One of the most common health complaints today is the experience of fatigue and lethargy. If you have fatigue along with other symptoms such as difficulty concentrating, insomnia, inability to lose weight, feeling anxious, allergies, or brain fog, Adrenal Fatigue may be at the root of the problem.
Adrenal Fatigue, also known as hypoadrenia, is a condition where the body is unable to keep up with long-term stress, resulting in various nonspecific symptoms such as tiredness, sleep disturbances, anxiousness, and weight gain.
Adrenal Fatigue can result from a range of stressors, including emotional stress, poor diet, sedentary lifestyle, substance use, exposure to environmental toxins, chronic illness, mental health issues, and genetic mutations.
To understand what adrenal fatigue is, it is important to understand the basics of what happens during stress. When your body is in a relaxed state, it experiences the "rest and digest" response, when no stress is being experienced. This response happens when your parasympathetic nervous system (PNS) is activated.
During stress, however, the "fight or flight" response is activated by your autonomic nervous system (ANS). As the name suggests, this system enables you to fight or flee from the situation and helps you respond and protect yourself.
During this response, your adrenal glands, two glands that sit atop your kidneys, release hormones to help your body respond to the stress. One of the main stress hormones these glands produce is cortisol. The release of cortisol is managed by the hypothalamus-pituitary-adrenal (HPA) axis. This releases cortisol according to the hormone Adrenal Corticotropic Hormone (ACTH) produced by your hypothalamus.
Cortisol, not only helps your body cope with stress, but this hormone also has many other important roles that include (1):
When the stressful situation resolves, your adrenal glands will stop producing cortisol, and your body will move back into the rest and digest response. However, if the stressful situation continues your adrenal glands will continue to produce cortisol. Eventually, this depletes your adrenal glands, and rather than your cortisol levels being high or within the optimal range, they become low. With low cortisol then comes a whole host of other symptoms, including fatigue, weakened immune system, inability to deal with stress, gut issues, metabolic slow down, etc.
Many may be aware that your adrenal glands play an important role in the stress response; however, another system is also involved that is not as well known. This is the NeuroEndoMetabolic (NEM) Stress Response System and consists of six different circuits, each made up of three related organs or systems. This system helps support your body during stress.
In Adrenal Fatigue, when cortisol levels become low, imbalances within the NEM system can start to occur in multiple different circuits. The symptoms of Adrenal Fatigue will depend on where the imbalance in the NEM system is. The different circuits in this system are:
These 6 different circuits help to regulate the stress in the body, however, if stress is chronic, then symptoms may start to arise as different circuits and their respective organs become dysregulated. It stimulates the sympathetic nervous system. This is also called the "fight or flight" response as the body arms itself to face what it perceives as a danger. The adrenal medulla secretes epinephrine. The HPA (Hypothalamus-Pituitary-Adrenal) axis also releases Adrenocorticotropic hormone (ACTH), which causes the adrenal cortex to increase production of cortisol. In turn, cortisol can affect the cardiovascular system, gut permeability, and metabolism of the body. That's why stress is a full body response, and does not only affect the adrenal glands.
Symptoms can vary from person to person and the severity of individual symptoms can also vary as the condition progresses. Here’s a list of the most common symptoms among people with Adrenal Fatigue Syndrome.
If you have many of these signs and symptoms, it is time to consider Adrenal Fatigue as a possible cause. None of the signs or symptoms by themselves can definitively pinpoint Adrenal Fatigue. However, when looked at collectively, these signs and symptoms form a specific picture of a person under stress. These signs and symptoms are often the end result of acute, severe, chronic, or excessive stress. The body is unable to reduce such stress.
The ability to handle stress, physical or emotional, is a cornerstone to human survival. Our body has a stress modulation system in place, known as the neuroendometabolic (NEM) stress response. The adrenal glands are part of this response system. When these glands become dysfunctional, our body's ability to handle stress is reduced.
» Infographic: More Signs and Symptoms of Adrenal Fatigue
Chronic stress is common in Western society. Adrenal Fatigue Syndrome can occur when the amount of stress exceeds the body’s capacity to compensate and recover.
Unfortunately, life itself can be stressful. At any one time, you could be facing a number of situations that cause stress, from work pressures and job changes to illnesses, marital problems, or environment changes. Pain, physical illnesses, and chronic health problems can also cause physical stress on the body.
Chronic stress is common in western society. The most common causes of stress are work pressure, changing jobs, death of a loved one, moving homes, illness, and marital disruption. Adrenal Fatigue occurs when the amount of stress exceeds the capacity of the body to compensate and recover.
One of the most overlooked causes of Adrenal Fatigue is chronic or severe infection. This gives rise to an inflammatory response. Such infection can occur sub-clinically with no obvious signs at all. Parasitic and bacterial infections including Giardia and H. pylori are often the main causes.
Adrenal weakness progresses through stages as the body de-compensates. It is the body's strategy to return to a state of simplicity from a life that is too complex for the body to handle.
In this stage, the body is alarmed by the stressors and mounts an aggressive anti-stress response to reduce stress levels. Some doctors call this the Early Fatigue stage.
ACTH increases from the pituitary gland. The adrenals are stimulated to mount a retaliation response. epinephrine and cortisol are released. There is usually, but not always, a corresponding reduction in the DHEA production. No symptoms are reported at this stage. There may be a sense of being tired. Daily activities continue unaffected.
With under chronic or severe stress, the adrenals eventually are unable to keep up with the body's demand for cortisol. Cortisol output will start to decline from a high level back to a normal level, while ACTH remains high. The adrenals start to become exhausted. Morning, noon, or afternoon cortisol levels are often low. Nighttime cortisol level is usually normal. Anxiety starts to set in, and the person becomes irritable. Insomnia becomes more common, as it takes longer to fall asleep. There are also frequent awakenings as well. Infections can become recurrent. PMS and menstrual irregularities surface. Symptoms suggestive of hypothyroidism (such as a sensation of feeling cold along with a sluggish metabolism) become prevalent.
A phenomenon called pregnenolone steal (also called cortisol shunt) sets in. The body starts to favor cortisol production over other hormones. Other hormones such as pregnenolone, DHEA, testosterone, and estrogen are less favored and start to decline. As a result, total pregnenolone output is reduced but the total cortisol output continues at a normal level. The daily diurnal cycle of cortisol shows a dysfunctional pattern. Cortisol is low in the morning, when it is needed the most. Nighttime cortisol is usually still normal.
There is occasional mild fatigue. A nap or some time off work usually can help the recovery process greatly.
Despite rising ACTH, the adrenals cannot keep up with the body's demand for cortisol. This may happen over a few years. Total cortisol output is reduced, and DHEA falls far below average. The nighttime cortisol level is usually reduced as the HPA axis "crash". The body is unable to maintain homeostasis. Early in this stage, mild symptoms characteristic of the first and second stages of Adrenal Fatigue become persistent or chronic (Phase A). As the condition gets worse, multiple endocrine axis imbalances tend to occur (Phase B). This manifests in the form of ovarian-adrenal-thyroid (OAT) axis imbalance in females and adrenal-thyroid axis imbalance in males. The body is in a constant state of mild to moderate fatigue in phase A and B.
As the body continues its downward path of impaired function, it gathers steam. The body becomes compromised in trying to maintain the fine controls of homeostasis. Normal equilibrium is lost. The body enters a state of reactive disequilibrium (Phase C). Severe fatigue is the norm for those with Phase C.
Your body will try to maintain equilibrium with the activation of the autonomic nervous system (ANS). However, the body is too fatigued. Other pathways of the NEM stress response are damaged as well. impaired metabolic, clearance, and detoxification pathways give rise to paradoxical, unpredictable, and exaggerated outcomes. Reactive sugar imbalances, fragile blood pressure, postural hypotension, heart palpitations, POTS, dizziness, anxiety reactions, being "wired and tired," periodic adrenaline rushes, fragile fluid state; such as hypersensitive dilutional hyponatremia, sudden onset of anxiety, and a sensation of impending doom are common.
There is a strong mind-body connection. Every thought process invokes a physiological response. Many of these symptoms represent what a "reactive sympathoadrenal response." This response is the result of an over-activation of two components of the ANS - the sympathetic nervous system (SNS) and the adrenomedullary hormonal system (AHS). These two components constitute the sympathoadrenal system (SAS). the body bathes in a sea of epinephrine and norepinephrine, when the SAS is over-activated due to stress. These two hormones are responsible for many of the above-mentioned symptoms.
As the body's key hormones fall below the minimum required reserve for normal function and output fails, the body may down-regulate the amount needed to preserve what is on hand for only the most essential body functions. This near-failure state (Phase D) is quite serious and requires professional attention. This is a state of extreme low energy as the body tries to conserve to survive. Normally helpful nutrients may backfire with paradoxical responses being the hallmark. Those in Phase D are usually bedridden most of the time. Normal daily chores need ambulatory help. Traditional macro-nutritional approaches may be helpful. But, the body may continue to decompensate. In these cases, a carefully titrated micro-nutritional program may be necessary to help the restore the body.
Eventually, the adrenals are totally exhausted. In this stage, the line between Adrenal Fatigue and clinical Addison's disease can be blurry.
Typical symptoms of Addison's disease may start to emerge. Fatigue becomes extreme. Other symptoms include weight loss, muscle weakness, loss of appetite, nausea, vomiting, hypoglycemia, headache, sweating, irregular menstrual cycles, depression, orthostatic hypotension, dehydration, and electrolyte imbalances. The body appears to have lost its normal homeostasis and is breaking down. If not attended to, the natural progression of this condition may be fatal.
The following diagram shows how Adrenal Fatigue progresses with time through the stages. This is not for diagnosis purposes. Adrenal Fatigue is not a recognized medical condition by mainstream institutions. This diagram helps to paint a broad picture of what is seen clinically. Each person's progression varies tremendously and is dependent on a wide variety of factors.
Adrenal diseases are only recognized in the conventional medical world as Addison's Disease, also known as adrenal insufficiency, on the extreme of producing no cortisol, and Cushing's disease on the other extreme of producing too much cortisol. The ACTH challenge test, used to diagnose Addison's Disease only detects extreme hormone underproduction at the lowest 2% of a bell curve. It is a test that measures the adrenal glands' response after given a shot of artificial ACTH, which is supposed to stimulate your adrenal glands to produce cortisol. However, if your adrenal glands aren't able to produce cortisol after this shot, then you may be diagnosed with Addison's disease. Those with Adrenal Fatigue have subtler adrenal dysfunction below normal but might still be able to produce some amounts of cortisol. Therefore, even though Adrenal Fatigue sufferers might have similar symptoms to those who have Addison's Disease, they tend to be dismissed by conventional practitioners due to their "normal" but suboptimal adrenal hormone levels. All the sufferers on the edges of the bell curve who have symptoms but whose values are not "high enough" for Cushing's, or not "low enough" for Addison's Disease, get little care or understanding from their medical providers and are left to self navigate on how to help their fatigue that hasn't improved with anti-depressant or thyroid medications.
Cortisol levels are crucial indicators of adrenal health and can be assessed through various tests, including blood, urine, or saliva. Home saliva cortisol and hormone testing kits for Adrenal Fatigue are designed to identify cortisol imbalances by requiring the user to collect multiple samples over a whole day. Monitoring cortisol at different times—morning, lunch, mid-afternoon, and evening—helps correlate cortisol levels with potential adrenal issues, such as metabolic imbalances or baseline adrenal function. It’s essential to align these cortisol measurements with specific symptoms experienced throughout the day to get a clearer picture of adrenal health.
However, given the significant individual differences and the dynamic nature of the body, laboratory tests should be used thoughtfully and only when necessary to ensure cost-effectiveness and relevance. It's not unusual for individuals with Adrenal Fatigue symptoms to have normal lab results and vice versa. In cases of Adrenal Fatigue in the later stages, the 4-point saliva cortisol curve often becomes flattened, which can persist during recovery, leading to potentially confusing test results. Depending on tests alone can be a common mistake in managing adrenal fatigue.
A thorough history taken by an experienced provider or nutritional health coach remains the most effective method to determine Adrenal Fatigue status, surpassing any lab test. Laboratory tests should be utilized as supplementary tools, rather than the primary measure of adrenal function and recovery decisions.
The key to Adrenal Fatigue Recovery is a comprehensive approach to lifestyle changes and nutritional support to allow the adrenals to heal themselves naturally. It is best to take nutrients one step at a time under professional guidance of an experienced Adrenal Fatigue expert to ensure the right step is taken at the proper time. This is especially true for advanced cases of Adrenal Fatigue who have been burned many times by taking the wrong supplement at the wrong time. The key is taking the time to understand your body with its signals and cries for help. A complete nutritional and lifestyle approach that helps the adrenal gland to normalize itself, along with ongoing adjustments in terms of nutritional supplementation to assist the adrenal during this recovery is key. That is why with Dr. Lam's Nutritional Adrenal Fatigue Recovery Program, we provide a personalized nutritional consultation with an Adrenal Fatigue expert to make sure your plan is individualized and correct.
Dr. Lam has gone through Adrenal Fatigue himself and recovered. Having helped thousands of adrenal fatigue sufferers recover, he has compiled together a comprehensive Adrenal Fatigue Recovery Program that incorporates a whole-body approach to Adrenal Fatigue recovery through:
Adrenal fatigue, consists of many different symptoms like fatigue, difficulty sleeping, salt or sugar cravings, needing stimulants like caffeine to get through the day, brain fog, and a general feeling of being unwell, that are caused by chronic (long-term) exposure to stress from any source (including emotional, physical, mental, or environmental) that exceeds the body's capacity to adjust to the demands placed on it by stress.
Adrenal glands can be restored to optimum health by adhering to healthy living principles. Adequate rest, specific nutrition, proper supplementation, and stress reduction are key components of Adrenal Fatigue recovery. With Dr. Lam's Adrenal Fatigue Recovery Program, you can have a guide on supplement usage, beneficial exercises, diet choices, and insights from Dr. Lam's own Adrenal Fatigue recovery journey. You even have a personalized nutritional consultation with Dr. Lam's team to ensure that you don't feel alone in this process of recovery. Call our office at +1-626-571-1234 if you would like to schedule a free initial phone consultation and get your adrenal fatigue recovery started today.
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