Dear Readers, this week’s column addresses a question from Shirley in Woodstock. Shirley wrote me to ask about adrenal fatigue and if there is a dietary and supplement protocol to help when a person has been wiped out by trauma or prolonged stress.
The answer is a resounding yes! Today we’ll explore that more and give some places to start if you’ve lived through extreme stress or trauma to help regulate your nervous system - and improve digestion. You see, whenever the nervous system is impacted long term, the digestive system is also disordered. Let me explain.
Rest and Digest
Have you ever heard the term ‘Rest and Digest’ (sometimes called ‘Rest and Recover’)? It refers to the parasympathetic nervous system, which is a state wherein digestion and recovery is carried out. You see, the body has to be in a specific state in order for these processes to happen. The alternate state is managed by the sympathetic nervous system, wherein the fight, flight, or freeze response is triggered. It’s a fear state wherein the blood flow to internal organs (including the brain and digestive system) is reduced and redirected to the limbs and sense organs to fight or run in order to protect against a perceived threat.
What happens when we’re in a state of prolonged stress or have suffered deep trauma is that our bodies become hypervigilant. They become tuned in to perceive potential danger and threats. This results in things like seeing danger where it isn’t (paranoia), being unable to relax, jumping at the smallest sound, being unable to sleep deeply, unexplained mood swings, an inability to think straight or focus on mental work, impulsive behaviours, extreme highs and lows of energy, and over time, digestive and mental health problems. In addition, prolonged stress can negatively impact blood pressure, heart rhythm, mineral absorption, fluid retention, and hormonal regulation.
Human beings that have been under chronic stress for prolonged periods or who have experienced episodes of extreme trauma can experience this. It’s often referred to as adrenal fatigue. But the complexity of adrenal fatigue is not well understood.
A Look At the Adrenals
The adrenal glands are triangular shaped organs that sit above the kidneys and manage some very important hormones.
Adrenaline: The adrenals manage the output of adrenaline (epinephrine) - the stress hormone that activates the sympathetic nervous response so you can spring into action if there is a threat. It raises heart rate, increases breath rate, and sending blood flow to the muscles and the brain. It also spikes blood sugar to create a quick source of energy for muscles to be stored in the liver.
Noradrenaline: The adrenals also manage the output of noradrenaline (norepinephrine), which is a stress hormone that causes vasoconstriction - tightening of the blood vessels.
Cortisol: The adrenals also regulate cortisol (hydrocortisone) - another stress hormone, which regulates how the body metabolizes fats, proteins, and carbs to energy. It also plays a role in regulating blood pressure and the cardiovascular system.
Corticosterone: The adrenals regulate this hormone, which works with hydrocortisone cortisol) to regulate inflammation and the immune system.
Aldosterone: The adrenals regulate this hormone, which helps control blood pressure.
Sex steroids: The adrenals also release estrogen and testosterone hormones in small quantities.
Understanding how many systems these little glands impact and send messengers (hormones) to regulate, helps us understand how profound the impact of prolonged stress and trauma on the health of the body.
In addition to all this complexity, the adrenal glands do not operate independently of other systems. Their function is closely related to that of the kidneys and of the hypothalamus and pituitary glands. The hypothalamus is located above the brainstem and works to control many of the body’s functions for maintaining stability. The pituitary gland is a small gland in the same area that does much the same thing - act as a control mechanism for hormone stimulation. What happens is when one of these glands is signaled it creates a cascade of reactions in the others. In nutrition we refer to this as the hypothalamus-pituitary-adrenal axis (HPA axis).
If there is dysfunction in any of these glands it can cause a problem in the function of the adrenal glands.
To better understand the HPA axis and the role it plays in the stress response, go here.
Eat to Beat Stress
If you’re astute you may have noticed above that the adrenal hormones are closely tied to glucose metabolism and storage. In a state of adrenal fatigue the body no longer creates enough cortisol to increase blood sugar levels when they fall too low. It becomes impossible to get energy from eating carbs. The adrenal glands are too pooped to function and it can be difficult to have energy to walk or talk or even think. This causes intense cravings for sugar and caffeine for energy. The resulting blood sugar spikes fuel more insulin and sugar crashes that further deplete energy.
By eating a diet that avoids glucose in all forms (starches and sugars) (ie, low carb or keto) we can avoid this entire loop. Remember I said people with chronic stress or trauma can become hypervigilant, overreacting to everything? Their bodies can be so sensitized to stress that blood sugar spikes can cause an adrenal reaction. The sugar high trips the hypervigilance. I’ve witnessed this over and over in people with mood disorders. In this case a low carb, ketogenic diet can be highly beneficial and can even reverse these disorders altogether.
So a diet to help with adrenal fatigue is ketogenic. It helps the body normalize its stress response and not be triggered by blood sugar spikes. It helps the body make energy in the absence of cortisol until the adrenals are working properly again.
Exercise for Stress
In addition to a ketogenic diet, exercise can help with stress. Now this is tricky. We aren’t talking about prolonged cardio here, as that can actually trigger cortisol and this entire feedback loop! This often happens in people who over exercise, doing cardio daily to stay slim. Once they hit a certain age and stress level the exercise no longer works and they find they start to get a belly. High cortisol causes stored belly fat. No matter how much they exercise they can’t lose the muffin top.
Oddly enough, if they slow down on the cardio and instead take up walking, hiking, dancing, yoga, or weight lifting - their cortisol goes down and they can lose the belly fat. If they do it in addition to a healthy keto diet the results are even better.
But there is a time to exercise vigorously to help with stress and burnout. This is immediately after a very stressful event that has spiked adrenaline. At that point the blood has been pushed to the muscles to run or fight. The body is wired such that some intense, explosive exercise (HIIT) or moving and shaking at that time helps to reset the nervous system and discharge the pent up energy from adrenaline. I find this a really interesting discovery. To read more about it go here. And here.
Herbs for nerves
There are a class of herbal medicines that can help to regulate an overstimulated nervous system. These herbs are classed as nervines. We also have herbs that can help the body adapt to stress. These herbs are classed as adaptogens. Together they are the bomb for adrenal fatigue and chronic stress conditions!
With herbs the best approach is a blend, because they work synergistically and the whole is greater than the sum of the parts. I make a herbal tincture for resetting the nervous system in clients with varying states of adrenal fatigue. Some of the herbs I like to use include Withania somnifera (ashwagandha). This is a potent nervine and adaptogenic herb with profound benefits on anxiety and stress related sleep disturbances.
Additionally, Scutellaria (skullcap), Avena sativa (oats), Valeriana (valerian), Passiflora (passion flower), and Humulus (hops) are also potent nervines. These tone and strengthen the nervous system to help it handle stressors.
Other adaptogenic herbs I like to use include Cordyceps (mushrooms), Ocimum tenuiflorum (holy basil), Schisandra chinensis (schisandra), and Gynostemma pentaphyllum (jiaogulan). Of these I think jiaogulan is underused and particularly effective.
A blend of these herbs in a tincture dropped into water can help reset the nervous system and normalize adrenal function in those who have been impacted negatively by stress. Those with panic attacks, hypervigilance, mood swings, and over excitement or fatigue can all benefit from judicious use of these herbs.
These are just some of the steps I recommend to help an overactive or fatigued nervous system. I hope you find the info helpful! As always, if you have your own nutrition related question, send me an email at email@example.com. If you’d like to read more articles like this, you can find me at askthenutritionist.substack.com.