A Primer on Adrenal Health


In our last article by Dr. Kadakia, we learned the importance of the thyroid gland and it’s impact on multiple body systems including weight, energy levels, and anxiety. The important connection between thyroid functioning and the adrenal glands was also discussed. Here I’m going to go into more detail about adrenal health to put more of the pieces of the puzzle together. The adrenals are a pair of small glands that sit on top of the kidneys. There are two main parts making up these special glands, the cortex and the medulla. The different layers of the cortex create the outside of the adrenal gland and are responsible for producing multiple hormones including cortisol, testosterone, DHEA-S, and aldosterone. The medulla, the inner aspect, produces primarily epinephrine and norepinephrine, the two main hormones responsible for the “fight or flight response”- increase in heart rate, constriction of arteries and dilation of veins. The adrenal glands are responsible for managing the stress response, playing a role in blood pressure management, and impact the functioning of other hormonal glands including the thyroid and ovaries as part of what is called the hypothalamic-pituitary axis, also known as the HPA-axis. These days we hear the most about cortisol when we’re discussing adrenal health. It’s a big player in adrenal function and has an impact on multiple systems in the body. It’s produced in response to stress and low levels of blood sugar. We require a basic amount of cortisol production on a daily basis with the highest quantity being produced in the morning, around 6-8 am and the lowest around 9-10 pm. This pattern of cortisol production is known as a circadian rhythm. Beyond the baseline amount of cortisol production, it’s also released in response to acute stressors. In order to explain this better, let’s go back to the days of our ancestors. If we are being chased by a saber tooth tiger, we need lots of immediate energy in order to run as fast as possible. Cortisol provides this by increasing blood sugar levels, breaking down protein in order to provide another energy source, increasing the release of epinephrine and norepiphrine, and diverting energy away from less important tasks of the moment such as digestion and reproduction. All if this is fine and good but in our current day and age, we find ourselves battling the modern day stressors or the proverbial saber tooth tiger on a regular, often daily basis. These chronic stressors also go beyond our mental/emotional response to the crazy world we live in. Other physiological stressors impacting the adrenals include chronic inflammation, poor gut health, food intolerances, and autoimmune diseases to name a few. Chronic over-production of cortisol is where we really start to get ourselves into trouble. The constant mobilization of blood sugar and decrease in insulin production leads to insulin resistance, increase in weight, and the first steps in developing diabetes. High cortisol levels at night lead to insomnia. Poor sleep has it’s own myriad of negative health implications. Dysfunction of cortisol production leads to a decrease in reproduction and sex hormone imbalances such as estrogen and testosterone and lowers the production of TSH, negatively impacting thyroid hormone production. When the adrenal glands are unable to produce the basic fundamental amount of cortisol, it’s known as Addison’s disease and requires medication to replace the missing cortisol. When the adrenal glands pathologically overproduce cortisol, it’s known as Cushing’s disease and comes with it’s own negative health implications. Both of these are different from what happens in response to chronic stress. In this case, the chronic overproduction of cortisol from different stressors may eventually lead to a deranged circadian rhythm in which you are producing higher levels of cortisol at the wrong times such as night before bed rather than the optimum time of first thing in the morning. And/or you might start running out of resources and begin producing less cortisol in general. This is what is often referred to as adrenal fatigue or dysfunction and leads to a myriad of symptoms including fatigue, insomnia, anxiety, and weight gain. Do you recognize the similar symptom picture, previously discussed in the thryoid article? It’s not a coincidence that dysfunction in both of these glands cause similar problems because the two work hand in hand as perfect business partners or partners in crime depending on how they are behaving. The doctors at True Health Medicine work to create strategies for improving both the adrenal and thyroid function.Visit our website for more information on how we can help you discover your optimal health.