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Adrenal Fatigue: The Stress Response

You’re stressed, take an antidepressant.

Tired of hearing that?

Some anxiety and depression is mental/emotional, of course, and antidepressants may be necessary.  There is also a hormonal stress response. Often treating stress and anxiety is about treating the hormonal cascade of stress from the adrenal gland. As always, find the under lying cause of the problem. Don’t just treat the symptoms!

Fatigue, depression, low blood sugar, bone loss, muscle loss, irritability, anxiety, intense stress response, dizziness when standing up, mineral imbalance, frequent infections, long infection recovery, reproductive issues, hormone imbalance, skin problems, and sexual dysfunction, infertility and severe peri-menopause can all be due to adrenal dysfunction.

The adrenal glands sit on top of each kidney. The goal of the adrenal gland is to moderate the “fight or flight” response. This same gland also controls sugar balance, mineral balance and a hormone precursor called DHEA.

The adrenal gland’s main goal is to stimulate your body to “fight or flight” from danger. This “fight or flight” response (sympathetic nervous response) speeds up heart rate, dumps sugar into the blood stream, mobilizes energy stores and slows digestion. This response is necessary to have enough energy to run away from danger.

The stress response works in two phases. First adrenaline is released from the adrenal gland. We all know the feeling of adrenaline, that “speedy” feeling that happens when we are suddenly stressed.

In minutes, adrenaline is replaced by the hormone cortisol. Cortisol lasts about seven hours. Cortisol helps convert protein into sugars to feed the brain, slows digestion, increases heart rate, sharpens senses and inhibits thyroid function.

The “fight or flight” nervous response is supposed to be activated when we are in danger. The system overrides all of our body’s processes. This override isn’t meant to last long. In our present state of society, we are always busy and stressed. We are over worked, under-nourished, constantly bombarded with chemicals in our food and environment and worrying about ourselves, others, politics and money!

This constant stress wears away the adrenal’s ability to manage an appropriate stress response! At first your stress response will become overactive and causes high chronic cortisol. Eventually the poor adrenal glands won’t be able to maintain that state of overproduction and then they crash making too little cortisol.

Just to note: adrenal fatigue and adrenal failure are not the same thing. Adrenal failure is often caused by autoimmune adrenal disease and it can be rapidly fatal.

There is a variety of factors that devastate a healthy adrenal response. Examples are coffee or other foods with caffeine, a diet high in high carbohydrate with and low in protein and fats diets, yo-yo dieting, chronic pain, divorce, hormone treatments (including steroids, the pill and estrogens), lack of sleep, stressful jobs, a demanding family, taking care of our ill loved ones, digestive problems, over-exercise, our own illness, chronic infections (esp lyme), emotional issues, toxic environments or toxic exposures, processed foods and lack of specific nutrients such as B vitamins.

When we are stressed occasionally, the stress response is helpful. When we are stress more than 2X/day, over time, then our stress response may fatigue and body functions suffer.

The long-term consequences of constant stress on our system are the constant release of cortisol and eventually the destruction of our health and loss of our recovery ability. Eventually we can’t even mount a stress response and have a full adrenal fatigue.

Examples of the symptoms from adrenal fatigue include:

  • Muscles don’t regenerate and are lost to provide sugar to the brain.

  • Higher blood sugar leading to sugar crashes and eventually Diabetes type II.

  • Changes of mental awareness leading to fatigue, depression, anxiety and memory loss.

  • High cholesterol and lipids. This is the body’s attempt to help the adrenal gland make more cortisol and the hormone precursor DHEA.

  • Decrease in speed and ability to heal.

  • Lower immune function leading to more infections, shingles and slower recovery.

  • Loss of the steroid hormone precursors DHEA leading to low testosterone or imbalanced estrogen and progesterone levels. These hormone changes are often seen in women as significant peri-menopausal symptoms (hot flashes, insomnia, seating) or PMS symptoms (bloating, sugar cravings, emotional changes).

  • Poor digestion from the constant decrease of metabolism. This tends to be seen as weight gain or severe weight loss.

  • Uncontrolled stress response with exaggerated symptoms. People will often experience anxiety, depression or physical shaking for a period of time after a stressful situation or sugar crashes (I love the word Hangry!) People will also start to perceive situations are more stressful than they need to be, due to the exaggerated responses.

  • Fibromyalgia which can be pain in the body due to stress, mineral imbalance and poor immune function.

  • Hypothyroidism due to the inhibition of thyroid hormone activation and also suppression of pituitary controlled release of hormone from the thyroid.

  • Chronic fatigue from the constant stress stimulation and insomnia. You wouldn’t want to sleep if you needed to run away from a tiger, but you also wouldn’t want to be awake for years.

  • Inflammatory disorders from the unregulated inflammatory pathways like cardiovascular disease, allergies, asthma.

  • Peri-menopausal symptoms from the imbalance in hormone production.

  • Acne from imbalance in hormones and poor immune response.

  • Hair loss from imbalance in hormones and damaged immune response.

  • Immune imbalances and decreased immune function.

  • Osteoporosis due to the adrenals glands role in mineral balance (through hormones called mineral corticoids).

Adrenal fatigue is a widespread and rampant problem in society. Unfortunately conventional medicine disregards this problem entirely, suggesting antidepressants and anti-anxiety medicines to placate the symptoms. The reason for this is that conventional medicine focuses on extreme “disease states.” The “disease state” of the adrenal gland is adrenal failure, which is an emergency situation. The slow degradation of adrenal function is entirely overlooked. Lab tests available to most conventional doctors do not account for adrenal function, only adrenal disease. Conventional medical lab tests only indicate if the adrenal gland is extremely high functioning or low functioning. The test barely accounts for the natural changes of adrenal function throughout the day.

The best way to determine adrenal function is to test cortisol at a variety of points through the day and correlate that to DHEA levels, intestinal antibody levels, progesterone and insulin. Fortunately, endocrinologists are starting to look at adrenal function in relation to thyroid and sexual issues.

Naturopaths focus on helping the body heal itself. We focus on finding the cause of your pathology instead of dealing with the diseases. It’s far more effective to find and treat an adrenal problem instead of treating each of the symptoms such hormone problems, osteoporosis, fatigue, stress, slow recovery, and infections. Furthermore, treating anxiety or depression with antidepressants still doesn't account for the cortisol and it's effects. Naturopaths have been treating this adrenal fatigue for years, with great success.

Adrenal glands fatigue in a predictable pattern. First there will by an overproduction of cortisol creating hyper-cortisol symptoms. Eventually the cortisol levels will crash and create hypo-cortisol symptoms.

Download adrenal handout with symptoms lists

You should consider adrenal testing and treatment if you have energy crashes during the day, feel emotionally imbalanced, sleep poorly, maintain excess weight, have a history of yo-yo dieting, experience sugar crashes, experience dizziness you change positions or you need caffeine and sugary things to get you going. Sugar addicts often have adrenal fatigue because coritsol helps to control sugar levels in cooperation with insulin. Calorie restriction diets tend to trigger a stress response causing loss of muscle mass before fat because of coritsol.

You can heal adrenal function. You can restore adrenal health with an appropriate diet and supplemental regime. Stable blood sugar, an active B complex and adrenal supplements all help. If coritsol is low, hydrocortisone can help, but you should still use supportive treatments and not just hydrocortisone. Hydrocortisone suppresses adrenal function so that it may heal, but you can do more than that.

There are different treatments for different stages of adrenal fatigue. You must take into consideration over production or under production of cortisol. Each stage of adrenal fatigue has a corresponding treatment. In general, adrenal glandular supplements and ginsengs are stimulating and help adrenal fatigue with low coritsol. Using stimulating treatments with anxiety will make you more anxious by increasing high cortisol. Use calming adrenal treatment for high coritsol states like bacopa, Rhodiola, and Phosphatidyl serine. There are also balanced adrenal treatments that should be used to help both conditions like holy basil and milky oats. Very high cortisol and very low cortisol requires specific interventions outside of regular adrenal support.

An appropriate B vitamin is also necessary for adrenal fatigue. Your adrenal gland uses a lot of B vitamins to function. One out of 10 people have a genetic mutations that require active folic acid and active B12. This can be tested, in part, with a blood test called MTHFR DNA mutation testing. The inability to turn on B12 and folic acid can cause adrenal fatigue.

ADRENAL FATIGUE, THE 21ST CENTURY STRESS SYNDROME by J Wilson is a good reference book.

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