3 March 2017 | Dr. Raj Joshi (MBChB, MRCGP, Dip Mtn Med, Dip FIPT, FRGS)

5 ways to restore your adrenal health

Adrenal Fatigue (also know as Adrenal Stress and Hypothalamus-Pituitary-Adrenal (HPA) Axis Dysfunction) is a stress-related condition that occurs when your adrenal glands, hypothalamus, and pituitary gland are functioning below their optimal level. It is typically the result of chronic physical or emotional stress. Adrenal Fatigue results in symptoms like a weakened immune system, low energy levels, an inability to handle stressful situations, and cravings for salty or sugary foods. Common symptoms are all too familiar and can include:

  • Difficulty getting up in the morning
  • Inability to handle stress
  • Regular and unexplained fatigue
  • Cravings for salty foods
  • Mild depression
  • Insomnia
  • Overuse of stimulants like caffeine
  • A weak immune system

Stress is part of everyday life and how you respond to it has a significant effect on your health. The most common daily stressors often go unrecognised and include things like lack of sleep, work overload, financial stress, poor diet, too much caffeine and alcohol and not enough exercise. Here are some tips to help you control your adrenal stress hormones.

1. Improve your diet

  • Eat within an hour of waking. This helps to maintain proper blood sugar after an evening fast and prevents excess cortisol production.
  • Eat a quality source of protein at each meal. Meals should be balanced with protein, veggies, healthy fats and minimal starchy carbohydrates:
  • Protein Sources – chicken, fish, turkey, meats, eggs, protein powder
  • Veggies – green leafy vegetables, cruciferous, anything with lots of colour
  • Healthy Fats – olive oil, coconut oil, raw nuts and seeds, nut butters
  • Carbohydrates – gluten free grains such as buckwheat, quinoa or rice and white potatoes.
  • Avoid excessive starchy carbohydrates and sugars. When you eat something sweet or very starchy it causes your blood sugar to spike and then plummet. Your adrenal glands must then release stress hormone to raise it. When blood sugar swings up and down repeatedly it may fatigue the adrenals. Once people have adrenal fatigue they often suffer from low blood sugar, or reactive hypoglycaemia, as well. Aim for a lower glycemic whole foods diet that does not spike your blood sugar, as well as healthy fats, protein, and plenty of fibre.
  • Eating foods that trigger an immune reaction can tax adrenal function. One of the more common food intolerances is gluten, a protein found in wheat, rye, barley, and oats. Dairy, eggs, soy, corn, and yeast are other foods that can cause inflammation and fatigue the adrenal glands.
  • Include high quality sources of fat with each meal such as olive oil, coconut oil, avocados and raw nuts and seeds. This adds to the satiety value of the meal and removes the desire to eat too many starches.
  • Meals should be smaller but more frequent throughout the day. Three main meals and 2-3 small, balanced snacks will keep blood sugar stable and decrease the desire for sweets or caffeine.
  • Use smaller plates or bowls for meals. This can prevent overeating by filling up a large plate with food. Most people do not realise they are actually full if there is still food on their plate so start small and wait 10 minutes before deciding on seconds. Chances are, you will realise that you are already full and satisfied.
  • Eat a balanced snack within one hour of bedtime to support blood sugar through the night. Waking in the night may be due to low blood sugar. When blood sugar drops, cortisol rises and can cause wakefulness. A good evening snack is half a cup of plain yogurt, berries and raw nuts. This provides protein, some carbs and a healthy source of fat.
  • Keep fruit to a minimum and choose low sugar fruits such as berries, pears, apples. Pears go great with walnuts and apples go well with almond butter. Including some fat with fruit decreases the effect of the sugar in the fruit by slowing digestion and absorption.
  • Alcohol should be consumed in moderation and with a meal. One glass of wine or one beer 1-2 times per week should be the limit.

2. Integrate exercise into your daily routine

  1. Exercise is best done in the morning to increase metabolic rate throughout the day and to improve the chances of adhering to a program. It is better to get up 30 minutes earlier and get exercise done before the events of the day compete for your time.
  2. The level of adrenal fatigue will determine which type of exercise is best. Those with mild adrenal fatigue can do more intense exercise such as interval training, weights, running, etc. Those with symptoms of more advanced adrenal fatigue may only be able to tolerate mild exercise such as walking, stretching, beginning yoga and gentle movement exercises.
  3. Duration of exercise should be 30-60 minutes. If experiencing adrenal fatigue or burnout, endurance exercise is not recommended. Extensive training programs involving intense running, cycling or fitness competition training is not advised.
  4. Find a type of exercise that you enjoy so you will stick with it. Try to spend some time outside exercising whenever possible. Not only are you more likely to exercise by being in the great outdoors but the exposure to the natural sun can help promote health levels of Vitamin D. However, it is important to also balance this with the risk of skin cancer and that not appropriately covering up and not wearing sun protection can increase this risk. Even while wearing high factor sunscreen, the ultraviolet radiation will still reach the skin as the sunscreen doesn't fully block out the sun's rays.
  5. Exercise increases happy hormones and neurotransmitters that make us feel good naturally so get up and get moving daily.

3. Get better sleep

  • Sleep in comfortable clothing or naked if night clothes tend to become uncomfortable.
  • Make sure your room is cool with some source of circulating air, i.e. fan, open window (if not too noisy outside). Some researchers feel that the perfect temperature for sleeping is around 20 degrees celsius.
  • Darken room if ambient light is an issue, i.e. street lights, full moon. You can purchase some dark shades or curtains. Having a dark room is necessary to optimise melatonin output.
  • Go to sleep before 10 pm and if tired go to bed earlier.
  • Go to bed and awaken at the same time each day, even on weekends. This helps to reinforce the sleep-wake cycle.
  • Have a bedtime routine that involves a relaxing activity that signals to your body that you are getting ready for sleep:
  • Shower
  • Bath
  • Reading a book
  • Listening to relaxing music
  • Do not consume caffeinated (i.e. coffee, tea, ice tea) beverages in the evening. Best to reduce caffeine altogether, and ideally avoid after 2 to 3 pm in the afternoon.
  • Herbal teas such as Chamomile and other sleep-promoting teas are okay in the evening.
  • Turn off computers, TV, video games other visually oriented electronics before 8 pm at night. If at all possible, do not engage in work that is mentally trying or stressful after 8 pm. This will allow for a more peaceful transition to bedtime. If you enjoy watching TV in the evening, avoid disturbing images or emotionally charged programs.
  • No strenuous exercise, i.e. cardio, weights, power yoga in the evening after dinner.
  • Remove night lights and other electronics from room. If must have, then keep cellphone or ipad/tablet at least 10 feet from bed to help reduce electromagnetic field (EMF) emissions.
  • If you cannot fall asleep, then get up and do something else such as meditating and/or deep breathing exercises. Mentally recite a prayer or mantra if worried about something and your mind cannot relax. Keep a notepad next to your bed to write down thoughts about things you may need to do the next day. This allows you to release it from your mind without worrying that you will forget it tomorrow.
  • Keep in mind that the stressors of the day can often seem amplified at night while we are lying in the dark perseverating on the day’s events. Let them go – nothing will be resolved in the night and will only make tomorrow more difficult for the lack of sleep. Things often seem clearer and less stressful in the morning after a good night’s sleep anyway.

4. Reduce your stress levels

  • It is important to take time to play and do the things in life that bring us joy. This is one of the best and most rewarding ways of reducing stress. Make a list of the things you like to do that bring joy into your life. Some things may take ten minutes like walking the dog or some things may take all day like going for a hike. Some of these experiences may occur over a weekend or require a week-long vacation. Choose to incorporate these joyful experiences throughout the day, week, month and year. Having something to look forward to, relieves the stress of the daily grind that can be so much a part of our lives.
  • We all must balance work with recovery. Taking the opportunity to get adequate sleep is one of the most important things we can do for ourselves.
  • Whenever possible get out into the great outdoors in somewhere with natural scenery and pure air quality. Not only are you more likely to feel better and your mood improves in a beautiful, natural environment, but it will be healthier too with less pollutants and exposure to the natural sun for healthy Vitamin D promotion. Remember, adequate protection from the sun still applies and common sense measures to reduce risk of skin cancer.
  • An afternoon nap or resting quietly is certainly acceptable if possible. Sometimes just sitting quietly away from the TV or computer can help relieve stress.

5. Measure your adrenal hormones

Consider an Adrenal Fatigue Check - a non-invasive saliva test that serves as a reliable marker of stress response and a critical tool for revealing adrenal imbalances. This test measures:

Cortisol diurnal rhythm - cortisol levels naturally fluctuate throughout the day and so 4 samples need to be collected to show your body's cortisol rhythm. The first sample should be taken 30 minutes after waking which represents the peak of your morning cortisol production. The remaining 3 samples are taken at noon, late afternoon and night time.

DHEA-S - DHEA is another of the body's long-acting stress hormones made by the adrenal glands, and measuring both cortisol and DHEA-S provides an assessment of how well you manage and internalise stress. These hormones must be in proper balance with each other for optimal health, and an imbalance can be caused by prolonged stress.

There is much more to treating Adrenal Fatigue than simply reducing stress or managing it better. If you have been under chronic stress for a long period of time, the depletion of key neurotransmitters and hormones has probably had a serious impact on your health, whether you realise it or not. These changes simply cannot be reversed overnight.

A comprehensive treatment plan for Adrenal Fatigue involves dietary changes, lifestyle changes, appropriate supplementation, and possibly even hormone replacement for more severe cases. But remember, the first step to solving your Adrenal Fatigue is recognising that you have it - hence the importance of appropriate measurement of your adrenal health.

Raj-Joshi-i-screen
Dr. Raj Joshi (MBChB, MRCGP, Dip Mtn Med, Dip FIPT, FRGS)
Raj is a Primary Care Physician and qualified Personal Trainer who practises functional and integrative medicine. He trained in the UK and is the Travel Medicine Director of The Centre for Health and Human Performance in London. Raj understands how lifestyle can influence disease, and how positive changes can prevent illness and treat medical conditions. Raj is considered to be the "Bear Grylls" of his field having put his practice and teachings on lifestyle to good use in the military and as one of the few individuals to have climbed the highest mountain on every continent in the world.
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