My latest series has been about the Priority Pyramid and how your hormonal health is affected by deeper issues than just hormones alone. (See my first post in this series here and the podcast here)
Today, I want to write a bit about how you can tell your adrenals are an issue for you.
The adrenals are glands that sit on top of the kidney and produce a hormone called cortisol. This hormone is a stress hormone but also an energy hormone. Ideally you will produce some of it (not too much or too little) according to a circadian rhythm. Healthy cortisol levels are higher in the morning and lower as bedtime approaches.
Adrenals are not commonly the only issue or even the root issue, but imbalances with them can cause many imbalances in hormones and contribute to gut health issues as well. It’s often difficult to pinpoint adrenal issues also since they can be sneaky. Below are some potential instances of adrenal issues.
Sound familiar? It might be worth taking a stress rhythm test (like this one) to see what your unique rhythm looks like and get unique supplement recommendations. Many adrenal issues can be addressed with changes in lifestyle and supplementation.
This is the “classic” adrenal fatigue individual- the woman, usually in her 40’s raising multiple children, exhausted, just trying to make it through each day, pushing through the exhaustion with a latte and a prayer.
The adrenal’s begin for us as an energy factory but that factory can burn out from overuse. When that happens, the chronic fatigue and exhaustion that is experienced is called adrenal fatigue. It makes getting through the day without a nap (or multiple naps!) very difficult and can even make coffee and caffeine lose it’s effectiveness.
Adrenal fatigue is the most recognized type of adrenal dysfunction for most people but it definitely isn’t the most common. In fact, many adrenal fatigued individuals are actually dealing with more complex issues like food sensitivity/allergy, autoimmunity or other gut health issues that are masking as adrenal fatigue.
This is a group I see more commonly than any other having adrenal issues. These individuals become especially worried because most of them had healthy lifestyles to begin with. For a period of time everything was under great control (these individuals often also have type A personalities) and worked just like expected. Then, something happens and what once worked just doesn’t work anymore.
Pushing through the exhaustion to perform ever more intense workouts, doing two a days, training multiple people in a day and actively participating, all of this puts extreme strain on the adrenals and makes it hard for them to keep up. The body begins producing excessive cortisol in response to these workouts which raise levels of testosterone in the body contributing to weight gain and instability. Many people come to me when they realize they are doing more and more and only continuing to gain weight or are battling extreme fatigue.
There are really multiple types of PCOS and the kind normally talked about (that develops in response to a weight issue) is actually one of the only types that responds well to extreme weight loss. Many women with PCOS were normal weight with PCOS until the hormone balance began to shift again leading to weight gain. Many women with PCOS are normal weight and don’t fall under the category normally discussed.
Many of these women who either had normal weight PCOS or are normal weight PCOS have a complex adrenal issue contributing to their symptoms. High cortisol and overactive stress responses can encourage insulin resistance and the overproduction of androgenic hormones.
It is important to recognize that if your weight gain happened after you were diagnosed and PCOS was an issue you dealt with before you gained weight, this is more likely the person we are discussing. If you gained weight and then were later diagnosed with PCOS, this may not apply to you.
Since cortisol ideally is produced along the circadian rhythm, most people have higher levels in the morning and lower levels as the evening comes. This helps make them sleepy and the levels raise before waking up to help them tackle the day. Many people, however, develop imbalances in these adrenal rhythms, developing extra high cortisol in the morning (waking you up with a jolt) and giving you a second wind that keeps you from getting enough sleep. This cycle then feeds itself and creates more imbalances as time wears on.
One of the most difficult to determine issues with cortisol comes in the form of unexplained weight gain. Unexplained weight gain can happen for a multitude of reasons but my red flag radar goes up whenever I hear someone describe themselves as very active. It is usually these people, the ones who eat very healthy but exercise excessively (they almost never think what they are doing is excessive) who have the most issues with adrenal based weight gain.
If you think adrenal issues are part of the puzzle, I’d suggest the following things to think about.
Do you spend two full days totally resting? No, yoga days don’t count as rest days. Light elliptical or a short jog doesn’t count either. Rest is just that, rest. Those struggling with adrenal issues need this and sometimes more. We all need to have at least 8 solid hours of sleep as well, preferably between the hours of about 9 pm and 8 am. Some working on adrenal issues will need even more.
No one needs or does well with exercise twice a day either. And if you’re a personal trainer, consider stepping back from how active you are in sessions to protect yourself from adrenal damage. It is also wise to think about limiting how often you wake up to do exercise before your body is ready (6 am or earlier) and how often you wake up with an alarm if you can help it.
I get it, life happens. And those of us who are mothers know that as mothers we often MUST push through. But be honest with yourself again, how much of your day is pushing through exhaustion because you need to vs. you feel pressured, bullied, or motivated to? Think about taking small gaps in the day for rest instead of for getting things done or doing things with or for others. You cannot pour from an empty cup.
Not all stress is emotional. In fact, the majority of stresses we experience come from biological stressors like diet. Eat an anti-inflammatory, balanced diet. Avoid intermittent fasting and restricted timing for eating as these will only increase stress.
Food sensitivities, allergies, autoimmunity and other gut health issues can contribute or mask adrenal issues. It is important to address these first.
Cortisol often requires supplementation to re-balance completely, but what is necessary depends on the issues at hand. It is best to work with a professional on this but here is some general supplemental advice.
If cortisol status is unknown or high: Products like phosphatidyl Serine have been shown to help balance cortisol numbers and this is one of my favorites to use, especially when I don’t know current cortisol status. This is one I recommend.
If cortisol is low: Supplementing with herbs like rhodiola has been shown to help increase cortisol levels in the body. These are two different supplements I like for increasing cortisol. (Find them here and here)
My favorite supplements and lifestyle advice for adrenal health depends on the issues at hand. If cortisol is high and needs to be lowered, the most important interventions are stress managment techniques, boundary setting