This article was first published ias "Energy to Spare!" in Delicious Living!, April 1998.

If you're in an energy slump, you could be suffering from adrenal exhaustion. Read on to find out how to keep your adrenal glands functioning optimally with nutrition, herbs and dietary supplements.

If energy is the currency of life, many of us have little left in reserve. We've dipped into our storage bank so often and pushed ourselves so much that we're simply energy depleted.

"A frequent reason why people are tired is because their coping mechanisms are worn out," says Ralph Golan, M.D., a preventive medicine specialist and author of Optimal Wellness (Ballantine). "In order to find their health again, (many people) need to restore the functioning of their adrenal glands."

The adrenals -- our "stress glands" -- produce hormones that help regulate energy levels. An overlooked secret to maintaining high energy -- or rebuilding vigor if we've lost it -- is to use diet, supplements and stress-coping techniques to improve adrenal function.

Energy Basics
Most of us can't define energy, but we know it when we have it. One simple definition is the capacity to do work. Everything that takes place in the body -- from breathing to healing a wound to exercising muscles -- requires energy. Glucose is the fuel all body cells burn for energy. Consistent, balanced levels of blood glucose (or blood sugar) is critical for making sure the body has a steady supply of energy.

The adrenals produce hormones that help balance blood sugar -- in effect, making sure we have the right amount of fuel to meet our varying demands for energy. If blood sugar falls too low, the adrenals respond to this emergency situation by releasing stress hormones that raise blood sugar. This provides more fuel for more energy. When we find ourselves getting a "second wind" -- a burst of energy -- during exercise or work on a long project, this is an example of how the adrenal glands can kick into action to make sure we have enough energy to finish the job.

The adrenals also give us the extra get-up-and-go we need during stressful situations. Although we don't normally think about it, the more stressful a situation the body encounters, the more energy it needs to cope with that situation. If we're running away from a stranger or a wild animal, for example, our muscles require more energy than if we're sitting at home watching TV. The adrenals respond to stress by releasing a flood of hormones that gives us additional energy to rise to the challenge. They'll even kick into another gear to provide us with longer-term energy during extended periods of stress.

But the adrenals can't give us unlimited energy forever. When the stress we experience becomes too great or continues too long, our adrenal batteries run out of nutrient reserves and eventually become exhausted. They stop producing adequate amounts of energizing hormones such as DHEA (dehydroepiandosterone), and fatigue sets in.

Tired of Being Tired?
Fatigue can be caused by many conditions, but one of the most common is poor adrenal function, also known as adrenal exhaustion. Golan estimates that half of his patients who are tired have this condition. Ann Louise Gittleman, M.S., a nutritionist from Bozeman, Montana, says three-quarters of her clients do. Unfortunately, many tired individuals have poor adrenal function without knowing it.

Adrenal exhaustion often is not diagnosed because conventional adrenal function tests determine only cases of extreme adrenal dysfunction, such as that in Addison's disease, a potentially life-threatening condition. "There's a wide spectrum of diminishing function between healthy adrenals and Addison's disease," Golan explains. "You could feel horrible, have no energy and have 100 other symptoms because of poor adrenal function, yet you might not show any abnormality on the standard adrenal function test."

The best way to determine how your adrenals are functioning is to take a saliva test that measures levels of adrenal hormones at four different times throughout the day, Golan says. This test, called the Adrenal Stress Index, must be ordered by your doctor. For more information, have your doctor contact DiagnosTechs, Inc., in Kent, Washington.

You can, however, get a good indication of whether you have poor adrenal function by how you feel. Common symptoms that may indicate adrenal exhaustion, in addition to fatigue, include: feeling easily overwhelmed by stress; a feeling of not being restored after a full night's sleep or having sleep disturbances; low stamina; slow recovery from injury or any type of stress; difficulty concentrating or focusing; poor digestion; low immune function; food or environmental allergies; a diagnosis of chronic fatigue syndrome; or premenstrual syndrome or menopausal difficulties. Consistent low blood pressure, low blood sodium levels and extreme sensitivity to cold often are present in later stages of adrenal exhaustion.

It's important to remember that the adrenals become exhausted from too much stress. Therefore, the solution for improving adrenal function and revitalizing energy is to decrease the body's stress load and increase its nourishment. When we do this, we give the adrenals an opportunity to rest and recharge so they can once again serve as the body energizers they were designed to be.

Avoid Quick Fixes
The first step in recharging adrenal energy is to avoid or minimize the use of stimulants that stress the adrenals and make them work harder. This is difficult to do because when we're tired, we often yearn for stimulants such as caffeine to give us the pep we're lacking. But frequently consuming caffeine (found in coffee, tea, cola and chocolate) is a big mistake: it can give us a lift, but it does so by evoking the body's stress response, further depleting adrenal energy, Golan explains.

Stimulant herbs such as ephedra, guarana and kola nut also should be avoided. "(These herbs) give you quick hits of energy, but they're temporary measures which end up wearing you out even more," Golan says. Although it's tempting to think herbal stimulants aren't harmful because they're natural, they can be if used in the wrong way. It's important to understand that exhausted adrenal glands are like a tired horse: they'll only become weaker if they're overstimulated, overstressed and whipped into action by the use of stimulants.

Eat for Long-Term Energy
The diet we eat is the most important factor for improving adrenal function and energy but it's often the most overlooked, according to Gittleman, author of The 40/30/30 Phenomenon (Keats). "Many people who are fatigued use stimulant herbs and other natural remedies to give them temporary energy, but they aren't looking at the underlying cause of their energy problem which is usually the diet they're eating," she says.

To understand how diet factors into the energy equation, you need to know a bit more about blood sugar balance. When nutrient-deficient processed carbohydrates such as sugar, sweets or white-flour products are eaten, blood sugar rises quickly. The pancreas responds to high blood sugar by oversecreting a hormone called insulin, which causes blood sugar to drop too low. The adrenals perceive low blood sugar as a major stress -- the body is, after all, running out of fuel for energy -- so the adrenals respond to this situation by releasing the stress hormones adrenaline (epinephrine) and cortisol into the bloodstream to raise blood sugar.

This same stress response occurs when we overeat nutritious carbohydrates such as whole grains. "It's surprising, but some of the highly touted carbohydrates over the past ten years -- foods such as whole-wheat bread, potatoes and even brown rice -- break down into glucose quickly, almost like sugar itself," Gittleman explains. "Overeating these foods or eating them without protein and fat causes the same blood sugar roller-coaster syndrome that sugar does, weakening the adrenals."

To eat in a way that balances blood sugar and supports adrenal health, you should avoid nutrient-depleted simple sugars, sweets and white-flour products and limit portions of other high-glycemic carbohydrates (carbohydrates that release glucose quickly) such as whole grains, potatoes and corn. Instead of emphasizing these foods in your diet, eat primarily vegetables and fruits (which release glucose more slowly over time), Gittleman suggests. Then make sure to balance the fruits and vegetables you eat in each meal and snack with protein from animal and vegetable sources and with healthy fats such as flaxseed oil, nuts and olive oil.

Although protein and fat have been avoided by many in recent years, these nutrients are essential for those with low energy, Gittleman says. They not only help balance blood sugar, but also provide building blocks that are needed to make adrenal hormones.

Use Supplements Intelligently
A balanced, nutrient-dense diet can go a long way toward improving energy, but Gittleman and Golan both believe in using nutrient supplements to provide additional support and prevent deficiencies. The following are vitamin and mineral supplements the two experts recommend for overcoming fatigue and restoring proper adrenal function. Work with your doctor to determine which ones are appropriate for you.

Pantothenic acid (vitamin B-5) is often considered food for the adrenals because many adrenal hormones can't be made without it. Since exhausted adrenal glands produce low amounts of adrenal hormones, supplementing the diet with pantothenic acid is often helpful for improving adrenal function and energy, Gittleman says.

Vitamin C and the B-complex vitamins -- known as the antistress nutrients -- can be effective for boosting energy: These nutrients enhance adrenal function and allow the body to cope with stress more effectively. The B vitamins also are necessary to help the body metabolize food into energy. Zinc and manganese also may be helpful: They are needed to form enzymes that allow the body to absorb and properly utilize B vitamins and vitamin C, according to Gittleman.

In addition to supplementing with certain key adrenal nutrients, another way to enhance adrenal function and improve energy is to take Siberian ginseng (Eleutherococcus senticosus). This herb is an adaptogen or tonic that normalizes body function and helps people adapt more effectively to a wide range of stressful conditions, according to The Healing Power of Herbs (Prima) by Michael Murray, N.D. Siberian ginseng can help improve low energy and increase mental alertness and work output, but it doesn't act in the same way as stimulant herbs like guarana. "Siberian ginseng seems to give you a quick hit (of energy), but it actually helps the adrenals restore," Golan says. "It can help the adrenals make hormones like DHEA that help buffer the adrenals from stress."

The supplements listed above are safe and often helpful for anyone who is tired, Golan says. But some remedies such as DHEA (a hormonal supplement) and licorice root (an herb) should only be taken under a doctor's supervision. Both remedies can cause harmful side effects or worsen adrenal function if taken in the wrong instances or amounts, Golan says.

It's also important to remember that natural remedies should be used in conjunction with positive diet and lifestyle changes. "If a person is taking a helpful supplement such as ginseng but they're pushing themselves beyond their body's ability -- staying up too late, trying to do too much, taking on too many responsibilities -- they may get some energy, but this quick fix won't work for them for very long," Golan says. "They're going to end up in a deeper hole because they aren't doing what is necessary to allow the body to heal." Overcoming adrenal exhaustion and restoring energy ultimately requires learning to lighten our stress load.

Lighten Your Load
Few of us realize how many different forms of stress our adrenals respond to every day. First, there is the stress many of us don't know about -- the type that affects us physically. This includes lack of sleep, physical injury or overwork. Anytime we go too long without food -- whether inadvertently or purposely (as when we fast) -- this also puts a strain on the adrenals. So, too, does being exposed to excessive heat, cold or chemical toxins.

The adrenals also respond to emotional stress -- the kind we normally think of. Whenever we encounter a situation that evokes feelings of fear, worry, anger, sadness, guilt or grief, it elicits the stress response, whittling away adrenal energy. On the other hand, doing things that promote positive feelings improves adrenal function, Golan reports.

The important thing to understand is each of us reacts differently to various situations in our lives. Something that causes distress in one person -- driving a car or flying in an airplane, for example -- might not affect another. Therefore, to improve adrenal function, we must examine which things are particularly stressful to us and learn to creatively cope with the ones we can't avoid. We also should try to eliminate any sources of stress that are unnecessary or unimportant to us.

Fatigue from adrenal exhaustion actually is our bodies' creative way of giving ourselves a long-overdue break, say mind-body experts such as Christiane Northrup, M.D. By causing us to be tired, this condition grabs our attention and gets us to slow down. It also sends us a message that something is out of kilter with our lives and we need to make positive changes. Substituting healthy lifestyle habits for unhealthy ones isn't always easy. But the more we can make changes and nourish ourselves in body, mind and spirit, the more our adrenal glands can recharge. And, as it turns out, the more they can recharge, the more they energize us.

This information has been reprinted with permission from New Hope Natural Media, a division of Penton Media. © Copyright 1998 by New Hope Natural Media. To find out about Delicious Living! magazine, visit its website at www.healthwell.com.