Dr. Elizabeth Tully
Image Massive Health

In my last two blogs, I have touched on the idea of Adrenal Fatigue. That is the concept that chronic stress and poor diet can lead your body down the path of hormonal imbalance and physiologic dysregulation that will eventually cause symptoms to appear.

These are not disease states. Many times you may have symptoms, for instance fatigue, and no disease is present. Adrenal Fatigue is a term that represents what may be taking place in your body during that time when you ‘don’t feel right’ but no disease or pathological process can be identified.  Another ways to say this is “The doctor says my tests are normal, but I still don’t feel good.”

Therefore the advice given here is not intended to diagnose, treat, cure, or identify any deficiency. It is meant to give you some information on how to support your body with correct nutrition, either by diet or supplement.

Because the adrenal glands are our stress handling center and a place of hormone manufacture and release, their effect on our body is intertwined with the other steroid family hormones.  For this reason you may suspect (or know) that you have imbalances in male or female hormones, the blood sugar handling hormones or even thyroid hormones.  If this is true, much of the same advice will apply to helping your body heal. Click here for stress inducing behaviors to avoid.

The adrenal glands secrete cortisol.

Common signs of increased cortisol include:

  • Increasing Fatigue
  • Weight Gain
  • Tired after meals
  • Mood, Thinking and Memory problems
  • Sleep Disruption (Inability to fall asleep or stay asleep)
  • Anxiousness/Nervousness
  • High Blood Pressure
  • Infections/Low Immune
  • Food Allergies/Seasonal Allergies
  • Leaky gut
  • Stomach Burning (Indigestion, Reflux, GERD)
  • Sweet and Carb Cravings
  • Decreased Libido

Notice anything familiar? If you do, you need to change your response to stress and watch your diet.

Get off the SAD diet

If you have never heard the term SAD, you may be a prime candidate for this advice. SAD stands for Standard American Diet and represents foods that are over processed and under nutritious. This topic could constitute many pages of research, recommendations and commentary, so for now I will trim it down to 3 recommendations :

  1. Reduce or Avoid processed foods including all grains .
  2. Increase your intake of fruits and vegetables to include some at every meal, including breakfast.
  3. Eliminate any beverage that is not water.

And 3 comments:

Processed foods describes anything not in its natural state and includes staples like fast food, junk food, snacks, flours and sugars and just about ANYTHING that comes in a package.  Fruits contain sugars in natural form and they can be consumed daily, but twice as many vegetables should be eaten. Beverages that contain caffeine or alcohol should be slowly eliminated by tapering down.  (Those with known conditions, such as diabetes, should follow their doctors recommendations on sugar and alcohol consumption.)

 Supplements to Increase Vitality and Healing

(I only use whole food supplements in my practice and find them superior for many patients.)

Vitamin C – The adrenal glands use and store Vitamin C because it is needed for hormone production. Vitamin C is also used for many other bodily functions and reactions. Because Vitamin C is a water-soluble hormone, it is easily excreted from the body and must be consumed every day.  Foods  high in vitamin C include broccoli, peppers, strawberries, oranges, and spinach. In my office, I recommend Cataplex C, a whole food supplements made by Standard Process Inc.

Vitamins B – When we are under stress, eat refined foods, smoke, or eat sugar we burn though our Vitamin B stores. Also needed for adrenal function I recommend Standard Process Drenamin which contains B vitamins and adrenal extracts.

Vitamin E is a precursor of hormone production and a food sources are usually high in (good) fat.  Add olives, avocados, sunflower seeds, spinach, Swiss chard, turnip mustard and beet greens to your diet. Whole food wheat germ oil is a natural source of tocopherols (an explanation of tocopherols is found here) and is an excellent way of getting Vitamin E.

Vitamin D – Vitamin D testing is strongly suggested as the many benefits of normalized Vitamin D levels are well-known.

Herbs to Consider**

Another topic that many pages can be devoted to, herbal support is appropriate for many tough cases.

Licorice – Known as an adrenal tonic, licorice is a support which may work best for those with low cortisol, as it has been shown to extend the life of cortisol. It has anti-inflammatory effects and may support lung and bowel function. Licorice is contraindicated in high blood pressure, edema, low blood potassium and congestive heart failure.

Ashwaganda – Considered adaptogenic,  it helps the body adapt to stress and is indicated with fatigue, sleep problems and weakness. Good for those who feel stressed out, its anti-inflammatory and anti-tumor effects have been studied.

**Care must be taken when using and buying herbs. Most herbs are contraindicated in pregnancy and lactation. Consult your doctor before starting any herbal protocol.

Symptoms of Adrenal Fatigue or Adrenal Insufficiency

Do you have problems with fatigue or lethargy? Is it hard to get up in the morning because no matter how long you sleep, you just don’t feel rested? Or do you have problems getting to sleep because you catch a” second wind” in the evening and stay up too late trying to get things done, and then can’t fall asleep easily?

Lethargy, fatigue or inability to handle stress might make sense to some who understand that the adrenals are part of our stress handling system. But what about the hidden signs that you might be taxed to the max?

Do you experience any of these Hidden Signs?

  1. Salt Cravings
  2. Allergies (Food allergies, Seasonal Allergies, Pet allergies, etc)
  3. Low Immune
  4. Increased Recovery Time from illness or injury
  5. Digestive problems
  6. Hormonal Problems
  7. Dizzy or light-headedness when standing quickly

If you see yourself in the images above, you may be suffering from Adrenal Fatigue

The Adrenal Glands.

The Endocrine system

The Endocrine system

 

The Adrenal glands are part of the endocrine system which is the interconnected system of hormone secreting organs.  Like the pancreas, ovaries or testes, the adrenal glands produce very powerful substances which are released into the body in tiny amounts. These substances create a complex system of signals designed to keep us healthy, fertile and able to meet the stresses of everyday life.

The adrenal glands are two small glands, approximately the size of a walnut, which sit on top of each kidney.

Adrenal Glands

Adrenal Glands

The adrenals are the stress handling glands and produce a number of hormones that help you process stress — physical, mental or emotional. They keep your body in balance and mediate the ‘flight or fight’ response.  The adrenals control fluid balance, blood pressure balance, blood sugar balance (especially between meals), inflammatory and anti-inflammatory response and immune system response and strength.

The hormones that the adrenals produce belong to the steroid family and help determine overall strength, energy, vitality and stamina. These hormone help us maintain a sense of well-being and keep up healthy mood and emotion and act as the back up system for our male and female hormones.  The adrenals produce precursors to testosterone, estrogen and progesterone along with the anti-aging hormone DHEA.

A cup full of Stress, anyone?

Is it any wonder that people who have stressed their adrenal glands are tired, anxious, overwhelmed and at times unhappy?

Bu, you may ask, how did my adrenals get stressed? I don’t remember a lot of big stressors, just normal life.

Therein lies the problem.  Our bodies are designed to handle a big stress and then rest.  A big happy stress, like having a baby and then a few weeks of rest.  Or a major negative stress, like the death of a loved one, and then back to life as usual. But in our hectic, over scheduled, traffic ridden, can’t-find-a-parking-place-and-I’m-late existence, stress accumulates and then tips you over the edge.

Factors Leading to Adrenal Fatigue

  • Lack of Relaxation
  • Emotional Stress
  • Lack of Sleep
  • Processed Non-Nutritious Food
  • Oral Contraceptives
  • Work Stress
  • Marital Strife
  • Sedentary Lifestyle
  • Smoking
  • Antacid Use
  • Persistent Pain
  • Prescription Drugs
  • Skipping Meals
  • Caffeine Use
  • Negative Thinking

I’m Stressed out just reading this.  What do I do about it?

The following is a list of positive things changes you can make. You will not erase a lifetime of bad habits immediately. First you must recognize the patterns that led you down the road to adrenal fatigue.

Change your daily patterns to include the following:

Pace yourself and allow down time to rest

Eat real, whole, fresh foods

Eat every two hours (yes even breakfast, even if is just 2 bites)

Eat a protein and fat with every carbohydrate

Get to bed by 10 – 11pm

Sleep until 7 – 8am when possible

Drink more water and herbal teas

Do things that you enjoy

Mild exercise such as swimming, walking, yoga

Find things that make you laugh, like a little kitten in a big comforter.

 

Little kitten, Big comforter

Little kitten, Big comforter

 

Do you have persistent pain?

Do you have persistent pain?

What is Persistent Pain?

A recent study published in the October issue of the Journal of Pain¹ describes persistent pain as pain that is present “every day or most days in the last three months”.  Persistent pain differs from chronic pain in that chronic pain is described as pain which continues over a three month period of time but not is necessarily experienced every day.  According to the Institute of Medicine (2011) 100 million Americans have chronic pain.

Data taken from  the 2010 Quality of Life Supplement of the National Health Interview Survey² states that 60% of adults report back pain over the prior three months.   Only 42% of those who reported back pain noted that their pain was frequent or daily and lasted over 3 months.  Therefore all 60% would be categorized as chronic, but only a portion of those would call their pain persistent.

Devastating Effects

The study goes on to report that sufferers of persistent pain are more likely to be older adults (60-69), with women having a slightly higher risk than men.  The long-term effects of this type of continuous pain include:

  • Anxiety
  • Depression
  • Fatigue
  • Work Disability
  • Overuse of Pain Medications

Common Factors

Certain characteristics were noticed in those with persistent pain.

18% were overweight

25% were obese

35% had been hospitalized in the previous year

45% had anxiety

57% reported depression

64% had fatigue

 

What’s wrong with this picture?

A 2014 study in the Journal of the American Medical Association titled “Management of Persistent Pain in the Older Patient: A Clinical Review”³  reviewed 92 studies, 50 of which focused on “older adults with osteoarthritis.  Although the study recommended a multifactorial approach, their first line approach is with Acetaminophen therapy, despite the fact that acetaminophen is associated with liver injury especially in patients who are taking more than one drug (even over the counter drugs) or drinking alcohol. 4  According to the study, if that doesn’t work, other drugs should be tried and other modalities should be included, such as “physical and occupational rehabilitation“.

Per the study above, many of my patients can attest that physical therapy doesn’t always work.  Acetaminophen as a pain reliever gets laughs from the majority of my patients who are turning to stronger prescription medications to reduce their pain.

Moreover anyone who actually listens to these people can attest to the fact that exercise can be uncomfortable or even impossible when you are in pain.  Weight gain, anxiety, depression and fatigue can all be related to the increased difficulty of performing every day activities while in pain.  In the medical literature, much is made of “fear avoidance behavior” in which the patient becomes afraid of doing certain tasks because they can aggravate their pain.  No notice is given to the many patients who “push through” the pain to fulfill their responsibilities to children, parents and employer, all the while getting worse.  A significant number of these people want to know what else BESIDES pain medications can be done.

 

Why chronic pain and persistent pain sufferers need Alternative Therapies.

Pain sufferers must DEMAND to know why they have pain. I have seen many patients misdiagnosed with arthritis.  What they have is joint misalignment which, when treated, can alleviate the pain.  I have spoken to many people who tell me, “I’m just getting old, the doctor says I have arthritis.”  This statement is usually accompanied by a gesture pointing out the offending joint (a knee, more often than not).  My response is always the same, “How old is the other knee?”

If it’s a normal part of aging, why doesn’t it happen on both sides?

Arthritis does NOT have to be a normal part of aging.  Accidents and injuries cause joint misalignment and the older you are, the further in the past those injuries are, the more likely that the joint has degenerated from not moving properly.

You must demand a greater understanding of your body.  You must work to eat right, exercise, and manage stress when you are young so that your body can rely on its healing abilities as you age.

Alternative therapies address you as a whole person.  We don’t look at your knee or your spine or your sleep habits by themselves. The whole person must be addressed.

Anxiety, depression and fatigue can be indications of adrenal fatigue. Weight gain, fatigue and weakness can be a result of a sluggish thyroid or early thyroid disease. Both thyroid and adrenal conditions can be subclinical (the blood tests are normal) and can sometimes follow a physical injury or emotional stress.

On going stress can result in digestion problems, leaky gut and an inability to absorb nutrients and process hard-to-digest foods. This will also lead to an inability to heal and perhaps persistent pain.

Alternative Therapist, like many Chiropractors, Naturopaths, Nutritionists and Acupuncturists can analyze your blood work and send you for further testing. We can recommend supplement, herbs or essential oils to help your body deal with the stresses accumulated over a lifetime.

It’s your life, demand excellence!

 

 

1.  Prevalence of Persistent Pain in the U.S. Adult Population: New Data From the 2010 National Health Interview Survey http://www.jpain.org/article/S1526-5900%2814%2900774-3/abstract

2.  Nurse.com News http://news.nurse.com/article/20141029/NATIONAL06/310290021#.VFbMHhaExG4 or

http://www.cdc.gov/nchs/nhis/qualityoflife2010.htm

3.      Management of Persistent Pain in the Older Patient: A Clinical Review   http://jama.jamanetwork.com/article.aspx?articleid=1899177

4.  Acetaminophen and Liver Injury: Q & A for Consumers   http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm168830.htm