Dr. Doni Wilson explains the symptoms of adrenal distress, how abnormal cortisol and adrenaline levels can affect your health, and how to recover – naturally.
Many patients come to me suffering from an array of health symptoms that are effectively ruining their lives. After struggling with sleep problems, low energy, mood issues, and a weakened immune system that seems to put them in a state of perpetual illness, they have reached a point where they are frustrated and confused.
Whenever I see such patterns of symptoms, experience has taught me that they are usually (at least in part) related to adrenal issues. Any time a patient is struggling with sleep, energy, mood and overall resilience, the first thing I investigate is the state of their adrenal health.
In fact, helping patients recover from adrenal distress and showing them how to support and maintain healthy adrenal function is, in so many cases, fundamental to their healing protocol.
Yet, despite the fact that adrenal function underpins so many other health issues – and that scientists have been researching and writing papers on adrenal health for the past century – surprisingly few doctors ever mention ‘adrenals’ to their patients or suggest that their symptoms might be adrenal related.
Instead, they tend to prescribe medications for the various symptoms. While these medications may stop the symptoms temporarily, they don’t address the underlying cause and can sometimes increase the severity of the adrenal imbalance.
Some more highly informed patients may suspect they have adrenal issues based on their symptoms. Many will try to heal themselves using various natural supplements*, rather than consult a medical professional. Unfortunately, while they might be on the right track, few know the ‘whole story’ of what is needed to make a FULL and permanent recovery after their adrenals have become depleted.
Because adrenal health is so important – but so few people understand it – today, I will explain the symptoms of adrenal distress, some basics about cortisol and adrenaline, and suggest strategies and natural remedies that can help you recover without drugs.
Signs You May Have Adrenal Problems
Adrenal imbalance is often responsible for a range of negative health symptoms, including:
- Poor sleep; waking unrested
- Exhaustion; needing naps during the day
- Frequent colds and flu
- Memory loss; brain fog
- Painful joints; frequent injuries
- Dizziness; weakness
- Blood sugar fluctuations
- Mood issues; depression; anxiety
- Allergies; autoimmunity; cancer
- Digestive issues
- Skin issues, such as eczema, psoriasis, hives, etc.
- Unexplained weight gain
When your adrenals are severely impaired, you are more likely to experience more than one of these symptoms. Because these symptoms often seem to be unrelated, people may not suspect they are arising from the same root cause.
Is It “Adrenal Fatigue” or “Adrenal Burnout”?
These days, “adrenal fatigue” or “adrenal burnout” have become catch-all phrases to describe any kind of adrenal problem. But I feel like these are misleading terms, as they imply your adrenals are under-producing cortisol and/or adrenaline. However, adrenal health can also become impaired when your body produces too much of these substances. For this reason, I prefer to use the terms “adrenal imbalance” or “adrenal distress.”
Getting a Clearer Picture of Your Cortisol Levels
The first thing I want to find out when I work with a patient with adrenal issues is how their cortisol levels show up at different times of the day.
Ideally, our cortisol levels should be highest in the morning when we wake up, and lowest at night when we want to go to sleep, after having gradually decreased throughout the day. Cortisol is one of the only hormones in the body that routinely changes levels throughout the day. Others may change according to various stimuli (e.g. melatonin increases when we are exposed to darkness; insulin increases when we consume carbohydrates).
To obtain a good picture of your “cortisol curve,” it’s best to check your cortisol four times within a single day (morning, midday, evening, and bedtime). This will give us a good idea of what’s going on. Typically, this is done with a saliva or urine test, so you don’t spend all day at a lab getting your blood drawn.
When your cortisol is checked in this way, in addition to the numeric levels of your cortisol, the lab will also give you a visual image of your cortisol curve compared to a normal one:
Figure 1 shows the kind of cortisol curve we would expect to see when your adrenals are operating normally.
Figure 2 shows an abnormal cortisol curve. In this case, the cortisol is too low in the morning and too high in the evening. It’s a reverse curve.
How Does an Abnormal Cortisol Curve Affect You?
While there is no iron-clad way to predict which symptoms you will have simply by looking at your cortisol levels, there are some tendencies I have noticed over my years in professional practice:
- If your cortisol levels are too LOW in the MORNINGS, you may feel fatigued in the morning and less able to get out of bed.
- If your cortisol levels are too HIGH at NIGHT, you may be a “night owl” and find it difficult to switch off at night, which can affect your sleep.
- If your cortisol levels DIP in the AFTERNOON, you may have daytime “crashes” where you feel like you need a nap in the middle of the day.
- If your cortisol levels are a COMBINATION of the above, you may experience any or all of the above symptoms.
In the long term, having low OR high cortisol can also lead to mood issues (depression, anxiety, etc.), impaired immunity, increased allergies, autoimmunity, and a predisposition to physical injuries.
Adding Adrenaline to the Equation
When we add in information about your adrenaline levels, we can understand more about how your body responds under stress.
Adrenaline is the name used for both norepinephrine and epinephrine. Both norepinephrine and epinephrine levels are affected by both your stress exposure and your genetics.
If we are consistently exposed to stress, adrenaline levels may be elevated. The enzymes that help get rid of adrenaline include COMT and MAO, and require SAM made through methylation.
If you have genetic SNPs (variations) on COMT, MAO, or methylation-related genes, such as MTHFR, MTRR and CBS, then your body might not break down adrenaline fast enough, or it might do the complete opposite – break it down too fast.
Adrenaline is made in our bodies from an amino acid called tyrosine. If you do not consume enough tyrosine to keep up with your body’s need to make adrenaline and how quickly your body gets rid of it, you can become depleted in adrenaline.
We can measure norepinephrine and epinephrine, as well as tyrosine and the breakdown products of adrenaline in the urine. This way we know exactly what is happening in your body and what kind of support it needs.
It is important to know that we need a certain amount of adrenaline all the time – just not too much, and not too little.
How Our Adrenals Respond to Routines
All our bodily systems adapt to the “routines” in our lives. For example, if you routinely go to bed at the same time every night, your body will prepare itself around the same time every night by lowering cortisol level and making you feel sleepy.
But when daily these routines are broken, your body responds by sending “stress signals” to put all systems on alert. To give a mental image of how your body responds to these stress signals, imagine an alarm clock:
- If your alarm clock goes off every morning at the same time and at the same volume, your body will be accustomed to it, even expecting it. When your alarm sounds, your body will react calmly, and you will wake up easily as you start your day. You might even find yourself waking up naturally before the alarm goes off.
- If, on the other hand, your alarm clock suddenly goes off at an unexpected time during the night at an ear-shattering volume, your body will immediately become stressed and go into high alert. Being jolted out of sleep, you’ll feel wide awake but possibly confused or anxious. Even after you realize there is nothing seriously wrong, you will probably find it difficult to fall back to sleep right away.
This analogy helps us understand what happens when stress causes cortisol levels to go too high (or too low) at the wrong time of day.
Abnormal cortisol levels will trigger stress responses EVERYWHERE in your body, because your adrenals are sending a system-wide signal. Once on high alert, it will take anywhere from a few minutes to a few hours for your body to relax and your adrenals to go back to normal.
Because our bodies adapt to routines, it is important to understand that they will ALSO adapt to STRESSFUL routines in our lives.
For example, if you always tense up when you arrive at work in the morning, your adrenals will adapt by producing more cortisol and adrenaline at that time of day, in an attempt to help you manage the stress. If this stress pattern occurs day after day, your body can get “stuck” in the stress mode. It will start to anticipate the stress and produce excess cortisol and adrenaline at the same time of day, every day – even on weekends and when you’re on vacation!
Getting stuck in stress mode can knock your cortisol curve way off, often resulting in a cascade of health symptoms, such as those listed earlier in this article. Thus, healing adrenal issues is not merely a simple matter of taking supplements; until the stress patterns are changed, the body will continue to respond to them. This means:
A crucial part of adrenal recovery includes lifestyle changes.
How Everyone Has a Different Stress Response
I want to emphasize that cortisol affects each of us differently. How it affects you is all down to your personal genetics and stress exposure, starting early in life. The combination of these two factors create what I call your “stress fingerprint.”
I believe that understanding your stress fingerprint leads to self-acceptance.
Knowing how our genes and our personal history have designed a blueprint for our health tendencies helps us accept our whole selves and work with what we have. It enables us to make choices to support our bodies correctly, and make the appropriate lifestyle changes that help us feel well in the long term.
IMPORTANT: I should point out that stress-related dysfunction of adrenal and cortisol is different from Addison’s disease and Cushing Syndrome, which is when your adrenals have stopped working altogether. While recovery from adrenal distress can be achieved with proper support, if you are diagnosed with Addison’s disease, the only option is cortisol replacement therapy; and for Cushing’s, the treatment is suppressed cortisol production.
I discuss all this in detail in my 35-page eBook A Guide to Adrenal Recovery, which you can get for free when you subscribe to my Weekly Wellness Wisdom newsletter or take my online quiz “Are You Suffering from Adrenal Distress?”
Choosing the Right Healing Strategy
Because everyone’s stress fingerprint is different, there is no cookie-cutter solution for adrenal distress.
For example, licorice (the herb, not the candy) is often helpful when cortisol levels are low because it supports cortisol production. However, if you already have high cortisol levels, licorice would not be an appropriate choice. Instead, I might recommend ashwagandha root, as it can help lower cortisol.
So, while there is no way for me to suggest a single healing strategy without seeing the whole picture of your adrenal health (i.e. cortisol levels, adrenaline levels, stress fingerprint), here are a few broad recommendations for the kinds of natural supplements you might choose from depending on how you need to shift your cortisol curve:
- When CORTISOL is too HIGH – phosphatidylserine, magnolia root, banaba leaf, and/or ashwagandha root
- When CORTISOL is too LOW – rhodiola, licorice, eleutherococcus, schisandra, vitamin B5, and/or vitamin C
- When ADRENALINE is too HIGH – magnesium, vitamin B6, B12, SAMe, and/or theanine
- When ADRENALINE is too LOW – tyrosine, rhodiola, and/or vitamin B5
In a recent blog post I wrote about my overall approach.
It involves 3 phases:
Step 1 Remove the Stresses
Step 2 Restore the Balance
Step 3 Build Resilience
Addressing imbalanced cortisol and adrenaline levels occurs during step 2 of this approach. Then in step 3, the goal is go learn to maintain optimal levels even while exposed to stress.
My Personal Recommendations
In my experience, people trying to heal themselves from adrenal issues may use one or two vitamins or herbs on the above list, but they may not be using all the supplements they need. Many “try out” a supplement, but stop taking it when the bottle is empty, not bothering to replace it.
They might also be unaware of the correct amount or the order to introduce products to obtain the desired result. For example, it is important to calm the nervous system and decrease elevated adrenaline and cortisol before supporting the adrenal glands to make more cortisol and adrenaline.
For all those reasons, and because I know so many people struggle with health issues related to adrenal function without sufficient guidance, I created my own products. I developed these products based on the findings of research conducted by many medical scientists, who have identified which nutrients and herbs are most effective for each situation.
Stress Support
This product contains vitamin C, B1, B2, B5, B6, B12, and magnesium to support your body to break down adrenaline and move it out of your body, ashwaganda and phosphatidylserine to decrease cortisol, and theanine and herbs to calm your nervous system overall.
CLICK HERE to read more about this product.
Sleep Support
This product contains vitamin B6, chamomile, valerian, passion flower, lemon balm, GABA, theanine, 5HTP and melatonin, to help calm your nervous system and help you to sleep better so you can recover from stress and heal your adrenal glands.
CLICK HERE to read more about this product.
Calming Support
This product contains niacin (B3), B6, B5, GABA and glycine, all of which help your body process stress and support the calming part of your nervous system.
CLICK HERE to read more about this product.
Adrenal Support
This product contains vitamin C, B5 (pantothenic acid), B2, B6, eleutherococcus (Siberian ginseng), Panax ginseng, ashwagandha, rhodiola, tyrosine, and licorice (glycyrrhiza). All these ingredients support the adrenal glands to heal from adrenal distress, and to make more cortisol and adrenaline.
CLICK HERE to read more about this product.
IMPORTANT: Before choosing ANY kind of supplement to address your adrenal issues, it is best to have your cortisol and adrenaline levels checked, as well as the levels of your neurotransmitters (serotonin, GABA) and melatonin. This information will help you determine which product is most likely to help you. An even better idea is to work under the guidance of an experienced naturopathic doctor.
Closing Thoughts
I hope this article has helped you understand a bit more about the causes of adrenal distress, how your adrenals respond to stress, and how to get back on the path to health naturally.
If you’ve been suffering from adrenal problems for a long time (even unknowingly), it can sometimes feel like you will never get well again.
But I know from experience that if we carefully examine your stress fingerprint, and use health panels to show us how your adrenals and other systems of your body are functioning, we can create a unique healing protocol – including supplements and lifestyle changes – that can restore, rebalance, and replenish your adrenals, and get you back on track.
As I said earlier, adrenal health is an extremely important part of my work with patients. If you know (or suspect) adrenal issues may be the underlying cause of your health issues, I invite you to check out:
- My free online quiz “Are You Suffering from Adrenal Distress?”
- My free 35-page eBook A Guide to Adrenal Recovery, which you will receive what you take the quiz OR subscribe to my Weekly Wellness Wisdom newsletter
- My Adrenal Recovery and Wellness Program – a special consultation program with me, where we create a unique healing protocol, based on your unique stress fingerprint and health panel results.
Until next time, I wish you well.
–Dr. Doni
23rd February 2018
*Please keep in mind that any and all supplements—nutrients, herbs, enzymes, or other—should be used with caution. My recommendation is that you seek the care of a naturopathic doctor (with a doctorate degree from a federally-accredited program) and that you have a primary care physician or practitioner whom you can contact to help you with individual dosing and protocols. If you ever experience negative symptoms after taking a product, stop taking it immediately and contact your doctor right away.