Adrenal Stress Support

1. Adrenal Stress Support Presented by: Dr. Stacey Richards BSc, ND

2. Naturopathic Education • 8 years of school includes • 4 years of Pre Med (Microbiology from the University of Manitoba) • 4 year Naturopathic Medical School training (CCNM- Toronto) • Residency options • Specialist in natural therapies, nutrition, herbal treatments, injection therapies, IV Therapy

3. Principles of Naturopathic Medicine • The healing power of nature • Trust the body’s inherent wisdom to heal itself • First do no harm • Utilize the most natural, least invasive and least toxic therapies first • Treat the whole person • View the body as an integrated whole

4. Principles of Naturopathic Medicine • Identify and treat the causes • Look beyond the symptoms to address the causes of illness • Doctor as teacher • Educate patients in the steps to achieving and maintaining health • Prevention • Focus on promoting health and wellness, and preventing disease

5. Naturopaths Treats the Whole Person

6. Stress Response • There are two types of stress – external stress and internal stress. • External sources of stress could be • a demanding job, • relationship turmoil or • living in a polluted city. • Internal sources of stress include: • poor eating habits, • skipping meals or • reliance on caffeine. When you skip meals or consume something that doesn’t work for your metabolism – sugar, caffeine, refined flour products – or you have extreme amounts of external stress, your adrenals over-produce cortisol and it’s levels rise in your body.

7. Stress Response • There are two key points about a healthy stress response that need to be emphasized: • First, it takes priority over all other metabolic functions in the body and • Second, it wasn’t designed to last very long.

8. Stress Response • If this were to happen once or twice a month it would be okay, but for most of us it happens every single day with absolutely no let-up. This eventually leads to what is known as the “cortisol switch

9. Stressors • Potential disruptors that put an extra demand on the adrenals include: • blood sugar drops • stress • inflammation • poor sleep • poor diet • chronic pain

10. The Stress Hormone • Cortisol: • Made and excreted by the adrenal glands 24 hours a day. It is supposed to be at its highest level in the morning when we are waking, around 7-8 am, and then slowly the level drops off during the day and is at its lowest by 11-12 pm. This is what we call a normal pattern, but there are many things that affect cortisol during the day and over time.

11. The Stress Hormone Cortisol • Cortisol has 3 main jobs: • raise blood sugar (to feed muscles so you can run or fight), • raise blood pressure, and • modulate immune function.

12. How Stress Affects the Body

13. Stage I: Alarm Phase – High DHEA/Cortisol • Stage I Alarm Phase: high DHEA/Cortisol

14. Stage II: Resistance: High Cortisol, Low DHEA • Sxunopposed cortisol – • palpitations • onset insomnia, • night sweats, • increase perspirx, • IBS, I • Increase systolic B/P • Insulin resistance & thyroid antibodies dev. • Extended dream phase (REM) & decreased restorative sleep and decreased delta wave sleep • Increased risk A/I dz • Diabetes, Belly fat, osteoporosis • 6 months to recover

15. Stage III - Low Cortisol and DHEA • Depression, • Sleep maintenance insomnia, • night sweat, exhaustion, bradycardia, • systolic hypotension • Anxiety • Aches and pains • Common cause of chronic fatigue and pain. • PMS, menopause, FM, impotence, infertility, CFS • 12 months to recover

17. Adrenal Fatigue/ Adrenal Dysfunction • Excessive fatigue and exhaustion • Non-refreshing sleep • Sleep disturbance, insomnia • Feeling overwhelmed or unable to cope • Craving salty and/or sweet foods • Sensitivity to light • Low stamina and slow to recover from exercise • Slow to recover from injury or illness • Difficulty concentrating, brain fog • Poor digestion, Irritable bowel syndrome, IBS • Low immune function

18. Adrenal Dysfunction and Hormones • Premenstrual syndrome • Menopause symptoms • Low libido, sexual drive or interest • Sensitivity to cold - thyroid • Fearfulness • Arthritis • Anxiety, Panic/anxiety attacks • Irritability, impatience, quick to anger • Depression • Reduced memory • Lack of lust for life and/or food • Excess hunger/Low appetite

19. TREATMENT • First, find the cause. • stressors in general that are present in your everyday life from everyday activities, your relationship, job and family • how you experience these moments of stress – i.e. what symptoms do you have when stressed • how you manage stress because part of the long-term treatment plan is a strategy to avoid getting back into the same boat down the road

20. Symptoms of Adrenal Dysfunction

21. Adrenal Fatigue or Cortisol Dysfunction • SIGNS AND SYMPTOMS OF ADRENAL FATIGUE OR CORTISOL DYSFUNCTION: • Inability to maintain steady energy levels throughout the day - Reliance on refined carbs and caffeine • Fatigue (lack of energy in the morning, even after a full nights sleep) • Tired but wired feeling, poor sleep (difficulty winding down or staying asleep)

22. Adrenal Fatigue or Cortisol Dysfunction • Amenorrhea, light or irregular periods, • Worsening PMS • Dark circles under the eyes • Brain fog and forgetfulness – ADD, scattered thoughts, inability to focus on one task for long • Fertility issues – difficulty getting pregnant • Unexplained hair loss • Sensitivity to light, or difficulty seeing at night • Cravings for salt and/or sugar • Weight gain in the mid-section – the dreaded muffin top • Low stamina for stress, and easily irritated, • high anxiety, panic attacks • Poor immunity; high incidence of colds and flu; chronic infections (bacterial, viral, fungal, yeast) • Light-headedness, dizziness upon standing up • Dry, unhealthy skin with excess pigmentation, adult acne • Lack of libido or no libido, cystic breasts

23. STEP 1: Diet • Over 2,300 years ago, Hippocrates is quoted as saying “Your food shall be your medicine and your medicine shall be your food” (Hippocrates 460 BC – c. 370 BC.) • Basic Strategy – Good For Everyone The individualized treatment plan can be very different from one person to the next. It is very important for your long-term recovery and health, that you have an individualized treatment worked out.

24. STEP 1 – Food Guidelines • STEP 1: FOOD GUIDELINES Support yourself nutritionally. • Eat regular meals, especially breakfast, which include high-quality protein, whole grains and good fats. Supporting your body’s natural rhythms by properly timing meals to prevent dramatic dips in blood sugar has lots of benefits: it minimizes cortisol output and frees up your adrenals to perform their secondary functions, and also gives you more sustained energy throughout the day. Properly timed, adequate nutrition will make you much more resilient to your daily stressors. • 1. Low Glycemic Love - Cortisol raises insulin and insulin raises cortisol. The best way to address high cortisol is to incorporate low-glycemic foods. Please refer to my “Balance Blood Sugar Protocol”. Note: On a scale of 1-100, any food below 55 is acceptable. Example: a bowl of cornflakes has a glycemic index of 93 while an apple is 39

25. STEP 1 • 2. Sugar baby – I know it’s irresistible to many of us but it increases insulin which increases cortisol. • 3. Avoid alcohol, caffeine & tobacco - They are all highly toxic to the adrenal glands. Wean yourself off of caffeine. Caffeine just artificially stimulates your adrenals and stresses them out even more. Try Yerba Mate or Dandy Blend as substitutes. • 4. Omega-3′s please - Omega 3’s have been proven to lower cortisol. Incorporate 4oz of wild-caught salmon 2-3 times a week, and add in walnuts, chia seeds, sardines and avocados. • 5. Dark-colored foods - Foods like blueberries, blackberries, black beans, kidney beans, black sesame seeds, sea vegetables, sardines, are great for healing the adrenals. • 6. Include foods like - Sprouted grains like quinoa, millet and brown rice. Also celery, escarole, asparagus and bitter dark leafy greens are deeply nourishing to the kidneys and adrenals.

26. Step 1: Diet -AVOID • Diet:  A whole foods diet, including raw fruits and veggies (especially dark green leafies)  lean protein sources such as fish, beans, poultry, bison, nuts and eggs  fresh fruits and vegetables and a number of these should be purchased organic and always GMO free - Environmental Working Group website (www.ewg.org)  healthy fats such as olive oil, avocado and flax  complex carbohydrates like whole grains, starchy veggies like yams  avoid all processed, packaged and preserved foods, sugar, caffeine, fried foods, foods with additives like high fructose corn syrup, BHT and MSG  avoid any identified food sensitivities like gluten, soy, corn, dairy or any others

27. STEP 2: Exercise • Exercise:  we no longer walk, run, hunt, gather and move constantly  need to “exercise” our body  • a few hours of exercise a day is ideal, bare minimum is 30 minutes, 60 is even better  • work closely with your doctor to be sure you start on the best routine for you - people who have adrenal dysfunction may simply not have the extra reserves for physical activity. Because of this, I recommend that if you have adrenal dysfunction, you work with someone to decide when to start any exercise program and what it should be.

28. STEP 3: Supplements High & Low Cortisol • Vitamin C –The highest concentration ot Vitamin C in our body • Vitamin D - I recommend supplementing with 2000IU/day for maintenance. • B Complex - On a whole they are responsible for maintaining normal blood sugar levels, fat metabolism, hormonal balance and proper absorption of zinc.

29. STEP 2 –Supplements Targeted • Optimal Adrenal - a well rounded supplement that supports the adrenal glands and nervous system with a combination of vitamins, minerals and herbs. This will work for any kind of adrenal imbalance.

30. STEP 3: Stress Management Techniques • Stress management techniques: • Meditation • Yoga • Journaling • Deep breathing • Targeted

31. Lower Cortisol

32. STEP 3 – Self care – MOST IMPORTANT There are a number of practices you can integrate into your life to restore healthy adrenal function. Instead of working harder you need to be working smarter. My suggestions below are the perfect place to start. • 1. Practice saying “probably not or no”. Women are programmed to overcommit, overprovide and people please, often at the expense of our own health and our stress response and adrenal function. • 2. Prioritize your commitments. I want you to clear the decks. Make a list of all your activities, commitments and to-do’s and identify what you can stop doing.

34. STEP 3 3. Let go of your addiction to struggle. We’ve been taught that we have to struggle to be good at something or to be successful in life but all it does is burn out our adrenal glands. 4. Laptop curfew. Reduce your light at night. Too much light at night actually stimulates your adrenals to produce more cortisol to keep you awake and energized. This prevents you from being able to wind down properly and actually get proper sleep.

35. STEP 3 • 5. Sleep!!! You must rest if you are going to help your adrenals get stronger and getting enough sleep is the most effective modality. • 6. Keep Your Girlfriend on Speed Dial. I believe that we should all have at least one woman we can call when the going gets tough. • 7. Handle Your Stress Response: Just as there are many ways to get stressed out, there are myriad ways to help your body relax. Deep breathing exercises, a yoga class, massage, qi gong, meditation practice, prayer, taking a walk, reading a book, a grounding morning routine, time with girlfriends, dance breaks, journaling, taking a bath. All of these exercises have an incredible impact on your stress response

36. Step 3: Self-care • 8. Walk barefoot on the earth. This may sound a little woo woo but there is actually scientific evidence that walking barefoot on the earth, grass or beach can help reset your adrenal function and improve chronic fatigue. • 9. Ask for help! Get comfortable with asking for help and letting go of this perfectionist ideal. You won’t look weak! People are willing to help you with the things you need. • 10. Consider this analogy - At the end of the day, you plug your cellphone into the wall to recharge it, but what do you plug into? Where are you getting your energy from and what is sucking your energy stores? Think about ways you can start to recharge your batteries (adrenals) – Healing your adrenals will provide you with the energy you need to execute on the vision you have created for your life.

37. Testing for • Mainstream Test  • First thing in the morning • Blood test • 1 sample at 1 point • Progressive Test • Test throughout the day to establish the pattern  • Use saliva to evaluate cortisol ‐ is a better tool for measuring  cortisol • Check DHEA levels at the same time 

38. CASE 1 - ML • ALWAYS Tired. Naps at 3pm • Brain Fog – poor focus and concentration. • Weight Gain • Craving sugar • Low libido • Depression • High Blood pressure • Acne • Low Energy 2/10 Very stressful job and family life

39. CASE 1: ML -50 year old Female

40. CASE 1: ML – 50 year old Female • PLAN: Basic treatment guideline: Probiotics, High EPA, Vitamin D/k and Hormone support (sugar cravings and adrenal) • Adrenal support – Cortisol • Followup in 6 weeks: More energy 6/10– not nearly as tired anymore. Cravings have improved by 60%. Mood has improved.

41. CASE 2 – AS – 30 year old Female • Difficulty sleeping – wakes several times at night • Trying to have a baby - Fertility • Periods heavy and painful • Anxiety • Drinks too much alcohol (according to her). Strong family history of alcoholism. Binge drinks with husband on weekends • Cycle is normal but painful • PLAN. Adrenal and hormonal support.

43. CASE 2 – AS – 30 year old Female • PLAN. • 1. Basic Treatment • 2. Adrenal Support • 3. Thyroid support. • Followup: She called the clinic a few days later saying she was feeling really calm and was concerned as to how non-anxious she was feeling. • Within 30 days stopped drinking • After 60 days Cycles were only painful for 1 day

44. THE END • Questions