Adrenal Gland Dysfunction
Adrenal gland dysfunction is typically related to a maladaption to stress, as first reported by Hans Selye in the general adaptation theory (GAS).
The General Adaptation Syndrome (GAS)
In order to develop a general theory for the physiological response of humans and animals to stress, Hans Selye, former director of Experimental Medicine and Surgery at the University of Montreal, performed an integrated analysis of the effects of stress on adrenal gland function. He called his model of stress adaptation the General Adaptation Syndrome or GAS. The GAS was thought by Selye to outline how the organism adapts physiologically to stressors in its attempt to restore homeostasis.
The GAS has proven useful for many years by providing a model of how stress-induced illness arises and by giving clinicians some insight into how to manage stress related conditions in their patients. According to Selye, there are three stages of stress response: alarm phase (acute stress); resistance phase (chronic stress); and exhaustion phase (burnout).
Stress includes not only psychological stress but also any insult to the body that may tax the adrenal gland function, including chronic infections, allergies, exposure to chemical toxins, use of stimulants (such as caffeine and nicotine), poor nutrition, physical trauma, and poor sleep habits, Other contributing factors include exogenous steroid use, chronic hypoglycemia, and pharmaceutical and non-pharmaceutical drug use. For instance, many people develop adrenal exhaustion after a physical trauma, such as a car accident, after an acute exposure to toxins in the workplace, or after an extended course of corticosteroid treatment.
Alarm Phase (Acute Stress)
The alarm phase of the GAS occurs when a stress is first encountered and an alarm is sounded in the body. This alarm, sometimes called the fight or flight response, is associated with an activation of the sympathetic nervous system.
Hormonally, we see an increase in the release of cortisol from the adrenal cortex and epinephrine from the adrenal medulla. This response is a normal defense mechanism that engages when an organism is threatened, and serves a critical function by stimulating the organism to respond to the threat at hand. Once this phase is over, the body goes through a 24 to 48 hour period of recovery, during which one desires primarily to rest.
However, this response can be considered maladaptive when the hormonal release is not appropriate for the situation (e.g., in states of hyper-vigilance, chronic anxiety syndromes, post-traumatic stress disorder). Animal studies of prolonged alarm reactions associate this stage with weight loss, gastric ulcers, and immunosuppression.
Resistance Phase (Chronic Stress)
Due to the challenges of modern life, for many people the perceived stressors are not short term but chronic. In this second phase of the GAS, the organism is still reacting to a perceived stress or stresses, but some of the outwardly observable signs of stress are different. Levels of cortisol and epinephrine are still elevated. This chronic elevation results in weight gain, although the person may appear to have returned to normal functioning. However, immunity and inflammatory responses are still suppressed, and thus there is an increased susceptibility to opportunistic infections, neoplasia, arthritis, allergies, and autoimmune conditions. In addition, chronically elevated adrenal hormone levels may lead to depression, hyperlipidemia, atherosclerosis, hypertension, hyperinsulinemia, insulin resistance, diabetes, osteoporosis, and other degenerative diseases.
Exhaustion Phase (Burnout)
No matter how vital the person, chronic stress can eventually lead to the exhaustion phase, characterized by a deficient production of glucocorticoids and an episodic increase in epinephrine. This phase is associated with deficient glucocorticoid and mineralocorticoid production, sometimes combined with episodic pulses of excess epinephrine. This is commonly known as adrenal exhaustion.
Adrenal exhaustion is associated with decreased resistance to stress, premature aging, and, if left uncorrected, even death. Conditions that are common in people in this phase of the GAS include allergies, chronic fatigue syndrome, fibromyalgia, hypoglycemia, multiple chemical sensitivities, irritable bowel syndrome, hypotension, insomnia, hypothyroid, and lack of motivation.
