Category: Adrenal Health

by Marcelle Pick, OB-GYN NP

As the great balancer of more than 50 hormones in the body, the adrenal glands have a broad impact on your health and energy. The adrenals are primarily responsible for activating your stress (“fight or flight”) response, shifting energy away from restorative processes like digestion and toward the organs of action — your heart and skeletal muscles — by pumping adrenaline and cortisol into your bloodstream. But they also synthesize numerous other hormones, including androgens and their precursors, such as testosterone and DHEA, as well as estrogens and progesterone — which is why it becomes more important than ever to support our adrenal glands as we approach menopause, a time when our bodies come to rely more heavily upon the regulation of hormones.

But aside from the life-critical job the adrenals play in activating your stress response and supplementing healthy hormonal balance as we age, the hormone cortisol itself has a powerful hand in so many other regulatory processes across all your systems: protecting the body from stress by regulating blood pressure, normalizing blood sugar levels, helping to regulate the immune and inflammatory responses, and influencing mood, memory, and clarity of thought.

Maybe this helps explain why, when your adrenal reserves are depleted, you might feel a little crazy, and your sleeping and eating habits seem a little crazy, too! In Ayurvedic medicine, the adrenal glands are connected to the “root” chakra and contribute to our groundedness, nourishment and physical health. With persistent stress, we become increasingly less grounded, which can increase stress even more — and the constant demand for stress hormones means the adrenals become depleted and ultimately exhausted.

But my experience with women over the years has shown me that you can provide stronger grounding and support to the adrenal glands by making some simple choices when it comes to eating and nutrition. Will your food choices make or break your adrenals? Not exactly — stress is the number-one major offender when it comes to adrenal depletion, and you can read more about this in our article on stress and the effects of high cortisol — but good nutrition, well-timed meals and snacks, and sometimes a gluten-free diet can significantly relieve the strain on your adrenal glands.

Think about the tires of a car. If you buy good quality tires and routinely check their air pressure, balance and rotate them, and patch any holes, the foundation for how your car moves on the road will be safe, steady, and strong. You’ll get better gas mileage, the car will respond better when road conditions are slippery or uneven, and the car will last longer. The same goes for adrenal function. Selecting high-quality foods, building a strong nutrient base, and paying attention to when and how you eat all make for more efficient and healthy adrenal function — and better health all around. Just as neglecting your tires may not immediately compromise your safety or your car’s efficiency, your adrenals can take a lot of strain before you begin to see the effects on your body.

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by Marcelle Pick, OB/GYN NP

• You’re irritable and quick to lose your temper.
• You’re prone to road rage or become extremely angry over little things.
• You feel as though you’re constantly on edge, ready to “lose it” at the least little thing.
• You feel listless, depressed, or emotionally numb.
• Your sex drive is low.
• You frequently have nightmares.
• You often feel an overpowering urge to cry.
• You have trouble concentrating or feel mentally foggy.
• You suffer from free-floating anxiety.
• You are easily startled.
• You simply feel stressed all the time.
• Everything seems like a chore.

As you can see, some of the symptoms are contradictory: can’t sleep/can’t stay
awake; always on edge/listless and depressed. That’s because adrenal dysfunction is a progressive condition that moves through successive phases, manifesting differently as the condition gets worse. The condition also shows up differently in different women, primarily as three main types.

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by Marcelle Pick, OB-GYN NP

In an ideal world, we’d get everything we need from a well-balanced diet, but no matter how well we eat, a stressful day can really burn through our nutrient stockpiles. So in addition to the small (but important!) changes you make in your eating and lifestyle habits, there are several natural supplements to consider for addressing weight gain rooted in adrenal imbalance.

Start with the basics: a well-rounded, high-quality multivitamin/mineral complex that includes the full B-complex group, vitamin C, vitamin D, calcium, and magnesium, as well as an omega-3 supplement, is essential for countering stress. I know how hard it is to get all of the nutrients our bodies require in today’s world of processed foods, and eating on the go! Give your body and your adrenals a hand with a solid nutrient base.

For further support, there are a number of medicinal herbs to consider. Traditional cultures have been drawing on botanical medicine for millennia, and today, research is bearing out the healing power (and safe use) of these herbs. I’ve had great success in restoring adrenal health with the following:

• Astragalus root. Studies show that Astragalus helps provide an increase in energy and endurance, as well as bolstering the immune system so you stay well when you’re under stress. It also aids healthy weight regulation by making cells more receptive to insulin and exerting an anti-inflammatory effect, helping to protect against insulin resistance and metabolic syndrome.
• Cordyceps. This “anti-aging” medicine is not actually an herb at all, but a fungus. And plenty of research documents the ability of Cordyceps to modulate the immune system, naturally lower high blood-sugar levels, support energy levels, and aid the body’s natural ability to adapt to stress.
• Eleuthero (Siberian ginseng). Eleuthero is sometimes called Siberian ginseng, but it shouldn’t be confused with “true” ginseng (herbs from the genus Panax). Eleuthero is a much gentler herb that functions as an adaptogen, meaning that it naturally augments the body’s resistance to stress. Studies indicate that it increases performance, concentration, and endurance during fatigue. Eleuthero also protects the cells of your brain and increases cell sensitivity to insulin.
• Rhodiola rosea. This herb is well-known for its ability to help the body respond to stress efficiently, while offering an increase in energy. Rhodiola extract additionally has a neuroprotective effect, increasing the ability to concentrate in people who report feeling “burnt out,” as well as natural anti-inflammatory and antioxidant effects.
• Licorice root. Probably the best known herb for supporting adrenal imbalance, licorice root increases energy, endurance, and vitality. It can also increase blood pressure, but most women with adrenal dysfunction have low blood pressure, so this can be helpful. If you are among the few who have adrenal imbalance with a history of hypertension, however, do be sure to monitor your blood pressure regularly.

I always take pleasure in learning more and sharing about the healing power of herbs. For my readers, I highly recommend you work with an integrative or functional medical practitioner to decide on the best course of action for you.

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by Marcelle Pick, OB/GYN NP

Conventional medicine is truly amazing at treating serious disease-state conditions, but when it comes to chronic health issues it does not have such a great track record. Unfortunately its focus on drugs also tends to suppress early-stage symptoms rather than treat their underlying causes. This is where functional medicine come is so well, we look at what is going on upstream that is creating the problems that are present.

By only looking at symptoms and getting a diagnosis this can have the effect of delaying treatment until a disease state has developed. This is true in the case of adrenal dysfunciton cortisol testing. In the conventional standard of care, any cortisol level within a very broad range is considered normal, and anything outside that range indicates disease. Serious disease I might add.

In our practice, we measure cortisol levels at several points in the day to track the adrenals’ day–night pattern (called the “diurnal rhythm”) using a panel of simple saliva tests. We expect to see cortisol higher  in the morning to help you get going,  and lower as the day progresses to night, when it is at its lowest to support restful sleep.

In the early stages of adrenal dysfunction, cortisol levels are too high during the day and continue rising in the evening. This is called  the “Race Horse” in my book, Is it Me or My Adrenals. In the middle stages, cortisol may rise and fall unevenly as the body struggles to balance itself despite the use of caffeine, carbs and other factors, but levels are not normal and are typically too high at night. This cause increased issues with regards to sleep, which greatly increases exhaustion. In advanced stages, when the adrenals are exhausted from overwork, cortisol will never reach normal levels, I call that my “Flatliner”.

Conventional medicine will detect only the extremes of these conditions, when damage to the adrenals has already occurred (Cushing’s disease and Addison’s disease). Within those extremes, you can feel miserable and still be told your cortisol levels are normal. But by responding to early-stage symptoms of adrenal fatigue, we can reverse the developing dysfunction.

Should you get an adrenal test?

In general, if you feel happy and well, have steady energy and emotions, sleep soundly seven to nine hours a night, wake up feeling rested, recover well from stress, and maintain a healthy weight without dieting, then your adrenals are probably doing well.

On the other hand, if your energy ebbs and flows during the day, you feel emotionally stretched much of the time, you sleep poorly most nights, you can’t lose excess weight even while dieting,  you use caffeine or carbohydrates as “pick-me-ups” — these are all signals indicating adrenal dysfunction.

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by Marcelle Pick, OB/GYN NP

The first step is to have a full physical exam to rule out disease or other factors. In our experience, women with mild to moderate cases of adrenal dysfunction can see such life changing improvement through the following  steps:

• Dietary changes to improve your nutrition and reduce carbohydrates and stimulants. Adding pharmaceutical grade nutritional supplements, and including essential fatty acids from fish oil.
• Stress reduction, including exercise and taking more time for yourself. It’s helpful to make a list of your stressors, especially those that are constant.
• Get more rest. Your body needs time to heal.

Women with more severe symptoms, or those that I call “Flatliners” in my book Is it Me or My Adrenals?  have reached complete adrenal dysfunction, and  usually need greater intervention and time to heal. At our practice we use the steps outlined above with the added natural support of phosphorylated serines, adaptogenic herbs, sometimes low-dose compounded DHEA, and occasionally deglycyrrhizinated licorice if the person does not have high blood pressure. We personalize the therapy to each woman’s symptoms and test results. We urge you not to self-prescribe these substances, as they can have adverse health effects.

It’s important to remember the role of emotional factors. Stress, pain from past hurts, self-destructive habits such as alcohol, overeating, overwork, and unresolved relationship problems — your past and present emotional responses may serve as an ever-present stressor.  Learning to Deal with these problems head on  is much more beneficial than trying to overcompensate for the stresses they create.

In all but the most extreme cases, we expect to see dramatic improvement within about four months. For mild to moderate adrenal fatigue the turnaround can be much faster.  Remember it took you a long time to get here, it may take a while to see results.

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by Marcelle Pick, OB/GYN NP

Introduction: a new diagnosis

• Do you feel exhausted, overwhelmed, and stressed all the time?
• Do you need five cups of coffee or a constant infusion of soda just to make it through the day?
• Do you have trouble waking up, falling asleep, or staying asleep, no matter which herbal supplements you try?
• Do you find yourself feeling constantly irritable or on edge?
• Do you feel that you need to exercise to stay in shape even though you’re exhausted when you do?
• Do you feel as though everything you eat turns to fat?
• Are you always hungry, frequently craving sweets, or tempted by “carbobinges?”
• Are you plagued by irregular or painful periods or PMS?
• Are you struggling with perimenopause or menopause: lowered sex drive, vaginal dryness, mood swings, and hot flashes?
• Do you find yourself feeling forgetful, “foggy” or unable to concentrate?
• Do you find that you do better when you’re always on the go?
• Do you find that you actually enjoy adrenaline rushes and feel a little bored without a crisis to handle?
• Are you struggling with anxiety, depression, or despair?

Sound familiar? If I’ve painted a picture you recognize—in yourself, in your family, among your friends and colleagues—you’ve just gotten a good look at adrenal dysfunction, a distressingly common problem in which overworked adrenal glands produce too much cortisol, the stress hormone.

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by Marcelle Pick, OB/GYN NP

We’re all familiar with stress — it’s a constant element in women’s busy lives. But what we aren’t so familiar with is the body’s response to stress and the ways in which the stress we face today goes far beyond the kind of stress we faced as we evolved — and ends up depleting our energy and health.

When faced with a stressful situation, our bodies rely on the adrenal glands sitting atop our kidneys to monitor our “fight or flight” response. For the most part, our stress response evolved from short-term events — crises that came and went. If we had to run from a predator, for example, our healthy adrenal glands responded by releasing adrenaline, which makes us more alert and focused, and cortisol, which converts protein to energy and releases our stored sugar, glycogen, so our bodies have the fuel needed to respond quickly. In concert, the adrenal response rapidly increases our heart and respiratory rates and blood pressure while releasing energy, tensing our muscles, sharpening our senses, and slowing our digestion so we are primed to escape or fight back, whichever is needed. When the threat is gone, the body returns to normal — quickly with respect to adrenaline levels, less quickly with respect to cortisol.

Permission to nurture yourself: Granted!

Stress can help create hormonal imbalance. Nurturing self-care can help restore that balance. If, like many women, you spend a lot of your time taking care of everyone else, it’s more important than ever to make time for yourself. Do something to care for your body, your mind and your soul — like getting a massage, a reiki treatment, even taking a nap or hot bath.

But in today’s society, women are inundated with stress — stress that doesn’t let up. And when chronic stress repeatedly forces the adrenal glands to sustain high levels of cortisol, two things happen: first, the adrenals can’t attend to their broader role in hormonal regulation because the same resources they use to make hormones like estrogen are required to make cortisol, and second, cortisol starts to damage healthy tissues. Eventually, adrenal fatigue sets in, and many women experience symptoms such as weight gain, fatigue, insomnia, fuzzy thinking, depression, cravings and mood swings. Once the adrenals become depleted, it can lead to adrenal exhaustion and much more serious health concerns.

There are many ways to replenish adrenal health naturally. One thing I can promise you is that when you heal your adrenal glands, you’ll see results on every physical and emotional level, and your whole body will thank you for it!

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by Marcelle Pick, OB/GYN NP

Two months ago, Lisa, a 28-year-old mom, came to see me. She was so worn out from mothering two kids and working full-time she couldn’t get out of bed. Just driving to our practice took everything she had. Her tests revealed severe adrenal imbalance and, as so often occurs in these cases, very low levels of an important hormone called DHEA.

DHEA is a natural steroid and precursor hormone produced by the adrenals. It’s also available at health food stores and on-line as an over-the-counter supplement. Manufacturers hype it as a magic cure-all for many things: muscle loss, weight loss, osteoporosis, and depression — even menopause. Recently headlines have linked DHEA to athletes “doping” with steroids, leading to a lot of confusion about DHEA, it’s role in the body, and how it should be used. Now DHEA is being labeled everything from “fountain of youth drug” to fraud – and the very real benefits of DHEA, particularly for women, are getting lost in all the controversy. The truth is that — for the women who need it — adrenal support with DHEA supplementation can make a big difference. I’ve seen it help patients get going again when they feel like they’ve hit rock bottom. But it’s never as simple as just popping a pill. When used appropriately — in a therapeutic setting under medical supervision — DHEA is a critical component to jumpstarting hormonal balance.

Just ask Lisa. After two months of treatment that included lifestyle changes and adrenal support with low daily doses of DHEA, she feels like herself again.

So let’s give you more information about DHEA and it’s role in hormonal balance. Then you can talk to your healthcare professional and make the best choice for your individual needs.

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What is DHEA?

Dehydroepiandrosterone, or DHEA, is a steroid hormone synthesized from cholesterol and secreted by the adrenal glands. The adrenals are walnut-sized organs located right above your kidneys. The average adult makes about 25 mg of DHEA per day (some more, some less) with dwindling production as we get older. Men at all ages have more DHEA than women.

Natural DHEA production is at its highest in your twenties: by the time we reach seventy we only make about 20% of the DHEA we had when we were young. A decline in DHEA with the passage of time is clearly what nature intended — and as far as we know, a healthy process. This is only one of the major reasons we don’t recommend self-prescribing DHEA through over-the-counter products.

Another reason is that DHEA is a very powerful precursor to all of your major sex hormones: estrogen, progesterone, and testosterone. (It’s molecular structure is closely related to testosterone). We call it the “mother hormone” — the source that fuels the body’s metabolic pathway: