What is Adrenal Fatigue?

HEALTH & WELLNESS

Mar 15

A skeleton sits at a desk with a laptop and a stack of papers, creating an image of how we might feel when our bodies are completely worn out from fatigue. Photograph: Tara Winstead.

Understanding adrenal fatigue, a condition in which the adrenal glands become too exhausted to produce sufficient levels of hormones, primarily cortisol, is essential. This condition is commonly triggered by extended periods of chronic stress, unresolved trauma, or infections. By grasping this concept, you can take measures to manage your stress and safeguard your health.

Adrenal fatigue is a term that describes a collection of non-specific symptoms. These symptoms often vary from person to person and can include:

Fatigue.
Crash of energy.
Frequent, lengthy infections.
Low blood sugar.
Craving carbs.
Craving salt.
Sleep disturbances.
Brain fog.
Joint pain.
Digestive problems.
Anxiety.
Depression.

While adrenal fatigue isn't an official medical diagnosis, it is a term commonly used to describe a set of symptoms. The medical term for this condition is adrenal insufficiency, which is a well-recognized medical issue. However, current medical understanding may not entirely capture the experiences of those in the middle of the spectrum between healthy and adrenal insufficiency.

Endocrinologists are specialists in hormones, and their testing methods are more comprehensive than those used in a doctor's office.

What causes Adrenal Fatigue?

Prolonged periods of physical, emotional, and mental stress are often the root cause of adrenal fatigue. I find the connection to trauma fascinating, especially when our traumas remain unresolved, as seen in many cases of PTSD and C-PTSD. Adrenal fatigue often manifests as sleep disturbances, inflammation, digestive issues, blood sugar spikes, energy crashes, and crippling fatigue.

When our adrenal glands are exhausted and unable to meet the body's demands for a constant fight-or-flight response, adrenal fatigue typically manifests, often triggered by chronic stress or unresolved trauma. When faced with a threat or stressful situation, our bodies release the hormone cortisol to prepare for the perceived danger. After resolving the threat, our bodies are designed to return to the "baseline." However, suppose the situation is prolonged, as in many cases of chronic stress and unresolved trauma. Our adrenals will eventually wear down because they cannot respond effectively to stressful situations.

Individuals with C-PTSD are particularly vulnerable due to the prolonged duration of stress this inflicts on the body if it remains unresolved.

The three stages of Adrenal Fatigue:

Stage 1: "Stressed"

Adrenal fatigue in its initial stage often results from a high-stress event, such as a divorce, the loss of a loved one, the loss of income, or the birth of a new child, to name a few examples. These stressors cause our cortisol levels to increase and decrease the DHEA hormone. Elevated cortisol levels can lead to issues like sleep disturbances, insomnia, and immune suppression.

Stage 2: "Wired & tired"

In the second stage, often called 'wired & tired,' our cortisol rhythm becomes irregular and no longer follows the intended pattern. At this stage, cortisol levels decline throughout the day and remain elevated at night, leading to symptoms such as anxiety, depression, low libido, poor memory, insomnia, recurring infections, and joint pain.

Stage 3: "Crashed"

In the third stage, the adrenals cannot meet the body's demands for cortisol due to exhaustion, resulting in persistently low cortisol levels both day and night. This will present as chronic fatigue and an inability to carry out daily tasks or work routines.

The busy life of your adrenals.

To illustrate the role of your adrenal glands, imagine them as an onion with three layers. The outer layers regulate salts in the blood (electrolytes), blood pressure, and the body's acid levels. The middle layer of your adrenals primarily controls blood sugar and the stress response (inflammation) and regulates how your cells utilize hormones from your body's other glands. The third and inner layer collaborates with the ovaries or testicles to produce sexual hormones used in reproduction, such as testosterone or estrogen.

The adrenal glands control a long list of vital functions, as outlined below:

Hormone regulation.

The adrenal glands regulate the usage of other hormones and are crucial for maintaining our well-being and bodily functions. After a hormone is released, it must be absorbed into a cell before it can take effect. The cortisol level in the bloodstream determines whether the cell will absorb the available hormone.

Cortisol.

Proper hormone levels are crucial for maintaining hemostasis. The hypothalamus and pituitary gland in the brain control the release of hormones. Once released, the adrenal glands determine how much is utilized. Each cell in the body has a membrane surrounding it, controlling what enters and exits. Hormones only function when allowed into a cell through an opening door. Cortisol produced by the adrenal glands opens this door for the hormones, enabling their entry. When cortisol is absent, the door remains shut.

Electrolytes.

Electrolytes, including the minerals sodium, potassium, chloride, calcium, and magnesium, are essential for our energy levels and must be balanced. The aldosterone hormone ensures that our electrolyte minerals remain neither too high nor too low. When we are out of balance with electrolytes, we may experience symptoms such as muscle cramps, digestive issues, or difficulty thinking clearly.

Inflammation.

When our adrenal glands function properly, they initiate the inflammation process and terminate it as soon as it is complete. If our adrenals are out of balance, the inflammation process may be prolonged or begin when unnecessary. An "unneeded inflammation process" is often the root cause of many of our chronic diseases and a primary factor in reducing our lifespans.

Sleeping and waking cycles.

The adrenal glands regulate your circadian rhythm and are primarily responsible for when you wake up and feel tired. The pineal gland in the brain collaborates with the adrenals to produce the hormone melatonin. When we wake up in the morning, it's due to a surge of cortisol. We feel tired in the evening because of a surge in melatonin. Our cortisol production decreases after lunchtime and nearly shuts off by bedtime in healthy individuals. If our adrenals are imbalanced, we usually lack this normal fluctuation of cortisol and melatonin.

Blood sugar.

The pancreas and adrenal glands work together to regulate blood sugar levels. When you haven't eaten for a few hours, the adrenals release cortisol, transferring carbs from their stores in the muscles and liver into the bloodstream to nourish your brain. When we are balanced, the pancreas manages this almost effortlessly, requiring little assistance from the adrenals. If your blood sugar drops, the adrenal glands must exert more effort and produce additional cortisol. Events that can trigger sudden drops in blood sugar include missing meals, consuming too few healthy carbs, or eating too many unhealthy carbs. One of the primary reasons it's crucial to focus on stabilizing blood sugar through diet is that a drop in blood sugar triggers the fight-or-flight response, adding extra stress to our bodies.

Survival mode (fight-or-flight) & chronic stress.

When facing a stressful situation, our adrenal glands produce hormones that channel our energy toward the perceived threat while diverting it from everyday functions. Although our environment has changed significantly compared to our ancestors, our biology remains the same. We may not encounter imminent dangers as frequently, but we are still impacted by constant stressors. In response to a risk or perceived threat, our bodies mobilize as the adrenal glands release stress hormones like adrenaline, causing the body to exert more effort than usual. Once the fight-or-flight response concludes, we are rewarded by the release of endorphins.

As society and our environments have changed, we experience more constant stressors, from consuming processed foods to varying sources of pollution to increased pressures from life itself. When we push our bodies too hard over time, we may find ourselves stuck in survival mode, which wears the body down and depletes its resources.

Body weight.

When we enter fight-or-flight or survival mode, a group of enzymes (c-jun-n kinase, insulin protease, and 11-beta hydroxysteroid dehydrogenase) causes adrenal hormones to increase the body's fat storage. If we remain elevated and in survival mode, weight loss cannot happen.

It's important to note that the more demands we place on our adrenal glands simultaneously, the more they shift into survival mode.

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