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Anatomy and Physiology
The adrenals are two small glands, one on top of each kidney, with a total weight of about 1/3 of an ounce. Each has a medulla,which is related to our sympathetic nervous system. The medulla secretes epinephrine and nor epinephrine (commonly known as adrenaline). The adrenals also each have a cortex, which secretes three different classes of hormones: mineral corticoids, glucocorticoids, and androgenic hormones.
The adrenal medulla has many nerves (preganglionic) from the sympathetic nervous system go to it, and end on special cells that secrete epinephrine and nor epinephrine whenever stimulated by the nerves. These hormones then travel through our circulatory system to all parts of our body. Some of the most important functions of epinephrine and nor epinephrine include:
1) Speeding up the rate of metabolism of cells as much as 100%2) Increasing blood pressure3) Dilating the blood vessels to the heart and skeleton while constricting most other vessels4) Increasing blood flow to the muscles while decreasing blood flow to organs not in use at the time5) Causing the liver to release glucose and thus increasing blood glucose levels6) Decreasing kidney function (resorption, etc.) and increasing urine output7) Dilating pupils8) Increasing muscle strength and mental activity (partially due to increased glucose levels)9) Dilation of bronchial (this is why epinephrine injections are given during asthmatic attacks)10) Breaking down glucose in muscles
The two most important hormones released by the adrenal cortex are cortisol and aldosterone. Aldosterone is the chief mineral corticoid. Aldosterone causes sodium retention and potassium excretion by the kidneys. If we had no aldosterone we would die within two weeks. Our sodium and chloride ions would decrease, and the potassium level in the fluid surrounding our cells would increase. The lack of sodium and chloride would lead to decreased fluid and blood volume and our heart would weaken and eventually we would go into shock. The increased potassium level would also poison the heart.
On the other hand, too much aldosterone leads to increased sodium levels in the extra cellular fluids (as a result we become thirsty to dilute the concentration), as well as increased potassium excretion. Over long periods of time this sodium/potassium imbalance would cause high blood pressure, and muscle weakness. Another effect of excessive aldosterone is that the body conserves excess hydrogen ions and they combine with buffer ions and our body becomes over alkaline.
The major glucocorticoids are cortisol (also known as hydrocortisone), corticosterone and cortisone. Since they all have similar effects on the system we will limit our discussion to cortisol (the major glucocorticoid).
Cortisol's main functions include the following:
1) Gluconeogenesis (Don't let long words scare you. Gluco means glucose, neo - new, genesis - beginning). Cortisol thus is responsible for the body transporting amino acids (the building blocks of protein) to the liver where they will be converted into "new" sugar.
2) It decreases the rate that cells use glucose, and decreases the rate of bringing glucose to the cells.
3) Cortisol increases blood glucose levels, and chronic excessive cortisol production or intake (cortisone pills and injections) can lead to a type of adrenal induced diabetes.
4) It causes increased breakdown of protein and slows the formation of new protein. Except for the liver and plasma all other protein stored in the cells is decreased.
5) Cortisol causes fatty tissue to be broken down and transported into the blood, helping the body to burn fat instead of sugar.
6) Excessive cortisol can depress the function of your immune system by shrinking thymus and lymph tissues and decreasing formation of antibodies and sensitized lymphocytes, which are necessary to fight disease.
Adrenal hormone secretion is under control of the pituitary gland (see pituitary chapter for more details).
Almost any type of stress to the body will cause the anterior pituitary to signal the adrenals (via ACTH) to produce more cortisol. These can include:
1) Moderate to severe physical pain2) Extremes in temperature3) Surgery4) Traumatic accidents (auto accidents, on the job injuries, etc.)5) Taking epinephrine or nor epinephrine (these are often used in asthma, and in the pain killers you get during your visit to the dentist)6) Intense anxiety or emotional trauma (problems at work or home, divorce, death in family, etc.)7) Overwork - mental or physical8) Lack of proper sleep9) Chronic diseases that wear down the body10) Pollutants in our air, water, cleansers, deodorants, hair sprays, etc.11) Pesticide and herbicide exposure12) Refined foods especially carbohydrates13) Exposure to substances you are allergic to
The adrenals also produce male and female sex hormones in small amounts and these can influence your secondary sex characteristics, severity of menstruation etc. The estrogen and progesterone are very important in women approaching menopause. If the adrenals are functioning properly there is evidence that they will slightly step up production of these at menopause. This will slowly transition the body and make menopause fairly symptom free. In the multitudes of women that suffer varying degrees from functional hypoadrenia, the menopause will be more severe with hot flashes, sweats, etc. (see chapter on ovaries for more information on menopause). Most adrenocortical hormones are synthesized from cholesterol, therefore, when these hormones are called for the body must from cholesterol formed by the liver. This is one reason why stress increases serum cholesterol.
Symptoms of Adrenal Malfunction
Due to our modern society with the many physical and emotional stresses, probably half the population possess varying degrees of adrenal malfunction. As we are under stress for long periods of time our adrenals produce extra cortisol and nor epinephrine. Over time, our adrenals by producing more hormones than they were made to comfortably manufacture and secrete, will "burn out" and decrease their secretion. At that time the body loses its capacity to cope with stress, you become sicker easier and for longer periods of time, and perhaps even a nervous breakdown could result.
General symptoms of adrenal malfunction can include (you will probably exhibit a few but not all of the symptoms), low back, sacroiliac, and knee pain (due to weak sartorius and/or gracilis muscles), tired feet with weak ankles and aching calves. You will probably wear out the heels of your shoes more on the outside (due to weak tibia is posterior and gastrocnemius muscles). Your eyes will be very sensitive to light especially when driving at night, and you might feel a need to wear sunglasses during most summer days. Depression, hay fever, asthma, bronchitis, colitis, insomnia, learning disabilities, ulcers (due to increased hydrochloric acid production), all may be partially due to adrenal malfunction.
If the major malfunction is with excessive production of mineral corticoids, muscle spasms and possibly even convulsions could occur as well as systemic alkalosis (which would manifest in extreme nervousness). The person might crave foods high in potassium.
Symptoms of a deficiency in aldosterone secretion (with resultant sodium loss) would include dehydration, excessive perspiration and urination, increased skin pigmentation, muscle twitching, heart palpitation.
A female suffering from increased output of androgens may develop excessive body hair, a deep voice. Cortisone derivatives are often given due to their function of suppression of adrenal function to treat this, but the side effects make it a treatment to avoid. In males excessive androgen can lead to development of breasts.
People that have a diminished output of cortisol can exhibit any of the following symptoms - they will crave substances that will temporarily raise their serum glucose level such as caffeine, sweets, soda or juice, tobacco, marijuana. They will sometimes get dizzy if they stand up too fast, or they may appear often to be in a daze. Irritability, headaches, blurred vision, erratic behavior and erratic energy levels may result. Since cortisol is an anti-inflammatory hormone, a decreased output over extended periods will make you prone to inflammatory diseases such as arthritis, bursitis, bronchitis, colitis, and allergies (many food and pollen allergies disappear when adrenal function is restored to normal). You will have no reserve energy and infections can spread quickly.
Excessive cortisol production due to prolonged stresses can decrease your immunity (see cortisol function #6 earlier in the chapter), leading to frequent and prolonged illnesses.
Diminished epinephrine output can lead to bronchial restriction resulting in asthma, and can also alter thyroid function.
Hans Selye' did an interesting experiment and showed that rats that had their adrenal glands removed were very prone to arthritis, but when they were given cortisol there were almost no instances of the disease (due to the side effects of taking cortisol injections, the answer is to get your adrenals to produce a sufficient amount instead of relying on medications).
In my practice I have also seen that people with weak adrenals are more prone to ligamentous sprains when under physical stress than people with normal adrenals. It is thus especially important for athletes to keep their adrenals strong.
Causes of Adrenal Malfunction
One of the main authorities on the adrenal glands is Hans Seyle'. He found that if you are under chronic prolonged stress your adrenal glands would go through a series of three stages. First they will begin hyper functioning to increase their hormone production and help you cope with the stress. With chronic stress the glands will become overtaxed and depleted. If you are still fairly healthy at this point the adrenals will rebuild themselves and actually hypertrophy (grow larger). But if the stress continues (remember stress can be physical, emotional, thermal, environmental, nutritional, etc.) the glands will again exhaust them and begin to under function. At this point in time you have no reserve capacity to handle stressful situations without overreacting or "going to pieces". It is our observation that in the process of rebuilding under functioning glands (adrenals and most other endocrine glands) they will go through a period of hyper or over functioning to try to catch up for lost time before returning to normal function.
Now on to causes of adrenal malfunction:
1) Frequent ingestion of white sugar, honey, maple syrup, fruit juices, sodas, etc. will cause a rapid rise in blood glucose levels. Our bodies are not made to handle large amounts of concentrated sweets (an ice cream sundae has 24 teaspoons of sugar) and this rapid rise will cause the pancreas to "freak out" and overreact in insulin secretion - this leading to a rapid fall in blood glucose levels. At that point the adrenals must put out large amounts of cortisol to bring the blood sugar back to normal. This type of diet that is very prevalent today will over time exhausts the adrenals and also lead to hypoglycemia.
One of the adrenal glucocorticoids (11-hydroxycorticosterone) is increased 400% by white sugar ingestion. To restate, this can lead to both adrenal exhaustion and immune system depression.
2) Caffeine, alcohol, marijuana,and methylxanthines (in chocolate) will have the same effect as the concentrated sweets listed above.
3) Many people feel that eating too many refined fats can impair adrenal function. These include margarine, vegetable oil, etc. In 1909 the average American ate 1.5 pounds vegetable fat per year. In 1983 it had risen to 53 pounds (over 3000% increase).
4) The adrenals can also be overtaxed by sudden or prolonged exposure to heat or cold, not enough sleep, mental trauma, chronic disease, exposure to toxins and pollutants, or substances you're allergic to.
5) If your adrenals are already somewhat depleted going on a fast can sometimes worsen the condition. The adrenals must stay very active during a fast to keep your blood glucose level and they could get further overtaxed.
6) Taking cortisone in injection form is common in inflammatory conditions of the joints and now hydrocortisone creams for itching and rashes are sold over the counter. Taking cortisone in these forms over periods of time could depress adrenal function and even lead to adrenal atrophy. It will also decrease your immune response by shrinking thymus and lymphatic tissue;suppressing antibody formation and depressing migration of white blood cells to areas they are needed. It is theorized that it directly limits the hypothalamus production of corticotrophin releasing factor thus decreasing anterior pituitary ACTH production and then decreasing cortisol production by the adrenal cortex.
It is interesting to note that before organ transplants, surgery patients are sometimes given large doses of cortisone. By thus decreasing the immune response, the patient's body is less likely to recognize and reject the foreign tissue.
The Physicians Desk Reference (1982 Edition) says that patients on cortisone therapy should not undergo immunizations because of possible complications and lack of antibody response. Other possible adverse reactions include psychic derangement, hypertension, loss of muscle mass, osteoporosis, peptic ulcer (steroids cause an increase in hydrochloric acid production by the stomach), impaired wound healing, convulsions, dizziness, headache, diabetes, cataracts, glaucoma, etc.
The June 1981 edition of The Physician and Sports medicine reported that cortisone injection can cause atrophy and even dissolving of tendons in the area it is injected. It is the author's opinion that cortisone therapy should be avoided if at all possible.
Other medications that can also depress adrenal function and possibly lead to atrophy include epinephrine and nor epinephrine (used for asthma and in some painkillers, especially by dentists), and some allergy medications.
The ideal way to approach the problem is to strengthen your own adrenal glands so they secrete enough cortisol and nor epinephrine to handle emergencies and prevent most problems (listed in symptom section caused by weak adrenals). Taking the medication too often brings short-term relief but weakens the adrenals and causes a chronic problem.
7) Pressure in spinal nerves in the lower thoracic spine can decrease adrenal function (see Appendix A).
8) A problem with pituitary function can alter ACTH production and affect adrenal function (see pituitary chapter).
9) Positively charged air from most heating and air conditioning systems can depress adrenal function.
10) The stress of pregnancy can aggravate a case of hypoadrenia. This can cause problems in the fetus. In the third trimester when the fetus starts producing its own adrenal hormones the mother, if she suffers from hypoadrenia, not having enough of her own will "rob" some of the fetus. The mother as a result will feel better until after she gives birth and she loses the extra hormone supply. Meanwhile, the fetus' adrenals being forced to produce enough hormones for it and an adult will get quickly depleted. The excess hormone production will also depress its immune system. The infant will become very prone to having allergies, recurrent infections, and be very irritable.
11) A study done by Dr. William Raab showed that nor epinephrine and epinephrine production would rise dramatically while watching exciting television shows. The side effects including higher blood pressure would last for several hours. A diet of lots of these shows could exhaust the adrenal medulla and under real stress, when you need these hormones in large amounts, they might not be available.
12) Eating foods you are allergic to can stress the adrenals and lead to dysfunction.
Other Indications of Adrenal Malfunction
1) At least one of the following muscles may test weak on manual muscle testing: sartorius, gracilis, tibia is posterior. Only one side will usually test weak so both sides should be tested (See Appendix C before muscle testing and figures 1.1, 1.2, 1.3).
2) With normal aldosterone secretion, when you shine a light into your pupil, the pupil should constrict for at least thirty seconds. In cases of decreased secretion it will dilate, alternately open and close, or constrict for less than thirty seconds.
3) Normal tongues should feel slick. If aldosterone is low your tongue may have another feeling.
4) Normally when you arise quickly from a prone position nor epinephrine and cortisol are secreted. This causes constriction of abdominal blood vessels and a resultant rise in blood pressure of about 5mm Hg. In people with hypoadrenia the blood pressure will either stay the same or drop, even up to 20 points. To do this test has the patient lie down and relax 4-5 minutes. Take their blood pressure and leave the cuff on (deflated), have them arise quickly and retake it as soon as possible. You can use this as a monitoring device if you are treating your adrenals to see if you are improving.
Prevention and Correction of Adrenal Malfunction
Symptoms of adrenal malfunction can start improving as soon as 2-3 days after commencement of therapy or it could be 2-3 months before any improvement is seen in resistant cases. The harder cases are people who have been on cortisone, epinephrine, allergy medication, alcoholics, sugarholics, people addicted to caffeine, marijuana, etc. With patience I've seen wonderful results in even the most difficult cases. Remember if instructions (especially dietary restrictions) are not closely adhered to progress can be slow or nil. A food binge midway through the program can slow progress greatly and cause the need for much added therapy to start the healing process again.
1) One of the most important steps in either preventing malfunction or regenerating tired adrenals is what I call the adrenal recovery diet. For 1-2 months the following foods must be eliminated - sugar (white, brown, and "raw"), honey, molasses, corn syrup, maple syrup, dried fruit and fruit juices. No alcohol, drugs, tobacco, caffeine, is allowed. Oil and margarine are kept to a minimum (1 teaspoon daily is allowed, but less or none at all is preferable). Fresh fruit is allowed. After 1-2 months if you feel much improved, small amounts of honey, molasses, dried fruit, and fruit juice, are allowed. But until then 100% compliance is very important. If you buy prepared food - read the labels carefully - if it has sweetening don't get it. Breads can be made using unsweetened applesauce or sweet potato to make the yeast rise. Many pocket breads, chapattis, essence bread, don't use any sweetening. Again the stricter you are the better and faster your results will be. During the first one or two weeks on this diet some people (usually the more severe cases) go through what I call withdrawal. Symptoms can include irritability, feeling edgy, craving sweets and feeling like you're going crazy. If this happens, please grin and bear it and it will eventually pass and then you will improve rapidly. Your body is doing without chemicals it is addicted to, and in the beginning it is a hard transition. With patience, determination, and prayer, you will successfully pass through.
2) Try to trace the problem down to its cause (see section on causes) and if at all possible eliminate the cause.
3) Get enough sleep; minimize stress and exposure to toxins and pollutants.
4) Mullein leaves made into tea are healing to the adrenal glands.
5) Dress properly for warmth and health. Clothe the extremities if it's not very hot out.
6) Don't fast.
7) Stay off medications containing cortisone and epinephrine. If on them consult with a holistically oriented physician to help you wean yourself and strengthen your glands.
8) Stand in the shower with your back facing the spray and have it beating down on your adrenals (just above the kidneys). Do 3 minutes of the hottest water you can stand followed by 30 seconds of the coldest, once daily?
9) Cup your hand and tap hard on the skin overlapping the adrenal glands for 2 minutes daily (see figure 1.4).
10) Eat fresh parsley daily. The gel inside the aloe vera plant is also helpful.
11) Evaluate the need for treating the pituitary, thyroid, liver, and pancreas, as one or more could also be involved and need treating simultaneously or later on in the future. For example, if the adrenals are malfunctioning secondary to pituitary malfunction, it is the pituitary that needs work. Or if you're not making enough cortisol it will tax the glucagons production of the pancreas to keep your blood sugar up, and the pancreas may eventually need work too (see respective chapters).
12) Have a good chiropractor check for nerve pressure involvement (I personally prefer one knowledgeable in Applied Kinesiology) - See Appendix A.
13) Rub vigorously for 1 minute 3 times a week a reflex point located 2 inches above and 1 inch to the side of the umbilicus. There is one point on each side (rub both) and they will probably be tender if the adrenals are malfunctioning.
14) During stressful times lie down and relax and place your hands on your forehead over your eyebrows. Stay like that for 10 minutes. It will be very calming.
15) Get out in the fresh air and let the fresh air circulate in your house. Air charged with negative ions is healing to the adrenals. This air is abundant in the forest, seashore and mountains.
16) Get out in the sunshine. The latest research suggests that sunlight striking the skin produces small amounts of epinephrine. This could help an overworked adrenal.
17) The proper amount of melatonin secretion by the pineal gland (see pineal chapter) may aid the adrenals in combating stress. Getting to bed early is helpful for optimum production.
18) Decrease your stress.
19) I'd like to briefly discuss 3 cases of adrenal malfunction I have seen over the last 4 years to give you an idea of the symptoms, results, etc.
Her parents brought in one patient, a 4-year-old girl, because once or twice daily she would throw an awful temper tantrum. It had been going on for about a year and the parents had no patience left to deal with it. After taking a careful history and doing a thorough exam it appeared she was suffering from hypoadrenia and food sensitivity to soy products due to her hypoadrenia. We treated the reflex points listed in this section and put her on the adrenal recovery diet. They came back one month later and reported that for the whole month she had only one tantrum and that she seemed like a totally different girl. After testing, it seemed her stronger adrenals had relieved her food sensitivity. We put her back on soy and allowed small quantities of juice, dried fruit, and honey back into the diet. The honey was used mainly in cooking where it was only a minor ingredient. About two months later she had a lot of sugary cookies at a neighbors and threw two tantrums. We reworked the reflexes and she was fine again. Since then, the tantrums haven't returned and her adrenals are strong enough now to handle occasional divergences on special occasions.
Another patient had an allergy to gluten (in wheat, rye, etc.) so much so that just a bite or two would keep him miserably congested for weeks and he would feel like he was "on drugs". All the doctors that he saw agreed that he'd have to abstain for the rest of his life. Again after determining hypoadrenia to be a major factor we put him on the adrenal recovery diet, used the reflex points, hot and cold showers, and adrenal tapping. We also put him on an allergy desensitization program. (See Appendix D). After 2 weeks he seemed to be much stronger and he went ahead and had bread and a bowl of noodles with no reaction and it has been fine since.
I was one of my toughest cases. On allergy shots weekly for 12 years and daily antihistamines and a diet with unlimited cakes, pies, and ice cream, my adrenals were exhausted. My capacity to handle stress was nil. I was irritable, very depressed, tired, many headaches, excessive urination, craved sweets terribly, and had quite erratic behavior. I gave up the shots and medication in 1970, but eating any wheat, corn, dairy, potatoes, would congest me terribly as would exposure to pollen. I could easily saturate a dozen handkerchiefs daily and often had to sleep with one stuffed up my nose. After 4 months on the diet, and using the reflex points, most of my symptoms were gone, though I still had the headaches and occasional congestion. Today I'd say the symptoms are 97% gone. I don't follow the adrenal recovery diet strictly any more. I occasionally have dried fruit or honey, maple syrup etc., yet I do keep them to a minimum. I notice that if I do not follow it for 3-4 days in a row - I can develop food sensitivity and get congested.
Once you have had severe hypoadrenia you always have to be careful with your diet, exercise, etc. You can never go back to a junk food diet without suffering, but you learn to relish the taste of God given natural foods, the old cravings leave, and the restoration of health and happiness is well worth it.
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