The Twenty-First Century Stress Syndrome
James L. Wilson
Hypoadrenia is a range of debilitating symptoms that are only too familiar to many people. It is known by many names including neurasthenia, adrenal apathy, subclinical hypoadrenia, and adrenal fatigue. The condition has been recognized, written about, and treated for over a hundred years, but is now generally not taught in medical schools, becoming a problem invisible to modern medicine. In contrast, fifty years ago it was more likely to be diagnosed.
However, adrenal fatigue is hard to determine, as it is a collection of signs and symptoms that are not readily identifiable. People might not have any obvious signs of physical illness, yet often live with a general sense of feeling unwell. They use coffee, tea, Coke, and other stimulants to get themselves going in the morning or at other points during the day. They have irregular sleep patterns, feeling the need to sleep in the morning or throughout the day, yet staying up late into the night.
The adrenal glands are approximately the size of a walnut and sit on top of the kidneys. Their purpose is to help the body cope with stress from every source, including injury and disease, work and relationships. Resilience, energy, and endurance depend upon their proper operation. They significantly affect the functioning of every tissue, organ, and gland in the body, and particularly affect the way a person thinks and feels. Hormones secreted by the adrenals influence all major physiological processes of the body. Muscular strength and stamina are also affected by the adrenal hormones, as is the propensity to develop some diseases, and ability of the body to respond to chronic illness. How well you live depends a great deal upon how your adrenal glands function. But the most common feature of poorly functioning adrenal glands is fatigue, which is the universal symptom of hypoadrenia. In the most serious cases, a person might have difficulty getting out of bed for more than a few hours a day. The adrenal glands also have an effect upon mental states. There is a tendency to increased fears, anxiety, and depression, with periods of confusion, difficulties in concentrating, and poor memory recall. Sufferers also have less tolerance and are more easily frustrated with the way things are going. They also seem to be lazy and unmotivated, and to have lost their drive and ambition. In fact, the opposite is true: they are forced to drive themselves much harder than people with healthy adrenals just to accomplish everyday tasks. As adrenal fatigue worsens, the foundation for other diseases is laid. This includes respiratory infections, frequent colds, fibromyalgia, chronic fatigue syndrome, low blood sugar, adult onset diabetes, and autoimmune disorders. People with adrenal fatigue often have erratic or abnormal blood sugar levels, a tendency to allergies, and decreased immune response. Women have more premenstrual tension. As adrenal function reduces, every organ in the body is affected, changes occur in carbohydrate, protein, and fat metabolism, in addition to the heart and cardiovascular system. Alterations occur at the biochemical and cellular level, and the shape of the body changes, especially around the stomach. At the extreme end of hypoadrenia, Addison’s disease manifests. A life-threatening disease that involves structural and physiological damage to the adrenal glands, leading to lifelong steroid medication.
Fortunately, Addison’s disease is rare affecting only 4 in 100,000 people and the seriousness of the disease means there are good laboratory tests for diagnosing the disease. However, there are no such laboratory tests for diagnosing adrenal fatigue in its varying degrees of severity. A person might be suffering from the symptoms of adrenal fatigue, and may even be quite unwell, but many laboratory tests will come back as showing normal function. Of those blood, urine, and saliva tests that indicate hypoadrenia, the interpretation is not exact, and the range of results too broad. The most valuable method for detecting adrenal fatigue is to simply be aware of some of the main symptoms, especially when doctors are unable to find any other recognizable illness. If a person suffers from three or more of the following symptoms, and has been checked by a doctor for other conditions, then there is a high chance they are suffering from adrenal fatigue. Many people living in modern societies, eating industrialized food, and under stress from work or family life will recognize many of the symptoms. They are:
- Fatigue not relieved by sleep
- A reliance on coffee, caffeinated beverages, or energy drinks
- Difficulty getting up in the morning even with several alarms
- Lack of energy, whereby everything feels like a chore
- Increased effort to do everyday tasks
- Decreased ability to handle stress resulting in yelling, road rage, and compulsive eating
- For women, increased premenstrual syndrome
- Mild depression including less enjoyment or happiness with life
- Fuzzy thoughts, losing track of a train of thought, and poor memory with absentmindedness
- Decreased productivity
- Craving for salt or salty foods
- Increased time to recover from illness, injury, or trauma
- Light headedness when standing up quickly
If these are the symptoms, what are the causes? Adrenal fatigue is usually caused by some form of stress, either physical, emotional, psychological, or environmental. An infection can also cause stress within the body. While calamitous events such as the death of loved one or a serious illness can cause stress, other lesser life events take their toll. This might include quarrelling with a loved one, an abscessed tooth, pressure at work, environmental toxins, or a poor diet. Dietary factors such as coffee and caffeinated drinks, white flour products, and sugar are particularly problematic. As these concurrent stresses accumulate over time fuelled by poor drinking and dietary habits, an unhappy marriage, or a stressful job, adrenal fatigue becomes stronger. Anyone who does not get enough rest and relaxation, who drives themselves constantly, who is never satisfied, who is under constant pressure, feels trapped and helpless, or is overwhelmed by chronic physical and emotional trauma is at risk of adrenal fatigue. Some professions are harder on the adrenals than others. By looking at the insurance actuarial tables for various jobs, and the corresponding rates of mortality, drug abuse, and number of sick days it is possible to determine the likelihood of adrenal fatigue by profession. The medical community is especially vulnerable. In the U.S., physicians die around ten years younger than their peers, have higher rates of alcoholism, and several times the rate of drug addiction when compared to the normal population. Fully two-thirds of doctors will end up divorced during their training period. Middle executives and teachers are also prone due to suffering from “sandwich stress.” This is a form of stress derived from having to meet the demands and expectations of people above you, such as the boss, and those below, such as pupils or workers under one’s charge. They also lack the authority to make changes to their position and often fall on their sword when things go wrong. People in these types of jobs often experience Syndrome X, a complex condition comprising glucose intolerance, increased triglycerides, low HDL cholesterol, hypertension, central obesity, and accelerated atherosclerosis. These symptoms reflect elevated cortisol levels, which over time deplete the ability of the adrenals to respond to stress.
Aside from a pressurized job, illness, and unhealthy relationships, the primary lifestyle factors that lead to adrenal fatigue are: lack of sleep, poor food choices, using food, sugar, and caffeine as stimulants when tired, staying up late, driving oneself, trying to be perfect, and a lack of rejuvenating activities. However, one of the most common chronic lifestyles that leads to adrenal fatigue is poor diet. Around 62% of Americans do not eat a single vegetable on any given day. If you are not eating vegetables, yet are eating industrialized processed food, then your adrenals are not getting the nutrients they need to function optimally.
In times of crisis the adrenal glands secrete steroid hormones that respond to changes in one’s physical, emotional, and psychological environment. Any number of factors can interfere with this balance. As physical, emotional, environmental, or psychological stresses increase, the output of the adrenal hormones is depleted; a person feels more unwell, both physically and mentally, tiredness sets in, and life and its activities become a chore.
Happily it is possible to prevent and recover from adrenal fatigue. There are concrete steps a person might take to promote healthy adrenal glands. The three most important steps are all lifestyle changes. They are: (1) how a person creates, spends, and conserves their energy; (2) what a person eats and drinks; (3) choosing which thoughts feed your mind, and what beliefs you base your life on.
Since 1919 physicians have noted that lifestyle is key to recovery. Unless you change your lifestyle to reduce strain, and adopt new habits then healing is seldom possible. The first important step is to remove the primary causes of adrenal fatigue. The most common of which are junk food, lack of fresh air, soft drinks, caffeine, lack of sleep, medicines, water containing chemicals, chemical pollutants generally, an unhappy home, overwork, sickness, and despair. A person needs to determine those things that contribute to their health and those which detract.
For many the most disturbing symptom is fatigue. This may be caused by being around a certain person or group, in a particular building or environment, or specific situations that leave one feeling drained. Identifying those situations that drain and and tire one will uncover the external factors that are causing adrenal fatigue. The adrenal glands cannot heal from fatigue unless they have the opportunity to rest. Bed rest is not normally necessary; rather it comes from removing the harmful stresses in life.
Rest and Relaxation
In the 1960s a Harvard cardiologist called Herbert Benson discovered the relaxation response. No matter how relaxation is elicited, the resultant internal changes are consistent. The body shifts from sympathetic to parasympathetic nervous system dominance; breathing, heart-rate, and oxygen consumption slow down; muscles relax; the brain generates slower alpha waves; and blood pressure drops. These changes occur almost immediately after beginning an activity that produces the relaxation response, while not at all when engaging in leisure activities. Stimulation of the adrenal glands diminishes so they rest, and all tissues in the body become less sensitive to stress hormones. Every part of the body can recuperate, rather than being on a state of red alert.
How and when a person sleeps also affects the functioning of the adrenal glands. It is important to be in bed before 11:00 p.m. Some people feel energized after this time, and experience a second wind, which keeps them awake until 1:00 or 2:00 a.m. This exhausts the adrenals, even though you may not feel tired during this time. For those who are able, the sleep between 7:00 and 9:00 a.m. is particularly restorative. The point is that when you sleep is as important as how long you sleep. Normally, cortisol levels rise between 6:00 and 8:00 a.m. helping a person to be alert in the morning. For those with adrenal fatigue, cortisol is slow to rise, meaning it takes longer to wake up in the morning.
To improve sleep and poor adrenal function go to bed around 10:30 p.m., avoid coffee, caffeine, chocolate, and stimulating drinks. Looking at a television or computer screen in the evening is particularly harmful. The recent plethora of smartphones, tablets, and ultralight laptops has led to the reading of backlit screens late at night, even while in bed. This prevents the elevation of the hormone melatonin, which in turn reduces the ability to have restorative sleep. Screens should be turned off by 8:00 p.m.
Lighting in one’s home and workplace, cooling and heating systems, air quality, fabrics and fragrances, cosmetics, even particular clothes are all factors in causing adrenal fatigue. A person might feel groggy after certain foods, in particular locations or clothing, or around certain fragrances. So environmental factors should be examined to see which make a person feel better or worse.
If a person is hypoadrenic then exercise is one of the last activities they feel like doing, but it is one of the most important. Rapid breathing during exercise helps to expel volatile gases from the body. The increased blood flow prevents plaque from building up in the arteries, and stimulates the liver, enabling it to perform its 3,000+ functions more efficiently. Exercise also normalizes blood sugar, insulin, cortisol, growth hormones, thyroid function, and sends more oxygen to the brain. It also decreases depression, which is a common symptom of adrenal fatigue.
A poor diet is one of the most common causes of adrenal fatigue. In all cases nourishing food is a major factor in recovering from its symptoms. Those people who used to have lots of energy before experiencing adrenal fatigue often use coffee, caffeine, and stimulating drinks in order to gain energy and wakefulness. Coffee and Coke are particularly harmful as they temporarily boost the adrenal glands, then further deplete adrenal reserves, consequently having a negative effect upon blood sugar. Over time people become more fatigued, which leads to more stimulants, more sugar, and the consumption of more food in order to boost flagging energy levels. The temporary increase in cortisol produced by the adrenal glands after consuming caffeine and fast food causes people with low cortisol, which is a common feature of adrenal fatigue, to gain weight. This is because even a temporary excess of cortisol causes fat to be deposited around the belly.
Eating sugar, sugary foods, refined carbohydrates, and drinking fruit juice is particularly hard on the body. Any food that converts too quickly to energy will eventually cause fatigue. Fat provides more sustained energy than refined carbohydrates, but it must be the right type of fat. The tendency of people with adrenal fatigue is to eat fatty, industrialized junk food, which in turn fatigues them further. Saturated fat should not be feared, and should actively be used when cooking, with the very best saturated fats being butter, ghee, and coconut oil, closely followed by animal fat from grass-fed animals. Olive oil should not be used for cooking, beyond rapid stir-frying. The very worst type of fat is that used for deep fried food, especially if it is polyunsaturated fat such as sunflower or vegetable oil. In stark contrast, eating essential omega-3 fatty acids from cold water fish, including mackerel, wild salmon, herring, and sardines is extremely beneficial.
Good quality protein from meat, fish, game, eggs, and dairy are also essential for recovery from and prevention of adrenal fatigue. Lightly cooked protein sources are particularly valuable as are dairy products.
In addition to craving for sugar and caffeine, those with adrenal fatigue often hunger for salt, which is the body crying out for something it needs. The current advice that inveighs against salt is incorrect: salt decreases the symptoms of adrenal fatigue, and speeds recovery. If a person with adrenal fatigue desires salt then they should listen to their body and use salt in their food, unless they are at risk of high blood pressure. This does not mean excessive salt should be used, nor any type of salt. The best salt is the grey sea salt harvested by traditional methods over the course of a year in Brittany.
Conversely, foods high in potassium, such as some fruits, make adrenal fatigue much worse. Fruit should seldom be eaten. If it is eaten it should be organic as people with adrenal fatigue are sensitive to chemicals. Preferred fruits are cherries, berries, apples, and plums, while bananas and figs should be avoided. In place of fruits people should eat vegetables, preferably six to eight portions per day, and cooked with a variety of methods which make different nutrients available. Seaweed and sea vegetables, eaten by many traditional cultures, are encouraged, as are homemade vegetable soups and meat broths.
What Not to Eat
It is difficult to know whether it is more important to eat the right type of food, or to avoid eating the wrong type. Eating the wrong type of food, even occasionally, can throw a person off for hours or even days. Hundreds of millions of people are addicted to white flour and sugar products. Many crave chocolate. This craving for chocolate might be the body signalling its need for magnesium, as chocolate is rich in magnesium. Ladies with chocolate cravings (i.e., virtually all ladies) should take magnesium supplements and be aware that inadequate levels of magnesium produces vicious premenstrual tension. Chocolate is also high in caffeine and a caffeine-like substance called theobromine, both of which are detrimental to the adrenal glands. It is better to use a craving for chocolate as a reminder that one’s body is deprived of magnesium, supplementing with 400 mg of magnesium per day, or incorporating magnesium rich foods into one’s life.
Adrenal recovery will take at least two months and may take up to two years, though this does not mean you will fail to see any improvement during that time. Taking adequate rest at the correct times, sidestepping stimulants and caffeine, eating traditional nourishing foods, while avoiding their modern industrialized counterparts, giving the screen and the smartphone a miss in the evening, exercising, and living one’s life by sound values can all help to prevent and recover from adrenal fatigue. The result is a life filled with energy, happiness, and steadfastness; relationships that are long lasting and meaningful; a body that does not feel unwell; and the vanquishing of a fatigue that weighs down one’s very soul.