Decreased Adrenal Function and Hypoglycemia

Compiled by John G. Connor, M.Ac., L.Ac. Edited by Barbara Connor, M.Ac., L.Ac.

TABLE OF CONTENTS
Introduction
The Role of the Adrenal Glands
Decreased Adrenal Function in Chinese Medicine
Hypoglycemia and Decreased Adrenal Function
Best Time to Eat for Adrenal Fatigue
Dietary Recommendations for Adrenal Fatigue
Useful Foods for Adrenal Fatigue
Useful Foods for Kidney Yang Deficiency
Foods to Avoid in Persons with Adrenal Fatigue
Useful Supplements for Adrenal Fatigue
Useful Supplements for Hypoglycemia
Useful Herbs for Adrenal Fatigue
Useful Herbs for Kidney Yang Deficiency
Herbs to Avoid in Persons with Adrenal Fatigue
Adrenal Cortical Extracts
References

INTRODUCTION
Barbara and I see many patients suffering from hypoglycemia and decreased adrenal function.  We get very good results using a combination of craniosacral acupuncture, herbs, supplements, dietary recommendations and hara visceral work.  We are writing this article in hopes of giving you a better understanding of these conditions and how we treat them.

THE ROLE OF THE ADRENAL GLANDS
v  The adrenal glands are located superior to each kidney.  They are comprised of an outer adrenal cortex and an inner adrenal medulla.  The adrenal cortex secretes mineralocorticoids, glucocorticoids and gonadocorticoids.  The glucocorticoids are cortisol (hydrocortisone), corticosterone and cortisone.  Of the three, cortisol is the most abundant and is responsible for about 95% of glucocorticoid activity.  Glucocorticoids, together with other hormones, promote normal metabolism, provide resistance to stress and participate in anti-inflammatory responses.  Cortisol helps keep blood sugar levels adequate to meet your body’s demand for energy.  The control of glucocorticoid secretion is via a negative feedback system.

v  Hyposecretion of glucocorticoids and aldosterone results in the condition known as Addison’s disease (primary adrenocortical insufficiency.)  Clinical symptoms include mental lethargy, anorexia, nausea and vomiting, weight loss and hypoglycemia, which leads to muscular weakness.  Loss of aldosterone leads to elevated potassium and decreased sodium in the blood, low blood pressure, dehydration, decreased cardiac output, arrhythmias and potential cardiac arrest.

DECREASED ADRENAL FUNCTION IN CHINESE MEDICINE
v  In his book Healing with Whole Foods Paul Pitchford explains that the concept of the Kidneys in Chinese medicine goes beyond that of Western physiology.  In Chinese medicine adrenal gland activity is generally assigned to the concept of the Kidneys.  Both the adrenals (in Western medicine) and the Kidneys (in Chinese medicine) contribute to the energy, warmth, sexuality and other aspects of the body.  Also anatomically the adrenals are located on top of the kidneys and produce secretions that make kidney activities possible.

v  The Chinese medical syndrome that corresponds to decreased adrenal function is Kidney Yang Deficiency.  The clinical manifestations of Kidney Yang Deficiency are: soreness of the back, cold knees, sensation of cold in the back, aversion to cold, weak legs, bright-white complexion, weak knees, impotence, premature ejaculation, lassitude, abundant-clear urination, scanty-clear urination, apathy, edema of the legs, infertility in women, poor appetite and loose stools.  The tongue is pale, swollen and wet and the pulse is deep and weak.

v  In his book The Web that has No Weaver, Ted Kaptchuk mentions adrenal gland hypoactivity as one of the various patterns that involves Kidney Yang Deficiency.  And Bensky and Barolet in their book Chinese Herbal Medicine Formulas and Strategies, recommend using the Chinese herbal formula si ni tang, which is good for Kidney yang deficiency accompanied by an increase of internal cold, for adrenal insufficiency.

HYPOGLYCEMIA AND DECREASED ADRENAL FUNCTION
v  Hypoglycemia literally means low blood sugar.  Most of the time when people say they have hypoglycemia they are describing a group of symptoms that occur when the body reacts to increasing blood sugar levels after eating and it may overdo its efforts to bring blood sugar back down.  Common symptoms include fatigue, anxiety, headaches, difficulty concentrating, sweaty palms, shakiness, excessive hunger, drowsiness, abdominal pain and depression.

v  According to James Wilson in his book Adrenal Fatigue. The 21st Century Stress Syndrome people who have hypoglycemia are usually suffering from decreased adrenal function.  Cortisol helps keep blood sugar levels adequate to meet our body’s demand for energy.  However, when our adrenal glands are fatigued, cortisol levels drop lower than normal.  This makes it more difficult for our body to maintain normal blood sugar levels.  As a result, people with adrenal fatigue also tend to have low blood sugar. The lower the blood sugar levels, the more cortisol it takes to normalize them.

v  He describes what happens as follows: When our adrenals are fatigued, the cortisol output is diminished and we have lower levels of circulating blood cortisol.  With lowered blood cortisol, our liver has a more difficult time converting glycogen into glucose.  Fats, proteins and carbohydrates, which normally can be converted into glucose, also cannot be as readily converted into glucose.  These reserve energy pools controlled by cortisol are critical to achieving and maintaining normal blood sugar levels, especially during stress.  Further complicating this matter is that during stress, insulin levels are increased because the demand for energy in the cells is greater.  Insulin opens the cell wall membranes to take in more glucose in order to provide more energy to the cells.  Without adequate cortisol levels to facilitate the conversion of glycogen, fats and proteins to new glucose supplies this increased demand is difficult or impossible to meet.  All this combines to produce low blood sugar.

v  He goes on to say that to the body, hypoglycemia is a strong stressor; an emergency call to action that further drains already fatigued adrenals.  People who treat their own hypoglycemia by eating something sweet with a cup of coffee or a cola are on a constant roller-coaster ride throughout the day with their blood sugar erratically rising and then falling after each sugar fix.  This throws not only cortisol and insulin levels into turmoil, but also the nervous system and the entire homeostasis of the body.  And by the end of the day, the person may feel exhausted without having done anything.  60% of people suffering from hypoglycemia go on to become diabetics.

Best Times to Eat for Adrenal Fatigue
v  The best time to eat breakfast is before 10:00AM in the morning because between 6:00 and 8:00 AM cortisol levels typically rise rapidly, peaking at around 8:00AM and while your cortisol levels are higher, you may not feel like eating.  In addition, the low liver function that often accompanies low adrenal function also suppresses early morning hunger.

v  Eat lunch between 11:00 – 11:30 Eat a snack between 2:00 and 3:00 Eat dinner around 5:00 or 6:00And eat a snack just before bedtime.

Dietary Recommendations for Adrenal Fatigue
v  30- 40% whole grains30-40% vegetables10-20% animal foods10-15% beans, seeds and nuts5-10% fruits  

v  Eating natural high quality food at frequent, regular intervals will make a difference to your adrenal health as well as to your energy level.Combine fat, protein and complex carbohydrates at every meal and snack.

v  Most people with adrenal fatigue do not do well having cereal grains in the morning (even those made from whole grains).Good sources of whole grains are brown rice, whole wheat, buckwheat, unpearled barley, whole oats, unhulled millet, quinoa and amaranth.

Useful Foods for Adrenal Fatigue
v  Foods high in magnesium such as kelp, almonds, cashews and other nuts, brown sesame seeds, whole wheat, peas and beans.

v  Carob helps normalize hypoglycemia.

Useful Foods for Kidney Yang Deficiency
v   Rice, sweet brown rice, oats, spelt, quinoa, corn, buckwheat and rye.  Sunflower seeds, sesame seeds, peanuts, chestnuts and pine nuts.  Yellow onions, Chinese yam, Chinese cabbage, parsnip, winter squash, sweet potato, kale, leek, scallion, mustard greens and carrots.  Lychee, pumpkin, cherry, citrus peel, dates and raisins.  Hot peppers, black pepper and cayenne Caution: use hot peppers and cayenne in small pinches as they can have a strong cooling effect.  Walnuts (start eating one walnut a day, then add one more each day, not to exceed 20 per day). Chicken, goat’s milk, beef, lamb, shrimp, mussels, fish (e.g., anchovy and trout).

In general, use warming foods and methods of preparation.

Foods to Avoid in Persons with Adrenal Fatigue
v  Avoid sugar, white flour and chocolate.  Chocolate contains magnesium; so chocolate cravings can mean your body craves magnesium.  However, chocolate also contains caffeine and theobromine, which can overstimulate the adrenals leading to further adrenal fatigue.  Take 400 mg/day of magnesium citrate instead.

v  Avoid hydrogenated and partially hydrogenated oils.  These oils use up the enzymes that would normally be utilized by the good oils, and they prevent your body from creating quality cell membranes and nerve sheaths.

v  Avoid foods high in potassium such as bananas and dried figs as they make adrenal fatigue worse.

v  Avoid caffeine containing foods and beverages.

v  Avoid fruit juices in the morning, do not have them by themselves and drink only small quantities of them.

v  Avoid alcohol and soft drinks.

v  Eat fried foods only once a month or less.

v   Use fewer cooling foods and fruits and raw foods.

Useful Supplements for Adrenal Fatigue
v  Vitamin C is used all along the adrenal hormone cascade and acts as an antioxidant within the adrenal cortex itself.

v  Magnesium is essential for the production of enzymes and the energy necessary for the adrenal hormone cascade.

v  Pantothenic acid is an essential co-factor in the adrenal cascade.

v  Niacin is essential for the adrenal cascade.

v  Vitamin E is essential indirectly in at least 6 different enzymatic reactions in the adrenal cascade.

v  Vitamin B6 is a co-factor in several of the enzymatic pathways in the adrenal cascade.

v  B Complex is needed in small quantities throughout the adrenal cascade.

Useful Supplements for Hypoglycemia
v  Research has shown that supplementing with chromium (200 mcg per day) or magnesium (340 mg per day) can prevent blood sugar levels from falling excessively in people with hypoglycemia.  The best source of chromium is true brewers yeast.

v  Vitamin B3 has also been found to be helpful for hypoglycemic individuals.

Useful Herbs for Adrenal Fatigue
v  Siberian ginseng has a wide range of activities that help support and rejuvenate adrenal function, increase resistance to stress, normalize metabolism and regulate neurotransmitters.

v  Ginger root helps modulate cortisol levels, normalize blood pressure and heart rate, burns fat, increases energy and metabolic rate and stimulates digestive enzyme secretions for proteins and fatty acids.

v  Ginger (Zingiber officinale) – Stimulation of the hypothalamus pituitary adrenal axis in stressful condition alters plasma glucose, triglyceride, cholesterol, BUN and corticosterone levels. There is also alteration in the blood cell counts. Pretreatment with the extract significantly ameliorated the stress-induced variations in these biochemical levels and blood cell counts in both acute and chronic stress animals. The extract treated animals showed increase in swimming endurance time and increase in anoxia tolerance time in physical and anoxia stress models, respectively. Treatment groups also reverted back to increase in liver, adrenal gland weights and atrophy of spleen caused by cold chronic stress and swimming endurance stress models. The results indicate that ethanolic extract of Zinziber officinale has significant adaptogenic activity against a variety of biochemical and physiological perturbations in different stress models. (Lakshmi & Sudhakar 2010)

v  Licorice root is known to naturally fortify cortisone levels.  It has also been used to help decrease symptoms of hypoglycemia.  CAUTION: Licorice raises blood pressure so monitor your blood pressure if you have high blood pressure and avoid it altogether if it raises your blood pressure above 140/90.

Useful Herbs for Kidney Yang Deficiency
v  Chives, garlic, cloves, basil, rosemary, angelica root, parsley, fennel, dill, anise, caraway, carob pod, cumin and cinnamon bark are all helpful for Kidney Yang Deficiency.

Herbs to Avoid in Persons with Adrenal Fatigue
v  Ephedra, cola nut and strong black teas.

Adrenal Cortical Extracts
v  Adrenal cortical extracts are not replacement hormones, but instead provide the essential constituents for adrenal repair by nourishing and helping rebuild our adrenal cells. 

v  According to Dr. Wilson corticosteroids, whether natural or synthetic, tend to reduce or shut down the activity of our adrenal glands.  This happens because our brain senses the presence of these cortisol substitutes and, in response, withholds the signal (ACTH) it would otherwise send to our adrenal glands to make more adrenal hormones.  Thus corticosteroids suppress the functions of our adrenal glands, over-riding the normal feedback loops that regulate and balance adrenal hormones.  Corticosteroids mask the symptoms of adrenal fatigue, and when used in excess depress immune function.

REFERENCES
Bensky, Dan & Randall Barolet, Chinese Herbal Medicine Formulas & Strategies, Seattle: Eastland Press, 1990
Kaptchuk, Ted, J., O.M.D., The Web That Has No Weaver, Chicago: Congdon & Weed, 1983
Lininger, Jr. Schuyler W. D.C., Editor in Chief, The Natural Pharmacy, Rocklin, CA: Prima Publishing, 1999
Ma, Shou-Chun, MTCM, Chinese Nutrition Class Notes from Northwest Institute of Acupuncture and Oriental Medicine, Seattle, 1994
Maciocia, Giovanni, The Practice of Chinese Medicine, Edinburgh: Churchill Livingstone, 1994
Maciocia, Giovanni, The Foundations of Chinese Medicine, Edinburgh: Churchill Livingstone, 1989
Murray, Michael, N.D. and Joseph Pizzorno, N.D., Encyclopedia of Natural Medicine, Rocklin, CA: Prima Publishing, 1991
Pitchford, Paul, Healing with Whole Foods, Berkeley: North Atlantic Books, 1993
Tortora, Gerard J. & Sandra R. Grabowski, Principles of Anatomy and Physiology, New York: HarperCollins, 1993
Wilson, James L., N.D., D.C., Ph.D., Adrenal Fatigue. The 21st Century Stress Syndrome, Petaluma: Smart Publications, 2003

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Compassionate Acupuncture and Healing Arts, providing craniosacral acupuncture, herbal and nutritional medicine in Durham, North Carolina. Phone number 919-309-7753.

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