Is it accepted as a ‘real’ medical diagnosis? No.
Are your feelings of fatigue ‘real’? Yes.
Is there a cause and can something be done? Yes.
Where does the term ‘adrenal fatigue’ come from?
The adrenal glands are two small organs found above the kidneys.
They produce a variety of hormones including cortisol, which is known as your ‘stress hormone.’
Cortisol functions to regulate:
- Sleep/wake cycle
- Blood pressure
- Blood sugar and metabolism
For example, let’s say you were being attacked. In order to protect yourself the body signals the adrenal glands to release stress hormones and shift you into a sympathetic ‘fight or flight’ state. Heart rate and blood circulation increase, glucose levels are upregulated for energy utilization, muscles are prepared for exertion, and digestion is suppressed (who wants to eat in a time like this?). Cortisol was designed to protect us in acute situations. You deal with the stress then you re-regulate.
However, when we are faced with chronic or enhanced stress and inadequate replenishment, we start to experience a state of imbalance and eventually reach depletion. Think of a flashlight – if we use it for long enough and don’t recharge the battery then it will flicker, become dimmer, then shut off completely.
Here are some examples when stress outweighs recovery:
- Compromising sleep to study for an exam
- Being consumed (physically, mentally, emotionally) in a job that we don’t really like
- Attending CrossFit 6x/week, working full-time, taking care of family and not getting adequate rest
- Forgetting to eat between work, workout, and errands
- Caring for loved ones and not leaving space for ourselves
- Suffering from a disease or injury that prevents us from doing the things we enjoy
- Eating more processed foods and sugar than nutritious foods
- Taking on unexpected stressors without having support or knowing how to cope with them
- Trying to complete a million tasks and not leaving space for down-time
Back to why it’s called ‘adrenal fatigue.’ The assumption is that when an individual is under a lot of stress the adrenals become exhausted and stop producing the hormone required to fight off stress and maintain balance, thereby leaving us in a completely exhausted state. Although this term is inaccurate (your adrenals are fine but rather, your body’s rhythm is simply out of whack because it isn’t receiving the correct tools to heal, replenish, or produce the hormones needed to function optimally) you can see where the term ‘adrenal fatigue’ comes from.
Common causes of fatigue (and hallmark symptoms). Rule these out first.
- Low iron – easy bruising, heavy periods, pale complexion, anxiety, light-headedness
- B12 deficiency – sensations of numbness and tingling, brain fog, limited meat intake
- Low thyroid function – joint pain, weight gain, bloating, heavy menses, PMS, constipation
- Blood sugar dysregulation – feeling ‘hangry’, energy crashes, weight changes, SAD diet
- Viral infection or illness – sore throat, low immune system, cold and flu symptoms, chronic disease
But let’s say you’ve already been to your doctor, had some labs drawn, and ruled out the above. Is it possible the fatigue, body aches, low mood, nervousness, digestive problems, and sleep disturbance are just ‘in your head?’ No, not at all! Although you may not have a medically recognized condition, it is possible you may have hormone dysregulation which isn’t considered a disease or pathology, but rather an ‘imbalance.’
So, what should you do? I recommend seeking a healthcare professional who is trained in health optimization – a practitioner who will evaluate your lifestyle (sleep habits, stress, nutrition, hydration, exercise routine) and provide alternative suggestions to get you feeling your best. This may include lifestyle changes, herbal therapy, and nutraceuticals.
So, what kind of hormone imbalance are we talking about here?
- Cortisol dysregulation
Cortisol is your stress hormone, and as noted above, helps regulate sleep, hunger/metabolism, energy, pain/inflammation, and more. Ideally, cortisol is highest in the morning when we are most alert, and decreases throughout the day until it is time to go to sleep. However, every time we stress our body (at work, the gym, arguing, hearing bad news, eating processed foods, drinking caffeine) cortisol spikes and shoots us into an unnatural rhythm. If we lack the time and tools to recalibrate, we begin to suffer from insomnia, cravings, mood swings, energy crashes, and more.
- Sex hormone dysregulation
Survival trumps reproduction. If all of our energy is consumed by stress and we aren’t refuelling ourselves with adequate nutrients and sleep, we lose out on. Our bodies are so out of rhythm that production of sex hormones (estrogen, progesterone, DHEA, testosterone) become almost non-existent. This can cause irregular or absent periods, fatigue, low sex drive, low mood, weight loss or gain, loss of muscle mass, infertility, poor workouts, and more.
Lets expand on cortisol, the hormone produced by your adrenals and the main culprit in so called ‘adrenal fatigue.’ Cortisol can be measured using blood, saliva or urine. Cortisol levels fluctuate throughout the day so I generally recommend a 4-point-cortisol test, meaning cortisol is measured at four different times throughout the day. From this we can analyze your rhythmic pattern which, in turn, will help decipher why you are experiencing adverse symptoms, what phase of cortisol dysregulaton you’re in, and how to treat it accordingly. However, sometimes your pattern is obvious and won’t require testing. Can you predict your rhythm (see below)?
Essentially, the closer you are to phase 0, the closer you are to ‘optimal health’.
What can be done?
Let’s face it. We are always going to be dealing with different stressors. So how can we support our body to cope with it better?
Step #1: Optimize your lifestyle habits.
- How is your sleep? Are you getting at least 7 hours per night?
- Do you exercise too little or too much? Do you feel better leaving your workout?
- Are you eating a healthy diet with an abundance of nutrients? How’s your digestion?
- Is your breathing fluent and efficient? Are you holding your breath or sighing throughout the day?
- Are you hydrated? Aim for 1 liter per 50 pound of bodyweight per day.
- How are your stress levels? How do you nurture yourself?
Optimizing the foundations of health is the key. If we can tweak these every day, we will become more resilient and feel so much better. Support may be needed from health care providers, loved ones, nutraceuticals, herbs, and potentially, even medications.
If you want more tips on how to optimize your lifestyle, please visit https://www.arynnd.com/blog.
Step #2: Include these tips in your dietary regime.
When it comes to nourishing the adrenal glands, food is of great importance and there are several ways you can improve your eating habits to support your adrenals. These include:
- Eat natural, whole foods since highly processed foods are difficult to digest and add stress on the body.
- Kick the caffeine since it exhausts the adrenal glands by stimulating the production of cortisol and adrenaline. Chaga mushroom tea is a great substitute because it supports energy levels and has adaptogenic properties that help us better cope with stress.
- Eat foods high in vitamin C, magnesium and B-vitamins (see ‘Step #3’ for food sources)
- Eat regular meals spaced 2-3 hours apart. This will prevent blood sugar dysregulation, cortisol spikes and unwanted energy fluctuations.
- Include lean protein, healthy fats, and colorful fruits & vegetables at every meal.
Breakfast (between 8:00 and 10:00 am)
- 2 – 3 eggs, or 4 – 6 ounces of left-over chicken or beef (protein)
- Sautéed greens, zucchini, yams (CHO) in 1 – 2 tablespoons coconut oil (fat)
Lunch (between 12:00 and 1:00 pm)
- 4 – 6 ounces of chicken, beef, or wild salmon (protein)
- Broccoli, brussel sprouts, yams (CHO)
- ½ avocado (fat)
Snack (between 3:00 and 4:00 pm)
- Apple (CHO) with 1 – 2 tablespoons of almond butter (fat + protein)
Dinner (between 6:00 and 7:00 pm)
- Crockpot stew:
- Ground beef (protein + fat)
- Kale, mushrooms, onions, carrots, yams (CHO)
Step #3: In times of high stress, support yourself with 3 essential nutrients.
- Required for the production of cortisol. The higher the demand on cortisol to cope, the higher the demand on vitamin C to produce it. It is also a great anti-oxidant to detoxify your body.
- Dosage: Vitamin C with bioflavonoids (2:1), 100-1000 mg 3 times daily (depending on your phase).
- Food sources: Colored vegetables & fruits (green leafy vegetables, kiwi, papaya, strawberries, tomatoes, peppers) & sprouts (sunflower, broccoli, alfalfa, clover).
- The ‘relaxation mineral’ required to produce the enzymes and energy necessary for the adrenal hormone cascade. It is an antidote to stress, promotes relaxation, lessens muscle cramps, and helps improve sleep.
- Dosage: Magnesium (bis)glycinate, 400 mg before bed.
- Food sources: Avocado, dark chocolate, dark leafy greens, fatty fish, nuts and seeds.
- Many of the B-vitamins are cofactors in the enzymatic pathways of the adrenal cascade. All the B-vitamins work together to support energy, nerve health, brain function and other bodily functions.
- Dosage: Generally, 1 capsule per day of a B-complex. However, vitamin B5 and B6 become increasingly important depending on the phase with recommended doses of 100-500 mg and 50 mg daily, respectively.
- Food sources: Avocado, asparagus, dark leafy greens, meat.
Probiotics, omega-3, herbal adaptogens, and vitamin D3 may also be supportive.
Step #4: Refer to the “tips” found below the cortisol graphs.
Step #5: Be your own doctor and individualize your treatment plan to you.
No person is the same. We have different upbringings, experiences, routines, passions, goals, triggers, health concerns, and ways of coping. As a result, there is no cookie-cutter guide to optimal recovery. You know your body better than anyone else (e.g., your partner, friend, mom, doctor, coach) so it is important to reflect and ask yourself “what do I need to heal…what will recharge my battery?”
For me, I am energized by good sleep, quality time with friends and family, nutritious foods, journaling, nature, sunshine, warm baths, massage, breathwork, and relaxation yoga. I am depleted by obvious stressors such as disease, loss, separation, unpredictable situations, arguments, and even things I deeply enjoy such as work and CrossFit which both require great amounts of mental, emotional and physical capacity. What do you need?
- Davis, C. P., & Cunha, J. P. (2019, December 18). What are treatment options for a cold? Retrieved from https://www.emedicinehealth.com/colds/article_em.htm#are_there_alternative_treatments_for_colds
- Hall, J. E., & ClinicalKey Flex. (2016;2015;).Guyton and hall textbook of medical physiology (13th ed.). Philadelphia, PA: Elsevier
- Hyman, M. (n.d.). Magnesium: Meet the Most Powerful Relaxation Mineral Available. Retrieved from https://drhyman.com/blog/2010/05/20/magnesium-the-most-powerful-relaxation-mineral-available/
- Marciano, M., & Vizniak, N. (2018). Botanical medicine. Vancouver, Canada: Professional Health Systems.
- McCulloch, M. (2018, October 11). 15 Healthy Foods High in B Vitamins. Retrieved from https://www.healthline.com/nutrition/vitamin-b-foods
- Moyer, K. (2017). Nutritional considerations for adrenal health. [Nutrition VIII Lecture Notes]. Boucher Institute of Naturopathic Medicine, New Westminster, British Columbia, Canada.
- Romm, A. (2018, July 18). Adrenal fatigue: Is it a real thing? Retrieved from https://avivaromm.com/adrenal-fatigue-real-thing/
- Romm, A. J. (2017). The adrenal thyroid revolution: a proven 4-week program to rescue your metabolism, hormones, mind & mood [First edition]. New York, NY: HarperOne