Are stress and adrenal imbalance keeping you from weight loss?

by Marcelle Pick, OB/GYN NP
Complete article www.womentowomen.com
[Ed: This article is geared toward women, but the facts apply equally to men.
We've also highlighted some key points for you.  The links below will take you to specific topics.]

• 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

WITH YEARS OF CHRONIC STRESS, the adrenal glands — which govern our stress response, help balance ... 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.

How stress can make us gain weight

Stress. 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.

Thyroid & Adrenals. When your adrenals are working overtime, the thyroid can also suffer. High adrenaline inhibits TSH (thyroid-stimulating hormone), inhibits the conversion of T4 to T3 (the more active form of thyroid hormone), and decreases the function of T3 at the receptor level. All of this can lead to an underactive thyroid, or what we call hypothyroidism. And an underactive thyroid can lead to weight gain or difficulty losing weight, primarily by slowing your metabolism.

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.

Cortisol. 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

Glucose & blood sugar. Women (and men) 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!

[The author has developed a comprehensive program for women with adrenal imbalance, featured in her 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.

When you eat. 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.

What you eat is equally important. Women (and men) 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.

Craving salt?  One symptom of adrenal imbalance is a taste for salt. Many women (and men) with adrenal imbalance have low blood pressure. Unless you have hypertension, it’s okay to include some iodized sea salts, Celtic salt, or other high-quality salty foods and condiments.  Here are some options:
     Tamari: wheat-free, gluten-free soy sauce
     Shoyu: soy sauce made with a mixture of soybeans and wheat, fermented with a special koji (Aspergillus oryzae)
     Miso: fermented rice, barley and/or soybeans, with salt and the fungus kōjikin
     Seaweed, kelp powder
     Umeboshi: pickled plums, plum paste, and vinegar
     Natural pickles, sauerkraut, and relishes

Pace yourself to promote healing

“When it comes to dietary supplementation for stress adaptation and cortisol control, the first line of defense appears in the form of a comprehensive multivitamin/mineral supplement.... In particular, vitamin C, magnesium, and the full B-complex group are probably the most important from the standpoint of their direct involvement in the body’s stress response, but all of the essential and semi-essential vitamins and trace minerals are needed as well.”

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.

Nutrient base. & suppliments
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.

Medicinal herbs  & botanical suppliments
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.

This article is excerpted from Women to Women, Changing women's health - naturally TM. To subscribe to their monthly newsletter, visit
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