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Stress And The Adrenal Glands

DH Stress | Stress And Adrenal Glands

 

Modern world stress has been greatly affecting how we function without us learning how to prevent or get rid of it, especially at the hormonal level. In this episode, Dr. Trish Murray dives deep into how stress and the adrenal glands affect each other in the body. She also discusses where the cortisol, adrenaline, and other hormones and neurotransmitters come from and how they work together. Check out hos episode to get more knowledge on how to prevent or treat stress and adrenal gland dysfunction.

Listen to the podcast here:

https://tmwellnessom.podbean.com/e/stress-the-adrenal-glands-with-dr-trish-murray/

Stress And The Adrenal Glands

Welcome to the discussion on the adrenal gland and stress. On this episode, it’s just going to be me talking about the adrenal gland and how stress in our modern world is affecting your adrenal gland, your hormone cortisol and how that can have an effect on a lot of your other hormones. We’re also going to talk about how do cortisol, adrenaline and these different hormones and neurotransmitters work, where do they come from and to try and understand the physiology of it. We’re going to talk about circadian rhythms and the different hormones and how they interact with each other and about how stress in general can affect our overall health. If we get dysfunction in our adrenal glands or in the function of our hormone system that produces our cortisol or we’re overproducing cortisol, it can be typically the initial cause or underlying root cause of many of the chronic diseases of our western world.

Adrenal Gland

First of all, what is adrenal gland? It is a glandular organ that sits on top of your kidneys. Your kidneys are in the back of your abdominal cavity. If you think of your rib cage and your diaphragm and above your diaphragm inside your rib cage, sits your chest cavity where your heart, your lungs, your esophagus and all that are. Below your diaphragm sits your abdominal cavity. In your abdominal cavity, there are intestines in your stomach and your pancreas, but also your kidneys sit in the back of that abdominal cavity. On top of the kidney sits your adrenal glands and your adrenal glands are extremely important in your ability to handle stress. They are very involved in your hormone production of particularly cortisol.

HPA Axis

We’re going to talk about what’s called the HPA axis first. That stands for the Hypothalamic-Pituitary-Adrenal axis. What this is, is that all of your hormones, no matter which hormone system you were talking about. We are talking about your adrenal and cortisol hormone flow and production with the HPA axis. We could be talking about, for example, the HPT axis or the hypothalamic-pituitary-thyroid axis. Hormones follow the bouncing ball. One hormone gets put out by one organ in your body. Let’s say the hypothalamus in your brain and then that goes into your bloodstream to a different organ in your body. That organ puts out a different hormone and then that hormone goes and tells another organ to do something. Hormones are like chemicals that are produced by different organs and send messages to other organs and tell them what to do. All hormones need to be in balance with each other.

When we talk about the HPA axis, the hypothalamus is an organ in your brain and it puts out corticotrophin-releasing hormone. That hormone travels in the bloodstream to your pituitary gland, for example, which is also in your brain. The pituitary gland, if CRH comes and tells it to, it puts out ACTH or adrenocorticotropic hormone and that goes in the bloodstream down to the adrenal cortex or the adrenal gland and tells that gland to put out cortisol when you are in a stressful situation. That is the hypothalamic-pituitary-adrenal axis. It is stimulated by stress. I’d also like you to realize that if you are overstressed all the time and you are producing too much or an overproduction or a continuous production of cortisol all day long at higher levels than normal. That cortisol and some of the hormones that came down to cause the cortisol to be produced, like the cortisol-releasing hormone from the hypothalamus inhibit when they’re too high the function of the production of your thyroid hormone and the glands that are in the path to produce your thyroid hormone.

DH Stress | Stress And Adrenal Glands
Stress And Adrenal Glands: In our modern world, we’re all under way too much stress that the sympathetic nervous system and adrenal gland are overactive, leading us down a path of chronic diseases.

 

This is why many Americans, more women than men, but men too, have hypothyroidism. One of the number one causes is our stress levels. This is an example of how one hormone can affect another. If you have high cortisol levels that are, for example, causing dysfunction in your thyroid gland, then you’re going to have symptoms like fatigue, cold intolerance, weight gain, even though you’re eating like a bird, memory problems and brain fog, poor concentration and inability to stay focused. If it goes on too long, you’re going to develop depression, you’re going to have hair loss in the shower and there’s all this hair in the drain. You’re going to have dry skin and you may develop infertility. You notice, we need to look upstream at the adrenal gland.

The one thing that I want you to understand is that the majority of traditional medical doctors out there are not trained to look at the adrenal gland or to do any testing of your adrenal gland in a way that’s going to look at its function. I was trained as a traditional medical doctor. I was trained in internal medicine. I was a primary care internist and until I went into functional medicine and learned what I’m talking about now, I had no idea how to look at these things and I never really assessed the adrenal gland. This is very important. We’ve talked about the adrenal gland in relation to your hormones, but also cortisol and your sympathetic nervous system and a neurotransmitter called norepinephrine are also important in the function of our handling of stress. Our dealing with fight or flight situations and our ability to be balanced in these situations from neurotransmitters from your nervous system as well as hormones from your hormone system.

Sympathetic Nervous System

I also want to go over what’s called the sympathetic nervous system physiologically and anatomically if you will.We have multiple nervous systems in our body. You have your central nervous system, which is your brain and your spinal cord and those are running our show as far as movement and things like that. You also have your central nervous system then can send messages out through your peripheral nervous system. The peripheral nervous system is the nerves that leave your spine and go out into your body, your arms, your hands, down your legs into your pelvis and so on. They allow us to move and feel pain and that thing. You have your central nervous system and your peripheral nervous system. There’s also a third nervous system in our body called the autonomic nervous system. That has two parts. There are the sympathetic and the parasympathetic parts of your autonomic nervous system. I wanted to go over this with you so that you understand this as well.

Your sympathetic nervous system’s main neurotransmitter is norepinephrine. The primary hormones that can affect your sympathetic nervous system are also epinephrine, which is also called adrenaline, and what we’re talking about and our focus is on cortisol. These chemicals, when you’re faced with stress or danger or trauma or fear or things like this increase in your body and these chemicals have a physiologic response of increasing your heart rate and cause constriction of blood vessels to increase blood pressure and divert blood flow away from your skin to your muscles, so that you can either fight something or run away from it in your fight or flight response to any threat in your life.

This is the system that we’re focusing on that can affect your adrenals, your cortisol and your overall health if it’s always elevated. That’s the problem is that we’re not imbalanced in our Western world. In our modern Western world, we’re all under way too much stress, so the sympathetic nervous system and your adrenal gland are overactive and leading you down a path of many chronic diseases. The nervous system or the other part of the autonomic nervous system that’s supposed to be in balance with your sympathetic nervous system is called the parasympathetic nervous system. The main neurotransmitter of your parasympathetic nervous system is called acetylcholine. The major communication from the brain or the central nervous system to the periphery of your body of the parasympathetic nervous system is through your vagus nerve. Your vagus nerve goes through your gut. The vagus nerve has been looked at now as a major highway of information and communication between your brain and your gut.

You notice the vagus nerve innervates your gut, your liver, your spleen, your lungs and your heart. The parasympathetic nervous system is meant to slow your heart rate, reduce your blood pressure and allow for improved digestion and breathing and also it is the part of your nervous system and the automatic nervous system that allows you to relax and to have increased libido and sex drive. You want a good balance between your sympathetic nervous system and your parasympathetic nervous system. What you also need to understand is that emotions and your perception of events in your life are what causes your brain to initiate messages that are going to increase your feeling of threat or fight or flight. Whether you have emotions that are more positive, hope, understanding, sympathy, empathy, praise, grace and things like this. You may be faced with difficult situations, but your emotional reaction to them is not quite as anxious, not quite as frustrated, not feeling helpless, but instead feeling hopeful and positive even though you are faced with adversity.

You notice we also need to work on our emotions and our perception of our experiences in our lives because that can determine which pathway that’s going to be overproduced. That is whether it be sympathetic fight or flight or whether it be more understanding and more parasympathetic and being able to balance yourself and come back to a more relaxed state more quickly. The other thing now that we’ve taken a look at hormones and the HPA, hypothalamic-pituitary-adrenal axis of hormones. We’ve talked about the autonomic nervous system and the sympathetic nervous system.

Circadian Rhythm

I’d like to focus now even more back on the cortisol hormone and the fact that the HPA axis and cortisol should have in our body is called a circadian rhythm. What that means is that when we first wake up in the morning, you’ve been sleeping all night, you’ve been resting and you are, the alarms have gone off or the sun has come up and you’ve woken up and your cortisol level should rise. That’s normal. Meaning we have to shift from sleeping and being completely relaxed and at peace and at sleep and our brain at the quietest frequency of our brain waves, we got to wake up. It is normal for our cortisol to increase by more than 50% within the first 30 to 45 minutes of waking up. We need to work on our emotions and perception of our experiences because that can determine which pathway is going to be overproduced.

That’s called the cortisol awakening response. From that point on throughout our day, our cortisol level should start to lower and deplete throughout the day. That’s why by the afternoon and into the evening, we should be more tired. By the time we go to bed, our cortisol level should be at the lowest level of the entire day. You notice if you were to measure it and look at a chart, it should drop like a slide from a high level as you climb the slide down to the lowest level at the bottom of the slide at the end of your day right before bed. An opposite hormone that is supposed to be up when we’re sleeping and opposing cortisol in our lives is called melatonin. The circadian rhythm of melatonin should be completely the opposite of the path or the flow for cortisol. Melatonin should be the lowest level when we wake up in the morning and should be at the bottom of it, slide, if you will. Then it should be increasing throughout the day and especially after dark, melatonin should be rising to its highest level at our bedtime and then start to slowly deplete throughout the night to its lowest level when the alarm goes off or when the sun comes up and we wake up.

Cortisol and melatonin are supposed to be in circadian rhythm balance with each other. If you are someone who has trouble falling asleep when you first get into bed, then you want to take care of your slow dose of melatonin, maybe three to five milligrams about an hour or so before you get into bed. You will notice then it will help you fall asleep better. If you’re someone who wakes up in the middle of the night at 2:00 AM or 3:00 AM and you feel wide awake, it can be because your cortisol and melatonin are out of balance. Your cortisol is too high in the night. It’s not low enough. To take melatonin right at bedtime may help you stay asleep but the other thing about melatonin is many patients come to me and say, “It’s not helping me sleep. I took it for a few nights.” Then they’re missing the point. You want to take a low dose of melatonin anywhere from even one milligram to maybe at the most five milligrams in the evening. Not necessarily like a sleeping pill, but more for the fact of trying to balance your cortisol. If your melatonin’s up and balances or show decrease your cortisol, then you’re going to stay asleep and you’re going to sleep better and you’re going to have a better circadian rhythm of these two hormones in relation to each other.

Dehydroepiandrosterone

Another hormone that I want to talk about in relation to cortisol and stress is called DHEA, dehydroepiandrosterone. This hormone is another hormone that when it’s normal or when it’s in optimal levels, gives us our resiliency, gives us energy and again gives us our sexual drive and our sexual libido. We want DHEA, melatonin, cortisol and others to be inappropriate balance with each other. Another hormone we’ll bring up in our category is our sex hormones, estrogen and testosterone. If you look at any chart that tells you what hormone comes from other hormones in the pathway I’ve talked about of this produces and to follow the bouncing ball, I will tell you that all hormones of the steroid pathway start and they come from fat and they come from cholesterol and lipids.

We need fat in our body. We need our lipids, we need our cholesterol in the right balance, but first of all it all starts from fat. Then it comes down through chemicals and if you are overstressed and if you are producing too much cortisol all the time, there is a concept called cortisol steal. If you come down the path and then you always go down and produce cortisol, you don’t have any leftover chemicals to go over and spill over into the more downstream hormones such as DHEA or into the androgen hormones such as going into testosterone or the female hormones going into estrogen. This is why if you’re overstressed all the time and you have cortisol steal and the production of your adrenal glands and too much cortisol is stealing from the production of your DHEA or the production of your testosterone or the production of your pathways to estrogen. You’ll notice you’re going to be wired. You’re going to be tired. You’re not going to be motivated. You’re going to get depressed or you’re going to be anxious. You are not going to have a sex drive and you’re going to deplete the production of your thyroid hormone. The top supplements that would benefit anyone with adrenal dysfunction are B vitamins.

Do you see that the whole thing starts up at the adrenal gland and your cortisol and can become a mess? The other thing is I talked before about cortisol awakening response. First thing in the morning is when we want our cortisol to rise. In the first 30 to 45 minutes after awakening, you want at least a 50% increase in your cortisol. If it’s intact, it provides the energy, the anticipation of the upcoming demands of your day and it is a sign of resiliency and vitality. If this is not intact, you’ll notice you’re not going to have any mojo. You’re going to feel depressed and you’re also going to have problems with your brain function. You’re going to have brain fog and you’re going to have cognitive decline.

Cause And Effect Of Stress

What causes all of this in the first place? What’s the cause and effect and what initiates this? In that regard, like all functional medicine, we have to come back and look in the mirror and look at our lifestyle because daily hassles, work stressors, shift work like if you’re working at night and awake when the sun is down and trying to sleep, when the sun is up, you notice that opposite of what we’re physiologically and naturally supposed to be doing. It confuses and throws off your sympathetic nervous system and your adrenal gland and your hormone function. If you are someone who had a lot of childhood adversity, maybe whether that be emotional trauma or physical trauma as a child, that’s still playing into your adult life, if you haven’t done any work on trying to process it for yourself. If you have poor relationship quality in your life, if your relationships in your life are not positive for you, then that’s causing excess stress. If your diet is too high in sugar and you develop insulin resistance and dysregulation of your sugar and your glycemic diet is too high, then that’s going to throw off your sympathetic nervous system and your HPA axis of your adrenal glands.

If you have chronic infections like poor teeth hygiene and your gums have inflammation all the time or if you’ve had chronic viral infections or you’re exposed to mold on a chronic basis in your home or office or workplace, these are causing problems. If you have poor nutrition, if you have increased toxicity, if you have increased inflammation and we’re all doing this, as we get older, aging. All of these things can alter your adrenal function and your effect increased cortisol and cause dysfunction and imbalance in your adrenal hormones. When this starts to happen and if too many of these things are going on in your life, then they’re the cause of an imbalance in your adrenal hormones. This can have a wide range of negative consequences. It can adversely impact your overall quality of life and create many chronic diseases and conditions and symptoms such as. They’re not direct specific in focal things either.

The HPA axis and adrenal dysfunction, the symptoms can be vague and they can be highly variable and they may include things like fatigue, lack of motivation, insomnia, as we’ve talked about. They can cause weight gain where you feel like you’re eating like a bird, but you still can’t lose weight and you’re gaining that weight all around the middle of your belly. That is very commonly a sign of adrenal hormonal cortisol dysfunction. You’re going to feel depressed, you’re going to have GI complaints, whether that be diarrhea or constipation or heartburn and you may have chronic pain. As you notice, lots of different systems are getting affected by this dysfunction that starts with your lifestyle and how much stress you’re under. HPA axis dysfunction or adrenal hormone dysfunction or sympathetic nervous system dysfunction is associated with many conditions. It includes high blood pressure, heart disease, gastrointestinal and immune dysregulation or dysfunction, autoimmune diseases, diabetes and metabolic syndromes such as insulin resistance, depression, anxiety, chronic fatigue, persistent chronic pain, neurodegenerative diseases like MS or Parkinson’s and cognitive decline like Alzheimer’s disease.

DH Stress | Stress And Adrenal Glands
Stress And Adrenal Glands: A saliva spit test is the best way to test cortisol in the body at different times of the day.

 

There is a lot of cause and effect here. It could all start with how stressed out you are, how much stress there is in your life and your diet and your nutrition. I’ve had many other podcasts that I’ve done one for example, nutrition and macronutrients. The vitamins, minerals and phytonutrients that you want to make sure you get from your diet. You always want to start with lifestyle in order to correct any of the problems we’re about to go into as far as the stages of stress, adaptation or dysfunction. Because you don’t go from being perfectly normal to being completely exhausted and you can’t even get out of bed. There are stages of dysfunction that happen. Let’s go over them now.

Stages Of Adrenal Gland Dysfunction

First of all, stage one of the beginnings of signs that your adrenal gland is dysfunctioning is called the alarm phase or stage one. What happens here is that a person may be asymptomatic. You may not necessarily feel exhausted. You may have a cortisol level and flow and physiologic process that is still happening normally. Even if you test your cortisol, the cortisol increases normally in response to stress or trauma and it typically falls normally back to normal at the end of a stressful event. In the same way that when a lion chases a deer or something and if the animal’s stress level goes up, then their cortisol goes up so they can run away. If they survive and they get away and the lions now left the area, all of a sudden, they shake it off and their cortisol level drops down to a more relaxed state.

In the alarm phase or stage one, your body and your physiology are still doing this normally. It’s a normal adaptation to increase stress. It may be asymptomatic. However, it may not necessarily be asymptomatic. You may know you’re stressed out, you may know your stress levels are too high. You may be having a little bit of problem with sleeping, but not as bad as it’s going to get if you don’t make changes now. Your cortisol awakening response again would typically be normal. Your other hormones, you’re still going to have a sex drive, but you may notice it’s not as good as it had been or when you’re relaxed or on vacation. This is stage one. It doesn’t mean there’s no problem at all, but if we were to do testing, essentially would come back normal.

Stage two is if you don’t do anything about your lifestyle and you keep staying under the high-stress levels and things progress and then you go onto what’s called stage two or the resistance phase. The resistance phase is a sign of early decompensation of your HPA axis and early decompensation and early signs of adrenal hormone dysfunction in response to your stress. If we were to measure it, your cortisol would typically be found to be elevated and your DHEA in response to that might be low or it might be normal. If you tested your DHEA ratio to cortisol, they typically might be low because your cortisol is too high. The symptoms you may present with in the resistance phase as you move along this dysfunctional pathway is you’re feeling more stressed.

You’re feeling wired. You’re feeling anxious. You may be having anxiety attacks. You may be having panic attacks. You’re going to have mood swings. You’re snapping at your spouse or you’re snapping at your children or your grandchildren. You’re snapping at your best friend and you’re like, “Why am I doing that? That’s not like me.” You’re going to be having decreased libido and sex drive. You may develop high blood pressure now. You may have low motivation and you may feel depressed. You may have thyroid dysfunction and be diagnosed by your doctor with low thyroid because it starts out with your adrenal dysfunction. You’re going to have blood sugar imbalances and your doctor may be telling you your blood sugar is starting to become too high. You’re becoming insulin resistant and you’re putting on weight and it’s gaining around the middle. You notice things are progressing. The majority of traditional medical doctors are not trained to do any testing of your adrenal gland.

If you don’t do anything about it and it keeps progressing, some of us are going to progress to stage three. That is adrenal insufficiency and adrenal exhaustion. Your adrenal gland cannot keep up with your stress levels. It cannot produce enough cortisol. Your DHEA is low, your cortisol is low and you have lost your mojo. You’re exhausted. You’re depressed. You have no motivation. You’ve lost the circadian rhythm of your cortisol. It’s really low if we were to test it or your bottom line is the graph of your cortisol. It should look like a slide and flat when it’s tested. This is concerning.

Adrenal Gland Tests

If you are someone who is saying to yourself, “I need to get my adrenals tested,” that’s something we do at our office, Discover Health Functional Medicine Center and it’s usually the advanced functional medicine labs out there. There are many of them. Genova Diagnostics is one that we use in my office.

Doctor’s Data is another and there are others. There are some that focus specifically on the adrenal testing. I will tell you that in the traditional medical model, if you go into your primary care doctor and say, “I want my adrenals tested,” they are not going to do this test because what it is usually is a saliva spit test. Your best way to test your cortisol in your body at the different times of the day, such as first thing in the morning and maybe if you’re trying to test your cortisol awakening response, you’ll test it again, 30 minutes or within 45 minutes of awakening, late morning, mid-afternoon and at bedtime. You notice if we do that and we’re testing your cortisol level at each of these different time periods to look at whether you have an appropriate circadian rhythm or not. Meaning the highest level should be in the morning and it should get lower until the lowest level at bedtime. We’re also looking to see is it in the normal range or not.

You also then from your saliva can test your DHEA and you can do a ratio between the two. This is called the Adrenocortex Stress Profile by Genova Diagnostics. We do it in my office at Discover Health Functional Medicine Center. If you are interested in this testing, you could go to our website, DiscoverHealthFMC.com and even right on the home page, be able to become a patient. You can schedule yourself for a 30-minute free session with myself or our nurse practitioner to talk about your interests and see what your needs are. See if there are a match and a fit and see whether we can help you. We do offer this test through Genova Diagnostics and it is something that we could have sent to your home. You could do it by a kit at your home. You send it out to Genova and we get the results and we can go over it. We do telemedicine through my office. These are things you could be considering.

Once we determine if someone has stage one, stage two or stage three of adrenal dysfunction, the treatment of any type of adrenal dysfunction requires tiers of treatment, meaning levels or stages of treatment. It is not just a pill in order to resolve this problem. There is way too much going on. As we said in the beginning, the cause of this is your lifestyle. If you’re not going to bed at a reasonable hour, you’re not winding down to be able to go to bed at night. You’re on your computer or your cell phone right up until you put your head on your pillow, that’s got to stop because the number one way to replenish your adrenal gland is through sleep. You notice just to give you a sleeping pill is not going to help.

It’s also if someone has depression and they’re on the most typical antidepressant, like an SSRI, a Selective Serotonin Reuptake Inhibitor. There have been studies that have shown that it depletes your cortisol awakening response. That’s going to add somewhat to your depression. It may balance your up and downs of your emotions, but it may not be the answer to resolving your underlying problem of cortisol imbalance, for example.

D.E.N.T Program And Treatment For Adrenal Dysfunction And Stress

We need to first start with lifestyle modification. At Discover Health Functional Medicine Center, we have a program I call the DENT program. That’s an acronym that stands for Diet and Detox, Exercise is for the E, N is for Nutrition and the T is for Self-Treatment. We’ve got to start there and we’ve got to individualize and optimize your diet. We’ve got to help you get rid of the toxins in your diet as well as in the rest of your world, such as cosmetics or cleaning products and things like that.

We’ve got to help optimize your exercise, come from where you’re at and what you want and what you feel is fun for exercise. We need to improve your nutrition and we’ve got to help you figure out a daily practice in order to quiet your mind and either meditate or deep breathe or be mindful in some way and do guided meditations or something. We’ve always got to start there with lifestyle. That’s the biggest rock that people need to pick up and start thinking about when it comes to adrenal fatigue or adrenal dysfunction. Once we get that going and along the way with that, we could overlap with tier two or stage two of treatments, which includes supplements and supplements are meant to be exactly that. Supplements are not the pill that’s going to solve the problem if you don’t go back to stage one or tier one and change your lifestyle.

The top supplements though that would be a benefit to anyone with adrenal dysfunction are B vitamins, first, B1, B2, B6, B9, B12. The B12s are the Folate, Riboflavin, Niacin, and Biotin. These are excellent B vitamins. If you are concerned on your adrenal gland, then you want to be on a good B complex every day. Besides that, zinc also. Zinc needs to be in the right ratio with copper. Taking 30, 50 milligrams of zinc every day and not taking any copper is not a good idea. Many times, you can find a good multivitamin that has a good ratio of zinc to copper in it. You’ll also want to be on magnesium and magnesium L-threonate for example, is something someone could take closer to bedtime, help quiet the mind and improve sleep. Sleep is the number one time that you are going to replenish your adrenal gland and balance your hormones.

DH Stress | Stress And Adrenal Glands
Stress And Adrenal Glands: If you’re producing too much cortisol, you lose your sex drive, your strength, your vitality, and your resilience.

 

Another supplement would be vitamin C, anywhere from 500 to a 1,000 or more a day. Fish oil and the Omega-3 fatty acids are the next supplements. CoQ10, 100, 200 milligrams a day would be the next supplement, and the final one I’ll mention is NAC which stands for N-acetyl cysteine. N-acetyl cysteine is a precursor to glutathione. Glutathione is the number one detoxifying agent in your body. You notice these supplements are trying to balance your hormones, improve your detoxification ability, improve your energy production and improve your overall health.

Tier one and tier two, and now what would be tier three? This is very unique to adrenal dysfunction and the adrenal gland and its production of cortisol because the next tier in the treatment of adrenal dysfunction deals with adaptogenic herbs. Adaptogens are herbs that are specific to be helping the adrenal gland adapt to your stress. I’m going to go over the different ones in a moment that is consistent with the different stages of adrenal dysfunction that we went over. Tier four, the last and final step of any type of treatment for adrenal dysfunction, and I say that with caution, and possibly hormonal replacement with DHEA or pregnenolone. DHEA, dehydroepiandrosterone, if you take any hormone endogenously, meaning it’s made synthetically by humans and you put it in your body and you cause your DHEA or another hormone level, estrogen or testosterone or pregnenolone to go up higher than all the other hormones, you notice that’s going to throw everything out of balance.

You don’t want to be going on any type of hormone replacement if you will for long periods of time. This needs to be individualized to you. If you’re going to get in to taking hormone replacement or stages three or four of these treatments we’re talking about, I strongly recommend you find yourself a functional medicine provider and be able to work with them. With an educated and trained professional, figure out what’s best for you as an individual. If we go into the adrenal adaptogens and we talk about which ones are touted best for the different stages of adrenal dysfunction, for stage one, the arousal phase, ashwagandha is one of them and ashwagandha is unique. It’s the only one I’m going to list off here that is consistent with all three stages of adrenal dysfunction. Stage one, the arousal phase. Stage two, the resistance phase and stage three, the exhaustion phase. You are going to hear that ashwagandha is one adaptogen that is positive for all three stages.

The other one for stage one with the other list continues with L-Theanine, which comes from green tea, 5-Hydroxytryptophan, Valerian root and something called Romania. Stage two, Ashwagandha, but something then called Rhodiola or Siberian ginseng, St. John’s Wort, Phosphatidylserine, dark chocolate. Dark chocolate can help and adapt your adrenal gland to keep up with the stress. Finally, for stage two, something called Cordyceps. Stage three, ashwagandha, Romania, Cordyceps, but then also something called Asian Ginseng and finally licorice. You don’t want to be getting into these adaptogens all on your own without any support or any input from a functional medicine provider or an integrative medicine provider that’s familiar with the adrenal dysfunction and how to appropriately treat it. Take that as a caveat.

We’ve talked about treatment. We’ve talked about the stages of dysfunction. We’ve alluded to a little bit about testing but to finalize this, I want to make sure you realize there are tests out there. They’re typically by advanced functional medicine labs such as the one we use is Genova Diagnostics and they do have kit tests where the way to test your cortisol levels is best through saliva. What you do is you get a kit with these little tubes and you generate enough saliva spit in the tube at multiple times throughout your day. The Adrenocortex Stress Profile tests and the Cortisol Awakening Test are something we do through my office and can be very helpful to identify if your adrenal gland is functioning normally. If your adrenal gland and your sympathetic nervous system are in balance or if they’re the underlying root cause of some of your problems such as mood disorders, insomnia, high blood pressure, obesity and even the development of diabetes. This is extremely important concept to consider. In the traditional medical model, they don’t look at this test and they don’t do it. The number one thing that can help your adrenal gland and your cortisol is to get optimal sleep.

In summary, we’ve covered now the adrenal gland and how it puts out the different hormones and how hormones are all in balance with each other. We’ve talked about the sympathetic nervous system or the autonomic nervous system and the fact that the two parts of it. The sympathetic nervous system and the parasympathetic nervous system need to be in balance with each other. We’ve talked about the fact that cortisol and melatonin should be in a balanced circadian rhythm with each other at night and during the day. We’ve talked about DHEA, estrogen and testosterone and how if you’re producing too much cortisol, there’s something called cortisol steal, which steals from those hormones and you lose your sex drive, your strength, your vitality and your resilience. We talked about the cortisol awakening response, which is normal and needs to be intact and can be tested through saliva to see if it’s intact. We’ve talked about the fact that this is all upstream medicine and the fact that if you are having vague and varied symptoms, this is the type of thing we want to be testing to see if we can help you with your lifestyle, get you back on track and balance your physiology and your nervous system.

If you don’t, you’re going to go down the path of the different stages of adrenal dysfunction. If you get to stage three, you’re depressed, you’ve lost your mojo, you can’t get out of bed and you feel exhausted. The number one thing that can help your adrenal gland and your cortisol is to get optimal sleep. I hope this has helped. Go to my website and you scroll right down the homepage. There are little educational programs. One of my favorite ones is 10 ways in 10 days to Stop Your Suffering and Live a Pain-Free Life. I would recommend that one to everybody. Once you are listening to that, you’ll get a little video every day for ten days with a challenge or a solution or something for you to try to improve your life and decrease your pain and your suffering. We’ll also tell you how to schedule if you’re interested for a free 30-minute consult with myself or my nurse practitioner at certain times during the week. We hope to hear from you. I hope this talk has helped. Take care.

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