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One of the key principles in the practice of Naturopathy is to find the underlying cause of the health issue at hand. A patient that comes to see me with digestive disturbance will be ill served by the simple prescription of laxative herbs to ease their constipation. This is what is commonly referred to as the practice of “green pharmacy” and simply substitutes the prescription of a natural agent for symptom suppression rather than a pharmaceutical one. The underlying cause of the constipation still needs to be discovered in order to restore true and lasting health.

The digestion affects many organ systems (and vice versa)

When our digestion is disturbed, there are many consequences for the rest of the body. Nutrient assimilation is impaired, and so we do not get the crucial building blocks for our body’s structures, hormones, neurotransmitters and cellular energy units. Unhealthy populations of microbes may flourish and cause inflammation and leaky gut, further reducing absorptive capacity. This can also impair the immune system and predispose an individual to allergic tendencies and aberrant cell growth.

However the gut is also easily impacted by disturbances in other organ systems, and it is the adrenal system and the stress response that I see impacting my patient’s digestive function more than any other. Investigating and treating adrenal dysfunction can often be the key step in resolving chronic digestive issues.

We can’t digest when we’re outrunning the bear

The adrenal system is amazing. It plays a crucial role in the fine balance of energy use and preservation, carefully orchestrating a cascade of stimulating neurotransmitters and hormones that allow us to do everything from wake up and function in the morning, to climb a 10 meter tree in 5 seconds flat to escape a rabid bear. Unfortunately, chronic stimulation of the ‘fight-or-flight’ mechanism of survival that keeps so many of us in consistent adrenal stress has a significant impact on health.

Our body cannot tell the difference between stress stimulated by being hunted by a hungry bear, and stress stimulated by being cut off in traffic. To the brain, and the adrenal glands, both of these situations require the same physiological response: massive surges in both cortisol and noradrenalin. This causes a series of up-regulating reactions ranging from increased heart rate and respiration, increased flow of blood to skeletal muscles, pupil dilation, increased blood clotting, and the liberation of vast quantities of stored sugars for energy production. There are also a series of inhibitory reactions that take place: loss of peripheral vision, inhibition of salivation and lacrimation (tear formation), depression of immune function, and inhibition of the digestive processes.

These ‘minor’ stresses occur on a frequent basis throughout the day of most individuals living in a city environment, and over time this constant fight-or-flight activation will take its toll on our health.

The digestion bears the brunt of adrenal overstimulation

From a digestive perspective, consistent adrenal stress will grind activity to a halt. Chronic constipation will often ensue, and this comes with its own set of health challenges. Infrequent emptying of the bowels can results in significant toxicity, with wastes that were due for elimination being reabsorbed to further burden the liver and lymphatic system. The normally acidic environment of the stomach also starts to become more alkaline, encouraging the bacteria that usually reside in the large bowel to migrate into the small intestines and sometimes the stomach itself. Other parasites and pathogens will also flourish in the lowered acidity. These microbes release toxins that break down the bowel wall, leading to leaky gut and immune challenges from inadequately digested proteins. These proteins can circulate to other tissues of the body and become the instigator of auto immune destruction of these organs in diseases such as Hashimoto’s thyroiditis, Lupus, and Sjogren’s syndrome.

You can see that there is a massive impact on health from digestive dysfunction, and the discomfort involved in chronic constipation is only the tip of the iceberg when it comes to the function of your physiology.

Are you adrenally hypo or hyper reactive?

A key step in the process to determine the appropriate course of action for adrenal dysfunction is salivary cortisol testing. This is a simple procedure that is done at home in which 4 swabs are taken from the mouth at different times of the day, typically 6am, 12 noon, 6pm and midnight. These swabs are sent for analysis, and the measure of cortisol at each stage of the day is plotted on a graph (another hormone called DHEA-S is also typically measured to further discern the individual presentation). Note that blood cortisol typically offered through conventional medical testing has very little value as most cortisol in the blood is bound to carrier proteins and is thus not detected by the test.

A healthy individual should start the day with high levels of cortisol, which will gradually decrease through to the evening. Clinically I will typically see one of two scenarios: either a chronically elevated cortisol throughout the day, or a cortisol that stays low throughout the day. Both of these situations can result in digestive dysfunction, however treatment protocols can be quite different so testing is important.

Can adrenal dysfunction be treated?

A mixture of botanical medicine and targeted nutrition can help restore adrenal function, however ultimately the best results will be obtained with the addition of a behavioral therapy that dampens the stress response. Meditation, yoga, and tai chi can all be powerful modulators of the stress response, however something as simple as a barefoot walk on the beach can also help tremendously. Avoiding substances that stimulate the adrenal glands such as caffeine is also very important, and specific diets to address either elevated or depressed cortisol are often employed in treatment.

In encourage you to pay close attention to the level of stress in your life. If you feel it could be affecting your health, start taking steps now to consciously lower your stress response. Five deep controlled breaths right now is always a good place to start!

In wellness,

James

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