What is adrenal insufficiency?

What is adrenal insufficiency?

Margie GanderSep 15, '21

Adrenal insufficiency is the inability of the adrenal glands to produce the normal quantity of hormones. It may also be defined as a reduced ability to cope with stress. It is one of the most common imbalances experienced by people today, and is often a MAJOR contributing factor towards the development of most lifestyle-related, chronic diseases. 

Cortisol, DHEA and adrenaline, are the three main hormones secreted by the adrenal glands in response to stress. These hormones protect your body against a variety of threats—including perceived threats by your unconscious brain.

Every morning when you wake up, there is a rise in cortisol called the Cortisol Awakening Response (CAR). This is a normal response and helps prepare you for the things you might encounter during the day - the morning rush to get your children ready for school, getting to work at time, a cut, a bumper bashing, an argument, a toxin, dealing with a sick parent, or a reaction to fast food. Any social, psychological, or physical stressors gives the signal to your nervous system to send a signal to the adrenal glands to produce these protective hormones. You can easily see now "why" these little glands can start to buckle under the pressure of your life!


What causes adrenal insufficiency? 

I like to always personalise your approach to adrenal health. There are many personal reason as to "why" you may be experiencing adrenal insufficiency. The best way to approach this is to determine the role the following play in your body: 

  1. Genetics: Your unique genotype for stress response can impact how well your adrenal glands function. We'll dive a little deeper into this later as I believe that true personalisation for optimal health, starts here.
  2. Congenital Weakness: Congenital means present at birth. However, it is not related to the genes. It is caused by nutritional deficiencies of the mother that are passed on to the child. It may also be caused by toxic metals or other toxins passed on from the mother's body that interfere with the functioning of the adrenal glands. This is a very common cause of adrenal insufficiency today.
  3. Nutritional Imbalances: This can begin early in childhood with an inadequate diet, diet inappropriate for one's oxidation type, poor food quality, or digestive problems that prevent proper nutrition. Even natural foods today often are low in vital minerals and do not provide adequate nutrition.
  4. Toxins: Pesticides, heavy metals, bacteria, solvents and other organic chemicals can all act as stressors that weaken the adrenal glands.
  5. Emotional or Psychological Stress: Responding to emotional stress over and over will eventually deplete the adrenal glands. A single overwhelming shock such as death of a loved one, can also deplete the adrenal glands.
  6. Stimulants: Most stimulants stress the adrenal glands out! This may cause one to feel better for a while, but the long-term effect is to weaken the adrenal glands.

Is there a "adrenal insufficiency" genotype?

Genomics has helped us to understand that we are not all the same when it comes to our stress response or adrenal gland function. There are some key genes that are involved in modulating this response. Knowing what your genotype is for these genes, can help you to personalise your environment, lifestyle and nutrition choices to optimise your adrenal health. 

GENE  FUNCTION

NUTRIENT

COFACTOR

BDNF

This protein promotes the survival of nerve cells (neurons) by playing a role in the growth, maturation (differentiation), and maintenance of these cells. In the brain, the BDNF protein is active at the connections between nerve cells (synapses), where cell-to-cell communication occurs.  

BDNF can be upregulated by: regular aerobic exercise, curcumin, resveratrol & omega 3. 

FKBP5

 

Acts as a co-chaperone that modulates not only glucocorticoid receptor activity in response to stressors but also a multitude of other cellular processes in both the brain and periphery.

 

FKBP5 can be upregulated by omega 3 fatty acids.

BHMT

The activity of this gene can be affected by stress, cortisol levels and may play a role in ADD/ADHD by affecting norepinephrine levels. BHMT-02 plays a role in the GUT-brain axis, playing a role in how an individual is able to concentrate while under the effects of stress.

 

BHMT-02 can be upregulated with TMG (trimethylglycine) or betainezinc, and phosphatidylcholine/choline
IL1B

IL-1B increases the release of hypothalamic corticotropin-releasing hormone (CRH), secretion of pituitary adrenocorticotropic hormone (ACTH), and adrenal steroidogenesis.

 

Can be downregulated by zinc, omega 3 and curcumin at the correct dosage. 
OXTR
Oxytocin is a peptide hormone and neuropeptide that is involved in the regulation of mood, anxiety, and social biology

Nutrients, minerals, and probiotics that are necessary for normal oxytocin production and functioning include:

i. Vitamin C - cofactor for oxytocin production

ii. Magnesium - required for proper oxytocin functioning

iii. Probiotics: improve microbiome (Lactobacillus reuteri)

SLC6A2

SLC6A2 encodes a cell membrane protein, which is responsible for reuptake of norepinephrine into presynaptic nerve terminals and is a regulator of norepinephrine balance. 

 

Melatonin can downregulate this gene's function. 
CYP21A2

This gene encodes a member of the cytochrome P450 superfamily of enzymes. The cytochrome P450 proteins are Phase I detoxification enzymes that catalyze many reactions involved in drug metabolism and synthesis of cholesterol, steroids and other lipids. CYP21A2 activity is required for the synthesis of steroid hormones including cortisol and aldosterone. 

 

Coleus Forskohlii, phosphatidylserine, sodium levels and the correct mineral ratios have been known to upregulate the CYP21A2 enzyme function.
GAL

Endocrine hormone of the central and peripheral nervous systems that binds and activates the G protein-coupled receptors GALR1, GALR2, and GALR3. This small neuropeptide may regulate diverse physiologic functions including contraction of smooth muscle of the gastrointestinal and genitourinary tract, growth hormone and insulin release and adrenal secretion.

 

Function is inhibited by the flavonoid, Fisetin. 

 

You can check order the GENOMIC INSIGHT test online to test your genetic variations for these key genes:

 

 

What can my biochemistry tell me? 

The Stress Theory of Disease states that the body passes through three stages when exposed to prolonged stress. Each stage has a particular biochemistry and specific conditions that impact on the glandular cellular profile of your adrenal glands. Often blood tests provide an indication that of "wonky" adrenal glands by testing its hormonal products but do not provide sufficient insight into the cellular health of this little gland.

Understanding the stage of stress that your body may be in can assist in personalising your health and remineralisation choices to move your adrenal glands from a less healthy and lower energy stage of stress to a more healthy and higher energy stage.

The 3 stages of stress can be characterised as follows:

  1. Alarm Stage: The alarm stage of stress is considered an early stage of stress in which the body has adequate energy to fight back against the stress. It is often associated with activation of the sympathetic nervous system, a fast oxidation rate, higher blood pressure and blood sugar, higher body temperature and more frequent bowel movements. The body reacts to acute stress by releasing hormones produced by the adrenal glands which mobilize the body’s energy to meet and overcome the stress.
  2. Resistance Stage: The resistance stage of stress occurs as the body attempts to adapt to the stress when it can no longer maintain an alarm stage. This stage of stress is best described as an endless battle, with the body attempting to contain the stress as it’s unable to eliminate it. The resistance stage of adaptation can go on for a long period of time in an effort to limit or minimize the stress. The body still has some energy reserves available to resist stress, though less than in the alarm stage.
  3. Exhaustion Stage: The exhaustion stage of stress occurs when the body has exhausted its energy levels in an attempt to contain the stress. In this stage, the body no longer has the necessary energy reserves to resist or contain the stress and is now in a holding pattern to prevent a further decline in health. Symptoms may include fatigue, depression, apathy, despair, constipation, dry skin and hair, adrenal exhaustion and at times less than optimal thyroid activity. 

Adrenal hormones are divided into two groups, those produced in the adrenal medulla and those produced in the adrenal cortex.

This mighty little glands function looks like this:

ADRENAL GLAND  HORMONES  FUNCTION 
Medulla 

Adrenaline

Noradrenaline

Increases heart rate, blood pressure, vasodilation in lungs, redistributing blood to the muscles and altering the body's metabolism, so as to maximise blood glucose levels (primarily for the brain).
Cortex
  1. Aldosterone
  2. Cortisol
  3. Cortisone
  4. Pregnenolone
  5. DHEA-S
  1. Aldosterone is called a mineralocorticoid hormone. Its primary function is to increase sodium retention by the kidneys. Aldosterone is a pro-inflammatory hormone required to initiate a healing reaction.
  2. Cortisol and cortisone are referred to as glucocorticoid hormones because they cause conversion of amino acids and glycogen to glucose. The corticosteroids are anti-inflammatory and provide a mild sense of euphoria. 
  3. Pregnenolone pays a key role in the production of other steroid hormones, including progesterone, DHEA, and estrogen. This is particularly important in menopausal women. 
  4. DHEAS plays an important role in making the male sex hormone testosterone and the female sex hormone estrogen. 

 

The Hair Tissue Mineral Analysis (HTMA) test is a great tool in helping you determine how well your adrenal gland's are functioning as well as which minerals are out of balance deep inside the cellular functioning of this gland.

 

How can I "reset" my adrenal glands?

Making sure that you are "adding-in" the correct amounts of nutrient and mineral cofactors for your genotype and cellular, glandular adrenal profile will help to support and protect your adrenal glands from the onslaughts from your life!

We've curated the ADRENAL SHOP to help you to make these choices more easily.

Stress is part of life, without these stress hormones we would not be able to function in the world. Supporting a healthy stress response empowers you to make the right choices that transform your body's relationship with stress and protect you for the "dark side" of adrenal insufficiency. 

Marguerite Doig-Gander

Founder of MY DNA CHOICES | BA (Speech, Hearing & Lang Therapy) Hons | FMCHC | ReCODE Coach | Men's Health |  Harvard T.H.Chan Certification in Nutrition | Harvard Medical School Fundamentals in Genetics | Immunology    

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