The Importance of Adrenal Health in Athletic Performance
As athletes, we often subject our bodies to far greater levels of stress than the average person in pursuit of our goals. While in some ways this may be a necessary part of our training regimens, it can have far-reaching ramifications on many aspects of our health.
Much of it starts with the adrenal glands, which can be thought of as the stress management centers of our bodies. The inner part of the adrenal gland secretes epinephrine and norepinephrine (once known as adrenaline and noradrenaline) in response to nervous system stimulus, while the outer adrenal cortex puts out cortisol, our “stress hormone”, DHEA, testosterone, estrogen, progesterone (reproductive hormones) and aldosterone (which regulates water and sodium balance).
Cortisol plays a role in hundreds of different functions within the body. It affects the way proteins, fats and carbohydrates are metabolized, mediates inflammation within the body, influences detoxification capability, modulates immune function, assists blood sugar regulation and cellular energy production, to name just a few.
When the body is under stress, cortisol will increase as a compensatory mechanism. Stress in this context may be mental/ emotional stress, or more physical stressors such as rigorous training, infections, toxicity, unbalanced nutrition and blood sugar regulation, chronic pain, inflammation and allergies.
There are three stages in a chronic stress response, starting with cortisol and filtering through to other hormones and body systems.
The body increases cortisol production in an attempt to counter the extra stressors. This is a normal occurrence, and can be protective for the body. Stressors increase, cortisol increases, stressors go away, cortisol falls back to normal and we go happily about our lives.
The problem is that many of us live in conditions of chronic stress and when the stressors are not receding, the adrenals will keep trying to pump out more cortisol. So in stage I, cortisol is high. Many people in stage I feel pretty good as they are on overdrive. Unfortunately, this artificially elevated feeling of energy and wellbeing will not last.
Now the stress response is becoming chronic. Cortisol levels have been running high, and the adrenals are getting tired. Gradually, as the adrenals run out of steam, cortisol levels start to fall. As cortisol levels come down, there will be a period of time when, on paper anyway, they appear normal. However, at this point we will see DHEA drop.
DHEA is another hormone produced by the adrenal glands. Cortisol and DHEA are interdependent, and DHEA’s function is to protect against the catabolic (breaking down) effects of cortisol. Therefore if DHEA levels fall, that protective mechanism is lost and cortisol can be damaging regardless of what level it is at. So in stage II, the cortisol: DHEA ratio becomes significant.
This stage is known as adrenal exhaustion. Cortisol is low, DHEA is low, and by now this person is feeling fatigued, run-down, is not recovering well post-exercise, has undue inflammation, is more susceptible to injury and illness, and is jeopardizing fitness and performance gains. At this level of adrenal exhaustion, training programs may have to be modified and therapies put into place to allow for recovery and regeneration. Aside from altering training, other underlying stressors should be evaluated such as toxicity, infections and nutritional issues.
Adrenal health and reproductive hormones
The other major issue that arises during chronic stress is that our reproductive hormones are also affected. The adrenals contribute 35% of our reproductive hormones pre-menopause, and up to 50% post-menopause, so the contribution of the adrenals should not be overlooked.
Pregnenolone is a precursor to all the adrenal hormones, including the reproductive hormones. As the demand for cortisol increases, more of the pregnenolone goes towards making cortisol, therefore less is available for DHEA, progesterone, estrogen and testosterone. Levels of these reproductive hormones fall which could result in PMS, irregular menses, amenorrhea (no menses), infertility, miscarriage, loss of bone density etc.
Evaluating adrenal health
So how do we know if our adrenals are suffering the effects of chronic stress? It is easy to do using a simple saliva test. Cortisol should be measured at different times during the day as it has a natural diurnal rhythm, starting high in the morning to provide more energy, tapering off at night to allow the body to shut down for rest and recovery, and the immune system to kick in and do its nightly housekeeping work.
Estrogen, progesterone and testosterone can also be measured via saliva testing. Typically a health practitioner would need to order that test for you, or you can order it via www.stillpointcenter.meta-ehealth.com (BioHealth test kits, #201 or 205).
How to help your adrenals
There are several lifestyle factors that you can moderate to help your adrenal glands. Nutritionally, stable blood sugar is key. This comes from eating small meals frequently (every 3 hours), eating some protein with every meal to avoid insulin surges, and minimizing high glycemic index foods. Caffeine is also a major source of stress for the adrenals and should be avoided where possible.
Sleep is a much overlooked aspect. Physical rest and repair happens between 10pm and 2am, with psychic regeneration between 2am and 5am. Staying up late deprives the body of those important hours. Athletes, in particular, need 7-8 hours per night, but often compromise sleep to try and fit in their training, work and family commitments. Remember, the immune system is active at night so sleep deprivation can contribute to immune compromise.
High cortisol levels at night can prevent sleep, so those with insomnia or trouble shutting down at night should explore that as a possible cause.
Rigorous exercise is a major stress on the adrenals. For many athletes, this is near-impossible to avoid, but can be helped by ensuring adequate rest and recovery periods (avoid overtraining), and incorporating rejuvenative types of exercise such as yoga.
There are several micronutrients that support adrenal health. Vitamin C and B complex work directly on the adrenals. The mineral chromium helps the adrenals through its regulatory effect on blood sugar balance. Ensuring adequate amounts of all vitamins and minerals is important. Essential fatty acids can help counter excess inflammation within the body that may have arisen from adrenal imbalance.
Herbal remedies also help a lot. Licorice is stimulating to the adrenals, so it should only be used where cortisol levels are low. It should not be used long term, by people with high blood pressure, or by women with high risk of estrogen-dependent cancers (licorice can be estrogenic). Ginseng can support adrenal health and energy levels. Korean Ginseng and is more stimulating and energizing, while Siberian Ginseng is more balancing and modulation. Ashwaghanda and Rhodiola are both balancing herbs that are safe for use in cases of high or low cortisol.
In some cases, pregnenolone and DHEA can be used in supplemental form. These are steroid hormone precursors, so they are not appropriate for everyone and should really be taken under the supervision of a qualified health professional. The benefit of pregnenolone and DHEA is that they can refill the deficiencies in the adrenal pathways left from increased demand on cortisol, leaving more raw materials available to make estrogen, progesterone and testosterone.
Beyond that, they also help reset the communication between the brain and the adrenals, which often gets muddled in times of chronic stress. This results in the adrenals working better on their own, rather than continuing to be dependent on supplements.
For such small glands, the adrenals are so very important to our health and wellbeing. As athletes, it is crucial that they are functioning well to be able to sustain the amount of work you put your body through. If you are constantly fatigued, if your ability to recover from hard workouts seems compromised, if you find yourself with recurrent infections or illness, or if your female hormones seem out of whack, it may be time to evaluate your adrenal health and get back on track.