Stress can be caused by environmental, physical, psychological or nutritional factors. One of the body’s initial responses to fear or stress is the release of hormones such as epinephrine (adrenaline) and cortisol that initially help us to react or adapt to a stressful situation. Cortisol raises blood sugar and blood pressure, increases the breakdown of protein, interferes with thyroid hormone action and stimulates visceral fat deposition, which can lead to metabolic syndrome. But, chronic stress is maladaptive and ultimately disrupts the body’s signaling system (the Hypothalamic-Pituitary-Adrenal Axis = “HPA Axis”) and the adrenal gland’s normal pattern of cortisol release.
This can lead to problems such as:

• Insulin resistance/diabetes
• Cardiovascular problems including arrhythmias, CHF, MI, atherosclerosis and hypertension
• Osteoporosis
• Dementia/memory loss
• Immune suppression
• Impaired thyroid function
• Decreased kidney function
• Exacerbation of skin conditions (acne, psoriasis, eczema)
• Gastrointestinal problems (GERD, Irritable Bowel Syndrome)
• Mood disorders and depression
• Increased risk of neurodegenerative diseases
• Sleep disorders
• Reproductive disorders
• Premature aging

Over time, the body may no longer be able to produce the needed amounts of cortisol and patients can ultimately end up with low cortisol levels (hypocortisolism). Fatigue, pain and stress associated with HYPOcortisolism may result in Chronic Fatigue Immuno-Deficiency Syndrome (CFS), Fibromyalgia and Post Traumatic Stress Disorder (PTSD), asthma, chronic pain syndromes, and autoimmune diseases.

Treatment of Adrenal Dysfunction

• Stress reduction techniques –Gentle exercise, Tai Chi, yoga, Pilates, meditation
• Sleep hygiene - Regular sleep-wake cycle, avoid third shift work. The following supplements may be helpful: 5-HTP, Melatonin, Phosphatidylserine, L-Theanine, Calming herbs (Valerian root, Chamomile, Hops, Passion flower)
• Lifestyle modification - Delegating responsibilities to eliminate stressors, regular meals, avoid caffeine and alcohol
• Vitamins and minerals - Magnesium Glycinate or Magnesium Citrate, B Vitamins, selenium, zinc, calcium, manganese, Vitamin E with mixed tocopherols, Vitamin C (Ascorbate)
• Adaptogens – Ashwaganda, Rhodiola, Holy Basil

Recommended Reading: “Adrenalogic – Outsmarting Stress” by Lena Edwards, MD, FAARM

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