Carefully assessing the adrenal function is important. The ad-renals sit on top of the kidneys and help the body deal with stressful situations. The stress can be physical, mental-emotional or spiritual. When the stress has become long term the adrenal function eventually becomes compromised. It is “fatigued” and its function becomes deficient. Fatigued adrenals have far reaching effects. They can influence thyroid, testicular and ovarian function, result in unchecked inflammation (joint pain, allergies) and impact immune function. I always marvel how the systems in the body are so connected.
The adrenals are multifaceted in their function. Here is a summary. There are two main components of the adrenals: the cortex and the medulla. The adrenal cortex secretes cortisol and dhea (dehydroepiandrosterone). The adrenal medulla secretes catecholamines (epinephrine and norepinephrine). The focus of treatment is primarily on the cortex and restoring cortisol and dhea to a normal level. The secretion of epinephrine and norepinephrine are mediated by the sympathetic nervous system. The adrenals are linked to the hypothalamic and pituitary system. This is known as the HPA axis which, when in balance, is a regulatory feedback system. Often the whole HPA axis needs to be rebalanced.
The brain is connected to the glandular secretion of the body. Appropriate signaling takes place and the individual can adapt to his or her environment. However, often the stress, and-or the perception thereof, is prolonged and the system can no longer maintain an appropriate reaction. The HPA axis can no longer keep up and the symptoms of adrenal fatigue emerge.
Cortisol is secreted to help the individual metaphorically jump over the multiple hurdles in life. Cortisol secretion is the “gas” after the accelerator is pushed on. It is the second wind that some people experience in the evening hours. It helps students get through finals week. It supports a person’s energy level and sense of alertness. It has a diurnal rhythm, meaning it fluctuates with the night and day cycle. Normally it is elevated in the morning and then tapers down towards the evening.
Assessing cortisol function with four evenly spaced salivary samples on a typical day is an easy way to measure levels. In eighty percent of lab results I see sub optimal levels. The other twenty percent have excess cortisol levels. Hyper cortisol function needs a different treatment strategy – namely to down regular the hyper excitation. The goal with treatment of low cortisol levels is elevate them into a normal range. Treatment strategies vary. Usually there is a component of glandular support along with herbal and nutritional medicines. Occasionally cortisol is prescribed.
Dhea is an important adrenal hormone that balances cortisol’s function. Levels of dhea are often deficient along with cortisol. Supplementation is also required. The majority of dhea is secreted by the adrenal glands though the ovaries also secrete it. Dhea supports energy production, immune function, and has general restorative function. It is a weaker androgen and needs to be used with caution in women.
I wish I could offer a simple remedy for adrenal support. However, each patient has unique needs. In clinical practice I consider glandular adrenal extracts foundational to treatment. Herbal extracts and specific nutrients are close seconds. Herbs such as: Siberian ginseng, holy basil, licorice, and rhodiola and at the top of my list. Nutrients such as B vitamins, especially pantothenic acid, and Vitamin C are paramount.
Usually I recommend three to six months of adrenal treatment. Ideally supportive lifestyle changes can be implemented too. These would include eight hours of sound sleep, routine exercise as tolerated and creating harmonious relationships with family and friends. In addition, I recommend eating real whole foods and have a regular meditative practice to restore the mind-body-nervous system function.