Did you know that four out of every five visits to the doctor’s office is stress-related? In today’s 24/7 society, stressors present themselves in many different forms: mental stress from a busy work day, physical stress from an intense training session or constantly being on the run, or emotional stress from relationships with family or friends. Although stress is essential for overall health (it provides the mental and physical challenges required to stimulate positive adaptation), if you have chronic or excessive stressors or poor coping mechanisms it may result in adrenal dysfunction and/or altered cortisol rhythm.
Why Are Your Adrenals So Important To Stress?
Your adrenal glands are small triangular-shaped glands positioned on top of your kidneys that secrete specific hormones in response to stressful stimuli. The glands are made up of two parts: the inner medulla that produces the hormone adrenaline in response to stress and the outer cortex that produces cortisol. Let’s take a look at how these two hormones drive your response to stressors in your environment.
When adrenaline is produced, it triggers the breakdown of body-fat for fuel and acts by raising your blood pressure and heart rate to increase your alertness. If you enjoy a cup of coffee in the morning, you’re getting a nice little jolt of adrenaline from the caffeine that helps to increase mental focus and work capacity during exercise. This happens instantly via your sympathetic fight or flight nervous system, which is a direct connection between your brain and adrenal glands.
Whereas adrenaline preferentially catabolizes (breaks down) fat, cortisol breaks down muscle tissue to provide fuel for your body. Like adrenaline, its job is to increase your blood sugar levels to provide energy for the body to overcome the stressful event. From an evolutionary perspective, this was critical for escaping from wild animals or other threats. Nowadays, you experience a boost when you’re in the gym or training hard, but when your session is over, your stress levels should return to baseline. (If you adrenals are out of balance, this isn’t always the case and has significant negative repercussions).
Today’s Stress Response
In nature, a stressor is short-term then subsides. For example, a zebra grazing in the savannah might spot a lion in the distance resulting in a boost of adrenaline and cortisol to increase the heart rate, breath rate, and shunt blood to its working muscles should it need to run for its life! The subsequent chase might last 10-20 minutes, then it would be over and the zebra could go back to relaxing and grazing.
Thankfully, in today’s world we don’t often have to run away from lions or bears, but “modern” stressors actually exert a much more debilitating toll on our body. How is this possible?
Today, stressors last all day long! The emails don’t stop, the deadlines don’t stop, and the commitments don’t stop. Your body – and more importantly your brain – are experiencing constant and prolonged stressors, far longer than would be experienced in nature. This leads to a heavy burden on your adrenal glands and your body.
What is Adrenal Dysfunction?
While the physiological mechanisms have evolved over millions of years, the realities of sitting at a desk and having to juggle all the mental tasks from work and home life can leave your brain (and body) stuck in “fight or flight” sympathetic overdrive. For some this can manifest itself as the over-production of adrenaline and cortisol, while for others the reverse can happen and you may feel sluggish or fatigued.
In years past, clients complaining of prolonged fatigue were often diagnosed with ‘Adrenal Fatigue’, the inability of the adrenal glands to keep up with a person’s busy life or increased number of stressors. Today, we understand this is not the whole story. A new area of medicine called psycho-neuro-endocrine-immunology (now that’s a mouthful!) or PNEI is uncovering that your brain is really the root cause of adrenal dysfunction, and therefore the key player in supporting your adrenals and stress response. In short, the hypothalamus area of your brain is the master switch that tells your adrenal glands to ramp up the production of adrenaline and cortisol (over-performing adrenals), or dial it back (under-performing adrenals).
Do You Have Symptoms of Adrenal Dysfunction?
In clinical practice, I see many patients with either over-performing or under-performing adrenals. There are symptoms on each end of the spectrum that indicate adrenal dysfunction. If you have difficulty waking up in the morning, poor energy during the day, feel better after eating meals, or have diminished libido then chances are your adrenal glands are underperforming.
If you’re a person with naturally high energy levels, have high blood sugars, experience excessive sweating, have difficulty falling asleep, or feel like your mind continually races with a list of tasks and deadlines then you may be suffering from over-performing adrenals. This constant fight or flight sympathetic dominance chronically elevates cortisol levels and may lead to roadblocks in your quest for a slimmer waistline, faster 10k run time or better overall health.
There is one more piece to this complex puzzle. Your daily cortisol rhythm can also get thrown out of balance by stress. In the morning, your cortisol should be at its highest to wake you up from deep sleep and get you ready to attack the day. In the evening, your level starts to lower and should be at its lowest point at bedtime. This allows the sleep hormone melatonin to ramp up and prepares your body for deep, restorative sleep.
If you suffer from general fatigue, poor recovery from workouts, low mood, and your short-term memory is poor (e.g. you often forget what to pick for dinner, where you left your phone, or your client’s name) then poor daily cortisol rhythm may be your area of adrenal dysfunction. If you struggle to get out of bed in the morning, hit snooze multiple times, or feel desperate for a coffee to get going then chances are your morning cortisol rhythm is out of balance. If you struggle to fall asleep at night, wake up throughout the night, or classify yourself as a night owl then you likely have an altered evening cortisol rhythm.
It is important to address adrenal dysfunction and/or altered cortisol rhythm as they can lead to serious negative consequences. These include increased inflammation, poor memory, increased risk of anxiety or depression, reduced testosterone production, slow thyroid function, increased belly-fat, decreased lean muscle mass, poor blood sugar control or insulin resistance, and cognitive decline.1 If you’re not sure whether your adrenals are functioning optimally, you can request a salivary-cortisol test.2
The Adrenal Dysfunction Fix
Diet is the first place to start when correcting adrenal dysfunction. It’s critical to obtain the building blocks essential for supporting a healthy stress response. The Paleo diet is the perfect place to start.
First, increase your intake of healthy saturated fats, such as butter, ghee, or coconut oil. Studies show that fatigued and over-stressed athletes are better able to recover and maintain performance on a high fat diet, in particular when high in saturated fats.3
Next, make sure you are achieving an adequate intake of protein, as high cortisol levels will quickly break down precious muscle tissue and leave you in a catabolic state. Aim for 0.7-0.9g of protein per pound of bodyweight.
Finally, it’s not only what you add to your diet, but also what you remove. If you’re suffering from adrenal dysfunction or altered cortisol rhythm then discontinue your caffeine intake – coffee, black tea, chocolate – for 4 weeks. Sugar and caffeine cravings are classic signs of adrenal dysfunction, so be sure to eliminate all processed sugars and carbs for 4 weeks.
Busy work days or long hours in the gym can leave you burning the candle at both ends and therefore being stuck in the fight or flight sympathetic overdrive. If the root cause of adrenal dysfunction starts in the brain, it makes sense to incorporate techniques that directly impact your central command center.
Meditation is an ancient technique that helps restore your cortisol rhythm and adrenal function by stimulating your “rest and digest” parasympathetic nervous system via the vagus nerve in your brain.
Not convinced? A recent study of medical students showed that those engaging in daily mindfulness meditation practices had much lower blood cortisol levels compared to a placebo.4 Meditation has also been shown to significantly improve anxiety and depression, classic symptoms of adrenal dysfunction.5
Try this simple technique before bed to improve your “resiliency” and capacity to cope with stress:
- Start by sitting with your eyes closed.
- Inhale deeply through your nose; let your belly expand for three seconds
- At the end of your inhale, hold your breath for one second.
- Exhale deeply through your nose for another count of three seconds; let your belly draw inward toward your spine.
- Repeat for 5-10 minutes.
Did you know that today we sleep a whopping 500 hours less each year than our grandparent’s generation? This sleep debt places a tremendous burden on our resiliency or capacity to cope with stress.
If you get less than 7 hours sleep per night, struggle to fall asleep, or wake up frequently during the night your cortisol levels will be elevated and you’ll be cutting yourself short on the recovery front.6 To support deep sleep, make sure your bedroom is set up for optimal recovery. How can you improve your sleep quality? Here are some simple tips:
- Turn down the lights in your house after 9 p.m.
- Shut off your television or laptop at least 45 minutes before bed.
- Make sure your bedroom is completely dark. Try using blackout blinds or an eye mask to prevent unwanted light.
- Keep your bedroom cool and wear loose-fitting clothing or sleep naked
We’ve got a in-depth article on how to get better sleep if you want to know more.
There are several herbs that can support adrenal dysfunction, depending on whether you suffer from over-active or under-active adrenals, or cortisol rhythm dysfunction. A key nutrient called alpha-GPC can benefit all types of adrenal dysfunction. Supplementing with alpha-GPC provides the hippocampus with the right building blocks to restore normal cortisol rhythm by supporting the production of acetylcholine, a key neurotransmitter concentrated in the hippocampus that can be depleted by busy work schedules, lacking sleep or high stress.7 Take 500-1,000mg daily upon rising for 8-12 weeks.
Prioritize the fundamentals of diet, sleep, and controlling your stress response (e.g. proper breathing) to upgrade your adrenal function and correct symptoms of adrenal dysfunction. Train your brain and fuel your body correctly to increase your resiliency and keep your stress response system in balance.
Dr. Marc Bubbs ND, CISSN, CSCS
Want to learn more? Listen to Dr. Doug Kechijian talk "Mental Performance In High Stress Situations" on the Dr. Bubbs Performance Podcast...
Check out more articles in the "Cortisol Stress" Series...
Reynolds G. The Hormone Edge. J of Physio. NY Jan 14, 2012.
Manetti L et al. Usefulness of salivary cortisol in the diagnosis of hypercortisolism:comparison with serum and urinary cortisol. 2013. Eur J Endocrinol 168(3):315-21
Antonio, J et al. Essentials of Sports Nutrition and Supplements. Humana Press. New York, NY.
Turakitwanakan W et al. Effects of mindfulness meditation on serum cortisol of medical students. J Med Assoc Thai 2013 Jan;96 Suppl 1:S90-5.
Wurtzen H et al. Mindfulness significantly reduces self-reported levels of anxiety and depression: results of a randomised controlled trial among 336 Danish women treated for stage I-III breast cancer. Eur J Cancer 2013 Apr;49(6):1365-73.
Leproult R, Copinschi G, Buxton O, et al. Sleep loss results in an elevation of cortisol levels the next evening, Sleep. 1997;20:865-870.
DiPerri R. et al. A multicenter trial to evaluate the efficacy and tolerability of alpha-glycerylphosphorylcholine versus cytosine diphosphocholine in patients with vascular dementia. J Int Med Res. 1991. Jul-Aug;19(4):330-41.