As a component necessary for survival, a dynamic equilibrium or steady state
must exist in the internal bodily environment. As a constituent of this steady
state equilibrium, the adrenals function to secrete specific neurotransmitters,
including epinephrine (adrenaline), norepinephrine (noradrenaline), and cortisol
in response to stress. Subsequently, with the release of these neurotransmitters,
a series of physiologic effects ensues. These events may include for example a
rapid heart rate or an increased alertness. Thus in these aspects stress represents
a protective and restorative event. Alternatively, constant or excess stress may
have negative consequences, manifesting as an assortment of symptoms
and encompassing a multitude of emotional, behavioral, and even physical
symptoms, which may include adrenal gland enlargement, gastrointestinal
consequences, as well as immune dysfunction.(1) Although an adaptive process,
when in excess, stress consequently results in adaptation, which in turn may
result in bodily or organ damage. This process has been defined by Selye as the
‘general adaptation (adjustment) or stress syndrome.’ Selye, the first to coin the
word “stress,” further categorized it to represent the “mutual actions of forces that
take place across any section of the body, physical or psychological.”(2)
An excess production of stress may manifest in a variety of symptoms, varying
enormously among different individuals. Stress related illnesses are a frequent
occurrence, noted as one of the most common clinical patterns seen in
healthcare clinics. As the degrees of stress vary broadly among individuals,
four categories and degrees of stress have been categorized, which include;
1) physical stress, including overwork, lack of sleep, or athletic over-training;
2) chemical stress, such as environmental pollutants, diets excessively high
in refined carbohydrates, food or additive allergies, and endocrine gland
imbalances; 3) thermal stress, including over-heating or over-chilling of the
body; and 4) emotional and mental stress.(3)
Hypoadrenia or adrenal fatigue is considered to be one of the most prevalent
debilitating conditions of the past fifty years; however it is rarely diagnosed,
and often it is misdiagnosed as other types of illnesses, including chronic
fatigue conditions, fibromyalgia or serious food/inhalant allergies. Most
patients describe their symptomatology as a ‘fatigue that simply cannot
be overcome.’(4) In addition to the adrenals acting alone, the combined
hypothalamic-pituitary-adrenal axis also contributes to the body’s ability to
cope with stressors, which include among others infections, blood pressure
fluctuations, and illnesses.
The adrenal glands play an essential part in many bodily functions, primarily as
a consequence of the hormones they secrete. As such they supply components
necessary for numerous biochemical reactions. As a consequence of these
hormonal factors, they significantly effect the functioning of every tissue, organ
and gland in the body. They also exert an effect on both mental processes
and the overall feeling of wellness. Taking into account all of these actions,
their primary function is to enable the body to cope with stress. In fact they
have been subjectively classified as “the glands of stress.”(4) Endurance, energy and
resiliency, as well as life itself depends upon their proper functioning. In fact,
the hormones secreted by the adrenal glands have been said to “influence all
of the major physiological processes in the body.”(4)
Adrenal dysfunction can take many forms, the most severe form being Addison’s
disease, which if left untreated is life threatening. Adrenal fatigue, although
less serious, effects millions each year, and usually goes undiagnosed. Diminished
function or adrenal hypofunction results from a deficiency in the function of the
adrenal glands, and may present as a broad spectrum of disorders. Cortisol has
a broad reaching effect in the body, as it not only affects glucose but also has
an influence on both protein and fat metabolism. As a consequence of adrenal
dysfunction, changes in carbohydrate, protein and fat metabolism may occur, as
well as alterations in fluid and electrolyte balance, heart and cardiovascular system
problems or a reduced sexual desire.(4) Nutrients, including vitamins, minerals and
botanicals are known to provide valuable support for the adrenals, and can offer
subsidiary and restorative components to overstressed adrenals.
Structurally, the adrenal gland is divided into two parts, an outer region called
the adrenal cortex and an inner region called the adrenal medulla. The adrenal
cortex, comprising the bulk of the gland, produces the mineralocorticoid
aldosterone and the glucocorticoid cortisol, while the cells of the adrenal medulla
produce epinephrine (adrenalin) and norepinephrine (noradrenalin). Androgens,
including DHEA and testosterone are also produced by the adrenal cortex.
Both epinephrine and norepinephrine have an effect on numerous organs or
functions thereof, including the heart, the liver, blood pressure, blood vessels and
airways.(5) The chief responsibility of the mineralcorticoids and glucocorticoids is
to regulate the stress response, via the synthesis of corticosteroids (cortisol) and
catecholamines (adrenaline).(6)
Vitamins associated with Adrenal Support
Vitamin C. In the adrenal glands the concentration of vitamin C is among the
highest in the body, being roughly 100 times that of blood plasma levels.(7) As such
the adrenals are extremely sensitive to inadequacies in vitamin C. In catecholamine
synthesis, vitamin C is required as a co-factor in the conversion of dopamine
to norepinephrine.(8) In humans vitamin C secretion occurs as part of the stress
response via hormone regulation, specifically in response to stimulation via the
adrenocorticotrophic hormone (ACTH). Utilizing adrenal vein catheterization, it was
demonstrated that following ACTH stimulation, the mean adrenal vein vitamin C
level increased approximately four fold, and then subsequently returned to near normal.