The Basics

The adrenal glands are two walnut-sized glands that sit on top of each kidney. They may be small but they exert powerful effects throughout the body. These glands are responsible for manufacturing and secreting steroid hormones such as cortisol, estrogen, and testosterone. Further, they regulate processes throughout the body such as electrolyte and water balance, blood sugar balance and blood pressure.

The Mechanism of Adrenal “Burnout”

One of the adrenal glands’ main purposes is to enable the body to deal with bodily stressors. This ancient system was designed to be activated to keep you out of danger’s way. When the adrenal glands are stimulated, they mobilize the body’s resources in order to fight off danger or escape via the sympathetic nervous system. This is commonly known as the “fight or flight” response and is mediated by epinephrine or adrenaline and the stress hormone, cortisol.

In most animals, this fight or flight response to stress is only present in short spurts during hunting or while being persued. After the stressor is gone, the body returns back to it’s resting state which is commonly called the “rest and digest” response mediated by the parasympathetic nervous system.

Problems arise, however, when the adrenal glands are dealing with chronic stress. Many people today are dealing with being overworked, worrying about money, stuck in crowds or traffic, eating at irregular times, and having insufficient sleep. Even something as innocent as watching the daily news can cause our stress hormone levels to rise as we become aware of worldly disasters, deaths and other terrible news. These modern day stressors all activate the fight or flight system and adrenaline and cortisol are released.

The problem is that it’s not healthy to have chronically elevated stress hormones so what happens over time is that there’s a feedback mechanism that ends up shutting down adrenal cortisol production. What this results in is that all-to-common complaint of being “burned out”. You end up fatigued but unable to sleep effectively at night – that sensation of being tired but wired!

Symptoms of Cortisol Imbalances

  • Trouble falling asleep or feeling “tired but wired”
  • Waking up at 3-4am
  • Morning fatigue with a second wind in the evenings
  • Brain fog or problems focusing
  • Cravings for sweet, salty, or carbohydrate-rich foods
  • Anxiety or depression
  • Overweight or difficulty losing weight
  • Fatigue or feeling “burned out”
  • Frequent illnesses
  • Low motivation and drive
  • Low libido
  • Severe menopausal symptoms

Testing for Cortisol Imbalances

The Adrenal Hormone Profile provides a focused evaluation of adrenal health, reporting DHEA, cortisol, cortisone and clinically important glucocorticoid and mineralocorticoid metabolites. This panel includes 4-point cortisol and cortisone measurements and graphing to assess for a proper cortisol curve throughout the day.


Treating Cortisol Imbalances

My approach to re-establishing a proper cortisol rhythm is multifactorial. I employ lifestyle interventions to remove root causes, and a combination of herbs, nutrients, acupuncture and occasionally prescriptions to deal with the specific presentation of cortisol levels in my patients. Sometimes I am trying to reduce cortisol at certain times of the day and in other cases, I am trying to raise the levels. All treatments are highly customized to provide the most effective treatment possible.