By Bridget Casey, ND
What are the adrenal glands and why are they so important?
The adrenal glands are two small, pyramid-shaped glands that sit on top of the kidneys. While these glands are relatively small, they are hugely important to various body systems and functions and I personally believe they are one of the most important, yet underappreciated, glands in the human body. In fact, I find that most people have not even heard of their adrenal glands. (I hadn’t either until I went to medical school!). Conventional medicine rarely addresses these glands unless there is a frank disease state such as Cushing Syndrome (hyper-functioning adrenal glands usually caused by a pituitary tumor) or Addison Disease (hypo-functioning adrenal glands usually resulting from an autoimmune disease). While addressing disease states is of course hugely important, I am also a believer in optimizing function and promoting good health – which often involves optimizing adrenal health. Here are some of the areas in which the adrenal glands play a major role:
- Blood pressure and fluid balance
- Blood sugar and glucose control
- Stress response and cortisol levels
- Circadian rhythm
- Energy levels
- Mood stability
- Reproductive hormone balance
- Thyroid function
- Inflammation and pain control
As you can see, these little glands play a big part in how we feel on a day-to-day basis and this is why I feel they are KEY to achieving and maintaining health and well-being.
The adrenal glands (or “adrenals”) are multi-layered glands, which produce a variety of hormones and substances which have various widespread effects. Here are the major compounds and their effects:
- Adrenaline (epinephrine) and noradrenaline (norepinephrine) – this is the name-giving substance produced by the center of the adrenal glands, in response to the sympathetic (aka “fight or flight”) mode of the nervous system. If you see a lion in your midst, this is what you’re feeling coursing through your veins. Epinephrine and norepinephrine are the neurotransmitters that give you quick-burst energy, excitability, responsiveness, etc.
- Aldosterone – this steroid hormone talks to the kidneys primarily to regulate blood pressure, blood volume and electrolyte concentration.
- DHEA – sometimes referred to as the “youth hormone,” this is the precursor to most sex hormones produced by the adrenal glands, including testosterone and estrogen. It has a balancing effect on cortisol and becomes of primary importance with aging, as adrenal gland production of sex hormones increases relative to declining ovary or testis function.
- Cortisol – this is the famous “stress hormone.” Similar to epinephrine and norepinephrine, this is also secreted in response to an acute stressor, but it is also produced and excreted in response to low-level and/or chronic stress (after the adrenaline is used up or wears off). Like most things in the body, we need some cortisol – not too much, not too little. In the right amounts, cortisol has the following actions in the body:
- Wakes us up in the morning (major player in our circadian rhythm)
- Raises blood sugar when it dips
- Maintains blood pressure (especially when standing)
- Reduces pain and inflammation
- Provides resistance to acute or chronic stressors (like infection, extreme temperatures, trauma, etc.)
However, over time, too much cortisol can lead to issues like:
- Weak connective tissues and difficulty healing
- Weak bones
- Growth inhibition
- High blood pressure
- Mood, cognitive and memory issues
- Blood sugar dysregulation
- Low libido
- Low sex hormone levels – including infertility and menstrual disorders
- Thyroid dysfunction
- Abdominal adiposity (fat)
- Skin thinning
- Immune suppression
As with most biological molecules, the hormones produced by the adrenal glands eventually need to be processed (metabolized) and, for the most part, excreted from the body. The majority of this processing occurs in the liver and the majority of the excretion happens in the kidney/urinary tract. Hence, liver and kidney function are paramount to maintaining proper levels of adrenal hormones. Here is a more inclusive list of factors that can interfere with adrenal function:
- Chronic unmitigated stress (aka nervous system imbalance)
- Medications – especially steroid-hormone-based meds like prednisone, hydrocortisone and the birth control pill
- Thyroid issues (both hyperthyroidism and hypothyroidism)
- Diabetes and blood sugar dysregulation
- Malnutrition (especially low protein levels and low cholesterol)
- Liver dysfunction
- Kidney dysfunction
- Abdominal adiposity (fat)
- Genetic issues affecting enzyme function
- And more!
The Big Picture:
Chronic stress, whether it be physical or psychological, initially causes adrenal “hyperfunction” where the glands are firing at a high level. This is what it means to be in “fight or flight” mode and if you were to measure the cortisol output here, it would typically be high. What tends to happen next is miscommunication within the endocrine system – particularly between the adrenal glands and the hypothalamus and pituitary glands in the brain. This is what alternative medicine practitioners refer to as “adrenal fatigue” or “HPA Axis Dysfunction.” Personally, I like to call anything on this spectrum “adrenal dysregulation.” Common symptoms I see associated with adrenal dysregulation include: low energy (this is a biggie!), difficulty sleeping, lack of motivation, chronic inflammation and/or sickness, poor recovery from exercise, low blood pressure, low libido, menstrual irregularities, blood sugar problems and cravings for salt, fat and stimulants.
What To Do:
If you feel that your adrenal health is subpar and you want to work on it, your best bet is to see a naturopathic doctor. Some functional medicine doctors and other health care practitioners are also well-versed in this area.
What do I do with my patients? To determine someone’s adrenal status, I usually do an extensive medical history and intake of current symptoms – as well as functional lab testing and Applied Kinesiology muscle testing, when indicated. Once we have determined where someone is on the adrenal health spectrum, we can decide how to best support the healing process. This typically involves a combination of the following…
Natural Therapies to Support Adrenal Health
- Lifestyle recommendations, such as stress management techniques and circadian-rhythm supporting habits
- Blood-sugar control via dietary modifications
- Nutritional support for the adrenal glands (with vitamins like B3, B5, B6, Folate, B12 and C and minerals like copper, zinc and magnesium – all of which are used by the adrenals)
- Herbal therapies – particularly with a group of herbs called “adaptogens” – aptly named because they help the body “adapt” to and handle stress by supporting the adrenals. Some of my favorites in this category include licorice, holy basil, ginseng, rhodiola, ashwaganda, astragalus and eleutherococcus
- Glandular therapies or homeopathic remedies specific for the adrenal glands
- Endocrine support – support for other major endocrine glands like the ovaries or testes, thyroid and pituitary is commonly needed to achieve proper hormone balance
Recovery time varies depending on the person, but most folks report a marked decrease in symptoms and an increase in feelings of well-being after addressing adrenal health issues. In addition, many take the lessons of maintaining adrenal health with them, and can fend-off future issues by implementing the lifestyle habits they have developed during this process.
If you think you might be struggling with adrenal dysfunction and you live near Providence, Rhode Island – come in and see me! I love working with folks on this and helping them get their adrenal mojo back!