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What is Adrenal Fatigue & does it Exist?

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In this article, we discuss the causes, signs, symptoms, treatments, and controversy surrounding adrenal fatigue as even the experts cannot agree if such a condition exists.

Low energy and tiredness are among the most common reasons patients seek help from a doctor. Despite being so common, it is often challenging to come up with a diagnosis, as many medical problems can cause fatigue. Doctors engage in detective work, obtaining a medical history, doing a physical exam, and doing blood tests. The results often yield no explanations. It can be frustrating for clinicians and patients when a clear-cut diagnosis remains elusive. An attractive theory, called adrenal fatigue, links stress exposure to adrenal exhaustion as a possible cause of this lack of energy.

But is adrenal fatigue a real disease?

The adrenals are two small glands that sit on top of the kidneys and produce several hormones, among them, cortisol. When under stress, we produce and release short bursts of cortisol into the bloodstream. The adrenal fatigue theory suggests that prolonged exposure to stress could drain the adrenals leading to a low cortisol state. The adrenal depletion would cause brain fog, low energy, depressive mood, salt and sweet cravings, lightheadedness, and other vague symptoms.

Numerous websites mention how to diagnose and treat adrenal fatigue. However, the Endocrinology Society and all the other medical specialties do not recognize this condition. The Endocrinologists are categorical: “no scientific proof exists to support adrenal fatigue as a true medical condition.” This disconnect between conventional and complementary medicine adds to the frustration.

The lack of a biological explanation can be disappointing. To make things worse, it’s not unusual for doctors to say “there is nothing wrong with you” or “this is all in your head.” The overwhelming amount of information on the Internet that recommends many types of treatment causes even more stress. Mental health conditions, such as depression or anxiety, may have symptoms similar to adrenal fatigue and may not respond well to antidepressants and counseling. And some patients do not believe that a mental health concern is the primary cause of their symptoms and many refuse medications due to concerns about their side effects.

What is Adrenal Fatigue?

Adrenal fatigue is an increasingly common yet sometimes controversial diagnosis used to indicate depletion of the adrenal glands. Cortisol is a hormone released by the adrenals for use in the regulation of blood pressure. In response to stress, the adrenals release greater amounts of cortisol. Adrenal fatigue is thought to occur when the adrenals have become overtaxed by excess cortisol release and can no longer produce levels of cortisol necessary for optimal body function.

According to James L. Wilson, PhD, “The adrenals put out over fifty hormones. We often only hear about DHA and cortisol, but forty percent of women’s estrogen or progesterone are made in the adrenal glands and about forty percent of testosterone in males is made in the adrenal glands.”

Practitioners who treat adrenal fatigue consider the expansive function of these glands and the range of deficiencies that may occur when the adrenals are not functioning optimally. “They have a very profound effect on the entire body,” says Dr. Wilson. “They are the glands that first respond to stress, but also the first to suffer as a result of stress.”

Adrenal Fatigue Symptoms

Common symptoms of adrenal fatigue are thought to include the following –

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Fatigue

Fatigue, particularly upon waking, with intermittent “crashes” throughout the day

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Stress Response

Poor stress response and mood regulation

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Brain Fog

Cognitive issues or “brain fog”

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Energy Levels

Increased energy levels in the evenings

Cravings

Cravings for salty and sweet foods

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Stimulants

Overuse of caffeine and other stimulants

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Immune System

A compromised immune system

Less common symptoms are believed to include –

  • Insomnia
  • Frequent urination
  • Loss of muscle tone
  • Poor circulation
  • Depression
  • Weight gain
  • Decreased libido

The Causes of Adrenal Fatigue

Adrenal fatigue is thought to occur when the adrenals have been overworked to a degree that they can no longer secrete levels of cortisol that are adequate for optimal function. Potential stressors include environmental and dietary influences, as well as anxiety and emotional stresses. Experiences such as grief, trauma, and autoimmune conditions are considered to have a possible chronic negative impact on adrenal function. An overuse of antibiotics is also believed to possibly have detrimental effects on cortisol production.

Distinction from Addison’s Disease

Adrenal fatigue is closely related to, but not to be confused with, Addison’s disease, a disorder characterized by insufficient cortisol production due either to a pathology directly affecting the adrenals or a disruption of signaling between the brain and the adrenals. While symptoms of Addison’s disease are similar to adrenal fatigue, the primary difference is that adrenal fatigue is considered a possible result of the overuse of otherwise healthy adrenal glands due to stress. You do get different symptoms with Addison’s disease versus adrenal fatigue, because you are talking about the difference between a body that cannot secrete cortisol versus a body that is not secreting sufficient cortisol.

Some studies argue against adrenal fatigue as a diagnostic category. Symptoms related to adrenal dysfunction are also referred to as “adrenal disorder” or “adrenal insufficiency.” Some researchers maintain that adrenal fatigue does not exist. Practitioners such as Dr. Wilson, however, disagree. “The research for this goes back years. Henry Harrower, one of the original editors of The Journal of Endocrinology, wrote quite a bit about low adrenal function. It was known by different names such as hypocortisolism and Minor Addison’s Disease,” says Wilson.

Adrenal fatigue has become increasingly recognized by naturopaths, homeopaths, and doctors of functional medicine. However, many traditional medicine doctors uphold that it is not a viable medical condition, in part due to how generalised its alleged symptoms are and the fact that they can apply to many other causes such as depression or hypothyroidism.

It is Not a Disease

“It is not a disease,” says Dr. Wilson. “It is a syndrome that results from being stressed to a point at which the body can’t respond in an optimal way.” He draws connections between adrenal fatigue and nearly all autoimmune diseases, since the mental and physical stresses accompanying such conditions also affect the adrenals. Doctors who treat adrenal fatigue also suggest that conditions such as clinical depression and PTSD often tax the adrenals in ways that can cause chronic deficiency. “About twenty-five percent of what’s considered clinical depression also involves low cortisol while about seventy-five percent of clinical depression also involves high cortisol,” says Dr. Wilson. “So, it is pervasive, with the adrenal having so much to do with proper immune function, proper blood sugar balance, and with brain function. There’s thousands of cortisol receptors in every part of the brain, and they work in conjunction with each other and with the other neurotransmitters.”

Adrenal Fatigue Treatment

Presently, there is no pharmaceutical method for how to treat adrenal fatigue, which some naturopaths and doctors of osteopathy consider to be a factor in traditional medicine’s view of the condition. Suggested natural remedies include lifestyle changes such as a low-sugar/low-caffeine diet, avoidance of junk food, a healthy sleep schedule, and nutritional supplementation.

Adrenal Fatigue Diet

The goal of an adrenal fatigue diet is to help your body maintain healthy blood sugar levels and support balanced cortisol levels. This meal plan mimics many other healthy, balanced diets by promoting whole grains, vegetables, healthy fats and high-protein foods to provide your body with lots of stable energy. To get started on this adrenal fatigue diet, try adding more of the following to your plate –

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Vegetables

Vegetables, especially brightly colored, non-starchy ones.

Fruit

Especially pears, apples, plums, cherries, kiwi, mango, papaya. Try to save fruit for your later meals of the day, and stay aware of how much fruit you eat, as too much can quickly raise your blood sugar.

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Whole Grains

Choose a variety of whole grains.

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Proteins

Healthy proteins

Healthy Fats

Healthy fats (such as avocado, fatty fish, olive oil, flaxseed oil, grapeseed oil).

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Salt

Adding sea salt (in moderation) to your food can help your body get important nutrients it’s lacking when you have adrenal fatigue.

While the above foods will help provide your body with lots of fuel for energy, try to limit the following to avoid fluctuations in your blood sugar and energy levels –

  • White sugar
  • White flour
  • Alcohol
  • Fried/fast foods
  • Processed foods
  • Caffeine
  • Artificial sweeteners

When you eat is also important for any adrenal fatigue diet. Eating balanced meals at regular intervals helps to keep your blood sugar steady. Make sure to eat breakfast and try your best not to skip meals!

Other Healthy Adrenal Routines

Other healthy routines such as adequate daily hydration, managing blood sugar through a balanced eating schedule, and meditation are also believed to have positive effects on restoring the adrenal glands to optimal function. You could also consider supplementation and here is a list of important ones –

  • Vitamin C
  • Magnesium
  • B vitamins
  • Coenzyme Q10
  • Ashwagandha
  • Rhodiola
  • Licorice Root

In Summary

Navigating this ocean of uncertainty is not an easy task. Symptoms associated with adrenal fatigue probably have multiple causes. Frequent follow-up visits and a strong patient-clinician partnership are critical elements for success. Alternative and complementary clinicians often have better results, because the appointments tend to last longer and they view patients through a more holistic lens.

Regardless of what we call it, there are millions of people suffering from similar symptoms, and a personalised plan that involves counseling, medications, supplements, lifestyle change, among others could work for many. Balanced Healing can assist you with your personalised plan to treat Adrenal fatigue.

References

Website – https://www.health.harvard.edu/blog/is-adrenal-fatigue-real-2018022813344

Website – https://www.endocrineweb.com/conditions/adrenal-disorders/adrenal-fatigue