In our health-conscious community, “adrenal fatigue” has become a very common term to describe someone experiencing poor adrenal health. However, in a conventional doctors office, the term “adrenal fatigue” is usually brushed off, receives an eye roll, or is not even recognized at all. This is unfortunate because adrenal fatigue is a very real thing.
Western medicine will recognize two extremes when it comes to adrenal health:
1. Addison’s disease, which is adrenal insufficiency
2. Cushing’s disease, which is adrenal excess
Although these two diseases are definitely real, there are also many states of adrenal health between these two extremes that are very real, as well, require attention, and do not deserve to be “brushed off”.
The majority, if not all, of the clients I work with suffer from some level of adrenal dysfunction and it is said that 90% of the population are undergoing varying degrees of adrenal stress, which is why I finally decided to begin a blog series about adrenal fatigue, what it is, how to test for it, and how to recover. Today we will begin by understanding exactly what adrenal fatigue is.
What is Adrenal Fatigue?
Unfortunately, adrenal fatigue isn’t exactly how it sounds. The adrenals simply don’t get “fatigued” and stop working. It is much more complex than that and I usually like referring to it as “adrenal dysfunction” rather than adrenal fatigue, but it is still far more complicated than that and deserves a thorough explanation:
The adrenals are two small glands that sit on top of your kidneys and are part of a system of your body called the endocrine system. We didn’t focus much on the adrenals in high school biology class, but I studied them extensively throughout my time at the Canadian School of Natural Nutrition and am currently studying them even more in depth in the course I am currently taking through Restorative Wellness Solutions.
The adrenal glands are in charge of many things throughout the body. They are most often known as the “fight or flight” response system, but they are responsible for so much more throughout our body:
1. Handling stress
2. Production of sex hormones
3. Energy and vitality
5. Anti-aging support
7. Fluid balance
8. Blood sugar regulation
9. Tissue repair
As you can see, they play a role in many functions throughout our body and since they are part of a larger system, the endocrine system, they are also connected and interact with other organs throughout our body, as well. This is a diagram of the endocrine system, which the adrenal glands are part of:
The endocrine system is in charge of releasing hormones directly into the circulatory system. These hormones are then carried to a distant organ.
The HPA Axis
The HPA axis is comprised of the hypothalamus, pituitary, and adrenal glands. They work in sequence, which is why it is referred to as an axis, and acts as a feedback system.
The message is sent to the adrenal glands when the hypothalamus releases the hormone CRF to the anterior portion of the pituitary. When the pituitary receives CRF from the hypothalamus, it then sends the hormone ACTH to the adrenals, specifically to the steroid hormone pathway, which is the message that is needed to produce cortisol from cholesterol. However, if there is too much adrenal hormone present, the system will down regulate by shutting off hormone secretion to maintain homeostasis.
It is not only important to go over the downstream workings of this system (hypothalamus -> pituitary -> adrenals), but the upstream, as well. The hypothalamus manages the nervous system, emotional response, immune system, and endocrine system. So, when the hypothalamus begins to dysfunction, it can and usually does affect many other aspects and systems throughout the body. One of the main reasons the hypothalamus will become dysfunctional is adrenal stressors. It is crucial to understand this upstream connection to properly address and assess adrenal dysfunction.
The Adrenals, Stress, and Cortisol
The adrenals produce hormones such as cortisol and our sex hormones – estrogen, testosterone, and progesterone. Although small (they are the size of a walnut), the adrenal glands are incredibly powerful and produce hormones in response to stress. The types of stressors that will cause our adrenal glands to produce hormones in order to maintain homeostasis include:
Whenever there is ongoing stress of any type, there will be adrenal dysregulation, which is why I see it so much in my private practice. The majority of the clients I work with have eating disorders, which is a huge stress on the body (and the adrenals), which is why it is so important that I fully understand adrenal health and how to support them, so I can provide all of my clients with the best support when restoring the function of their adrenals.
Although I see adrenal dysfunction in my patients with eating disorders or those with a history of an eating disorder, adrenal dysfunction will also be present in individuals with chronic pain, gut issues, food sensitivities, poor sleep, infections, etc. because all of these issues are stressors on the body and the adrenals. Stress is not only mental stress, it includes everything from dietary stress (sugar, food allergies, etc.) to lifestyle stress (overexercising, lack of sleep, etc.) to biochemical stress (blood sugar imbalance, inflammation, mold exposure, etc.)
It is the adrenal glands’ responsibility to handle the stress we encounter and keep our body in homeostasis. Our adrenal glands handle acute stress by producing adrenaline. For an example, our ancestors would encounter predators when hunting and gathering food. This situation would require an acute stress response from the adrenals, which is exactly what they are required to do. However, in today’s world, the stress we face is on a daily basis and becomes chronic. For an example, you may wake up in the morning to your alarm going off (lack of sleep = stress, circadian rhythm disruption = stress) and then you proceed to the kitchen and grab some coffee (caffeine = stress) and leave your house to go to work without eating breakfast because you’re in a rush (being in a rush = stress, lack of food = stress). At work you deal with negative people (negative people = stress) and then you come home and become shaky, weak, and tired because you haven’t had a proper meal all day (blood sugar imbalance = stress, under eating = stress, malnutrition = stress). As you can see, it’s very easy for us to experience stress all day, every day, which is how stress can so easily become chronic.
Cortisol is just one of the many hormones produced by the adrenal glands. It is released in the response to stress, but has many other functions, as well:
1. Boosts energy
2. Improves digestion
3. Reduces inflammation
4. Enhances immune function
5. Maintains emotional stability
6. Eases joint movement
7. Mobilizes and increases amino acids in blood and liver
However, when cortisol is chronically elevated, negative health conditions can occur:
1. HPA axis dysfunction
2. Decreased thyroid function
3. Decreased sex hormones
4. Increased fatigue
6. GI issues
7. Insulin resistance
8. Liver stress
9. Fluid retention
10. Depression and anxiety
and the list goes on…
The body will not be able to sustain such high cortisol forever, though. There is a “tipping point”, which is usually brought on by additional stress whether it be an infection/illness or another layer of mental or emotional stress. When this “tipping point” is reached, cortisol levels will begin to drop as the adrenals can no longer keep up with production. If the stress continues, the body enters a catabolic state and many functions throughout the body are further compromised such as digestion, immunity, and inflammation increases.
As you can see, adrenal dysfunction or “adrenal fatigue” is a lot more complex than the adrenals simply becoming “tired” and requires a full body, holistic approach when it comes to healing and restoring the health of these two little glands.
Symptoms of adrenal dysfunction include:
4. Difficulty concentrating
5. Light headedness
7. Dizzy spells
9. Sugar/carb/salt cravings
10. Weight issues
11. Food allergies
12. Poor immunity
13. Poor reproductive health
14. Confusion/poor memory
and the list goes on…
Many of these symptoms relate to both high and low cortisol, which is why testing the health of your adrenals is so important as different healing strategies will be used for a patient with high cortisol vs. a patient with low cortisol.
In the next post of this adrenal health series, I will be talking about testing methods. Please note that I am able to order adrenal hormone tests for my clients who require it. If this is something you are interested in or suspect adrenal dysfunction, please contact me here for more information or read more about my one on one coaching services here.