Adrenal fatigue

Are stress and adrenal imbalance keeping you from weight loss?

by Marcelle Pick, OB/GYN NP

• How stress can make us gain weight
• Best place to store fat? The belly
• Number-one for your adrenal health: Eat!
• Pacing yourself to promote healing
• Natural supplements for adrenal imbalance

Too often, women and their healthcare practitioners think weight loss is all about cutting calories and exercising more. But I have several patients who’ve tried these avenues with no success. The majority of women I see at my practice are genuinely trying to do everything “right” for their health. They exercise regularly, eat well, take their supplements, and so on. But many are frustrated with their weight gain and haven’t lost a pound. They’re literally desperate when they come to me — and trust me, I know how they feel, because I’ve been there!

These patients are always surprised when I ask them about the stress in their lives, and they want to know, What does stress have to do with weight gain?

With years of chronic stress the adrenal glands — which govern our stress response, help balance a woman’s blood sugar, and regulate many other of our body’s processes — can become imbalanced, leading to cortisol dominance or deficiency, insulin resistance, and unwanted weight gain. When this happens, it doesn’t matter how many calories you cut from your diet. The body is in crisis mode and is preparing for a famine. To do this, it clings to every calorie and packs it away in case the need arises.

Many women with adrenal imbalance feel like exhaustion is just their natural state of being. Some depend on caffeine and high-carb snacks to get through the day. Others can barely get out of bed. Our adrenal glands are fundamental to our health, and when they are out of balance, the body prepares for disaster the best way it knows how — by storing calories. Genetically, some of us are more predisposed to this than others. But the good news is that if we heal the adrenals, stubborn pounds often fall away without too much effort, and our energy returns.

Let’s take a closer look at the adrenal glands, then talk about solutions for healing yours — and finally getting rid of that stubborn weight.

How stress can make us gain weight

I’ve seen stress lead to weight gain over and over — especially as women’s lives become increasingly demanding. How often do you hear or say the words, I feel so stressed-out!? Being stressed-out is often perceived as an emotional state. But in fact the body understands stress quite physically. And one of the ways it physically handles stress is by being stingy about how it uses calories, storing them primarily in the form of fat around the abdomen.

Why we’ve evolved this way has much to do with living in the wild. If we were being chased by a bear, our adrenals shifted instantly into fight-or-flight mode, releasing adrenaline and cortisol into the blood. The adrenaline and cortisol helped to give us that superhuman strength and to quickly mobilize energy production from carbohydrates and fats. And once the threat was gone, our instincts led us to refuel with calorie-dense foods that are most readily stored as fat. The problem is that this sequence of events takes place whether the threat is real or perceived. Since most of our modern-day stressors don’t require fleeing or fighting, we generally don’t need all the extra calories our bodies crave and keep. What has also changed is that in the past, stress came and went. Many of us exist now in a state of constant stress, operating at elevated cortisol levels over long periods of time.

Current research suggests that through an amplification of the brain’s reward cascade, long-term increases in cortisol (and other glucocorticoids) may cause us to take more pleasure in high-fat, high-sugar foods, and our bodies to deposit those calories in the form of more fat. We are also learning that elevated levels of glucocorticoids like cortisol can turn on genes that increase production of leptin, the “I’m-full” hormone. Leptin is released to alert us that we don’t need to continue eating. An increase in this hormone may sound like a good thing, but with too much, we can become resistant to it, leading us to feel constantly hungry.

Best place to store fat? The belly

Women with adrenal imbalance often have a “spare tire,” or what we call visceral fat deposits. This happens for several reasons. Under normal circumstances, when we haven’t eaten for a while, our blood sugar (glucose) drops and the brain sends a message to the adrenals to release cortisol. Under fasting conditions, cortisol mobilizes glucose (via glycogen in the liver), amino acids (primarily from muscles), and fat (from fat cells). This prevents hypoglycemia (low blood sugar), keeping your brain and body fueled with energy in the absence of food. So cortisol maintains glucose levels in the blood, while insulin helps usher glucose into the cells.

When we have long-term stress, cortisol and insulin remain high in the blood, and the extra glucose that isn’t needed for energy gets stored in the form of fat in our fat cells (adipocytes) — primarily abdominal fat cells. This is called “visceral fat.” Scientists have discovered that fat cells have special stress-hormone receptors for cortisol, but that there also seem to be more of these cortisol receptors on the fat cells in the abdomen than anywhere else in the body! If you think about it anatomically, the abdomen provides the most physical space to pack on extra weight. Sadly, visceral fat then begins itself to function as a metabolically active endocrine organ that reacts to the stress response, spurring yet further abdominal fat deposition. So the cycle continues unless we take steps to heal the metabolic imbalance. A good place to start is with the adrenal glands.

Number-one for your adrenal health: Eat!

Some of you may have read my article on how to eat for adrenal health; everything I discuss there applies here as well. And because this is such a widespread problem for women today, I have also recently developed a comprehensive program for women with adrenal imbalance, as featured in my book, The Core Balance Diet. Here are a few key points.

Above all else, what you eat and when you eat can make a big difference. As I explained above, cortisol is integral to maintaining blood sugar, so it makes sense that keeping your blood sugar as level as possible lightens the load on the adrenal glands. Allowing yourself to get too hungry puts added stress on your adrenals, forcing them to pump out excess cortisol. To prevent this, I recommend you eat well and regularly — three balanced meals and two balanced snacks per day.

Cortisol has a natural cycle that works with your circadian rhythm. Normally, cortisol is highest in the early morning and declines gradually throughout the day to help you get ready for sleep. Because eating always bumps up cortisol, it’s ideal to eat your largest meal in the morning. Eating within one to two hours of waking helps cortisol reach its optimal morning peak, replenishes your body, and relieves your adrenals from maintaining fasting blood sugar levels. Healthy snacks between meals help moderate the natural downward slope of cortisol levels as the day wears on. If you experience a slump in the late afternoon, a balanced low-carb snack around 3:00 PM will help avert this. I also advise eating dinner early, around 5:00–6:00 PM if you can, and making this your lightest meal of the day. (For a picture of how this works, see our diagram of the effects of meals and snacks on the cortisol cycle.)

What you eat is equally important. Women I’ve seen with adrenal fatigue often load up on sweets and caffeine to raise energy levels. But this often leads to an even greater drop in energy. When you need a boost, reach instead for micronutrient-rich foods that support your adrenals, like asparagus, avocado, cabbage, garlic, ginger, and lean protein. Limit or avoid refined and processed sugars (especially high-fructose corn syrup), other processed foods, damaged fats, alcohol, caffeine, and possibly gluten. I’ve found that many of my patients with adrenal imbalance are sensitive to gluten, and do much better when they take it out of their diets.

Pacing yourself to promote healing

In theory, pacing yourself seems like an easy concept, but in our busy daily lives, self-care is often the first thing to go. Healing your adrenals means taking time for yourself, and for many of us, that means slowing down. We live in a multitasking world where we’re expected to be on-line 24/7. From cell phones and e-mail to TiVo and Facebook, we rarely take a break. If there was ever a good time to simply “unplug,” it’s when your adrenals are tapped out. I know it seems counterintuitive: we think being “on the go” all the time would help us to lose more weight. But if you’re tired, wired, and overweight, it’s likely you will need to lower your stress and heal your adrenals to stop the vicious weight-gain cycle.

What do I mean by pacing yourself?

• Sleep. If you really want to heal your adrenals, you need eight to nine hours of sleep a night — that is, when it’s dark. Many patients tell me they get a second wind after dinner, or that they’re “born night owls.” Burning the midnight oil can be seductive — it’s when many of us finally get some time to ourselves. But when you turn your circadian rhythm upside down, your cortisol cycle can follow, leaving you tired all day and wired all night. You can avoid this pattern by eating less late in the day, avoiding conflict and stimulation in the evening, and turning in a little earlier each night until you are in bed, asleep, by 10:00 PM. And until you are healed, go ahead and grant yourself the luxury of taking naps and sleeping in, when you can. Quality sleep is essential for your adrenals to heal and the pounds to be shed!
• Exercise wisely. If you already exercise regularly and intensely, try easing up for a few months while your adrenals are healing. The idea is to keep your heart rate under 90 beats per minute. If you don’t exercise, cultivate a habit of walking 15 minutes once or twice a day, especially after meals. I find it’s most restorative to do this outdoors. The science is solid that regular exercise is crucial for repairing your metabolism. Exercise also helps to reduce stress, as long as you are enjoying it. Whatever you do, don’t add to your stress by forcing yourself to exercise or exercising too much!
• Play. For once in your adult life, make having fun a priority! Many of us forget just how relaxing a few hours of fun or a good laugh can be. So today I am writing out a virtual prescription for you: “Play!” Take play seriously, and carve out time each day (at least three times a week) to do something you find completely, utterly enjoyable, no matter how frivolous or unproductive it may seem.
• Breathe. Simply by taking three to four deep, abdominal breaths through your nose you can slow your heart rate and calm the whole body down. Find time throughout your day to just breathe, and especially when you are feeling stressed use deep breathing as a way to calm your sympathetic nervous system. Learn to recognize the signals that you need to take a break, and get some fresh air, have a cup of herbal tea, or simply put your feet up. I can honestly say that whatever is stressing you out is not worth sacrificing your health!

Natural supplements for adrenal imbalance

In an ideal world, we’d get everything we need from a well-balanced diet, but no matter how well we eat, a stressful day can really burn through our nutrient stockpiles. So in addition to the small (but important!) changes you make in your eating and lifestyle habits, there are several natural supplements to consider for addressing weight gain rooted in adrenal imbalance.

Start with the basics: a well-rounded, high-quality multivitamin/mineral complex that includes the full B-complex group, vitamin C, vitamin D, calcium, and magnesium, as well as an omega-3 supplement, is essential for countering stress. I know how hard it is to get all of the nutrients our bodies require in today’s world of processed foods, and eating on the go! Give your body and your adrenals a hand with a solid nutrient base.

For further support, there are a number of medicinal herbs to consider. Traditional cultures have been drawing on botanical medicine for millennia, and today, research is bearing out the healing power (and safe use) of these herbs. I’ve had great success in restoring adrenal health with the following:

• Astragalus root. Studies show that Astragalus helps provide an increase in energy and endurance, as well as bolstering the immune system so you stay well when you’re under stress. It also aids healthy weight regulation by making cells more receptive to insulin and exerting an anti-inflammatory effect, helping to protect against insulin resistance and metabolic syndrome.
• Cordyceps. This “anti-aging” medicine is not actually an herb at all, but a fungus. And plenty of research documents the ability of Cordyceps to modulate the immune system, naturally lower high blood-sugar levels, support energy levels, and aid the body’s natural ability to adapt to stress.
• Eleuthero (Siberian ginseng). Eleuthero is sometimes called Siberian ginseng, but it shouldn’t be confused with “true” ginseng (herbs from the genus Panax). Eleuthero is a much gentler herb that functions as an adaptogen, meaning that it naturally augments the body’s resistance to stress. Studies indicate that it increases performance, concentration, and endurance during fatigue. Eleuthero also protects the cells of your brain and increases cell sensitivity to insulin.
• Rhodiola rosea. This herb is well-known for its ability to help the body respond to stress efficiently, while offering an increase in energy. Rhodiola extract additionally has a neuroprotective effect, increasing the ability to concentrate in people who report feeling “burnt out,” as well as natural anti-inflammatory and antioxidant effects.
• Licorice root. Probably the best known herb for supporting adrenal imbalance, licorice root increases energy, endurance, and vitality. It can also increase blood pressure, but most women with adrenal dysfunction have low blood pressure, so this can be helpful. If you are among the few who have adrenal imbalance with a history of hypertension, however, do be sure to monitor your blood pressure regularly.

I always take pleasure in learning more and sharing about the healing power of herbs. For my readers, I highly recommend you work with an integrative or functional medical practitioner to decide on the best course of action for you. For use in our Personal Programs we have developed Adaptisol, a combination formula of adaptogenic herbs for optimal adrenal support.

Let your body relax and release

In talking with women every day, I know how much we have on our plates. It can be next to impossible to take a minute for ourselves, with co-workers, families, friends, aging parents, and our social responsibilities all needing some of our time. But I also know that weight gain and lack of energy are serious concerns for women, and that it’s frustrating to try everything to shed extra pounds without success. For many of us, the stress in our lives is intimately connected to our weight. Our bodies are wise — when stress is the predominant state, your body will protect you by holding on to extra pounds.

You can coax your body away from “crisis mode” by healing your adrenals. Doing this often means taking more time for you — including taking more time with what you eat, how you sleep, and how you live each day. You deserve every bit of it! And once you replenish your energy and calm your stress response, you will be amazed and delighted by how the weight will come off!

Our Personal Program is a great place to start

The Personal Program promotes natural adrenal balance with nutritional supplements, our exclusive adrenal support formula, dietary and lifestyle guidance, and optional phone consultations with our Nurse–Educators. It is a convenient, at-home version of what we recommend to all our patients at the clinic.

• To learn more about the Program, go to How the Personal Program works.
• To select the Program that’s right for your symptoms, go to Choose the plan that works for you.
• To assess your symptoms, take our on-line Adrenal Health Profile.
• If you’re ready to get started, learn about our risk-free trial.

If you have questions, don't hesitate to call us toll-free at 1-800-798-7902. We're here to listen and help.

We’re always happy to welcome new patients to our medical clinic in Yarmouth, Maine, for those who can make the trip. Click here for information about making an appointment.

Related to this article:

References & further reading on stress, adrenal imbalance, and weight gain

 

Original Publication Date: 06/22/2009
Last Modified: 08/17/2009
Principal Author: Marcelle Pick, OB/GYN NP