What Causes Adrenal Fatigue (Part II): Blood Sugar

Adrenal fatigue can be drastically affected by both low blood sugar and high blood sugar.

Often, a blood sugar imbalance (glycemic regulation) occurs silently, operating below the surface. This is what makes glycemic dysregulation so dangerous: you could be heading towards adrenal fatigue without having any symptoms.

When we eat carbohydrates, our body breaks them down into their original components – sugars. Sugar enters our bloodstream, causing our blood sugar to rise. Excess sugar in your blood is dangerous, so our body releases the hormone insulin which moves the sugar from our blood to the inside of our cells. (1)

In the world of blood sugar regulation, there are two conditions that you need to be familiar with:

1. Hyperglycemia – also known as high blood sugar, can lead to diabetes or insulin resistance.
2. Hypoglycemia – known as low blood sugar.

Both high and low blood sugar cause tremendous stress to our body. (2) In fact, this stress may be so significant that it can cause adrenal fatigue. Most alarmingly, you may not even recognize the symptoms until adrenal fatigue has already developed.

This is the second article in my What Causes Adrenal Fatigue series. Make sure to check out the other articles when you’re finished with this one:

An Introduction | Sleep | Inflammation | Stress | Treatment

How does glycemic dysregulation cause adrenal fatigue?

Our brain runs on sugar (glucose), and measures levels of sugar with a variety of gauges. One of the gauges is the hypothalamus, which is a part of your brain at the base of your skull.

The way the hypothalamus controls blood sugar is by sensing sugar levels and signalling the adrenal glands. The adrenal glands produce cortisol, and one of cortisol’s main jobs is regulating blood sugar levels. (3)

If sugar levels are too low, you’ll likely feel hungry. If the levels are too high, the hypothalamus will instruct you to stop eating. This proper function happens when your body’s blood sugars are balanced.

High blood sugar/diabetes can prevent your hypothalamus from properly sensing glucose levels. This malfunction can become a key driver in developing adrenal fatigue. (4)

The HPA axis also plays a pivotal role in managing energy balance, food selection, and feeling full after eating (satiety). In fact, new research suggests that HPA axis dysfunction could be a potential cause of obesity. (5), (6)

How does blood sugar become imbalanced?

In today’s world, we have infinite access to comfort foods – foods high in fat, sugar, and salt. Think how comforting a bag of your favourite potato chips or a container of ice cream can be!

In periods of high stress, we are drawn to comfort foods. This is because eating comfort food lowers stress hormone levels within the brain (7) which leads to an overall feeling of less stress.

Here’s the scenario:
You are going through a period of high stress. Every night all you want to do is curl up in front of the tv with your favourite high-calorie comfort foods.

Little do you know that this is because your body has elevated stress hormones – you just know it makes the stress seem more manageable. That’s because the easiest way to re-balance these hormones is through comfort foods.

Now, if you continue to regularly eat highly processed comfort foods it is very likely that you will become overweight. Should it continue even longer, you may become obese.

In a sense, we create a perpetuating loop of stress. Initially, we trade a lowering of stress hormones for the extra calories found in comfort foods and in the short term, this works. But eating so many more calories over the long term results in weight gain. This extra weight often leads to blood sugar imbalances which is a stress on our system. Eventually, adrenal fatigue develops.

So far, I’ve only talked about the connection between dysglycemia and adrenal fatigue. However, this isn’t a one-way street. Adrenal fatigue can also cause blood sugar imbalances.

With adrenal fatigue, cortisol levels are often too low to regulate blood sugar levels. Low blood sugar levels can result in obesity and other metabolic illnesses like diabetes. (8)

How do you know if you have glycemic dysregulation?

It can be challenging to diagnose yourself with hyperglycemia or hypoglycemia without proper testing. Some of the more general symptoms associated with hypoglycemia are (9):

• Sweating
• Nervousness
• Weakness
• Shaking
• Extreme hunger
• Nausea
• Dizziness
• Headache
• Anxiety

Some of the general symptoms associated with high blood sugar are (10):

• Increased thirst
• Headaches
• Trouble concentrating
• Frequent urination
• Blurred vision
• Fatigue

These symptoms can be challenging to recognize in ourselves, however, there are laboratory tests your doctor can run. These include (11):

• Hemoglobin A1C
• Oral glucose tolerance test

Additionally, you can purchase a glucometer from your local pharmacy and track your own blood sugar. I recommend the following testing schedule:

• Fasting – take this reading first thing in the morning; before any food is ingested
• Right before eating lunch
• One hour after eating lunch
• One hour after the above reading (two hours after eating lunch)

Follow this schedule for three days. The data you collect should give you an idea of what your blood sugar levels look like.

For your reference, these are the ranges where your blood sugar readings should fall into (12),(13):

• Fasting: less than 5.6 mmol/L
• One hour after a meal: less than 7.8 mmol/L
• Two hours after a meal: less than 6.6 mmol/L

How do you treat dysglycemic and adrenal fatigue?

Treatment is not always as intuitive as you may think. For example, if you are overweight or obese, logic would say that losing weight would be the best plan. While this is a good idea, the way it’s done is equally important.

Aggressive weight-loss plans are massive stress to our system. In a body that is already suffering from adrenal fatigue, rapid weight-loss strategies will only add to the level of stress and further deplete the body’s metabolic reserve. This is why weight loss needs to occur gently, at a moderate pace, without extreme calorie deprivation. (14)

Strategies to treat dysglycemia

Here are some useful lifestyle strategies you can implement to better regulate blood sugar.

1. The glycemic index of foods (GI index)
   • This “diet” was popular during the Atkins and South Beach fads.
   • The GI index indicates how easily a food is broken down into a simple sugar – more specifically, how much of an effect the food will have on your blood sugar. The higher the number, the more of an effect it will have.
   • For those with both high and low blood sugar readings, limiting the number of high GI foods will better regulate blood sugar.

2. Eat soluble fiber
   • Researchers at Lund University in Sweden found that eating soluble or fermentable fibers for breakfast (think oatmeal) decreases the glycemic impact of all other meals that day. (15)
   • Try to include one serving of soluble fiber in every breakfast. Examples include:
     • • Fruits – citrus fruits, apples, strawberries
     • Vegetables – sweet potatoes, avocado, brussels sprouts, broccoli
     • Legumes – peas, black beans, lima beans

3. Follow a Mediterranean or low-carbohydrate diet
   • A two-year-long study done by the New England Journal of Medicine found that the Mediterranean-style and low-carbohydrate diet improved glycemic control. (16)
4. Remove refined carbohydrates from your diet
   • Especially soft drinks and sweetened beverages (including fruit juices).

Following these tips is a great start to regulating blood sugar levels. In turn, this will reduce the stress on your HPA axis, getting your dysglycemia and adrenal fatigue under control.

Now, I want to hear from you.
What practices have you found to regulate your blood sugar?

Looking for more information about adrenal fatigue? Check out our other blog posts.