Oct42018

Natural Adrenal Support For Athletes

What Are The Adrenal Glands:

The adrenals are 2 glands that sit on top of our kidneys and are part of the Endocrine or Hormonal System. They are responsible for producing and releasing a handful of different hormones most importantly:

  • Epinephrine (Adrenaline) and Norepinephrine- responsible for our fight or flight responses
  • Aldosterone- Helps regulate sodium and water balance which influences blood pressure.
  • Cortisol- AKA our stress hormone. It helps our body adapt to stress, works closely with the immune system, and other hormonal systems, influences energy metabolism- how we break down fats, proteins and carbohydrates, and cellular energy production. It mediates inflammation, and assists in blood sugar regulation.
  • Androgens (Including Androstenedione and Dehydroepiandrosterone or DHEA.)- These hormones are building blocks to testosterone and or estrogen, the main two sex hormones.

How Do the Adrenals Become Fatigued?

The adrenals are working for us day and night to help keep balance in the body. Cortisol, is released throughout the day in bursts and patterns driven by eating and activity as well as daylight and darkness (in a circadian rhythm). At different times in the day, different amounts of cortisol are released.

In the morning there is a spike of cortisol release, our greatest amount for the day. This is a signal to our bodies to get up, eat something and start our day. Cortisol starts to drop after we eat in the morning and into the afternoon and finally is at its lowest point in the evening signaling us to settle down and go to bed. The normal cortisol rhythm is interrupted when there is more exposure to stress. Our sympathetic nervous system overrides the normal pattern and stimulates more cortisol to be released. Stress can include anything such as:

  • Emotional or mental stress
  • Illness- acute or chronic
  • Environmental stress- toxins, chemicals, etc
  • Food- especially processed food, sugars, caffeine
  • Exercise- Yes exercise! Especially at high intensities

When there is stress, the adrenals have to work harder to bring the body back into balance. This ability to respond to our outside environment is crucial to survival. Some “stress” is good for us. It signifies us to react, adapt and allows us to push our bodies and become stronger.

So what’s happening in our bodies when more cortisol is released? First, there is a dramatic rise in blood glucose (blood sugar), fatty acids and amino acids. Why? Because your body is preparing to act and respond to this stress. It needs to make sure there is enough energy to feed your active cells and muscles. Glucose is the main fuel for your brain so you conserve glucose by making some from proteins and fats. As a result of utilizing more fuel, your blood pressure goes up and the veins constrict to ensure the nutrients are transported quickly throughout the body. This process is an adaptive mechanism that helps us maintain balance when exposed to higher amounts of stress. In other words… When stress goes up and your body produces more cortisol you may feel an increase in heart rate, pulsing adrenaline through your body, heightened alertness, and ready to go!

If stress is extreme or experienced for a continual amount of time, this is when
we start to see issues like immune depression, inflammation increase, and adrenal
insufficiency.

Adrenal Insufficiency:

Although the term Adrenal fatigue is often used interchangeably with adrenal insufficiency they are really two different things. Adrenal fatigue refers to a state where the adrenals have hit rock bottom. Most of the time the issue is just insufficiency, meaning they are not working to their optimal capacity.

There are 4 major stages of adrenal insufficiency:

Stage 1- “The Alarm Phase”

  • This stage refers to the adrenals immediate response to stress
  • As stated before when exposed to a stressor the adrenals release more cortisol resulting in a chain of events that allows us to adapt and handle the situation.
  • It is a somewhat short lasting spike in cortisol, epinephrine and norepinephrine, insulin, and DHEA
  • One may feel the initial response as increased adrenaline including elevated heart rate, and increased focus and alertness.
  • Most don’t notice any major symptoms besides sometimes some tiredness after the spike of cortisol/adrenaline falls
  • We go in and out of this phase sometimes on a daily basis

Stage 2- “The Alarm On Repeated Snooze” Phase

  • At this stage you have hit the snooze button yet the alarm keeps coming back on again and again and again.
  • The adrenals are responding to stress but the stress seems to be continual.
  • Your adrenals continue to produce cortisol and the other hormones however some of the precursors to making DHEA and your other sex hormones begin to be diverted towards more cortisol production in order to keep up.
  • At this phase cortisol is still high but your sex hormones may start to drop.
  • Also cortisol is elevated for longer periods of time then in the initial alarm phase.
  • Symptoms include:
    • Beginning stages of fatigue
    • Wired but tired- alert during the day but then crashing in the afternoon or evening
    • Weight gain- especially around the trunk or waistline
    • Insulin resistance
    • At this stage people start to reach for or rely on stimulants like coffee or sugar to give them a boost
    • This stage refers to most students, interns, residents; heck most Americans!

Stage 3- The I Don’t Want To Get Out Of Bed Phase

    • In this phase, the adrenals are working hard and have been working hard for sometime now.
    • Cortisol is still be produced but not without sacrifices.
    • The sex hormones: DHEA, Testosterone, Estrogen and Progesterone levels significantly drop in this phase
    • In particular, a hormone called pregnenalone, which is the grandmother of hormones because it is the precursor to DHEA, Estrogen, Testosterone and Cortisol starts to shift toward making cortisol rather than the sex hormones.
    • Cortisol levels overall may start to drop as the body can’t keep up with the rate in which it is using cortisol or we may see a flip in cortisol levels.
    • This means cortisol levels may be lower in the morning when they should be high to stimulate you to get out of bed and higher at night when they should be at their lowest.
    • Symptomatically this looks like:
      • fatigue in the morning, hard time getting out of bed and starting your day, or not feeling rested in the morning
      • fatigue that continues throughout the day although you can make it through…sometimes not without a nap!
      • Crashes in the afternoon or evening
      • Wired but tired feeling at night. Hard time falling asleep or staying asleep evening though you are exhausted
      • Low libido (or sex drive), drop in muscle mass, or menstrual irregularities for women
      • Lack of enthusiasm
      • Consistent or reoccurring infections or cold- remember the adrenals play an important role in immune regulation!

Stage 4- The “I Can’t Get Out Of Bed” Phase

      • AKA the Burnout Phase or Adrenal Fatigue
      • At this stage, it’s no longer a choice of getting out of bed or not…you basically can’t!
      • OK so some can or have to get out of bed but not without debilitating fatigue.
      • At this stage you are low across the board- cortisol, DHEA and sex hormones as well as many Neurotransmitter
      • Your body just simply cannot keep up with the chronic exposure to stress.
      • Symptoms include:
        • Extreme debilitating fatigue- often can’t hold a job and athletic performance greatly suffers
        • Irritability, depression, anxiousness, apathy
        • Weight loss
        • Low libido
        • Increased infections, illnesses and harder to heal from them
        • Brain fog, issues with memory

Besides the symptoms, an easy way to access the overall health of your adrenals and their functioning is to do a saliva test that requires 4 samples throughout the day to track the rise and fall of your cortisol and DHEA levels. This is a great way to see what stage you are at and how to appropriately treat.

So What Does This All Mean For Athletes:

Obviously, we know that exercise is good for us. It allows us to burn calories, maintain a healthy weight, sweat and detoxify, improve our circulation and cardiovascular system, boost our mood and much more. But at what point can exercise cause issues? High-intensity athletes are constantly pushing their bodies to overcome new challenges. This makes them strong, more able and powerful- but it also taxes the adrenals. Remember we said that exercise, especially at high intensity, can be a stressor for the body. This means that during times of high-intensity training, the adrenals are working hard to pump out enough cortisol to keep up. Thinking back to our stages of Adrenal insufficiency the athletes burn through stage 1 and 2 pretty quickly; sometimes even stage 3. If not enough time for recovery is given or you don’t replenish your body with what it needs to make more of these adrenal hormones then you are burning the candle at both ends.

This is how overtraining can occur. Overtraining can best be defined as the state where the athlete has been repeatedly stressed by training to the point where rest is no longer adequate to allow for recovery. It is during the rest periods where the body truly becomes stronger. It is an adaptation to maximal loading on the cardiovascular and muscular system that happens during rest and results in higher performance. So not enough rest and support to the body and adrenals results in chronic fatigue, low libido and hormones and lower performance that can last a few weeks to months

So for the athletes doing cross fit, high-performance athletes, professional athletes or just those you work out a lot or at high intensities make sure you are supporting your adrenals. Here’s how:

Natural Ways To Support Adrenals:

The Precursors
These include minerals, vitamins, and nutrients that are needed by your body to make
cortisol.

Vitamin C
Vitamin C is a water-soluble vitamin that is known for its antioxidant support, and immune boosting qualities but it’s also a huge precursor for the adrenals to produce cortisol. So when our bodies are experiencing more stress we use up more Vitamin C to make cortisol, thus increasing our bodies demand of it.

Appropriate dosing to support your adrenals depends on your stress level. Start with 1000 mg daily and work up slowly to a target of 2000-4000mg or to bowel tolerance. Vitamin C can loosen your bowel movements. If this happens then drop the dose down a bit.

The best form is buffered Vitamin C or liposomal. You can increase absorption of Vitamin C if it is taken with bioflavonoids like it is found in nature. Pure encapsulations and Thorne Research makes a buffered ascorbic acid powder and Thorne also has a Vitamin C with flavonoids capsules.

B Vitamins: B5, B6, B12

B Vitamins are critical for many pathways in the body including detoxification, neurotransmitter production, and cellular energy. They also help the body make cortisol and support the pathways that have to do with increasing energy. B5 helps produce Co-Enzyme A, which is responsible for cellular energy. B 6 helps to make cortisol and different neurotransmitters, and B12 helps increase energy and supports detoxification.

A B complex supplement can be a great place to start. Thorne research has a product called Stress B-complex that specifically has higher amounts of B5 to support the adrenals. It is important when choosing a B complex to look for the methyl or active forms that way our bodies can readily use the vitamins. Orthomolecular Methyl B Complex is another good option.

Omega 3 Fatty Acids

Found in fatty fish, avocados, flaxseed oil, walnuts are known for its anti-inflammatory properties. It also supports the brain, neurological functioning, and mood. Omega 3’s and essential fatty acids, in general, are also a building block to cortisol and other hormones. Hormones are made from cholesterol, which is a lipid (or fat) so making sure you have enough healthy fats to make these hormones is key. The best way to get Omega 3 besides your diet is to supplement with fish oil or an oil supplement with the appropriate ratio of Omega3:6:9. For fish oil, I like Nordic Naturals and aim to get 2000-4000mg of Omega 3/day. There is also Udo 3:6:9 oil and Bodybio makes a Balance oil that supplies Omega 6 and Omega 3.

Adaptogens:
Besides precursors, there are herbs that can greatly help support the adrenal glands. Collectively they are called Adaptogens- because they help your body adapt! Here are some of my favorites:

Rhodiola (Rhodiola rosea)- Is indicated for those who are exhausted, anxious, depressed and burnt out. It can reduce fatigue, increase energy and endurance during exercise. It also enhances memory, cognitive function, and mood. For some, it can be mildly stimulating. If that’s what you are looking for, great. If you tend to be someone who gets jittery easily you may want to start with lower doses or take in the morning only.

Eleuthrococcus( Eleutherococcus senticous- Siberian Ginseng)- It restores normal size and function of the adrenal glands. It has been researched extensively and is commonly used in Russia to increase performance in athletes, as well as mental capacity. It is safe taken long-term and can help the body resist getting sick. It increases energy without being over stimulating and can help with anxiety, insomnia, and overall mood.

Ashwagandha (Withania somnifera)- is a very helpful adaptogen. It is indicated for those who are exhausted or debilitated while under stress. It is a relaxing, tonifying adaptogen. Although it does not have true sedative effects, it can make some people feel sleepy so it may be best taken at night. Taking it at this time can help those who are wired and tired from high cortisol at night and it can definitely help restore restful sleep. It takes time for effects to be felt so it must be taken for a few months. Taken on its own I’d suggest taking it at night but when combined with other herbs if fine during the day.

American Ginseng (Panax quinquefolius)- This herb is indicated for adrenal burnout- stage 3/4 adrenal fatigue. It helps with mental, emotional and physical exhausting and nervous exhaustion. It is for those with low blood pressure, and low blood sugar. It helps decrease susceptibility to illness and enhances physical and mental stamina and cognitive functioning. Use sparingly in those with high blood pressure or high blood sugar.

Licorice Glycyrrhiza glabra- Licorice is a very potent adrenal- modulator. That is it helps balance the adrenals. It has the ability to block the break down of cortisol and aldosterone, thus increases the effectiveness of these hormones. It helps increase energy and endurance. This herb is good for adrenal fatigue as it is also very anti-inflammatory, immune supportive and liver protecting. Licorice is also known as the great synergizer. It helps other herbs work better together. Caution: It can increase blood pressure so those with high blood pressure should avoid.

Manage Your Stress:

Once you get the adrenals working more optimally it’s critical to make sure stress doesn’t make them crash again. Besides taking supportive vitamins and herbs lifestyle habits can be key in helping to reduce stress.

      • First make sure to give yourself enough time between workouts to fully recover. Remember that this resting phase is when your body adapts to become stronger
      • Practice things like daily meditation, journaling or prayer. It doesn’t have to belong. I suggest to my patients to meditate for 5-10 minutes in the morning right when they get up. This way you can start the day with a clear head and more calm state. You could also do this at night before bed!
      • Finally is diet. For the adrenals blood sugar balance is key. This can be done by eating small regular meals, having protein with each meal and avoiding high glycemic index foods. Diet is so individualized based on activity level, how your body breaks down different foods so make sure you talk with your coach, nutritionist or naturopath about what diet is best for you and your activity level. Overall Eating an organic, whole food based diet, with lots of variety is best. Also avoiding foods that aggravate the adrenals like sugar, alcohol, processed foods and caffeine is best.

References:

Ducharme, Nicola. “Adrenal Health and Athletic Performance.” RestorMedicine. N.p., 16 July 2015. Web. 07 June 2017.

Lam, Dr. Michael. “The Truth About Trying A Pregnenolone Supplement for Adrenal Fatigue.”View This Adrenal Fatigue Page in English. DrLam.com, 27 Mar. 2017. Web. 07 June 2017.

“Overtraining Syndrome.” The Overtraining Syndrome. N.p., n.d. Web. 07 June 2017.

“Supplements For Adrenal Fatigue.” Adrenal Fatigue Solution. N.p., n.d. Web. 05 June 2017.

“The Four Stages of Adrenal Fatigue.” Adrenal Fatigue Solution. N.p., n.d. Web. 06 June 2017.

Tilgner, Sharol. Herbal Medicine: From the Heart of the Earth. Creswell, OR: Wise Acres, 2009. Print.