Hans Selye was the first scientist to really bring the effects of stress to light in his book The Stress of Life. Stress is caused by changes in our environment and it can be positive or negative. Both elicit similar responses in the body. There is a predictable set of physiological changes in response to stressors and these were collectively called General Adaptation Syndrome (GAS).
There are 3 stages of adaptation:
1. Alarm reaction - this is the initial response which involves increased adrenal secretions and activation of fight or flight responses
2. Resistance - changes in water balance and carbohydrate metabolism representing adaptation to stress
3. Exhaustion - This involves depletion of adrenal secretory functions
The adrenal gland sits on top of the kidneys and it has two parts with distinctly different functions. The inner portion or the medulla secretes epinephrine and norepinephrine which are associated with the sympathetic nervous system. The outer portion which is called the adrenal cortex makes steroid hormones. The main functional groups of hormones from the adrenal cortex are mineralocorticoids such as aldosterone, glucocorticoids such as cortisol and sex hormones. The mineralocorticoids are responsible for water balance in the body and maintaining blood pressure by controlling sodium and potassium levels. Cortisol has anti-inflammatory properties and it also affects carbohydrate metabolism by raising blood sugar and using fat and protein for energy. It also promotes the deposition of fat in the trunk area of the body. The adrenal cortical secretions are controlled by chemical messengers from the brain through the hypothalamic-pituitary axis (HPA). The controlling areas in the brain work on a circadian rhythm as well as various feedback loops. In normal HPA function, we have high cortisol levels upon awakening (after fasting all night) and the cortisol levels fall throughout the day and are at the lowest point during the first two hours of sleeping.
Adrenal dysfunction can be described as a multi-stage process. 1. Acute adrenal dysfunction 2. Adrenal Fatigue and 3. Adrenal Exhaustion. Addison's disease which is a serious medical condition of adrenal failure could be considered the fourth stage. The first 3 stages correlate with the three stages of GAS.
In the first stage the patient has elevated levels of cortisol. This stage is often missed because in the absence of lab testing it simply appears that the patient is stressed and many people are stressed at work or home from busy lives. The first stage patient may have difficulty sleeping. The second stage is where symptoms become more apparent. The patient may begin to put on weight, especially in the midsection. They may have mood swings and suffer from hypoglycemia. Some patients suffer from chronic inflammation and perhaps develop fibromyalgia or headaches. The third stage shows increasing numbers of the above symptoms with added severe fatigue.
In looking at the functions of the adrenal gland and how it is stimulated there are several effective lifestyle changes that can maximize the proper function of the adrenal gland. It is important to address both the physical and mental aspects. You can really help your body manage stress by engaging in meditative practices such as yoga and tai chi or simply taking walks with pleasant scenery. Make sure you don't get stuck at your desk for hours on end. Take a break - even to just make a cup of tea and get a healthy snack. You have to walk to the break area to do it so that's like a mini-break.
Caffeine is a powerful stimulant and it really pushes the adrenal glands into overload. It also disrupts proper water balance since it is a diuretic. Have you ever noticed that when you drink a lot of caffeine it takes more and more for you to get that buzz that you are seeking? Over time the caffeine fatigues the adrenal glands and so you have less of that "awake" feeling from consuming caffeinated beverages. I was very disappointed to learn this because I really love coffee. I have several types of coffeemakers in my house. So, what to do? Naturally decaffeinated coffee is great! I tried decaf from the supermarket and it smelled foul upon opening and no wonder since it is decaffeinated by chemicals. Then I found naturally decaffeinated coffee in which they remove the caffeine by a water-based process. I got mine at Trader Joe's and if you are lucky enough to live in an area where they have those stores I heartily recommend checking them out. However, as more and more people become aware of the problems with caffeine there are naturally decaffeinated products showing up in our regular stores. You may wish to start off half caf or slightly decaffeinated to wean yourself off so you can avoid a nasty headache.
Make sure you get enough fiber as this helps to manage your blood sugar levels. You can supplement your fiber by adding psyllium husks to juice. Psyllium is one of the components in powdered laxatives but it is best to get the psyllium by itself without the added chemicals found in the laxatives. Start in small doses since it will take time for your digestive system to adjust and it can cause flatulence if taken in large amounts. I like to add it to fruit smoothies with yogurt which has the added benefit of providing beneficial bacteria for the digestive system. And when it is in the smoothie you can’t taste it. In my last article I spoke of the dangers of fructose consumption but when you consume the fruit whole (or blended in smoothie) you are not going to absorb as much fructose - even less so if you add psyllium to your smoothie. Do not skip meals. This includes breakfast. I asked a patient if they skipped meals and they said no but indicated that they eat breakfast 5 hours after getting up. This is like skipping breakfast. In order to keep your blood sugar levels in check you really need to eat something within an hour or so of getting up. Some good things for busy people on the go are a cup of yogurt and a fruit or a homemade smoothie with protein. You can also do toast with peanut butter (or sunflower butter). If you really like your fruit juice make sure it is a small juice glass.
In my office I have a protocol for testing hormone levels and special supplements to support the adrenal glands. But the lifestyle modifications mentioned above are also very important.
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