ALL About Your Adrenal System-And Why Adrenal Health Is Really, REALLY Important

Adrenal glands are small triangular glands located on top of the kidneys. Their role is to produce hormones that regulate your metabolism, immune system, blood pressure, stress response and other essential functions. If these glands become over-taxed, they can become dysregulated, producing either too much, or too little of certain hormones and critical physiological responses, which can significantly impact virtually every process in the body. 

Essentially, adrenal glands are there to ensure our survival.  These glands regulate how we adapt to stressful situations and manage the “Fight or Flight” mechanism, enabling us to escape or combat that which is threatening our safety and survival.

The adrenal glands instigate a myriad of physiological changes that allow us to fight or fly from a situation perceived as dangerous or stressful.  Some of these main responses include:

1. Activation of the Sympathetic Nervous System (SNS): When faced with stress, the sympathetic nervous system becomes activated, leading to the release of neurotransmitters such as norepinephrine and epinephrine (adrenaline). This activation prompts the "fight-or-flight" response, preparing the body for immediate action.

2. Release of Stress Hormones: The hypothalamus-pituitary-adrenal (HPA) axis is activated in response to stress. The hypothalamus secretes corticotropin-releasing hormone (CRH), which stimulates the pituitary gland to release adrenocorticotropic hormone (ACTH). ACTH then stimulates the adrenal glands to produce and release stress hormones, including cortisol. Cortisol helps regulate metabolism, suppress inflammation, and mobilize energy stores for use by the body.

3. Increased Heart Rate and Blood Pressure: Norepinephrine and epinephrine released by the adrenal glands stimulate the heart to beat faster and increase blood pressure. This helps deliver oxygen and nutrients to vital organs and muscles, preparing the body for physical action.

4. Dilation of Pupils: The release of adrenaline causes the pupils to dilate, improving visual acuity and enhancing the ability to detect potential threats.

5. Enhanced Respiration: The respiratory rate increases to supply more oxygen to the bloodstream, supporting heightened physical activity and alertness.

6. Suppression of Digestive and Reproductive Functions: During acute stress, blood flow is diverted away from non-essential functions such as digestion and reproduction, and redirected to the muscles and vital organs involved in the stress response. This can result in symptoms such as decreased appetite, digestive discomfort, and temporary infertility.

7. Release of Endorphins: In response to stress, the body may release endorphins, which are natural painkillers produced by the brain. Endorphins help dampen pain perception and promote a sense of well-being.

8. Activation of the Immune System: Acute stress can temporarily enhance immune function, preparing the body to defend against potential injuries or infections. However, chronic stress may suppress immune function over time, increasing susceptibility to illness and delaying healing processes.

Pretty cool right?!?!

Yes, this incredible ability to quickly enhance certain bodily mechanisms is built into our genetics and ensures our survival by giving us the energy and acuity to fight to see another day!  Yes, this process is super helpful in life-threatening stressful situations, like for example, when you are getting chased by a hungry tiger.   This incredible cascading of physiological processes work together like a symphony, equipping you with your greatest chances to either fight off this hungry attacking tiger or run and escape this danger.

Again, this whole mechanism is triggered in response to stress… like a tiger… but also traffic.  And work stress.  And your mother-in-law.  And also your finances, being late for the carpool pick-up again, that big deadline at work coming up, the disagreement you had with your spouse, and the stress that comes with trying to really show up and be the person that everyone wants you to be while at the same time trying to find the time to take care of yourself and actually start to address that every growing “to do” list.

Some stressors in our lives are self-evident.  Other stressors, though in ways more subtle, will also dramatically trigger this adrenal-stress response, such as eating unhealthy foods, pollution, environmental factors like living with mold, exposure to toxins, over-training/exercise, and even poor sleep habits, or sleep apnea.

***Apnea is when breathing is disrupted during sleep.  This can be due to either complete pauses in breathing or breathing very shallowly.  Apnea deprives the body of oxygen and apnea is very common.  It is easy to see how a fight with a tiger can trigger a huge stress response, but can you imagine what stress signals are coursing through your being when your body thinks it is being choked or drowning, unable to get sufficient oxygen while you are sleeping?!?  Apnea is a significant factor in not only adrenal health but also overall health.  Apnea is very common and also absolutely overlooked and unrecognized.

So, you can see, our adrenal system is always at work keeping us safe.  Which is fine… that’s what it is designed to do…in moderation.  Problems arise when we live with chronic taxation and stress. 

This might sound familiar to some…

Anyone you know?

Chronic stress often results in adrenal dysregulation.  This is when the adrenal system is no longer able to properly regulate itself, resulting in either an overactive or underactive adrenal function.  Both of which create significant implications for our health.

The Effects of Adrenal Dysregulation

An overactive adrenal system, also known as adrenal overactivity or hyperfunction, can occur due to various factors such as tumors, medications, or medical conditions affecting the adrenal glands. When the adrenal glands produce excessive amounts of hormones, it can lead to a range of symptoms. Here are some common symptoms associated with an overactive adrenal system:

·         High Blood Pressure (Hypertension): Excess production of aldosterone, a hormone produced by the adrenal glands, can lead to increased sodium retention and potassium loss, resulting in elevated blood pressure.

·         Weight Gain: Adrenal overactivity may contribute to weight gain, particularly in the abdomen, due to cortisol's role in promoting fat storage, especially visceral fat.

·         Muscle Weakness and Fatigue: Excessive levels of cortisol can lead to muscle breakdown and weakness, contributing to feelings of fatigue and lethargy.

·         Increased Heart Rate: Elevated levels of adrenaline (epinephrine) and norepinephrine can lead to palpitations, rapid heart rate, and a sense of heightened alertness or anxiety.

·         Irregular Menstrual Cycles: In women, adrenal overactivity may disrupt menstrual cycles, leading to irregular periods or cessation of menstruation (amenorrhea).

·         Excessive Sweating: Increased production of adrenaline can stimulate sweat gland activity, leading to excessive sweating even in non-stressful situations.

·         Insomnia and Sleep Disturbances: Elevated cortisol levels can interfere with the normal sleep-wake cycle, leading to difficulty falling asleep, staying asleep, or experiencing non-restorative sleep.

·         Anxiety and Mood Changes: Adrenal overactivity can contribute to feelings of anxiety, irritability, and mood swings, as well as exacerbate symptoms of depression.

·         Digestive Issues: Adrenal dysfunction may affect digestion and lead to symptoms such as abdominal discomfort, bloating, diarrhea, or constipation.

·         Increased Appetite and Cravings: Cortisol can influence appetite regulation, leading to increased hunger and cravings, particularly for sugary or high-carbohydrate foods.

·         Skin Changes: Excessive cortisol production may result in skin changes such as thinning, bruising easily, or the development of stretch marks (striae).

·         Weakened Immune System: Prolonged elevation of cortisol levels can suppress immune function, increasing susceptibility to infections and delaying wound healing.

An underactive adrenal system, also known as adrenal insufficiency or hypofunction, occurs when the adrenal glands do not produce enough hormones to meet the body's needs. This can result from various factors, including autoimmune conditions, infections, or damage to the adrenal glands. The symptoms of adrenal insufficiency can vary in severity and may develop gradually over time. Here are some common symptoms associated with an underactive adrenal system:

·         Fatigue: Fatigue and weakness are hallmark symptoms of adrenal insufficiency. Individuals may feel persistently tired, even after adequate rest, and may experience difficulty completing daily tasks or activities.

·         Weight Loss: Unintentional weight loss can occur due to decreased appetite and metabolic changes associated with adrenal insufficiency.

·         Muscle Weakness: Weakness and muscle fatigue may develop, making it challenging to perform physical activities or exercise.

·         Low Blood Pressure (Hypotension): Decreased production of aldosterone, a hormone that helps regulate blood pressure and electrolyte balance, can lead to hypotension. Symptoms may include dizziness, lightheadedness, and fainting spells.

·         Nausea and Vomiting: Gastrointestinal symptoms such as nausea, vomiting, and abdominal pain may occur, especially during times of stress or illness.

·         Salt Cravings: Adrenal insufficiency can result in salt cravings due to decreased aldosterone levels, which can lead to sodium loss and electrolyte imbalances.

·         Hyperpigmentation: In some cases of adrenal insufficiency, particularly primary adrenal insufficiency (Addison's disease), increased production of adrenocorticotropic hormone (ACTH) by the pituitary gland can stimulate melanocytes in the skin, leading to hyperpigmentation. This typically presents as darkening of the skin, especially in areas exposed to sun or pressure, such as the elbows, knees, knuckles, and scars.

·         Hypoglycemia: Insufficient cortisol production can impair glucose metabolism, leading to low blood sugar levels (hypoglycemia). Symptoms may include weakness, shakiness, sweating, confusion, and fainting.

·         Depression and Mood Changes: Adrenal insufficiency can contribute to feelings of depression, anxiety, and mood swings, affecting overall emotional well-being.

·         Decreased Libido: Reduced production of sex hormones, such as testosterone and estrogen, can lead to decreased libido (sex drive) and changes in sexual function.

·         Menstrual Irregularities: Women with adrenal insufficiency may experience menstrual irregularities, including changes in menstrual cycle length or amenorrhea (absence of menstruation).

As you review this list of symptoms caused by adrenal dysregulation, does anyone come to mind?  Unfortunately, adrenal taxation is so common, I am confident all of us know many people who are currently experiencing disorders with this aspect of our endocrine system.

Testing the Adrenal Function

The best way to understand adrenal functioning is through a salivary cortisol test.  Cortisol is a hormone secreted by the adrenal gland in response to perceived stress.  The amount of cortisol at a given time can offer insight into how the adrenal gland is functioning.

Normal cortisol levels fluctuate throughout the day.  Normal cortisol levels are higher in the morning (when one typically awakes), then gradually decline through the day and elevate again through the night.  Healthy cortisol levels are always in flux, rising and falling throughout the day, very much like the ocean tides.

Typically, conventional medicine will measure cortisol levels with one blood test at some point during the day.  This method is ineffective because the cortisol level should fluctuate throughout the day.  Testing the cortisol with only one marker is incapable of understanding the arch of this hormone throughout the day.  Theoretically, cortisol should be higher in the morning and lower in the night.  Theoretically…

Healthy Adrenal Test Results

Here is an example of a “normal” healthy cortisol test (see Example 1).  Notice the saliva is tested four times throughout the day- at 8 AM, Noon, 4 PM, and Midnight.  The blue squares show the patient's result of free cortisol at each of these time intervals.  The blue line then connects the patient's test results to show the cortisol rhythm throughout the day.  The green band shows the reference range for where the free cortisol should be in a healthy normal adult. 

With the example below, the blue line is all within the green reference zone, suggesting this individual has a “normal” output of cortisol throughout the day, suggesting a healthy functioning adrenal gland.

Example 1

Overactive Adrenal Test Results

Chronic stress, in all the many forms that this can show up, or any type of significant over-taxation, will cause your adrenal glands to pump out more cortisol in an attempt to keep you safe and functioning.  Again the output of cortisol from the adrenal gland is ultimately a defense mechanism to equip you with the ability to fight or fly from a stressful situation.  Unfortunately, for many, we live our lives in a continuous stressful situation, and the adrenal gland responds accordingly.

Below in Example 2, are the test results for someone with an overactive adrenal gland pumping out way more cortisol than should be found in a typical “healthy” individual.

Notice how the patient’s results (indicated with the blue squares and blue line) are significantly elevated above the green expected reference range.

Individuals with a cortisol profile such as this are likely to be stressed out and anxious.  Most likely, they have a great deal of difficulty fully relaxing as their mind is running and they always feel they need to be handling something or taking care of something.  Often they may feel they don’t have control over their own life and reach for control where they can find it. For example, these individuals may constantly be trying to maintain an impeccably clean house. Typically, these individuals have difficulty sleeping.  They probably feel life is fast and challenging, and they are doing their best to keep up with it, yet somehow always seem to be falling behind.

Example 2

Underactive Adrenal Test Results

There are also times when the adrenal function is incapable of releasing the stress hormones needed to support us in daily life.   The adrenals can become so taxed with trying to manage chronic stress for so long that the gland is no longer able to keep up with the demand of cortisol needed to manage the taxations in our life.  Most often an underactive adrenal function is the result of remaining in an overactive adrenal function for too long (see Example 2).  The adrenal gland simply becomes tired and no longer capable of functioning normally.  Some refer to this state as “adrenal fatigue”.

In Example 3 below, you will see how the patients' test results indicated by the blue squares and blue line are far below the green reference range.  The adrenal glands for this client are no longer capable of producing an adequate amount of cortisol.

Individuals with a similar adrenal profile are likely to be very tired…all the time.  Often, they do not awake feeling refreshed, and it takes them longer than usual to get out of bed and become “fully functional” for much longer than the average person.  It is typical that these individuals turn to caffeine to help them get through the day.  Often, these individuals have a very low or non-existent libido.  They may experience brain fog and have difficulty focusing.  Salt or sugar cravings are common and perhaps the most common craving is sleep.  Likely, these individuals feel they have been struggling for a long time, trying to keep it all together, and they are just so tired from all the struggle.

Example 3

Significantly Over-Simplified, Yet It Illustrates a Point

What is described above is a very stripped-down and simplified explanation of how the adrenal glands function. The adrenal function is actually the result of a very complex messaging system composed of other hormones and regulatory checks and balances occurring together.  So, while there is much more to the intricate processes of adrenal regulation, the above examples do a great job illustrating basic adrenal functioning and how testing can offer incredibly valuable insight on how the adrenal system is working.  Ultimately, this information offers insight on what needs to happen to regulate the adrenal system and support each client in feeling healthy and more in balance.

Perception & Choice- Your Super-Power in Regulating The Adrenal System

Fortunately, we have a great deal of power and resources available to bring our adrenal glands back in balance!  Probably much more power than you know.  Perhaps the most important, most impactful, and most powerful resources we have are perception and choice.  The most common cause of adrenal dysregulation is chronic stress.  By reducing the stress, we reduce the taxation of the adrenal system.  Yes! It’s that easy!  And of course, it is not that easy…

But perhaps it is.

I suspect most of us are aware of some of the greatest stressors in our lives at this time.  Is it your work? Is it your marriage? Is it your family? Identifying our source of stress is critical in making changes to make our circumstances different.

For many clients, I find their occupation is a huge source of stress.  I have heard the words, “My job is sucking the life out of me”, way more times than anyone ever should.  It’s real.  If your work is the #1 biggest taxation on your being… then quit.

And right now, I would guess there is a part of your being that just had a visceral reaction and screamed… “Quit?!? Sounds nice!  But, I just can’t quit!”

Sure, you can. 

You can.  

You could simply not go to work tomorrow… or ever again.

Of course, all choices have consequences.  Perhaps if you get up and walk out of your job right now, you will decrease some stress, but you may invite other stressors when you run out of money. 

So perhaps quitting your job right now isn’t the best idea (but maybe it is).  Perhaps you can make a choice to change your relationship to your work.  What could you do to make it better?   What changes can you make to create a less taxing relationship with your job?

Likewise, the same principles apply to your marriage if this is a significant source of stress.  Perhaps the best choice is not to get a divorce (but maybe it is).   Perhaps there are changes you can make to have a different relationship with this relationship.  Is there something that needs to be said?  Is there something that needs to be heard? What role are you playing in this dysfunction?  Perhaps you need to dance differently with your partner.  (See awesome article here). 

The point here is that the first step (and perhaps most important and impactful) in healing the adrenal system is to mitigate that which is stressful to our system.  Without changing the primary sources of our stress, it will be challenging to decrease the stress we experience.

Basic Actions to Support the Adrenal System

1. Reduce Stress and Support the Nervous System

·         Identify stressors: Emotional, work, environmental, or physical stress can overtax the adrenals.

·         Relaxation techniques: Incorporate daily meditation, deep breathing, yoga, tai chi, or progressive muscle relaxation.

·         Mindfulness and journaling: Helps to process emotions and reduce cortisol spikes.

·         Limit stimulants: Reduce caffeine, nicotine, and excess sugar, which increase adrenal workload.

2. Optimize Sleep and Circadian Rhythm

·         Consistent schedule: Go to bed and wake up at the same time every day.

·         Sleep hygiene: Dark room, no screens 1 hour before bed, cool temperature, calming bedtime routine.

·         Avoid late-night stressors: Emails, work calls, and high-intensity exercise close to bedtime can impair adrenal recovery.

3. Nutrition for Adrenal Support

·         Stabilize blood sugar: Eat small, frequent meals with protein, healthy fats, and complex carbs.

·         Nutrients that support adrenals:

o    Vitamin C (citrus, bell peppers, berries)

o    B vitamins (whole grains, leafy greens, eggs)

o    Magnesium (nuts, seeds, dark chocolate, leafy greens)

o    Zinc (pumpkin seeds, oysters, beef)

·         Adaptogenic herbs: Ashwagandha, Rhodiola, Holy Basil, Licorice (with professional guidance) can support adrenal resilience.

·         Hydration: Adequate water intake with electrolytes (salt, potassium, magnesium) to combat fatigue.

4. Moderate Exercise

·         Gentle movement: Walking, yoga, swimming, or tai chi instead of high-intensity cardio during adrenal fatigue.

·         Avoid overtraining: Intense workouts increase cortisol and can worsen adrenal burnout.

·         Morning sun exposure: Helps regulate cortisol rhythm and supports natural circadian signaling.

5. Support the HPA Axis

·         Avoid chronic stimulants: Energy drinks, coffee, and excessive sugar.

·         Regular meals and snacks: Prevent blood sugar crashes, which stress adrenals.

·         Biofeedback or guided relaxation: Can reduce sympathetic (fight-or-flight) dominance.

6. Consider Targeted Supplementation

·         There are a lot of products out there- some that are good and some that are terrible.

·         Proper supplements need to be custom-tailored to address your specific needs.  Also there are very different treatment strategies that must be employed if your cortisol is elevated to reduced.    

7. Detoxify Lifestyle Stressors

·         Reduce chemical exposure: Household toxins, artificial fragrances, and processed foods.

·         Healthy work-life boundaries: Limit overwork and allow downtime for recovery.

·         Emotional support: Counseling or supportive communities can reduce chronic emotional stress.

8. Chinese Herbal Medicine

·         Chinese herbal therapy has been successfully supporting health and balance for thousans of years.

·         At The Center, we are able to custom-mix prescriptions from medicinal Chinese herbs to specifically address your needs. 

9. Acupuncture

·         Acupuncture has a unique way of mitigating the negative effects of stress on the adrenal and immune systems.

·         In addition, acupuncture can nourish the “Qi” or energy of the adrenal system to quickly return the body to a great sense of balance and ease.

10. Monitor and Track Progress

·         Lab work: Cortisol, DHEA, thyroid, and blood sugar panels can guide treatment.

·         Symptom journal: Track fatigue, sleep, cravings, and energy levels.

·         Adjust strategies gradually: Recovery can take weeks to months; avoid “quick fixes.”

In Summary

The world can be stressful. 

Our bodies are designed to flow, and flex, and adapt to the stressors we encounter.  Much of our ability to do this adapting and flowing happens with our adrenal system.  The adrenal system will work for us and do what it is designed to do…until it can’t.  Chronic stress, prolonged taxation, and ongoing perceptions of threat will tax our adrenal system.  Ultimately, the adrenal system becomes compromised and dysregulated, and as a result, causes a wide variety of symptoms of imbalance.

Solutions are readily available for correcting these imbalances and supporting the adrenal system. Some solutions may be as easy as remembering to breathe.  At other times, additional testing and therapies such as acupuncture, herbal medicine, and nutraceutical supplementation may be necessary.

The first step in healing is to recognize the signs.   No, it is not normal to be chronically fatigued.  No, it is not normal to gain weight for no reason.  No, it is not normal to need coffee to function.  No, it is not normal to have no libido. No, it’s not normal to have difficulty relaxing.  And no, it is not normal or healthy to be chronically stressed out.  By first recognizing your current symptoms and feelings, you can begin to make choices that can change the trajectory of your current course.  By understanding what is happening and WHY you may be feeling the way you are feeling, you can begin to choose differently, and as a result, you will get different.

I know this was a big article and thank you for making it this far.  The truth is that this article is just skimming the surface of adrenal health and the critical role it plays in the regulation of virtually every physiological process in the body and mind.

You don’t need to figure it out all on your own.  As always, at The Center: Natural Health Specialists, we are here to support you with comprehensive holistic natural medicine.  

Adrenal testing, interpreting symptoms, beneficial services and products, and most importantly, a PLAN to support you may be found here. 

Call us at (919) 848-0200 to schedule or let us know if you have any concerns about your adrenal health. We got you. :)

Article by Quinn Akira Takei, Doctor of Oriental Medicine(NM), Licensed Acupuncturist, Chinese Herbalist, Functional Medicine Practitioner, and Holistic Health & Wellness Coach.

The Center: Natural Health Specialists, 8404 Six Forks Road, Suite 201, Raleigh, NC 27615. (919) 848-0200. www.TheCenterNHS.com