Epinephrine, often better known as adrenaline, is synthesized from norepinephrine in both the CNS and the adrenal medulla. Much like norepinephrine, this excitatory neurotransmitter helps regulate muscle contraction, heart rate, glycogen breakdown, blood pressure and more, and is heavily involved in a stress response. Elevated levels of epinephrine are often associated with hyperactivity, ADHD, anxiety, sleep issues, and low adrenal function. Over time, chronic stress and stimulation can deplete epinephrine stores leading to difficulty concentrating, fatigue, depression, insufficient cortisol production, chronic stress, poor recovery from illness, dizziness and more.
Low levels of adrenaline are very rare, even if you have lost your adrenal glands due to disease or surgery. This is because your nervous system can make noradrenaline or norepinephrine, which functions very similarly to epinephrine. However, it is possible to have adrenaline deficiency caused by rare genetic enzyme deficiencies. There are also some cases of adrenal insufficiency that result in low levels of hormones produced by the adrenal glands. Some people also believe in adrenal fatigue, or mild and undetectable (via current blood tests) decreased production of these critical hormones that results in a variety of symptoms.
Research shows that patients with ADHD and concomitant anxiety (self-reported) excrete higher norepinephrine and epinephrine levels than controls (Pliszka, et. al. 1994; Dvorakova, et. al. 2007).
Epinephrine produced by the adrenal medulla, regulates the "fight or flight" response in reacting to stress. In the absence of immediate threat, this neurotransmitter increases alertness, focus attention, sustain thought, fine-tune vigilance and facilitate many cognitive functions. The brain and body norepinephrine and epinephrine systems function in direct and interactive ways (Pliszka, et. al. 1999). In ADHD, these systems may be dysregulated and likely to contribute to inappropriate modulation of attention, impulse control and anxiety (Hunt, 2006).
Stimulant medications commonly used in ADHD increase norepinephrine and epinephrine levels. However, if these neurotransmitters are too high, symptoms associated with depression, irritability, high blood pressure, increased sweating and sleep difficulties may arise. Urinary norepinephrine and epinephrine levels are also elevated in patients with abdominal obesity (Landsberg et al., 1991), anxiety and depression (Hughes et al., 2004), bipolar disorder (Koslow et al., 1983), hyperglycemia (Troisi et al., 1991), hyper-insulinemia (Troisi et al., 1991), obstructive sleep apnea (Kheirandish-Gozal et al., 2013), post-traumatic stress disorder (Yehuda et al., 1992), and stress (Holzman et al., 2009; Fujiwara et al., 2004).
If symptoms of high norepinephrine and epinephrine are problematic, consider evaluation for medications and/or supplements that may contribute to higher neurotransmitter levels in this this individual.
Supplements such as SAMe, magnesium, vitamin B2 may aid with promoting norepinephrine and epinephrine metabolism. Additionally, nervines, adaptogens, biofeedback and meditation may help quiet down the overactive sympatho-adrenal response.
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