigue. Having used homeopathic medicine myself to heal from adrenal fatigue, I can tell you that the remedies can have a remarkable effect on the symptoms as well as the underlying condition. There are also remedies which can help support hormones, reduce excessive bleeding during menstruation and assist in moods.
Of course, doing all the above without reducing stress levels isn’t going to fix the problem. There are many meditation and stress reduction apps online to choose from, which can be of great help, especially the Yoga Nidra ones, as apparently practicing Yoga Nidra for twenty minutes gives similar benefits as an entire night’s sleep. Here is an example. But nothing beats getting out into nature. A gentle walk on the beach or through the bush, or even lying under a tree in your local park are all great ways of reducing stress. If you have a dog or cat (or other type of pet), cuddling your fur baby is also a fabulous way to reduce stress levels.
Horsing around with the kids instead of yelling at them always works for me, as long as I can remember not to start off grumpy after a tough day or bad night’s sleep.
And of course doing your best to ensure a healthy work/life balance is crucial.
If you’re struggling to get anywhere with your adrenal and hormonal issues, seeing a professional therapist specializing in adrenal fatigue and hormone balance is advised. Because as you can see from the above, it is a very complex tangle of problems and further testing and treatment may be required.
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