Adrenal High

If you scored high in the ‘Adrenal High’ section of the Health Score Quiz, please read this article as it contains some useful information and resources to help you.

This page is designed to help you understand why you might be experiencing symptoms relating to the function of your adrenals as well as their related hormones. This section in particular looks at why you might be experiencing symptoms associated with an increased/excessive production of adrenal-based hormones.

What are the adrenal glands?

The adrenal glands are small glands that sit on top of the kidneys. They make up part of a more complex interaction of glands and hormones known as the Hypothalamic Pituitary Adrenal Axis (HPA). The glands in the brain are called the hypothalamus and the pituitary gland. This axis, looks at how these glands are communicating with each other to produce hormones that have a significant impact on how we feel on a day-to-day basis.

The adrenal gland is made up of the adrenal cortex found on the outer layer and the adrenal medulla, located deeper within the adrenal gland. The cortex helps to produce hormones like cortisol, aldosterone, DHEA and sex hormones, whereas the medulla helps to produce hormones like adrenaline.

The HPA axis is involved in the production of hormones, typically in response to our body’s circadian rhythm (24-hour internal body clock) and stressors. Thus, these glands and hormones respond to internal cues such as the current level of hormones in the body, our body clock, inflammation, oxidative stress, immune challenges as well as our external cues like light, stress, meal timing, sleep etc to help regulate adrenal hormone production. This can have a significant impact on our physical and mental energy as well as ability to sleep at night.

What do adrenal hormones do?

Mineralocorticoid hormones like aldosterone act upon the kidney and influence blood pressure. When one is making higher levels of these hormones it can cause one to increase the level of sodium being retained/reabsorbed and potassium being excreted, resulting in increased volume within the blood vessels and thus increase blood pressure.

Cortisol is the main glucocorticoid and increases in response to stress. It is the hormone that we will put a lot of focus on here as we look at your “adrenal high” score. The main function is allowing the body to cope with stress. Cortisol can influence our metabolism, immune system, growth and reproduction, cardiovascular function and more.

Cortisol when elevated can suppress the immune system, hence why cortisol-based medications are used to suppress one’s immune system in cases of acute treatment for autoimmune diseases.

Cortisol also increases the production of glucose from proteins and fats in a process known as gluconeogenesis, but at the same time decreases the glucose uptake in certain areas of the body, the net result being elevated blood glucose. The primary function of this is to allow more glucose availability for the brain.

Interestingly cortisol also activates the breakdown of fats while simultaneously stimulating the growth of fat cells. The net result of chronic stress is said to be an increased risk of mobilising and storing fat, with some evidence pointing towards the increase in fat around the mid-section with chronic stress states, particularly when one has little activity and especially when a caloric surplus is present.

Chronically elevated cortisol can also negatively impact on muscle, bone, skin and connective tissue growth and recovery. However, it should be noted that we are talking about chronic stress here. It is often overlooked that acute stressors followed by adaption periods is what allows our physiology to develop and become stronger. Not all stress on the system is bad, its more about the amount and frequency of that stress!

The primary adrenal androgen is DHEA. DHEA can then be converted to other hormones in the peripheral tissues, gonads (testes and ovaries). DHEA coverts into a variety of androgenic hormones, one of which being testosterone. For females the adrenal glands are the main source of testosterone production, likewise males in puberty. In post puberty males levels of testosterone produced in the adrenals is very low compared to that of what the testes are producing. In females, high body fat can increase the production of androgen hormones within the fat tissue itself, hence high fat levels in females can contribute to issues such as PCOS, facial hair growth etc. It is possible that high stress and HPA dysfunction can have a major impact on the balance of sex hormones in males and females, thus adrenal function & stress should be considered in any sex hormone imbalance.

The inner area of the adrenal gland (medullar) is where we make what are known as catecholamines, such as adrenaline. These are produced as part of the “fight or flight” response, aka stimulation of the sympathetic nervous system. These hormones help to increase blood pressure, blood flow, heart rate, glucose levels etc to increase alertness and readiness for the immediate stress. This shift in the nervous system will downregulate areas like digestion, which are seen to be no longer important at that moment in time. This means less blood flow to the digestion and a down regulation of acids and enzymes that support digestion. Although this is primarily a system for very acute stress, some individuals stimulate this system far too frequently and as a result this can lead to a number of health issues and symptoms.

What are the consequences of a “high” adrenal state?

Pure and simple, high stress states, especially chronic high stress states can have significant consequences to health.

High amounts of stress can result in an increased risk for stroke, cardiovascular disease, diabetes, obesity, Alzheimer’s, sleep disorders, mood disorders, immune disorders and much more.

If you score high in the Adrenal ‘high’ section, it is highly likely that your body is in a heightened state of stress all too frequently. Review the sections from your nutrition and lifestyle to see if there are any sections there that might be contributing to the physiological reaction that your symptoms are suggesting.

Some people can be very aware of the symptoms of stress, whereas others may have become so detached or even desensitised to the effects of stress hormones that they no longer notice. Often, we develop coping strategies to help manage stress, but a lot of the time these methods are further contributing to ill health, such as drug and alcohol use, emotional or night-time eating.

In many cases simply removing the stress is not possible, so we have to explore ways in which we can improve resilience to stress and adopt healthier coping strategies, whilst ultimately trying to lower stress or reframe it so that it no longer has the same physiological impact.

Stress is seen as the 21st centuries health epidemic, with around 80% of GP consultations said to be stress related. If you scored high in the Adrenal ‘High’ section then you are showing almost certain symptoms of being in a chronic stress response state.

It should be noted that we are not looking for a stress-free life, in fact, stress is good at the right dosages with the right recovery. We need stress to perform, adapt and thrive.

Acute stress responses are needed to optimise brain function and put in place physiological adaptations that would be of benefit if you were to get injured. It’s all about balance, some stress is good, so long as we have the most appropriate ways of adapting too and recovering from that stress.

There is so much that we can do to help manage the amount of stress we expose ourselves to, how we respond to stress and how we recover from stress as well. We offer nutrition and lifestyle practices to help our clients with stress as well as offering experts in the field of mindfulness and meditation therapy, hypnotherapy, behaviour change coaching and more.

If you would like help in exploring support in this area, please get in touch via our enquiry form at the bottom of this page.

What is Addison’s Disease & Cushing’s Disease?

Two clinically diagnosable conditions associated with the adrenal glands are Addison’s disease and Cushing’s disease.

Cushing’s disease results from an increase in adrenocorticotropic hormone (ACTH) from the pituitary gland which stimulates the adrenals to make extremely high levels of cortisol. This is often the result of either pituitary tumour but can also result from excessive production of corticotrophin releasing hormone (CRH) from the hypothalamus.

Addison’s disease is also known as primary adrenal insufficiency. This clinical condition results in not enough cortisol and/or aldosterone being produced to function, resulting in a bed ridden state, extreme fatigue, weight loss, extremely low blood pressure and potentially loss of consciousness. It may result from inadequate levels of ACTH or CRH and often requires hormone replacement therapy.

These are clinical conditions that require medical support from specialists in this area and it is not the purpose of this health assessment to be diagnosing these types of clinical conditions, instead we are focused on sub-clinical imbalances that result more from chronic nutrition and lifestyle imbalance.

Unfortunately, the conventional mindset is that you either have perfectly working adrenals or a clinical condition and nothing in between. This is evidently not the case and we have supported a number of clients with sub-clinical imbalances in these areas through a Functional Medicine approach.

Appropriate testing for sub-clinical adrenal issues

Below I am looking at tests that may be useful for those with non-clinical adrenal issues. Hence this is not what is recommended if trying to rule out Addison’s disease or Cushing’s Syndrome. If symptoms are so significant in this area those conditions need to be ruled out by your primary healthcare provider or an endocrinologist. The below testing is more about looking for more functional imbalances. This picks up on the many that are not diagnosable as having a condition like Addison’s or Cushing’s, but still have imbalances in the adrenals/HPA axis and may benefit from understanding where those imbalances might be and to what significance they are.

I also have to say that adrenal testing is not something I do a great deal of, as the symptoms of sub-clinical adrenal issues are usually enough for me to go on and the important step is to often look at what might be driving the adrenal issues in the first place. Thus, I will spend a lot of time working on nutrition, lifestyle, stress management, past traumas and also ruling out other physiological imbalances that might be dysregulating the adrenal glands and some of their hormones, such as immune imbalances, infections, inflammation and more.

Sub-clinical adrenal test options:

• 4-point cortisol test (saliva) or 4-point cortisol and cortisone test (dried urine)
• DHEA-sulphate (blood/urine)
• General blood haematology & biochemistry, ensuring that it contains sodium and potassium to assess their ratio

Symptoms associated to high adrenal hormone output

As someone who scored high in this section, it is likely that you are experiencing symptoms associated with an elevation above normal adrenal hormone production. These symptoms include:

• Feeling agitated or having erratic moods
• Struggling to fall or stay asleep
• Feeling overwhelmed
• Craving sweet foods
• Above normal blood pressure readings
• Gaining weight specifically around the mid-section
• Increased muscle weakness or poor recovery from exercises
• Elevated blood glucose

Conditions that might warrant adrenal testing

Below are some conditions that may warrant adrenal testing because of their correlation to excessive production of adrenal hormones:

• Chronic migraine
• Mood disorders
• Polycystic Ovarian Syndrome (PCOS)
• Irritable bowel syndrome (IBS)
• Type 2 diabetes
• High blood pressure
• Cognitive impairment
• Osteoporosis/osteopenia

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