Is Adrenal Fatigue a Hoax?
I’ve had clients say their doctors have told them adrenal fatigue is an outright hoax. Adrenal fatigue isn’t acknowledged in the conventional medical model because it is not a disease for which drugs can be prescribed, and that’s how our medical system works. Adrenal fatigue should really be called hypothalamic-pituitary-adrenal (HPA) axis dysfunction, which is a fancy way of sayingthat the feedback loop between the brain and the adrenals is fried, so there is miscommunication and resistance about when and how to release stress hormones. Adrenal fatigue starts isn’t the fault of the adrenals per se; it’s a dysfunction between the brain and adrenal glands.Your adrenals are 2 small glands that sit atop your kidneys and produce cortisol and sex hormones. In many ways the HPA axis and the adrenals are the command and control center for your body, and they help you manage your stress levels, hormone levels, thyroid function, sleep, sex drive, and metabolism. When everything is functioning normally, you have good and stable energy throughout the day, you sleep well, you have a good sex drive, and you maintain your weight.
When you encounter stress, the body reacts with a chain of hormonal events to get you ready for battle. Corticotropin-releasing hormone (CRH) is released from the hypothalamus. CRH stimulates the production of adrenocorticotropic hormone (ACTH). ACTH stimulates the release of cortisol, the body’s main stress hormone. Cortisol keeps blood sugar and blood pressure elevated so you’re able to fight or flee and stay alive during the stressful event. This is a normal and healthy stress response.
But when you are chronically stressed and this chain of events is continuously triggered, your cortisol stays elevated, you become eventually depleted of the hormones you need to battle the stressor. At this point you are facing burnout and may also notice anxiety and depression, as serotonin is depleted when cortisol is chronically elevated, and now there is neuroendocrine dysfunction.
Adrenal fatigue is a constellation of symptoms, such as insomnia, anxiety, fatigue, or brain fog, that disrupts your day-to-day life. These nagging issues wouldn’t send you to the hospital, maybe not even the doctor, but they are your body’s way of signaling to you that there is an imbalance. People may ignore these signs, thinking it’s part of stress or “getting old,” or they may go to a doctor who will prescribe them meds based on their symptoms: Ambien for insomnia, for example, or antidepressants and anti-anxiety meds. But here again, the underlying imbalance isn’t addressed, and the problem continues until it triggers a full blown illness or disease.
When your adrenals begin to falter, you may notice
- fatigue
- weight gain
- digestive issues such as bloating, constipation, diarrhea
- sugar and/or salt cravings
- the “3pm crash”
- brain fog
- increased susceptibility to illness
- decreased ability to handle stress, feeling frazzled
- insomnia or waking around 4am, unable to get to sleep
- anxiety
- depression
- PMS/hot flashes associated with menopause
- inability to focus
- low sex drive
Causes of Adrenal Fatigue
- emotional stress. Interestingly, 95% of adrenal fatigue cases are precipitated by extreme emotional stress. That could be a death, divorce, injury, job loss, OR even positive stress like getting married or having a baby. Stress really is the main cause of imbalance in the body.
- diet. Too many processed foods, too much coffee/caffeine, irregular mealtimes, refined sugars, nutrient poor meals, not eating enough or eating foods that lack nutrients because they are processed or refined.
- pain, chronic inflammation
- microbiome imbalance & digestive infections such as h pylori, dysbiosis,SIBO, candida, parasites (more common than you might think!)
- lack of sleep
- autoimmune conditions
What starts out as chronic stress is usually burning the candle at both ends: staying up all night studying (or partying), chugging coffee or sodas, working 2 jobs, working 80 hours a week, skipping meals, sleeping only 4 hours a night– or not at all. People typically feel pretty good in this stage because your body is churning out more cortisol in response to the stress to make you more alert and get you through whatever you’re doing (the fight or flight response). A little stress is normal and good, and we all have it. BUT it’s your body’s ability to recover that matters, and if you’re not sleeping or eating well and continue in stress mode for years, you’re headed for burnout because your body doesn’t have the chance to recuperate.
Once your body can’t keep up with your stress levels, you start to burn out. Your brain is signaling that there is a stress, but your adrenals can’t produce the required amount of cortisol to keep you going, and you start to crash. Now you’re in adrenal burnout and experiencing low cortisol. Your resources to fight the stressor have been depleted. If you’re a woman, you may start to have irregular cycles or a worsening in PMS symptoms because your body is starting to borrow molecules of other hormones, like progesterone (one of your main female hormones), to make cortisol. Your body perceives that survival is more important than reproduction, so women notice infertility or cycle irregularities. Your body knows a stressed environment is not ideal for creating a baby! This lack of progesterone can leave you estrogen dominant.
You may also experience symptoms of hypothyroid, such as constipation and thinning hair, because your adrenals affect your thyroid as well as your female hormones. You’re probably tired or having trouble sleeping, and you may be gaining weight (especially around the midsection) and are unable to lose it no matter what, because your metabolism has slowed due to your body being in a state of stress. A stressed body is not in fat burning mode– it’s working to conserve resources.
If you continue down this path, chugging caffeine to keep yourself going, skimping on sleep to get your work (or your partying) done, or skipping meals to prevent gaining even more weight, you’re headed for serious burnout. The kind you can no longer ignore. At this point, your adrenals, thyroid and female hormones are imbalanced, and even though your doctor may look at you, perplexed, because your blood work came back ok, you know there’s something wrong because you’re not feeling right, you’ve gained weight, maybe have anxiety, and your hormones have gone haywire.
How to Reverse Adrenal Burn Out
saliva testing to determine cortisol levels
restore circadian rhythm
SLEEP, at least 8 hours nightly. In bed by 10pm.
eat in regular intervals to maintain stable blood sugar
eat enough calories for healing
eat hormone-building, nutrient dense foods and good fats
stop chugging coffee
support digestion with probiotic foods
minerals and vitamin C
adaptogenic herbs
B vitamins
address stress in job, relationships
The first step is saliva testing to determine what your cortisol levels look like. Some doctors may offer blood testing for cortisol, but they’re not nearly as accurate and only offer one snapshot of what your cortisol levels are doing during the day. The saliva test requires 4 samples so you get an idea of your cortisol rhythm. They should be highest in the AM to wake you up and get you through the day, lowest at night so you drift off to sleep. If cortisol is too low, say, in the morning, you’ll be tired. If it’s too high at night, you can’t sleep. Your body is in sync with the natural rhythm of light and dark, and the closer you can re-establish that rhythm, the more you’ll heal. The saliva testing requires 4 samples during the day to measure your cortisol rhythm, then you’ll have the information you need to repair. High cortisol is treated much differently than low cortisol, so it’s important to test and see what your rhythm looks like.
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