• Siri DeMarche

The quick n' dirty on Adrenal Fatigue + Combative Steps to Take

Updated: Mar 21

*As always, scroll to the very bottom for a TLDR synopsis*


"Adrenal Fatigue" as a diagnosis gets thrown around like silly string at a ten year old's birthday party. Some sources talk about it like it is a common but serious problem, while others declare it not to be a real thing. What gives? What is adrenal fatigue (spoiler alert: it's real and it sucks), how do you know if you might have it, and what steps can you take to combat it and/or prevent it? All these questions will be answered in this post. Stay tuned my friends, stay tuned :)


First, what are your adrenals? Your adrenal glands sit on top of your kidneys (like cute little kidney sport caps). They regulate many critical hormonal jobs in your body, and one of their primary functions is to modulate the release of cortisol (your main stress hormone). Cortisol is essential for survival. We need cortisol in emergency situations, so that we can shift into our fight-or-flight mode for survival purposes. We are built to handle stressful events. In order for our ancestors to evade predators, their sympathetic nervous system responded by switching the body into fight-or-flight mode. To do this, the adrenal glands release cortisol. Cortisol increases blood pressure and blood sugar for faster response timing and consequently an increased chance of survival. After our ancestors had successfully evaded their predators, their levels of cortisol decreased, as well as their blood pressure and blood sugar levels. When the body perceives stress and releases cortisol, you experience measurable increases in blood sugar, blood pressure, and energy. After the threat has passed, your body calms back down, and your vitals return to normal again. Balance was restored.


Note: Ongoing stress (aka predators to your brain) does not restore this balance.


Now let's shift our focus to current day. Because, uh, chronic stress is a thing. Some stress is good, great even, essential for getting sh*t done. But today's levels of chronic stress have created an epidemic of extreme exhaustion leaving folks dependent on caffeine to stay awake throughout the day, consistent feelings of irritability, and living in constant fear of being "hangry." Intense cravings for salty and/or sugary foods, trouble losing weight (despite getting plenty of exercise), little to no sex drive, energy crashes in the afternoon, and a second wind before bed- making it difficult to wind down and sleep.. are all perpetuating this cycle.


Unfortunately, many people think that this is the way it's supposed to be. That this is what aging is, this is what corporate life does to you, this is "the hustle"..etc. How much does would that suck?! Just because something is common, does not make it normal. Let me repeat that: Just because something is common, does not make it normal. The feeling of constant and unrelenting fatigue is not normal, but it is a primary symptom of adrenal fatigue.


In a healthy person, cortisol is higher in the morning to help with waking the body and slowly decreases throughout the day. Melatonin, your "sleep time" hormone, is inversely proportional to cortisol. When cortisol is high, melatonin is low and vice versa. Adrenal fatigue happens when there is an imbalance in this cortisol rhythm. Cortisol is either low when it should be high, high when it should be low, or always high, or always low.


The problem is that modern life tends to be stressful, not just in emergency situations, but all the time. Unlike acute stress, for which we are biologically programmed to handle, chronic stress switches on the flight-or-fight response without turning it off again. Blood pressure and blood sugar stay elevated and we remain in this heightened state. Now, this can only go on for so long. Eventually, our ability to keep releasing cortisol gets tapped out, after being triggered so often and for so long. The result is adrenal fatigue.


This problem is not isolated in your adrenals. Your brain communicates with your adrenal glands, telling them what to do via the hypothalamic-pituitary-adrenal axis (HPA) aka the brain-adrenal axis. Your hypothalamus releases corticotropin-releasing hormone (CRH) to tell your pituitary gland to release the adrenocorticotropin hormone (ACTH). ACTH then says, "hey adrenal cortex, release the cortisol!" Adrenal fatigue is really a dysfunction of your brain's communication with your adrenals, not the adrenal glands themselves.


...or cortisol

Adrenal fatigue is different from other adrenal gland problems. It is far more common (to vastly varying degrees) and also more difficult to pin down. Luckily, functional medicine practitioners have gotten good at understanding and recognizing it (and testing for it in the first place).


Some of the common culprits:

-Excessive exercise

-Toxin exposures

-Emotional stress

-Food intolerances

-Chronic gut infection

-Autoimmune conditions

-Viruses

-Microbiome dysfunction


These stressors can cause cortisol to remain elevated for a long time, exhausting your poor lil' adrenal glands.


Symptoms can include:

-Trouble falling or staying asleep

-Irritability

-Fatigue

-Blood sugar fluctuations

-Changes in blood pressure

-Low immune system

-Digestive issues

-Brain fog

-Dizziness when standing too quickly

-Increased allergies

-Asthma

-Weight fluctuations and/or difficulty losing weight

-Depression

-Decreased sex drive

-Slow start in the morning

-Cravings for salty and/or sugary foods

-Afternoon fatigue

-Blood sugar issues

-Chronic inflammation

-Weak nails and brittle hair


Adrenal fatigue absolutely sucks, so what can you do?

1. Ask your doctor about diagnostic labs

One lab you can have run is a 24-hr adrenal stress index to get a comprehensive overview of what's going on. It's a salivary test that tracks your cortisol levels, HPA axis quality, and other hormone levels throughout the day.

*Adrenal fatigue is primarily a brain-based issue, so it is important to rule out brain inflammation.


2. Get a handle on your chronic stress

Understand where your stress is coming from and take steps to mitigate and modify this areas of your life. Maybe that's testing for food intolerances, detoxifying your environment, or taking a step back from your hectic schedule for a hot sec. While you will never eliminate all of the stress from your life, you can learn to navigate it and break the cycle of chronic stress.


3. Use thine food as thine medicine

The foods you eat will either perpetuate stress or calm it. For example, some great foods to de-stress the brain and hormonal system are avocados and oysters.


4. Practice breathing exercises

Breathing with focused awareness is powerful for reducing the stress response. My personal favorite is box breathing (because it's easy to remember)- inhale for four counts, hold for four counts, exhale for four counts, hold empty for four counts. Take time throughout the day to check in with your breath-I am so so guilty of unconsciously holding my breath and box breathing has instrumental for modulating my stress response. Cultivate awareness around your breath to reboot the HPA axis. Mindful meditation is another great tool for those struggling with adrenal fatigue.



5. Practice Yoga or Tai Chi

Both these disciplines bring intense alertness and stillness into your life, helping to mitigate and balance stress. Side note: I am also a certified yoga instructor and would be happy to provide guidance on where to start for those interested, write out some flows..etc. Just let me know!


6. Natural Medicine

Rehabbing the brain-adrenal connection is not a quick fix- like most everything important, it takes time. In addition, we are all totally different. What might work for one person may not necessarily work for another. As such, it is important to discuss natural medicine therapy with a qualified practitioner who is able to make personalized recommendations based on your needs.

Regardless, some more general natural medicines that can help you balance stress. include adaptogenic herbs like Ashwagandha, Rhodiola Rosea, Holy Basil, and Eleuthero Ginseng. These guys can have a profound regulatory effect on cortisol rhythm. Magnesium is also a wonderful adrenal support, in addition to relaxing stressed muscles & nerves and promoting quality sleep. Methylation support is another easy natural remedy that does wonders for the adrenal glands.Taking methylated B12 and folate are effective in supporting healthy methylation pathways, which help to balance the melatonin-cortisol rhythm. GABA support is also easy to incorporate in your adrenal support regime. Taking a quality GABA supplement (your calming and inhibitory neurotransmitter) and herbs like passion flower, and amino acids like theanine, glycine, and taurine are all awesome ways to decrease stress by acting on the gabaminergic pathways in the brain.


7. Sleep!

To allow your brain and adrenals to recuperate overnight, it is crucial to get enough sleep. Ensuring quality sleep by any means necessary and available. Things like turning off any screens and eating your last meal a few hours before bed are helpful to support quality sleep. Most adults need at least seven hours of shut eye per night.


8. Visit a functional medicine practitioner

Depending on your individual brain-adrenal dysfunction, it may be necessary to work with a qualified practitioner to assess your condition and potentially replace a small portion of your levels of the missing adrenal hormones for a period of time. Certain amounts of DHEA and pregnenolone (the precursor to cortisol) can stimulate your body to begin producing it naturally. You need professional guidance to determine how much and how often.


TLDR

Your adrenal glands sit on top of your kidneys. They regulate many critical hormonal jobs in your body, and one of their primary functions is to modulate the release of cortisol. Cortisol is essential for survival. We need cortisol in emergency situations, so that we can shift into the fight-or-flight mode for survival purposes. We are built for stressful events. When the body perceives stress and releases cortisol, you experience measurable increases in blood sugar, blood pressure, and energy. After the threat has passed, your body calms back down, and your vitals return to normal again.


In a healthy person, cortisol is higher in the morning to help with waking the body and slowly decreases throughout the day. Melatonin, your "sleep time" hormone, is inversely proportional to cortisol. When cortisol is high, melatonin is low and vice versa. Adrenal fatigue happens when there is an imbalance in this cortisol rhythm. Cortisol is either low when it should be high, high when it should be low, or always high, or always low.


The problem is that modern life tends to be stressful, not just in emergency situations, but all the time. Unlike acute stress, for which we are biologically programmed to handle, chronic stress switches on the flight-or-fight response without turning it off again. Blood pressure and blood sugar stay elevated and we remain in this heightened state. Now, this can only go on for so long. Eventually, our ability to keep releasing cortisol gets tapped out, after being triggered so often and for so long. The result is adrenal fatigue.


Adrenal fatigue is really a dysfunction of your brain's communication with your adrenals, not the adrenal glands themselves.


Common culprits:

-Excessive exercise

-Toxin exposures

-Emotional stress

-Food intolerances

-Chronic gut infection

-Autoimmune conditions

-Viruses

-Microbiome dysfunction


Symptoms:

-Trouble falling or staying asleep

-Irritability

-Fatigue

-Blood sugar fluctuations

-Changes in blood pressure

-Low immune system

-Digestive issues

-Brain fog

-Dizziness when standing too quickly

-Increased allergies

-Asthma

-Weight fluctuations and/or difficulty losing weight

-Depression

-Decreased sex drive

-Slow start in the morning

-Cravings for salty and/or sugary foods

-Afternoon fatigue

-Blood sugar issues

-Chronic inflammation

-Weak nails and brittle hair


What to do:

1. Ask your doctor about diagnostic labs

2. Get a handle on your chronic stress

3. Use thine food as thine medicine

4. Practice breathing exercises

5. Practice Yoga or Tai Chi

6. Natural Medicine

7. Sleep!

8. Visit a functional medicine practitioner



References

Adrenal insufficiency: Physiology, clinical presentation and diagnostic challenges.

Isolated ACTH deficiency during single-agent pembrolizumab for squamous cell lung carcinoma: a case report.

Predictive Factors of Adrenal Insufficiency in Outpatients with Indeterminate Serum Cortisol Levels: A Retrospective Study.

Sport-Related Concussion Preceding Adrenal Insufficiency and Hypopituitarism.

A Challenging diagnosis that eventually results in a life-threatening condition: Addison's disease and adrenal crisis.

Stress-Dosed Glucocorticoids and Mineralocorticoids Before Intensive Endurance Exercise in Primary Adrenal Insufficiency.

Neuroinflammation disorders exacerbated by environmental stressors.

Biobehavioral effects of Tai Chi Qigong in men with prostate cancer: Study design of a three-arm randomized clinical trial.

Possible adrenal insufficiency among fatigue patients in a psychosomatic medical clinic.

Gabaminergic and serotonergic modulation of the antidyskinetic effects of tiapride and oxiperomide in the model using 2-(N,N-dipropyl)animo-5,6-dihydroxytetralin.


Statements made on this website have not been evaluated by the U.S. Food and Drug Administration or any other medical body. I do not aim to diagnose, treat, cure, or prevent any illness or disease. Information is shared for educational purposes only. You must consult your doctor before acting on any content on this website, especially if you are pregnant, nursing, taking medication, or have a medical condition.

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