Adrenal Balance By Sophie Knapp, MScN, CN

March 06, 2023

Our modern world, heavily influenced by the unspoken need to be productive, fully-booked, and constantly hurrying from one agenda item to the next, puts many of us in a constant state of stress, aka fight or flight. Chronically functioning at this capacity is taxing on our bodies, especially our adrenal glands, and commonly burns us out! 

Let's dive into how to break out of the need to be busy & warm up to a new way of being that involves a calmer lifestyle & lots of nourishing food choices.

Stress Response / Adrenal Overview:

The adrenal glands are hormone-manufacturing machines that live atop your kidneys. These glands make sex hormones, epinephrine, norepinephrine, & most important to today’s conversation, they make cortisol. 

Cortisol tends to get a bad rap, but having adequate levels of in the body is essential for  keeping us alert, energized, & overall healthy. Generally speaking, we want our levels of it to be higher in the morning, lower in the evening, & within well-established, healthy laboratory ranges. 

Cortisol becomes a problem when our levels get too high or too low. True disease like Cushings, Addison’s, and genetics can be the culprit for abnormal cortisol levels, but most people experience unfavorable levels from being too stressed (high) or from being too stressed for too long (low). 

Whether your cortisol is off the charts high or low, getting your adrenals back on track looks similar for folks in both camps. The key to healing is to verify what your hormone levels look like, & commit to long-term eating & lifestyle change. Healing adrenals usually takes anywhere from 3-12 months & may require the involvement of multiple experts like a primary care doctor, nutritionist, & therapist, for example. 

Read on to find out how your adrenals can be rebalanced by managing stress, eating healthy, taking herbs & specific nutrition supplements, & adjusting your lifestyle.

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Reducing your stress burden sets the foundation for adrenal healing. This can look different on everyone, but I’ve laid out a few suggestions if you’re not sure where to get started.

Begin with a visual exercise:

Get your stressors out of your head, and put them somewhere tangible. My favorite way to do this involves a pad of paper, fun-colored pens, and an open, curious mindset. 

First, make three lists:

One of everything you’re obligated to do and are already doing, the second of everything that’s causing you stress (you may have some overlap), & the third of everything you’ve been wanting to do. That last list could be obligations you haven’t yet found the time & space for, or it can include the fun things like taking up a new hobby or making more time for yourself or friends. 

Then, do your best to take those lists & map them out visually to see how much time and energy they each take up. It’s not an exact science–the idea is to get a reasonable visual to work with. Draw out a weekly or monthly calendar, and start by filling in items from your first & second lists, the ones with the obligations & stressors. Color code the items from each list. For example, everything on list one is written in blue, while everything from list two is written in red.

Now take a peak back at your third list, the one with all the things you’re hoping & dreaming you had time for. Compare it to the visual you just made. Is there actually time to fit any of these things in? If so, write them in! If not, critically analyze your first & second lists & see if there’s anything you can let go of. 

Even if you aren’t able to incorporate anything from the third list, you’ve still achieved a lot by doing this exercise. You’ve taken your stressors out of your head & put them somewhere else, clearing at least a small space of mental clutter. This alone brings with it some relief. You’ve also made yourself very aware of how you’re spending your time & are hopefully feeling more connected to why. Overall, think of it as seeds planted, & the edge being taken off your stress load for the time being.

 

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Other choices you can make to ease your stress load mentally & physically:

It’s important to recognize that many of us are stuck in fight or flight out of pure habit. New York Times Best-Selling Author & Clinical Psychologist Dr. Nicole LePera uses the Instagram handle @the.holistic.psychologist, and she recently made an intriguing post describing why getting sucked into busy culture feels deceptively rewarding.

She starts off, “Are you addicted to your own body’s stress hormones?” Now addiction is an alarming word, but she continues to make a key observation about stress & our brains’ reward system: “At the same time [cortisol is released], dopamine or the ‘feel good’ chemical is released into the brain / encouraging us to repeat the stressful behaviors that lead to more hits of dopamine.” What she’s saying is that when our minds perceive stress, they also counterintuitively experience a surge of the same neurotransmitter we release when we take recreational drugs, make an impulsive purchase, or accomplish something big. Cortisol & dopamine being released in tandem sets us up to seek out more stress so that we can also get a surge of dopamine to experience an ongoing feeling of happiness in our lives. It roots us in a pattern of needing an excess of stress to feel happy in our lives.

She describes some ways that this phenomenon can drive our behavior: “Addiction to cortisol can look like: chronic patterns of high level conflict in relationships, never being able to sit still (always going), over-scheduling yourself, finding yourself in ‘drama’ regularly, [&] lack of boundaries.” 

Most importantly, she describes how we feel when we try to move away from this lifestyle: “ We feel bored, empty, or in need of distraction when we’re not stimulated by our stress response.” The fact that we feel like something is terribly wrong when we’re not stressed also pushes us to continue piling stress on our plates. Thus, the cycle rages on & on, all while overworking our well-intentioned adrenal glands until they just can’t keep up anymore.

With the recognition of how deeply ingrained stress is in our behavior patterns, talking to a therapist can be crucial for healing burnt out adrenals. They can help you gain recognition of how your habits feed into your stress load & support you as you navigate toward a more down-regulated way of experiencing life.

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The Vagus Nerve:

The nerve that takes you out of fight or flight and grounds you in rest & digest is called the vagus nerve. This gigantic cranial nerve originates in your brain & travels throughout your entire abdomen. It's responsible for so much in your body including activating the rest & digest side of your nervous system. This side of the nervous system is the opposite of fight or flight, & when it's activated, we feel calm, peaceful, & at ease.

 

In the context of balancing your adrenals, when you’re in fight or flight and triggering cortisol release from them, the vagus nerve is shut off. But you can override that fight or flight response and wake the vagus nerve up using a variety of techniques. The more you activate this nerve, the more you increase its “tone,” and the harder it’ll be for you to spiral into fight or flight when it’s not necessary.

In addition to stimulating this nerve regularly, activating it first thing in the morning can have a profound effect on its tone throughout the day. Instead of doing something that immediately triggers a fight or flight response like reaching for your phone or diving head first into work, upon waking, make a ritual of doing something that activates your vagus nerve. Your ritual can take as little as a minute or as long as a couple of hours, but no matter how long it lasts, you’ll feel its effects stick with you and reverberate throughout your day.

How to activate the vagus nerve:

• Take slow, deep belly breaths. Even just one can take the edge off of a triggering moment. Taking 10 can profoundly shift your nervous system state.
• Take cold showers or cold plunge. Commit to regular sessions & practice staying calm through the shock of the cold stimulus.
• Practice yoga &/or meditate regularly. Your mind is a muscle. The more you show up in this capacity, the easier it is for the effects of these practices to ignite & be felt.
• Listen to binaural beats. Change your vibration from the outside in. 
• Cultivate positive self-talk. Say affirmations in the mirror. Catch yourself when you’re being critical of yourself, & reframe it in a positive light. Cognitive behavioral therapy is tremendously effective for many to improve this skill. 
• Hum, sing, gargle, chant, they all active the vagus nerve directly.
• Get outside, & spend some time with our sweet Mama Earth. Getting back to our roots sparks something instinctual in us & naturally makes us more calm. 
• Get a massage, hug, or cuddle with somebody you trust–turns the vagus nerve on in a snap ;)
• Socialize (as your energy levels allow) & laugh. 

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Optimizing the type of physical activity you do can help ease the burden on your adrenals while you recover. If you do have the energy to workout, focus on doing less cardio & HIIT style workouts, & consider eliminating them completely until you’ve recovered. Emphasize activities that get you moving but don’t jack up your nervous system as much like yoga, pilates, walking, weight-lifting, etc. 

 

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Prioritize sleep, & practice good sleep hygiene. Try to go to bed & wake up around the same time each day. Avoid eating, watching screens, & drinking excess fluids within an hour of bedtime. Make sure your room is dark and cooler, around 60F. 

 

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How to eat for adrenal balance:

Above all else, eat in a way that keeps your blood sugar stable.

The number one way to do that is to include healthy fats, fiber, & protein in every meal & snack you eat. That means don’t just eat an apple. Slather some almond butter on there! Emphasize whole foods, & eat less processed, convenience foods. Eat all the colors! To support a diverse & thriving microbiome, aim to eat 30 unique plant foods each week, which includes herbs used in cooking. Alcohol is best drastically minimized or avoided during this time too.

I get asked about intermittent fasting in my practice all the time. If you’re struggling with energy issues, I tell folks that this style of eating usually contributes to the problem. People tend to feel better when they ensure their fasting window is no longer than twelve hours. Eat three meals a day, and have some snacks if you feel peckish, low energy, or grumpy in between. Most importantly, make sure to include breakfast with your morning cup(s) of coffee & within the first hour.

Speaking of, If you really want to get your adrenals back on track, cutting out coffee or switching to decaf is often a necessity. Here’s why: cortisol levels naturally rise in the morning. Caffeine in coffee causes cortisol levels to rise too. Especially if you're drinking coffee without any food in the morning, you're creating a recipe for skyrocketing your cortisol levels to the moon. Your adrenals can’t pump out an infinite amount of cortisol meaning that after blasting off for the morning, you’re likely to crash hard in the afternoon. 

So skip the morning fast and the caffeine! Instead, reach for decaf, a hot cup of delicious coffee alternative like RASA, Dandy Blend, or Teeccino, and reap the benefits of having healthy cortisol & energy levels throughout the day every day.

Something more specific to focus on during times of heightened stress is protein. Since we deplete it faster in stressed states, it’s helpful to up your intake during these times. Protein powders are an easy way to boost it, as are clean nutrition bars. Papa Steve’s (vegan options available; GF) and Off the Farm (GF) are two of my favorite high-protein, whole food, no added sugar, snack bars available at WILLOWTREE. Clean & tasty protein powders I recommend are from Sprout Living & Four Sigmatic. If you’re a meat eater, emphasizing turkey as a protein source can help load your body with protein & the amino acid tryptophan needed to make serotonin, one of the neurotransmitters you release to feel calm & at ease. An uptick in serotonin will help you feel more satisfied with your life as you learn to move away from cortisol & dopamine driving your good moods.

Other micronutrients to up while stressed are B-vitamins & magnesium. A high-quality B-complex is very safe to supplement for just about everybody, & is recommended if you’re not able to consistently eat a variety of fresh, whole foods (which are the best source of B vitamins.) Magnesium is abundant in foods like nuts, seeds, & chocolate, but even folks who consume high amounts of these struggle to meet the daily requirement. Consider supplementing 200-400mg of Magnesium Glycinate to support your body during this challenging time. If you're someone who gets constipated when stressed, reach for Magnesium Citrate as it can help facilitate bowel movements.

Lastly, if you’re someone who has been too stressed for too long and are feeling chronically fatigued, salts are the key to nourishing your adrenals back to life. Sodium and potassium are two salts to focus on. You can safely increase your intake of these by making homemade "Gatorade" with water, citrus juice, and a pinch of pink salt. Alternatively, you can drink coconut water or add electrolytes to water. My go-to electrolyte product is Trace Minerals' “Trace Mineral Drops." Be sure to chat with your doctor about this one, especially if you have high blood pressure.

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Herbs can be our greatest allies when coping with adrenal imbalance. Though it’s advised to consult your healthcare practitioner before beginning any new herbs or supplements, if you are otherwise healthy & not on medications, they’re usually very safe. 

Bear in mind with herbal medicine that herbs are often most effective when used long enough to build in your system to a certain extent. That’s to say that they may take a week or two to deliver their full potential of effects. However, since they can build in your system, many herbalists use the rule of thumb of taking an herb for three weeks, then taking three days off to ensure the herb isn’t putting too much burden on your detox systems. 

The tried & true herbs to support the body while adrenals are healing are adaptogens. Herbs in this category are touted for their ability to help the body cope with stress. Some are better at making us feel more at ease if we are in a heightened energy state, while others best serve us to bump our energy levels up if we’re feeling sluggish. Peruse the following lists to see how each adaptogen could best support you.

Herbs for those who are too hyper during the daytime:

• Reishi mushroom
• Ashwagandha

Herbs for those who need an energy boost during the day:

• Rhodiola
• Eluthero
• Licorice
• Holy Basil aka Tulsi

An herbal blend for overall support, whether you’re feeling like a slug or the Energizer Bunny:

SuperYou from Moon Juice. This superstar combo of adaptogenic herbs has helped many find balance while returning to optimal adrenal health, and it could be the best blend for you too. 

Non-adaptogenic herbs can help to curb stress or anxiety if that's holding you back. The following can be taken during the day for those who have too much cortisol (high energy, anxious, etc.) &/or in the evening for those who need help winding down:

• Hops
• Passionflower
• Chamomile
• Lavender
• Skullcap
• Valerian

 

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DUTCH Testing:

Feel like you’ve tried everything but just can’t get your hormones dialed? Or are you realizing that your hormones are out of whack, & you’re unsure where to begin? Enter state-of-the-art testing!

A heightened stress response shows up in your hormone levels but doesn't necessarily mean your adrenals are having problems. Testing your gut health and the composition of your microbiome using a GI Map &/or mapping out your metabolism with an OMX Metabolites test can help uncover the root cause. It’s a short-term investment of time, energy, & resources to have these tests done, but they lead to long-term relief & overall financial savings. No guessing what’s wrong, which supplement will cure you, or which diet is optimal. Testing puts you on the most optimized path to recovery & is profoundly worth it!

The DUTCH test stands for Dried Urine Testing for Comprehensive Hormones is often where to start with folks dealing with burnout & fatigue. It’s a go-to for folks suffering from adrenal-rooted disorders. Check out the article What’s a DUTCH Test on Knapp Nutrition’s website for more details.

 

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With a toolbox full of applicable eating & lifestyle change, hopefully you can hop on a track to healing your adrenals & reconnecting with feeling like your best self!

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