A Holistic Approach to Adrenal Health

As the summer heats up, we are naturally drawn to cool waters.

Just like the principle of yin and yang in East Asian medicine, our health depends on balancing opposite energies.

This idea of balancing yin and yang in summertime has me reflecting on how to best support the body this season: how to take full advantage of the warmth and light (yang) available this time of year in ways that nourish the energetic reserves (yin) in our body.

Balancing Fire + Water in the Body

In East Asian medicine, summer is associated with the Fire [火] element which correlates with the Heart [心] meridian and is imbued with qualities of warmth, connection, and joy. Balanced Heart Fire brings about a kind of deep contentment (yes, that Zen-like quality of being able to rest in the present moment) that comes from being in alignment with your life’s purpose.   (Words purposefully capitalized here to denote entire word-fields of meaning embedded in the ancient characters, not the English words or ideas represented by the lowercase words ‘fire’ or ‘heart’.) 

 When Fire qualities are out of balance in the body, other qualities might start to arise such as feeling frazzled, burned out, anxious (tired but wired), restless or sleepless, or even frenetic or manic. Some people do experience more of this during the heightened activity of the summer season. 

Using the principle of yin and yang means working to balance and tonify functions associated within our Kidney organ network.  The Kidney meridian is associated with the Water [水] element and seen as the root of life, governing our reservoirs of energy — vital essence, or Jing [精] — vitality, our sense of deeply rooted calm, wise action (non-doing), and the courage and capacity for deep rest. As a way of balancing polar opposites, it’s a good time of the year to tend to the Heart by balancing Kidney energy. To do this, I look to tonifying the adrenals.

Understanding Adrenal Balance: the HPA Axis

The adrenals are small glands that sit atop of the kidneys are provide pulsed secretions of stress hormones in response to our everyday life demand. Understanding the adrenals as a source of finite energy and exploring the stages of adrenal taxation or fatigue can help better navigate underlying responses to stress, recovery, and resiliency.  And hopefully, help us to make best use of the increased light and warmth for our overall health.

The Concept of ‘Adrenal Fatigue’

The term ‘adrenal fatigue’ refers to a subclinical state or set of symptoms that arises when the adrenal glands, which are responsible for producing stress hormones like cortisol, become overworked. Adrenal fatigue can occur due to chronic stress, over-exertion, prolonged lack of sleep, chronic anxiety, and other lifestyle factors. While adrenal fatigue is not officially recognized by conventional medicine, many people experience symptoms that indicate their adrenal glands are not functioning optimally. 

The Four Stages of Adrenal Fatigue

Adrenal fatigue can be categorized into four stages, each with distinct symptoms and appropriate strategies for support.

Stage 1: Alarm Reaction

The first stage of adrenal fatigue is known as the Alarm Reaction and is essentially the body's immediate response to heightened stress. During this stage, the adrenal glands produce high levels of cortisol to cope with the incoming stress. 

The physical signs and symptoms associated with the first stage of adrenal fatigue might be considered part of the status-quo operating in an hyperactive society. Often excessive adrenal output is highly rewarded in mainstream culture, so the first stage of the adrenal/stress response system may not be noticeable until it’s progressed into the subsequent stage. However, prolonged activation of the stress response can start to strain the Kidney organ network.

Symptoms:

• High energy levels (initially)

• Increased alertness and focus

• Difficulty sleeping due to elevated cortisol levels

• Interrupted or dysregulated appetite

• Transient impacts on fertility, ovulation, or libido

• Mild anxiety or nervousness

• Sugar and caffeine cravings

Therapeutic Strategies:

• Mindfulness, Boundaries, and Self-Regulation: The first and most important approach to responding to the alarm stage of the stress response is about reclaiming your own health and energetic reserves.  This is extremely challenging, but rewarding introspective work as you start to value what kinds of tasks, demands, or relationships are worthy of your sympathetic overdrive.  Whether your nervous system responds best to breathwork, self-compassion habits, or therapy . . . the process of proactively finding your center rather than reflexively or compulsively jumping into high gear is the name of the game here.  I feel another deep dive on the fight, flight, fawn, or appease nervous system state. This is complex and deserving of our careful attention, but suffice it to say, that some people’s wiring may make highly stressful circumstances feel somehow more comfortable or familiar than calm ones.

• Nervines: Herbs such as chamomile, milky oats, blue vervain, and bacopa monneiri can help support the nervous system to release excess tension and remain centered but focused. Drop doses of these herbs in tincture-form throughout the day and perhaps before bed can act as herbal allies, liquid reminders of how to recenter and modulate the stress response.

• Yin tonification: Regular incorporation of mushrooms like cordyceps, chaga, reishi, or lion’s mane or herbs like schisandra or rehmannia can help relax, nourish, and soften the body, soothe the nervous system, and protect against exhausting reserves.

• B Vitamins and Magnesium: These nutrients are essential for energy production and maintaining the stress response.  The body goes through these nutrients at higher rates during periods of stress.
  

Stage 2: The Resistance Response

In the Resistance Response stage, the short-term stress in the Alarm Phase are prolonged and become more consistent. The body tries to adapt to the ongoing stress by maintaining it’s high production of cortisol. At first, this may be possible depending on energetic reserves, but over time, the Resistance Response phase leads to declining adrenal function as the glands become overworked.

Symptoms:

• Fatigue, especially in the morning

• Difficulty waking up despite adequate sleep

• Mid-afternoon energy slumps

• Cravings for salty or sugary foods

• Weakened immune function

• Signs of weakened water metabolism: puffiness, water retention, frequent urination

Therapeutic Strategies:

• Celebration + Rest: One of the most important things you can do to prevent this deeper stage of adrenal fatigue is to honor the end of short, stressful periods whenever available. Honor their completion with a pause and some rest!  Even after positive stressors such as major milestones (work projects, weddings, graduations, board exams, deadlines, travels, moving), it can be easy to remain on high alert and jump right into the next thing. But to protect your stress response system, it’s important to schedule down time and decompression following bursts of intensity. Tell your nervous system it’s off-duty by limiting 24/7 availability and consciously celebrating a completion phase with the kind of rest you really need — mental rest, a social outlet, downtime, etc. — before moving on.

• Herbal Adaptogens: Stronger herbal allies such as eleuthrococcus, panax ginseng, astragalus, and holy basil can help the body both adapt to the increased incoming stress as well as balance adrenal tone. These adaptogens are not meant to help you continue subjecting yourself to intolerable conditions, however. They are meant to help restore your energy reserves while you seek more lasting changes.

• Immune Support: Moderate doses of vitamin C (1,000 – 4,00 mg daily) nourish the taxed adrenal glands as well as enhance immune function, which is often compromised in this stage.

• Minerals: Magnesium and Potassium are crucial for adrenal function and can help alleviate fatigue and muscle weakness. Please check with your healthcare provider to make sure that you can tolerate potassium.
  

Stage 3: Adrenal Exhaustion

The next stage of the stress response occurs when the adrenal glands can no longer keep up with the body's demand for stress hormone production.  The resulting insufficiency of the stress response shows up with a range of more debilitating symptoms.

Symptoms:

• Extreme fatigue and exhaustion

• Difficulty getting out of bed

• Inability to focus; poor concentration and memory

• Depression and anxiety

• Increased susceptibility to infections

• Metabolic changes and weight gain

• Decompensation of other susceptible health issues

Therapeutic Strategies:

• Lifestyle Modifications: At this stage of adrenal fatigue, your body is forcing you to choose rest. Follow it’s lead and decrease physical, mental, and emotional demands until your reserves recover. In most cases, pushing through will lead to further declines in energy.

• Herbal and Glandular Support: Often a combination of rebuilding and nourishing herbs such as licorice root, ginseng or any of the adaptogenic herbs mentioned above may be combined with supplements derived from bovine adrenal glands to directly support adrenal output. Hopefully within about 8-12 weeks, the body will be able to start weaning off glandular support and return to herbal adaptogenic strategies above.

• Nutritional Support: Vitamin C and Omega-3 fatty acids are essential for adrenal health and can aid in recovery.
  

Stage 4: Adrenal Failure

Deeper taxation or collapse of adrenal function occurs when the glands are unable to produce adequate amounts of cortisol and other essential hormones.  From the western biomedical perspective, the first three stages are not recognized as precursors of adrenal impairment. Adrenal Failure is the first and only conventionally-recognized medical diagnosis and it is an extreme condition.  If the adrenal glands are not functioning as they are meant to, immediate medical attention is crucial and may result in the diagnosis of a lasting condition such as Addison’s disease.

Symptoms:

• Severe fatigue and weakness

• Low blood pressure

• Unexplained weight loss

• Hyperpigmentation (darkening of the skin)

• Salt cravings

• Susceptibility to autoimmune conditions or immune dysregulation

Therapeutic Strategies:

• Professional Guidance: In this stage, it is crucial to work with a healthcare provider for proper diagnosis and treatment of severe adrenal dysfunction.  Treatment may be critical for survival and often involves replacement of hormones that the body is no longer able to produce on its own.

• Supportive Herbs: Adaptogenic herbs still play a role in supporting overall health and resilience, but they should be used with professional guidance.

• Hydration and Electrolytes: Ensuring adequate hydration and electrolyte balance is essential for maintaining health in this critical stage.

 

Supporting Adrenal Health for Overall Wellness

Supporting adrenal health can have far-reaching benefits, extending beyond mitigating the symptoms above. Maintaining healthy adrenal function can improve overall energy levels, enhance the immune system, and support the body's ability to handle stress. Here are some conditions that can benefit from adrenal support:

• Nervous System Regulation: On an unconscious, automatic basis, structures in the brain constantly calculate a highly-sophisticated energy budget for the body. The brain’s energy budget automatically decides our threshold for perceived stress and the amount of fatigue that we feel when confronted with demands. This all happens without our active participation and takes into account adrenal tone. In this way, depleted energy reservoirs may be contributing to increased reactivity and triggers.

• Chronic Fatigue Syndrome: This is a complex condition that may be influenced by many factors including underlying infections, inflammation, and mood, but it can be improved by supporting the adrenals.

• POTS and Other Subtypes of Dysautonomia: These are complex and nuanced diagnoses, but adaptogenic herbs, along with a comprehensive treatment plan, can support improved resiliency.

• Depression and Anxiety: Balanced cortisol levels can have a positive impact on mood and mental health.

• Autoimmune Disorders: Supporting the adrenals can help modulate immune function and reduce inflammation in autoimmune conditions.

• Metabolic Disorders: High levels of cortisol and stress increase insulin resistance and blood sugar dysregulation and contribute to weight gain.  Adaptogenic support as well as some of the other treatment strategies listed above can Improve the resiliency of the stress response system.

• Hormonal Transitions: Following menopause and andropause, the proportion of hormones produced by the ovaries and testes drastically diminishes and is made up for in the peripheral tissues and adrenal glands.  Adrenal toning during this transitory period can help support sustained energy levels and other symptoms that arise.

 

Partnering with the Season of Summer

Here are some tips for using the yang nature of summer to your adrenals’ advantage:

• Sun Exposure: Exposing the body to natural sunlight, especially for 15-30 minutes within the first hour of your day, is helpful for establishing a healthy circadian rhythm and influencing balanced adrenal output.

• Physical Activity: Engage in balanced physical activities that allow for a mix of both challenge and recovery.  Too little endorphin release due to lack of activity may be a cause of lethargy for some people, while for others, incorporating more rest and moderate exercise is key.  The majority of your physical exercise should put you in a calm nervous system state while you are building strength. A special note that exercising while fasting spikes cortisol for most people, but especially for women.

• Healthy Diet: Incorporate fresh, seasonal fruits and vegetables to provide essential nutrients for adrenal health. Getting adequate protein in a savory (not sweet) breakfast meal is therapeutic for the adrenals.

• Mindfulness Practices: Be proactive about managing your stress levels. Choose daily practices that help you attune and respect your body’s energetic reserves.  It’s not just a daily 10-minute meditation, but habitually returning to check in with your body and nervous system that makes the difference. 

Whether you are experiencing symptoms of adrenal fatigue or simply looking to optimize your health, you can take proactive steps to rebuild your energetic reserves and enhance our body's ability to cope with stress.

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