Inclusion And Exclusion Criteria
Inclusion criteria were: whole article written in English, cortisol profile and fatigue or energy status as the primary outcome, specific tests performed for evaluating the adrenal axis, absence of corticosteroid therapy, absence of confounding diseases that would lead to an impaired cortisol status caused by the disorder itself . Studies with a merely description about adrenal axis impairment with no tests performed were excluded.
The Truth Behind Adrenal Fatigue
I think its best if we leave the condition known as AF behind us. The theory served us when we didnt have a thorough understanding of how the human body responded to stress. Now that we have more information, we need to stop using this outdated theory.
A more up to date theory on how the human body processes and deals with stress is called the hypothalamic-pituitary-adrenal axis. HPA axis dysfunction or maladaptation is the modern-day equivalent to adrenal fatigue. Instead of suggesting that the adrenal glands fatigue, thus decreasing cortisol production, HPA axis dysfunction links the stress response to your brain, not your adrenals.
It is your brain that both perceives and interprets stress from your environment. If you narrowly avoid getting in a car accident, its your brain that perceives the scene as stressful. In response, your brain signals to your adrenal glands to release cortisol and adrenaline. These hormones improve your reaction time. Which makes you more likely to avoid any other car accidents in the immediate future.
In short term stress like a near miss on the freeway the HPA axis does its job. And it does its job very well. But when the stress becomes chronic, the HPA axis struggles. Your HPA axis adapted to deal with short, intense bouts of stress . The chronic long term stress so common today is not what your HPA axis is ideal at managing.
The downside of the stress response
How Is Adrenal Fatigue Different Than Chronic Fatigue
Chronic fatigue syndrome is quite different to adrenal fatigue. Most importantly, burnout is not the only factor which sets the wheels of ill health in motion.
Often the trigger for chronic fatigue is a viral infection such as glandular fever or a bacterial infection such as pneumonia. For this reason, many practitioners firmly place the focus of treatment on the immune system rather than looking to the endocrine system as the root cause of fatigue. Sufferers also have a number of other differentiating symptoms that are not usually present in people with adrenal exhaustion. These include:
- A persistent sore throat that is unresponsive to conventional treatment
- Muscle or joint pain accompanied by tender lymph nodes
- Exercising makes the symptoms worse
- There are intermittent periods of relief followed by unexplained relapses
Theres also the possibility that people with chronic fatigue syndrome may go on to develop adrenal fatigue as their illness progresses. This is because stress can predispose a person to its onset, or exacerbate the symptoms. Unfortunately, for many sufferers of chronic fatigue this means that their illness often serves as a welcome mat paving the way for adrenal exhaustion.
The following table may be helpful in highlighting the differences between the two conditions:
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Questionnaires For Fatigue Assessment
Among all studies included in this review, nineteen different types of questionnaires and scores were reported. The most commonly used were: the Maslach Burnout Inventory , SF-36 , the Chalder Fatigue Scale , the General Fatigue Scale of the Multidimensional Fatigue Inventory and the Shirom Melamed Burnout Questionnaire . In ten studies, more than one type of survey was performed. In four studies, the methods to assess fatigue were not specified or assessed. A summary of the assessed questionnaires is shown in Table .
Table 6 Assessed questionnaires employed in the selected studies
Low Thyroid Aka Hypothyroid
Low thyroid, or hypothyroid, also shows up as fatigue, but it’s because the thyroid isn’t functioning optimally. Your thyroid is like the body’s metabolic thermostat, and it controls metabolism, weight, temperature, and heart rate. It also plays a major role in fertility and your menstrual cycle. With hypothyroid, you either don’t make enough thyroid hormones to meet the body’s needs , or you can’t convert the available thyroid hormone to the active form.
The primary cause of hypothyroidism for most women is Hashimotos. In this autoimmune condition, the body mistakenly attacks its own thyroid tissues. But people can have hypothyroid for other reasons or even subclinical hypothyroid, which is an early form. With subclinical hypothyroidism, most labs technically fall within normal limits, but you can still have symptoms.
Both adrenal fatigue and hypothyroidism benefit from lifestyle changes like diet, supplements, stress management, and sleep, but other treatments differ. Hypothyroidism may require medication to get the thyroid hormone levels back to normal. At the same time, adrenal fatigue can often be resolved without medication .
If you are wondering if you have either, it’s essential to consult with a doctor or other healthcare professional. With proper diagnosis and treatment, you and your doctor can manage both conditions effectively.
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But What If I Have Symptoms Of Adrenal Fatigue
If you have tiredness, brain fog, lack of motivation, among other symptoms, you should first have a thorough evaluation with a medical doctor. Anemia, sleep apnea, autoimmune diseases, infections, other hormonal impairments, mental illnesses, heart and lung problems, and kidney and liver diseases are just some among many medical conditions that could cause similar symptoms. If the workup from your medical professional turns out normal and you believe you might have adrenal fatigue, I would recommend you consider a fundamental question: Why would your adrenals be drained? Take a better look at what types of stress might be affecting you. For many, the hectic pace of modern life is to blame.
The lack of a biological explanation can be disappointing. To make things worse, its not unusual for doctors to say “there is nothing wrong with you” or “this is all in your head.” The overwhelming amount of information on the Internet that recommends many types of treatment causes even more stress. Mental health conditions, such as depression or anxiety, may have symptoms similar to adrenal fatigue and may not respond well to antidepressants and counseling. And some patients do not believe that a mental health concern is the primary cause of their symptoms and many refuse medications due to concerns about their side effects.
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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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.
Adrenal Fatigue Vs Chronic Fatigue
- Are they the same condition?
There are a lot of similarities between Adrenal Fatigue and Chronic Fatigue Syndrome.
The end result and symptoms seem identical for both CFS and AF.
But do they have different root causes?
The chart below shows the number of times people search for certain terms in Google. It shows a 10-year trend, up to October, 2014.
The number of searches for
Chronic Fatigue has been decreasing.But the number of searches for
Google Search Trends in USA
Search Trends from Google
How likely is it the prevalence of Chronic Fatigue is at thesame time that Adrenal Fatigue is increasing?
It more likely that desperate people are starting to find out about Adrenal Fatigue first, rather than Chronic Fatigue.
The term Adrenal Fatigue has been growing in alternative medicine.
So it is not surprising that once people have given up looking for solutions from conventional doctors, they turn toa Naturopathic Doctor, Nutritionist, etc., who now use the term Adrenal Fatigue.
Up until the early 2000’s, chronically sick people came to the conclusionthey had something called Chronic Fatigue Syndrome.
More and more, people are coming to the conclusion that they have something called Adrenal Fatigue.
But …. are they the same condition? Other than the above chart …. are thereother hints that they are one in the same?
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The Difference Between Cfs And Af
Chronic fatigue syndrome can cause AF. Adrenal fatigue does not cause CFS. This is the biggest difference between the two conditions.
Adrenal fatigue will often be a part of CFS. In order to overcome CFS, you need a well-functioning HPA axis. If you have AF, no matter the cause of your CFS, you wont improve your energy. To reclaim your energy, you need to identify and treat the root cause of your CFS and ensure your HPA axis is functioning optimally.
Signs And Symptoms Of Low Thyroid Functioning
Testing for all of these, especially thyroid antibodies, gives a more complete picture of what’s happening in your body. Sometimes you can have normal TSH, but these labs are off, indicating issues with thyroid hormone conversion.
In the case of Hashimoto’s, thyroid antibodies are high and can start to rise long before TSH goes up.
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Things You Need To Know About Empaths And Adrenal Fatigue Syndrome
How Severe Is Your Lack Of Energy?TAKE THE QUIZ
Being an empath can be an incredible gift that brings you closer to those you love, but it can also wreak havoc on your body and mind. Its essential for empaths to know how to protect themselves from becoming overwhelmed by the feelings of others and avoid the chronic stress that can lead to Adrenal Fatigue Syndrome.
Thyroid And Other Hormone Optimization
The most common hormone issue with fatigue, other than cortisol, is low thyroid function. Most physicians do not measure all the needed blood tests , look for signs on physical exam or listen to the patient for clues about under-functioning thyroid. Symptoms of functional hypothyroidism are:
- Hair changes -brittle or hair loss.
- Low body temperature and cold intolerance
Thyroid problems can occur at any age, often after stress or viral illness, which can lead to thyroiditis , found in almost 10% of women. Treatment with whole thyroid extracts can make an enormous difference in fatigue and other symptoms.
Normalizing other hormones especially DHEA, pregnenelone, and the sex hormones, estrogen and progesterone in women and testosterone in men and women can be an answer to fatigue as well. Appropriate testing is the first step as well as assessing symptoms and use age specific bio-identical hormone therapies can make a world of difference.
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Chronic Fatigue Can Also Be Also Be Triggered By A Variety Of Events In Addition To Long Standing Stress
Patients I see often have the onset of fatigue after a viral infection, environmental exposure such as mold in a water damaged home or workplace, travel borne illness like diarrhea from a parasite or bacteria. The first question I always ask is what events preceded the onset of the fatigue. In susceptible individuals the immune response to infections or toxins like mold, leads to a state of chronic inflammation called CIRS Once this occurs it leads to chronic fatigue as well as other symptoms such as joint pains, headaches, depression and digestive problems.
In addition to adrenal/midbrain based fatigue, there are other common causes of tiredness and lethargy that are best evaluated with an integrative medicine approach. The following is a list of other causes for fatigue, tiredness and lethargy :
What Is Adrenal Fatigue Steps To Overcome It Naturally
Did you know that chronic stress can affect your bodys ability to recuperate from physical, mental or emotional stress? This is likely why most people have dealt with adrenal fatigue at some point in their lives.
Many proponents of this condition estimate that almost every person can experience adrenal fatigue, also known as hypoadrenia, to some degree at a particularly stressful point in his or her life.
Because the adrenals influence many parts of the body, symptoms of adrenal fatigue can mimic a number of disorders and isnt always easily recognizable.
Adrenal fatigue symptoms, like brain fog, moodiness and trouble sleeping, can be indicative of many disorders and are often overlooked by doctors. But more and more people are starting to realize that a combination of these health issues often indicate the onset of adrenal fatigue.
If you have adrenal fatigue, it can have significant effects on your overall health. Luckily, you can improve this common issue naturally by focusing on your nutrient intake and lifestyle choices.
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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.
What Causes Adrenal Fatigue
Adrenal Fatigue can be caused by intense or prolonged stress or can be a result of an acute or chronic infection or a stressful or traumatic event in ones life.
Adrenal Fatigue used to be rare and now is all too common because of our 24/7 lifestyle we lead. Lack of relaxation accompanied by sleep deprivation, poor eating habits and excessive caffeine intake all contribute to this condition.
It will interest you to know that Adrenal Fatigue or Dysfunction has been coined as the 21st Century Stress Syndrome, by Dr. Wilson, who has three doctorates and two master’s degrees, all in different health-related disciplines.
Could what you are experiencing be adrenal fatigue after all?
Can you answer YES to more than half of these statements?
I have allergies to several things in the environment and my allergies are getting worse.
I experience blurred vision.
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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.