Adrenal Glands: The Stress Responders
As you learned last week, your thyroid gland is in charge of your metabolism. This week let’s learn how your adrenal glands take charge of your survival and stress response. The adrenal glands get blamed for an awful lot of “what’s wrong” with the body. But remember, they’re doing their job. Blaming the adrenal glands would be a bit like blaming your accountant or bookkeeper for the taxes due because of how much money you made. They’re just the messengers for what’s going on in your body and life.
WHERE ARE THEY?
The two adrenal glands are like little pyramid-hats sitting on top of each of your kidneys. The release several important hormones that help regulate your immune system, blood pressure, stress response, even sexual development, and with the thyroid, your metabolism.
This is a bit of a long one, but that’s because the end of the post is packed with actionable tips! Hang with me, I got you!
TWO LAYERS, MANY ROLES
CORTEX (OUTER LAYER)
This one actually has three sublayers too. You can think of each layer as having its own class or “theme” which produces specific kinds of hormones.
Salt: Mineralocorticoids (ALDOSTERONE)
Mineral meaning specifically “salt and potassium”, corticoid meaning “produced in the cortex” (the adrenal glands’ outer layer). Because in the body water follows salt, these hormones help regulate salt and thus water balance. This is important, because this impacts our blood pressure. How it does this is pretty elaborate and involves the kidneys and colon. Basically, aldosterone, the main mineralocorticoid hormone, increases how much sodium your kidneys and colon send into your bloodstream or how much potassium you pee out. An increase in sodium causes you to retain water in your blood, which can increase blood volume. This is important if your blood pressure levels ever drop out of a healthy range (like in case of an injury). If this is outta whack, your blood pressure can be too high (hypertension) or drop too low (hypotension). Perhaps the most famous person with low aldosterone was JFK, who was thought to have had Addison’s disease (along with likely, Celiac disease and hypothyroidism).
Sugar: Glucocorticoids (CORTISOL)
Gluco meaning “glucose” aka sugar. These play a crucial role in regulating your stress response, suppressing inflammation, the sleep-wake cycle, plus regulating glucose, protein, and fat metabolism, as well as blood pressure. (Remember ACTH that was released by the pituitary gland? It controls how much cortisol your adrenals make.)
Stress regulation & blood sugar
Stress, whether acute, chronic or traumatic all trigger cortisol release. The body doesn’t know why you’re stressed, but assumes that stress means “danger.” So, it’s going to tell your liver to release glycogen (stored sugar) so it has resources to get away from/survive the danger. So, now you have more sugar in your blood. Does that mean your pancreas is going to start making more insulin to take up that sugar? Actually, no! Normally, insulin helps move glucose from the bloodstream into cells for storage or energy use. But during stress, cortisol suppresses insulin to prevent glucose from being stored, keeping it readily available in the blood. This makes sure that, if you need to respond quickly to a threat (like running from danger or facing a challenge), your muscles and brain have enough energy to do so. This is an amazing survival strategy, in moderation. However, in our modern age, everything stresses us out: traffic, getting our homework or job done on time, making dinner, that fight with our friend or loved one…it’s all activating. This is why “stress management” isn’t just stylized self-care. It’s crucial to your overall health.
Suppressing inflammation
Cortisol also suppresses inflammation. Sugar is pro-inflammatory, so this might sound good, but again, it’s meant to be a short-term intervention. It happens because the body needs to focus on immediate survival rather than healing or immune responses (fighting an infection takes a lot of energy that is irrelevant if we’re running away from danger). Cortisol acts as a “brake” so that prolonged inflammation doesn’t cause collateral damage (via harm to tissues, organs, or run rampant immune responses). Cortisol works with adrenaline to keep things quick and instinctual (which is also why sometimes it’s hard to think when we’re stressed; cortisol shuts down the part of our brain that’s good at making intellectual decisions again, remember you don’t want to over-think running from danger, you just want to get away from it).
Metabolism
Cortisol doesn’t only get energy from glycogen (stored sugar in the liver). It also triggers the breakdown of muscle proteins into amino acids (building blocks). These amino acids are used by the liver to create glucose (through gluconeogenesis) or to repair tissues when needed. In times of short-term stress, cortisol preserves proteins in certain tissues (like the brain and heart), redirecting energy from less critical systems. Over time, this can cause muscle weakness, which is why people who are stressed out and working out to lose weight, often can’t build muscle well.
Cortisol stimulates lipolysis, the breakdown of stored fats (triglycerides) into fatty acids (building blocks). These fatty acids are used by muscles and other tissues as an alternative energy source when glucose is limited. Over time, chronic cortisol exposure can lead to fat redistribution, often causing fat accumulation in the abdomen (visceral fat) while breaking down fat in other areas like the limbs. Again, this is why gentle exercise can sometimes have a better effect than “hardcore” workouts. You’re getting endorphins, without causing more cortisol release.
Cortisol is a master energy resource regulator helping your body adapt to stress by making sure energy is available from all sources—carbohydrates, fats, and proteins. It balances these processes to maintain energy levels and ensure survival during stress. However, if cortisol levels remain elevated for too long, it can lead to negative effects, like muscle loss, fat gain, and insulin resistance.
Sleep-wake cycle (circadian rhythm)
Melatonin and cortisol work together to regulate your sleep-wake cycle. Under normal circumstance cortisol naturally peaks in the early morning (between 6-8am), helping you wake up and feel alert. It plays a key role in boosting energy, blood sugar, and alertness, preparing the body for the demands of the day (normal, appropriate “stress”). Melatonin conversely peaks between 9pm and midnight signaling to your body that it’s time to sleep. As it rises, cortisol levels begin to fall, creating a natural shift that promotes relaxation and sleep.When stress is prolonged, cortisol levels may remain high even at night. This can disrupt melatonin production, making it harder to fall asleep or stay asleep. Often resulting in poor-quality sleep, that leaves you feeling tired and stressed the next day. This can create a vicious cycle of stress and sleep deprivation. For a healthy wake-sleep cycle, cortisol and melatonin need to follow their natural rhythms—cortisol high in the morning, low at night, and melatonin low during the day (suppressed by daylight), high in the evening. This is where all the talk about blue-light blocking glasses comes into play. Daylight has more blue light, limiting exposure at night promotes more melatonin production when you need it.
Sex: Androgen precursors (DHEA & ANDROSTENEDIONE)
These are steroid hormones produced in both the adrenal cortex and gonads (ovaries and testes), they are precursor hormones to testosterone and estrogen.
DHEA is one of the most abundant hormones in the body. It eventually gets converted into androstenedione. DHEA is the sex hormone balancer in both men and women. It’s linked to mood regulation, energy levels, maintaining muscle mass, bone density, sexual health, even immune function. These hormones decline with age and in response to chronic stress, leading to a variety of health effects, especially in women who rely on them more for testosterone production. We’ll learn more about these hormones in the gonads blog post.
MEDULLA (INNER LAYER)
Catecholamines (adrenaline aka epinephrine & noradrenaline aka norepinephrine)
The body isn’t confusing enough, we’ve got parts of the world calling a hormone one name, and others calling it something else. Oddly, in the US, we tend to call this hormone epinephrine when we’re thinking of an EpiPen when we need it for a bee sting or peanut allergy, but then we use phrases like “adrenaline junkie” or “adrenaline rush.” Will got it right: "a rose by any other name would smell as sweet." It’s the same hormone. In Europe, they use adrenaline and noradrenaline, in the medical world in the USA they use epinephrine and norepinephrine. I’m going to use adrenaline, because I think you’re actually more familiar with that term.
Adrenaline = Epinephrine
Noradrenaline = Norepinephrine
Catecholamines are known as the “fight or flight” hormones. Think of these like cortisol, but with more intensity. The adrenal medulla is directly controlled by the sympathetic nervous system, not another endocrine gland.
ADRENALINE
Makes your heart pump faster so more blood (and oxygen) get to your organs and muscles so you can fight or flee danger. It dilates your airways so you can get more oxygen. It also stimulates the liver to release more sugar (energy boost). And it redirects blood away from non-essential areas (like your GI) and toward your muscles and brain so you focus and move faster). It makes you sharper and more responsive.
NORADRENALINE
This is adrenaline’s copilot. It has similar effects to adrenaline, but is more directly involved in keeping blood pressure stable during stress.
Once the immediate threat has passed, the body works to return to a state of balance (homeostasis). Adrenaline and noradrenaline levels drop, heart rate and blood pressure return to normal, and the body’s systems resume their usual activities.
In chronic stress, the adrenal medulla may frequently release adrenaline and noradrenaline, which can lead to problems like high blood pressure, anxiety, difficulty relaxing, and GI imbalances. Repeated activation of this response without recovery can leave you feeling exhausted and contribute to long-term issues like “adrenal fatigue.”
Sounds great, huh?
MORE ON ADRENAL FATIGUE
This is actually a misnomer. It’s not a medical diagnosis and your adrenals actually don’t get “fatigued” at all, it’s the rest of your body does. So, when you hear this term, your adrenals aren’t burnt out and they haven’t stopped working. They’re actually working so hard to respond to perceived danger, it’s the rest of your body that’s fatigued. The rest of your body is tired from the effects of cortisol and adrenaline. It’s tired from breaking down your muscle, redistributing fat, having a lot of excess sugar in your blood with insulin suppression (leading to insulin resistance), decreased inflammation (meaning poor immune response), even thyroid suppression because your metabolic needs are all over the place…need me to go on?
Stress management is non-negotiable for your health. You can eat all the kale you want, but if you’re internal monologue is stressed, your external world is wearing you down….you need help.
HOW DO I PREVENT BURNOUT?
You know why clichés are clichés? Because they’re usually right. This next bit is basically a lot of clichés and things you already know, but sometimes (a lot of the time) we need reminding for our own good.
Water is life
Yup, hydrate. Your body is something like 70%. Nearly every body function is dependent on it. And studies show that as little as 1% dehydrated can lead to a 5% decrease in cognitive function. Most of us are way more than 1% dehydrated. Dehydration actually causes stress.
Take a breath
Breathe. Likewise, not breathing, causes stress. Some research shows depression is linked to shallow breathing. Similarly, rapid breathing is linked to anxiety. Are you aware of your breath? Can you practice regulating your breathing, even for just 3 minutes 1-2x a day?
Time heals all wounds
Piggybacking on breathing, take a time out of your day to heal. Use those 3 minutes you’re connecting with your breath to also quiet your mind. Meditation itself is a cliché for healing, because it calms down your stress response. In the beginning, meditation is awful because it’s the first time in a while you’ve given yourself your own attention. So, the back log of mind-shit (forgive the expletive) floods you. Breathe through this, it will pass after a bit, then it will be boring (read: annoying), then it will start to feel good.
Every cloud has a silver lining (blue sky thinking)
Aka the attitude of gratitude. It’s cheesy, but the brain looks for confirmation of what it knows. If you “know” the world is out to get you, that’s what you’ll find and you’ll stress out about it. If you trust the world is always going to provide solutions or opportunities even to painful situations, you’ll find those. Practice gratitude, even if it’s jaded at first like “I’m so grateful my day didn’t totally suck, and I had a good lunch.” Start where you are.
The truth shall set you free
Admit what’s working in your life, and what isn’t. Reducing conflict, releasing resistance, is naturally going to decrease your stress.
Don’t cry over spilled milk
Don’t stress over what’s out of your control or what’s already happened, use the tools above to help you through upsetting situations.
Laughter is the best medicine
When in doubt, circumnavigate (nope, not the same thing as bypass) with laughter! I personally love looking up old comedy skits of Robin Williams (RIP), Steve Martin (also his banjo playing), and Jim Carey. Also, sometimes watching a movie that makes you cry (I’m looking at you Pixar shorts) is also a great way to release emotions you’re having trouble processing.
Sleep on it
Seriously, neck-and-neck with laughter, sleep is the best medicine too! We could do a whole post on sleep hygiene. What are some of your sleep tips?
