Deeper into the Web...Adrenal Dysfunction
This article is meant to follow-up my previous thyroid dysfunction article. In that article, I outlined some of the possible issues to consider when looking at an under active thyroid. The article focused on thyroid metabolism, how to assess it, and what influences it. One notable omission to that article (because it needed an article of its own) is the influence that the adrenal glands have on thyroid function.
The adrenal glands are little globules which sit atop the kidneys and secrete an array of hormones. Some of the hormones produced include estrogen, progesterone, and epinephrine. However, for this discussion, we are most interested in the hormone: cortisol.
Cortisol is our stress hormone. It is released from the adrenals in response to ANY stress whether it is from emotional strain/anxiety, pain, allergies, insomnia, chronic inflammation or food intolerance exposure (a major hidden source of stress on the body). In the body’s eyes, all of these are equal. Following a stressful experience, the body will secrete cortisol which initiates our “fight or flight” response. The amount of cortisol we release is kept in check by negative feedback loops which tell the body when levels get high enough. Then, the body can stop production. Over time, under chronic stress, these feedback mechanisms become overwhelmed and cortisol is allowed to be produced out of control. This is bad for many reasons.
Insomnia: High cortisol levels, especially at night, will cause insomnia of some type. Even if total cortisol production is normal, sometimes the adrenals become confused and secrete high levels at night. I have seen this many times.
In addition to this mess, high cortisol levels are a powerful inhibitor of thyroid metabolism. Specifically, cortisol blocks the conversion of T4 (the inactive form of thyroid hormone) to T3 (the active form). So chronic stress resulting in high cortisol levels will depress thyroid metabolism and cause all of the associated problems (central weight gain, fatigue, depression, low body temp, etc.) in addition to all of the problems stated above.
This situation of cortisol overproduction will continue and eventually the adrenals will give up. They will quite literally become exhausted and the production of cortisol will slow to a trickle. Now you’ve got troubles. Cortisol gives us our “get up and go”. It is vitally important for the proper functioning of almost all body systems. Once the adrenals have thrown in the towel, many organs and organ systems will also have problems functioning.
The following are signs or conditions associated with poor adrenal output:
FATIGUE, weight loss, weakness, chronic pain, asthma/allergies, poor concentration, headaches, depression, and inflammation. Also, becoming intolerant to exercise, or feeling worse after exercise is a good sign that your adrenal glands are quite fatigued.
In addition to this, a more insidious (and potentially serious) problem arises. The cells in our body that requires the most energy are not in the heart or the brain, but are in the stomach. These cells, called parietal cells, produce hydrochloric acid (HCl) which allows us to digest and absorb our food. They also produce something called intrinsic factor which allows us to absorb vitamin B12 and folic acid. As the adrenals glands fail, one of the first things that goes wrong is our ability to produce acid. Then, we can’t digest out food properly, we can’t absorb the nutrients we need (especially minerals), and our body slips deeper into a state of deficiency and fatigue. Symptoms such as bloating, heart burn, indigestion, and increasing intolerance to foods are common with low HCl production. This low acid production will also contribute to yeast and/or parasite overgrowth in the intestines.
Furthermore, folic acid keeps something called homocysteine in check. High homocysteine levels (from low folic acid levels) are a significant risk factor in cardiovascular disease. Also, homocysteine itself will disrupt thyroid metabolism at the cellular level! It blocks T3 from binding with a helper enzyme. Here again we see how intimately the thyroid and adrenal glands are inter linked.
Goodness Gracious! What to do?!? The good news is that assessing the adrenal glands couldn’t be simpler. I use a simple, relatively cheap saliva test that measures your adrenal hormones at four times throughout the day. This way, we can tell not only if you are high or low, but also we can see exactly when the dysfunction is happening. This becomes very important when considering fatigue, insomnia and anxiety problems. If the high or low numbers are happening in the morning, my advice would be very different than if they were abnormal at night. Also, the test tells me about your DHEA levels (another adrenal hormone), your immune status, and if you are sensitive to gluten. Hidden gluten sensitivities are a major cause of high cortisol levels. I will typically have people do a concurrent saliva based thyroid test as well in order to illuminate the whole picture. Unfortunately, MD’s do not do or recognize the adrenal test, however I have found this to be one of the most insightful tools I have into underlying endocrine imbalances.
As far as how to address the problem, there is definitely no cookie cutter way of going about it. It is highly dependent on if your adrenal function is too high or too low, when the problems occur, and if the thyroid is involved or not. For high adrenal output, I use some unique supplements only available to physicians, which gently inhibit the glands. For poor adrenal function, I use everything from vitamin B5,B6,C to zinc and magnesium to herbs (licorice, ginseng, ashwaganda) to cortisol and DHEA replacement therapy. It is also important to support liver function, improve gut permeability and employ stress reduction techniques.
As you can see, this is complicated stuff. All of these endocrine systems feed back on one another in some fashion and getting to the root of the problem can be tricky. If you feel that you may have a dysfunction in your adrenal or thyroid activity, I would highly recommend that you go to somebody who understands these issues, otherwise you could just be throwing darts in the dark. Get tested! It is the best way to know what is really going on. Good Luck!