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Your Adrenal Glands Part I: Tiny Glands That Pack a Punch

by Dr. Stephen Gangemi on November 3, 2013

adrenal glands stressedYour adrenal glands are small walnut-sized glands that sit on top of each kidney. Though they only weigh three to five grams, they’re responsible for producing hormones to provide your body with sufficient energy, balance blood sugar, fight inflammation, regulate electrolytes, maintain libido, sustain blood pressure, and provide your body with a host of other vital hormonal functions.

The adrenal glands essentially help your body handle stress, whether acute or chronic, so they play a huge role in overall health, fitness, and well-being. Unfortunately, many people suffer from some type of adrenal gland dysfunction which can and will result in a variety of health issues especially those related to daily energy requirements – both mental and physical.

In this four-part series on the adrenal glands, we’ll learn about how important, yet undervalued, the adrenal glands are. We’ll learn common signs and symptoms of adrenal gland problems, their interaction with other systems of the body, and how to recover from any adrenal gland dysfunction to restore your overall health.

JFK Cushing's SyndromeFunctional vs. Pathological Health Problems

Conventional medicine rarely addresses adrenal gland dysfunctions. Allopathic doctors feel as though a person only has an adrenal gland problem if they have some type of hormonally-related disease or condition to these glands, such as Addison’s disease or Cushing’s syndrome. President John F. Kennedy had Addison’s disease. Though these diseases do occur and should not go untreated, there are far many more individuals who suffer from a non-pathological condition of the adrenal glands which is significantly impairing their health.

Functional health problems are those in which an organ is not working optimally yet there is no known or diagnosed pathological (disease) condition. Functional health problems are much more common than pathological problems and if left untreated, can result in pathology to an organ or any related system of health.

If you’re under any sort of stress, or have ever been under any stress, (that’s everyone), either chronic or acute, your adrenal glands have helped get you through it. Some people never quite recover from a stress. Years of eating poorly, living in an unhealthy environment (emotionally or physically), or trauma to the physical body, such as an accident, illness, or exercising too intensely for too long, often lead to poor adrenal gland function. This results in the individual never being able to get their zest for life back due to the adrenal glands being impaired.

Adrenal Hormones and Your Health

Let’s take a quick glance at these glands to get a basic understanding of their function and value in your overall health. The adrenal glands are actually composed of two separate functional entities, the outer cortex and the inner medulla.

The Adrenal Cortex

The cortex is the outer zone of the adrenal gland which secretes three hormones – cortisol, DHEA-S, and aldosterone. Cortisol is the major adrenal hormone that is released in response to blood sugar changes, inflammation, and of course stress. When there is stress to the body, either good, (you’re exercising vigorously or you won some money), or bad, (you’re living off caffeine or just lost some money), it’s cortisol that helps you deal with this stress by sparing glucose availability in the brain so you can keep some sort of focus (hopefully).

DHEA is the precursor to our sex hormones, testosterone and estrogen, and it’s also important for the immune system, cardiovascular system, and overall muscular health.

Aldosterone is the hormone which helps regulate you electrolyte levels, (sodium and potassium); therefore it’s important for maintaining and regulating blood pressure. It’s aldosterone that can cause you to lose a lot of salt when you sweat resulting in fatigue and muscle cramps.

The Adrenal Medulla

The medulla of the adrenal gland is the inner zone, (10-20% of the total gland), which secretes adrenaline and noradrenaline, (also known as epinephrine and norepinephrine). These hormones help to regulate blood sugar levels, heart rate, nervous system and cardiovascular function, and they even affect your brain – specifically concentration and overall alertness and mental acuity.

dadrenal gland circadian rhythmAdrenal Glands and Stress

The interaction, or perhaps I should say relationship, between cortisol and DHEA is important to understand when discussing the adrenal glands role in overall health. The adrenal glands release their hormones in a circadian rhythm, which is a 24-hour cycle. The hormonal levels should normally be highest in the morning around 6-7am and lowest at night around 11pm-12am which allows for restful sleep. So it’s normal for your hormonal levels to fluctuate throughout the day; actually if they don’t then you’ll have problems. If you’re under high levels of emotional or physical stress, not sleeping well, exercising intensely, or eating poorly, (especially high sugar and/or caffeine intake), then your adrenal hormones could be significantly altered, maybe even to the point where they can no longer respond to stress in an appropriate manner.

Initially, under acute stress, the normal response of the adrenal glands is to secrete higher amounts of cortisol so you can deal with the stress at hand. So if someone almost runs you over while you’re walking into Whole Foods (not uncommon), then your adrenalin levels will spike temporarily and they will soon be followed by a spike in cortisol which will often remain elevated for several hours after your parking lot experience. If there are continuous other types of acute stress such as this, then eventually your DHEA levels will being to rise too along with cortisol to help support the stress. If the stress or stressors are not resolved, as is often the case of chronic, multiple health stressors, then cortisol levels will continue to creep up and up while the DHEA level will go the other direction and plummet.

This inverse relationship between cortisol and DHEA is what causes a lot of health problems and is also the result of many chronic health problems. Eventually, much like the fable “The Boy Who Cries Wolf”, the body no longer pays attention to the high levels of cortisol so the body must make more and more just to get the once-desired effect. This is called receptor down-regulation and it’s exactly what happens when a person becomes a Type II diabetic – their body is making too much insulin but no longer paying attention to it, so it must make more and more. For your body, it’s like “whipping a tired horse.” You’re struggling to make it through the day and have to push yourself harder and harder at the expense of your health and adrenal glands. Eventually, if the health problems persist, then the cortisol levels will eventually drop along with the DHEA (and aldosterone) as the glands are too fatigued to produce the appropriate levels of hormones necessary for even mediocre health. Chronic fatigue, depression, immune system problems, persistent pain, and a host of other health problems can be associated with this type of adrenal fatigue.

In Part II I discuss testing for adrenal gland problems and you’ll see why so many people aren’t thought to have, (or are diagnosed with), adrenal gland issues. I’ll also go through many common signs and symptoms of adrenal gland problems.

I'm a board certified chiropractic physician and clinical nutritionist with a passion for true natural health care. I implement dietary & nutritional therapies, exercise & movement practices, and lifestyle changes along with manual therapy techniques to help the body heal and prevent illness and injuries.

From → Health Concerns


Leave a comment
  1. ginny lewis permalink

    I am looking forward to your next article on adrenal glands and stress, as this may be what my teenage daughter has. She has had depression/anxiety and IBS issues that she takes anti-depressants and Bentyl for. She’s very stressed with high school. I’m wondering what I can give her to support her adrenal glands.
    Thank you, Dr. Gangemi!

  2. Rosie Kinzel permalink

    Great article and topic. Looking forward to the next ones.

  3. SteveL permalink

    Great article thanks so much.

  4. Elisabeth Pallante permalink

    I hear that the little old ladies in Whole Foods’ parking lots are the most vicious.

  5. rhonda short permalink

    I think you are mistaken about John f Kennedy. He had addison’s disease, not cushings (hence his dark skin color). Everything I’ve read indicates so. And I’ve never read anything about over use if corticosteroids. Pretty sure it was full blown autoimmune addison’s.

    • I believe you’re right – but did he not develop Cushings from the treatment with corticosteroids? Thanks.

  6. Sheri permalink

    do you think having ulcerative colitis for many years could cause adrenal fatigue?

  7. Kelly permalink

    Words cannot express how incredibly thankful I am to have found your website. I have always been a competitive distance runner. In recent years, I have also become a fitness instructor and a mother (two very difficult jobs!), all while continuing to run and train competitively (all while not sleeping enough and probably not eating enough calories). In April of 2014, I crashed. My body tightened up, I had injury after injury, I had a plethora of symptoms and until recently, I had to give up running. I went from doctor to doctor. I was finally put on synthroid by an endocrinologist due to my newly discovered hypothyroidism. Life was miserable and I had finally come to terms that his as hellish as it might be, was my new life. After researching, I honestly believe I suffered from adrenal fatigue thus causing my thyroid to be off balance. For the last few weeks, I cut out caffeine, dairy and anything artificial (sweetners and processed foods). I always thought I was a healthy eater before, but I had a coffee habit I could not kick (with sweet and low and creamer). I focused on good fats, meats, LOTS of vegetables, fruits and taking in lots of vitamin C. I tried to sleep more, reduce stress and live a better life. I am happy to report that on my low dose of thyroid meds, I feel “hyper.” I firmly believe that thanks to you, I am going to be able to reduce my dosage and eventually get off of them all together. Thanks! Wish you were in Texas! This might have been discovered 9 months ago!

  8. Cheryl permalink

    I’m finding this so interesting. I was born with one kidney, and assume that I only have one adrenal gland. This is unconfirmed, but makes sense to me. I am 55 and would say that I was highly stressed for almost 20 years of that. What tests would be good to have done, as so much of what you have mentioned in your articles is happening to me.

  9. Ranijyothi permalink

    Interesting subject!

  10. Kate permalink

    Ok, Doc, after years of suspecting I have adrenal fatigue (I have pre-syncope almost every time I get up from a seated or prone position, I cannot lose weight despite aggressive training and excellent diet) a reproductive endocrinologist I am seeing for endometriosis treatment tested my hormones. DHEA came back low (according to the lab) and my testosterone was non existent. He didn’t test for estrogen,but my bet is that it is low too. Since MDs don’t buy adrenal fatigue, will the low DHEA trigger him to look closer at my adrenals? How can I frame it so he doesn’t dismiss it? 36 y/o. Btw, I have tried treating it naturally, with both bovine adrenal supplements and the adoptogenic herbs, to no avail, apparently. Diet is clean.

    • You’re best option is to find a holistic doc like a chiropractor or naturopath who treats adrenal conditions.

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