With the number of people living with chronically elevated stress and experiencing burnout, adrenal fatigue has become a bit of a “buzz term”. But the truth is, there is no such thing as “adrenal fatigue” and if you ask most medical doctors about it, they may look at you like you’re crazy.
Adrenal fatigue is not a recognized medical condition because physiologically, the adrenal glands don’t actually become “fatigued”. The title of the condition is a misnomer, the constellation of symptoms is real, and there are many people, especially women, suffering from it.
Common complaints include fatigue, weight gain, sugar cravings, hair loss, hormonal symptoms, menstrual irregularities, anxiety, and thyroid symptoms. These are often disbanding because they don’t fit into a well-established diagnosis. So, until there is a more appropriate name for it, adrenal fatigue is what we will call it.
What is really going on?
The adrenals are 2 small glands that sit on top of each kidney. They produce a number of hormones, including cortisol, which helps the body respond to stress. Our entire stress response system is controlled by something called the Hypothalamic-Pituitary-Adrenal axis (HPA axis), which is how the brain and the adrenals talk to each other.
When there is a stressor, like being chased by a saber tooth tiger, the HPA axis becomes activated and there is a cascade of hormonal responses that follow. It starts with the release of corticotropin-releasing hormone from the hypothalamus, which leads to the secretion of adrenocorticotropic hormone (ACTH) from the pituitary gland. ACTH then travels to the adrenal glands to trigger the release of cortisol, which helps our body react to the stressor.
Evolutionarily, this system is here to keep us alive and able to react to an immediate threat. It was meant to be short-lived and would stop firing once we found safety. However, in the modern world, these dangers no longer include running from a vicious animal, they are our never-ending to-do lists, high demands, and unhealthy lifestyles. So now, for many of us, stress is constantly present. This causes our adrenals to release more and more cortisol until the HPA axis becomes dysregulated. Then as our body tries to protect us, it dials back on the amount of cortisol it is producing. The outcome is low levels of cortisol. “Adrenal fatigue” is a state of dysregulation.
Symptoms of “Adrenal Fatigue”
In general, “adrenal fatigue” symptoms include a range of feeling “tired but wired”, overwhelmed, and stressed, to feeling completely burnt out and deeply exhausted.
Common symptoms include:
- Fatigue
- Anxiety
- Sleep problems
- Sugar and caffeine cravings
- Drop in energy around 3-4 most afternoons
- Weight gain, especially around your midline
- Getting sick more often
- Low blood pressure
- PMS
- Menstrual irregularities
- Low libido
- Brain fog or forgetfulness
- Digestive problems
- Thyroid symptoms
- Exercise intolerance or difficulty recovering
Long-term, chronic stress can lead to a number of conditions including diabetes, insulin resistance, high blood pressure, heart disease, insomnia, hormone imbalance and PCOS, infertility, and autoimmune diseases.
How do know if this is you?
If you’ve seen a doctor about these concerns already, you’ve likely been told you are “fine” because your blood work may have come back “normal”. However, blood work may not cut it – although it may be important for ruling out other conditions that may be causing your symptoms, such as Hashimoto’s or iron deficiency anemia.
Depending on the type of symptoms you are experiencing, your healthcare provider will determine which testing should be done (if any), and this may include sex hormones like progesterone and DHEA, blood glucose, insulin, cortisol, vitamin D, and other nutrients.
There are also a handful of specialty tests that you can do with a naturopathic doctor or a functional practitioner, but you may not even need these to tell you what is wrong.
In my opinion, the best test is to evaluate your lifestyle.
- Are you overcommitting?
- How are you taking care of yourself?
- Are you unhappy?
- Have you exposing yourself to environmental pollutants?
- Are you undereating?
- Are you not sleeping enough?
If so… let’s change that.
Simple strategies to avoid “Adrenal Fatigue”
When you are stressed and overwhelmed I can appreciate that the last thing you want to do is to add more work to your plate, but when it comes to adrenal overdrive, lifestyle changes need to be made to set you up for lasting success. You will thank me in the long run.
Here is what you have to do:
- Relaxation techniques
Relaxation doesn’t mean sitting on the couch and bingeing Netflix or going to spa. This needs to be an active commitment. This includes breathing techniques, meditation, journaling, yoga, etc. These calming practices immediately shut down your stress response and tell your body that it is safe.
- I have my patients set reminders in their phone to breathe every 1-2 hours. They know when this alert pops-up to take 3 slow, deep breaths no matter what they are doing. Easy, peasy, and powerful!
2. Sleep hygiene
Cortisol helps to regulate your circadian rhythm and if your sleep is off, your cortisol levels will be too. If you don’t fix your sleep patterns, your adrenal glands will never be restored.
- Sleep 7-8 hours a night in a dark room, with no distractions
- Stop using electronics 1 hour before bedtime or use blue-light blocking glasses
- Expose yourself to light first thing in the morning
- Stop Fasting & Regulate blood sugar
Fasting and intermittent fasting can be wildly beneficial for some, but if you are dealing with “adrenal fatigue”, skipping meals adds stress to an already stressed out system. The goal is to eliminate as many stressors as possible, and lack of food or blood sugar dysregulation is a big one!
- Eat regular meals, limit refined and simple carbohydrates, and focus on meal quality protein, healthy fats and vegetables.
- Exercise, but don’t over-do it
Exercise is an amazing way to decompress and correct metabolic dysfunction, however, you can easily over-do it. Like fasting, high-intensity interval training may not be for you, even though you can read the long list of health benefits online. Exercise is a stress on the body, and while you heal your adrenals, a less intense form of physical activity is a go.
- Limit caffeine
When you are exhausted caffeine may be the first thing you reach for, but this empty fuel will put your body into a more depleted state. Fight the urge and limit your caffeine intake.
- Supplements to support the adrenals:
Although lifestyle changes should be the foundation of your treatment. Many supplements are there to speed up your recovery. Here is a shortlist of my favourites:
- B-complex
- Magnesium
- Vitamin C
- Zinc
- Fish Oil
- Adaptogens –Rhodiola and Ashwagandha are my go-tos
In Conclusion
These simple strategies don’t only help to correct an already exhausted system, but they can be used to prevent burnout in anyone under significant stress. We could all benefit from more of a conscious commitment to incorporate more self-care into our lives.
Although “adrenal fatigue” may not be a physiologically correct title. Stress can lead to overactivation of our HPA axis leading to a number of frustrating symptoms and multiple health conditions. “Adrenal fatigue” may not be real, but your symptoms are, and you deserve to be heard.
In health & nourished adrenals,
Dr. Bronwyn