Adrenal Fatigue And Stress
Both emotional and physical stressors, as well as a history of trauma, including childhood events, can effect the adrenal function and the stress response throughout life. The midbrain , the seat of control of the adrenal system, stores memories of trauma and stress. This part of the brain is the crossroad between emotions like fear, traumatic events, and the function of the endocrine system including the adrenal production of cortisol and 30 other hormones. When long term stress occurs, unlike other physiologic functions , the stress response often stays up-regulated even after the stressful situation is resolved. This is called allostatic load and leads to chronically elevated cortisol and adrenal response, even when not needed. Eventually, in most people, the brain will reduce the excess allostatic cortisol production as a protective mechanism to prevent the serious consequences of elevated cortisol-weight gain around the middle, diabetes, immune suppression leading to greater cancer risk, heart disease and depression and anxiety. When cortisol responsiveness is lowered the outcome is worse fatigue, poor exercise tolerance, increased food and airborne allergies and reduced capacity to adapt to new stressors, major of minor . This is what many call adrenal burnout.
Case Study The Night Owl
Nancy is a 38-year-old mother of two who works from home. Over time, she found she was procrastinating more and more on her assignments, staying up later and later to complete them. Eventually, she found it nearly impossible to wake up in the morning and equally impossible to go to bed before 2 or 3 a.m. She was tired of missing her kids getting ready for school and was losing her ability to focus on her work because of fatigue.
Once Nancy understood the role hormonal imbalances can play in fatigue, she recognized that being a night owl was not actually healthy for her body. That’s when she decided to order an at-home functional medicine lab test. Receiving detailed information about her cortisol levels helped Nancy understand her difficulty sleeping and motivated her to take action.
She committed to making small but powerful changes to her bedtime habits. She adopted positive rituals, like removing screens from the bedroom and eliminating sugar after 7 p.m. Slowly, she began to settle into a supportive sleep cycle. Today, she happily reports that she’s able to sleep at least 7 hours each night. Best of all, she routinely falls asleep before midnight â a feat that felt nearly impossible to her just months before.
Remedies For Adrenal Fatigue
Recovering from fatigue that involves the midbrain and adrenal function requires looking at the whole person and the stress load they are dealing with. Proper diet is critical in resetting adrenal function including high fiber, low inflammation foods, avoiding food allergies and gluten and eating the right fats. Specific stress management techniques including meditation, proper individualized exercise as well as supplements for sleep issues are all part of the fix.
Most specifically to reset the cortisol function, the use of adaptogenic botanicals and nutrients are needed. I have found high dose omega 3 marine lipids , flaxseed powder and phosphatidyl serine to be very important. To provide the best of the adaptogens in one supplement, I have developed the Cortisol Control Formula combining the adaptogenic herbs with anti-inflammatory botanicals to optimize adrenal function. In addition, minerals such as magnesium and vitamins like B5 and B6 all support normal adrenal function and lead to higher energy.
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Chronic Fatigue Risk Factors
Some factors increase the chances of developing chronic fatigue. These can include:
- Age: CFS commonly affects people in their 40s and 50s but can occur at any age.
- Sex: Women are diagnosed with chronic fatigue more often than men. This may be due to social factors since women are more likely to report their symptoms or have more responsibilities at work and home combined.
- Women exposed to oral contraceptive pills, hormonal IUD or any other synthetic hormones.
- Stress: People who have difficulty managing stress may have a high risk of chronic fatigue.
What Is Lyme Disease
Lyme disease is caused by a specific spirochete bacteria, Borrelia burgdorferi. It often coexists with coinfections such as Babesia, Bartonella, Ehrlichia, and others. Deer ticks carry these pathogens and transmit them to humans when the tick bites us.
Lyme disease and its coinfections are quite common, especially in the Northeast and Midwest of the U.S. According to the CDC, Lyme disease exists throughout the country. The south and along the West Coast see the next highest prevalence.
Acute infection can cause symptoms of a rash, fatigue, joint pain, headaches, brain fog, fever, night sweats, and more. This infection is typically treated with antibiotics and resolves completely within weeks.
Several factors that make CLD a bit mysterious to the medical community. The nonspecific symptoms and the lack of reliable testing for anything but acute infection are all obstacles to proper treatment. The inconsistent presence of a rash at the onset also confuses things.
Of course, we dont dispute the fact that acute Lyme disease exists. But for Chronic Lyme Disease, its another story.
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Why Standard Approaches Fail At Treating Chronic Fatigue Syndrome
If you or a loved one is suffering with Chronic fatigue Syndrome you are probably aware of the many symptoms that go along with it poor sleep, unexplained weight gain, memory loss, Brain Fog, anxiety and depression.
Traditional medicine treats these symptoms by medicating with sleeping pills, antidepressants, antianxiety pills, and or thyroid medications. Unfortunately, this treatment approach may lead to more complications and more health problems due to the side effects of these medications down the road.
The focus on drugs also tends to suppress early-stage symptoms rather than treat their underlying causes. Before you resort to covering up your symptoms with these drugs, I urge you to check the function of one of the most neglected glands in your body your adrenal glands.
Every challenge to the mind and body creates a demand on the adrenal glands. Today, these challenges are endless: the threat of losing your job, lack of sleep, a demanding boss, financial pressures, yo-yo dieting, relationship problems, death or illness of a loved one, skipping meals, reliance on stimulants like caffeine and sugar, digestive issues, over-exercise, illness or infection.
The resultadrenals that are over producing and are constantly on high alert. The over worked adrenal glands eventually wear outresulting in a commonly missed conditionADRENAL FATIGUE.
Are You Just Tired Or Is It Chronic Fatigue Syndrome
If you’ve been searching for answers about your fatigue, you’ve probably come across information regarding chronic fatigue syndrome, fibromyalgia and other chronic conditions that can cause serious fatigue problems. With so much information out there, it can be hard to know what you are dealing with.
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Asian Ginseng/panax Ginseng For Adrenal Fatigue
Asian ginseng or panax ginseng is a herb thats been used for thousands of years. Its been shown to improve stamina of your nervous system and mental clarity for people who suffer from mental fatigue, brain fog and emotional stressors. We highly recommend Asian/Panax ginseng for patients who experience chronic stress.
Is Chronic Fatigue Adrenal Fatigue
Identifying the cause of chronic fatigue is often a challenge in medicine. If obvious medical conditions like heart disease, diabetes, autoimmune conditions are ruled out most physicians assume fatigue is a symptom of depression Though that can be the case, in the majority of medical visits where fatigue is the main complaint an underlying cause can be identified using the concepts of integrative medicine
Fatigue is one of the most common reasons for medical evaluation, with up to 35% of all primary care visits for problems of fatigue and tiredness. One confusing area is the role adrenal function plays in fatigue. Many endocrinologists dispute the existence of adrenal fatigue except in cases of Addisons disease On the other hand it is common to hear non MD practitioners make a diagnosis of adrenal exhaustion as a frequent cause of fatigue.
Actually both ideas are accurate. The adrenal gland makes cortisol, the most important adaptive and stress hormone which controls many of the functions which effect energy production. Cortisol maintains blood sugar, fights inflammation and allergies and helps us survive stressful challenges. Cortisol is one hormone that we can not live without, allowing us to survive the challenges our distant ancestors faced with struggles for survival. However, with the type of chronic low level on going stress we face today, the adrenal response can become dysfunctional leading to fatigue and other symptoms.
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Fatigue In Other Disorders
Complaints regarding fatigue not entirely explained by the underlying pathophysiology of the disease have been observed in patients suffering from other disorders, such as chronic low back pain , breast cancer survivors , and HIV . Therefore, the role of the HPA axis in the etiology of fatigue in these subjects has been analyzed and the findings are presented in Table .
Table 5 Studies in Other Disorders : Methods of and respective results
Adrenal Insufficiency And Chronic Fatigue Syndrome: Any Connection
Hani Raoul Khouzam, MD, MPH
After reading Dr Hani Raoul Khouzams article Chronic Fatigue Syndrome: An Update on Diagnosis in Primary Care , I realized that the symptoms of chronic fatigue syndrome are extremely similar to those of adrenal insufficiency. At least 8 of the CFS symptoms are identical to the severe withdrawal symptoms a patient experiences from stopping prednisone too quickly. Has adrenal insufficiency been investigated as a cause of CFS?
Christine Jones, GYN NPThank you for your question. Clinically, chronic fatigue is common in both adrenal insufficiency and CFS. However, adrenal insufficiency is a well-defined medical condition with signs and symptoms in addition to chronic fatigue. These symptoms are not usually present in patients with CFS.
Among the symptoms of acute adrenal insufficiency are dehydration, hypotension, hypoglycemia and, at times, delirium with altered mental status. Acute adrenal insufficiency is usually a complication of an acute medical illness, such as sepsis associated with tuberculosis or chronic fungal infection or disseminated intravascular coagulation. Acute adrenal insufficiency can also occur during labor or following a traumatic delivery.
So, in summary, in response to your thoughtful comments, adrenal insufficiency is considered one of the conditions in the differential diagnosis of CFS rather than a cause of CFS.
Hani Raoul Khouzam, MD, MPH
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A Vicious Circle Perpetuating Illness
Based on nearly five decades of research, critical illness researchers have proposed a model that describes how NTIS is maintained by reciprocal relationships between inflammation , O& NS and reduced thyroid hormone function, forming a vicious circle . This model can help to explain the perplexing failure to recover of some critically ill patients in ICUs that survive their initial severe illness or injury. We describe the main elements of this model in a simplified manner below, as well as the implications for metabolism and the immune system. We also provide evidence suggesting that the vicious circle observed in prolonged critical illness also underlies ME/CFS.
Figure 4. Simplified model to explain the perpetuation of prolonged critical illness: a vicious circle.
You May Be Suffering From Adrenal Fatigue If You Regularly Experience One Or More Of The Following Symptoms:
Other Symptoms Of Adrenal Burnout also know as Adrenal Fatigue or Adrenal Insufficiency You May Not Be Aware Of.
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Relationship To Other Hypotheses Of Me/cfs Pathogenesis
Our hypothesis that maladaptive mechanisms which prevent recovery in prolonged critical illness also underlie ME/CFS complements several other hypotheses of ME/CFS pathogenesis. In this section we provide an initial and non-exhaustive discussion of some of these complementarities.
Allostatic overload: Some researchers consider ME/CFS to be a maladaptive response to physical, infectious, and/or emotional stressors. They describe an allostatic overload or a crash in the stress system . Our hypothesis fits into this theoretical framework and offers an explanation for the possible underlying physiological mechanisms by drawing on the research from critical care medicine.
Hypothalamic endocrine suppression: Researchers have suggested that hypothalamic endocrine suppression could explain ME/CFS and fibromyalgia . Our thesis upholds this hypothesis and seeks to strengthen it by suggesting that the controversy around the existence of central endocrine suppression in ME/CFS may be resolved by studying the pulsatile secretions of the pituitaryrather than single or average measurements of circulating tropic and non-tropic hormone concentrations, which can fail to discern the dysfunctions of the endocrine axes.
What Is The Outlook
Most people with adrenal fatigue will recover quite quickly but severe symptoms may take some months to recover, or even longer. The time for recovery will vary enormously from person to person and will also depend on the cause of stress and the severity of symptoms. Following a good treatment plan, as described above, will help you to recover more quickly.
Further reading and references
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Cadegiani FA, Kater CE Adrenal fatigue does not exist: a systematic review. BMC Endocr Disord. 2016 Aug 2416:48. doi: 10.1186/s12902-016-0128-4.
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Ross IL, Jones J, Blockman M We are tired of ‘adrenal fatigue’. S Afr Med J. 2018 Aug 28108:724-725. doi: 10.7196/SAMJ.2018.v108i9.13292.
Related Information
- Next Review 26 November 2025
- Document ID 29210
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Know The Difference: Adrenal Fatigue Vs Chronic Fatigue
The feeling of tiredness is an extremely common occurrence. Its one of those feelings we have felt throughout our lives whether we were infants, children, teenagers and even adults. Its likely that we will continue to experience tiredness as we grow into our senior years. Tiredness is usually accompanied by small, minor symptoms such as heavy eyelids, frequent yawning, and low energy. This is normally not a cause for concern since these symptoms represent a message from the brain to the body saying, I need some rest, please get some sleep.
The Cause Of Chronic Fatigue
Officially the cause of Chronic Fatigue is unknown but many theories exist. Many of these are discussed below. We find in practice many chronic fatigue patients may have a number of issues combined which could include:
Pathogens Numerous studies have demonstrated a high incidence of chronic infections in chronic fatigue syndrome and fibromyalgia. These include viral infections of Epstein bar , Barmah Forest virus, cytomegalovirus , human herpes virus-6, , and bacterial infections such as mycoplasma, chlamydia pneumonia and Borrelia burgdorferi . Unfortunately standard tests which look for an elevation of IgG and IgM antibodies, is not a sensitive means of detecting chronic infections in these patients. Chronic infections are almost always present in those whose symptoms started very acutely, especially with an infection, those whos symptoms were ever associated with swollen lymph nodes or sore throat and those with significant cognitive dysfunction or flu-like symptoms.
Toxins exposure to environmental chemicals including pesticides, heavy metals or copper toxicity, intoxicants, neurotoxins, etc can poison mitochondrial function and thus affect energy production.
Allergies/Intolerances -certain food allergens are able to cause a variety of symptoms including fatigue. Many of our patients have been found to have an intolerance or allergy to a number of foods they consume in their diets that they were unaware of due to the delayed reaction often seen with intolerances.
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What Are The Adrenal Glands And What Do They Do
You have two small adrenal glands that lie just above each kidney. Each adrenal gland has an outer part and an inner part . Cells in the adrenal glands make various hormones. A hormone is a chemical which is made in one part of the body but passes into the bloodstream and has effects on other parts of the body.
Cells in the outer part of the adrenal glands make the hormones cortisol and aldosterone. The amount of cortisol that is made is controlled by another hormone called adrenocorticotropic hormone . ACTH is made in a small gland that lies just under the brain . This in turn is stimulated by another hormone which is produced by another part of the brain called the hypothalamus. ACTH passes into the bloodstream, is carried to the adrenal glands and stimulates the adrenal glands to make cortisol.
- Cortisol is a hormone that is vital for health. It has many functions which include:
- Helping to regulate blood pressure.
- Helping to regulate the immune system.
- Helping to balance the effect of insulin in regulating the blood sugar level.
- Helping the body to respond to stress.
Cells in the inner part of the adrenal glands make the hormones adrenaline and noradrenaline . These have various actions throughout the body.
The Stress System And Cfs/seid
Stress is defined as threat to homeostasis. It is generally accepted that these processes are adaptive, designed to re-establish homeostasis. However excessive and/or prolonged activation of the stress system can disturb normal physiology. The stress system comprises the hypothalamic-pituitary-adrenal axis of which cortisol is the major mediator, and the sympathoadrenal system which produces the catecholamines epinephrine and the sympathoneural system producing norepinephrine. Both glucocorticoids and catecholamines act widely to mediate the stress response.
Stress results in stimulation of parvicellular neurons of the paraventricular nucleus of the hypothalamus and the release of the neuropeptides corticotropin releasing hormone and arginine vasopressin into the hypophyseal portal blood system . The combined action of CRH and AVP on the anterior pituitary corticotropes stimulates secretion of adrenocorticotropin hormone . Circulating ACTH acts on the zona fasciculata of the adrenal cortex to stimulate cortisol synthesis. Basal cortisol acts to prevent arterial hypotension by augmenting the effects of catecholamines, and maintain normoglycaemia through insulin counter-regulation.
Figure 1. The stress system.
Several complementary sets of studies have examined basal and stimulated pituitary-adrenal gland function in CFS.
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