Adrenal Glands and the Rest of You

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Q. How can the adrenal glands affect blood pressure?
A. Well, there is the Western way, being a "type A" personality. People with a type A personality are stressed and put out more cortisol. This leads to putting on more weight, experiencing increased blood pressure, and things like that.

There is also the non-Western way, which is acknowledged by other systems of medicine. The adrenal glands may be hypofunctioning. One sign is a blood pressure "deficiency." An example might be a little old lady who might be tired and fatigued but might have very high blood pressure. That's the deficiency-type high blood pressure, and it is recognized more in Chinese and Tibetan medicine. It is very real; it is not so much that it is overlooked in medicine, but our drug system is not an herbal system. It is difficult to treat this deficiency-type blood pressure.

Q. What are some of the dangers of high blood pressure?
A. The basic dangers are two-fold. First of all, there is the risk of a stroke. You constantly have to be aware of that, especially the systolic pressure — the top number. If it starts to get in the ISO's to 200's, we call it malignant hypertension. It needs to be reduced and prevented, but would you be. willing to prescribe toxic drug medications in order to manage that problem?

Absolutely; you wouldn't even blink. Would you potentially be shortening the patient's life? Of course. We do not openly say that, but when you have a risk of stroke, you do not care about anything else. As a cardiologist, I am more fearful of a stroke than a heart attack. If I can get a patient through a heart attack, the patient will be weak, but we can work with it. With a stroke, however, what's done is done.

The second problem is chronically high blood pressure that isn't malignant but is enough to do end-organ damage over time. Elevated blood pressure affects the eyes, heart, and kidneys, and it slowly increases the risk of all types of other problems.

Q. If you have a quick spike in heart rate because of sudden, intense exercise or a stimulant, does that increase the risk of a stroke, even though your blood pressure is usually relatively normal?
A. It should not be a larger risk. The danger, though, is the "weekend warrior." Blood pressure and heart rate should go up during exercise. It should not go up into the 200's, but if a person is not in very good shape, it becomes a little more dangerous.

The weekend warrior who really overdoes it faces more of a risk, but this seldom happens. Normally, the risk of a stroke is related to very high blood pressure, but potentially, yes, it could happen. You have to be careful.

Q. Is there a correlation between how quickly your heart races during exercise and blood pressure problems?
A. Not necessarily. That would depend more on the intensity of what you are going to do. You should not get on a bicycle and start pedaling, then have your heart rate immediately go up. You might get some cardiologists who disagree with that, though.

What that correlates to is that your heart burns fat during rest and exercise. If you are a jogger or a runner, you can feel when you hit your pace. When you start to go above it, you have gone from burning fat to burning sugar. The heart and the body do not like that. That's when you get sore. The heart wants to burn fat, and it does that when you've got that pace going.

Q. How common are tumors on the adrenal glands?
A. A rare event. These tumors are called pheochromocytomas. They do occur, and they are usually missed. Some ultrasound and x-rays examinations can detect them, but when they happen, it's a big problem. What we are looking at is kind of a secondary cause of the hypertension. An excess of cortisol is called Cushing's syndrome, or excess aldosterone.

Atherosclerosis is a systemic disease. It affects the smaller pipes first, such as the eyes, kidneys, toes, and fingers. That's why diabetes and hypertension affect those parts of the body first. Eventually the bigger pipes are affected, such as the aorta, the femoral arteries, and the renal arteries.

The renal arteries feed the kidneys. If the renal arteries become narrowed, this is a major problem and it is a lot more common. A patient may come in because of suddenly high blood pressure. The first thing I do is an ultrasound on the kidneys and renal arteries to look for a pheochromocytoma and to make sure that those pipes are open and that they haven't been narrowed. Then I look at the thyroid gland The thyroid is often the most common secondary cause of hypertension.

Q. What do you do if you find an adrenal tumor?
A. We would probably remove the adrenal gland, or part of it immediately. What would happen is that you have the blood pressure problems all the time and you could have a stroke and die because of that. These are notoriously difficult to control with medications because they are unreliable.

When the endocrine system — because of a malfunctioning thyroid or adrenal gland — is responsible for blood pressure problems, the pressure can be very unpredictable. You can be fine for a while, but all of a sudden the numbers can jump to 200/120. I teach my interns that the thyroid gland burns brightest before it bums out, like a light bulb that flickers before the filament pops. After that happens, the thyroid is very hard to rehabilitate.

Most of the time, you just have to burn out the thyroid and give medication. This is difficult to do. Patients come to me with hyperthyroid conditions, and I tell them that if they want to take a year, let us rebuild the thyroid. They cannot drive because they are at risk for a stroke, but I would be willing to work with them. I have had patients who do choose to take the bus or the train for a year instead of waiting for the thyroid gland to be removed. Sometimes we can rehabilitate the thyroid, but patients do face the risk of a stroke the entire time.

Q. What happens if you remove the adrenal glands?
A. There are ways to replace adrenal function with medication, but remember that you have two adrenal glands. The activity of the other one just increases, and you are fine. Sometimes surgeons can remove just part of the gland or just the tumor, but it depends on the type of tumor.

Q. What harm can malfunctioning adrenal glands have on the heart?
A. When you have adrenal problems, you are sick. It really is a problem, and it is going to be ignored conventionally. Not until the adrenals are broken do physicians treat it. But we can treat it naturally with botanicals.

Q. Are any specific foods are harmful to adrenal glands?
A. Yes. Regardless of blood type, white flour and white sugar are killers. The blood pressure spikes, then goes lower than it should be. Your body has to respond in numerous ways, and it is a huge Stressor. It will respond with the adrenals, by norepinephrine, by any way it can. That is why people eat a sugary candy bar for breakfast and at 10 a.m. they are ready to fall asleep. Any of those foods that give you a rapid rise in blood sugar that is hard for the pancreas to handle will also detrimentally affect the adrenals.

Also, there is the case of allergies. When you support the adrenal glands, allergies improve, and vice versa. We also look at the two core organs to treat during allergy season: the liver and adrenals. One of the things we say during allergy season is to stop drinking coffee.

Q. Do diet drugs harm the adrenal glands?
A. Yes, they all do. Anything that is a stimulant harms the adrenals. That's why as soon as someone loses weight with those pills, they have nightmarish fatigue and weight gain, and it's a mess.

Q. Do any prescription drugs harm the adrenals?
A. Stimulants. The adrenals are about creating balance; they are trying to maintain an even energy. When you see people who take pills to wake up and go to sleep, they are almost always overweight. Elvis Presley comes to mind. Uppers and downers, all the time.

Q. What about prescription steroids?
A. Yes, steroids do have an effect. They can suppress adrenal as well as thyroid function. To balance that, we take patients off the steroids at some point and see whether their glandular function returns.

Q. Some people who are known as "adrenaline junkies" need the thrill of jumping out of planes and similar situations that involve an extreme rush of adrenaline. Are these people in any danger of wearing out their adrenal glands?
A. They always run the risk of overexerting the adrenal glands, but it depends on the level of physical fitness. It's a combination of fast speeds and the high competition.

Q. What could happen if you lose all adrenal function or if you have both adrenal glands removed?
A. Addison's disease. You have to take medication to make up for it. John F. Kennedy was a famous person who had this disease. Some people think that there is a genetic factor to that disease, as well. You can test for it.

Most adrenal problems do not show up in tests, though. When we treat the problems, patients get better.

Q. What can an excess of caffeine do to the adrenal glands?
A. The main thing is that if you wake up and are grumpy until you drink your coffee, it is a problem. The first rule I tell people is to never drink coffee to wake up. Your adrenal function should be highest in the morning and lowest when you go to bed. So if you need coffee, that's telling you that you need help. The adrenal help is not there.

Blood pressure problems may develop as well. Blood pressure is highest in the morning, and this is related to adrenal function. This is the deficiency blood pressure that that Western medicine does not understand. They understand that the pressure is high, but they do not understand what to do when someone is calmer with high blood pressure.

Q. How do the glands change as a person gets older?
A. It depends on calcification. Blood pressure goes up as you get older in those who eat more acid diets and cannot handle it. We must still keep our bodies alkaline. If an older person eats an acid-laden diet — junk food and things like that — calcium leaves the bones, where it should be, and goes where it should not be. It goes all throughout the body, including parts of the adrenals (which is not very common), but more of it goes into the muscle layers of the blood vessel and contributes to arteriosclerosis (hardening of the arteries).

Aging causes the blood vessels to become less pliable, and the blood pressure rises. Conventionally, people recognize this as a normal consequence of age, but in natural medicine we do not. We see that vegetarians do not have this automatic increase with age.

We used to factor age into hypertension, but we stopped that. I disagree with the automatic elevation.

Q. In general, does blood pressure tend to have a higher base level in older people?
A. In the West it does; in vegetarian societies, it does not.

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Interview by Decker Weiss, N.M.D., First naturopathic physician to complete a conventional residency program in the Columbia Hospital System, the Arizona Heart Hospital, and the Arizona Heart Institute.

Decker Weiss holds a cardiology fellowship through the American Association of Cardiovascular and Pulmonary Rehabilitation.

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