The thyroid and adrenals are so intricately connected. It wouldn’t be a surprise to me at all if many of my Hypothyroid Mom readers are struggling with adrenal stress and they have no idea. A Yale-trained physician shares the ten signs of adrenal imbalance to watch for and the natural treatments she uses with her patients.
Written by Aviva Romm M.D.
Have you heard of the adrenal glands? They are 2 tiny little organs that sit on top of your kidneys and control quite a few actions in your body including your stress response, weight, blood sugar, blood pressure, and immune system. The adrenal glands are really quite incredible in that, as a species, they are our primary survival organs.
Fight or Flight: The Role of the Adrenals
The adrenal glands control our fight or flight mechanism. When we are in danger, or think we are (think: worried your boss is going to fire you, worried about money, worried about your kids, your marriage…), they mobilize all of our resources to fight or get away from that danger.
Historically, as humans, the immediate dangers we faced were typically short-lived. We had to, for example, run away from a saber-toothed tiger that was chasing us. When this system got activated, we pumped out a hormone called cortisol, which made our thinking sharp, gave us energy, and mobilized blood sugar to fuel our muscles. We breathed faster, our heart rate went up, and we got into high-energy action. Once we were safely out of harm’s way, the chemical process resolved and we went back to normal. Insulin, another hormone pumped out in the fight or flight response, mopped that extra mobilized blood sugar back into your cells, your breathing and heart rates went back to normal, and all was once again well in your world.
You‘ve probably seen vivid examples of the fight or flight mechanism on the Nature Channel. Think of watching gazelles around a watering hole. They are calmly drinking when along comes a lion. Suddenly the chase is on and there’s all kinds of action. Once the lion catches a weak or sick or elderly gazelle, what do the other gazelles do? Go right back to calmly drinking at the watering hole as if nothing happened. This is a clear representation of what our nervous systems do!
What is Adrenal Fatigue?
Now imagine if lions were constantly chasing those gazelles. Eventually the gazelles would wear out and collapse. In nature, constant stress is rare. But in the human world – well, we’ve managed to create all kinds of constant stresses for ourselves! And our health pays the price – first because of adrenal overdrive, and then because of adrenal burnout, or “adrenal fatigue.” One of the many consequences of constant adrenal overdrive is that we pump out too much blood sugar and insulin, eventually becoming insulin resistant and gaining weight – especially around our middle. We also get cravings for fat, sugar, and salt (translate: chocolate covered pretzels and ice cream!), the fuel our adrenal system needs to make this whole reaction work each time.
The adrenal glands act as shock absorbers to our system – they help us bounce back from life’s many stressors. When we’re under too much stress, or unrelenting stress, eventually the adrenals get tired of working overtime. Then we experience something called adrenal fatigue – we get really tired, can’t fight off colds as well, and are less resilient to life’s bumps.
10 Common Signs That You Might Be Suffering From Adrenal Stress
The reality is that most of us are under a lot of stress a lot of the time. Home pressures, work pressures, money pressures, kid pressures, and all those inner pressures we put on ourselves to be perfect – eat the perfect diet, do our yoga or workout, excel at work, be the best mom on the block. It’s never ending. Most of us are somewhere on the spectrum between adrenal overdrive and adrenal fatigue.
Here are the 10 most common signs that tell you that you’re experiencing either adrenal overdrive or adrenal fatigue:
- You’re having trouble falling asleep even when you’re tired (“tired and wired”) and even when you do sleep, you’re not rested when you wake.
- You get irritable or angry really quickly or more often than you want to.
- You’re craving sugar/carbs, fat, salt – or all of the above!
- You get tired around 3-4 most afternoons, and that’s when you really want something sweet or some extra caffeine.
- You’ve been gaining weight, perhaps noticing a spare tire growing around your middle.
- You feel anxious or blue.
- You’re getting sick more often than you used to.
- Your hormones are all over the place, you’re having fertility problems, and perhaps your libido is nowhere to be found.
- Your memory and focus are not what you think they should be.
- Your digestive system is a mess.
If you are experiencing any – or many – of these, read on…
Is There A Test For Adrenal Stress?
While there are tests that a functional or integrative doctor can do for adrenal fatigue, if you’re experiencing a few of the above symptoms, you can actually start to treat yourself without special testing. If you do want to get tested, you can ask your doctor to check a salivary or serum cortisol. The best testing looks at a 24-hour range so you can see where your peaks and dips of cortisol occur through the day, which can give your doctor some clues as to what might be going on to trigger these. Some tests, for example, the Adrenal Stress Index, also include DHEA, progesterone, insulin, and fecal sIgA, which look at the effects of adrenal stress on other hormones, blood sugar regulation, and whether your gut is being stressed.
Natural Treatments For Adrenal Stress
MAKE RELAXATION A WAY OF LIFE.
Believe it or not, the best treatment for adrenal stress is not supplements or herbs or fancy diet strategies – it is simply learning to practice relaxation. Relaxation techniques such as meditation, mindfulness, and active stress reduction help to let your adrenals know that you are safe – and this allows your system to recalibrate to a lower stress state, including pumping out fewer stress hormones. If you have already progressed from adrenal overdrive into adrenal fatigue, relaxation techniques can help your adrenals to heal and restore themselves.
PRACTICE “SLEEP HYGIENE”.
While you might be feeling wired, especially if you are in adrenal overdrive or if adrenal fatigue led you to a 4 pm cup of coffee, your body actually needs 7-8 hours of sleep each night to restore your body and for your adrenals to have time to rebound. See here for complete details on improving your sleep and sleep hygiene techniques.
KEEP YOUR BLOOD SUGAR STEADY.
When your blood sugar drops, it tells your body you are starving – and this is perceived as danger by your adrenal system. Keeping your blood sugar steady lets your adrenals know you are not in survival mode and that they do not have to go into action. Allowing your blood sugar to dip by skipping meals, living on coffee, and then spiking it up with sugary foods when you’re famished, taxes your adrenals. The most important step to blood sugar balance is starting your day – every day – with a high protein breakfast, and then eating a diet high in protein, good quality fats, and vegetables regularly throughout the day. Don’t let yourself get hypoglycemic and avoid sugary foods that give you a blood sugar spike.
CUT BACK ON CAFFEINE.
Caffeine allows us to push past our natural energy limits and triggers some of the same adrenal chemicals (adrenaline, for example) that get fired up when we’re under stress, leading to increased cortisol production and adrenal overdrive. I know it’s hard to cut back on caffeine when you’re exhausted and hitting that 4 pm slump, but cutting back (or completely cutting it out) is the only way to break that vicious cycle. I can promise you that after you get through caffeine withdrawal (takes a few days, drink a lot of water to avoid headaches!) you will actually have more natural energy, not less!
EXERCISE – BUT NOT TOO MUCH!
Exercise is so healthy for the body and the spirit – but many women, particularly hard core runners and spinners, are getting too much of a good thing. Over-exercising actually contributes to adrenal fatigue, which is why many runners find that they get sick easily and why many over-exercisers have trouble losing weight. So if you’re burning your candle at both ends in your life, and you’re over-exercising, cutting back can help to restore your energy.
TAKE A SPECIAL CLASS OF HERBS CALLED ADAPTOGENS.
A daily multivitamin with B-complex and magnesium as well as a class of herbs called adaptogens are just what this doctor orders for patients with adrenal fatigue!
Adaptogens are a special class of herbal medicines that have been used in Traditional Chinese and Ayurvedic medicines for centuries to promote a sense of well-being. In those systems, these herbs are considered the “Kings” and “Queens” of herbal medicines for restoring health, vitality, immunity, stamina, and promoting longevity. The term adaptogen refers to the unique ability of these herbs to help you adapt to the stress in your life. They do this by “normalizing” or “regulating” the adrenal stress response.
Adaptogens help your body to cope more effectively with the demands of everyday life. They provide a sustained sense of calm, and while they increase energy, with the exception of Chinese ginseng, they are non-stimulating.
In addition to their effects on stress adaptation, adaptogens have profound antioxidant and anti-inflammatory effects that protect your cells from damage from a variety of chemical exposures. Also, one of the definitions of adaptogens is that they are non-toxic, even with long-term use. You can rely on these herbs to be safe and gentle.
Adaptogens are truly remarkable in that the chemicals they contain actually help to normalize adrenal function. They calm and nourish the adrenal glands, and support the processes that are controlled by the adrenals – from blood sugar and immune system regulation, to hormones and blood pressure. Amazingly, they work whether you are experiencing adrenal over-stimulation or adrenal fatigue. In fact, not only do they help you to adapt, but they also adapt to your particular biochemical needs!
While some adaptogens can work fairly quickly, in just a matter of days, their actions tend to be more subtle, with benefits building up over months of taking them regularly, either in capsules, tablets, or tinctures, as discussed below.
Most of my patients receive an adaptogen or a formula containing a blend of adaptogens as part of their health plan – after all, who isn’t dealing with some level of stress! I generally recommend a combination of 3 of the ones below that seem most specific to the patient — but you really can’t go wrong as long as you look at the cautions — these are very safe, and are very synergistic with each other. You can also find a combination product that includes several of these together.
Not all herbs referred to in the popular media as adaptogens truly are; however, the ones below meet all the scientific criteria for being in this category. There is quite a bit of cross-over in the effects of these herbs, so they can be used somewhat interchangeably, but each also has its own slightly unique “personality,” or what it is especially known for, as emphasized in the descriptions. All of these can be used in any combination.
Adaptogens work best when taken for a minimum of 3 months, and for as long as a year!
Remember, there’s more to living a balanced life than just taking herbs – but these botanicals can go a long way to helping you to restore your balance, your health, and your sense of well-being. Of course it’s always a good idea to check with your primary doctor before taking supplements or herbs.
My Favorite Adaptogens
ASHWAGANDHA: THE SOOTHING ADAPTOGEN
Ashwagandha has over 4,000 years of traditional use in India. It is considered both a food and a tonic medicine for improving energy, memory and learning, promoting libido, and preventing premature aging. Ashwagandha is calming and anti-inflammatory. It is used to improve sleep, reduce anxiety, improve memory, and reduce inflammation and oxidative stress (damage from inflammation). It boosts the immune system, is included in the treatment of arthritis and can be beneficial in the treatment of fertility challenges.
Dose: 3 to 6 grams of the dried herb in capsule form daily OR 2 to 4 mL (20-80 drops) of tincture, in water, 3 times per day
Cautions: Not for use in pregnancy; though not likely to be a problem, use cautiously if you are sensitive to plants in the nightshade family; avoid with pharmaceutical sedatives and pain medications.
RHODIOLA: THE SPIRIT CALMING, ANTI-ANXIETY ADAPTOGEN
Rhodiola extract helps promote a calm emotional state and supports strong mental performance, optimal immune function, and hormonal balance. It is a key adaptogen for reducing anxiety. It improves mental and physical stamina, improves sleep, and reduces stress, “burn out,” and irritability. It boosts the immune system, decreases the frequency of colds and infections, and reduces inflammation. It is used in the treatment of chronic fatigue syndrome as well as fibromyalgia. It can be beneficial for poor appetite and as part of a treatment plan for chronic stress headaches.
Dose: 200-400 mg in capsules or tablets daily OR 2-3 mL (40-60 drops) of tincture, in water, 2-3 times daily. Use products standardized to 2-3% rosavin and 0.8-1% salidroside
Cautions: Avoid if you have bipolar depression with manic behavior.
HOLY BASIL: THE VITALIZER
Holy or “sacred” basil has been revered in India for over 5,000 years as an herb that calms the mind and spirit, and promotes longevity. In Ayurvedic medicine it is called Tulsi, which means “incomparable one.” It is used to improve energy and relieve fatigue, for its anti-inflammatory and antioxidant actions, and to lower blood glucose, triglycerides, and cholesterol. Holy basil may also protect the liver, helps with nicotine withdrawal, and elevates the mood, especially providing relief from mild depression. While this herb is related to common basil, it is a different species and common basil is not a substitute.
Dose: 2-3 mL (40–60 drops) of tincture, in water, three times daily
Cautions: None known.
SHATAVARI: THE HORMONAL HARMONIZER, QUEEN OF WOMEN’S ADAPTOGENS
Shatavari is considered the “Queen of Herbs” in Ayurvedic medicine, where it is beloved as one of the most powerful rejuvenating tonics for women. It is nourishing and calming, as well as hormonally balancing; it is used for irritability and many hormonal imbalances affecting the mood, for example, emotional symptoms of PMS and menopause. It is also used as a fertility tonic and may be used for vaginal dryness, low libido, and sleep problems in perimenopause. In addition, research suggests benefits for improving immunity, antioxidant activity, improved insulin secretion, reduction in gastric acidity, and the prevention of stress ulcers. It has mild estrogenic and cholesterol-lowering effects.
Dose: 2-4 mL (40-80 drops) of tincture, in water, 2-3 times daily
Cautions: Avoid if you have a history of estrogen-receptor positive cancer.
ELEUTHERO: THE PERFORMANCE AND FOCUS ENHANCER
Eleuthera is one of the most well-researched adaptogens. It is used to increase mental alertness and performance, enhance concentration and increase energy and stamina, reduce stress and fatigue, reduce dream-disrupted sleep and insomnia, and enhance immunity and improve detoxification. It is anabolic, which means it helps build muscle and prevents the breakdown of muscle as we age.
Dose: 2-3 g of dried root in capsule daily OR 2-4 mL of tincture, in water, 2-3 times daily
Cautions: There have been rare cases of insomnia reported with Eleuthero; if you have insomnia, either select a different adaptogen, or consider taking only before noon; also Eleuthero is not recommended for those with high blood pressure.
My Favorite Adaptogen Products
Stress Manager (Herb Pharm): A blend of the liquid extracts of Eleuthero root, Reishi fruiting body, Holy Basil leaf, Rhodiola root, and Schisandra berry
Adrenal Health (Gaia Herbs): Capsules with a blend of Ashwagandha, Holy Basil, Rhodiola, Schisandra, and Wild Oats
Vital Adapt (Natura Natural Products): A blend of the liquid extracts of many well-known adaptogenic botanicals including Eleuthrococcus, Rhodiola, Schizandra and Ashwagandha.
HPA Adapt (Integrative Therapeutics): Capsules with a combination of 5 adaptogenic herbs such as rhodiola, Sensoril brand ashwagandha, and eleuthero root extract. (Note: This product is only available through licensed health professionals, so someone would have to order it for you.)
Are There Any Times NOT To Use Adaptogens?
Due to lack of safety data, I do not recommend adaptogens for use during pregnancy, however they are considered safe for use while breastfeeding, and can help new moms to cope with the stress and demands of sleepless nights! I also do not recommend adaptogens if you are taking any medications that suppress the immune system, unless your doctor also approves, as there can be herb-drug interactions in this case.
About Aviva Romm M.D.
Dr. Aviva Romm is the mother of four grown children, a Yale-trained physician specializing in integrative medicine for women and children, a midwife, an herbalist, an award-winning author, and the creator of Natural MD Radio.
The recent past President of the American Herbalists Guild, a founder of the Yale Integrative Medicine program, and the author of 7 books on natural medicine for women and children available on her Aviva Romm M.D. website including Botanical Medicine for Women’s Health, The Natural Pregnancy Book, Naturally Healthy Babies and Children, Natural Health after Birth, Vaccinations: A Thoughtful Parent’s Guide, ADHD Alternatives (with her husband Tracy Romm Ed.D.), and The Pocket Guide to Midwifery Care.