This episode is for my mom.
Like me, she's dealt with years of mystery health issues. She's gone to countless doctors, tried hundreds of supplements, dozens of diets, and only ever experiences relief for short periods of time.
But among her many tests, the one that sticks out to me is that her adrenals are absolutely shot. And if there is one thing that will put a halt to any healing, it's burned out adrenals.
She told me about this months ago, so why am I only just writing this episode now?
Because while I was visiting my parents in Florida this past weekend, we all went to the gym together and as we left at noon my mom says, "I'm starving, I haven't eaten yet today... besides coffee."
Now as a functional nutrition coach, I know some of the worst things she could do right now are a) skip breakfast b) start the morning with coffee (particularly on an empty stomach) and c) workout without food in her belly.
When I said as much, her response was "I guess I just didn't really understand what the adrenals were or what to do about it."
And that's when I realized I needed to write this episode. Because even though she listens to health podcasts and audiobooks 24-7, this was a gap in her knowledge and a key to her healing. And maybe it is for you too.
To be fair, adrenal fatigue is a bit of an outdated term, but I know it's the term most people are familiar with. The more accurate name would be HPA Axis dysfunction. Because there are lots of things that can go wrong with the adrenals that isn't just them getting 'tired'.
Let's do a quick anatomy lesson. The HPA Axis refers to the hypothalamus and pituitary in the brain communicating with the adrenals (H-P-A). In a healthy HPA Axis, when we experience a stressor the hypothalamus communicates with the pituitary which then signals the adrenals to produce the stress hormone cortisol.
Cortisol helps us respond to said stressor by diverting blood flow away from digestion and towards our limbs in preparation to fight or run away, dilating our eyes, breaking down our own tissue for energy, raising blood sugar, and suppressing inflammation so you don't feel the effects of the breakdown. This is the fight/flight response at work and its sole purpose is survival.
Once the stressor is removed, there should be a negative feedback loop that stops this fight/flight response. Cortisol should subside and the adrenals should then be able to produce DHEA which comes in to build back up what cortisol has broken down.
Mind you, this process isn't only stimulated by emotional stress. Infections, chemicals, drugs, pesticides, heavy metals, food sensitivities, parasites, bacteria, viruses, mold, oxidative stress, unresolved trauma, toxins, unhealthy food, injury, and lack of sleep all start the stress cascade.
But what happens over time when the stressor doesn't subside and we aren't able to get out of fight/flight? A multitude of things can happen.
One: Signaling along the HPA Axis starts to malfunction, meaning the communication between the hypothalamus, pituitary, and adrenals starts to break down. It's like if you were trying to work for 3 days straight with no sleep. You're going to start making some pretty big mistakes. This can cause cortisol to be high when it should be low and low when it should be high.
Two: You can have receptorship problems, meaning the hormones that are released for signaling can't be received by the cells.
Three: You can have liver problems causing too high or too low cortisol-binding globulin, leading to imbalances of cortisol in the blood.
Four: You can have cortisol metabolization issues.
Five: The adrenals simply can't keep up with the demand for cortisol, there's no time to replenish because you're constantly pulling from your internal stores.
At this point your body has no choice but to switch to using adrenaline to make it through which is highly catabolic, meaning it breaks your body down at a rapid rate causing all sorts of chronic health issues, feelings of being tired and wired, and the inability to recover and heal.
When this happens you can experience a plethora of wide-ranging symptoms like:
Sometimes I think there's a misconception that we go from health to illness overnight, usually because that's how we experience symptoms. One day we're fine, the next day we have a migraine. One day our energy is good, the next day we can hardly keep our eyes open.
But that's not how the body works. It loses function in stages, and adrenal burnout is no different.
Stage 1: Homeostasis.
In this stage, our body has enough energy and internal resources to overcome our stressors and we're in a state of good health.
Stage 2: Acute
In this stage we're encountering more short-term stressors, but our body has strong enough adrenals and enough internal resources to deal with those stressors by increasing cortisol.
So our adrenals are able to meet the demand, and because we’re getting an increase in cortisol we’re probably actually feeling pretty good, we might even experience a bit of a high because of the anti-inflammatory and energy effects of cortisol.
This is what a lot of workaholics experience early on. They're feeling the buzz of constantly checking things off their to-do list and have energy to put in long hours and think they're 'thriving'.
Ideally from here we drop back down into homeostasis relatively quickly when the stressor is removed.
Stage 3: Compensatory
If we don’t drop back down into homeostasis and we continue to get hit with stressors and it becomes more chronic that’s where we head towards compensatory.
At this point your cortisol should be higher considering the amount of stress you’re dealing with but your body isn’t quite able to adapt as well as it used to.
Your adrenals are tiring out and they can’t keep up.
At this point you’ll start to feel more symptoms, systems start losing function, your hormones will start to fall out of balance, you may be self-medicating with things like coffee and pain relievers, and while you feel like crap a doctor is telling you everything looks normal.
A note on hormones: DHEA is a precursor to testosterone and estrogen. So when cortisol is chronic and we can't release DHEA, it negatively impacts our ability to produce these important sex hormones. Plus when our demand for cortisol is high, our body can dip into our progesterone to make more, leading to even further imbalance.
Stage 4: Exhaustive
Finally if we don’t support our body and we continue to get bombarded with stress we enter into the exhaustive phase which can last for a really long time.
Here is where we really struggle because at this point we can’t produce enough cortisol to deal with the amount of stress our body is experiencing and we switch to adrenaline.
This causes our internal resources to get more rapidly depleted, we’re dealing with chronic symptoms and/or encountering new diagnoses, we struggle regulating our blood sugar and weight, we can't heal because our body is breaking down faster than it can repair, and we just feel awful.
Think about this phase like when your phone is about to die and you switch to power saving mode. The screen isn’t as bright, you can’t use the bigger apps, and even the apps you do use might not have as much functionality because there isn’t enough energy to give to them, and if you don’t plug the phone in it will eventually shut down altogether.
Now that you know what HPA Axis dysfunction is and how it can show up in your life, you're probably wondering what you can do to support your adrenals and get back to a state of health and wellbeing.
There are two major focuses you need to have: eliminating as many stressors from the body as possible (remember stress comes in many forms), and eating/supplementing/living in a way that supports the adrenal gland itself.
This is going to look differently for everyone and it can be helpful to have a coach identify the habits that are causing the biggest problems for you. But here are some things to consider:
Restoring your adrenals.
I know this was a lot of information and I gave you a ton of action steps to play with. So kudos to you for making it this far!
If you're feeling overwhelmed, don't know where to start, or just want someone to break this down into a step-by-step plan and walk you through this extremely important journey, I would love to support you.
All it takes is you stepping forward and starting the conversation. With a free consultation I'll ask you about your current symptoms, habits, and goals and help you figure out the best course of action (whether that's working with me or not). Click here to book yours now.
And to my mom, I hope this episode has been helpful, I love you to the moon and back!
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