Stress is a healthy response of the body but lies on a continuum.
Stress fuels our “fight or flight” response that is necessary for survival – but it is supposed to be a short-term event.
From the morning commute, to the morning office meeting, to the little argument you had with your spouse, to the stress of running kids to and from their activities – it really is no wonder that our adrenal glands are take such a beating.
So when does good stress go bad?
Our Friend Cortisol
You may recall that when you are “stressed” your body secretes cortisol.
Cortisol has a number of effects on the body, that can exacerbate just about any health condition if its levels are chronically raised.
Chronic low levels of cortisol may contribute to widespread nutrient deficiencies, belly fat, loss of bone density, food allergies and gastrointestinal disturbances, and may drive immune imbalances.
Stress is peculiar in that you can feel calm and appear calm, but underneath the surface you can be a raging storm.
This begs the question then, how do you know if you’re just stressed or if it has progressed to a point of adrenal fatigue or exhaustion?
The Sleep Barometer
Sleep is a useful, yet imperfect, gauge of adrenal function. Cortisol has a natural rhythm to it, high in the morning, lower through the day, and then rising again overnight. Alterations to this rhythm are a sign of adrenal imbalances.
Individuals who have trouble falling asleep likely have high levels of cortisol at night. These individuals are exhausted 8-9pm but if they stay up until 10-11pm they feel wired until 2-3am in the morning. This can be caused by stressors we are accustomed to hearing about, but other stressors such as food sensitivities or excessive exercise, can contribute to high levels of cortisol.
Some individuals fall asleep fine, but wake frequently. These are people that are starting to show a little bit of adrenal fatigue. These individuals have such high demands for cortisol that their body has trouble keeping up. When the body tries to release cortisol overnight, it has difficulty, releases epinephrine and norepinephrine in its place, and you wake up.
Lastly, some individuals have aspects of both: they have trouble falling asleep and staying asleep. These individuals’ adrenals are taking a roller coaster ride throughout the day. They also are likely to have some blood sugar imbalances or hormonal imbalances as a result of chronic stress. Although no pattern is “perfect” when it comes to the human body, this is typically a sign that things are further along the stage of fatigue and heading toward exhaustion.
One useful way to measure stress is to utilize Salivary hormone testing for Cortisol, and its precursor DHEA.
DHEA is a precursor to both your sex hormones and cortisol. Too much DHEA and you can drive testosterone levels to rise, not enough and you can put strains on other body systems. Salivary testing allows samples at 4 set times throughout the day so you get a sense of your body’s natural cortisol rhythm, as well as pooled levels of DHEA.
It’s important to recognize that if you are constantly stressed and are pumping out cortisol and depleting your DHEA, you are doing so at the expense of your sex hormones, B Vitamins and some minerals like magnesium.
Both men and women may notice decreased libido. Men may notice difficulty attaining or maintaining erections. Women may experience menstrual abnormalities.
Over time, individuals start developing belly fat (a textbook sign of high cortisol), impaired blood sugar regulation, high blood pressure, and more complex hormonal abnormalities such as Andropause, Polycystic Ovarian Syndrome (PCOS), or endometriosis.
Some individuals spend decades in a stage of adrenal fatigue. Some may never progress to a clinical stage of exhaustion, yet still suffer from improper blood sugar regulation and chronic hormone insufficiency. They depend on coffee during the day to keep them alert, and may “wind down” with a glass or two of wine at night.
Adrenal exhaustion is when patients lose the capacity to produce both cortisol and DHEA. These patients may need to be supplemented with DHEA directly may even require medical hormone replacement therapy. These patient’s can suffer a “crisis” where their body tries to build a stress response and just find themselve unable. They may fall into a severe depression and find themselves isolated from work, family, and friends. Although a “crisis” is relatively rare aside from tumors, adrenal exhaustion can become life-threatening, and these individuals need immediate attention.
Why Worry About Adrenals?
Some clients understand that stress will be a normal and natural part of their lives, and they just simply want to lose weight, or they simply want their blood sugar in normal levels. In Functional Medicine, there’s a degree of prioritization that may need to take place if you’re looking at identifying for the “root cause” of a disease process.
You may not be able to balance blood sugar levels without “priming” the adrenals first. You will have a lot of difficulty losing weight when cortisol is feeding the process.
Unfortunately belly fat is often the first to come on and the last to go, and along with issues of detoxification, can cause frustration for individuals with stubborn weight problems. Sometimes supporting digestion may be a first priority, so that you’re not driving cortisol production with unknown food allergies and sensitivities or general GI inflammation.
If you suspect that you have underlying adrenal problems, you may benefit from being evaluated and possibly tested. There are general food recommendations, as well as herbal and nutraceutical support to address stress-related problems.
Lifestyle techniques such as deep breathing, yoga, accupuncture and meditation are also a necessary piece, but for individuals already wired and “on edge”, it can be very difficult to sit still and clear the mind.
Stress is a normal and healthy part of life, adrenal fatigue is not. What makes stress difficult is that the difference between the two is not always clear cut.