Causes Signs Symptoms Treatments And Controversy
With James L. Wilson, PhD
Excess stress causes the adrenal glands to increase cortisol production.
If you’re feeling tired and fried, chances are you’ve probably heard of adrenal fatigue and wondered if it may be the source of your constant exhaustion. But what exactly is it, and how do you know if it’s what’s causing your lack of oomph? Let’s investigate.
Adrenal fatigue is an increasingly common yet sometimes controversial diagnosis used to indicate depletion of the adrenal glands. Cortisol is a hormone released by the adrenals for use in the regulation of blood pressure. In response to stress, the adrenals release greater amounts of cortisol. Adrenal fatigue is thought to occur when the adrenals have become overtaxed by excess cortisol release and can no longer produce levels of cortisol necessary for optimal body function.
James L. Wilson, PhD, who coined the term adrenal fatigue in his book Adrenal Fatigue: The 21st Century Syndrome, describes the adrenals as two little glands that sit over your kidneys and are about the size of two large grapes and weigh about five-to-eight grams.
According to Wilson, The adrenals put out over fifty hormones. We often only hear about DHA and cortisol, but forty percent of womens estrogen or progesterone are made in the adrenal glands and about forty percent of testosterone in males is made in the adrenal glands.
A Functional Medicine Guide: Adrenal Fatigue
My patients come to me with many different health issues, but the most common one by far is fatigue. I witness the epidemic of extreme exhaustion on a daily basis, as my patients tell me how they wake up feeling exhausted and depend on caffeine to keep them awake throughout the day. They are irritable and hangry , crave salty or sugary foods, or both. They have trouble losing weight despite dieting and exercise, and have little to no sex drive. Their energy level crashes in the afternoon, but they often get a second wind before bed and find they cant wind down or sleep soundly, perpetuating the cycle.
Sadly, many think this is just the way people feel, and that it must be normal because everyone else seems to feel the same way. But just because something is common doesnt make it normal. Feeling constant, unrelenting fatigue is not normal. In fact, it is one of the primary symptoms of adrenal fatigue.
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Assess And Restore Your Iron Levels
Iron deficiency anemia is one of the most common causes of fatigue. Your doctor can test your iron levels with a simple iron or ferritin blood test. If you are low in iron, taking an iron supplement may help improve your fatigue .
Adequate stomach acid is necessary to absorb iron well, so low stomach acid can contribute to fatigue [21
Avoid taking iron unless you know you are deficient, as excess iron can cause other problems.
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What Is Adrenal Fatigue
A relatively new term, adrenal fatigue was proposed as a new condition in 1998 by Dr. James L. Wilson, a naturopath and chiropractor. His assumption was that an overstimulation of the adrenal glands by long-term stress could lead to an inconsistent level of cortisol in the bloodstream.
In addition to this overload or improper stress hormone levels, people with adrenal fatigue often dont have enough DHEA, the parent hormone responsible for the creation of many necessary hormones in the body.
Dr. Wilson describes the unique progression of adrenal fatigue throughout the day as follows:
- You wake up and are unable to function without a significant amount of caffeine.
- You finally feel a boost of energy during the early part of the day.
- Then your energy levels crash around 2 p.m., rise around 6 p.m. and fall again around 9 p.m.
- Your energy finally peaks again at 11 p.m.
Is Adrenal Fatigue Real?
The major issue with recognizing or diagnosing adrenal fatigue is the inability to distinguish its symptoms and patterns from other disorders. The parameters for this condition are nonspecific, which, unfortunately, has led to a great controversy around this topic, even though the very nature of cortisol and bodily hormones is that the effects are far-reaching.
A diagnosis for this condition is difficult because stress hormone levels typically fall in what conventional medicine would call inside the normal range, although the symptoms are clear to those suffering from the condition.
Take An Actual Break To Reset Your Nervous System
There are likely a handful of things in your life that youve been engaging in that have been draining your metaphorical batteries for a while now. In order to earn your way back to a clean bill of health, you must begin by taking a proper break from the things that have been exhausting you.
Take a two week break from work. Start saying no to social events that drain you. Pass off your least favourite responsibilities to someone else for a while.
Yes, people will be disappointed with you. But your health comes first. Full stop.
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Intervene Into Your Chronic Stress
Another key element of adrenal fatigue treatment is managing chronic stress. Pinpoint your key areas of stress and work to modify them, whether that means testing for food intolerances, detoxifying your environment, or just letting yourself heal by clearing your schedule for a while. You can never eliminate all stress in life but if you can be sure to work in periods of rest and relaxation so stress levels can subside for a while, you will break the chronic stress cycle to regain your health and feel like yourself again.
Cortisol & The Stress Response
When we undergo an excess of mental or physical stress, the adrenal glands can become depleted. The adrenal glands release a stress hormone called cortisol. Cortisol plays several important roles in the body. It helps control the bodys use of fats, proteins and carbohydrates suppresses inflammation regulates blood pressure increases blood sugar and can also decrease bone formation. This hormone also controls the sleep/wake cycle.
Cortisol is released during times of stress to help your body get an energy boost and better handle an emergency situation. This is a great support when we are actually facing an immediate danger and need an energy boost to fight or flee from a situation. When we experience stress on a regular basis, however, excesses of the cortisol hormone are released. Not only does this deplete the adrenal glands responsible for many necessary functions, but it can have its own slew of negative health effects over time.
Chronic stress, or a constant stress experienced over a prolonged period of time, can lead to mental health problems, such as depression, anxiety and personality disorders cardiovascular disease, including heart disease, high blood pressure, abnormal heart rhythms, heart attacks and stroke obesity and other eating disorders menstrual problems sexual dysfunction gastrointestinal problems, and much more. Chronic stress is terrible for the whole body.
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Improve Your Gut Health
If you have digestive imbalances or conditions like IBS, SIBO, and IBD, your fatigue may be coming from your gut . In a meta-analysis of 24 studies, more than 50% of Irritable Bowel Syndrome patients were found to have fatigue . Fatigue is also associated with leaky gut, and repairing leaky gut has been shown to reduce fatigue [7
Trusted SourcePubMedGo to source]. To learn more about how to use probiotics, see our Probiotics Starter Guide.
Address Any Underlying ThyroidDysfunction
Fatigue is one of the main symptoms of hypothyroidism . If you have hypothyroid symptoms, including fatigue, hair loss, weight gain, and dry skin, reach out to your medical provider for evaluation.
If you are hypothyroid, treatment with thyroid medication may significantly help your fatigue. However, some people dont experience adequate fatigue improvement with thyroid medication. Thats because there is a strong connection between thyroid health and gut health. Thyroid patients usually benefit a lot from improving gut health.
In short, you may experience fatigue relief by improving your thyroid health along with your gut health.
How Do Men Get Adrenal Fatigue
If a mans stress level remains excessive for a prolonged length of time , the adrenal glands respond by producing the adrenal hormone cortisol continually. This over-exertion taxes the adrenal glands to the point where the glands are unable to produce the necessary levels of cortisol to keep up with the demand and subsequently these drastically diminished levels of cortisol eventually lead to adrenal fatigue in men. This hormonal imbalance-induced fatigue affects all other hormones in the body, producing a chain-like reaction. While attempting to maintain high cortisol production to manage the chronic stress levels, the adrenal glands are unable to maintain the production of other necessary hormones. One such hormone is DHEA, or dehydroepiandrosterone. DHEA is vital to maintaining the balance of hormones in your body, and low amounts of this important hormone contribute to adrenal fatigue symptoms in men.
There is also a condition known as Cushings syndrome that, while rare, can lead to high levels of cortisol and, therefore, adrenal fatigue.
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Address The Root Causes Of Your Fatigue
Overcoming your fatigue is about addressing the true underlying causes. You may need some help figuring out what these are. Once you know where your fatigue is coming from, focusing on your digestion, your thyroid health, your iron levels, your diet, or your unique stressors can have you feeling energetic again in no time.
Eat Healthy Fats Every Day
Avocados
Avocados contain beneficial B vitamins and monounsaturated fats that boost neurotransmitter production and brain health. This fatty superfruit also contains potassium, which naturally helps to lower blood pressure.
Full-fat kefir
Bacterial imbalances in your gut can contribute to brain problems because the gut and brain talk to each other through the vagus nerve. Kefir is rich in beneficial bacteria for your microbiome and also has fat-soluble vitamins A, D, and K2, which are important for brain health, so it helps out from both ends of this critical connection.
Coconut oil is super versatile you can cook with it, put it in smoothies, or just eat it off a spoon as I do. It offers good fats like medium-chain triglycerides that can help with brain function.
Wild-caught fish
Omega-rich foods like Alaskan salmon can help decrease inflammation, which is crucial for brain and hormonal health.
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Foods For Adrenal Fatigue You Should Eat
How Severe Is Your Lack Of Energy?TAKE THE QUIZ
When youre dealing with adrenal fatigue, having essential coping strategies on hand helps you feel better. Thats why incorporating the right foods for adrenal fatigue into your diet makes a huge difference!
With adrenal fatigue, you may experience hair loss, trouble sleeping, extreme tiredness during the day, weight fluctuation, and increased cravings. You might even take longer to recover when you get sick, so taking care of your body and immune system is a must.
Your diet will always influence your health and the way you feel. If youre dealing with symptoms of adrenal fatigue, changing up your diet could help!
Supplements To Improve Fatigue
Trusted SourcePubMedGo to source, 42 Trusted SourcePubMedGo to source] have been shown to benefit fatigue. Supplementing daily for a short while may improve your fatigue.
Low blood levels of vitamin D have been proposed as a contributor to fatigue in a number of autoimmune health conditions, including lupus . However, there are few studies that confirm the relationship. So, though there are numerous reasons to take vitamin D, fatigue isnt one of them.
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See A Wellness Chiropractor:
Stress on the upper cervical spine can cause an increase in sympathetic tone and stress hormone production. If this problem is not corrected, over time, it can lead to poor tissue healing and adrenal fatigue .
Seeing a wellness based chiropractor who can accurately assess for upper cervical subluxations and give specific corrective adjustments and exercises to stabilize this region can be extremely helpful in reducing stress on the body .
Other subluxation problems that need to addressed include forward head posture, loss of cervical curve which both put a lot of pressure on the nervous system and lead to an increase in sympthatic tone.
Get An Adrenal Fatigue Test
You can just follow the advice at the bottom of this article , but if you want to be really sure that you have adrenal fatigue, I recommend getting a cortisol test from a functional medicine doctor.
Standard doctors often dismiss cortisol test results because they fall within the normal range of cortisol. But feeling like crap isnt normal, and you shouldnt accept it. Its similar with testosterone: 300 ng/dL is within the normal range, and so is 900 ng/dL. But if you triple your testosterone levels, I promise youll feel a lot different.
Its the same with cortisol. In the morning, normal cortisol is anywhere from 7-28 ug/dL in the afternoon, its 2-18 ug/dL.Thats a huge range, and the reason I dont suggest a standard doctor for a cortisol test. You dont want normal you want optimal.
A functional medicine doctor will look more carefully at your cortisol levels and be able to tell you if you have adrenal fatigue.
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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.
Tempeh Kale Taco Salad
The Tempeh Kale Taco Salad is an excellent alternative to any animal-based proteins and nutrients. So, if youre vegan or vegetarian, this healthy and filling salad will provide you with everything you need from your meal. The tempeh and beans are high in proteins, while the kale contains magnesium.
And voila, you have a tasty, healthier version of the regular taco youll find in fast food places. To add some healthy oils to this meal, just sprinkle a bit of olive oil or tahini dressing.
Get the full recipe here.
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Reset Your Stress Response
Some tips for managing stress:
STEP #1 Recognize the Feeling
The first step to overcoming anxiety is to recognize it for what it is a set of feelings that are the result of a series of biological responses to a perceived threat. Pay attention to what happens when you become anxious: Your heart rate increases, your breathing accelerates, you may start to sweat, and your mouth might get dry. You may feel that you are going to pass out. Or you may have an urge to run, flee. You may have difficulty concentrating or experience memory lapses. You may experience nausea, chest pressure or pain. At bedtime you may be unable to fall asleep. You may feel a sense of impending doom even that you are going to die. But you are not. These are the signs of anxiety. It is your bodys flight-or-fight response kicking in.
STEP #2: Have an Emergency Response Practice
One of the quickest ways to reset your response from going down an anxiety pathway is to learn to use your breath for a quick reset. The quickest reset comes from doing a technique such as tapping or breathing exercises. You can retrain your brain to reduce negative thoughts with apps like Calm and Headspace.
For more advanced practice in learning to use your mind and breath to get and stay out of anxiety, check out HeartMath an affordable and effective biofeedback device that we can teach you in the office, and you can easily use at home.
STEP #3 Create Safe Space for Your Brain
A Q& a With Dr Alejandro Junger
What exactly are the adrenals? And what systems in the body do they control?
The adrenals are two small glands that sit on top of our kidneys. They are involved in the production of the hormones that regulate the fight or flight reactions, adrenalin, and noradrenalin. The way I think about them is kind of like the power strip into which the organs are plugged for energy, much like your home appliances are plugged into a socket. If the adrenals are not working optimally, your organs will run low on voltage and not be able to run optimally.
What happens to the adrenals when were in a constant state of stress, i.e., fight or flight levels of anxiety? How can you tell if your adrenals are out of whack?
When we are in a constant state of stress, the adrenals are overworked, and much like anything that is overworked in the body, they can run into exhaustion. When this happens, we feel exhausted, and depending on what organs are most affected, the symptoms may vary. Common symptoms of adrenal exhaustion are a general lack of energy, difficulty sleeping, clouded mind, depression, weak immunity with frequent colds or other infections, and difficulty digesting. But pretty much anything else can go wrong when our adrenals are exhausted, such as infertility, low blood pressure, and anemia.
Is it true that caffeine taps out the adrenals? How much is acceptable?
Can you destroy your adrenals? Is it possible to revitalize them?
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