Wednesday, December 1, 2010

Understand How Cortisol and Stress Affects Your Weight

Adrenal fatigue is a condition which occurs because of our busy American lifestyle. With all of the demands placed on upon us physically and emotional today, this condition is seen in all practices. Surveys indicate that more than 70% of the American people feel that their lives have been affected by the recession and feel added stress. Many of you are all ready seeing these changes in your patients and practices. Times are very different than just a few years ago and it is directly affecting our patient’s physical ability to cope with these changes.

Adrenal fatigue is defined as a deficiency in the functioning of the adrenal glands. People who suffer from adrenal fatigue do not suffer from full blown disease. The extreme variations of adrenal disease are Addison’s and Cushing’s disease. Addison’s disease is the rarest from of Hypoadrenia. It occurs in 4 out of every 100,000 people. Hypoadrenia is responsible for 70% of the adrenal disease and is an autoimmune disorder.

Adrenal Fatigue is a collection of broad signs and symptoms, known as a “syndrome” that results when the Adrenal glands function below the necessary level.
Over the past century this disorder has been known as:

Non-Addison
Hypoadrenia
Sub-clinical Hypoadrenia
Neurasthenia
Adrenal neurasthenia
Adrenal apathy

Who Suffers From Adrenal Fatigue?
Anyone!
- An illness, a life crisis, or a continuing difficult situation can drain the Adrenal resources.
- Lifestyles can make one more prone to Adrenal issues such as:
- Poor diet, substance abuse, too little sleep and rest, or too many pressures all result in the symptoms of Adrenal Fatigue.
- Life Events
- Death, Marriage, Birth of a child
- Lifestyle leading to Adrenal
- Executives working 60-70 hours a week, juggling family life, kids, a home, and financial stress.
- This situation goes on for several years.
- Finally symptoms start to present but the person keeps going.

What are the symptoms of Adrenal Fatigue?

Fatigue
Weight Gain
Low Blood Pressure
Low Pulse
Depression
Light Headed/Dizziness
Hypoglycemia
Hair Loss
Decreased Sex Drive
Decreased Immune Function
Allergies
Arthralgias/Myalgia

Do these symptoms sound familiar? It is estimated that 50% of the people diagnosed with hypothyroidism also suffer from adrenal fatigue. Many people who suffer from hypothyroidism cannot be completely balanced because they never receive adrenal support. Without adrenal support the thyroid gland continues to get stimulated without any support leaving the adrenal glands depleted even more. This process then increases the symptoms of hypothyroidism. A conservative estimate indicates that 50% of the people with thyroid disorder are also affected with adrenal disorder. The figure below shows the connection between thyroid and stress hormones.

Common Diseases
Many associated diseases can occur with chronic stress or adrenal fatigue. Symptoms of these disorders vary from mild to severe.

Hypoglycemia
Allergies
Arthritic Pain
Decreased Immune Function
Psychiatric Disorders
Syndrome X

The Stress Response
The stress response cycle is very complex. There are four different zones of the adrenal cortex each secreting different hormones such as; cortisol, DHEA, testosterone, aldosterone, and progesterone. The adrenal cortex produces over 50 hormones all working as bridges to form other adrenal hormones. These changes affect: Carbohydrate, protein and fat metabolism, insulin and blood sugar control, fluid and electrolyte balance, cardiovascular system and Sex drive.

Testing for Adrenal Fatigue
A simple saliva test can be conducted at home to diagnose adrenal fatigue. Blood or saliva testing can be used to evaluate hormones to determine if adrenal fatigue is a concern. The most common hormones tested are testosterone, DHEA in saliva or DHEA-S in blood. Cortisol should always be tested using saliva. Typically a diurnal cortisol is evaluated but you can order one or two if you prefer. If you chose to order one or two you will usually order a morning or evening cortisol or both. When ordering a diurnal cortisol collection of the sample is done between seven and eight o-clock in the morning, and noon, then the third sample is collected between three and four o-clock in the afternoon. The last sample is collected between ten o-clock and midnight.

Iris testing If a person’s adrenal glands are working properly the pupil will normally contract if a light is shined across the eye. If adrenal issues are present the pupil will not be able to hold the contraction despite the light shining on it. This dilation will take place over 2 minutes and last 30-45 seconds.

Ragland’s Test: Is commonly done in a medical office for a variety of reasons and not ever thought of as a test for adrenal function. This test is done by the evaluation of one’s blood pressure readings. Having the patient sit and obtain a blood pressure reading. Have the patient stand and take the blood pressure. The patient will rest for 6 minutes lying down the patient will stand up and immediately take the blood pressure.

Interpretation of Test:
If the blood pressure is 10 mm Hg. lower after standing, suspect adrenal gland weakness.
The greater the drop in blood pressure the greater the degree of adrenal dysfunction.
Sergent’s White Syndrome: This test was first described in 1971 by a French physician Dr. Sergent. The test is simple and doesn’t cost the patient anything. Simple use the end of a pen and lightly draw a line about 6″ on the abdomen. Watch for a line to appear within a few seconds this is a normal response.
The line should initially be white then turn red within a few seconds. If adrenal issues are present the line will remain white.

HPA Axis
The regulation of cortisol is done by the HPA Axis. The hypothalamus mediates between external and internal states to keep the body balanced. Cortisol is the chief agent used by the hypothalamus to balance body chemistry. Any stressors listed above can trigger the body’s stress response and interrupt normal requirements for cortisol.

Cortisol protects the body by normalizing blood sugar levels. A drop in blood sugar triggers the adrenal glands to produce more cortisol. Cortisol increases blood sugar by converting fats and proteins to energy. Cortisol also has anti-Inflammatory properties when secreted in normal levels.

Cortisol levels affect White Blood Cells, and specifically produce lymphocytes. Cortisol regulates blood pressure and central nervous system function by affecting; behavior, mood, excitability and all other neurons in the brain.

Stress hormones and neurotransmitters provide a quick burst of energy. They speed up the necessary body systems by increasing heart rate and breathing. It can also shut down the unnecessary body systems such as the reproductive system and immune system.

Cortisol receptors exist on almost every cell in the body and have an important role in brain function. If serotonin is depleted it can result in fatigue, depression and inflammation. Moderate and transient amounts of cortisol increase the release of dopamine. If dopamine levels reach abnormally high levels people will experience symptoms of attention deficient or attention deficient with hyperactivity. Dopamine will also become elevated when people consume diets high in sugar which often happens when cortisol levels are low this occurs because people are looking for a rush to increase their energy levels. While high and chronic levels of cortisol decrease the production and release of dopamine.

The immune system can be directly affected by the adrenal function. Allergies involve the release of histamine a pro-inflammatory. Cortisol is a strong anti-inflammatory. It is the histamine & Cortisol reaction that produces the symptoms experienced with allergies. Food allergies are common during adrenal fatigue because of these added stressor placed on the immune system. The most common food allergies are corn, wheat, eggs, and dairy. The symptoms can vary in severity and may be temporary if the adrenal glands can be restored.

How common is Adrenal Fatigue
According to “The Adrenal Fatigue Organization” it is estimated that 80% of North Americans suffer from Adrenal Fatigue at some point in their lives!

Treating Adrenal Fatigue
Once Adrenal fatigue is diagnosed an individualized adrenal program can be initiated. An adrenal program contains life style changes and nutritional support which will help balance the body. It will restore the body’s ability to balance and correctly utilize sugar, support in digestion, and rebuild the adrenal glands to properly handle stress and return the body back to its normal state. In some cases it is necessary for hormones to be replaced for short periods of times until the body can repair and produce them on their own. The hormones replaced are DHEA, testosterone and hydrocortisone.

Unfortunately, restoring the adrenals is not a quick fix. You can expect a patient to be on this program for six to twelve months at minimum. If patients have been ill for several years they can expect to be on an adrenal program for one to three years before they are healed. Patients can expect to have periods of time that they feel good and then crash. It is important to provide patients with education and support during this time.

An example of an adrenal program includes using supplements: Vitamin C, B, and Trace Minerals. Herbs that are used to assist in treatment include Ginseng, Rhodiola, Withania, Ashwaganda, and Licorice. Many other supplements can be used but these are the most common. A variety of programs can be initiated and all practitioners who are knowledgeable with adrenal fatigue will create variations in their treatment programs.

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