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The adrenal gland and the 'just being sick' syndrome

Part 1 in a series...

It isn't possible to discuss all the various aspects of the adrenal glands in one column. For example, did you know that in most animals the adrenal medulla and adrenal cortex are two separate and distinct organs? It is only in humans that the cortex appears as an envelope wrapped around the medulla.

My intent, therefore, is to discuss the two glands in separate columns and conclude with a summary of the nutritional aspects in a third.

The adrenal glands are together commonly referred to (in this magic-bullet marketplace of nutritional supplements) as the "stress" glands -- as in "stress formulas." However, it might be worthwhile to state why that connection is now so commonplace.

If we know the biochemistry and physiology that takes place behind the scenes, we may be able to recognize stressed adrenal glands before they become exhausted. This is important, because the most commonly heard complaint in every doctor's office is "I'm tired. I don't know what's wrong, I'm just sick and tired of being tired."

Hans Selye was awarded the Nobel Prize in medicine in the mid-'60s for his landmark research that identified the effects of stress on the human body. He found that stress, regardless of its source (chemical, mechanical, or emotional), always elicited a specific response. He called this process the "General Adaptation Syndrome" and said it consisted of the following stages:

1. Alarm reaction to any stress...

2. Resistance or compensation to meet that stress...

3. Exhaustion if the stress was too strong or was maintained too long, thus exhausting the body...

4. Resulting in the stages of disease, degeneration, and finally death.

Selye's complete findings can be found in his book, "The Stress of Life" (McGraw-Hill, 1956) which is still available in bookstores.

For now, let it be said that the adrenal glands are primarily responsible for triggering the alarm response. This reaction is directed at reducing and eliminating shock and is accomplished (in part) by the release of norepinephrine and epinephrine (the catecholamines) from the adrenal medulla.

The effects of norepinephrine are almost identical as direct sympathetic stimulation:

-- Increased activity of the heart.

-- Inhibition of the gastrointestinal tract.

-- Dilation of the pupil of the eye, etc.

The effects of epinephrine are similar to norepinephrine, except that epinephrine increases the metabolic rate of the entire body. This includes increasing the rate that stored glycogen in the liver is converted to glucose and released into the blood.

Plainly, the maintenance of adequate blood sugar levels is of paramount importance in any "fright, fight, or flight" response. You will remember that the adrenal medulla in humans is an embryonic outgrowth of the sympathetic nervous system. Thus, the connection between it and the "fright/fight/or flight" syndrome is obvious.

Once the immediate release of epinephrine (adrenalin) and norepinephrine (noradrenalin) is realized, the alarm reaction features a more generalized response by the entire body. However, if these alarm reactions are long continued or too frequent, the body's ability to respond quickly will diminish and the adrenal medulla will hypertrophy in a vain attempt to meet the increased demand for these hormones.

It is at this point that symptoms of fatigue and inability to cope with stress appear. It is clear that if the stress continues uncorrected and the increased nutritional needs of the organ are not addressed, the gland will begin the long, slow decline into atrophy.

In previous columns, I have discussed the nutritional requirements of the autonomic nervous system and the need for adequate calcium and potassium to allow cellular response for these alarm reactions. I addressed the relationship of these minerals to protein and carbohydrate metabolism and diet. In this series, I will talk about the nutritional needs of the adrenal glands and why more than vitamins B and C are needed for a "stress formula."

But before entering that discussion, let's take a look at the clinical appearance of this syndrome and what is found on examination.

Insufficiency symptoms and signs

Common symptoms of adrenal involvement are:

*** Fatigue, bordering on exhaustion

*** Awakening after sleeping a few hours and the inability to go back to sleep

*** Hypoglycemia

*** Inability to tolerate stress

*** Depression

*** Low blood pressure and postural hypotension

*** The appearance of Pottenger's saucer (the so-called Anterior Dorsal complex)

Autonomic control

Sympathetic control of the adrenal medulla is from the 5th to the 9th thoracic segments of the spinal cord nerves and pass almost directly to the medulla. This accounts for the action of the adrenal medulla having the identical function (except for sweat glands) as the motor cells in the sympathetic ganglia.

It also explains the appearance of muscle contraction in the mid-thoracic spine producing Pottenger's saucer during periods of adrenal stress. I have discussed this phenomenon previously, and will discuss it again in future columns.

Parasympathetic fibers from the Vagus nerve innervate the adrenals, but have no part in the production of the catecholamines (epinephrine and norepinephrine).