I was watching an interview with Dr. Alan Christianson today, part of the Diabetes Summit this year, and while I don't watch many of these due to their saying the same old thing basically, this one did interest me because the topic was hormones and diabetes, a very interesting field indeed.
These presentations are of course geared toward the general diabetic public and thus tend to be very simple in scope, but there was one thing that really impressed me in this talk, and that's the part that adrenal fatigue is actually a mechanism of downregulation. So Dr. Christianson gets this and that's fantastic, because few people do.
Instead, the approach tends to be to some degree at least to treat the adrenals themselves as dysfunctional, in the sense that they are tired, weak, etc, and given that they are producing too little cortisol in this state, we need to get them cranking out more.
This is the absolutely wrong approach though, as what causes this isn't weak adrenal glands, it's downregulation of adrenal hormones. Downregulation of hormones is a big problem with diabetes in general, it's what's wrong with our insulin regulation for one thing, where insulin gets downregulated and then doesn't work as well as it should.
In a real sense, we can think of all hormonal downregulation as stemming from an overexposed state, leading to the body deciding that these excessive levels are a bad idea, and this is what happens with adrenal fatigue as well. So cortisol goes too high, from various factors, stress being a major one, and then the body downregulates it.
This may be through resistance or just turning down production, and although with insulin it does turn it up for a very long time, the end stage of type 2 diabetes does have it turned down, where we do get insulin deficient. So this is the same thing, first of all it gets turned up as we get more and more resistant to it, and then eventually it gets turned down.
You can notice this with the caffeine people get from coffee, infrequent drinkers can really get a pickup from it, people like me who drink it all the time don't notice anything, until you go off it perhaps. So I don't feel any different on coffee, but I did give up caffeine for about a month and suffered from extreme lethargy, to the point where continuing on wasn't an option.
So I'm resistant to the effects, that's a lot like insulin resistance, and I need a lot of coffee to get me through the day, a lot more than people without such resistance, and the resistance here goes way beyond just the caffeine, it also involves the physiological effects of the drug as well, the adrenergic response.
A lot of this is due to hormonal downregulation, for instance I can drink cup after cup and my pulse can be in the low 60's and my blood pressure can be something like 116/62. So this is not what we tend to see when one is under the influence of a lot of caffeine, but when I'm not in it, then forget about it, I can't even manage to get around.
Does this mean I should give up caffeine and it's the problem? Well that's the simple minded approach that most people take, and this arises from just looking at the problem superficially. So we can ask, why do I need this much caffeine to get around? Some of that is due to this downregulation but it's only one factor in the equation, and we so often want to simplify too much.
Resolving hormonal downregulation is a tricky affair at best though, and yeah things that stimulate the response do play a role, but it tends to be more complicated than this. In reality, the stimulants probably play a secondary role in all this, with inflammation being an even more potent driver of all of this.
One does become relatively immune to things like caffeine, I sure am now, it doesn't do much to me at all as I've said, other than keep me able to withstand what is a very sedentary lifestyle. So the body for the most part compensates for these stimuli, you get resistant to them in other words.
However, with excessive inflammation, there's no adapting to this, no resistance to it, you need to address the problem head on. This is really what is behind adrenal fatigue, and insulin resistance as well for that matter, and in the case of cortisol, it's the body's main defense to it actually.
However, increasing cortisol is not the best way to fight this, if it is downregulated. It may help short term, and one of the things we do see short term is an alleviation of this inflammation, but in the end the body is fighting against this, because this hormone in excess, like all hormones in excess, will just cause problems over time.
So the last thing we should be doing in cases of adrenal fatigue is to attempt to get the adrenal glands to step up their capacity. This is what did us in, in the first place. We should not want to tire them out further if they are already tired, even though this is an oversimplification.
Strategies to downregulate cortisol further, like taking supplements that lower it like Relora, may not be the answer either, especially if you are already in the state of adrenal fatigue, because this will tend to let the inflammation that is behind all of this run even more rampant.
So that's the conundrum here, you can be damned if you do and damned if you don't, but the problem really isn't in the adrenal glands in the first place, and if we continue to think it is, we're just going to keep going off track if not making the problem even worse.
Dr. Christianson gets this at least, although I don't think he focuses enough on the main problem, chronic inflammation, and we cannot afford to neglect this.
He's not a big fan of adaptogens, but I do think they can be very helpful with this because they do serve to regulate hormones and that's what we want, better regulation. More than anything though, we need to look to treat the inflammation, although things like stress management and supplements that may help us with this, including things that help inflammation, including adaptogens, and also things such as lemon balm, which I've become a bigger fan of lately.
So we don't need more cortisol, we just need less of a need for it, that's the path we want to be focusing on.
Of course this all impacts diabetes a great deal, and regardless of what state our adrenal hormone health is in, we need to pay very close attention to excessive chronic inflammation as it's behind diabetes as well.