Most people learn to cope with a set amount of physical or mental stress––work stress, family stress, or even environmental stress. To an extent, stress is unavoidable—and some forms of it can actually help propel us to grow as individuals and do our best in times of pressure and change.
However, chronic stress is a different story. For a lot of people, this lasting fatigue can lead to a whole host of problems, including something called adrenal fatigue, more accurately referred to as hypothalamic-pituitary-adrenal (HPA) axis dysfunction. Adrenal fatigue is a term that has garnered a lot of important debate and conversation recently, but many experts within the medical community agree that our bodies do experience levels of fatigue that need to be addressed.
So What Is Adrenal Fatigue, Exactly?
Adrenal fatigue is generally defined as the over-stimulation of the adrenal glands, but this is an oversimplification of a complex issue. It’s not actually a formal diagnosis, but it’s a term applied to non-specific symptoms that could include:
- Extreme and relentless fatigue
- Aches and pains
- Loss of hair
- Brain fog
- Sleeping issues
- Autoimmune symptoms
- Skin issues
- Food cravings
The term was coined in 1998 by the doctor James L. Wilson, who also termed it “hypoadrenia.”
Your adrenal glands work in tandem with the hypothalamus and the pituitary gland (the HPA axis), which is why adrenal fatigue is more accurately referred to as HPA axis dysregulation.
It’s not just stress that affects the HPA axis, however; there are many variables that play into how your adrenals will react, including genetic background, environment, lifestyle, and stress levels.
No matter how you refer to the grouping of symptoms, the science does underscore the need for a stronger focus on how the adrenal glands and the entire HPA axis works within the context of health issues and lifestyles. One study found that people with chronic fatigue had adrenal gland issues, while another found that people with chronic obstructive pulmonary disease (COPD) saw adrenal changes with treatment.
In a 2001 study, patients with depression had elevated cortisol and HPA axis dysregulation. The same study even linked this HPA axis activation to increased risk of suicide.
How Stress Wreaks Havoc on the Body
When you’re feeling the impact of stress—especially over a long period of time—your body jumps into literal survival mode, as if you’re being chased or attacked. In order to stave off any potential threat—the threat being your everyday stressors, and not, say, a pouncing lion—your adrenal glands try to protect you. They do so by releasing the fight-or-flight stress hormone known as cortisol.
Your two tiny adrenal glands are located just above your kidneys and are part of the endocrine system, like adrenaline and, of course, cortisol.
Of course, cortisol is there to help you. It’s helpful when you actually need to protect yourself, of course, but it’s not helpful—in fact, it’s just the opposite—when you’re in cortisol overload day in and day out.
When you feel that exhaustion, depletion, and anxiety on a regular basis, that constant surge of excess cortisol can lead to all sorts of issues, including decreased immune system function, Cushing’s syndrome (elevated cortisol levels), and Addison’s disease (insufficient cortisol levels). It can make you feel extra wired (and then totally exhausted but unable to sleep properly), which is what happens when you’re constantly in fight or flight mode.
According to gut and hormone specialist Dr. Brie Wieselman, LAc, cortisol also promotes high levels of circulating glucose, which signals your pancreas to secrete insulin. Of course, because cortisol levels are always high, glucose levels are always high as well, which is anything but useful, and can even lead to weight gain (especially in the belly), which leads to more cortisol production, which can lead to issues taking that weight off. It’s a cycle—and a vicious one at that.
Additionally, those high levels of insulin may trigger a condition called metabolic syndrome, which is actually a cluster of conditions that may increase your risk of heart disease, stroke, and type 2 diabetes—all triggered by high blood pressure, fat around the belly and midsection, high blood sugar, and wacky cholesterol and triglyceride levels.
If you have adrenal burnout, you may have digestive issues as well. In fact, one study found that stress has a major influence on the balance of your intestinal microflora, or your gut microbiome. It can disrupt the balance of probiotics, which are the good bacteria your gut needs. The study found that anger, fear, and stress significantly changed the gut function—even more than diet.
So if your boss, health concerns, financial security, long commute, or hectic family life is deeply stressing you out—it could be affecting your physical health in ways that require real help. In short, the stress goes far deeper than the emotional or psychological.
Fortunately, there are things you can do to heal your body (and your mind).
Getting to the Root of Your Adrenal Fatigue
If you are experiencing the above symptoms of adrenal fatigue, working with a qualified practitioner is of utmost importance to determine if you have HPA axis dysfunction. Treatment is key.
Because adrenal fatigue can mimic autoimmune diseases like fibromyalgia or rheumatoid arthritis, it is key to work with a practitioner who is able to look at your health and wellness through a finely tuned and holistic lens. Additionally, actually having an inflammatory disease like an autoimmune condition could also contribute to adrenal fatigue symptoms.
Being misdiagnosed can only complicate matters, prolonging your path toward healing and a better quality of life.
Discovering the causes of adrenal fatigue, rather than throwing medicine at the symptoms, will help restore balance and regulation to a body whose adrenal system is totally out of balance.
The road to healing may be found by way of controlling your cortisol levels, and this involves rerouting your nutrition and dietary choices, stress reduction techniques, regular exercise, and, in some cases, bioidentical hormone replacement therapy (BHRT). To test your cortisol levels, you will likely be asked to take a saliva or urine test—a process that the practitioners within the BodyLogicMD network can help you with. You may also need a blood test or adrenal stimulation tests.
If you and your doctor decide to go the route of bioidentical hormone replacement therapy, you’ll be asked to modify your lifestyle choices in addition to being supplemented with bioidentical hormones, which are chemically identical to your body’s natural hormones.
Bioidentical hormones are actually made from naturally occurring sources, such as soy or yams. They’ve been found to be safer and more effective than conventional hormones. Because bioidentical hormones have the same structure as the hormones your body makes, your body is better able to tolerate them, making it a preferable treatment.
Bioidentical hormones are made using a compounding pharmacy, which operates under FDA guidelines. Compounding pharmacies make compounded bioidentical hormones according to exact specifications laid out by your doctor. This means you get a fully customized and unique-to-you treatment plan. The hormone prescription will take into account your medical history, your symptoms, your lifestyle—what you eat and how much you exercise—and any lab results that come up.
Additionally, you’ll want to focus on bettering your diet. Your mother always told you an apple a day could keep the doctor away—and she wasn’t wrong!
First, you’ll want to decrease your intake of stimulants like caffeine and sugar. Both of these oh-so-addictive treats are actually antagonistic, leaving you feeling more wiped out. According to a 2005 study, caffeine increases cortisol secretion in people at rest or undergoing mental stress, while sugar leads to a whole host of problems.
So what to eat? Foods that stabilize your blood sugar are helpful, including coconut oil and coconut milk, as coconut may help fight insulin resistance.
You’ll also want to focus your diet on:
- Lean proteins
- Low-mercury fish
- Olive oil
- Leafy greens (like kale and chard)
When you eat matters as well. You’ll want to support your adrenal glands by staying aware of your blood sugar levels. This means you should be eating breakfast every morning and then eating at regular, timed intervals throughout the day. Don’t skip lunch or dinner; feed yourself regularly and eat smart, clean snacks, like an apple or nuts, when you’re feeling hungry.
Supplements for Adrenal Fatigue
Beyond food, there are a family of herbs called adaptogens that specifically target your ability to manage—or adapt to—your stressors. The most popular (and perhaps the most widely studied) include:
- Holy basil (also known as tulsi)
often turn to these supplements for adrenal fatigue, as they can help support
the body’s ability to cope.
Adaptogens are plant compounds that “increase resistance of the recipient to a variety of physical, chemical, or biological stressors,” says a 2009 study. Among a host of other herbs, adaptogens also stabilize and normalize the body’s function.
Ashwagandha root extract has actually been used to not only help the body adapt to stressors, but also support weight management in adults who are overweight due to prolonged stress (which is why people with adrenal fatigue often complain of belly fat that won’t go away easily).
Holy basil was also found to combat stress, largely by helping to balance levels of blood sugar and blood pressure. It also acts as an anti-depressant and provides cognitive benefits.
Ginseng, too, has the ability to directly impact both the adrenal glands and the HPA axis, but its mechanism is not fully understood.
Any adaptogenic supplements you take should be only the most bioavailable and the highest of quality. AdrenaMed, for example, is a concentrated adaptogenic herbal and vitamin formula that is made from cordyceps, rhodiola, and ginseng—all of which may help support a healthy stress response. B vitamins, such as pantothenic acid, are included as well, as vitamin B is known to support the adrenal gland.
Adpt-Adrenal, which also includes rhodiola and ashwagandha, is an herbal supplement that was designed to help you cope with everyday stressors—such as traffic, long days at work, and family obligations.
To specifically target your cortisol levels, Cortisol Benefits was designed to support your adrenal function and HPA axis regulation. It incorporates ashwagandha and Asparagus officinalis, which has anti-fungal, antimutagenic, anti-inflammatory, and diuretic properties. Together, the ingredients may help boost:
- Cognitive ability
- Heart health
- Stress responses
- Hormone levels
You’ll also want to focus on seriously lowering any inflammation levels you may have. Turmeric root’s curcumin can help support you with its antioxidant properties.
Exercise & Adrenal Fatigue
It may seem counter-intuitive, but movement can actually support healthy adrenal function. When you’re tired, exercise is probably the last thing you want to do—understandably!— but integrating moderate exercise into your lifestyle is helpful. You shouldn’t go too hard, but hitting the gym three to four times a week should be a goal.
You don’t need to run a marathon, but going to a yoga or pilates class—or any class that you enjoy and that challenges you—is important. If you have extreme adrenal fatigue, it’s actually best for you to avoid intense workouts like extreme cardio or heavy weightlifting. Workouts like swimming, tai chi, or walking are good and won’t force your body to expend energy it doesn’t have.
Another tip? Stick to morning workouts. Doing so will activate your metabolism early in the day without disturbing your natural sleep patterns later in the day, according to Fawne Hansen, an author and wellness coach specializing in the treatment of chronic stress and adrenal fatigue.
Remember that you shouldn’t push yourself, either. When you are burned out on the HPA axis, rigorous exercise can actually do more harm than good, according to Chris Kresser, MS, LAc.
As your energy increases, so too can your workouts—but ration your energy, Kresser explains, as you only have so much to begin with. The goal is to ensure you’re not stressing yourself out unnecessarily.
In the end, effective and meaningful stress management is key. Obviously, you can’t get rid of every stressor, but you can try to introduce small moments of peace to your day.
It may mean lightening up your load and taking some time to clear your calendar here and there. It’s important that you say no to things that negatively impact you and actively add times of true joy to your day.
Adding a simple, daily, digital-device-free timeout ritual for yourself can do wonders. If you can, set aside 30 minutes to stretch, breathe deeply, and do something enjoyable. Try and log off your email, disconnect from your duties, and spend some time mindfully doing something good for yourself.
Perhaps you like to color or do crafts. Maybe you like to zone out by listening to some music at your local park. In fact, spending time in nature can have a profound impact on your nervous system and immune function, helping to reduce cortisol levels.
You can also look to breathing techniques, guided imagery exercises, and progressive muscle relaxation. All of these exercises and practices are described here, and are easy enough to fit into a busy day. If you’re looking to increase your quality of life and say goodbye to feelings of chronic fatigue, exhaustion, and aches and pains, talk to one of the health and wellness experts in the BodyLogicMD network. They can help you find the right kind of approach—and the most effective treatments—to fit your wellness needs.