HPA axis dysregulation, adrenal fatigue, adrenal dysfunction; so many terms used by health and wellness experts to say that someone is stressed and tired and tired of being stressed. Having crashed and recovered from my own “adrenal fatigue” experience after finishing medical school, I can tell you that it has taken a few years to feel that my system is finally balanced again. Lack of sleep, long study sessions, leading to recurring illnesses; my tired system could no longer cope with the demands of the outside world. It was time I did something to fix it! Today I’m giving you a small insight on the importance of your adrenals and what you can do to help yourself if you are stressed.

What is stress and how do we respond to it?

A stressor can be a major life event, whether positive or negative; it can come from an external source like our school, work, home life, trauma, abuse, suppressed emotions or it can be a physical stressor like a major surgery or body injury. How we respond to a stressor is based on genetics, individual differences, our upbringing and if over time we have developed healthy coping mechanisms or not.

Quick anatomy lesson

The adrenal gland is made of 2 sections: the cortex and the medulla. The cortex makes your steroid hormones like estrogen, progesterone, DHEA, testosterone and glucocorticoids and mineral corticoids like aldosterone responsible for blood pressure management. The medulla produces the catecholamines, epinephrine and norepinephrine(aka adrenaline and noradrenaline) which are regulated by the sympathetic nervous system aka the flight or fight response.

When we experience a stressor, it activates the HPA axis (hypothylamus-pituitary-adrenal axis). This leads to an increase in cortisol. This increase in cortisol leads to a change in our metabolism, immune system, blood pressure, growth and even our reproductive system. Focusing on metabolism and energy today, this rise in cortisol increases our liver’s production of sugar which gives us a boost of energy. Cortisol also actives fat breakdown for more energy and create more fat cells, which is why long term stress can lead to weight issues. A healthy system is able to appreciate that burst of cortisol which rises in the morning and falls at night. A healthy system can cope. But what happens if constant outside or inside stressors are not giving that HPA axis signal a break? No self-care, not eating healthy, no personal boundaries and now our bodies are chronically stressed.

How do some of us respond to chronic stress?

• Sleep deprivation to full blown insomnia.
• Avoiding physical activity or over-exercising.
• Overeating comfort foods, or complete aversion to foods.
• Self-medicating with alcohol, cigarettes, prescription medications.
• Avoiding friends and family, social events, refusing to leave the house.
• Anxiety, depression or constant emotional upset, irritability or crying.

Has any of these been happening to you? Below I explain the four phases of adrenal dysfunction and some common symptoms patients may experience.

Lab testing for a stressed and tired body

Blood and Saliva testing are both important!

If you are tired of course it may not always be due to an HPA-axis/adrenal dysfunction it may be due to a virus like EBV, or thyroid or low testosterone, low B vitamins etc. These below are a few of our start up tests we do in my practice when a patient comes to me, stressed and tired.

• CBC, CMP, Lipids, A1c: the basic labs to assess for iron deficiency, kidney and liver functions, healthy fat levels and the A1c assesses for diabetes which will make you tired too.
• TSH, FT3, FT4, TPO, TGB, TSI: Your thyroid tests to assess for other causes of your fatigue.
• FSH, LH, Estrogen, Progesterone, Testosterone, DHEA-S: Your hormone labs that will contribute to a more pronounced fatigue and are impacted by a stressed and tired body.
• Vitamin D, B12/B9, iron panel: your most essential vitamins to help your adrenals work better and will contribute to more fatigue if they are not well absorbed.
• EBV, CMV: any other labs that assess for viral diseases that can lead to chronic fatigue syndrome. Depending on what patients will tell me we add or take away from this list.
• Salivary Cortisol Test: My patients’ favorites. They want to to see on the labs what their bodies are expressing. I completely understand. As well a salivary cortisol test allows for great guidance in supporting a stressed and tired body when we know where you stand.

Depending on what the labs show and what phase of HPA axis dysfunction you are in these recommendations will vary. Today we are solely focusing on phase 1.

Nutrient Support for a stressed body

• Mind your diet: especially your sodium intake. Too much salt causes your body to eliminate cortisol more slowly so make sure you stay below 3000mg.
• Add food to lower cortisol: Basil, beets, celery, cacao, walnuts, flax, chia seeds, green tea, kimchi, yogurt, sauerkraut.
• Add adrenal supportive herbs: lemon balm, passionflower, ashwaganda, chamomile, green tea.
• Add adrenal supportive vitamins and minerals: Vitamin B5, B6, C, E and magnesium are key to maintaining healthy adrenal function.

Lifestyle Recommendations for a stressed body

• Exercise and meditation support: exercise is a stressor and when your system is already stressed it can be more of a detriment to your body than taking a break from the gym. I ask my patients, how do they feel after a workout, reguvenated or depleted? If you feel depleted a high intensity session is not for you! A stressed body benefits from outdoor, in nature exercise whenever possible to decrease excess cortisol. No intense cardio or HIIT training sessions. Yoga, pilates that are gentle and restorative and are good options too.
• Sleep support: No matter the phases, sleep is always a must. But when you are stressed sometimes that may be the first thing you part away with, a good night’s sleep. Aiming for to 8hrs can start with some suggestions made above, making sure you are not exposing your eyes to artificial light too close to your bedtime, keeping a dark, cool room less than 72 degrees Fahrenheit, to stimulate natural melatonin production.
• Healthy boundaries: At work and in your daily life. I ask my patients to take inventory of what is causing them stress. What can we remove, delegate or live without? What toxic relationships do we need to part ways with or have conversations with a licensed therapist to resolve internal emotional stress, etcetera.
• Consistency and discipline: are the most difficult habits when recovering from bad habits is what we need to work towards in order to help our adrenals recover. Don’t give up. Stay consistent with waking and bedtime hours, slowly work towards implementing dietary changes that support heathy blood sugar balance(timed meals, focus on whole foods) and if all that is not leading you to a more thriving live experience than it’s time to chat with a health and wellness provider like myself to get your body back on track.

Our practice offers many ways to support a system under stress. Starting with a health consultant adept at dealing with hormonal imbalances and giving you the best support to reach your health and wellness goals. You may inquire more about our Naturopathic Services here.