(Part 3 of 4)
We decided to sit down and have a chat with our practice owner and MD, Dr. Philip Oubre, and functional nutritionist, Aubree Steen.
We’re diving into another 4 part series. We’re diving into part 3 here, following with:
1. What are the adrenal glands/their function? Why are they important?
2. Stress and its effects on the adrenal glands
3. How stress hormones affect every other function in the body (i.e. autoimmunity, chronic illness, hormones, energy – weight, mood) (this video)
4. Supplementation/lifestyle/nutrition support for adrenals
Feel free to watch the video, or read our transcript below.
Dr. Philip Oubre, MD (00:00):
Hey everybody. We are in the adrenal month, we’ve got four videos on adrenal health. And we’ve talked about the function of the adrenal glands, we’ve talked about what affects the adrenal glands, and now we’re actually going to be talking about what the adrenal glands affect, so it kind of backwards. We’ve been talking about what stimulates the adrenal glands and what makes them go wrong, now we’re going to talk about the consequences of those adrenal glands going wrong, what does that do? Okay. And so, one of my favorite and least favorite books is actually written by Robert Sapolsky, I think is his name, and it’s called Why Zebras Don’t Get Ulcers.
Aubree Steen, FNTP (00:31):
Dr. Philip Oubre, MD (00:31):
And one of the reasons… Yes. So one of the reasons why it’s one of my favorite books is because he totally nerds out on every system of the body and how it reacts to cortisol and how basically cortisol rots the entire body, the soul and everything of the body. And he uses research to prove it all. And so, one of the reasons why it’s my least favorite is because I’ve read the whole book, completely depressed, expecting that truly next chapter he’s going to teach me how to resolve this, and then the book just ends and there’s never a, “Oh, here’s how you fix this.”
Aubree Steen, FNTP (01:01):
Dr. Philip Oubre, MD (01:01):
Yes. But it’s a wonderful book, especially if you need some nighttime reading, you have some insomnia and want to go to sleep, it’s pretty boring, but it’s wonderfully boring in the sense that he really dives into the science behind it. So if you, like me in the beginning of transitioning into a functional medicine doctor, is kind of a skeptic about, oh, the adrenal glands are so important, read the book and you will find out exactly how every single system of the body is rotted by cortisol. So hopefully that’s a good intro to this video of what all can completely go wrong with cortisol.
Aubree Steen, FNTP (01:32):
It stresses me out.
Dr. Philip Oubre, MD (01:33):
Yeah. Now that your adrenals right fire from learning that.
Aubree Steen, FNTP (01:36):
Just thinking about it.
Dr. Philip Oubre, MD (01:40):
And so we’re going to talk about several things, we’ve got our list. And so, we’re going to talk about several things that the adrenal glands effect, even though it can affect everything in the entire body, we’ve kind of picked our top five. And our first one of the top five is, it affects your energy levels or your fatigue levels, and it affects your brain fog or your brain function. So Aubree, you want to take off with that one or what?
Aubree Steen, FNTP (02:02):
Dr. Philip Oubre, MD (02:03):
Okay, great. So I’ll keep talking then, you and I can talk forever.
Aubree Steen, FNTP (02:06):
I’ll come in.
Dr. Philip Oubre, MD (02:07):
So the adrenal glands and the reason why they contribute to fatigue and brain fog is because the adrenal glands are basically the time clock of your body. So they’ve done this study actually, if we put you in a room with solid light and no shadow, no light, no moon, no sign or anything, you will still generally follow about a 24 hour time clock. They actually showed, I think the research showed that you actually went to a 25 hour time clock, which is a little interesting, you don’t get that extra hour per day. Anyway, so your adrenal glands are responsible for knowing about what time of the day it is. So if we put you in that room and we ask you, “What time is it?” Then you could probably pick about what time of the day it is.
Dr. Philip Oubre, MD (02:46):
Now obviously, if you stayed in that room for too long, it would throw everything off. So the reason why the adrenal glands contribute to fatigue is because the adrenal glands release cortisol, as Aubree said in the first or second video, you’re supposed to be releasing cortisol even before you awake.
Aubree Steen, FNTP (03:00):
Dr. Philip Oubre, MD (03:01):
So the cortisol is kind of the [inaudible 00:03:04], shock the body awake. And then after you awake within 30 minutes, it’s supposed to reach, what did you say? 200%?
Aubree Steen, FNTP (03:08):
Dr. Philip Oubre, MD (03:09):
Yeah. And so that is the highest it reaches all day long, after that 30 minutes or maybe an hour after, whatever it is.
Aubree Steen, FNTP (03:14):
Dr. Philip Oubre, MD (03:15):
60 minutes. Yeah. Then it’s really just falling the rest of the day. It’s not a sharp fall, it’s just a slow fall.
Aubree Steen, FNTP (03:20):
It’s a nice little bell curve, kind of like that.
Dr. Philip Oubre, MD (03:23):
And then in the evening, obviously is when it’s the lowest and that’s when you go to sleep and then you repeat the whole process. So if your cortisol levels mismatch the environment at any point, then you have fatigue.
Aubree Steen, FNTP (03:34):
Dr. Philip Oubre, MD (03:34):
So one of the things I love to talk about is mismatch of environment to hormones. So for example, if a lion jumps out in a trail and you’re walking down down it, that is an immediate kind of euphoric event of, oh my God, I’m going to die. It’s the jumping out of an airplane adrenaline rush of, oh my gosh, this feels great because I’m in a intense situation and I’ve got the hormones to match it. Now, if you take a totally different environment, if you take us sitting on the couch and we get the same hormonal surge as if a lion did jump out, but you’re sitting on a couch, calm, it’s a very-
Aubree Steen, FNTP (04:10):
Dr. Philip Oubre, MD (04:10):
Very uncomfortable sensation. And that’s basically a panic attack. A panic attack is a mismatch of hormones to the environment. If you’re sitting in a bed and your heart is pounding, it is a very disrupting sensation.
Aubree Steen, FNTP (04:21):
Right. In a social situation and anything like that, right? Social anxiety is a perfect example of that. You’re with people, essentially a social interaction that’s supposed to make you feel good and connected, but if you’re sitting there internally panicking and freaking out, that’s that mismatch, and that’s why people commonly have panic attacks when they’re around other people too.
Dr. Philip Oubre, MD (04:38):
Correct. So the mismatch of environment, if we carry that same message over to the cortisol, so if you were waking up in the morning and your cortisol is supposed to be 200% of what it normally is, but it’s not, then you have a mismatch of environment. And so usually you’re tired in the morning, and then as you go throughout the day, your adrenal glands have been trying to keep up all day long and then you’re actually releasing too much cortisol by the time the evening hits, and that’s when people get their second wind. And actually when they feel the best is between 4:00 PM and 8:00 PM, people feel their best. And then they’re exhausted, but can’t go to sleep at night.
Dr. Philip Oubre, MD (05:13):
And then even if they do go to sleep at night, they’ll frequently wake up, they’ll be restless, and we kind of call that wired and tired. Throughout the day, you’re wired, you’re kind of ready to go mentally, but physically you don’t actually have the energy to do that. And so that’s that mismatch of environment. The cortisol is not right with the time of the day and that leads to energy dysfunction.
Aubree Steen, FNTP (05:35):
And that’s why it’s really important to follow your circadian rhythm. Right? And so that’s making sure that… It’s different for everyone, but most people have a similar circadian rhythm. You’re supposed to wake up with the sunrise and start to wind down with the sun fall, right?
Dr. Philip Oubre, MD (05:48):
Sun fall, that’s a new one.
Aubree Steen, FNTP (05:50):
Dr. Philip Oubre, MD (05:50):
The sun just falls out of the sky.
Aubree Steen, FNTP (05:55):
The sunset, right?
Dr. Philip Oubre, MD (05:56):
Aubree Steen, FNTP (05:57):
And then go to bed. So when you’re commonly stressed out or have finals, or working really late and you’re pushing your adrenals, you have to think about it, when you’re in stress too, those adrenal hormones are firing even more. So now you’re affecting high cortisol throughout the evening time, the nighttime, that’s why working late is really bad for you as well, and pushing yourself-
Dr. Philip Oubre, MD (06:15):
Says the one who worked late yesterday.
Aubree Steen, FNTP (06:16):
Dr. Philip Oubre, MD (06:16):
Her, not me this time, her.
Aubree Steen, FNTP (06:21):
Okay. Or like 10:00, 11:00, midnight studying and being like, “I’m just going to push this for now and not do it tomorrow.” It’s the worst thing that you can do, because now you’re having that mismatch of hormones, and now your whole next day is going to be affected as well. So you have to match that circadian rhythm, and it slightly changes for people, but genuinely sunrise and sun fall.
Dr. Philip Oubre, MD (06:40):
And it’s one of the reasons we get more tired in the winter time, when the sun falls earlier in the evening, you get tired sooner, that’s part of that circadian rhythm, that’s kind of supposed to happen. We can talk a lot about that, but we’re going to go ahead and move into our second one, because I’m sure you’re dying to know. The second one is weight loss and adrenal glands heavily affect the weight loss hormones, and just the ability to lose weight or inability to lose weight, or gain weight appropriately. Gosh, that breaks my heart when people are like, “I’m eating so clean and I’m still gaining weight.”
Aubree Steen, FNTP (07:08):
Gaining like 10 pounds or something.
Dr. Philip Oubre, MD (07:09):
Oh, its miserable.
Aubree Steen, FNTP (07:11):
And it’s stressors too, right? And I mean, shamelessly, we’ll always talk about ourselves too, just to relate, but I’m that kind of person too. My stress response is to gain weight immediately. And you see a lot of women who do that too, and they eat right or they’re overexercising, which we’ll talk about in a little bit, but cortisol, when it’s constantly elevated, it makes you store fat, it’s the fat storing hormone basically. So if you’re constantly in a fight or flight state, your cortisol is going to keep storing fat and you’re not going to be able to use it properly, and then you’re not going to be able to use it or lose it.
Dr. Philip Oubre, MD (07:44):
Another thing about cortisol and weight gain is that cortisol does not make you gain weight in the sexy places. It’s not going to put it in your boobs and butt.
Aubree Steen, FNTP (07:52):
Dr. Philip Oubre, MD (07:53):
It’s going to put it in your belly, your face and that little hump in the back of your neck, it’s going to make have the little hump back. So if that’s where you look at your primary weight sources, then you know that at least a portion of your issue is actually hormones. So let’s just say you’re in a weight gain hormonal balance, based on your hormones, your hormone balance is where you’re going to put that weight. So let’s say you’re eating too many calories, but your hormones are actually perfectly balanced, then if you’re a female, you’re going to put it in boobs and butt and thighs. Whereas if you’re a male, you’re going to put it in the belly.
Dr. Philip Oubre, MD (08:25):
Now, if you take a menopausal woman and same thing, you have them where they’re eating too many calories, but their hormones are balanced for menopause, meaning they have no estrogen progesterone, and they have a little bit of testosterone, they actually gain weight like a man because of hormones. So that’s why you’ll see kind of elderly ladies with a little pooch of a belly, not so much boobs and butt anymore, because the main hormone is testosterone. So if you take anyone and put them in a chronically stressed state and give them excessive calories, then they will put it in the non-sexy places, the neck, the face and the belly.
Aubree Steen, FNTP (09:00):
Every female patient I’ve had that has been on hormones commonly says they get the puffy face, and you know what you’re talking about, right? Their face gets puffy, they get a belly that they can’t lose, and then they get…
Dr. Philip Oubre, MD (09:11):
Do you mean steroids, not hormones?
Aubree Steen, FNTP (09:11):
Oh, steroids, yeah. Sorry. That’s what I meant.
Dr. Philip Oubre, MD (09:13):
Because we do a lot of hormone replacement, that’s not what happened. On steroids.
Aubree Steen, FNTP (09:14):
No, you feel great in hormone replacement. Sorry. No, cortisone, things like that, any type of steroids that kind of perpetuate that, right? And so that’s an inappropriate amount of hormones too in your body, it’s needed at the time, but they always complain about those same areas that you’re talking about.
Dr. Philip Oubre, MD (09:30):
Aubree Steen, FNTP (09:31):
Dr. Philip Oubre, MD (09:31):
Aubree Steen, FNTP (09:32):
I mean, there’s some people right? To each their own, but…
Dr. Philip Oubre, MD (09:37):
So third on our list is… It looks like meal.
Aubree Steen, FNTP (09:40):
Dr. Philip Oubre, MD (09:41):
Aubree Steen, FNTP (09:41):
Dr. Philip Oubre, MD (09:42):
So adrenal glands affect your mood and vice versa. So in the first couple of videos, we really talked about how your perception of stressors and your stress affects the adrenal glands. And then this is the feed forward cycle of, as your adrenal glands get off, they start frying your mood. And so, one of the things we’re taught in med school, even conventional medical school is that if the adrenal glands are off, typically we talk about this in lows, you get those stones, bones, groans, and moans or something like that. And the moans is kind of the like, I’m apathetic, I’m depressed. I have no motivation for life. I’ve lost that vigor. And that’s another mismatch of hormones is the cortisol is supposed to rise during a stressful time, it’s supposed to fall during not, but when it’s constantly high all day long, all night, then that’s when you’re getting this just flat appearance and flat situation.
Dr. Philip Oubre, MD (10:29):
And that’s one of the big reasons in my opinion, why depression and anxiety go hand in hand is because the adrenal glands are releasing too much cortisol, that’s flattening the mood and just making you apathetic where you have no luster for life, but at the same time, remember in one of our other videos, we talked about Paul Revere, “The British are coming.” So with the cortisol being so high, it’s also saying, “Adrenaline’s coming, adrenaline’s coming.” So even the smallest amount of regular adrenaline pushes you into anxiety, and then of course the anxiety can spin into panic attacks.
Aubree Steen, FNTP (10:58):
Right, and it depends on what type of adrenal stage of dysfunction you’re at. Right? So if you’re in stage three to where you’re like over producing-
Dr. Philip Oubre, MD (11:04):
There’s only four stages.
Aubree Steen, FNTP (11:05):
Oh sorry. Yeah. You’re in between basically stage two and three, where you’re over producing so much, and we see these patients who come in and they’re like this, and they’re talking like this and they’re constantly panicking and they’re like, “I don’t know why.” And then you’re just like, “Okay.” And you want to hug them and be like, “Take a breath.” Right?
Dr. Philip Oubre, MD (11:19):
Aubree Steen, FNTP (11:19):
That’s a stage before burnout. That’s a stage where your body’s fighting, fighting, fighting when you’re anxious about everything and you’re like, “I’m crying at this, my spouse is making me frustrated, but I don’t even know why looking at him makes me sick.” I didn’t mean to point to you. Looking at my boss makes me sick.
Aubree Steen, FNTP (11:34):
You have all these little triggers or like, “My kid was just asking me for dinner and and I flipped out.” Right? And then you have the burnout stage, you all know this, where you’re so burnt out, I did this yesterday, where you sit in a car and you just stare. Right?
Dr. Philip Oubre, MD (11:49):
Aubree Steen, FNTP (11:49):
Where someone calls me and you’re like, “Hey, I can’t talk.”
Dr. Philip Oubre, MD (11:54):
Just not functioning.
Aubree Steen, FNTP (11:55):
Yeah. And you all know that feeling from a long day of work, a long day of even emotional exhaustion, a fight with somebody, a partner, a friend, whoever may be, you would just feel drained and like the life has been sucked out of you. So people in constant adrenal fatigue and chronic adrenal exhaustion, they sit there and you can tell, everything has been taken away. They’re almost just a shell of a human, and they don’t want to feel that way obviously, they don’t know how to get out of it.
Dr. Philip Oubre, MD (12:18):
Aubree Steen, FNTP (12:19):
A little depressing, but…
Dr. Philip Oubre, MD (12:21):
Yeah, well, it’s true. And so mental illness is heavily related to adrenal dysfunction. It may not be the only cause of your mental illness, but it’s certainly one of those puppeteer hormones that… Yeah you don’t have enough serotonin, well, it may be one of the reasons is because you have too much cortisol, which is the puppeteer hormone that’s affecting your , your [inaudible 00:12:38], and your other neurotransmitters. So we could talk all day about this stuff, but moving on to the next one is sleep. Sleep is a big one and sleep is both a backwards and forwards thing, in the sense that poor sleep affects the adrenals. We kind of talked about that already, or maybe we didn’t, we wanted to. But then as the adrenal glands get off, then it starts affecting the sleep. And then as the sleep gets affected, then it affects the adrenals, and back and forth, and back and forth.
Aubree Steen, FNTP (12:59):
You’ll see that when you’re waking up every two hours at night, that’s a huge thing. It’s a huge dysregulation. That’s your adrenals honestly, I feel like they don’t know what to do with the cortisol, because it’s supposed to be this nice kind of even flow throughout the night, that’s when we’ll commonly supplement for it and help adrenals and be like, “Let’s try this supplement to help calm down the adrenal glands,” and people get better sleep. That’s the anxious sleep.
Dr. Philip Oubre, MD (13:19):
Because you can have poor sleep at both too high cortisol and too low cortisol. One of my early patients, she had to take two Ambien at night just to get to sleep, and so we did her adrenal testing and her cortisol was literally zero at night before bedtime, even before taking the Ambien. And that was a light bulb moment for me of like, wow, that’s so interesting. You would think that if her cortisol… Obviously it wasn’t zero, it was just unregistered by the test, because remember zero is dead. And so the cortisol was so low, but she still couldn’t sleep. So that was an early message to me that any hormone out of balance, whether too low or too high, can cause symptoms of that problem.
Dr. Philip Oubre, MD (13:55):
So if your sleep is affected, make sure you’re taking care of your adrenals and then as you take care of your adrenals, it will take care of your sleep, vice versa. The big thing with sleep and adrenals is you got to wear blue blockers, if you ever have light at night, looking at your phone, looking at your computer, looking at your TV, one of the first things to do is of course, put on blue blockers to block the blue light so that it stops activating your adrenal glands, but cold and dark is the way to get to sleep, and of course having good hygiene.
Aubree Steen, FNTP (14:21):
Yeah, like under 60 degrees and sleeping, and your blue blockers better be ugly, they better be orange and thick and make you look like a fool.
Dr. Philip Oubre, MD (14:31):
Agreed, like Bono, but more orange, not blue. Okay. And then last but not least in the adrenal world is of course that the adrenal glands both trigger autoimmunity, by themselves they trigger autoimmunity, but they also can… I mean initiate auto-immunity, but they can also be the main source of a flare. So if you have an autoimmune condition, this is probably is not that surprising to you and maybe it’s kind of connecting some dots, but if you ever have a stressful situation that could have nothing to do with your autoimmune condition of, oh, someone died or I almost got in a car crash or something, and your adrenal gland spike, all of a sudden you wake up the next morning with joint pain, or a rash, or gut disruption, or whatever it may be. Or say you’ve worked too many hours, you all of a sudden have a gut flare, even though you didn’t even eat any of your trigger foods or do any of your trigger behaviors, you still had the flare.
Dr. Philip Oubre, MD (15:21):
So the adrenal glands have a difficult role in the sense that too much cortisol kind of overstimulates immune system. This is one of the things that’s a little hard to understand, hard to explain, even for myself, is that cortisol, when it’s down the right balance has the right stimulus on the immune system, because cortisol does stimulate the immune system. But at the same time, it’s got the right regulation, not too much, not too high, as far as a balance.
Dr. Philip Oubre, MD (15:45):
If cortisol starts going too high, you would think that, oh, it would be… Because we use steroids for suppressing the immune system, so when you have high cortisol, which is basically steroids, you would think it would suppress the immune system, but when you naturally produce too much cortisol, it’s almost like it’s a confusion of the immune system. It’s not really a suppression, it’s not really a stimulus, it says, “Go fight something, we’re not sure what you should fight, we’re stressed. There’s something going on, just go fight something.” And that’s one of the beliefs as to why your own cortisol can stimulate an autoimmune flare, but if we give you prednisone, it actually suppresses an autoimmune flare. That part’s always a little confusing, but it’s what we see in reality, whether we can explain it or not.
Aubree Steen, FNTP (16:25):
Dr. Philip Oubre, MD (16:27):
And then of course the way the adrenal glands can trigger autoimmunity, I don’t want to just trigger, I want to use initiate autoimmunity, is because the adrenal glands, as we talked about in other videos, it releases cortisol, cortisol stimulates yeast, and candida, and fungus overgrowth in the bowls, as well as other bacterial imbalances. And then that is one of the things that correlates directly to autoimmunity through the [inaudible 00:16:48] gut and stuff. So not only can the adrenal glands initiate an autoimmune condition, but it’s also the main one responsible for flares and triggers.
Aubree Steen, FNTP (16:55):
Agreed. Stress is the amplifier.
Dr. Philip Oubre, MD (16:58):
Aubree Steen, FNTP (16:59):
So just think about that. If there’s any issue that you have, you have to think where your hotspot is, is your hotspot gastrointestinal? Or do you get gas or bloating or abdominal pain? Or you can’t pass a bowel movement right, constipation, or if you get nauseous, things like that, and you’re stressed, you’re going to see it manifest in that area too. Right? I’ve seen stress hives cover people’s bodies, right? So if skin expression is your stress, high stress is going to make that worse, obviously. So just think about what it is. And a lot of the times it’s people’s mood too, so if you’re constantly anxious or sad or even happy, I guess, but stress will amplify it.
Dr. Philip Oubre, MD (17:38):
Well, just to wrap that up, the main thing that is cortisol affects every part of the body, whether it’s your memory, your mood, your hormones, everything. And if you want to know all about the things, that it mortifies the body or rots the body, is you can read Why Zebras Don’t Get Ulcers, it’s a fascinating, fun book. And then the top five things we talked about is fatigue and brain fog, inability to lose weight, poor mood, poor sleep, and of course, autoimmune triggers. And this wraps up our video, so feel free to like our channel, subscribe and you’ll get notifications for our future videos.
Aubree Steen, FNTP (18:13):
Cool. Hit the bell. Bye, guys.