Adrenal fatigue

Eating to support your adrenal glands small choices can make a difference
by Marcelle Pick, OB/GYN NP Fatigue is one of the most common symptoms I hear about from my patients at the clinic. And when I ask these women to tell me about whats going on in their lives, all too often the answers include more responsibility than seems humanly possible. Theyre waking up still tired, unable to think straight in the morning without caffeine; needing high-carb snacks, more caffeine, or a nap to get through the afternoon; then burning the midnight oil because theyre too wired to sleep. Pretty soon these women are in a seemingly unending cycle of exhaustion and poor nutrition and they feel desperate for the energy they once had. Science tells us that if you experience stress on a chronic basis, the tiny adrenal glands that moderate your stress response and balance many other hormones in your body will suffer. Adrenal fatigue is what develops. And as the adrenal glands become increasingly compromised, women end up with excess abdominal weight, decreased immunity, lack of concentration, irritability, disrupted sleep, and ultimately, pure exhaustion. But the upside is: adrenal fatigue can be prevented and reversed. Ive seen it time and again. And one of the best places to start is by paying closer attention to the choices you make about food and not just what you eat, but when you eat it andhow. From my own experience and that of my patients, I know its difficult to make good nutritional choices when were going through periods of stress. Not only are our minds preoccupied with the stressor at hand, but our bodies are telling us they desperately need support, so we reach for foods that provide quick energy. Particularly at the end of a stressful day as the body is entering a period of recovery, overeating or making poor choices can be easy to do. I know it feels overwhelming to think about changing your eating patterns, but believe me, small, incremental changes can really support better adrenal gl and function and your daylong energy reserves. You dont have to drag through the long days or dread your alarm clock every morning. Lets look at some options for supporting your adrenals so you can enjoy good energy all through the day, and get a great nights sleep. The difference can be like night and day!

Your foundation rests on adrenal health

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 you r car moves on the road will be safe, steady, and strong. Youll 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 cars efficiency, your adrenals can take a lot of strain before you begin to see the effects on your body.

First and foremost: timing your meals and snacks

One thing I often tell my patients is to never allow themselves to get too hungry. Low blood sugar by itself puts stress on your body and can tax your adrenals. You may not realize that your body is in constant need of energy even as you sleep. And the primary adrenal hormone cortisol serves as a kind of moderator in making sure your blood sugar between meals, especially during the night, stays adequate. It does this by signaling to the liver to release its stored sugar, glycogen, when there isnt food on board. Long periods without food make the adrenals work harder by requiring them to release more cortisol to keep your body functioning normally. So eating three nutritious meals and two to three snacks that are well-timed throughout the day is one way to balance your blood sugar and lessen the adrenal burden. When you eat can also make a difference in preserving, supporting, and restoring your adrenals. As you can see in the graph, cortisol has a natural cycle that works with your circadian rhythm. Normally, it begins to rise around 6:00 AM and reaches its highest peak around 8:00 AM. Throughout the day cortisol gradually declines with small upward bumps at meal times in preparation for nighttime rest.

Its ideal to work with this natural cycle to keep the tapering-off of levels as smooth as possible as the day progresses and to avoid dramatic ups and downs. To do this, it helps to get the majority of your food in earlier in the day, and to eat an early dinner (by 5:00 or 6:00 PM). If its difficult to eat early, as it is for many of my busy patients, at least try to make your evening meal the lightest one of the day, to prevent a surge of cortisol from ramping up your night -time metabolic rate and disrupting your ability to fall or stay asleep. Many of my patients tell me they overeat to soothe themselves in the evening. This night-eating habit is due to the appetite-stimulating effects of residual cortisol, and unfortunately, it only further disturbs our hormone axis. Keep in mind that cortisol will also rise a bit with exercise. Lighter activities, such as a walk after dinner or a bit of gentle stretching before, will not subvert this natural tapering-off process. But to work in concert with your bodys natural cortisol cycle, more intense exercise is best planned for the morning.

But Im not hungry in the morning...

As your mother probably told you, breakfast is important. But maybe you dont feel hungry in the morning, and if so, it could be for the following reasons:

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Corticotrophin-releasing hormone(CRH), which has appetite-dulling effects, begins to enter the bloodstream at a fast rate first thing in the morning. Decreased liver function, which can accompany adrenal dysfunction or a heavy toxic burden, can also dampen morning hunger.

Even if you dont feel hungry, having a nutritious breakfast within an hour of rising preferably with protein will provide energetic benefits to your metabolism and cortisol levels that last throughout the day.

Here are some other simple ways to gently support your bodys natural cortisol cycle:

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If possible, eat breakfast by 8:00 AM or within an hour of getting up (earlier is better), to restore blood sugar levels after using glycogen stores at night. Try to eat lunch between 11:00 AM and 12:00 noon. Your morning meal can be used up quickly. Eat a nutritious snack between 2:00 and 3:00 PM to get you through the natural dip in cortisol around 3:00 or 4:00 in the afternoon. Make an effort to eat dinner around 5:00 or 6:00 PM, and make this your lightest meal of the day.

Supporting your bodys natural rhythms by timing meals and preventing dramatic dips in blood sugar not only minimizes cortisol output and frees up your adrenals to perform their secondary functions, but gives you more sustained energy throughout the day and life becomes much more enjoyable when we have the energy we need.

Eat, drink, and support adrenal gland function

As our awareness about when we eat increases, its also helpful to think more about what we eat. Stress often brings out the worst in us especially when it comes to food choices. Many of my patients with adrenal fatigue tell me they reach for foods that give them an instant burst of energy foods like cookies, cakes, doughnuts, white bread or pasta. These foods contain refined sugar and flour, and allow a great surge of energy, but generally the surge is followed by an even greater dip in energy, causing you to feel worse. Another problem with high-carb foods like these is that they often contain gluten, a protein that is found in many grains (including wheat, rye and barley, and oats) and fr equently used as a food additive, too. I have found in my practice that many women with adrenal fatigue are sensitive to gluten. For this reason, a gluten-free diet is one of the first things I suggest to my patients withsymptoms of adrenal fatigue, who often report feeling much better when they get the gluten out of their diets. Other women with adrenal fatigue drink more and more coffee or soda throughout the day to stay awake. They may think its not affecting their sleep patterns, but research has linked higher caffeine intake to classic night owl or eveningness behavior. (See our article on the effects of caffeine for more info.) Caffeine can pick you up in the short term, but it can also over-stimulate the adrenals, which only compounds fatigue as it wears off. If you find yourself craving caffeine or sugar for that matter it may be that your cortisol is low, but it also simply may be that your body needs to rest. I encourage you to honor your bodys request and take a break, instead of winding it up another notch. Take a quiet moment and treat yourself to some deep breathing or a tenminute walk. And if drinking a cup of coffee is a relaxing part of your routine and you dont want to give it up, drink it in the morning with something nutritious to eat, and add cream to dull the negative effects of caffeine.

Choosing adrenal-healthy beverages

Just as with food, your choices about drinks can either contribute support or strain on your adrenal glands. Here are some good and not-so-good choices.

Adrenal draining

Adrenal restoring

Ginseng [Panax sp. ] Drinks that Eleuthero/Siberian contain ginseng [Eleutherococcus caffeine senticosus] (in the morning)

 Alcohol Gatorade

Herbal teas like chamomile, passionflower, valerian Vegetable juice (with salt), like V-8

Every day we make choices about what we eat and drink. Some days those choices are helpful for the body and other days or meals arent so helpful. What I encourage you to focus on is balance. Nourishing your body with balanced meals and snacks can do wonders for your energy and feed your adrenal health at the same time. Yet, you dont want to be so stuck on eating right that you cause yourself more stress! I always tell my patients to eat their best 80% of the time. The other 20% is up to them. Eating meals and snacks that are made of fresh whole foods, preferably organic or locally grown, without colors, dyes, chemicals, preservatives or added hormones are best to strive for. Including some protein in all your meals and snacks (especially in the morning) will have a stabilizing effect on your blood sugar, which in turn can help you overcome caffeine and sugar cravings. (For more information on eating balanced meals, see our Personal Program Nutritional Guidelines.) To lessen the stress that often comes with trying to eat healthfully, think about preparing nutritious foods on the weekends so you have them ready and available on busy weeknights, or stop at a health food store to pick up some hot prepared food. Dont feel guilty if your food isnt homemade every day in your own kitchen. Guilt is the last thing your adrenals need!

Salt and adrenal fatigue

Women with adrenal fatigue often crave salt and many of my patients are surprised when I tell them to honor this craving. Yes, salt can increase blood pressure, but low blood pressure(hypotension) is a very common sign of adrenal fatigue at all stages. If you feel lightheaded when getting out of bed in the morning, standing up quickly, or getting up out of a bath or hot tub, you may very well have low adrenal function, and including more salt in your diet could be helpful. But try to make it good-quality, iodized sea salt. Craving for salt in people with adrenal fatigue is complicated to explain, but in a nutshell, its a result of low aldosterone. Aldosterone, a steroid hormone produced by the adrenal cortex, is part of the complex mechanism that regulates blood pressure in the body. Levels of aldosterone go up and down in much the same diurnal pattern as cortisol does, and likewise go up as a normal response to stressful situations. Production of aldosterone by the adrenals depends on how much cortisol - stimulating hormone (ACTH) is being sent from the brain. The brain takes its signals from the amount of circulating cortisol not circulating aldosterone so high cortisol tends to lower the brains ACTH production, which in turn decreases aldosterone secretion, leading to lower blood pressure. Another consequence of low aldosterone is electrolyte imbalance and cell dehydration, which both have negative effects on almost all physiological reactions in the body: aside from salt cravings, low blood pressure and lightheadedness, patients with adrenal fatigue often experience an irregular heart beat, lethargy, muscle weakness, and increased thirst. These are all a result of imbalance in sodium and other minerals, including potassium and magnesium. Increasing y our salt intake is one way to help restore these imbalances.

A nutrient-rich foundation essential for healing adrenal fatigue

If you decide to do nothing else for your adrenals, I urge you to provide your body with a strong nutrient base.

If you need additional support for adrenal health

Our Essential Nutrients provide an optimal nutrient foundation for your adrenal health. Yet some women need extra nutrient support for healing adrenal fatigue. Here are my top recommendations:

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Ashwagandha (Withania somnifera) Eleuthero / Siberian ginseng (Eleutherococcus senticosus) Phosphatidylserine Licorice root (Glycyrrhiza glabra) Extra B vitamins (B-complex)

You can begin on your own with the first two herbs listed above. If you do not notice improvement within a few weeks, see a functional medicine or naturopathic practitioner for a program that best fits your personal needs dosage, timing, blood pressure, cortisol levels, and other factors should be taken in to consideration.
Vitamins like C, E and all the B vitamins have crucial roles in the reactions that occur in the adrenal cascade. And a mineral like magnesium provides necessary energy for your adrenals and every cell in your body to function properly. Calcium and several trace minerals like zinc, manganese, selenium, and iodine provide calming effects in the body. These minerals can help to relieve the stress that comes with and causes adrenal fatigue, which will ultimately lessen your cortisol output. A strong nutrient foundation also supports the endocrine system overall. There is great synergism between the different organs of the endocrine system (including the adrenal glands), where each organ and its secretions interact with the others to upregulate and downregulate activity to keep us in balance. But as hormonal levels become deficient or excessive, the natural response of our cells is to compensate by increasing or decreasing their receptors for those molecules. To do all this optimally, they need nutritional support!

Small things, dramatic differences

Your adrenal glands are tiny in comparison to many other organs. They are roughly the size of a walnut, yet they have enormous responsibilities in your body. When they are functioning at their peak, these small glands can help you feel energized when you need to be and relaxed when it is time for rest. They contribute to the production of estrogen, testosterone, progesterone and so much more. But lifes demands can slowly drain the balancing power of the adrenal glands. Even the healthiest persons adrenals, though evolutionarily equipped to handle periods of stress, become fatigued under chronic, unrelenting stress. You have the power to lessen the burden on your adrenals and your whole body. It doesnt take much. The small choices you make in regards to your nutrition and eating patterns will make a difference. Heres my advice to you: support your foundation with a high quality nutritional supplement and eat good food in harmony with your bodys na tural daily rhythms. Soon youll find the energy you thought you lost and itll be here to stay!