What if I told you that adrenal fatigue doesn’t actually exist? This might make you extremely angry because you are exhausted and fatigued and having been dealing with this for a long time.
I know that your symptoms are real. I know you have been struggling and I am not trying to dispute that. But I do want to challenge our entire understanding of adrenal fatigue and what is actually going on in your body.
What is Adrenal Fatigue?
The concept of “adrenal fatigue” theorizes that the adrenal glands are like a muscle. Over time as they are constantly being told to pump out cortisol, they begin to fatigue and eventually give out. The term was coined in 1998 by Dr. James Wilson.
Lately, a lot of people tell me that, “My adrenals are completely shot!”
People who have been diagnosed with adrenal fatigue suffer from fatigue, exhaustion, low blood pressure, intense sugar cravings, a run-down immune system, difficulty waking up in the morning and an inability to cope with stress in general.
The medical community does not acknowledge “adrenal fatigue” as a real condition and they refuse to do so. Why?
Some believe it is due to inadequate testing. Most health care professionals will use a blood test to look at cortisol levels. A single cortisol measurement tells you little about how the cortisol rhythm is presenting throughout the day. And the very natural of giving someone a needle is enough to spike cortisol and make the test completely inaccurate. That seems like a fair argument. Maybe we just need to look more at saliva and urine testing for cortisol levels and assessing adrenal fatigue.
But maybe the problem is with the whole theory of adrenal fatigue. The adrenals are not made to give out. Some organs are meant to give out with time (ie. the ovaries) but the adrenal glands are meant to last.
There are, of course, certain conditions that do in fact cause the adrenal glands to under function. Addison’s Disease is one of these conditions. This is an auto immune disease that attacks the adrenal glands, leading to their malfunction. There is also “adrenal insifficency” in which the pituitary stimuli to the adrenal glands doesn’t work very well. This is a real diagnosis but it is rare.
In the 17 years since Wilson proposed this theory of ‘adrenal fatigue’ there doesn’t appear to be any evidence to support it. The research does not show that the adrenal glands actually cease to function or wear down over time.
So What is Actually Causing Your Symptoms?
The problem is not in the adrenal glands but in the entire stress feedback loop. This is know as the Hypothalamus-Pituitary-Adrenal axis (HPA Axis). This is the communication system that allows you to response to stress. Let me explain.
When you end up in a stressful situation (maybe you were hiking and saw a bear or maybe your boyfriend just broke up with you), the perceived stress stimulates you adrenal glands which pump out adrenalin.
Adrenalin travels to the brain and notifies the hypothalamus that stress is present. You hypothalamus sends corticotrophin releasing hormone (CRH) to the pituitary gland and then the pituitary gland sends adrenal corticotrophin releasing hormone (ACTH) to the adrenal gland. The adrenal gland responds by giving off cortisol.
Now your cortisol is elevated and all your resources shift from rest and digest functions and move into the muscular and skeletal system so that you can fight or flight for your life.
The problem is chronic stress which leads to chronically elevated cortisol levels. Chronically elevated cortisol is not normal or sustainable. Keep in mind that stress is normal but it should be short, intermittent and quickly resolved, bringing you back to a calm, relaxed state.
Unfortunately, we have so many challenges. Most of us have significant mental and emotional stress but we also have a lot of internal stress caused by poor diet, lack of sleep, toxin exposure, gut dysfunction and intestinal infections to name a few.
Cortisol is a catabolic hormone. This means that it breaks down the body over time. It also suppresses immune function, interferes with thyroid hormones, causes insulin resistance and messes with your blood sugar.
Chronic stress really can mess with the HPA-axis. For example, inflammation can directly cause a breakdown in communication. Inflammatory cytokines which are by-products of inflammation can actually bind with ACTH and prevent it from reaching the adrenal gland. So the adrenal glands are doing their job, they just aren’t getting the proper message.
When cortisol production is lower than it should be, it can cause a lot of symptoms. Cortisol is very energizing. It is also pain-killing, anti-inflammatory and immobilizes blood sugar. Without good cortisol production, you feel fatigued, have aches and pains and experience frequent hypoglycemia.
A great at home test to check your HPA axis function is to lie down on your back and then quickly stand up. If you feel dizzy, that’s a good sign that your HPA axis is malfunctioning. It is the job of the HPA axis to normalize blood pressure from a lying to standing position.
Other Reasons Your Adrenal Glands Don’t Work Well?
Lack of Adrenal Nutrition
Your adrenal glands need certain nutrients and vitamins to function at their best. If you adrenal glands don’t have these necessary thing,s they aren’t going to be as good at their job.
These Nutrients are Crucial:
Vitamin C – Vitamin C is needed for the production of cortisol, adrenalin, testosterone, aldosterone and dopamine (an important neurotransmitter).
B Vitamins – Particularly B5, B6 and B12 are needed to produce adrenal hormones and for cellular energy functions.
Magnesium – You adrenals cannot function without magnesium.
Zinc – Not only is zinc critical for your immune function but is also involved with insulin resistance. Blood sugar and cortisol go together hand in hand. When blood sugar is low, cortisol rises to bring it up. When blood sugar is high, cortisol can be lower. Zinc can help stabilize blood sugar levels and keep cortisol at bay.
The Top 3 Stressors That Cause HPA Axis Dysfunction?
Blood Sugar Dysregulation
One of cortisols main jobs is to raise blood sugar. Having low blood sugar is incredibly stressful to the body. Every time your blood sugar drops, your body thinks your survival is threatened. This initiates the stress response and pushes up cortisol to stabilize your blood sugar.
If you eat low quality, high sugar food then blood sugar drops will happen more frequently. This will keep you in a chronic stress state and mess with your HPA axis over time.
Protein is crucial for blood sugar regulation. Eat a diet high in protein and healthy fat and low in sugar and refined carbohydrates. Managing blood sugar is one of the most important things you can do to fix your HPA Axis Dysfunction.
Poor Sleep Habits
The HPA Axis prefers a natural circadian rhythm. In fact, this axis does a lot of it’s regeneration between the hours of 10pm and midnight. If you go to bed late then you miss out on this crucial time for repair and healing.
Not getting enough sleep, going to bed late or waking up late is one of the quickest ways to mess up this feedback loop. Make sure you get to bed by 10:30pm and wake with the sun. Re-establishing a normal sleep pattern is one of the best ways to nourish your stress system and get rid of your fatigue. For more ways to get a better night’s sleep, click here.
This is an important one. The information about exercise is pretty flawed. We are led to believe that more is better, even when we are tired and sick. “Just push through it!” Right?
Overdoing exercise, especially endurance activities, can really tax your stress system. Exercise is a stressor. In many cases it can be a good stressor but too much of it will put you into a chronic cortisol situation. When I run hormone panels on endurance athletes I often see poor hormone output and dysregulated cortisol production.
If you already know you have adrenal fatigue, then exercise needs to be light. Too much will only prolong your recovery and keep you feeling run down.
Keep exercise fun and playful. Stick to weight training and interval training. You do not need to run a marathon to be healthy. Exercise should make you feel energized. If it makes you feel exhausted then it’s too much. Take it down a notch or two.
Other internal stressors that can keep you in fight-or-flight response include; food intolerances, gluten sensitivity, leaky gut, liver congestion, intestinal infections, SIBO, heavy metal toxicity and poor diet.
Other Causes of Exhaustion and Fatigue
HPA axis dysfunction isn’t the only thing that can lead to exhaustion and fatigue. Here are some other common causes:
Anemia – If your body isn’t getting enough oxygen because you are iron deficient then you aren’t going to have energy. Anemia often causes extreme fatigue.
B12 Deficiency – This is one of the most common deficiencies associated with fatigue. Best sources of B12 are animal products or nutritional yeast flakes.
Lack of Sleep – If you aren’t sleeping, you won’t feel energized. Period. Make changes so that you can consistently get 7-9 hours of sleep every night.
B Vitamin deficiency – This can cause fatigue, anemia and poor adrenal function
Vitamin D deficiency – Make sure you are getting enough sun exposure. Moderate unfiltered sun exposure is the quickest way to get your Vitamin D levels up. Deficiency can lead to fatigue.
Estrogen Dominance – This interferes with thyroid hormone production which can lead to energy problems
Testosterone Deficiency – We need this hormone to maintain healthy energy levels. If you aren’t making enough, you will likely be fatigued.
Caffeine Consumption – Caffeine has a direct effect on your cortisol levels. It causes your adrenal glands to release cortisol and thus reducing your levels for the rest of the day.
Poor Protein Intake – If you aren’t getting enough protein, you will likely struggle with fatigue. Make sure you are getting enough. I recommend 0.4-0.7 grams per pound of body weight.
Adrenal Fatigue may not exist but the symptoms you are experiencing are real. A better way to refer to this condition (although not quite as sexy) is HPA Axis Dysfunction.
If you want to feel better, you need to search for the root cause of your stress. This means taking a good look at your diet and lifestyle but also assessing your risk for internal stressors. If you eat an organic whole foods diet, practice healthy lifestyle choices and still feel like crap, seek out the professional help.
Want to see me talk about this post in a video? Check it out.