What Causes Adrenal Fatigue (Part II): Blood Sugar

This is the second article in an ongoing series. Make sure to check out the next articles when you’re finished with this one:

• What Causes Adrenal Fatigue? (Part I): An Introduction
• What Causes Adrenal Fatigue? (Part II): Blood Sugar
• What Causes Adrenal Fatigue? (Part III): Sleep
• What Causes Adrenal Fatigue? (Part IV):  Inflammation
• What Causes Adrenal Fatigue? (Part V): Stress
• What Causes Adrenal Fatigue? (Part IV): Treatment

The type of food you eat, the time at which you eat, and the quantity of food consumed, all have a drastic effect on adrenal fatigue – in a positive or negative way.

Often, these effects on blood sugar (glycemic regulation) occur silently. They operate below the surface without awareness. This is what makes glycemic dysregulation so dangerous: you could be heading towards adrenal fatigue without having any symptoms.

An example:
Imagine yourself to be a multi-millionaire, retired on a beach in Mexico in a perfect relationship with your husband. In a word, it’s stress-free. Yet, you could still be moving towards a diagnosis of adrenal fatigue (at a rapid rate) if your body is unable to regulate its blood sugar.

When we eat foods like carbohydrates, our body breaks these down into their original components – sugars. This sugar enters our bloodstream causing a rise in what is called blood sugar. Having excess sugar in your blood is dangerous, so our body comes equipped with a wonderful hormone called insulin. Insulin transports sugar from our blood (where it’s dangerous) to the inside of our cells. (1)

In the world of blood sugar regulation, there are two illnesses that you’re likely familiar with:

1. High blood sugar (or insulin resistance) also known as diabetes
2. Low blood sugar (medically known as hypoglycemia)
   • you may know this feeling as being hangry

Both high and low blood sugar cause a tremendous stress to our body. (2) In fact, this stress can be so significant that it can cause adrenal fatigue. Most alarmingly, it can occur with little-to-no symptoms until you’ve already developed adrenal fatigue.

How does glycemic dysregulation cause adrenal fatigue?

One of cortisol’s main functions is in relation to regulating blood sugar levels. It can be used for day-to-day needs or in times of high-stress situations that require excess fuel for your muscles (think running away from a bear). (3) 

Our brain runs on glucose (sugar), this is its fuel of choice. To regulate sugar levels, your body comes equipped with a multitude of gauges that constantly measure sugar levels. In particular, the hypothalamus (a part of your brain at the base of your skull, often called the reptilian brain) is conditioned to be extremely sensitive to fluctuations in glucose levels. (4) 

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 is free from blood sugar imbalance.

High blood sugar and/or diabetes, for example, can impair your hypothalamus from sensing glucose levels. With your fuel gauge malfunctioning, this can become a key driver in developing adrenal fatigue. (5)

The HPA axis also plays a pivotal role in managing energy balance, food selection, and feeling full after eating (satiety). New research suggests that the HPA axis dysfunction could be a potential cause of obesity. (6), (7)

How does blood sugar become imbalanced?

In today’s world, we have infinite access to comfort foods. Comfort foods are defined as those foods high in fat, sugar, and/or salt. Think, a bag of your favorite potato chips or, a container of Ben and Jerry’s ice-cream.

In periods of high stress, we are drawn to comfort foods. The consumption of comfort foods lowers stress hormone levels within the brain. (8) Leading to a feeling of lowered stress.

Here’s the scenario:
You work a high-stress job. So, every day after work your body has elevated stress hormones. The easiest way to re-balance these hormones is through comfort foods. Therefore, each evening meal (and bedtime snack) consists of highly processed comfort foods. Should this type of meal plan exist for any extended period of time, it is very likely that you will become overweight. Should it continue even longer, obesity may develop.

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. In the short term, this works. But long-term consumption of excess calories results in weight gain. Excess weight often leads to blood sugar imbalances which then creates another stress to our system. Eventually, adrenal fatigue develops.

So far, I’ve illustrated only how blood sugar imbalances can cause adrenal fatigue. This mechanism is not a one-way street. Instead, it is bi-directional, meaning that adrenal fatigue can also cause blood sugar imbalances.

When one has adrenal fatigue, low levels of cortisol are often insufficient to regulate blood sugar levels. This results in higher chances of obesity and other metabolic illnesses like diabetes. (9)

How do you know if you have glycemic dysregulation?

It can be challenging to diagnose yourself with high or low blood sugar without having proper testing. Some of the more general symptoms associated with low blood sugar are (10):

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

Some of the general symptoms associated with high blood sugar are (11):

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

While the above symptoms can be challenging to recognize in ourselves, there are laboratory tests your doctor can run. These include (12):

• Hemoglobin A1C
• Oral glucose tolerance test

Additionally, you can purchase a glucometer from your local pharmacy and track your own blood sugar. I’d 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 the above schedule for a period of three days. Afterward, the data you collect should give you a comfortable outline of what your blood sugar levels look like.

For your reference, the below ranges are where you would like your blood sugar readings to fall into (13),(14):

• 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 glycemic dysregulation?

Treatment is not always as intuitive as you may think. For example, if you are overweight or obese, logic would assume that losing weight would be the optimal plan to help re-balance your HPA axis. While this can be a great strategy, the way in which it is done is of paramount importance.

Aggressive weight-loss plans are massive stressors 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. This will further deplete the body’s metabolic reserve. Weight-loss needs to occur gently, at a moderate pace, without extreme calorie deprivation. (15)

Below 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.
   • For those with both high and low blood sugar readings, limiting the number of high GI foods will better regulate blood sugar.

2. Consumption of soluble fiber
   • Researchers at Lund University in Sweden found that those eating soluble or fermentable fibers for breakfast (think sweet potatoes) decreased the glycemic impact of all other meals that day. (16)
   • Try to include one serving of soluble fiber in every breakfast. Examples include:
     • Fruits
     • Vegetables
     • Legumes

3. Utilize 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. (17)
4. Remove refined carbohydrates from your diet
   • Especially, soft drinks and sweetened beverages (including fruit juices).
5. Eat breakfast
   • This initial meal helps to regulate your blood sugar for the entire day.

Following the above tips is a great start to regulating blood sugar levels. In turn, this will reduce the stress on your HPA axis.

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.

Also published on Medium.