Long-term behavioural problems in adolescents linked with low stress hormone levels. Why?

The adrenal glands sit on top of the kidneys, and are the chief glands in the body responsible for the body’s response to stress. In short, when our brain senses stress it signals the adrenal glands to produce hormones such as adrenaline (ephinephrine) and cortisol. These hormones allow the body to respond to stress. Once the stress is gone, the adrenals will generally reduce their hormone production and are then, we hope, ready to respond to the next challenge.

I was interested to read of a recent study which looked at the cortisol levels in adolescents suffering with ‘behavioural problems’ [1]. Here, in essence, are the findings of the research:

If the behavioural problems started relatively recently, cortisol levels tended to be high.

If the behavioural problems started some time ago (in earlier childhood), cortisol levels tended to be low.

The idea put forward to explain this is that, over time, the body learns to down-regulate the production of cortisol from the adrenal glands.

This might be true, but there’s an alternative explanation too.

The adrenal glands only have a finite capacity to do their job properly. Just like the liver can only cope with so much alcohol and the brain can only do so much ‘thinking’ in a given period of time, the adrenals have the potential over time to weaken. In natural medicine there is a bit of a vogue for identifying and treating this problem, and the condition is often termed ‘adrenal fatigue’ or ‘adrenal weakness’.

I, personally, believe in this phenomenon. Over the years, I have seen many individuals with supposedly vague health issues who appear to not have responded to traditional or even natural approaches. A hallmark feature of these individuals is fatigue. In particular, additional stress or challenge in the form of anything from emotional stress to strenuous exercise can cause individuals to get much more tried or ‘crash’, quite quickly.

One phenomenon that I find almost always has adrenal fatigue as its root is ‘burnout’. Here, usually hard-driving individuals who are used to getting a lot done in the average day can, almost overnight, go into a state of low energy and low mood that may take a long time to emerge from. Some of the most prominent symptoms of adrenal weakness include:

Fatigue
Adrenally weakened individuals tend to be tired. They often lack the vitality they once took for granted. They quite often have to force themselves through the day, and may prop themselves up with caffeine to give them the energy they need to complete whatever tasks they face. As time goes on, these individuals often feel the need to take more sleep. However, it is not uncommon for an adrenally compromised person to feel very tired on waking, irrespective of how much sleep they get.

Easy fatigue and lack of resilience
Adrenally weakened individuals often have little in the way of energy ‘reserve’. Not only do they generally feel tired, but they often get tired out or exhausted quite easily. For individuals with adrenal compromise, any additional stress, be it of a physiological and/or emotional nature, on the body can cause real energy lows. A busy week at work, the stress associated with a child’s illness, or a couple of late nights can be all it takes to bring energy crashing down.

One activity which tends to bring this concept to the fore is exercise. Individuals with good adrenal function tend to feel buoyed up and energised by exercise. While adrenally weakened individuals may feel emotionally satisfied to have taken exercise, the fact is it can lead them to feel tired and ‘wiped out’ the same day or the day after.

Insomnia
Adrenally compromised individuals can often get a ‘boost’ of energy in the mid-late evening, which can cause them to have difficulty getting off to sleep. Also, they can be prone to dropping their blood sugar level in the night, which essentially turns on the body’s stress response. This can cause waking in the night, typically at 3.30 – 4.30 am. Individuals can find themselves quite alert at this time, and may find that they are unable to get back to sleep again until about half and hour before the alarm goes off.

Low blood pressure
Stress is often thought to cause raised blood pressure. However, long term stress through its effects of adrenal function can actually lead to low blood pressure (hypotension) in time. Adrenally weakened individuals often have a blood pressure of 110/70 mmHg or less. These individuals also tend to have a blood pressure which drops on standing from a seated or lying position. This condition, the medical term for which is ‘postural hypotension’, can cause occasional dizziness on standing.

Salt craving
Some individuals with adrenal weakness will crave salt. Probably what is going on here is that the body is looking to salt to help replenish sodium which is not being retained due to a lack of aldosterone and/or other hormones.

Sugar craving
Adrenally compromised individuals can often crave sugary foods such as biscuits or chocolate. This is usually a sign of the episodes of low blood sugar they are prone too.

An increased tendency to allergic conditions such as hay fever and asthma

The need to eat regularly
Individuals with adrenal weakness tend to need to eat regularly to keep them from feeling weak, light-headed or ‘shaky’. If the body is not being fuelled from the outside (by eating), the body needs to generate sugar from the breakdown of stored fuels in the body such as glycogen in the liver. If the adrenal glands are weakened, it is possible that stress hormones such as cortisol are not made in sufficient quantities to enable adequate amounts of sugar to be mobilised in this way.

One way of assessing adrenal function is via salivary samples which are analysed for cortisol and, often, another adrenal hormone known as DHEA. If there is evidence of adrenal weakness on such testing, then supporting the adrenal glands can, over time, really help to restore lost energy and vitality.

Some of the approaches that I have found to be important in practice include ensuring adequate rest and sleep, the avoidance of strenuous exercise, regular eating of a truly nutritious diet (I find a diet rich in protein works best here), and nutritional supplementation. In particular, some medicinal herbs including rhodiola, liquorice, ginseng and withania do seem to help the adrenal glands function better and recover more quickly.

The best resource I have come across in terms of raising awareness regarding adrenal fatigue and offering constructive advice on how to manage this issue is www.adrenalfatigue.org

References:

1. Ruttle PL, et al. Disentangling psychobiological mechanisms underlying internalizing and externalizing behaviors in youth: Longitudinal and concurrent associations with cortisol. Hormones and Behavior 2011;59(1):123-132

13 Responses to Long-term behavioural problems in adolescents linked with low stress hormone levels. Why?

  1. Lori 11 February 2011 at 12:24 am #

    Another risk involved in all this: it can kill you.

    My brother had Addison’s Disease (adrenal failure). He was a juvenile deliquent, married and had two kids at a young age, had lower back surgery that never healed and left him in a lot of pain, and ran a business 60 hours a week. He’d had a childhood skin illness that hadn’t been properly diagnosed and treated, and he took a lot of cortisone. He also smoked.

    He died a few years ago at age 56.

  2. Tony Mach 11 February 2011 at 2:58 am #

    I’m battling with these (and other) symptoms. Had a salvia test, lowish Cortisol in the morning, high DHEA. I had some improvement by going first from a Lutz-sytle diet, then to a Atkins Phase 1 diet and now I try to eat a Primal/Paleo-style diet.

    What I found interesting, I reintroduced potatoes for two weeks and started to feel that I loose my energy again, sleep problems. Then I ate a big dish of fried potatoes on friday and the whole weekend was literally lost. Couldn’t really get out of bed, my thinking was sluggish, hours went by and I couldn’t really say what I have done. On Sunday I woke up after 4 hours “sleep”, but couldn’t stay awake, couldn’t fall asleep again. Sunday afternoon I felt like some doped me, like someone put me on Mirtazapine…

    So I looked into what could be the problem and I found Glycoalkloids. When I saw the structural formula of these alkaloids, and saw the steroid backbone, it hit me. While I can find little studies regarding this (only some regarding Estrogen), I think Glycoalkaloids can interfere with the steroid part of the hormone system (besides the other havoc Glycoalkaloids cause).

  3. Nata 11 February 2011 at 12:48 pm #

    @Tony Mach
    I have adrenal fatigue, too. I control it with primal style diet, working contracted hours, regular walks, lots of water, very small amounts of alcohol and take suplements.

    I regularly crash after eating roasted potatoes, too. I have done it so many times that in last two years I can’t even be tempted by this food, I actually feel aversion. Sugars crash me too, so I very rarely eat them. White bread gives me palpitations! and so on…

    I don’t work long hours I used to do, and I openly state this on any interview I attend. I work contracted hours and sometimes hour or two more but I can not sustain more than that.

    Thanks for the tip on Glycoalkloids, it is nice to know possible explanation at least for potatoes.

  4. Chris 11 February 2011 at 5:00 pm #

    It’s a funny old world.

    We are progressing deeper into period that will be remembered in the future for errant economic dysfunctionality characterised by the apparent resistance of money to circulate to peoples and parts of the economy where it is scarcest and where it’s presence would be most restorative. I’ll refrain from expounding in full but such dysfunctionality stems from the asymmetry of capital distribution which in turn is determined, preordained almost, by factors presently ‘hard-wired’ into economic transactions.

    There is no doubt, surely, that in the adverse economic times in which we find ourselves the trend of redundancies will be set to continue. Older people may willingly treat this as early retirement and withdraw from the job market. But however people take it redundancies are going to result in more people with more time on their hands.

    Businesses trading in adverse economic conditions are going to want to produce or deliver more for less. Public stock companies have the compulsion to deliver shareholder value even in contracting markets. All will be considering costs and measures to reduce them. As employees are expensive reducing head-count while expecting a down-sized workforce to produce MORE is an attractive ambition. Insecurity amongst employees will drive them to work harder, longer, or both. And as an aside wage repression, quite evident in the industry in which I work, is afflicting peoples ranging from the unskilled to the skilled, while paradoxically a few fortunate occupations benefit from remuneration inflation.

    While I do not deride enterprise and economic activity per-se the idea that an improper and unsustainable work life balance that some adopt by choice and others have impressed upon them constitutes another example, and I can bring several to mind, of how certain aspects of human activity do not deserve to be considered tenable. Might we anticipate that diagnosis of adrenal fatigue will be on the rise, Doc?

    In ‘Down And Out In Paris And London’ George Orwell documented a memoir upon vagrancy and low pay. He directs observations that vagrants, not unsurprisingly, suffer(ed) ill health from poor diet, malnutrition, disease from living rough, died sooner than they ought, and while ling rough were a burden and a cost to society. Orwell directed a prescription; that vagrants could be be organised to grow food for themselves. Orwells prescription is quite insightful though not properly explained and here’s why.

    The underlying cause of the conditions Orwell described and adrenal fatigue are the same. When you get down to the nuts and bolts it each arises from the possibilities and consequences of the ability to produce an agricultural surplus yet a paradoxical inability to utilise that ability equitably. Hell, if something did not stand in the way of the equitable utilisation of the capacity for agricultural surplus history could have been so different. So could peoples health.

    Thanks for bringing adrenal fatigue under the spotlight.

  5. Janet 11 February 2011 at 10:40 pm #

    Glycoalkaloids apart, the depressant effects of potatoes can be easily explained by the fact that they are pretty well pure starch – i.e. strings of glucose molecules – and therefore act like pure sugar for many people (a short high followed by a crash in blood sugar with the attendant fatigue, palpitations, etc.)

  6. Tony Mach 12 February 2011 at 12:05 am #

    @Nata
    I tried Plantain this week and I think it could become a replacement for potatoes for me. It is low in antinutrients, has no sugar, no fructose, mainly starch. I peeled and cut them, put them with ghee for three minutes in the microwave oven – almost like potatoes. I will try frying them next week. I bought a couple of green ones and one that was already yellowish – don’t buy the yellow ones, they turn a bit sour when heated.

    Re Glycoalkaloids: There are glycoalkaloids in all nightshades, like pepper bells (not black pepper!) or tomatoes, albeit different ones than in white potatoes. Therefore if you eat other nightshades you should watch out for symptoms.

    And one more thing, the sweet potato is *not* a nightshade. ASFAIK sweet potatoes contain no glycoalkaloids or only a very small amount compared to white potatoes – the information I could find is a bit fuzzy on this. So this might be another alternative.

  7. Laura 15 February 2011 at 3:23 pm #

    I would recommend two Eye Openers by two great pioneers in the field of hormone research and therapy:

    1. Re Adrenals “The Safe Uses Of Cortisone” by
    the “father” of Cortisone research
    William McK.Jefferies,M.D.,F.A.C.P.

    2. Re Thyroid “Hypothyroidism-The Unsuspected
    Illness” by Broda Barnes M.D.

    Thyroid and Adrenals are like Siamese Twins.
    Subclinical underfunction of both glands seems
    very common and the symptoms often identical.

    If out of print,used copies possibly on Amazon.

  8. Simon Pimenta 15 February 2011 at 10:26 pm #

    The following research may be of interest, given the link between adrenal fatigue and stress:

    Dr. Bruun Wyller says: ‘Recent research on CFS pathophysiology has revealed alterations of cardiovascular regulation and thermoregulation, characterized by enhanced sympathetic nervous activity and increased secretion of epinephrine. These findings indicate a state of permanent distress response – sustained arousal – in CFS patients. Based upon our findings, we have formulated a theory of sustained arousal in CFS…’

    Bruun Wyller, Vegard MD et al, “Can Sustained Arousal explain the Chronic Fatigue Syndrome”, Behavioral and Brain Functions, 23 February 2009, [accessed 26 May 2010]

  9. Kevin eakins 18 February 2011 at 5:19 pm #

    This is an excellent illustration of one of the effects of hypo-adrenalism: the inability of young people to delay gratification accompanied with often impulsive and self-destructive behaviour. Its not so much a lack of will or moral fibre but rather an underlying physical disorder that is becoming all too common in modern society. Its clear to me that hypo-adrenalism is part of this picture. Also i fear that if we as adults continue to live in a hypo-adrenal state we somehow pass that onto the next generation. However each generation seems to exhibit the same symptoms only worse. This presents a rather pessimistic outlook for humanity unless we change the way we live dramatically.

  10. Tony Mach 12 May 2011 at 10:43 am #

    I wonder if adrenal fatigue is the same condition as gradual onset ME/CFS. The sleep problems seem to be different than in ME/CFS (insomonia vs. non-refreshing-sleep). It’s a shame that school-medicine treat these diseases with psychopatholgic bias – if it acknowledges the patients at all.

  11. Tesfay Kinfe 26 July 2012 at 11:06 pm #

    I think I get it today what my health problem is. I have had suffered from this problem for more than a decade. my syptoms do match with those you mentioned. But in addition to these, I do not usually get thirsty……..thank you so much! I will try to work on it from today on wards. It is indeed a grand help. Please email me when ever you get new infromations that can help. God bless you. Tesfay

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