Wednesday, August 14, 2013

The Adrenal Glands, Part 2 - 9 Steps to Reversing Adrenal Fatigue

In Part 1 of our discussion on adrenal fatigue, we discussed the biochemistry and physiology behind the impacts of chronic stress on your physical health.  To sum it up: we're working too hard, doing too much, and sleeping too little to recover from this stress.  It's making us sick and keeping us fat, and it's of utmost importance to reverse adrenal fatigue if you are hoping to lose weight or perform your best. Indeed, when you register for health coaching through Sweat and Butter, one of the first things that our coaches will address is stress.

In Part 2 of this discussion, we'll give you a head start on fixing adrenal fatigue.  Swallow these 9 pills, and let us know how you feel in the morning (we already know the answer):

1) Clean up your sleep
Sleep hygiene is all the rage these days.  It refers to optimizing your sleep environment in order to maximize restfulness when you're asleep.  Improving your sleep habits is the number one thing you can do to prevent recurrent adrenal fatigue symptoms.  Remember: when you sleep, your adrenals sleep, too.

The jury is still out regarding exactly how much sleep we humans need, though it's probably somewhere in the range of 7-9 hours per night.  But the quality of sleep is even more important than the quantity.  The science of sleep is still in its infancy, but studies suggest that you will find sleep most restful when (a) the room is pitch black, (b) the room is quiet, (c) you go to bed with a clear mind, and (d) you limit light exposure prior to laying down (light disrupts your circadian rhythm through the dysregulation of cortisol and melatonin).  If improving sleep hygiene isn't sufficient, limited research supports magnesium supplementation as a sleep aid.  Steer clear of melatonin supplements.  It's a hormone, and supplementing with hormones can throw you way out of whack.

As you already know, sleep is one of Sweat and Butter's five major categories of lifestyle modification because it influences so many metrics of health.  Stay tuned to the Sweat and Butter Journal for future posts on this important topic.

2) Meditate
Yes...I said it.  Meditate.  This doesn't require you to pack your bags to some far-off ashram in India. All that I recommend to my patient-clients is to find a quiet room, dim the lights, reduce distraction and sit still.  Focus on your breathing.  Imagine you can watch the air around your face being inhaled then exhaled.  Set your phone to airplane mode, start a timer for 5 minutes and relax your mind until the timer goes off.  Don't continue your meditation beyond the 5 minutes, even if you feel like you could go for 10.  Turn off the alarm, and carry on with your day.  Try this for 30 days, then bump it up to 6 minutes.  I have to give Chris Kresser credit for finally getting me to try this.  He mentioned this 5-minute smartphone alarm strategy in a podcast a while back, and I've been hooked ever since.

3) Increase your consumption of starchy vegetables and tubers
If you recall from Part 1 of this discussion, your adrenal glands help regulate your blood sugar.  If you eat a diet with too few carbohydrates, your adrenals have to work double-time to maintain sufficient blood sugar levels to feed your brain's insatiable hunger for sugar.  Processed carbohydrates are always going to be a no-no, but if your adrenals are smoked, increasing your carbohydrate intake will likely alleviate that groggy feeling you've experienced from chronic stress, excessive exercise, and sleepless nights.  Hold off on the sweets, bread, and pasta.  You can get all of your carbohydrate needs from sweet potatoes, yams, squash, and nuts in addition to increasing your consumption of vegetables.

4) Ease up on exercise
Exercise is an incredible tool for weight loss and vitality.  It is implemented in the military forces to train tougher soldiers and by professional sports teams to develop stronger, faster athletes.  It is the mainstay of many transformative weight loss and general fitness programs (e.g. Insanity, P90X, Crossfit, etc.) because it helps increase muscle mass, a necessary component of restoring insulin sensitivity in your body.  But exercise is a huge stress on the body, and, in excess, is no different from any other stress.  If you are working your butt off in the gym for hours on end, we are talking to you!  Many individuals have found that a combination of high-intensity exercise and low-carb dieting is the magic combination driving their successful weight loss stories, but too much of this potent combination wreaks the same havoc on your adrenals as any other stress.

You don't have to cut all exercise out of your life.  When you find yourself sleep-deprived or working longer hours than usual, I recommend limiting the high-rep, high-intensity workouts and opting instead for a few sets of heavy weight lifting.  When I can tell that my body needs a break, and I still want to do something physical, my go-to is the following:
  • 5 sets of 5 reps - Heavy back squat
  • 3 reps, then 3 more reps, then 2, then 1 - Heavy deadlift
  • 4 sets of 2 reps - Light snatch
Note: Increase the weight such that your first set of heavy back squat is lighter than the following set, etc. You can substitute any weight training movements into this sequence, and I encourage you to mess around with various rep schemes.  The lower reps keep your muscle working, but it's not as taxing on your adrenals as the aerobic, high-rep sessions that form the foundation of most clients' exercise programs, particularly women.  And please, for the love of the tender baby jesus, don't attempt any movement using heavy weights without some form of professional instruction beforehand.

5) Use your vacation days or call in sick
If you speak to citizens of virtually every other country in the world, you'll find out that we are the laughing stock of the world with regards to the amount of hours we slave away at work.  A 2007 report by the Center for Economic and Policy Research found that, of the 21 richest nations in the world, the US of A is the only one that doesn't guarantee workers paid vacation days or holidays:

Our culture views hard work as virtuous, and perhaps it is, but the number of hours that we spend working cuts time from our relationships, meditation, education, fun, and all of the other things that we are saving for retirement.  If your work place allots sick days or vacation days, USE THEM!  If it helps to ease your conscience, call them "so I don't get sick down the road" days.

I'll never forget those days that my mom took off from work to help out at my elementary school functions.  She's a busy hospital administrator who regularly works ten-hour days before spending her evening at home preparing to do it all over again the following day.  When she managing to find time to chaperone a class party or Boy Scout function, it meant the world to me as a child.  In addition to bolstering your relationships with friends and family, you can use the free time to kick back with a beer and simply enjoy a sunny day out from behind your desk.  This stuff is important!!

6) Unplug
We are on information overload.  Texting, tweeting, Facebooking, Instagramming, podcasting, audiobooking, blogging, and the TV dominate our lives.   Our drive to "get 'er done" is now manifesting as an anxiety-ridden information free-for-all, and it's hurting our health.  You remember how great it was to spend the weekend at that cabin that was so deep into the woods that you didn't get cell phone or 3G reception so you were forced to go without it?  How about that time when the power went out, and you were forced to sit around and talk to your family?  It felt great to be unplugged from your electronics, right?  We're all guilty of this, even those of you who claim to live a life free of TV.  Our society is geared around 24/7 entertainment: elevator music, multiple TVs at bars, music while we are on hold with customer's everywhere because we have been conditioned to need it!

Information overload is stressing you out by making you feel compelled to check your Facebook newsfeed or how many people re-tweeted that picture of your breakfast.  Re-create these golden, unplugged moments regularly to give your mind a break from the action: turn off your phone, steer clear of the news if the negative and/or irrelevant headlines are bringing you down, and leave your iPad in the kitchen.  Or, better yet...

7) Go outside!
A Scottish study found that city dwellers had a higher rate of medication prescription for depression, anxiety, and psychosis.  What does this mean? merely shows an association, which doesn't necessarily mean that living in the city causes these disorders.  But have you noticed a difference in your stress levels when you spend time in a rural setting away from the noise and distraction of city streets?  Every time I go into the woods for even a few hours, I re-emerge with a clear mind and a subjective feeling of happiness.  Another thing that you can try once in a while is simply walking around in the grass barefoot.  One of our health coaches, Vanessa, even goes barefoot while walking her dog!  It feels great to be contact with the dirt, and you'll soak in some sunshine in the process.  The next time you attend an outdoor concert, slip off your shoes and squeeze the grass and dirt between your toes.  Getting funny looks?  Just tell them: "It's therapeutic, baby."

At Sweat and Butter, we respect the inner-animal in all human beings.  There is evolutionary rationale for the benefits you reap from nature, but you'll have to wait for future posts to read more.  I can say that the advantages of unplugging from life are the primary motivators for Sweat and Butter's much anticipated health retreats that we will begin hosting the spring of 2014.  Stay tuned!

8) Love thy neighbor
Community is key.  If you aren't making time for the people in your life, you aren't doing your stress levels any favor, which means more pressure on the adrenals to keep you moving (GO! GO! GO!) from the moment your alarm clock jars you from your sleep.  A study on friendship and stress concluded that having a best friend present during a stressful experience attenuated a person's stress response.  Translation?  A little friend time will go a long way in reducing your stress levels long-term.  

To make matters worse, if you feel stressed then the people around you can probably feel it, too.  Set some goals to implement these changes into your life.  By making this transformation something that you do with your spouse, partner, or colleague you help one another mitigate the effects of stress, which, as we have discussed, is critical in meeting your other health goals.  Schedule time with friends that have similar health goals as you, and be sure to incorporate stress-reducing activities into your exercise and diet plans.  This will make your time together more meaningful while helping one another keep stress at bay.

9) Drink less caffeine
Our nation consumes, on average, three 9 oz cups of coffee per person daily, and 60% of coffee drinkers state that they require coffee in the morning.  Caffeine bullies the adrenals into working harder, and coffee is loaded with it.  Many people swear by coffee and, indeed, can't get through their day without several cups.  These same people are likely in some degree of adrenal fatigue.  Kicking a horse that has keeled over with exhaustion might convince it once or twice to get up and keep running, but, eventually, that horse is cooked.  Coffee and energy drinks work the same way, by kicking your adrenals to ramp up epinephrine, which spikes your blood sugar in the morning as part of the "flight or fight" response. You should be neither fleeing nor fighting first thing in the morning, but, if your adrenals are fatigued, you need the caffeine kick to get moving.  Caffeine is also addictive.  If you're a caffeine addict, you need to try to break the addiction, because your 24/7 consumption of coffee is forcing the adrenals to work beyond their capacity.  It's likely also screwing up your circadian rhythm (see Step #1).

We have covered a lot in these two posts.  Part 1 helped you understand why it's important to minimize stress for the sake of our adrenals.  Part 2 outlines an action plan for you to make some of these changes in your life in order to recover from adrenal fatigue.  My last piece of advice on this topic is to not attempt to make all 9 changes simultaneously.  That's asking a lot of yourself, and it increases your risk of failure.  Start with one of them, feel it out, and implement it for a few weeks before trying to incorporate a second.  This strategy will slowly develop these activities into healthy habits, and that's the point of this transformative game. 

You're welcome, adrenals.

Nathan Riley is a 2014 MD candidate at Temple University School of Medicine.  He writes about food, movement, sleep, relationships, and stress in order to bridge the gap between his patients and evolutionary theory and clinical evidence. You call follow him on Twitter @BeyondtheMD. He can be reached at

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