ADRENAL STRESS AND FATIGUE

by Mary L. Clement, RN, ND

     Adrenal stress and fatigue is a syndrome of our fast-paced, caffeine-addicted, sugar, drug and alcohol-abusing society. Adrenal fatigue potentially affects all persons and undoubtedly affects those of us who have dealt with chronic addictive disorders. In response to acute stress, our adrenal glands secrete powerful hormones, yet with chronic stress, adrenal output of these hormones may lessen resulting in a decrease in coping mechanisms as well as in overwhelming fatigue. With chronic stress, we may wake up tired; we may go to bed tired; and we may not feel refreshed even after napping.

     Stress directly affects the adrenal glands. Each of two adrenal glands is embedded in fat above each kidney and is comprised of an outer portion called the medulla, and an inner portion called the cortex. The outer medulla secretes epinephrine and adrenaline in response to acute stress, resulting in an "adrenaline rush". The inner cortex secretes several hormones including cortisol, DHEA (dehydroepiandrosterone), and aldosterone in response to physical and emotional stress, blood sugar imbalance, electrolyte imbalance, pain, caffeine intake, chronic illness and surgery.

     A major metabolic stress is blood glucose (blood sugar) imbalance which not only affects the adrenal glands, but also affects the pancreas and the liver. Anorexia and starvation cause a chronic pattern of abnormally low blood glucose resulting in an increased output of adrenal cortisol. Cortisol signals the liver make new blood glucose from available amino acids. On the opposite metabolic spectrum, binge eating of refined sugars and carbohydrates or over-consumption of alcohol may cause an initially high glucose level, followed by a surge of pancreatic insulin. The output of insulin results in a lowering of blood glucose. Continual blood glucose fluctuations and storage of blood glucose as triglycerides may potentially leading to a pre-diabetic condition. Storage of triglycerides leads to abdominal obesity.

     Alternating cravings for salt and sugar are a physical symptom resulting from imbalanced blood glucose and electrolyte levels. Starvation, dehydration, bingeing and purging or vomiting from alcohol may in result in the dangerous reduction of the body's electrolyte levels affecting both cellular function and the electrical conduction of the heart.

     The psychological addiction of drug abuse and cutting may result in an abnormal adrenal secretion of epinephrine and adrenaline, giving a stress-induced "adrenaline high". Adrenal cortisol, secreted after the physical act of cutting, is the body's response to reduce pain and inflammation from the injury to the soft tissue.

     Chronic stress from any source may result in bone-tired fatigue, difficulty getting out of bed in the morning, dragging through the day, needing to nap often with a "second wind" in the evening or falling sleep or staying asleep with difficulty. To increase depleted energy, the stimulating effects of sugar, coffee, espresso, colas, caffeinated teas, and chocolate become the standard; however, in the long run, these "quick fixes" potentially feed addiction and continue to fatigue the adrenal glands to a greater extent.

     Hans Selye, a physician and endocrinologist at the University of Montreal, spent 50 years researching the role and consequences of long term stress on the body. His adaptation theory of chronic stress leading to adrenal failure gives us the platform for assessing and treating adrenal fatigue and exhaustion. (Note that adrenal exhaustion differs from actual adrenal disease, such as Addison's disease which needs to be evaluated, treated and monitored by an endocrinologist.)

     "The Social Readjustment Rating Scale" from Holmes, T.H., and Raye, R.H., taken from the Journal of Psychosomatic Research"; 11 (1967) 213-218, is the gold standard for measuring levels of stress in our lives. For our specific purpose here, I have adapted this survey to incorporate additional Life Change Units (LCU) for the levels of stress that we experience with addictive disorders. (See Adapted Stress Survey at the end of this article.)

     Recovery from adrenal fatigue associated with starvation, bingeing, purging, drug and alcohol abuse and cutting takes time. Eliminating simple carbohydrates in the form of white flour and sugars, caffeine and alcohol reduces stress on the adrenals. 9-1-1 STRESS CONTROL, MIND-BODY RESTORE REMEDY, ADDICTIONS can help with adrenal fatigue. Included in daily supplements should be nutrients such as B vitamins, Vitamin C and adaptogenic herbs to support adrenal function. Taking quiet time, journaling, praying, exercising, laughing, and enjoying family and friends nurtures the nervous system and helps allow the adrenals to slowly, steadily recover.

     See Adapted Stress Survey (PDF).