by Naturopath Karen Clickner
“So if your blood tests are normal, what is going on? Well it may likely be a gland, and don’t assume it is the thyroid.”
Women are tired of being tired. They are also tired of arguing with the blood tests their doctors hold out in front of them to show that there is nothing wrong. They know that they shouldn’t have to feel the fatigue, low libido, anxiety, depression and even hair loss that has become their daily life. In fact, you can even throw in Fibromyalgia, Chronic Fatigue Syndrome, Osteoporosis, chronic insomnia, weakened immunity and numerous other symptoms. So if your blood tests are normal, what is going on? Well it may likely be a gland, and don’t assume it is the thyroid.
Please direct your attention to the center of the stage. The person that is in the spotlight has the answer for you, and his name is Matt Damon. That’s right Matt Damon, the gorgeous actor who also shares a condition with you known as Adrenal Fatigue Syndrome. Matt’s adrenals gained notoriety when he experienced severe adrenal fatigue during grueling dieting and training while preparing for a recent film.
Adrenal Fatigue Syndrome
The adrenal glands are essential for our day-to-day ability to handle stress. They adapt to our environment and our sensory awareness, maintaining a constant state of readiness for any stress that our brain identifies. Stress is something that can vary from person to person, including what may trigger a stressful response. Once you decide that something is stressful, the adrenal glands will release a cascade of chemicals into the blood which will alter the function of every cell in your body. This “fight or flight” response is intended for short-term change, but in our present world, may become a long-term adaptation, changing the very nature of who you are.
The adrenals are actually a part of the kidney meridian and in fact, lie on top of each kidney. There are two areas of the adrenal, the cortex on the outside and the medulla within. The adrenal cortex releases three groups of hormones, the first of which is known as Mineralocorticoids, which include aldosterone. These hormones increase blood levels of sodium and water and decrease blood levels of potassium. That means they control muscle tension levels, blood pressure, circulation, water retention (and all the bacteria in it) and maintain your pH balance. They are made from cholesterol, so if you are on the fat-free path, blood pressure medication is in your future. They are also strongly triggered by stress.
Adrenals and Combating Stress
The second group of hormones are known as the Glucocorticoids, the most important of which is cortisol. They provide your body tissues with ready energy to combat the effects of stress. Once stress occurs, they begin to break down available stores of fat and protein for energy and tissue building. So again, if you have low levels of fat and protein in your diet, your body will cannibalize your own tissue. These hormones also dampen inflammation and depress immune responses. Cortisol redirects blood to larger muscle groups and also inhibits the thyroid by increasing thyroid-binding proteins made in the liver.
It has a strong link to progesterone, testosterone and particularly DHEA, as high cortisol levels can exhaust DHEA production. In fact our very body metabolism is determined by the balance between DHEA and cortisol. If the adrenals are healthy, then cortisol enables the body to produce progesterone even after menopause, making up for the drop in ovarian function. This can be important, as post-menopausal progesterone maintains emotional balance through a calming action, so low levels can cause anxiety. Cortisol also cycles numerous times through the blood so its effects, whether positive or negative, can be long-term.
How DHEA can Affect You
The final group of hormones are the Androgens such as DHEA. In females DHEA is thought to increase sex drive and libido. DHEA also helps with weight loss by maintaining lean muscle mass, but it also increases the turnover rate of bone cells which can lead to osteoporosis if high levels are maintained over time.
The Adrenal Medulla is the trigger for determining how strongly we will react to stress. It does this by secreting only one group of hormones known as the catecholamines. These include epinephrine or adrenalin and norepinephrine. The presence of these chemicals will produce a euphoric feeling and also will increase heart rate, respiration and decrease unnecessary functions such as reproduction and digestion.
But the positive and necessary effects these chemicals produced in the first 30 minutes of stress are replaced by negative and damaging changes when sustained for longer periods of time. This is what is known as sympathetic dominance and this is what leads to Adrenal Fatigue Syndrome. Adrenal depletion is not viewed by the medical community as a condition that merits significant attention, yet possibly 75% of symptoms begin as a result of adrenal fatigue.
Symptoms of Adrenal Fatigue
Some of the general symptoms of adrenal fatigue are constant tiredness, need for extra sleep, inability to cope with stress, reduced sex drive, body pain, sighing, yawning, recurrent infections, irritability, craving sweet food, irrational anxiety and digestive distress. Many current drugs can deplete the adrenals such as the Statin drugs. And not only drugs, but many foods can stress the adrenals as well such as caffeine, alcohol, sugar and nicotine.
The initial stress will cause the adrenals to go into the “Alarm Phase”. This is a normal period of resistance to the stress, intended to be of short duration, such as 30-40 minutes and should be asymptomatic. Both cortisol and DHEA increase during this phase. High levels of cortisol will initially cause an insulin surge, causing sugar cravings. For people that experience recurring Alarm phases, such as firemen, critical care nurses, EMT’s, public speakers and performance artists, I use herbal adaptogens which will fine-tune the stress response mechanism so that this phase is more efficient.
Adaptogen is a term first defined in 1947 by Lazarev as “.a substance which elicits a state of raised resistance to stressors.” Adaptogens help the adrenals to produce normal levels of hormones despite chronic stress being present. They promote regeneration, increase concentration, balance mood and increase metabolism. The initial Alarm Phase response will be stronger and faster and feedback control is more effective so the response is shut off faster. This prevents depletion of the adrenals and damage to the adrenal tissue.
Restless Leg Syndrome & Stress
The second phase of adrenal response is one of continued resistance, in which cortisol remains high but DHEA decreases and we become sympathetic dominant. We are hyperadrenal during this phase, with symptoms that may include anxiety attacks, mood swings, onset insomnia, restless leg syndrome and a generally “stressed” feeling. Due to the higher cortisol levels, many patients experience “epic” dreaming, which is very exhausting. Increased cortisol levels extend the length of REM cycle sleep, allowing less time for Delta Wave sleep, which is the period of healing, repair and growth. Because of this, healing capacity diminishes and immunity weakens.
Increased levels of cortisol also use up our stores of calcium. If there is insufficient calcium that is bioavailable, the body will cannibalize bones and other structures. Higher levels of cortisol will increase prolactin which can cause a lack of ovulation and increases the removal of calcium from bones into the blood, which supports sympathetic dominance. High cortisol increases obesity by increasing fat deposition and the loss of lean muscle mass. It also has an antagonistic effect upon insulin production. It will cause headaches from vasoconstriction and inhibit the conversion of T4 to T3 for thyroid function. It shrinks and kills off hippocampus cells depleting emotional memory.
Adrenal Fatigue & Psychic Awareness
Many people believe that psychic awareness is based in the hippocampus, meaning that as adrenal fatigue sets in, psychic awareness may falter. As DHEA levels decrease and the catecholamine reserves are depleted, depression will begin. It is common for potassium levels to be low compared to sodium levels during this phase and higher protein intake will sustain the increased cortisol levels.
Phase 3 is the exhaustion phase in which cortisol and DHEA levels are both low. The person has now shifted from sympathetic dominance or resistance to parasympathetic dominance or exhaustion. The adrenal is now under-functioning and the body will enter a conservation mode. Symptoms of this phase are depression, maintenance insomnia and exhaustion, all of which can contribute to Chronic Fatigue Syndrome. Low levels of cortisol can bring on Fibromyalgia symptoms, impotence in men, panic disorders, infertility, anorexia nervosa, low white blood cell levels and low blood pressure.
Returning to Sleep
Sleep will be disturbed by waking up and not returning to sleep, a result of cortisol surges from the adrenals having lost their proper timed response. These surges can be worsened by hypoglycemia issues. Low levels of DHEA can cause recurring infections, arthritis, obesity and early menopause.
Many of these people simply lie down under the weight of the stress. They give up, they cry, they feel that life offers nothing for them. Instead they feel that life and the people around them simply drain them. They believe it will never change, and sometimes they are right. Choices are made which serve only to maintain the status quo, even though it is bringing them to the brink of despair. So the first order of business are adrenal tonics which will conserve cortisol, while nourishing and restoring the adrenal glands. Adrenal tonics are different from adaptagens because they increase or release available energy from our reserves. They reduce side effects of corticosteroid drugs and improve regulation of cortisol and DHEA output. They give the adrenal glands a rest by providing temporary energy. At the same time I will give them high-grade nutrition and provide restoration and treatment for each body system that relies on adrenal function, in order to temporarily spare the adrenals.
Natural Chemistry & Managing Stress”Although stress seems to be our worst enemy, it is also something we cannot live without.”
So providing natural chemistry in the form of herbs, compressed foods and nutritional therapy can bring someone back from the brink. It also gives them the incentive to learn new coping strategies, relaxation techniques and hopefully to make healthier choices every day. Although stress seems to be our worst enemy, it is also something we cannot live without. Notice what a double potential stress has here. It is the factor, which produces painful symptoms, causing limitations and even degenerative conditions.
On the other hand it is the signal of a weak point, which, if managed correctly, can guide one to greater strength, more endurance, fewer limitations, and finer art. We cannot control every situation and experience so there is no stress involved and we wouldn’t want to. So instead we need to learn how to recognize stress, pay attention to each body symptom and discover the way to work through it with coping mechanisms, body therapies and herbs. What we need in our lives is to learn how to form a working relationship with the stresses of our activities and the results of our choices. Remember, it is not the stressor that is good or bad, but what we learn to do in response to it.
Suggested formulations for adrenal fatigue and related symptoms:
To relax the mind – I suggest a soothing complex of Valeriana, Zizyphus and Passiflora which can help with relaxation of the mind and restful sleep. California Poppy provides more of a sedative effect for those whose minds are racing at night. For those who have severe mood swings, or who have a strong link between their emotions and their body function, I suggest a combination of Schisandra, Damiana, Scutellaria and Hypericum. Sleep is especially important as it is only during sleep that neurotransmitter chemicals and hormones are synthesized and normal chemical balance can be restored.
To restore nervous system balance – Providing a combination of organically-bound minerals such as potassium and iodine can break the sympathetic dominant cycle by working through the nervous system and bring the body fluids into pH balance. Ashwaganda or Withania will also provide an excellent adaptagen for the adrenal glands during this period.
To restore adrenal reserves – Adaptagenic herbs such as Rehmannia, high-grade Licorice, Eleuthero and Ashwaganda can all help to restore depleted adrenals from chronic sympathetic dominance.
To balance digestive function – Digestive enzymes including hydrochloric acid, powdered digestive fiber such as cellulose, apple pectin or barley bran, and the use of a digestive bitter formula can all help to normalize digestive function so that nutrition can be absorbed and utilized by the body tissues. The digestive bitter formula that I make for my patients includes Dandelion root, Tangerine fruit peel, Milk Thistle, Ginger rhizome, Gentian root and Chamomile.
To support immune function – It is essential during this recovery period to prevent the additional stress of illness. I suggest a combination of Echinacea Angustifolia and Echinacea Purpurea to modulate the activity of the immune system, reducing hyperimmune responses such as allergies. Also, lymphatic drainage can be of particular benefit during this time to cleanse and remove debris from body tissues. Galium or Phytolacca decandra are perfect for this. In severe cases, I will even use an adrenal or spleen desiccate to prevent further body degeneration.
Listen to: Interview with naturopath Karen Clickner on personalized natural treatments: Karen discusses holistic approaches to treatment and the differences between individuals. Karen has taught at the Reese Institute, the Wood Hygienic Institute, The Florida Institute of Massage Therapy, Massage Institute of New England and the Palmer School of Massage Therapy.
Interview with naturopath Karen Clickner on infertility and natural treatment: Karen also discusses adrenal fatigue and causes and herbal treatment of common problems in men and women. Karen’s articles have been featured in various publications including AMTA Journals. Karen is currently owner of I.S.I.S. in Brookline, MA and maintains a private practice in Geneva, Switzerland and London, UK. Her latest book, Ancient Healing for Modern Times will be available soon.