The Adrenals

by Dr Jenna

The adrenal glands sit on top of the kidneys like little hats, these glands are in charge of our fight or flight response but they also have other functions.  In fact they are divided into two parts, the outer cortex, which is the part that is responsible for steroid production and the medulla or inner aspect, which is directly linked to the sympathetic nervous system.

The cortex is responsible for making corticosteroids, there are three different corticosteroids.  Mineral corticoids are responsible for blood pressure and fluid balance.  Glucocorticoids regulate lipid and glycogen metabolism and immune system suppression.  The third layer produces androgens which are converted to sex hormones.

The medulla produces the catecholamines, epinephrine, and norepinephrine which act together in stressful situations to create a quick response on a variety of organs.  This creates the fight or flight response that we are all familiar with.  When we are under stress the adrenal glands cause our blood pressure to increase so that more blood is pumped out to our muscles and organs.  Our pulse also rises to get blood to where it is needed, it helps to constrict our small blood vessels and dilate our large blood vessels to shunt the blood to our larger organs and muscles.  We also increase the fluid volume to increase the blood flow through the renin angiotensin system.  When the renin angiotensin remains out of balance we get into fluid overload causing oedema and high blood pressure.  When catecholamines remain out of balance we remain in a constant state of stress either keeping our cortisol levels high so we do not relax or they stay low and we lack energy. 

Androgen synthesis is controlled by the hypothalamic-pituitary-adrenal (HPA) axis.  The hypothalamus in the brain and the pituitary gland work as a negative feedback loop to regulate how much cortisol and androgen (which determines our sex hormones) that we produce.  So stress will cause disruption in our hormone production.  For women ongoing stressful situations can stop their menstrual cycles or cause their hormones to get out of balance.  This can lead to a whole host of other reactions such as oestrogen dominance, testosterone over load and many others.   For men it can affect their testosterone levels which can also lead to a variety of symptoms. 

Cortisol is also regulated by the HPA axis - corticosteroids are produced from cholesterol and we need fat to produce all of our hormones.  When we eat a low fat diet or take medication that lowers our cholesterol it can affect how we produce our corticosteroids.  ACTH produced from the pituitary gland regulates how much cortisol we produce.  The release of ACTH is regulated by CHR produced in the hypothalamus so it all regulates our production of corticosteroids.  Glucocorticoid mobilise fats, proteins, and carbohydrates so we can burn fuel.  When the body perceives stress it will give a burst of cortisol which causes a quick turn over of fuel for the body to respond.  Under prolonged stress this process also gets disrupted.

In our modern society we live in constant states of stress, we have high stress jobs, drive in traffic, and watch stressful information on the television or internet.  Exposing ourselves to lots of screen time can affect our adrenal glands, especially when it is at night. Our bodies were not designed to live in this constant stress.  We use drugs such as caffeine, nicotine and stimulants to help stimulate us more but this can often cause further damage to the adrenal function.  Persistent stress can result in adrenal fatigue, this can present as fatigue if the cortisol levels are low, or difficulty sleeping if the cortisol remains high. If this persists for prolonged periods, it can develop into chronic fatigue.  

To keep our adrenal glands healthy we should try and decrease our stress levels.  You can do this by working on reducing your stress response- listening to inspiring music while in traffic is a good start.  Undertaking a practice such as meditation, yoga or tai chi allows the body to relax which helps to reset the adrenal cortex.  Avoiding television or screen time during meals and before bed time can also help.  Of course reducing or eliminating stimulants such as caffeine, energy drinks and nicotine helps our adrenals to be restored to health.

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