Adrenal Stress – And What To Do About It

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Dr. Zoltan P. Rona

Progesterone is one of the most important hormones secreted by the adrenal gland; it has a major role to play in supporting healthy menstruation, bone building, and fertility.

Are you stressed out?  Chronically tired? Allergies getting worse instead of better?  Catching one infection after the next despite a good diet?  Premature menopause? Most working adults are dealing with more emails, texts, and other computer and cell phone pressures than ever before. Working moms and other caregivers often feel like they are on call 24/7. If you are coping with these kinds of lifestyle challenges, chances are good that you’re suffering from some degree of adrenal insufficiency or weakness.

How Do the Adrenals Weaken?

Most commonly, different types of stress are involved. While some of these stresses are beyond our immediate control (nasty bosses, transit strikes, investment losses, hostile in-laws, divorce, tornadoes, etc.), other stresses that weaken the adrenals are dependent on our diet and lifestyle choices.  For example, a high caffeine and refined carbohydrate intake, cigarette smoking, heavy alcohol consumption, and drugs too numerous to list can all stress the adrenals by causing a greater than normal secretion of adrenal hormones leading to eventual depletion of stress hormone reserves. Working long hours under fluorescent lights at a sedentary job, and getting little to no exercise, also weakens adrenal function.  So does long hours of watching television, reading newspapers filled with bad news, and staring at computer screens.

Menopause: Menopause is one major life transition strongly connected to adrenal glandular function. In the healthy female, once the ovaries stop producing estrogen and progesterone, the adrenal glands take over production to maintain a comfortable balance. If this transition period does not occur smoothly, women entering the menopause will experience severe and often debilitating hot flashes, vaginal dryness, depression, loss of libido, accelerating osteoporosis, memory disturbances, and blood sugar control problems (hypoglycemia).  Adrenal insufficiency can cause exaggerated or early menopausal symptoms that create the need for hormone replacement therapy.

The ability to deal effectively with physical, chemical, emotional, and environmental stressors such as viruses, radiation, and prolonged physical exertion depends largely on the health of your adrenal response.

Delicate Hormone Balance

The adrenals are a pair of glands shaped like Napoleon’s hat that lie just above the kidneys.  They secrete more than three dozen hormones derived from cholesterol directly into the bloodstream. Each gland, about one to two inches in length and weighing only a fraction of an ounce each, is composed of two distinct parts, the inner adrenal medulla and the outer adrenal cortex. The outer region secretes hormones known as corticosteroids, of which there are three types: mineralocorticoids, glucocorticoids and the 17-ketosteroids (sex hormones). Adrenal cortical hormones are controlled by ACTH, a pituitary hormone. The inner adrenal medulla secretes epinephrine (adrenalin) and norepinephrine (noradrenaline) – the hormones that mediate the “flight-or-flight” alarm response to stress.  Adrenal medullary hormones are controlled by the sympathetic nervous system.

The glucocorticoids (cortisol, corticosterone, cortisone) cause blood sugar levels to go higher, inflammation levels to go lower, and allergic reactions to diminish. Abnormal levels of glucocorticoids could be partially responsible for hypoglycemia or diabetes, an exaggerated pain response, and poorly controlled allergies.

The mineralocorticoids, the most important of which is aldosterone, cause the body to retain sodium while increasing potassium excretion.  Abnormal aldosterone levels can therefore create imbalances between sodium and potassium and, consequently, fluid levels in the body.

The major sex hormone produced by the adrenal cortex is the androgen, DHEA (dehydroepiandrosterone), which is then converted into other sex hormones (testosterone, estrogens, progesterone).

Shades of Imperfection

Conventional medicine categorizes adrenal function as either normal, low (adrenal insufficiency a.k.a. Addison’s disease), or high (Cushing’s Syndrome, a rare disorder caused by an overactive adrenal cortex). However, most individuals affected by suboptimal adrenal function fall between these two extremes and are left without any conventional medical solution to their health problems.

Adrenal weakness is at the bottom of poorly controlled stress conditions ranging from anxiety, allergies, and recurrent infections to hypoglycemia, depression, autoimmune disease, and chronic fatigue of unknown cause. If initial screening tests fail to show either low or high levels of certain steroids, conventional medical thinking is that adrenal function is “normal”, regardless of patient signs and symptoms. Studies, however, show that adrenal function can be compromised long before abnormalities start appearing in such laboratory tests, and that the use of adrenal glandular support reverses signs and symptoms and replenishes depleted organ reserves.

Signs and Symptoms of Weak Adrenal Function

The many signs and symptoms of adrenal insufficiency are often brushed off by conventional doctors as “nerves” requiring a prescription for antidepressants, tranquilizers, or estrogen. Many of these signs and symptoms, however, should alert both doctor and patient to look deeper with the use of special tests (e.g. glucose tolerance test, cortisol, DHEA, hormone challenge tests, etc.).  The results of these tests could provide a more definitive diagnosis.

An inability to concentrate, excessive fatigue, nervousness, irritability, depression, and anxiety are the commonest symptoms associated with poor blood sugar control (hypoglycemia or diabetes), and ultimately linked to adrenal glandular weakness.  Lightheadedness or dizziness, faintness or fainting, as well as insomnia are also common problematic blood sugar control symptoms; so are cold, clammy palms and red palms or fingertips.

Progesterone is one of the most important hormones secreted by the adrenal gland. It has a major role to play in healthy menstruation, bone building, and fertility.  Many women who suffer from hot flashes, vaginal dryness, mood swings, and PMS symptoms (fluid retention, depression, food cravings, breast pain and tenderness), are suffering from relatively low progesterone levels which can often be corrected by normalizing adrenal function.

The adrenal glands are also responsible for blood pressure control.  If you have access to a blood pressure measuring device there is a simple self test you can use if you suspect low adrenal function.  Take, or have someone take, your blood pressure several times both reclining and standing.  If your blood pressure is usually somewhat on the low side (postural hypotension) on standing (105/60), but elevated to (120 or 130/70 or 80) on reclining, chances are good that your adrenals are malfunctioning.  There should be very little difference between standing and reclining blood pressures if adrenal function is optimal.

Other, lesser known signs of chronic adrenal weakness or insufficiency include:

  •  Thin, dry, scaly skin; thin-muscle type (asthenic habitus)
  •  Skin pigmentation of temples; Exaggerated reflexes
  •  Angular appearance with long arms and legs (span is greater than the height)
  •  Inflammation of lymph glands of the neck (swelling, pain, or tenderness)
  •  Sparse hair on body, but usually a full head of fine and abundant hair
  •  Typically blonde, blue-eyed; or red-head with skin allergies
  •  Crowded lower teeth; high palatal arch (roof of mouth)
  •  Pain and tenderness over adrenal area when pressure is applied (Positive Rogoff’s sign)
  •  Scanty perspiration (except underarms or hands and feet)

The Adrenal Insufficiency Connection

A long list of suboptimal health conditions and diseases are stress-related and stem from a weak or an exaggerated adrenal response.  The following is just a partial list of conditions that may require adrenal glandular support:

  •  Anxiety and/or panic attacks; Depression
  •  Asthma; Cancer; Autoimmune diseases (fibromyalgia, chronic fatigue syndrome, Graves’ disease, MS, rheumatoid arthritis, etc.)
  •  Diabetes Mellitus (Type II); Hypoglycemia
  •  Headaches (tension, migraine)
  •  Infertility; Menstrual problems (PMS, dysmenorrhea, menorrhagia, amenorrhea); Premature menopause
  •  Multiple chemical hypersensitivity/allergies
  •  Recurrent ‘flus, colds and other infections

Adrenal Glandular Support

A majority of cases requiring adrenal glandular support programs can help themselves without prescription hormones.  A combination of diet and lifestyle changes, with or without nutritional supplements, is usually all that’s required.

Diet: Avoid foods and beverages that stress the adrenals, especially sugar, alcohol, caffeine, tobacco, fried foods, processed foods, pork, sugar, and refined carbohydrates. A high percentage of symptomatic individuals are also allergic to gluten (wheat, spelt, rye, barley, oats) and casein (dairy products) and should avoid these foods altogether.  Various forms of the Paleo diet are ideal for adrenal insufficiency. Unless allergic to them, eat more fresh fruits and green leafy vegetables, along with garlic, onions, shiitake or maitake mushrooms, olives, and legumes. Avoid fish and seafood due to their high mercury and other toxin content.

Lifestyle: Start with regular, moderate exercise, meditation, biofeedback, or other relaxation techniques to reduce stress. And regular exposure to sunshine is important as a way of getting vitamin D because deficiency of this vitamin leads to adrenal gland damage; in more severe cases, consultation with a health care provider is required.

Nutritional and Herbal Supplements:

Dosages depend  on severity of symptoms and individual tolerances

  •  Multiple vitamin and mineral supplement
  •  Green drink (spirulina, chlorella, barley, kamut, etc.)
  •  Bee pollen
  •  B complex vitamins with extra vitamin B5 (pantothenic acid) or royal jelly
  •  Vitamin C and bioflavonoids
  •  Vitamin D
  •  Raw adrenal extract
  •  Coenzyme Q10
  •  Herbal adaptogens such as: Holy Basil, Rhodiola, Ashwagandha, Shisandra, Bacopa, Siberian ginseng
  •  Licorice root (can raise blood pressure if used excessively)

For quickest results, use the very safe and effective herbal adaptogens. An adaptogen can optimize excessively high or low levels of the stress hormones. This is only provided that the adrenals have been diagnosed by conventional doctors as “normal”. Severely damaged adrenals requiring medical intervention will not respond as well to an adaptogen herb or formula. Those who take prescription anti-hypertensives should avoid licorice.

Hormone replacement:  In more severe cases that fail to respond adequately to the nutritional approach, low dose bioidentical adrenal hormones could be prescribed for short periods of time. These include: DHEA, pregnenolone, cortisol, testosterone, progesterone, and estrogens.

The use of steroid drugs (e.g. prednisone) for extended periods of time can cause shrinking (atrophy) of the adrenal glands and should be monitored regularly to prevent long term side effects.  This is less likely to occur when one takes low dose DHEA, pregnenolone, or other bioidentical steroids but should not be ignored as a remote possibility.

For more information on reversing adrenal woes, see the references below and consult a natural health care practitioner for an individualized adrenal enhancement regime.

Best Selling Books by Dr. Zoltan P. Rona:
Vitamin D: The Sunshine Vitamin
Complete Candida Yeast Guidebook (co-authored with Jeanne Marie Martin)


  • Cleare, Anthony, J. and Wessely, Simon, C., Chronic Fatigue Syndrome:  A Stress Disorder?  British Journal of Hospital Medicine, 1996;55(9)
  • Freeman, Roy, M.D. and Komaroff, Anthony L., M.D., Does the Chronic Fatigue Syndrome Involve the Autonomic Nervous System?”  American Journal of Medicine, 1997;102:357-364.
  • Goldberg, Samuel, M.D., et al.  Adrenal Suppression Among Asthmatic Children Receiving Chronic Therapy With Inhaled Corticosteroid With and Without Spacer Device,  Annals of Allergy, Asthma and Immunology, March, 1996;76:234-238.
  • Rubin, Robert T., et al.  Adrenal Gland Volume in Major Depression:  Relationship to Basal and Stimulated Pituitary-Adrenal Cortical Axis Function,”  Biological Psychiatry, 1996;40:89-97.
  • Selye, H.  Stress in Health and Disease.  Buttersworth, London, 1976.
  • Tintera, John W.  Hypoadrenocorticism, 1969; the Adrenal Metabolic Research Society of the Hypoglycemia Foundation, Inc., 153 Pawling Avenue, Troy, New York, USA 12180.
  • Tintera, John W.  The Hypoadrenocortical State and Its Management,: N.Y. State J. of Med., Vol. 55, No. 13, 7/1/55.
  • Wilder, Ronald, L. Adrenal and Gonadal Steroid Hormone Deficiency in the Etiopathogenesis of Rheumatoid Arthritis,  Journal of Rheumatology, 1996;23(suppl 44):10-12.
  • Paleo diet for adrenal insufficiency.
  • Nutrients that fight adrenal fatigue:
  • Adaptogenic effects of Bacopa.
  • Rhodiola benefits.
  • Holy Basil benefits.
  • Ashwagandha benefits.
  • Siberian Ginseng benefits.
  • Shisandra benefits.



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