If you’re gaining weight, feeling dizzy when you stand up, craving salt or not falling asleep even though you’re tired, you may be dealing with a health challenge both alternative and mainstream practitioners call “Adrenal Fatigue” (AF). You would be in good company. Although it’s impossible to know the full impact and incidence of the crisis, according to Dr. Kerry Saucer writing in the book “Exhausted & Drained? It's NOT Just in Your Brain”, estimates are that millions of Americans suffer some degree of AF.
The adrenal glands, two tiny pieces of tissue sitting atop the kidneys (renals) play an especially significant role in maintaining the movement of fluid through the circulatory system and can be thought of as a center for blood pressure monitoring and control. They accomplish this important job by constantly monitoring blood oxygen and carbon dioxide. When the former drops and the latter builds up, a hormone called “aldosterone” is secreted. In response, blood pressure (or the force of movement through the circulatory vessels) is adjusted, redirecting blood flow to the legs and arms and away from the skin, digestive and excretory systems.
Aldosterone is our salt-retaining hormone. Excesses of aldosterone leads to high blood pressure and low potassium. Deficiencies of aldosterone, on the other hand, can lead to low blood pressure and a racing pulse, the desire to eat salt (salt-craving), dizziness or light-headedness when standing up, and heart palpitations. This can occur when chronic aldosterone secretion, in response to long-term stress, causes a depletion of this important mineral modifying hormone and may be an important cause of adrenal fatigue. According to Dr. Ted Friedman, Associate Professor of Medicine at UCLA Medical School, over half of his AF patients suffer from low levels of aldosterone.
While adrenaline and cortisol get all the press when it comes to the hormones of duress, aldosterone may actually be as or more important for the stress response, at least when it comes to hypertension. So, what does aldosterone do? How does it affect blood pressure? Well, it controls the mineral concentration of the blood. Aldosterone is our fluid and salt control hormone. It is the determining factor in assuring the appropriate concentrations of electrical minerals like potassium, sodium, magnesium and calcium (i.e. the electrolytes) are in the blood, within tissues and inside of cells. When the adrenals sense low oxygen, aldosterone will get secreted, pulling electrolytes out of tissue fluids and into the blood. This will, in turn, attract water, increasing the blood volume, thereby raising the pressure. In other words: more electrolytes in the blood means more fluid in the blood, which means more volume and more pressure. This salt pulling effect and subsequent increase in fluidization and blood volume/pressure provides the rationale for the low salt, anti-hypertensive diet. By limiting intake of dietary salt (so goes the medical logic), there will be less electrolytes available for the adrenals to secrete into the circulation, reducing fluidization and blood pressure elevation.
The effect of aldosterone is particularly significant when to comes to sodium. When aldosterone secretions are normal, sodium levels are also normal. In times of stress, aldosterone levels go up and the concentration of sodium in the blood likewise increases. When aldosterone levels are perpetually elevated, sodium levels are also chronically elevated in the fluids circulating in the body.
However, as the stress response decreases and circulating aldosterone levels fall, sodium and fluids are removed from the bloodstream and ultimately excreted in the urine. This reduces blood volume and sodium reserves as well. Initially these biochemical compensations may not even be noticeable, but over time, loss of water and sodium can create deficiencies which may become severe. Even a small loss of sodium may sometimes have consequences. Some of the untoward effects of hyponatremia (low sodium levels in the blood) include: nausea and vomiting, headache, confusion, loss of energy and fatigue, restlessness and irritability, muscle weakness, spasms or cramps, seizures and coma.
When the blood’s sodium supply is not replenished by eating salt-containing foods or liquids, sodium and water is pulled from interstitial fluids into the blood to keep levels from getting too low. If too much salt or fluid is pulled from the interstitial fluids, the small amount of sodium inside cells themselves begins to migrate into the interstitial fluid. As the sodium is pulled from the cell, water escapes as well. This leaves the cell dehydrated and sodium deficient. Because sodium levels are kept tightly regulated in order to keep them balanced with potassium, these effects can throw off the ratio. In order to keep proportions constant inside the cell, potassium begins to migrate out in small quantities. However, each cell has minimum requirements for the absolute amounts of sodium, potassium and water necessary for its proper function. Cell function suffers when these requirements are not met, even if the proper ratio is maintained.
Aldosterone modification is the logic behind treating hypertension with ACE inhibitor drugs like lisinopril and losartan. These kinds of medications are involved in regulating the important blood pressure control hormone. Via the aldosterone connection, physical stress and subsequent adrenal activation play importantly roles the development of high blood pressure. It’s not just physical stressors, mental and emotional burdens can also affect the mineral hormone. In a 2010 paper published in the journal Neuroscience and Behavioral Reviews, researchers from Harvard Medical School demonstrate that adrenal aldosterone is an important link between psychological stress and heart disease, the leading cause of death in the United States and around the world.
If you’re dealing with long-term adrenal fatigue issues, the chances are good that you have an electrolyte imbalance and you must be careful how you rehydrate yourself. Drinking lots of water or liquid without adequate sodium replacement can make you feel worse because it further dilutes the amount of sodium in your blood. Moreover, your cells need salt to absorb fluids. If you suspect dehydration (unexplained fatigue is a sign) or if you think you are deficient in electrolytes, try adding salt to your water (about 1/4 teaspoon). Sea salt is a better choice than regular table salt because it contains trace amounts of minerals in addition to the sodium.
When your aldosterone levels are low and you are dehydrated and sodium deficient, you may also crave potassium because your body is sending you the message that your cells are low on potassium as well as sodium and water. However, after consuming only a small amount of potassium containing foods or beverages, you will probably feel worse because the potassium/sodium ratio will be further disrupted. Avoid soft drinks or electrolyte-rich sports drinks because they are high in potassium and low in sodium, which will only add to the imbalance. Further, most ‘hydration’ drinks and sodas contain artificial colors, additives, and unhealthy sweeteners. You are much better off having a glass of water with salt in it or eating something salty with water, to help replenish both sodium and fluid volume.
So how do you make sure that your aldosterone and your adrenal glands are operating correctly?
Well for one thing nutrition is critical. As mentioned, salt is super important. This is one reason why drinking salt water can be so beneficial. Veggies are also great sources of electrolyte minerals. Veggie juices can be particularly helpful. Veggie juice is pretty close to an instant way of raising electrolyte levels and getting the adrenal glands their precious salts. Of course supplementation with all 90 essential nutrients is important. Make sure you’re working on digestive health, stabilizing the blood sugar, laying off sweets, while using chromium, vanadium, selenium and niacin supplements. Be sure you’re getting Vitamin C, the B-complex (especially B-5 and B-12), zinc, iodine and EFAs all of which play an especially important role in adrenal health.