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We often view mental health and physical health as two separate entities, however they are interconnected. We know that it is easier to eat healthy and exercise if we are in a good place mentally, and we know that eating healthy and exercising effects our mood, emotions, and sense of well-being. Everything we do to nurture and nourish ourselves can fall under the umbrella of health.
Considering this, we can now pinpoint the number one detriment to our health as stress.
This is particularly true when we consider all the different forms of stress.
Stress can be any of the following:
- Emotional stress (day-to-day stress around bills, to-do lists, expectations, etc., etc.)
- Environmental toxins
- Pathogenic infections (viruses, bacteria, yeast, parasites, etc.)
- Nutrient deficiencies
- Blood sugar imbalance
- Lack of sleep
- Emotional trauma/Past trauma
- Physical trauma (wounds, sports injury, over-exercising, physical labour)
- Negative thought patterns and beliefs
Now how many of us are facing multiple forms of stress?
Whether we perceive that stress as something physical or emotional, our body will have the same hormonal response to this stress: that is the hormone cortisol.
Cortisol is the hormone responsible for helping the body to cope with all forms of long-term stress. It is one of the most underrated hormones in the body.
There is a lot of focus on balancing the female sex hormones to address PMS, and equal amount of discussion around balancing insulin to manage weight and metabolic syndrome. However, it can be difficult to balance any of these hormones, without first addressing cortisol levels.
What is Cortisol?
When looking at how to balance hormones naturally, it’s important to understand cortisol. The part of the brain that senses stress is the hypothalamus. It responds to stress by secreting the hormone known as corticotropin releasing hormone. This hormone is immediately sent to the pituitary gland, triggering the release of adrenocorticotropin hormone, or ACTH. It is ACTH that signals the adrenal glands to secrete cortisol. Cortisol then signals the hypothalamus to inhibit the release of corticotropin hormone and regulating the cortisol levels via negative feedback.
The body’s response to stress via the hypothalamus, pituitary gland, and adrenal glands is known as the HPA axis. Cortisol, or hydroxycortisone, is classified as a glucocorticoid. Glucocorticoids are a group of steroid hormones made from the adrenal glands that help the body to cope with stress. They do so mainly by affecting the metabolism of carbohydrates, fats, and proteins.
Just like all steroid hormones, it is made from cholesterol. The diagram below illustrates how cortisol, corticosterone and other hormones from the adrenal glands (aldosterone and DHEA) are synthesized from cholesterol.
Cortisol’s Effect on the Body
Virtually every cell the body has cortisol receptors. Cortisol’s main function in the body is to increase glucose, in order to help the body cope with a long-term stress. However, it also helps the body prepare for an extreme and immediate stress, most commonly known as “flight or fight.”
Here is how it effects some different parts of the body:
Cortisol enters a muscle cell and initiates the synthesis of proteases to commence protein catabolism. Thus, causing amino acids to be released into the blood stream. It can also have a similar affect to bone and connective tissues, breaking down collagen and other proteins to release amino acids into the blood stream. These amino acids will be put to good use in the liver.
Cortisol enters a fat cell (adipocyte) to activate the transcription of lipases to breakdown triglycerides to release fatty acids and glycerol into the blood stream. The glycerol is then taken up by the liver.
Cortisol stimulates the process of gluconeogenesis. The liver intakes amino acids and glycerol released by the muscle and adipose tissues, as well as lactic acid released by the muscles and even some odd chain fatty acids. Through gluconeogenesis, the liver can take these components and make glucose. However, cortisol also stimulates glycogenesis, or the production of glycogen. This is so glucose can be stored, but easily accessible if needed.
Cortisol increases the sensitivity of adrenergic receptors on different areas of the body, including smooth muscle tissue such as blood vessels. Epinephrine and norepinephrine bind to these adrenergic receptors when the sympathetic nervous system is activated. The sympathetic nervous system, or flight or fight response, is the body’s extreme stress response often for life-or-death scenarios.
Some of the affects of norepinephrine and epinephrine include constriction of blood vessels, iris dilation, increased heart rate and glycogenolysis. In a life-or-death situation, the body needs fast fuel in the form of glucose (to run away or fight) therefore norepinephrine and epinephrine break down the glycogen that cortisol conveniently stored for them. Going to the trouble of breaking down fat for energy in the middle of crisis would not be practical. It’s worth noting that in modern times, it is quite possible to have flight or fight response activated in a non-life-threatening scenarios, as long as the body is perceiving it as an extreme stress.
Cortisol decreases lymphocyte reproduction, particularly the T-lymphocytes. It also lowers fevers, decreases edema and vasodilatation. It reduces the release of interleukin-1 from the white blood cells. These actions collectively lower one’s immunity, particularly the inflammatory immune response. This is why corticosteroids (cortisol-like drugs) are used as an immunosuppressant for those who receive organ transplants, as well as to treat autoimmune disorders such as Crohn’s. Corticosteroids are also used to reduce inflammation in the body, such as topical creams to treat eczema.
Cortisol is what wakes us up in the morning. It can prevent us from dropping into a coma, if blood sugar dips too low. It helps us cope with the inevitable changes in life and adapt to our environment. We don’t realize how essential cortisol is to life, until its levels are depleted.
What is Adrenal Fatigue?
Adrenal fatigue is essentially subclinical hypoadrenia, meaning the adrenal glands are no longer secreting a sufficient amount of cortisol and other adrenal hormones. Subclinical means that it is not severe enough to require medical intervention, however it still effects a person’s day-to-day life.
Symptoms of adrenal fatigue include:
- Difficulty waking up
- Not feeling rested even after a full night’s sleep
- Lack of energy (everything seems like a chore)
- Mild depression
- Increased time to recover for injury, illness, or trauma
- Dizziness from standing up to quickly
- Low blood pressure
- Craving salty foods
- Decreased tolerance to stressors
- Less productivity, takes longer to complete tasks
The reason why blood pressure is affected by adrenal fatigue; it is due to the hormone aldosterone, which causes an increase in blood pressure. Inadequate levels of aldosterone, due to inefficient adrenal glands, will result in low blood pressure. Low postural blood pressure is an indicator of adrenal fatigue. Blood pressure typically should increase when going from sitting to standing, however if it decreases, this may mean insufficient aldosterone.
What Causes Adrenal Fatigue?
Adrenal fatigue is generally caused by a combination of the following:
- Poor diet
- Over consumption of caffeine and other stimulants
- Lack of sleep
- Overextending yourself
- Emotional Trauma (e.g. abusive relationships)
- Poor sleep patterns, shift work
- Recurring infections
- Environmental toxins
Who’s at Risk of Adrenal Fatigue
From the above list, it’s clear that those most at risk may be university students, new parents and shift workers, particularly those working a stressful job (nurses, doctors, police officers, paramedics etc).
In Adrenal Fatigue: The 21st Century Stress Syndrome by James L. Wilson ND, Dr. Wilson described many case studies of patients he treated for adrenal fatigue. One common factor seemed to be an abusive relationship or some other kind of other emotional trauma, which eventually manifested itself physically in the body as adrenal fatigue. Another common contributing factor was the workaholic type, which was usually combined with other factors. For instance, Wilson recounts one patient who was a chemical engineer and suffered from adrenal fatigue mostly likely from a stressful work environment and chemical exposure.
It seems both physical and emotional factors contribute equally and can create the perfect storm in adrenal fatigue.
How to Manage Adrenal Fatigue with Nutrition
Blood Sugar Balance
Keeping blood sugar balanced is one of the easiest ways to keep cortisol stable, and how to balance hormones naturally.
A blood-sugar-balancing meal consists of:
- Protein: Chicken, fish, beef, eggs, hummus, brown rice and beans
- Fiber/Starch: Brown rice, gluten free oats, sweet potato, quinoa
- A healthy fat: Olive oil, coconut oil, avocado, nuts and seeds
- Non starchy vegetables: Spinach, broccoli, cauliflower, red peppers
A person with adrenal fatigue should aim to eat three meals a day and snack as required.
Some blood sugar balancing snacks may include:
- Hummus and vegetables
- Nuts and seeds
- Rice cakes and almond butter
Foods high in refined sugars and carbohydrates will often cause a spike in blood sugar, followed by an overproduction of insulin, and therefore a blood sugar crash. This will then cause a cortisol spike.
Therefore, in order to achieve blood sugar balance, avoid these foods:
- White bread
- White pasta
- White rice
- Pastries, doughnuts, cakes
- Low fat yoghurt
- Soft drinks
Blood Pressure Balance
If you have chronically low blood pressure, some extra good quality salt in your diet may be beneficial.
Good choices include:
- Himalayan Salt
- Celtic Sea Salt
- Kosher Sea Salt
- Sea vegetables (wakame, kelp, dulse, nori)*
*Add sea vegetables to water when cooking rice or sprinkle on foods. This not only has salt, but trace minerals such as iodine, which are vital for the thyroid gland (the thyroid works closely with the adrenal glands).
Salt cravings are common in adrenal fatigue, so feel free to give in!
Here are some healthy salty snacks to satisfy your cravings:
- Toasted nori with salt and sesame seeds
- Roasted almonds (preferably homemade)
- Roasted chickpeas
Add a pinch of salt to your water, as well, to increase absorption.
Managing Adrenal Fatigue through Lifestyle
Changing your diet can be hard, but changing your life is even harder. A big part of how to balance hormones naturally and managing adrenal fatigue goes way beyond nutrition. The first step is to identify the main stressors in your life; it could be a particular person or a particular job.
The answer isn’t always to let that person or thing go. Instead, it may be just to change how you respond to the stress. It could mean changing your work hours or establishing boundaries in a personal relationship.
When we think of stress management, we think of bathing in lavender oil while chanting OM. While sometimes that can help, stress management is much more than that. Relaxing activities can include taking up a hobby, watching a funny movie, or just spending time with people you love.
However, there is a reason why everyone thinks of yoga (and OM) when they think of stress management; the reason it has been around for hundreds of years is because it works!
Yoga for Stress Management
There are eight limbs of yoga outlined in the Yoga Sutras by Maharishi Patanjali. Of those eight limbs, there are three practices most commonly utilized for stress management: Pranayama, Dhyana and Asanas.
In simplest terms, pranayama refers to breathwork, dhyana to meditation and asanas to the postures and poses we think of when we hear the word “yoga”.
However, it is all considered yoga and part of a much larger philosophy. So if you don’t have the time to study yogic philosophy, you can still benefit from the principles. Even doing something as simple as taking a deep belly breath a few times per day, especially before a meal; this will help to calm your nervous system.
If you are too anxious to sit and mediate, try a more dynamic yoga practice, such as vinyasa or hatha yoga. These forms of yoga were mainly created to prepare the body to sit for a long period of time in meditation.
If you’re too unfocused or anxious for a slow yoga practice, then you may want to try running or dancing. Anything that will get out some excess negative energy and where you can focus on your breath. Guided meditations are particularly helpful, if you are struggling to focus on your own. It will give you a chance to shut off your brain and let someone else take the wheel.
Finding Your Balance
A body in motion wants to stay in motion. It’s simple physics. So, once we get going, it can be difficult to slow down or change direction. Cultivating new healthy habits can be difficult in the best of circumstances, but it’s particularly challenging if you are already feeling depleted and burned out.
Healing adrenal fatigue, and balancing your hormones naturally may feel like one step forward and two steps back at times, so it’s important to be patient with yourself. It cannot be done with dietary, or supplement changes alone and generally requires a change in lifestyle and mindset. The upside is, it’s gets easier as you move along in your journey.
As you reduce your emotional stressors, you will be less tempted by sugar and other stimulants. So as you begin to eat nourishing foods, you will feel happier and less stressed. In essence, healing adrenal fatigue is all about re-establishing your rhythm and balance.
Kirsten Colella, Certified Nutrition Practitioner, graduated with high honours from the Institute of Holistic Nutrition. In addition, Kirsten is a certified yoga teacher, teaching at her farm in Durham. She practices what she has learned, embracing and living her passion for holistic health and all it encompasses. As a mom of three lively youngsters, Kirsten certainly makes use of yoga’s pranayama breathwork. She enjoys making healthy food for and with her children. You can see Kirsten’s healthy recipes, on Instagram @essentialbalanceholistic