(Health N Vitality, Fall 2005)

When we refer to stress, we generally have the idea of someone who is burnt out and exhausted or one who is over reactive. In this article I’d like to put stress in perspective because stress is an unavoidable part of life. The body can adapt to stress given that the stress is not too great and the body's own adaptive mechanisms have not been reduced in any way.

In his excellent book, Treat the Cause (Prentice-Hall, 1998) Dr. Peter Papadogianis underscores the fact that there are a variety of stressors, including physical, emotional, professional and social as well as chemical. As a matter of fact, anything that elicits a response from the body is a stressor.

These stressors can be categorized into two general categories, eustress and distress. The eustress is the good stress, without which the individual cannot improve or grow. Exercise stresses the body, and the body responds to that stress by adapting. Exercise leads to changes, muscle growth for example, that help the body meet the accrued physical demands. Distress is the kind of stress that we would consider a bad stress from a physiological point of view. The death of a loved one, the loss of a job as well as the absorption of xenobiotics, could all be considered as distresses. Humans need not consider any stressor as an absolute distress since many of these can help us grow as persons. For the body, from a physiological perspective, however, distresses are always bad. They ilicit response without leading to any positive physiological or biochemical change.

There are three basic ways to face stressors in our lives:

• Eliminate the stressor altogether. This is sometimes possible, though not always. Smoking is a stressor and it can be eliminated. There are other factors which cannot.
• Learn to react positively to stressor. This is possible in relation to stressors that are affected by or brought about by our perception of reality. However, here again, there are a variety of stressors that will not be less stressful because we change our perception.
• Help the body cope with the stressors. Because there are stressors we cannot remove, others that will be eliminated or for which we will change our perception to gradually, we must help the body cope as effectively as it can to stressors.  

Stress adaptation: an overview

The adrenal glands have a major role to play in stress response.

Adrenal Medulla

During stress the adrenal medulla secretes epinephrine (adrenaline) and norepinephrine (noradrenaline). These help cope with stress by increasing heart rate, blood pressure, oxygen consumption and blood sugar levels as well as blood flow to the skeletal muscles in order to support the fight or flight response. Furthermore, epinephrine prompts the release of pituitary hormones. The pituitary gland releases endorphins, natural narcotics, which suppress immunity and reduce the perception of pain.

Adrenal Cortex

During stress the adrenal cortex secretes mineralocorticoid and glucocorticoid hormones. The mineralocorticoids increase sodium reabsorption and the elimination of sodium through the kidneys, thereby increasing water retention. The glucocorticoids increase blood sugar levels and inhibit inflammation as well as immune response.

Assessing adrenal dysfunction

One way to determine if the adrenal glands are functioning optimally is to assess the difference between systolic blood pressure when lying down and standing.  Normally systolic blood pressure should be about ten points higher standing than lying down.  If the blood pressure is actually the same or lower standing, the adrenal glands may be under-active (hypoadrenalism).  The blood pressure should be taken while lying down after about 5-10 minutes of rest.  Then, the blood pressure should be taken again, immediately upon standing.  The lower the blood pressure upon standing, the higher the degree of subclinical hypoadrenalism.  Hypoglycemia is also a good indicator of adrenal fatigue.

Of course, when adrenal diseases such as Cushing’s syndrome and Addison’s disease are suspected, a physician should be consulted immediately.

Factors involved in adrenal dysfuntion

Because an enormous number of factors can act as stressors, the list given below is very limited.  These factors, however, are often involved in exacerbating stress and weakening adrenal response.

Xenobiotics (foreign chemicals such as additives, xenohormones, environmental chemicals, and drugs) will elicit an adaptive response from the body.

Nutritional deficiencies have a major role in weakened adrenals.  The body’s stress response, as well as adrenal function per se, requires specific nutrients.  These nutrients include vitamins C, B3, and pyridoxine (B6), folic acid, magnesium, and manganese.  Vitamins B12 and B5 (pantothenic acid) are also very important for normal adrenal secretions.  Calcium is requires for the proper release of adrenal hormones.

Certain “foods” have a negative effect on the adrenals.  These include foods containing caffeine (coffee, guarana, and kola nut) as well as refined sugars.

Psychological stressors are, of course, also involved.

Supplemental support

The most popular and biochemically justifiable supplements are the following:

• A “stress” supplement supplying the whole array of B vitamins as well as vitamin C.
• Calcium (chelate or citrate) as well as magnesium (chelate, citrate or malate)
• Pantothenic acid (or royal jelly, the most concentrated food source) and niacinamide
• L-tyrosine
• Adrenal glandular extracts

Herbal support

A whole category of herbs, traditionally referred to as adaptogens, have been used to prevent or offset the effects of stress on the body.  There is one consistent finding when it comes to the use of herbs in stress or adrenal function-used properly they are very effective and exceptionally safe.  They should not, however, be used during pregnancy or while nursing, by children, or by individuals with adrenal or kidney diseases and hypertension unless specifically prescribed by a health care practitioner.

The following herbs have been used with success to help support the adrenals and thereby improve adaptation to stress.  The list is not exhaustive, but it does list the most “popular” and well researched herbs: 

Ginsengs:

Asian ginseng (Panax ginseng)

The pseudo ginsengs:

Ashwagandha (Withania somniferum), Licorice (Glycyrrhiza glabra), Siberian ginseng (Eleutherococcus senticocus), Schizandra (Schisandra chinensis), Suma (Pfaffia paniculata).

As far as physical performance is concerned, Siberian ginseng will have the greatest overall adaptogenic effect, whereas Suma will have a greater effect on strength and muscle growth.

Yes, stress is a normal part of life.  Happily, it is possible to help the body adapt more effectively and be less vulnerable to the good as well as the bas stressors of life.  Exercise, sufficient sleep, a health promoting diet, and herbal-nutritional support are all effective measures in helping us cope with the “stress of life”

Adrenal dysfunction or stress adaptation related symptoms

The symptoms, and this list is by no means complete, may include one or more of the following:

• Burnout
• Depression
• Type 2 Diabetes
• Diarrhea
• Dizziness
• Dysmenorrhea (or amenorrhea)
• Emotional instability
• Fatigue
• Hair loss
• Headaches 
• High Blood Pressure
• Hormonal imbalance (general)
• Hypoglycemia 
• Immune system depression
• Indigestion 
• Insomnia
• Irritability
• Loss of appetite (or possibly excessive appetite)
• Menopausal symptoms
• Neck or back pain
• Premenstrual tension syndrome (PMS)
• Sweating
• Trembling
• Water retention
• Weakness

What can we do?

• Reduce your consumption of refined sugars
• Reduce your consumption of stimulants (coffee, chocolate, cola, guarana and tea)
• Reduce your consumption of alcohol
• Increase your intake of the B complex vitamins (whole grains, nuts and seeds)
• Increase your magnesium intake (whole grains, nuts and seeds and green vegetables)
• In some cases, a "stress" supplement supplying the whole array of B vitamins as well as vitamin C is often required
• Finally, extra support in the form of pantothenic acid (vitamin B5) and niacinamide (vitamin B3) may also be required as well as extra L-Tyrosine (an amino acid) or adrenal glandular extracts (these supplements should be recommended by a health care professional).