Tuesday, December 6, 2011

The Misunderstood Adrenal Glands: Your Key to Thriving in Stressful Times

     Few organs are as crucial to quality-of-life as the adrenal glands.  They balance blood sugar, provide potent anti-inflammatory hormones, help to regulate blood volume and pressure, and produce sex hormones.  And when the going gets really tough - say you round a corner on the hiking trail and come face to face with a bear - the adrenals provide the hormonal juice for "fight or flight."  You can't live without your adrenals  The most serious form of low adrenal function - Addison's disease - is life-threatening, and relatively common thanks to our reliance on prescribed corticosteroids (prednisone, hydrocortisone.)  President Kennedy suffered from Addison's disease after taking prednisone longterm for back injuries he sustained in war.  Yet, as essential as these little hat-shaped glands sitting on top of your kidneys are, they are rarely considered or discussed at all at a conventional doctor's visit.

     As it turns out, the "fight or flight" reaction works very well for those surprise appearances of bears on the trail, but not so well when people are under the kind of constant, low-grade stress that most of us are exposed to every day of our lives.  Getting little bursts of stress hormones on a regular basis leads to all sorts of health problems, if the adrenals are not well nurtured.

     The incidence of Addison's disease - adrenal failure - is 4:100,000, with equal distribution between the sexes.  Yet many, many more people suffer with varying degrees of adrenal stress and exhaustion.  Hans Selye famously developed a theory of physiological adaptation to chronic stress which he called "General Adaptation Syndrome," consisting of 3 stages:

     1.)  Alarm reaction - characterized by weight loss, stomach ulcers, and deterioration of the thymus gland and lymph nodes (key organs of the immune system.)
     2.) Stage of Resistance (or suppression) -  where the effects of the alarm reaction apparently reverse and health appears to return toward normal.  However, this apparent balance is an illusion.  The immune system and inflammatory response are suppressed and, without changing the stress level or supporting the adrenals, it's only a matter of time before the final stage is reached.
     3.) Stage of Exhaustion - decreased stress resistance, premature aging, exhausion and without attention, eventually death.

     94% of people with low adrenal function suffer with excessive fatigue.  Other symptoms include nervousness and irritability, PMS, salt craving, depression, allergies, alcohol intolerance, pain in the neck and shoulders, confusion, poor memory, heart palpitations and heart attacks, faintness (especially when going from lying to standing,) sparse body hair, scanty perspiration, dry thin skin and weight loss.

     Adrenal HYPER function, a medical condition called Cushing's Syndrome, is not nearly as common.  High amounts of cortisol and cortisone cause a round "moon face" obesity that's all concentrated on the trunk, with thin legs and arms, high blood pressure, osteoporosis, kidney stones, reduced resistance to infection (particularly fungal,) psychiatric disturbances, muscle wasting, male pattern balding, and menstrual irregularities and inappropriate hair growth in women.  Hyperadrenalism affects women 8X more than men.  Cushing's syndrome, which is diagnosed by a high 24-hr. urine cortisol test, is often caused nowadays by the over-prescribing of prednisone (although it's a mystery to me why women are prescribed so much more prednisone than men - perhaps it's because the incidence of autoimmune diseases - which are usually treated with prednisone - are generally higher in women than men.  One should be careful to always wean off of prednisone very slowly to avoid throwing the body the opposite direction - into Addison's disease.

     So, in today's world, where practically everyone is under increased stress, what can we do to protect and strengthen our adrenal glands?  The most fundamental behavior is to eat a blood-sugar-balancing diet of frequent meals (including some protein and good fat in every meal and snack,) avoidance of processed sugars, and regular exercise.  Adequate rest and relaxation and stress management techniques such as meditation are essential for both low and high adrenal imbalances.  For low adrenal function, a good multivitamin is recommended with high doses of the B-vitamins.  Also, omega-3 fatty acids and antioxidants such as CoQ10, alpha lipoic acid, or N-acetylcysteine (NAC) are helpful.  DHEA should be avoided if cortisol is low, because it will further lower it.  Other stimulants such as caffeine should also be avoided, even though the first instinct with low energy is to reach for a stimulant.  In the case of caffiene, it causes fluctuating blood sugar levels that further stress the adrenals.  Some good herbs to support adrenal function are:  Eleutherococcus root (Siberian ginseng,) Astragalus root, Dioscorea (wild yam) root, Schizandra fruit, and Borage.

In addition to good dietary habits, sleep is incredibly important for the adrenals.  The latest research indicates 5-1/2 to 7-1/2 hours is adequate, and maybe even ideal, for many people.  If sleep is a problem, try melatonin (or cannabis, which naturally increases the production of melatonin by the pineal gland.) first.

Thursday, November 17, 2011

How do you heal a broken heart?

Greetings!  Welcome to what I hope will become a source of information and a forum for discussion of issues relevant to natural health and wellness.  Let me introduce myself:  Victoria Hamman, ND.  I am a licensed naturopathic medical doctor, in private practice in San Francisco, CA.  I have been practicing for 12 years, treating a wonderful variety of people of all ages and conditions.  I went to Purdue University for my undergraduate Bachelor of Science degree, and received my Doctor of Naturopathic Medicine from Bastyr University.  Naturopathic medicine is broadly based on the philosophy of "Vis Medicatrix Naturae," which translates to stimulating or balancing natural vital energy (health) with natural medicines.  I use herbal medicines (plants from European and American traditions, not Chinese formulas,) all sorts of nutritional supplements, special diets, homeopathy, natural bioidentical hormones, exercise and stress management techniques to holistically address whatever deficiencies, excesses or imbalances might be causing a person's dis-ease.

Today, I'd like to talk about "Broken Heart Syndrome:" a phenomenom that illustrates the mind/body connection maybe better than any other.  Most of us know that heart disease is the number one killer of Americans (although cancer is right on its heels and may even have surpassed it at the time of this writing.)  The most dramatic manifestation of heart disease is myocardial infarction, or a heart attack.  A heart attack occurs when something (a blood clot or atherosclerotic plaque) blocks the flow of blood through one of the vessels that feeds the heart muscle itself.  Without oxygen-rich blood to feed its hard-working cells, a bit of the heart muscle soon dies.  Where that ischemia, or cell death, occurs determines whether the whole person dies as well.  The left ventricle of the heart requires a strong contraction to push the blood out of the heart with enough force for it to reach the hinterlands of the body - the tips of the toes and fingers.  When the artery that feeds the left ventricle becomes blocked, the heart cannot maintain that contraction and soon stops (cardiac arrest) if the clot is not dislodged, allowing the oxygen to get to it's destination.  That artery is called the Left Anterior Descending Artery, or LAD.  It's also called "the widow-maker."

In the 1990s, Japanese doctors started recognizing a different kind of heart attack -  with no arterial blockages.  These patients had the same symptoms as those suffering from a "regular" heart attack, indeed, sometimes they even die, but the entire mechanism of cause is different.  With these heart attacks none of the usual risk factors such as smoking, hypertension or obesity apply.  Instead, the heart goes into spasms, and sometimes failure in response to emotional stress.  It is now called "Broken Heart Syndrome."

I first became interested in this phenonmenon several years ago when a close relative suffered a heart attack shortly after her 50th birthday.  She experienced sudden chest pain that radiated into her jaw while walking the dog.  She had never experienced pain like this before and said it felt like a spasm. Shaken, she quickly took a couple aspirin and drove home.  While she was talking on the phone, describing her experience, the pain came back.  This time she called 911.  Blood tests and  cardiac imaging confirmed that she had suffered a heart attack, but there was no evidence of cholesterol build-up or a clot.  The attending cardiologist described her arteries as "pristine."  Of course, it could have been a clot that had dissolved.  But this individual had endured a great amount of stress in the months and even years leading up to this incident.  An acrimonius and hurtful divorce had been finalized just a few months before the attack. 

Broken heart syndrome happens when emotional stress triggers a rush of adrenaline and other stress hormones that cause the heart's main chamber - that left ventricle - to balloon suddenly.  This sets off dramatic changes in rhythm and blood chemistry that are typical of a myocardial infarction.  Interestingly, it has recently been discovered that women are likely to suffer from this type of heart attack 7.5X more than men.  It also happens 3X more often in women older than 55 than in younger women.  This raises all sorts of interesting questions about hormonal reactions and interactions.  Stress hormones are governed by the same "master glands" - the hypothalamus and the pituitary - as the sex hormones such as estrogen, progesterone and testosterone.  Is the decline of  these hormones that happens at menopause somehow involved?

One thing is certain: we will probably all experience some extreme emotional stress in our lives.  Loved ones die; marriages break up.  Even if your individual life is going well, just living on this planet in the 21st century carries its share of stress and heartache. Sometimes a broken heart occurs months after the most severe stress is experienced.  Studies performed decades ago show that grief and depression create a bigger risk environment for heart disease than smoking cigarettes. 

So how can we shore up a poor aching heart?  I believe the answer lies in paying loving attention to the adrenal glands.  Few organs are as crucial to quality-of-life as the adrenal glands.  They balance blood sugar, provide potent anti-inflammatory hormones, help to regulate blood volume and pressure, and produce sex hormones. 

What can you do to strengthen and protect your adrenal glands?  Eat a blood-sugar-balancing diet of frequent small meals and snacks (including some protein and good fat in every eating,) avoid processed sugars, and get regular exercise.  Adequate rest and relaxation and stress management techniques such as meditation, Tai chi, or yoga are essential.  Omega-3 fatty acids and antioxidants such as CoQ10, alpha lipoic acid or N-acetylcysteine (NAC) are helpful.  A good multivitamin with high doses of B-vitamins and a decent dose of magnesium (300mg or more) is recommended.  Finally, there are some good adrenal tonic herbs - eleutherococcus, astragalus, wild yam, schizandra fruit, borage and rhodiola - which can be incorporated into your wellness plan depending on your individual needs.   I usually recommend that people consult with a naturopathic doctor before committing to an herbal program.  Unusual reactions can occur - such as blood pressure spikes - with some of these herbs.