Adrenal fatigue/ insufficiency, is the number one issue that I see in my clinic. But you probably have never heard of it! So let’s start with a quiz and see if any of these things apply to you…
- Do you have difficulty waking up in the morning,
- Do you need coffee to get going in the morning?
- Have you recently gained weight, especially around the middle?
- Do you feel like you get every cold and flu that is going around?
- Do you have more difficulty dealing with stress and pressure than you used to?
- Do you have a low libido?
- Do you frequently feel lightheaded upon standing quickly?
- Do you struggle with poor memory or “brain fog”?
- Do you feel especially tired in the mornings and afternoons between 3-5pm?
- Do you feel the need to snack or eat frequently to maintain a normal blood sugar?
- Do you crave salty foods?
- Do you feel extremely tired between 7-10pm but get a second wind if you stay up later?
- Do you struggle with PMS: heavy bleeding, moodiness, fatigue during menstrual cycle?
- Do you frequently have pain in the upper back or neck with no apparent reason?
- Do you notice improvement of these symptoms if stress levels are lower, such as during a holiday or time away from work?
If you answered yes to 5 or more of these questions then you may have adrenal insufficiency/ fatigue…but what is this?! 99% of GPs won’t know what it is and won’t be testing for it – so its so important that you know this information of you have ongoing fatigue, as there is a solution to your symptoms.
First let’s begin by understanding what are the adrenal glands ….
Your adrenals are two walnut sized glands that sit on top of your kidneys and are part of the endocrine or hormone system of the body, involved in producing over 50 hormones. Hormones affect every function, organ and tissue in the body directly or indirectly and react to each other as well as respond to conditions in the body in a highly sensitive balancing act. The adrenal glands work closely with the hypothalamus and the pituitary glands in the brain in a system known as the hypothalamus-pituitary-adrenal axis (HPA axis). This axis is basically our central stress response system, combining the endocrine and central nervous system.
Normally, the adrenal glands release cortisol on a rhythm, known as the cortisol clock, which is when cortisol is boosted throughout the day to help wake us up, with a decline in this hormone level in the evening to aid the body in sleeping. This cortisol clock, however, doesn’t always apply when external stress occurs, and can become greatly disregulated, hence causing the common symptoms of adrenal fatigue of insomnia at night and crashing fatigue in the day. Our cortisol is not being boosted in the day to wake us up and make us jump out of bed and is instead being boosted in the evenings, making us wide awake at bedtime or 3am.
Adrenal glands play a huge role in stress response. Your brain registers a threat, whether emotional, mental or physical. Part of the adrenals release cortisol and adrenaline hormones to help you react to the threat (known as the fight-or-flight response), rushing blood to your brain, heart and muscles. Another part then releases corticosteroids to dampen processes like digestion, immune system response and other functions not necessary for immediate survival – hence how adrenal insufficiency or fatigue can cause also frequent infections and poor, slow digestion.
So to understand what adrenal fatigue is its first important to look at what causes it.
The most commonly understood triggers to adrenal insufficiency/ fatigue are:
Prolonged stress/ a stressful lifestyle- this includes the ‘busy-ness’ of life, this is the number one causative factor I see in clinic.
A stressful event such as divorce, death of a loved one
Poor diet
Reliance on energy drinks or caffeine
Food sensitivities
Lack of sleep
Pain
Surgery
Negative self talk or history of trauma
All of these triggers, often not experienced in isolation, cause the adrenals to pump out large amounts of adrenal hormones over a prolonged period of time. Our body is simply not designed to do this and in fact these stress hormones will end up adversely affecting other body systems, such as the brain. In response, our adrenals are shut down, causing adrenal fatigue. So adrenal fatigue is not thought to be caused by a lack of adrenal hormones or the adrenals not being able to keep up with our stressful lives and using up all the hormones, but by our own body’s protective mechanisms.
How do you know if you have adrenal fatigue?
There are two ways that I assess whether a person is presenting with adrenal fatigue – those are assessing symptoms and performing testing.
In consultations I ask many questions about your lifestyle and how you are currently feeling, often I see women presenting to me as exhausted, finding it hard to cope with stress, drinking lots of coffee in the morning, wanting to snack all day, putting on weight around the middle, constant brain fog – these symptoms are massive indicators to me that the adrenals are under pressure. I listen to how you are feeling. I can hear your adrenal function in what you are telling me! I can then arrange for blood, salivary hormone or urinary hormone testing to assess the health of your adrenal glands (and often we assess thyroid too as they really operate together and are often heavily influencing each others function) – we can test your cortisol and DHEA levels throughout the day to assess the function of your cortisol clock, is it dysregulated, is it out of balance, and also assess what stage of adrenal fatigue you are at. Are your cortisol levels still sky high, causing insomnia, palpitations, anxiety or have they dropped low, is your body in protection mode as you have been releasing such high levels of cortisol for so long, causing fatigue, depression – or are you swinging between the two.
What can happen if adrenal fatigue/insufficiency is left untreated/ uncorrected ? ….quite simply horrendous burnout.
So First lets understand what is known to be four stages of adrenal fatigue to se how we end up in burnout.
1) alarm stage – the first stage of the stress reaction, you could still be coping fairly well, will often have increased sense of alertness but with tired periods creeping in
Salivary test results at this stage normally show elevated cortisol and DHEA
Stage one is common and how most of us live a lot of the time!
2) Continuing the alarm stage- symptoms will begin to worsen with continuing stress, a common feeling in this stage is feeling wired but tired, sleep quality worsens, insomnia begins, coffee intake increases and you are often asleep by 8pm on the couch
Salivary test results at this stage show lowering of DHEA, other sex hormomes such as progesterone can start to drop too as the endocrine system concentrates on producing cortisol (stress hormones)
3) Resistence stage – lack of enthusiasm, constant tirendness, low sex drive and regular infections, the wired feeling of the previous stage has gone
Salivary test results will show substantial drops in DHEA, testosterone, progesterone, possibly oestrogen – cortisol levels may also begin to drop
4) Burnout
Depression, anxiety, extreme fatigue, apathy, irritability are the symptoms now apparent
Salivary test results will finally show a drop in cortisol as production has been shut down, sex homrones are also low as are neurotransmitters . We have finally crashed.
The earlier you get support with adrenal health the better as the longer you leave it the harder it is to heal.
And so now to the all important and positive topic, how can you resolve adrenal fatigue/ insufficiency?
I have been supporting women to overcome adrenal fatigue for over 12 years, and in this time I have found there are 3 key factors in adrenal recovery:
Nutrition
Relaxation/ lifestyle modifications
Herbal and nutritional supplements
1) Nutrition- food is medicine, so this is always my primary focus in supporting those I work with and there are some key areas which can make a key impact if removed
Caffeine – interferes further with the sleep cycle and also when you drink caffeine it triggers the same stress release of adrenaline and cortisol that we are trying to regulate, if you just have one occasionally this wont adversely affect you, but drinking every day 2 cups or more and this is adversely affecting your adrenal glands
Processsed and sugary foods – this increase inflammation in the body, hinder digestive proesses, rob the body of nutrients, exacerbate blood sugar issues and cravings
Instead eat more plant based foods, beneifical fats such as coconut, avos, nuts, seeds, just eat organic or grass fed meats and eggs, drinks lots of water
2) Relaxation practice/ lifestyle modifications- it is vital to bring some form of active stress management into your life to balance your adrenals, whether that’s meditation, breathing exercises, creativity, social connection, exercise or all of the above, we must put our body into a safe and relaxed state, releasing feel good neurotransmitters. Get an early night, don’t overschedule yourself, learn to say no, do something for yourself and give yourself permission to heal.
3) Herbal/ Nutritional supplements – herbal medicine is absolutely wonderful at supporting adrenal recovery, thanks to a great group of herbs known collectively as adaptogens – adaptogen herbs do not alter mood but help the body be able to better cope with stress and mediate the stress response – recent research has shown this happens through the medtiation of an enzyme known as JNK.
My favoutite adaptogens are siberian ginseng, withania, licorice, rhodiola, schisandra. I love to hand pick and mix a liquid herbal mix for each client, everyone is different and customising a herbal mix for each patient is just so individualised and much more effective.
I like to combine these with nutrients such as magnesium, taurine, B vitamins, Vitamin C which nourish and restore the adrenal gland, help us better deal with stress and restore energy levels and immune system function.
Remember when using to herbs to consult with a trained herbalist such as myself, herbs are still medicinal when taken in supplement form and are not suitable for all people or for all conditions.
So I hope you now have a clearer understanding of what adrenal fatigue is and how you can get support to heal it – please don’t hesitate to message me to book an appointment so that I can help you if you think you have adrenal fatigue/ insufficiency
Victoria Martin
I help women feel calm, hormonally balanced and re-energized
flat belly diets
What is adrenal fatigue…and do I have it?!