If you’ve been pursuing an aesthetic physique for any measure of time you’ve likely heard how important it is to dial in your training and diet. Although these are critical aspects, one topic that doesn’t receive the attention it deserves is proper recovery—specifically when it comes to sleep.

Most people can appreciate the importance of sleep on a superficial level but often aren’t aware of just how detrimental sleep deprivation (SD) can be on body composition. A 2010 study entitled “Insufficient Sleep Undermines Dietary Efforts to Reduce Adiposity” came to some pretty startling conclusions that may have significant implications on aspiring bodybuilders and physique athletes. The intervention had two groups, both of which maintained equated caloric restrictions. One group had 8.5 hours of bed rest and the other was restricted to 5.5 hours. The length of the intervention spanned fourteen days.

The researchers found that although the total weight loss was virtually identical between both groups the sleep restricted group lost 60% more lean mass than the other control group. Sleep restriction “decreased the fraction of weight lost as fat by 55%”.¹ This is a massive difference in body composition outcomes.

The design of the study was well constructed, however, there was no resistance training protocol which is worth mentioning. It’s likely that if both groups were engaged in a resistance training program during this intervention the total amount of lean mass lost would be reduced. But in my estimation, the results would still favor the longer bed rest group.

So why was there such a dramatic difference in body composition between groups? What are the actual mechanisms involved and were there any indirect factors associated with each outcome? Let’s explore this in more depth to gain a better understanding of the implications of sleep deprivation on body composition and the measures you can take to prevent its occurrence.

1. Neuroendocrine Response and Hunger Signaling

Your neuroendocrine systems play a major role in regulating your physiological and/or behavioral state.²

Sleep deprivation triggers a response from your neuroendocrine system that results in a cascade of biochemical reactions which increase hunger signaling, specifically for high sugar, high-fat foods.³

During sleep deprivation, your subjective feelings of fatigue increase, as a response appetite can increase to provide more energy for your body to function. If you are dieting and trying to maintain a caloric deficit this response presents a significant obstruction to dietary adherence.

2. Muscle Catabolism

Sleep deprivation also has very powerful catabolic effects (tissue breakdown). One of the adaptive responses to sleep deprivation is reduced resting metabolic rate (RMR) along with increased ghrelin concentrations which promote fat retention. In this physiological state muscle catabolism becomes a significant risk if you are in a caloric deficit.¹

In the above intervention, the sleep deprivation group lost substantially more lean tissue. We know that fat mass has a higher energy density than lean mass, so the fact that the total weight loss across both control groups was virtually identical suggests that the longer bed rest group maintained a higher RMR.

3. Increased Ghrelin and Fat Retention

Increased ghrelin concentrations are one of the neuroendocrine responses to sleep deprivation. As mentioned above, ghrelin can increase hunger signaling, but it can also increase fat retention. If in a caloric deficit there is an increased risk of changes in body composition that preference retention of adiposity over lean mass.⁴

4. Decreased Resting Metabolic Rate

RMR is your body’s daily energy requirement at complete rest. Total daily energy expenditure (TDEE) is your RMR plus any additional energy expenditure that occurs throughout the day (ie. walking, sitting, working, exercising, eating, etc).

Sleep deprivation acutely decreases RMR⁵ and often negatively impacts TDEE because of an increase in subjective ratings of fatigue that may result in decreased desire to be physically active.

5. Decreased Performance and Increased Risk of Injury

Although performance isn’t a metric bodybuilders are judged on in competition, certain performance metrics are directly linked to hypertrophy. Sleep deprivation has been shown to impede several performance metrics along with varying timelines.

The first performance outcomes that seem to be impacted are explosive power, speed, response time, and coordination.⁶

This is significant because if response time and motor control are impeded during strenuous physical training it can increase the risk of injury. Strength qualities seem to be retained for longer but eventually the same drop off in performance is observed.

6. Decrease In Mood and Motivation to Train

Interestingly, sleep deprivation states can result in decreased performance especially at submaximal loads due to its negative impact on mood ^{7, 8} which may decrease intrinsic motivation to train.

This is especially applicable to bodybuilders because the majority of hypertrophy training typically occurs between the 60-80% 1RM range.

Preventative Measures to Minimize Sleep Deprivation

Now that we’ve established just how impactful sleep deprivation can be on body composition, it’s time to look at potential preventative measures you can implement to minimize the above risks.

1. Ensure you’re sleeping eight hours every night. More is often better and there doesn’t appear to be any downsides to sleep extension, however significant benefits to performance and cognitive ability have been reported in the literature.⁹
2. If sleeping for eight hours daily is not feasible due to individual circumstances, planning routine naps into your day does a good job of minimizing the risk of SD.¹⁰
3. Maintain a consistent sleep schedule when possible. Some people are early risers and others function better at night. Regardless of where you fall on the spectrum, continuity is a great teaching tool for your body and can help regulate predictable sleep patterns. Research on irregular sleep times also finds a strong correlation to increased SD when compared to a congruent sleep schedule.¹¹
4. If stress is a potential obstruction to sleep length or congruency developing a plan to reduce stress can have a significant impact. If you are prone to anxiety and stress, reducing intake of stimulants (ie. caffeine, pre-workouts, etc.) may reduce sympathetic activity and diminish subjective feelings of stress and anxiety.¹²

By implementing the above strategies you can be fairly certain that you’ll minimize any potential risk for SD and its negative impact on body composition.

Good luck and lift big!

References:

1. Nedeltcheva, Arlet V., et al. “Insufficient Sleep Undermines Dietary Efforts to Reduce Adiposity.” Annals of Internal Medicine, vol. 153, no. 7, May 2010, p. 435., doi:10.7326/0003-4819-153-7-201010050-00006.

2. Levine, Jon E. “An Introduction to Neuroendocrine Systems.” Handbook of Neuroendocrinology, 2012, pp. 3–19., doi:10.1016/b978-0-12-375097-6.10001-0.

3. Spiegel, Karine, et al. “Brief Communication: Sleep Curtailment in Healthy Young Men Is Associated with Decreased Leptin Levels, Elevated Ghrelin Levels, and Increased Hunger and Appetite.” Annals of Internal Medicine, vol. 141, no. 11, July 2004, p. 846., doi:10.7326/0003-4819-141-11-200412070-00008.

4. Scrimshaw, N. S., et al. “Effects of Sleep Deprivation and Reversal of Diurnal Activity on Protein Metabolism of Young Men.” The American Journal of Clinical Nutrition, vol. 19, no. 5, Jan. 1966, pp. 313–319., doi:10.1093/ajcn/19.5.313.

5. Spaeth, Andrea M., et al. “Resting Metabolic Rate Varies by Race and by Sleep Duration.” Obesity, vol. 23, no. 12, May 2015, pp. 2349–2356., doi:10.1002/oby.21198.

6. Mah, Cheri D., et al. “Sleep Restriction Impairs Maximal Jump Performance and Joint Coordination in Elite Athletes.” Journal of Sports Sciences, vol. 37, no. 17, 2019, pp. 1981–1988., doi:10.1080/02640414.2019.1612504.

7. Reilly, Thomas, and Mark Piercy. “The Effect of Partial Sleep Deprivation on Weight-Lifting Performance.” Ergonomics, vol. 37, no. 1, 1994, pp. 107–115., doi:10.1080/00140139408963628.

8. Pilcher, June J., and Allen I. Huffcutt. “Effects of Sleep Deprivation on Performance: A Meta-Analysis.” Sleep, vol. 19, no. 4, 1996, pp. 318–326., doi:10.1093/sleep/19.4.318.

9. Mah, Cheri D., et al. “The Effects of Sleep Extension on the Athletic Performance of Collegiate Basketball Players.” Sleep, vol. 34, no. 7, 2011, pp. 943–950., doi:10.5665/sleep.1132.

10. Haslam, Diana R. “Sleep Deprivation and Naps.” Behavior Research Methods, Instruments, & Computers, vol. 17, no. 1, 1985, pp. 46–54., doi:10.3758/bf03200896.

11. Kang, Jiunn-Horng, and Shih-Ching Chen. “Effects of an Irregular Bedtime Schedule on Sleep Quality, Daytime Sleepiness, and Fatigue among University Students in Taiwan.” BMC Public Health, vol. 9, no. 1, 2009, doi:10.1186/1471-2458-9-248.

12. Sawyer, Deborah A., et al. “Caffeine and Human Behavior: Arousal, Anxiety, and Performance Effects.” Journal of Behavioral Medicine, vol. 5, no. 4, 1982, pp. 415–439., doi:10.1007/bf00845371.

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Adrenal Fatigue 101

Also known as “chronic stress,” Dr. James Wilson defines adrenal fatigue as “a collection of signs and symptoms, known as a syndrome, that results when the adrenal glands function below the necessary level.” The adrenal glands are responsible for balancing and regulating hormones in your body – namely cortisol. Cortisol is a stress hormone that helps you deal with the “little fires” you experience any given day, including:

• The annoyance of sitting in traffic
• Minor injuries
• Frequent high intensity workouts with inadequate recovery
• Digesting processed food items and artificial ingredients
• Low water intake
• Eating on the go
• Frequent usage of NSAIDs
• Allergies and 24-hour bugs
• Work deadlines and demands
• Relationship spats
• Laundry lists of “to-dos”
• Anything else that threatens homeostasis

Hitting full-speed CrossFit metcons 6 days a week is a great way to break your body down. [Photo courtesy Cara Kobernik]

While stress is normal and a guarantee in life, when you experience constant stress over a prolonged period of time, your body can only take so much before breaking down. Try as your body may to fight, with little relief in sight, adrenal fatigue manifests in some of these common signs and symptoms:

• General fatigue and weakness, especially in the morning and afternoon
• Suppressed immunity
• Difficulty losing or gaining weight
• Increased allergies
• 3pm “crashes” and headaches
• Feeling wired and tired at night
• Loss of appetite
• Poor recovery between workouts or plateaus in progress
• Running on fumes every day
• Anxiety, stress, and depression
• Digestive distress
• Cravings for foods high in salt, sugar, or fat
• Hormonal imbalance
• Muscle and bone loss and muscular weakness
• Shortness of breath
• Chronic headaches
• Skin problems
• Autoimmune disorders
• Increased PMS or menopausal symptoms
• Low sex drive
• Lightheadedness when getting up from sitting or lying down
• Decreased ability to handle stress
• Trouble waking up in the morning (despite a full night’s sleep)
• Dizziness

Steps to Healing

If you think you might be suffering from adrenal fatigue, do the following:

Don’t self-diagnose. Know the signs and symptoms of adrenal fatigue so you can find professional help. Schedule an appointment with a knowledgeable practitioner who can run appropriate tests. Thanks to technology and the way many practitioners work, this can be accomplished remotely if you can’t find a practitioner in your area.

Change your lifestyle. Sometimes the simplest lifestyle shifts can make a big difference:

• Get a little more consistent sleep
• Up water intake. Drink at least half your bodyweight (measured in pounds) in ounces per day.
• Remove processed diet and sports supplement foods, and replace them with whole foods.
• Add an extra rest (or active rest) day during the week.
• Vary your workout intensity levels, and focus more on body-building style strength rather than pushing hard with WODs and heavy weights
• “Candle down” before bed. Shut off screens. Read a book. Dim the lights. Take a warm shower.
• Find encouragement and support to ‘not sweat the small stuff.’

Take a probiotic or eat probiotic foods 1-2 times per day. A healthy gut contributes to healthier hormonal balance.

Sprinkle, sprinkle. A pinch of sea salt in water is a great energy booster and adrenal balancer, as sodium and potassium levels tend to be off in adrenal fatigue.

Use safe supplements. Consult with a knowledgeable practitioner before using “over-the-counter” adrenal supplements. However, two great arsenals for feeling better include essential oils (especially lavender) and AdrenaCalm, a topical cream by APEX Energetics created to soothe and support crazy adrenals.

Read up. I recommend the book Adrenal Fatigue: The 21st Century Stress Syndrome by Dr. James Wilson, as well as his website. Dr. Michael Lam also has a website with a wealth of information.

Combat Fatigue With Knowledge

If you experience constant fatigue or a plateau in your training, you might find yourself saying things like, “If I just dial in my diet some more,” or “If I just add in a little cardio…” But what you really need is rest, permission to de-stress, a careful look at your nutrition, and education.

The majority of us will experience adrenal fatigue at some point in our lives. Knowledge is power, so take steps today to prevent problems in the future. 

Just what is stress doing to your training, anyway?

Lower Stress to Increase Fitness

The post Adrenal Fatigue and the Athlete appeared first on Breaking Muscle.

After all, if you don’t know what’s going on inside your body, then how do you know you’re not one of those people who are healthy on the outside, but unhealthy on the inside? And if you struggle with anything like brain fog, constipation, bloating, low libido, poor sleep, or slow workout recovery, then you probably fall into the category of people who need to test their body.

As a matter of fact, even if you’re exercising hard and eating healthy, it turns out that what’s actually going on inside your body can be quite disturbing, and include:

• Low testosterone and high cortisol, manifesting in overtraining symptoms, low libido, lack of motivation, and loss of competitive drive.
• Low luteinizing hormone, high estrogens, and low progesterone, manifesting in brain fog, appetite cravings, and a seeming inability to shed fat despite lots of training.
• High thyroid-stimulating hormone and low thyroid hormones, resulting in a constant feeling of being cold, sluggish metabolism, and impaired digestive function, gas, and bloating.
• Low magnesium and electrolyte levels, which can cause trouble getting to sleep at night, waking up multiple times during the night, or being tired during the day.
• High inflammation markers, resulting in sore joints, nagging injuries that won’t go away, missing workouts from sickness or having sniffles all the time, and occasional ghost symptoms, like random headaches, heart flutters, or muscle tingling and numbness.

The Wide World of Testing

It can be confusing to navigate through the world of testing. There are certainly quick and convenient testing services such as WellnessFX and DirectLabs, which have bundled testing packages and allow you to purchase a test online, print a piece of paper called a requisition form, then bring it to a lab near your house for a quick and easy blood draw. But many people have physicians who can run these tests (allowing for insurance coverage), so I’m still often asked what the best parameters to test are if you want to get the most bang for your buck and find out exactly what’s going on inside your body.

So which blood values should you test if you’re concerned about issues like this or want a full, informed glance about what’s going on inside your body and what’s in your blood?

Without further ado, here are the top ten ways to test your body:

1. HDL:Triglyceride Ratio

While there are a host of things you can test on a cholesterol panel, such as LDL, total cholesterol, HDL, VLDL, etc., one of the most important parameters to pay attention to is your ratio of HDL to triglycerides. In people who are consuming low fiber diets high in vegetable oils and processed ingredients (a stereotypical “gym junkie” diet), I tend to see sky-high triglyceride and low HDL.

Your goal should be to get HDL higher than triglycerides, and preferably a 1:1 ratio or better of HDL:triglycerides.

2. HS-CRP

C-reactive protein is a marker of full-body inflammation. Inadequate recovery or overtraining, high intake of inflammatory foods like sugar and commercial meat or dairy, and high stress levels can all elevate HS-CRP.

I recommend that for athletes looking for ideal levels of anti-inflammation, HS-CRP be consistently below 0.5.

3. Free Testosterone

For both men and women, testosterone is an anabolic, growth-promoting hormone associated with everything from fat loss to muscle gain to libido to heart health to anti-aging. But often, even if total testosterone is elevated, free testosterone is low. This is usually because total testosterone is bound to sex hormone binding globulin (SHBG). This typically happens due to excessive stress or inadequate calorie intake. A good way to do detective work on whether this is occurring is a free testosterone measurement.

Use this chart to look at the age group references for free testosterone and shoot for the top percentage for your age group.

4. TSH

Thyroid-stimulating hormone is made by a small gland in your brain called the pituitary and triggers your thyroid gland in your neck to produce thyroid hormones (triiodothyronine (T3) and thyroxine (T4)), which are crucial for your body’s use of energy.

In athletes and active individuals, high TSH is usually due to three factors:

1. High cortisol levels causing cell thyroid receptors to be insensitive.
2. Small intestinal bacterial overgrowth from gut dysbiosis, usually due to excessive carbohydrate intake, psychological stress, or both.
3. Excessive caloric or carbohydrate restriction.

When you test TSH, look for ideal values to be between 0.5-2.0.

5. IGF-1

You’re probably familiar with growth hormone (GH) as a potent anti-aging and anabolic, muscle-building hormone. IGF-1, or insulin-like growth factor-1, is stimulated by GH and is an easier way to measure GH activity than to measure GH directly, which is a more difficult and inaccurate lab test. Both these hormones are the main hormones responsible for cellular and muscle growth, and both support anabolic pathways that lead to enhanced repair and recovery, so if IGF-1 is suppressed, then recovery is compromised.

Low IGF-1, specifically anything below about 115 ng/mL, is usually a result of lifestyle stress, exercise stress, and calorie restriction or nutrient depletion.

6. Vitamin D

25-hydroxy vitamin D is a blood measurement that allows you to see if your levels of this potent steroid and hormone precursor are adequate. Most athletes and exercisers tend to be deficient in this anabolic, fat-soluble vitamin, and often, low vitamin D correlates to low testosterone and high cortisol.

I generally recommend looking for levels between 40 and 80 ng/mL – and if you test low, don’t necessarily go out and mega-dose. Instead, get natural sources of fat-soluble vitamin D, such as wild caught fish, whole eggs, and liver.

7. Glucose

Just because you fall into the acceptable reference range for fasting glucose doesn’t mean you’re safe. For example, a doctor may look at a fasting glucose of 95 mg/dL and say you have no risk. But that amount of glucose in the bloodstream can cause over secretion of insulin that adversely impacts your cells, your recovery, and your waistline.

Fasting glucose levels should ideally be below 85 mg/dL in active individuals. If they’re not, you’re probably too stressed out (which mobilizes the liver’s storage carbohydrate) or you’re eating too much sugar.

8. Adrenal Stress Index (ASI)

An ASI looks at four different saliva samples at different points throughout the day, and helps to reveal the health of your adrenal glands. A basic ASI will measure two parameters:

Cortisol Levels: You’ll measure four different cortisol levels throughout the day to determine if you have a proper circadian pattern. Normally your cortisol levels should be at the highest levels in the morning and then decrease throughout the day. This pattern will help to give you the energy you need throughout the day, while the lower cortisol levels at night will allow you to rest and fall asleep.

If you’re overtrained, you usually have low cortisol levels in the morning, and they also tend to be lower than normal throughout the rest of the day. But as you’ve learned, it is common for the cortisol levels to be high in the initial stages of overreaching, as this is the body’s response to chronic stress. But over a period of time, the adrenal glands will weaken, which will eventually result in depressed morning cortisol levels.

DHEA: This is manufactured by your adrenal glands, and plays an important role in immunity and in the stress response. If you’re dealing with chronic stress on a regular basis, the chances are these hormone levels will also be low.

9. Heart Rate Variability (HRV)

HRV is an important marker of your nervous system health and recovery status. There are a variety of apps that measure HRV, and I personally use one called the SweetBeat.

HRV works this way: your parasympathetic nervous system (“rest-and-digest”) influences your heart rate via the release of a compound called acetylcholine by your vagus nerve, which can inhibit activation of your heart’s electrical activity and decrease heart rate variability. In contrast, your sympathetic nervous system (“fight-and-flight”) influences heart rate by release of epinephrine and norepinephrine, and generally increases electrical activity in the heart and increases heart rate variability. If you’re well rested, haven’t been training excessively, and aren’t in a state of overreaching, your parasympathetic nervous system interacts cooperatively with your sympathetic nervous system to produce responses in your heart rate variability to respiration, temperature, blood pressure, stress, etc.

As a result, you tend to have really nice, consistent and high HRV values, which are typically measured on a 0-100 scale. The higher the HRV, the better your score. But if you’re not well rested (overreached or under recovered), the normally healthy beat-to-beat variation in your heart rhythm begins to diminish.

While normal variability would indicate sympathetic and parasympathetic nervous system balance, and a proper regulation of your heartbeat by your nervous system, it can certainly be a serious issue if you see abnormal variability – such as consistently low HRV values (e.g. below 60) or HRV values that tend to jump around a lot from day-to-day (70 one day, 90 another day, 60 the next day, etc.).

10. Oxygen Saturation

Oxygen saturation (SPO2) is a measurement of how much oxygen your blood is carrying as a percentage of the maximum it could carry. Normal healthy oxygen saturation values are between 96% and 99% at sea level. Oxygen saturation below 95% may indicate lack of recovery, although it can also occasionally indicate anemia, especially when accompanied by chronic daily weakness, fatigue, and shortness of breath during exercise.

I generally look for values to consistently be above 96% in the athletes I work with.

How to Order Tests

Using online testing services, a full panel that includes the first seven tests above (along with a range of other tests such as red blood cells, white blood cells, kidney and liver markers, etc.) will typically cost $400-800, but in many cases, if you submit your receipt to your health insurance, they will cover part of the cost. You can also, of course, approach your physician to run these tests for you. The ASI, HRV, and SPO2 testing would be something extra, but these three are also important markers to track.

If you’re looking for a health expert to walk you through the entire testing process, but don’t know where to start, then I recommend finding a functional medicine or naturopathic practitioner in your area. Look for a physician who has worked with athletes or physically active populations and is willing to pay attention to parameters that affect not just health or risk of dying, but also performance and optimizing living.

Good website resources for this to start your search for a physician include:

• Health Profs
• Functional Medicine
• Naturopathic
• Primal Docs
• Paleo Physicians Network

Remember, even if you look great on the outside, it doesn’t mean you’re healthy on the inside. But you’re now equipped with everything you need to know to test your body in the best way possible, and truly find out what’s going on inside your body.

Now it’s time to start the detective work!

Photos 1,2,4, and 5 courtesy of Shutterstock.

Graphic by Mikael Häggström [Public domain], via Wikimedia Commons.

The post The Top Ten Ways to Test Your Body appeared first on Breaking Muscle.

Take your time to read over these seven articles about how what adrenal fatigue looks like, and explore the array of solutions and strategies discussed for getting yourself or your clients back on track.

Are You Suffering From Adrenal Fatigue? (Lindsey Mathews)

Do you feel like you’re in a haze? Like you’ve been working hard through a challenge or crisis and aren’t back to full energy? It’s possible you’ve overworked your adrenal glands.

Find Your Off Button: How to Use Yoga for Better Rest and Recovery (Bethany Eanes)

Our bodies evolved to make us stronger and less vulnerable during times of danger. As athletes, we pump this system daily. The downside? Our bodies are not so good at turning off this system.

Join Me on My Journey to Heal My Adrenal System (Vanessa Bennington)

My adrenal system is all jacked up. There, I said it. I’m going to document my tests and the various healing modalities I try out, so you can learn alongside me how to get healthy.

Healing the Adrenal System: The Effectiveness of Massage Therapy (Vanessa Bennington)

Studies have shown massage can lower cortisol levels and increase dopamine and serotonin. In my own quest to heal my adrenal system, I decided to sit down and talk with a massage therapist.

How Meditation Can Heal Your Adrenal System (Vanessa Bennington)

There are tons of studies examining the benefits of meditation on adrenal hormones, blood pressure, heart rate, and mood. Here’s some science and some types of meditation to try.

The post 7 Approaches to Fixing Your Adrenal System appeared first on Breaking Muscle.

There are a ton of adrenal supplements out there. You can get everything from desiccated bovine adrenal gland to blends of exotic herbs you probably never heard of before. Most people get overwhelmed with the number of supplements that are marketed for adrenal health, and depending on the person, quite a few of these supplements might actually make some symptoms worse. So, my focus today will be on the top three supplements that can help nearly everyone, including myself, heal or maintain their adrenal health.

Why three? Because more than that and I start forgetting the names and why I’m taking them. I think most of you would agree that when your supplement regimen starts to become too complicated or expensive, you just don’t stick with it. So, in an effort to simplify things I found what I consider the top three that should be in most people’s medicine cabinet.

#1. Magnesium

Oh, I know, I know. That’s boring right? Well, wait until you hear about all the wonderful things magnesium can do for your adrenal glands. First, it’s been shown that magnesium deficiency increases anxiety and depression. Basically, when you are magnesium deficient the set point at which your adrenals kick in and start producing the fight-or flight hormones is lower. So, even relatively minor things can set you off causing cortisol, epinephrine, and norepinephrine to soar.

It’s also believed that stress can cause you to lose more magnesium through the urine than is normal. So it can become a compounding problem. You get stressed out, lose magnesium, then you are even more at risk to overreact, trigger the stress response again, and lose even more magnesium.

When magnesium levels are low, every cell becomes hyper-excitable. Magnesium and calcium work together to regulate electrical impulses within cells. Calcium enters the cells, triggering an electrical impulse, and is then escorted out of the cell by magnesium. However, when magnesium levels are too low, calcium enters the cell and hangs out for a while causing cellular dysfunction, hyper-excitability, and prolonged contraction of muscles. Have you ever gotten a muscle twitch and wondered what in the heck was going on? Or maybe you’ve gotten in bed at night only to feel your heart pounding inappropriately? You are probably stressed, not sleeping, and deficient in magnesium.

The recommended dosing for magnesium is said to be about 3-10 mg per pound of body weight. However, this is going to vary greatly depending on each individual’s needs. The rule of thumb is to increase your dose slowly and back off once you start experiencing loose stools. Also, look for magnesium citrate or magnesium malate, especially in powder form, as they are better absorbed by the body.

#2. Vitamin C

Yep, another boring one. Oh, but it’s not. Vitamin C is not only good for preventing the common cold, but it can also help your adrenal glands function normally. Vitamin C is, in fact, absolutely essential for adrenal function. It’s required for catecholamine synthesis – for example, the creation of norepinephrine, epinephrine, and dopamine – and the synthesis of testosterone, cortisol, and aldosterone.

Even if you’re like me and you make too much epi and norepi, you can still use the vitamin C, as it seems to also function to regulate those chemical levels when stress rises. Studies have shown that vitamin C helps to lower the amount of cortisol, norepi, and epinephrine produced in response to physical stress when taken in adequate amounts (around 1500 mg/day).

Vitamin C is also a potent antioxidant that helps protect the body (and adrenals) from DNA mutations. Not a bad thing. When looking for a vitamin C supplement look for the “buffered” version to avoid GI upset and increase your dose until you notice loose stools. Yeah, I know, the old “loose stools” dosing system again.

#3. Ashwaghanda

This herb is what is known as an adaptogen. It does what its name alludes to – it helps your body adapt. Ashwaghanda is especially good at helping the adrenals adjust to stress. To put it in the most basic terms: It helps you to produce stress hormones when you need them and stop producing them when you don’t.

Studies have shown that supplementation with ashwaghanda decreases anxiety, improves immune function, and improves sleep. It also functions as an antioxidant. Many people report a calming effect when they take ashwagandha, but even if you feel you have adrenal fatigue and are tired and dragging most of the time, this herb can help you as well due to its adoptogenic properties. It will help you to produce more epi, norepi, and cortisol if that’s what you need.

While there are many other adaptogenic herbs out there, Ashwaghanda has the most research behind it and the least number of potential side effects. The recommended dose is around 500mg per day. No loose stool with this one.

So, there it is. The most basic list of adrenal supplements you’ve probably ever seen. These three heavy hitters will help people who don’t like taking a ton of pills protect and/or heal their adrenals and feel their very best. I just checked my supplement cabinet and noted that I need to pick up some magnesium and start taking the vitamin C packets I’ve had in their for a while. Time to heal the adrenals!

References:

1. David C. Nieman, Edith M. Peters, Dru A. Henson, Elena I. Nevines, and Milla M. Thompson, “Influence of Vitamin C Supplementation on Cytokine Changes Following an Ultramarathon.” Journal of Interferon & Cytokine Research. no. 11 (2000): 1029-1035. (accessed May 30, 2013).

2. Dean M.D., N.D., Carolyn. The Magnesium Miracle. Ballantine Books, 2007.

3. S. B. Sartori, N. Whittle, A. Hetzenauer, N. Singewald, “Magnesium deficiency induces anxiety and HPA axis dysregulation: Modulation by therapeutic drug treatment.” Neuropharmacolog. no. 1 (2012): 304-312. (accessed May 30, 2013).

Photos 1&2 courtesy of Shutterstock.

Photo 3 via Wikimedia Commons.

The post The Top 3 Supplements for Improved Adrenal Health appeared first on Breaking Muscle.

I want to stop before I completely break. I think I’m just bent at this point. So, I decided to finally take action and look into some alternative and natural therapies to deal with lowering stress and regulating the adrenal system. Last week we looked at acupuncture and how it can help the adrenal system return to a normal state of function. This week, I explored how massage therapy can help to lower hormones like epinephrine and norepinephrine and regulate cortisol in the hopes that I can eventually become a very calm, Zen-like being. Cross your fingers, guys!

As I began researching massage therapy, I started to wonder why I hadn’t considered it before. There is a wealth of information on massage therapy and how it can positively impact depression and anxiety, as well as help those dealing with eating disorders and myriad other illnesses. Multiple studies have shown that massage therapy can lower cortisol levels, increase dopamine and serotonin (our happy, feel-good hormones), and lower excitatory hormones like norepinephrine and epinephrine.

If you have too much norepinephrine or epinephrine it can lead to feelings of anxiety. Too little dopamine and serotonin can cause depression and other psychological problems. If massage fixes these, it seems like a no-brainer, right? I guess I always considered it one of those things you did if you had lots of extra time and money and wanted to relax a little. I likened massage to taking a long hot bath, with candles and rose petals and Enya playing in the background. Not for me. I’d get bored in about five minutes and start frantically thinking about all the things I could be doing if I weren’t sitting in this silly tub or getting a massage. Yes. I am that bad. Picture a squirrel on meth. That’s me on a bad day.

In order to get a better understanding of how massage could help me and others to heal our adrenal systems, I decided to find an expert on the topic. Melissa Finley, LMT, owner of Mending Hands Massage Therapy in Sarasota, Florida, has over 2,300 hours of training and advanced certifications in prenatal, postnatal, and fertility massage. Originally, Melissa started Mending Hands in New York City and became one of the top-rated private practices in Brooklyn. In her “About Melissa” section on her website she states she thinks “napping is important.” Obviously, I could learn a thing or two from this chick!

I asked Melissa how massage can benefit those, like me, who really need to work on anxiety and regulating neurotransmitter and cortisol production. Melissa explained:

Your body can move between two main states of being – the sympathetic state and a parasympathetic state. The sympathetic mode is what we think of as fight-or-flight mode. It’s when the body triggers the autonomic nervous system’s stress hormones and ups our adrenal response. Most of us are in some level of sympathetic state just dealing with day-to-day stresses. Massage has been shown to help the body shift into a parasympathetic state. By supporting real stress relief, massage can set the body into a “rest and digest mode.” What’s awesome is even a relaxation massage has the opportunity to chemically support a healthier state of being.

And yes, multiple studies have shown that regular massage definitely decreases those hormones that cause anxiety and raise calming, happy hormones and keep cortisol lower.

Now, if you’re like me you might be wondering how often you need to get massaged to notice an improvement. I, of course, am thinking I want to know the minimum effective dose so I can, you know, pack the most I can into my schedule. Oh, boy. I still have lots to learn.

Melissa believes that the time and sessions required to notice a difference in mood and adrenals is specific to each individual. She said:

Some people find amazing benefits during the first session, others take more time to settle in and fully receive the treatment. One of the other aspects of massage that can prove to be helpful, is that the more massage your receive, the more you gain from it’s benefits. Kind of like the way you work up the endurance to run a marathon, the more your body receives massage, the deeper and more effective massage becomes.

So, like most things in the health and fitness world, the more consistent you are the greater your outcomes. 

Of course, just like trainers and coaches and workout programs, there are many different massage therapists and types of massage out there and I figured that finding the right person and the right kind of massage to tackle adrenal issues would be important to maximize outcomes. Melissa believes taking the time to research massage therapists in your area who have experience working with adrenal issues is a great way to start. Once you think you’ve found a good fit, she believes it would be best to “start by getting a few sessions with a therapist who is willing to work slow and connected. It’s a great way to build trust and expectation between client and practitioner, as to cut down the possible anxiety of a new treatment. Once trust is established, Swedish, Shiatsu and even deep tissue can help with both the physical stress and psychological anxiety.”

Melissa also suggests being very open and honest with your massage therapist about what results you are looking for from the treatment. She advises asking lots of questions and finding a good listener. So, you should research and find a reputable, experienced therapist then commit to a regular routine until you find your individual dose.

Massage therapy, as we’ve discussed, can be an effective treatment for anxiety and adrenal issues if the right provider, frequency, and plan is implemented. Plus, there are no negative side effects. That’s something we certainly can’t say about most of the drugs and traditional therapies used to treat mood disorders. Like Melissa told me, “It’s a proven therapy to help with stress on both the physical and psychological levels. Plus, one should never underestimate the power of taking even an hour for yourself to breath, rest, and receive therapeutic attention.”

Most of us, especially me, should take that statement to heart. Slowing down and taking the time to do something that nurtures our bodies in a more gentle way is something we need to do even if it feels like “wasting time” initially. Eventually, I hope more people view massage as an essential part of physical and psychological health maintenance rather than a luxury to be indulged in when we have the time.

References:

1. Field T, Hernandez-Reif M, Diego M, Schanberg S, Kuhn C., Cortisol decreases and serotonin and dopamine increase following massage therapy. Touch Research Institutes, University of Miami School of Medicine, Miami, Florida , 2005.

2. Field T, Schanberg S, Kuhn C, Field T, Fierro K, Henteleff T, Mueller C, Yando R, Shaw S, Burman I., Bulimic adolescents benefit from massage therapy. Touch Research Institutes, University of Miami School of Medicine, Miami, Florida , 1998.

Photos courtesy of Shutterstock.

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Most health care providers will do one of the following:

1. Hand you a prescription for an antidepressant or something like Xanax.
2. Send you to psychologist.
3. Tell you to take a vacation or just wait a few weeks and things “should” get better.

We all know these “solutions” aren’t really much help at all. Antidepressants and drugs like Xanax or Ativan just mask the problem and usually cause additional issues to crop up. If you weren’t already gaining weight, suffering from low libido, or addicted to medication, you probably will be soon. Of course, some people do need these medications from time to time, but in most cases there is a better solution. As for seeing a psychologist, the counseling is without question beneficial, but the medications are the same as the ones your primary care provider might prescribe. And waiting for your anxiety and stress to “go away” or taking a week long vacation just to come back to the same routine will not fix your problems. In fact, you’ll probably just waste money going on a vacation you can’t enjoy because you’re a ball of nerves the whole time (and we all know how great creating a worse financial situation is for stress and anxiety).

So, what are you supposed to do? I’ve asked myself the same thing over the years and I’ve come to a broad and deep conclusion. Finding a treatment plan that works to restore balance to the adrenal system, neurotransmitter levels, and mental health requires some in-depth considerations. It has to be multi-faceted, individually tailored, and must be consistently adhered to for quite a long time. You can’t fix this stuff over night, folks.

In fact, I still haven’t “fixed” my stress and adrenal issues because I’m the worst patient ever. I don’t follow instructions very well. I am incredibly hard headed and set in my ways. I believe this is probably half the reason my system is so jacked up. So, over the next few months I am going to implement several different therapies, document my findings, and compare my results. The therapies I plan to explore include massage, yoga, acupuncture, and herbal treatments and remedies, as well as meditation and positive self-talk. Yes, I am going full-on hippie mode. Can you dig it?

Let me give you some baseline information about me. (Isn’t this fun? I’m just offering up my personal medical file for you to read. I hope I don’t regret this later.) I have had my cortisol levels and neurotransmitters checked in the past. My cortisol isn’t the worst I’ve ever seen but it certainly isn’t perfect. As I mentioned in previous articles, cortisol should peak in the morning then gradually fall over the course of the day. My levels are low to normal in the morning, low during midday, normal in the evening, then high at night. This indicates some adrenal dysfunction and some problems with producing the right amount of cortisol at the right time. I often feel a bit sluggish, but generally okay in the morning, then tired and dragging midday, okay in the evening, and then a little too wired at bed time. Not ideal.

I also examined my neurotransmitters. This is where it gets interesting. Things are a bit of a mess. I basically over produce everything. Leading the pack is epinephrine. My level is off the charts high! Norepinephrine is also elevated but not as much. Dopamine, serotonin, glutamate, GABA, PEA, and histamine were also all elevated. All these levels were taken in the morning around 8:00am.

Now, if you know anything about or have done any research on neurotransmitters, you are aware that norepi and epi are excitatory neurotransmitters. Dopamine, serotonin, and GABA are inhibitory neurotransmitters. At first glance at my labs, one might think I’m fine. Everything is high, but that’s okay because if everything’s high I should be feeling pretty balanced. However, because my epinephrine is so elevated, far more than any of the inhibitory neurotransmitters, I am still “over stimulated.” The calming guys like GABA and serotonin are just trying to balance things out, but they can’t quite do it. Ever heard the phrase “wired and tired.” That’s me. I am generally pretty anxious in the morning but also dragging a bit. It’s a weird, uncomfortable feeling that makes you want to lie in bed and do nothing, but when you do, you can’t make yourself relax enough to enjoy it or rest. Lovely.

So, how did I get this way and what do I intend to do about it? It’s difficult to say how long and why this has been going on, but I remember having anxiety as a young teen. Couple that with my eating disorder, chronic cardio, and then huge amounts of stress in my twenties including divorce, grad school, and working multiple jobs, and I’m sure somewhere in there my hormones took a turn for the worse. I am actually quite fortunate that my adrenals are not in a more severe state of dysfunction. Many people end up not producing enough cortisol or neurotransmitters. This is also often diagnosed as chronic fatigue.

So, it’s fair to say this has been an ongoing problem for several years now and I do intend to take some measures (finally) to get the problem under control. As I mentioned previously, I will implement several natural therapies and chronicle my experience with them, record several objective and subjective markers to track progress, and repeat cortisol and neurotransmitter testing in several months. And I will keep you up to date as this all rolls out. Sounds fun, right? Let the journey begin!

Photos courtesy of Shutterstock.

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Epinephrine – Norephinephrine’s Sidekick

As part of the adrenal system, we know keeping our norepinephrine levels in check is important in maintaining energy levels, alertness, appropriate stress responses, mental health, and of course, great athletic performance and body composition. However, it’s just one part of the adrenal puzzle. This week, I want to focus on epinephrine, norepinephrine’s sidekick. Norepi and epinephrine function well together and where you find one, you almost always find the other. (Think Batman and Robin.)

Like norepinephrine, epinephrine – also known as adrenaline – is a catecholamine that acts as both a neurotransmitter and hormone. It’s an antagonist of alpha-1, alpha-2, beta-1, and beta-2 receptors throughout the body. It’s produced by the adrenal medulla and the central nervous system and is a major component of the “flight or fight” response. It gets us ready to handle stress by increasing heart rate, blood pressure, and the ability of the heart to pump blood efficiently. It causes vasoconstriction, or the clamping down, of some blood vessels and vasodilation, or the relaxation, of others. It also causes bronchodilation and increased respiration. This opens the airways and allows for better oxygen delivery to the cells of the body, as well as CO2 removal from the bloodstream.

Epinephrine also triggers some metabolic changes that free up quite a bit of glucose. The liver stops producing insulin and the muscles and liver break down glycogen into glucose. Glycolysis is triggered in the muscles, which involves the breakdown of glucose into pyruvate. This in turn enables the formation of ATP and the fueling of muscular contraction. Another energy source is accessed as the triggering of lypolysis breaks down fat into ketones (the other energy source). Short story, epinephrine frees up energy to be used by the muscles and brain in response to the perceived stressor. 

Epinephrine is often administered as a drug. It’s used in cases of cardiac arrest due to its ability to increase cardiac output, increase blood flow to the heart, and increase blood pressure. It also is used to treat anaphylaxis, bronchospasm/asthma, and even hypoglycemia. Ever seen or heard of an EpiPen? People with severe allergies usually carry them at all times. This is basically nothing but straight epinephrine meant to protect the individual carrying it from going into anaphylactic shock if exposed to their allergen.

Epinephrine is made in the same way norepinephrine is made. In fact, you must have norepinephrine to make epinephrine. Again, the amino acids phenylalanine and tyrosine are the building blocks of the fight or flight hormones. If you are lacking phenylalanine or tyrosine in your diet, you need to either supplement or include foods high in those amino acids. Tyrosine is used to first make L-DOPA, L-DOPA is converted to dopamine, and dopamine is converted to norepinephrine. Then, within the chromaffin cells of the adrenal medulla and cytosol of the adrenergic neurons, norepinephrine is methylated (a fancy words that means an enzyme adds a methyl group to a substance) and converted to epinephrine. Epinephrine is then stored in chromaffin cells of the adrenal medulla until it’s needed in the body. Whew.

Now, how do we get the adrenaline out of the chromaffin cell? First, the sympathetic nervous system (SNS) and adrenocorticoptropin hormone (ACTH) kick off the synthesis of adrenaline. ACTH also causes the adrenal cortex to release cortisol (another stress related hormone) enhancing epinephrine synthesis even further. At the same time, the SNS stimulates the release of epinephrine by the chromaffin cells into the blood stream. And what stimulates that release? Perceived and actual stressors like loud noises, bright lights, higher temperatures, a big meeting with the boss, or anticipating a hard workout or lift. Anything that causes you to feel as though you need to be ready to defend yourself, causes the body stress (real or perceived), or brings you anxiety can cause a release of adrenaline.

The action of adrenaline is terminated by the reuptake of the hormones into nerve receptors and metabolism by different enzymes. Unlike many other hormones, epinephrine does not down-regulate it’s own production. So, it is possible to have chronically elevated adrenaline levels in the body. It’s the like annoying party guest that doesn’t know when to leave. This can be caused by numerous things such as administration of exogenous epinephrine or tumors in the adrenals or along other parts of the sympathetic nervous system. Also, the body can also have problems making enough epinephrine, as is the case in Addison’s disease and adrenal fatigue.

We now have a basic understanding about epinephrine and where it comes from, how it’s made, and what causes it to be released in the body. Now I want to start your wheels spinning so you start to think about what can go wrong if epinephrine production gets off track. If we make too much epinephrine, for too long, we can end up with a huge list of issues. The same can be said for not enough epinephrine should you wind up with a nice case adrenal fatigue.

If epinephrine affects blood pressure can too much or too little for too long cause blood pressure problems? What about this blood sugar thing? If we fail to make enough epinephrine is our blood sugar too low? What if we make a ton and our insulin production is always dampened? Also, what happens to parts of the body that aren’t getting enough blood flow because of chronic vasoconstriction due to elevated epinephrine? Makes you think, right? These adrenal hormones have some huge implications for your health and fitness. Stay tuned next week when we look at yet another part of the adrenal system.

References:

1. Oliver von Bohlen und Halbach , and Rolf Dermietzel, Neurotransmitters and neuromodulators: handbook of receptors and biological effects, (Wiley-VCH, 2006)

Photos courtesy of Shutterstock.

The post Understanding Our Adrenal System: Epinephrine (Adrenaline) appeared first on Breaking Muscle.