Burnout to flourishing. Adrenal fatigue, the 21st century stress syndrome top tips
1) The many modern stressors
Stress is broadly defined in our modern society as a “state of mental or emotional strain or tension resulting from adverse or demanding circumstances”. But it’s so much more than just a mind state. Actually, to the body a stressor may be almost anything which creates a disturbance – temperature changes, environmental toxins, infections, physical injury and of course, strong emotional reactions. Even though there are a myriad of different stressors and stress triggers, there is only one stress system in the body. Everything from being involved in an emotionally charged meeting, mainlining caffeine, to sprinting for your train, involves a biochemical response which is handling, in the main, by the same body system- the adrenal glands.
2) The adrenal glands
The adrenals are two little almond-shaped glands which sit on top of your kidneys. Through their production of several important hormones they help maintain the balance of many bodily functions including heart rate, blood pressure, immune response capabilities and breathing.
The inner part (medulla) of the adrenal gland is related to the sympathetic nervous system. It produces the hormones adrenaline (epinephrin) and noradrenaline (norepinephrine) which govern the fight or flight response, which we’ll examine shortly.
The outer layer (cortex) secretes a different class of hormones called corticosteroids, the key player here being cortisol and we’ll be delving into some it’s remarkable effects as well.
3) The fight or flight response
The amygdala, part of our emotional processing centre, sends a distress signal to the hypothalamus which is like a command centre, activating your fight or flight response by signalling to your adrenal glands to release adrenaline and cortisol, among others. As the adrenaline circulates through the body it brings on a number of physiological changes:
- Your heart rate elevates and its force of contraction increases. You can feel your blood pressure rising.
- Blood is shunted away from the skin and internal organs (apart from heart and lungs which are key to keeping you alive).
- The amount of oxygen and glucose to the muscles and brain is increased as your resources are mobilised to help you solve the problem.
- At the same time the rate of breathing increases to keep up with the higher oxygen demand. Your nostrils flare.
- Sight, hearing and other senses become sharper.
- Sweat production increases. You may notice your hands are clammy.
4) Cortisol- the biomarker of stress
Commonly referred to as our “stress hormone” cortisol works alongside adrenaline to support the body in times of stress. Sustained elevations in cortisol has an ageing effect, breaking down skin and muscle tissue and encouraging fat gain.
Cortisol also plays a role in memory with many cortisol receptors residing in an area of the brain known as the hippocampus. This is the region where memories are processed and stored. Excess cortisol has been shown to overwhelm the hippocampus causing atrophy and memory loss related to the damage. Thankfully the damage incurred is usually reversible with the subsidence of stress.
Under normal circumstances, our level of cortisol is regulated by the circadian rhythm, responding to the day-night cycle. It is highest in the morning peaking at approximately 8 a.m. followed by a gradual tapering off until about midnight, when circulating levels are at their lowest. Stress, sleep deprivation, caffeine and alcohol all increase cortisol levels, with potentially dire consequences over the longer term.
5) Detecting adrenal burnout
Wired & tired or flat out fatigued
Hunger/ food cravings, particularly salt & sugar
Weight gain, targeted around the middle
High blood sugar
Increased bone resorption and osteoporosis
Poor muscle mass
Mood swings/ irritability/ anxiety/ depression
Poor memory & concentration
Difficulty sleeping (insomnia)
General immune suppression (never gets sick) followed by increased rate of infection including susceptibility to yeast infections
Decreased sex drive/ erectile dysfunction
6) Invest in your energy potential
Skipping meals or failing to eat at regular intervals are both typical examples of situations where we unwittingly place the adrenals under addition strain. On the other hand, eating small, regular meals across the course of the day keeps the blood glucose levels more stable, ensuring a consistent supply of energy and giving the adrenals some much needed rest, so that they are refreshed and ready for when you truly need them.
The same theory applies to eating foods which are too high in carbohydrates or are just neat sugar. When our blood sugar levels get too high because of poor food choices, they provoke an insulin response.
To stop this vicious cycle of surplus and shortage in addition to eating at regular intervals we also combine carbohydrates with healthy fats (e.g. avocado on toast or nuts & fruit) or protein (chicken breast and brown rice salad). This simple food combining technique helps to delay gastric emptying and keep the supply of sugar to the bloodstream slow and steady, which in turn keeps the body system happy without taxing the adrenals.
7) Nutraceuticals that nourish
Various nutrients can be very useful in supporting and enhancing adrenal function:
Potassium is critical to maintain potassium levels in the body to avoid water retention and elevations in blood pressure, among other things. Daily intake should be 3-5g and is best done by consuming potassium rich foods such as: Asparagus, avocado, carrots, lima beans and tomatoes, apricots, bananas and peaches. Even animal products contain good levels of potassium, particularly chicken and salmon.
Vitamins C, B5 & B6 are all needed for the production of hormones by the adrenal glands. Supplementation during times of stress may be appropriate in those needing adrenal support. B5 is particularly important as deficiency has been linked to adrenal atrophy characterised by fatigue, headache, sleep disturbances and abdominal discomfort. Minimum therapeutic dose is 50mg p/d.Food sources of B5 (pantothenic acid): wholegrains, legumes, cauliflower, broccoli, salmon, liver, sweet potatoes and tomatoes.
Minerals including zinc and magnesium. Magnesium blocks excess production of aldosterone which elevates blood pressure. Stress causes large amounts of magnesium to be “dumped” in the urine and so prolonged stress increases the likelihood of a deficiency.
Omega-6 fatty acids are needed by individuals with high cortisol output (linoleic or gamma-linolenic ) to maintain proper tissue response to challenges but need to be balanced with Omega 3’s in order to keep inflammatory processes in check. Good sources of essential fatty acids: Borage oil is the most balanced Omega 6 & 3 oil and can be used as a dressing over salads or vegetables. Avocados, nuts and seeds (particularly walnuts, pumpkins and sunflower seeds) and other salad oils such as flaxseed.
Read more about the benefits of flaxseed from BeHealthy here:
8) Adaptogenic herbs to restore the adrenals
Certain herbs may also be helpful in restoring and optimising adrenal function. They are classed as “adaptogens”, agents which:
- Protect against mental and physical fatigue
- Provide non-specific resistance against stress
- Normalise an abnormal state caused by some excess or deficient physiological factor
Panax (Korean) Ginseng
(Supplements should have a ginsenoside quantity of 25-50mg. A high quality root of 1-2g p/d should meet this criteria). Studies have demonstrated that ginseng possesses the ability of humans to withstand extremely stressful conditions (heat, noise, work load increase, exercise and others), increase mental alertness and work output and improve the quality of work under stressful conditions.
Can help to normalise elevated output of DHEA and cortisol. It is generally considered a more subtle adaptogen than the Panax variety.
Contains glycyrrhizin, a substance which extends the half-life of cortisol secreted by the adrenal cortex.
The root is the portion which has been studied for therapeutic benefit. They have a slow growth cycle and only 5-7yr old plants are suitable for harvest which leads to challenges for resource management. Used to increase mental alertness, stamina and enhance work performance.
Clinical studies show that 3.3 grams daily for 6 weeks modestly improves blood pressure and some measures of mood, including depression, anxiety, and somatic symptoms.
9) Don’t skimp on sleep
The benefits of a good night’s sleep extend far beyond feeling rested the next day. According to Dr. Merrill Mitler, a sleep expert and neuroscientist at the National Institutes of Health, “Sleep services all aspects of our body in one way or another: molecular, energy balance, as well as intellectual function, alertness and mood.” While the experts recommend that adults get between 7 and 8 hours of shut-eye per night, they also emphasize the importance of quality sleep.
10) Movement is medicine
Aside from the obvious endorphin release, which produces a natural high and enhances feelings of wellness, exercise improves cardiovascular function by decreasing heart rate and reducing blood pressure and cholesterol levels.
It is important to recognise that exercise itself is a physical stressor and so High impact training (HIT) may not be the most appropriate form of exercise to engage in when you’re going through a period of increased stress. Clinical insights on the effect of HIT on body mass. Instead movement therapies such as yoga, tai chi, and qi gong are more supportive of the nervous system.
For someone suffering with low adrenal function, finding the energy to engage in exercise may be very challenging. At times like these engaging in gentle, low impact activities, such as a walk in a park – a recent study by the University of Exeter Medical school showed that “moving to greener areas provided an immediate improvement in mental health which was sustained for at least 3 years after the move”
11) Practice Mindfulness
Relaxation techniques may be used to counteract the result of stress by inducing its opposite reaction – a relaxation response. The physiological effects shift you out of stress or sympathetic mode and move you into a state of parasympathetic dominance, designed for repair, maintenance and restoration of the body. In this state:
- Heart rate and blood pressure are reduced and the heart beats more efficiently
- Blood is shunted to the internal organs, particularly the digestive tract, greatly improving our ability to digest and assimilate nutrients from our food.
- The rate of breathing slows and sweat production decreases.
- Blood sugar levels are maintained in the normal physiological range.
Check out this Mindfulness Body Scan:
12) Stay connected
Confidants, friends, acquaintances, co-workers, relatives, spouses, and companions all provide a life-enhancing social network — and may even increase your chances of longevity. A likely reason for this effect is that people who enjoy close relationships with family and friends receive emotional support that indirectly helps to sustain them during times of stress and crisis.
It’s also important to cultivate a better relationship with yourself. Taking time to get to know the authentic “you” and how you need to shape your life in order to create the time and space that will allow for the best version of yourself to unfold.
13) Pace yourself and focus on you
Look at your diary and as far as possible, plan ahead to prepare yourself for peak periods of output for efficient energy management.
-On a monthly basis factor in at least one event or activity – something which feeds the soul and is inspiring.
-On a weekly basis plan to move your frame, either through yoga or meeting a friend, preferably for a walk or attending a class.
-On a daily basis consistently eat good quality food to nourish your body as best as you possibly can. Set clear boundaries for the day, depending on what you need to deliver both at work and at home. Create some time to engage in a restorative activity. This may be yoga or meditation or a simple breathing exercise but equally may also simply be having a hot bath or an early night every now and then.
Feel Good recipe suggestions
Roast carrot and avocado salad with orange and lemon dressing (high in potassium)
500 g medium differently coloured carrots , with their leafy tops
2 level teaspoons whole cumin seeds
1-2 small dried chillies
sea salt , crumbled
freshly ground black pepper
2 cloves garlic , peeled
4 sprigs fresh thyme , leaves picked
extra virgin olive oil
red or white wine vinegar
1 orange , halved
1 lemon , halved
3 ripe avocados
red wine vinegar
4 x 1 cm thick slices ciabatta or other good-quality bread
2 handfuls mixed winter salad leaves (like Treviso, rocket, radicchio or cavolo nero tops) , washed and spun dry
2 punnets cress
150 ml fat-free natural yoghurt
4 tablespoons mixed seeds , toasted
- Preheat the oven to 180°C/350°F/gas 4. Parboil your carrots in boiling, salted water for 10 minutes, until they are very nearly cooked, then drain and put them into a roasting tray. You should flavour them while they’re steaming hot, so while the carrots are cooking get a pestle and mortar and smash up the cumin seeds, chillies, salt and pepper. Add the garlic and thyme leaves and smash up again until you have a kind of paste. The idea here is to build up the flavours. Add enough extra virgin olive oil to generously cover the paste, and a good swig of vinegar. This will be like a marinade, a rub and a dressing all in one! Stir together, then pour over the carrots in the tray, coating them well. Add the orange and lemon halves, cut-side down. These will roast along with the carrots, and their juice can be used as the basis of the dressing.
- Place in the preheated oven for 25 to 30 minutes, or until golden.
While the carrots are roasting, halve and peel your avocados, discarding the stones, then cut them into wedges lengthways and place in a big bowl. Remove the carrots from the oven and add them to the avocados. Carefully, using some tongs, squeeze the roasted orange and lemon juice into a bowl and add the same amount of extra virgin olive oil and a little swig of red wine vinegar. Season, and pour this dressing over the carrots and avocados. Mix together, have a taste and correct the seasoning. Call your gang round the table while you toast or griddle your ciabatta slices.
- Tear the toasted bread into little pieces and add to the dressed carrot and avocado. Mix together, toss in the salad leaves and cress and transfer to a big platter or divide between individual plates. Spoon over a nice dollop of yoghurt, sprinkle over your toasted seeds and drizzle over some extra virgin olive oil.
Asian salmon & sweet potato traybake (high in Vitamin B5)
1 large sweet potato
2 lemongrass stalks
2.5 cm piece of ginger
2 cloves of garlic
1 teaspoon sesame oil
150 ml organic vegetable stock
150 ml reduced fat coconut milk
6-8 lime leaves or 1 lime
1 long red chilli
4 x 150 g salmon fillets, from sustainable sources
soy sauce , optional
- Preheat the oven to 190ºC/gas 5.
- Scrub the sweet potato clean, then slice into thin rounds. Arrange the slices, overlapping, in a large roasting tin.
- Bruise the lemongrass, then finely chop the tender parts. Peel and finely chop the ginger and garlic. Peel and finely slice the chilli.
- Mix the sesame oil, stock, coconut milk and two-thirds each of the lemongrass, ginger and garlic. Pour over the potatoes, tuck in the lime leaves (or squeeze the juice on top and scatter over the zest) and sprinkle with the chilli.
- Roast for 20 to 25 minutes, or until the potatoes are done. About 8 to 10 minutes before the cooking time is up, sit the fish on the potatoes and top with the rest of the lemongrass, ginger and garlic.
- When the fish is just cooked, drizzle with soy sauce, if you like. Delicious served with green beans and mangetout.
Puy lentil, parsnip & walnut salad (high in omega 6 fatty acids)
1 litre vegetable stock
250 g puy lentils
1 bay leaf
50 g walnuts
2 tbsp olive oil
FOR THE DRESSING:
3 tbsp walnut oil
1 tbsp red wine vinegar
2 tsp runny honey
1/2 tsp Dijon mustard
1/2 clove of garlic
a large bunch of watercress , or rocket leaves
a few shavings of vegetarian hard cheese , to serve
- Preheat the oven to 200C/gas 6. Peel and trim the parsnips, cutting them into batons approximately 5cm long and 1cm thick. Finely chop the shallot and crush the garlic. Bring the stock to the boil, add the puy lentils and bay leaf and simmer gently for 25–30 minutes, or until the lentils are just tender but still retain some bite. Drain the lentils, discard the bay leaf and set aside.
- Place the walnuts on a baking tray and toast in the oven until lightly browned and fragrant. Remove the tray from the oven, scoop out the walnuts, and add the parsnips in their place. Drizzle with the olive oil and roast for 35 minutes until golden.
- Make the dressing by whisking together the walnut oil, vinegar, honey, mustard and garlic. Season and stir in the garlic and shallots.
- In a bowl, toss together the lentils, walnuts, parsnips and dressing. Place the watercress or rocket onto plates, pile on the lentil salad and top with shavings of vegetarian cheese.