Meet Your Adrenal Glands

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The picture was not just to get your attention, It will make  lot of sense in a minute.  So before I get to the adrenal glands, what is functional medicine?  Naturopathic medicine can be practiced from a functional medicine perspective and often is.  However, any form of medicine can be applied in this fashion and if the approach is to be labeled holistic it almost has to be.  Basically, functional medicine individualizes treatment, and does not get overly hung up on black & white laboratory results and interprets symptoms as part of a complex message from the body .  Does this make sense?  A quick example.

A test result of higher than 120 mg/dl fasting blood sugar (FPG test) on two occasions is considered a positive marker for pre-diabetes (there are different opinions on this -but for the sake of this example 120).  What if it is 100 mg/dl?  Some individuals (those who fall outside of the statistical chart which led to the decision of 120 mg/dl) may experience typical symptoms even if they do not meet the criteria for a diagnosis.  We often call this a sub-clinical diagnosis, or in this case functional medicine.

Basically the point is don’t get too hung up on pure data, as it only tells part of the story and is captured at a single moment in time, viewed though a very small lens under high magnification.  Functional medicine is by its nature more holistic, as you still use the laboratory results but only as a piece of information for insight into blood chemistry.  The person tells the whole story – always.  My reason for having you understand this slightly different approach is that subacute adrenal fatigue may be one of the most under-diagnosed functional impairments in todays high stress society.  A way of life we were not inherently designed for.

Ok, thanks for bearing with me through that, now for the adrenal glands.  Sitting like small hats above each kidney, they are most well known for the hormone which bears their name – adrenaline.  Another hormone coming from the adrenal glands which is now often called ‘the stress hormone’ is cortisol (there are several other crucial ones especially DHEA, but for simplicity lets just stick to cortisol).  Now for the zebra picture.  Go back to more primitive times, and you and I become a fairly tasty two legged snack for several apex predators.  We, like most predator/pray animals have a flight-fright response.  In other words a quick oh-sh** decision based on your most immediate instinctive reaction.

Today we have replaced the lion with 21st century life, and the zebra has learnt to ride motorized vehicles.  The original function of this tiny endocrine powerhouse was to help us through a very acute stress response a la apex predator.  These glands can become overworked after a period of time at which point we often use the label adrenal fatigue, or adrenal exhaustion.  Remember, this is from a functional perspective if these glands stopped working completely so would you.  There is a saliva test which we can use to gain a window of biochemical insight called the A.S.I. or adrenal stress index.  This test measures the circadian rhythm of the hormone cortisol which should be at its highest in the morning and slowly diminish during the day.

Now just because I trust that you will understand I will throw out one more often misunderstood detail.  Realize that depending on where in the spectrum of adrenal exhaustion you are, the levels or cortisol will vary.  At the start of the stress response cortisol will be very high, and over time as it is unable to keep up, it will diminish.  The symptoms you experience will span somewhere in-between the effects of high cortisol (belly fat, insomnia) and low cortisol (fatigue, inflammation).  Your experience of adrenal fatigue will match a combination of the following symptoms (this list is in no ways exhaustive):

• Low energy especially upon waking – you need some coffee or something to get you going.
• Chronic fatigue.
• Low libido.
• Difficulty falling asleep, staying asleep, insomnia.
• Poor skin regeneration.
• Thyroid function impairment.
• Blood sugar imbalances.
• Chronic muscle & joint pain.
• Inability to lose weight.
• Inflammatory conditions (asthma, eczema, allergies, and may more)  This is particularly interesting because you know what the standard of care is for these conditions?  Pharmaceutical cortisol = cortisone!!!

These are the reasons that adrenal fatigue goes so undiagnosed in conventional settings.  The symptoms are at a first glance unrelated, but then so is a zebra riding a motorcycle.  There are many ways to treat adrenal fatigue, but there are far more ways to prevent it.  Since the treatment of such a condition is going to be very individualized, I will focus here on prevention.  You will be surprised again I think at how simple these are.

• Avoid caffeine and stimulants after midday.
• Get into a regular sleep pattern.
• Exercise regularly.
• Back to basics nutrition (whole foods, especially protein,  and healthy non-hydrogenated fats)
• Stress management (if you said what’s that, email me now!).
• Switch to sea salt.
• Eat the yolk!

I distilled the biochemistry and symptom picture for a general population and have left out the hormone DHEA from the mix for the sake of simplicity.  If you have more questions, please don’t hesitate to ask.

Dr. Nishant Rao is a co-founder of WellWire.com. He is a well-traveled naturopathic doctor and new father, practicing an integrative approach to create wellness in and around Los Angeles. Become a patient or discover his practice.