Stress, Adrenal Fatigue and Disease:  An Interview with Tracy Tranchitella, ND
Part II
By Mike Bundrant

Even the Journal of the American Medical Association is recognizing the health risk associated with chronic stress. In a review of the scientific literature on the relationship between stress and disease, Carnegie Mellon University psychologist Sheldon Cohen has found that stress is a contributing factor. 

Cohen's JAMA article was based on a paper commissioned by the Institute of Medicine to examine the evidence that stress influences major diseases. The JAMA article explores the mechanisms through which stress contributes to disease and weighs the results of studies that have examined whether stress plays a role in triggering or worsening disease states. Those studies reveal that does stress play a role.

Said Cohen, "The majority of people confronted with even traumatic events remain disease-free. Stress increases your risk of developing disease, but it doesn't mean that just because you are exposed to stressful events, you are going to get sick."

We might take this as a hopeful sign that the medical establishment is beginning to validate long held naturopathic principles. In Part II of my interview with local naturopathic physician, Tracy Tranchitella, ND, we explore this topic from a naturopathic perspective, which includes a discussion of adrenal fatigue.

HT:  What is your perspective on the role of stress?

Tracy:  Stress plays a major role in our health.  I think it affects us on every level.  Everybody who walks into my office has some level of chronic stress.  I frequently run adrenal stress profiles to see where they are, because when it comes to stress, adrenal levels are one thing you can test to see they are holding up to the stressors. 

Usually, by the time people make it into my office they are pretty far along in adrenal fatigue.  There are three stages of adrenal fatigue.  In the first stage cortisol levels are high.  People feel pretty good in that phase.  It’s sort of like being on an adrenaline high or like you’ve had too much caffeine. You’ve got a lot of energy and you’re going and going and feeling good, powering through the day.  But, that’s not stable energy.  It’s adrenaline.  The body can only withstand that type of energy level output for so long before it starts to go the other way. 

HT:  It’s compensatory? 

Tracy:  Exactly.  That type of energy is not meant to be sustained for a long period of time.  Adrenaline is meant to help us in times of acute stressors, but our stressors are so much different today.  We have ongoing stressors that keep us in a state of chronic stress. We don’t get that brief, stressful moment followed by a period of recovery.  It’s a continual burden.  So, people will jack-up their adrenals to get through the day, but that’s
not going to work for too long before they enter a level of fatigue and intolerance of stress. 

That’s when you will see sleep patterns change; fatigue during the day without being able to sleep at night is a really bad combination.  They may also experience exercise intolerance which is the inability to recover well after exertion.  Another example is the inability to tolerate the slightest stress.  Stage two adrenal fatigue is when you are not really able to compensate anymore and the adrenals are saying, “I give up.  I can’t do it anymore.”   

That’s why I run adrenal stress profiles on most of the people who come into the office.  By the time they make it in here they are usually in stage two.  They are not really compensating anymore and are starting to fell the effects adrenal fatigue and lack of sleep which have far-reaching effects on their health.  If you are not sleeping well, you lose the ability to rest and recover.  This plays a major role in the development of chronic illnes. It is so important for us to recognize when that is setting in. 

If sleep starts to change such that you aren’t able to sleep enough to recover from the previous day, everything goes down hill from there. Restoring restful sleep is one of the first things I work on with patients. If they can start sleeping well again, they are going to start feeling so much better during the day and be less likely to reach for the caffeine, which sets up that vicious cycle of pushing themselves. 

HT:  What else can people do to reverse the affects of stress?

Tracy:  Exercise always plays an important role too.  Exercise helps us to release some of that stress in a very healthy way.  On the other side of that, however, people can become obsessive about exercise and actually worsen their adrenal fatigue.  It’s really important for people to pay attention to how they feel after they exercise.  If they feel worse after they exercise, then they don’t have enough of  reserve to recover from that kind of expenditure. If that is the case, then they need to dial it back and give themselves a break until they take care of the adrenal fatigue.  Participating in gentle yoga and moderate walking may be the way to go for a while until the adrenals recover and they can take on something more strenuous.

HT:  Back to adrenal fatigue, just to finish up, what do you do for someone who is in stage two?  You have a protocol that you use for people, correct? 

Tracy: I do have a protocol that I use for people and it seems to work fairly well.  We supplement with some Pregnenalone and DHEA. I’m cautious about DHEA in women.  Sometimes it doesn’t work well for them.  So, I always ask a few questions to see if it’s going to be appropriate for them or not.  Pregnenalone, DHEA, some B-complex, vitamin C, and some minerals in the evening, away from your multi-vitamin. Taking minerals in the evening helps the body to relax and get better sleep. 

The goal is to support the adrenals.  What you do with the Pregnenalone and the DHEA helps to give the adrenals a bit of a break from having to make these hormones, so that they can recover a bit.  And the body can use those hormones in the way that it needs to.  Diet and lifestyle are key components also.  Avoiding sugar and excess caffeine, eating balanced meals and supplementing with a basic nutritional program can help to bring the adrenals back into balance.