Feeling Tired? Stressed? Adrenal imbalance may be the cause - PartII
By Dr. Martin Gleixner, MSc, ND
Feeling over-stressed and over-worked? Also experiencing declining energy levels? Are multiple cups of coffee a necessity to get through your workday?
In today’s society, symptoms of tiredness and ‘burnouts’ are reaching epidemic proportions. Despite our best attempt to explain certain health conditions with modern science and medical research, the cause of such symptoms can remain elusive while conventional treatments are often unsuccessful.
I introduced the topic of ‘adrenal dysfunction’ in a previous column. In that article, I provided a general overview of adrenal gland imbalances, their causes, and a review of appropriate lab/saliva testing to obtain a proper diagnosis. I also discussed the importance of using a multifaceted approach in treating adrenal gland imbalances.
The top priority in properly treating any health condition is to address the causes of the disease. When someone has an acute infection for example, it is often helpful to determine the type of bacteria so that the most appropriate treatment can be determined. In a clinical setting (i.e. doctor’s office), chronic health conditions are primarily addressed not by treating the cause(s) but rather easing the symptoms. Although I maintain the importance of providing relief from unpleasant symptoms, patients now expect more from our medical system. As a Naturopathic Doctor, I conduct extensive detective work to determine which imbalances in the body contribute the most to one’s health challenges. Many patients appreciate my detective skills and some have even called me the naturopathic version of the MD on the T.V. show “House”. Through extensive detective work, many imbalances in the body can be revealed.
In this column, let’s review the causes related to adrenal related problems and provide an example of treating a problem by ‘thinking outside the box’. Specifically, I will show how helping patients address inflammation in their bodies can help improve the recovery of their adrenal glands.
Our adrenal glands do not operate in isolation, but rather involve many different systems in the body. Interactions between different systems are becoming so well accepted by scientists that a new branch of medical research called psychoendoneuroimmunology has been created (psycho=mind/emotions; endo=hormones; neuro=nervous system; immuno=immune system). The adrenals therefore interact with our brain and other nervous system tissues, as well as with endocrine glands (e.g. thyroid and gonads) and our immune system. This topic is explained beautifully in Dr. Gabor Mate MD’s book entitled “When the Body’s Says No” who explains how the cost of hidden stress can affect our health.
Based on such interconnections, adrenal problems therefore involve many different symptoms ranging from energy depletion or inappropriate energy levels based on the time of day (e.g. high energy before bed), insomnia, mood changes, decreased exercise tolerance, food cravings, digestive complaints, blood pressure changes, recurring infections, worsening hotflashes, weight problems, increased risk of chronic diseases, among others. For this reason, the term ‘adrenal dysfunction’ should be used cautiously because it involves much more than the adrenal glands themselves and does not only include the symptom of fatigue.
Once your ND confirms the diagnosis of adrenal dysfunction, the next step is to determine which among all the causes are most important for each individual:
- Chronic inflammation & immune dysfunction: inflammatory diseases, infections, tissue damage, autoimmune diseases or from chronic exposures to environmental allergies or food sensitivities/allergies. This topic will be discussed below.
- Inadequate sleep and rest.
- Higher than usual life demands: excess work hours, extra commitments raising children, caring for a sick loved one, relationship difficulties, etc…
- Excess exercising or sedentary lifestyles.
- Perceived or subconscious emotional stresses: such as worry, anxiety, loneliness, depression and a feeling that life is out of control.
- Emotional traumas.
- Modern life stresses such as information overload, technology over-usage, deadlines, job insecurities, multiple task complexities, and incessant noise.
- Chronic illnesses.
- Blood sugar imbalances and related poor eating habits such as irregular eating, missing meals (especially breakfast), and not eating three balanced meals per day.
- Nutrient deficiencies created by chronic digestive tract issues such as malabsorption or inadequate elimination.
- Excess intake of harmful foods such as sugar, refined carbohydrates, saturated fats, processed foods, caffeine, alcohol, etc…
- Chronic exposure to toxins.
- Liver dysfunction (note: the liver metabolism many hormones).
- Polypharmacy or inappropriate use of prescription medications.
Despite medical interventions, statistics are showing that the rate of autoimmune disease, many cancers, allergies, eczema (& other skin conditions) and digestive conditions such as Crohn’s disease is skyrocketing. For example, the incidence of celiac disease, a type of autoimmune condition has more than quadrupled since 1950. All these conditions involve the immune system that is designed to orchestrate inflammation in the body. The term inflammation (like cholesterol for example) has been labeled as been ‘bad’ things. As it turns out, inflammation (& cholesterol for that matter) is essential for life. Inflammation is a normal physiological process because this is how our body is able to repair itself after any type of irritating stimuli (trauma, infectious agent, improper food choice, environmental toxins, etc…). However, if such assaults are too pronounced or continue long-term, they can easily overwhelm our immune system and create inflammation that is out of control. Here are four possible scenarios:
- Chronic inflammation: When inflammation occurs in the body for long enough, it starts to injure cells/tissues and can causes changes in the ability of cells to function appropriately. Osteoarthritis, hepatitis (liver inflammation), atherosclerosis (or hardening of the arteries) and eczema are good examples. Generally speaking, most chronic health conditions involve a certain degree of on-going inflammatory process. Examples include chronic reflux (GERD), gastritis, and chronic sinusitis, to name a few.
- Hypersensitive immune system: If our immune system becomes imbalanced or hypersensitive, the immune system can have increased reactivity to foods, and other allergens. Food sensitivities such as gluten or casein (dairy protein) are commonly diagnosed at the Moncton Naturopathic Medical Clinic and have been found to contribute to many health conditions. Likewise, seasonal or environmental allergies affect many people.
- Dysfunctional immune system: When the immune system is unable to shut off or control it’s own inflammatory processes it can lead to autoimmune reactions. In this situation, the immune system actually reacts to and attacks our own cells in the body. It is very important to evaluate for the presence of an existing autoimmune condition (e.g. rheumatoid arthritis, celiac disease, lupus, diabetes type 1, Hashimoto’s thyroiditis, etc…), exploring one’s family history for any autoimmune disease, reviewing other risk factors for autoimmune conditions, and performing laboratory testing such as the anti-nuclear antibody (ANA) test.
- Certain health conditions appear to involve both chronic inflammation and a dysfunctional immune system: cancer and inflammatory bowel disease (Crohn’s disease, ulcerative colitis) are good examples.
Luckily, certain biological systems are established in the body to help regulate such problems. Among other checks and balances, our adrenal glands help control this inflammation and mitigate its damage by releasing cortisol (& other hormones) in the body. Cortisol’s potent anti-inflammation action quells the fire wherever it may be needed in the body. If the disease is not treated however, the inflammatory process is ongoing and the adrenal glands are called on 24-hours a day to secrete cortisol. Chronic inflammation therefore can prevent our adrenal glands to recuperate. Overtime, the adrenals produce sub-optimal levels of hormones thereby causing a depleted state in the body. If inflammatory problems are not corrected, ‘adrenal dysfunction’ follows.
Please note, that although cortisol helps to initially dampen the inflammatory ‘fire’ in the body, when secreted in excess amounts on a chronic basis, it can actually damage the body. Cortisol therefore has a ‘double edge sword’ like effect in the body.
Addressing health conditions that involve chronic inflammation and immune system imbalances, is often required to improve ‘adrenal dysfunction’. Here are a few clinical examples of patients exhibiting symptoms of adrenal dysfunction (and where other causes for fatigue were ruled out):
- Patient with long-term undiagnosed food sensitivities exhibiting symptoms of irritable bowel syndrome (IBS) such as chronic constipation (e.g. starting since childhood). Only once the offending food(s) were removed and the gut healed, did energy levels returned to normal. In such cases of gut problems, the improved capacity to absorb nutrients was also invariably important.
- Patient with hair loss, anxiety and multiple digestive complaints. Only once a proper diagnosis was achieved for celiac disease and gluten foods avoided, did the adrenals able to recuperate and energy levels return.
- Patients who are left depleted after they have battled through cancer when other causes of fatigue were dealt with (anemia, chemo side-effects, etc…).
- Patient with uncontrolled chronic arthritis. With diet modification and naturopathic botanical formulations to reduce inflammation, adrenal related symptoms improved.
- Overweight patient with hepatitis (liver inflammation). By dealing with insulin resistance and improving the body’s ability to process carbohydrates, this patient corrected their liver inflammation and reduced weight. Symptoms of fatigue related to adrenal dysfunction improved.
Work with your medical doctor and Naturopathic Doctor to prevent chronic disease in the first place via pro-active lifestyle choices. Also explore treatment options that address the root cause of adrenal problems (e.g. inflammation in the body) rather than its end-result (e.g. mood changes by taking anti-depressant medications).
Using an individualized approach that addresses all important factors (see list of causes as shown above) will provide better therapeutic outcomes for ‘adrenal dysfunction’. Improved treatment outcomes aim to optimize your health so that you can thrive in life.
Published by Dr. Gleixner on Wednesday November 19th, 2014 in Times & Transcript. Modified December 23rd 2019.
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