Eric Bakker N.D.March 30, 2022

At least 50% of adults who seek medical treatment self-diagnose themselves as being afflicted with fatigue. This article will go into detail about one of the most common physiological reasons accounting for chronic tiredness of so many suffer from, a condition known as hypo-adrenalism, otherwise known as under-active (or ’burned-out’) adrenal glands.

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What Is Adrenal Fatigue?

At least 50% of adults who seek medical treatment self-diagnose themselves as being afflicted with fatigue. This article will go into detail about one of the most common physiological reasons accounting for chronic tiredness of so many suffer from, a condition known as hypo-adrenalism, otherwise known as under-active (or ’burned-out’) adrenal glands. I’m certain that many readers will relate to this article, because so many people we see in our natural medicine clinical practices come in for similar problems. Most people get little joy from their fatigue like state in a medical doctor’s office, apart from being told they need to ‘get a grip’ or to ‘stop being depressed and to get on with your life’. Surveys have shown that almost 60% of the population in America believe they are under a great deal of stress at least once per week (presumably surveys completed in NZ would reveal similar statistics).

Conventional Western medicine recognises only really one form of adrenal insufficient hormone-related disease, a condition known as Addison’s disease. This condition was first recognised in 1855, it is life threatening and the person has to take corticosteroids for the rest of their lives. Non-Addison’s hypoadrenia (adrenal fatigue) is not something that severe that they considered it a medical emergency; in fact, modern medicine does not even recognise it as a syndrome.

Medical practitioners commonly view adrenal exhaustion as ‘depression’, and prescribe likewise. It is difficult to assess just how many people in this NZ suffer from poorly balanced adrenal hormone control, ‘because the blood tests all come back normal’. Is it really ‘all in the head’? In fact, it is more likely in the back above the kidneys.


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What Are The Adrenal Glands?

The adrenal glands are a pair of small pyramid shaped hormone-producing glands which live on top of your kidneys, they are very close to the major artery of your body, the aorta, where they can produce immediate responses by delivering hormones rapidly in to the circulatory system. These small glands, the size of small walnuts, produce over 40 hormones, and the most important ones in terms of exhaustion and stress are adrenalin, cortisol, aldosterone, and the steroid hormones such as the oestrogens and testosterone.

Your body produces adrenal hormones continually and precisely, and these amazing glands are super responsive to even the smallest of changes in a person’s environment. This means that too much physical, emotional, and/or psychological stress can deplete your adrenal glands, and cause a decrease in the output of one hormone, particularly cortisol.

With each tiny increment of reduction in adrenal function, every organ & system of your body becomes more profoundly affected. You not only become progressively more tired, your immune system slows right down, sex drive diminishes or goes out the window, changes occur to the way your body metabolises fats, carbohydrates and proteins. Fluid and electrolyte balance, heart and cardiovascular system, and many other alterations take place at biochemical and cellular levels.

Deepak Chopra mentions in his book called Quantum Healing that every single thought a person has will start a cascade of change to the hormone system. We call this system the hypothalamus-pituitary-adrenal axis. These neuropeptides start the first of the three stages of stress, causing a response followed by a quick resolution, or a continual cascade of hormonal stimulation leading to widespread changes in the body. Let’s take a brief look at these three stages:

The 3 Stages of Stress (the General Adaptation Syndrome)

The term “general adaptation syndrome” (GAS) refers to the physiological process that occurs when your body reacts to a stressful situation. In 1946, a researcher by the name of Hans Selye was the one who first recognised the phenomenon.

You’ll understand the general adaptation syndrome (GAS) more easily if you think of it as having distinct stages of stress and how your body reacts to each level. The GAS process has three phases, and a distinct group of physiological shifts that take place within your body distinguishes one stage from another stage.

There are three steps involved in the process of general adaption syndrome. At each of these stages, your body will respond in a manner that is distinct from the others. During this procedure, your body will go through a number of physiological changes, some of which may have a detrimental effect in the long run.

The explanations for each of GAS’s three stages follows:

1. The Fight or flight response (alarm phase)

When a stressful situation confronts you, it causes the release of adrenalin, noradrenalin, and cortisol from the adrenal glands. These powerful hormones direct blood toward the muscles and limbs in order to allow you to fight or flight. In addition, the pupils of your eyes dilate and you become much more alert. When the stressful situation reduces, the increased production of adrenalin, noradrenalin and cortisol and reverts to normal. This occurs via a “negative feedback” mechanism that allows your body to normalise, a condition we call homoeostasis.

2. The Resistance phase (adaptive phase) 

Characterised by adaptation, which involves you learning to cope with a perceived threat (a stressor). During this resistance phase, cortisol receptors in your brain become less sensitive to the feedback mechanism that produces homoeostasis after “fight or flight”. This causes increased production of cortisol and results in various disorders controlled by your hormonal system. Ideally, the resistance phase continues until the stressful situation is resolved, leading to a return to the resting state. Stress-induced diseases like headaches, memory loss, insomnia, poor libido, high blood pressure and heart diseases occur during this phase.

3. The Exhaustion (exhaustion phase)

The exhaustion occurs when the capacity for resistance (adaptation) is completely overwhelmed. The exhaustion of the adaptive capacity of the adrenal glands results in stress-induced diseases such as hypo-thyroidism (under active thyroid). Patients initially develop adrenal exhaustion, eventually leading to an underactive thyroid. Depletion of energy characterises this stage, and may lead to poor metabolism, insulin resistance, and eventually leading to poor immune states. The exhaustion phase of continual stress can eventually lead to adrenal insufficiency or even a total shutdown of the adrenal glands.


Adrenal Fatigue Test

Here is a simple test you can do at home to determine if you have adrenal fatigue. To do the test you can do it alone with a mirror. It may not be present if you only suffer mildly from hypoadrenia. Your body will experience a surge of adrenaline whenever it is put in a stressful situation and goes through an episode of anxiety. Your pupils will become larger because of the adrenaline, which is one way that the hormone prepares your body to either fight or run away. Other changes include a quickening of the heart rate, constriction of the muscles, and an increase in the flow of blood to the extremities.

How To Do The Dilated Pupil Test for Adrenal Fatigue

  • Sit in a darkened room for a few minutes to dark-adapt your eyes, then shine the light from a not-to-strong penlight from about 6 inches away onto the centre of one eye, keeping it there for at least 30 seconds.
  • If you are healthy, you’ll see your pupil (the dark circle in the centre of the eye) contract immediately as the light hits your eye. The pupil normally remains contracted in the increased light. But, if you have some adrenal insufficiency, the pupil cannot hold its contraction and will dilate despite the light shining on it.
  • Retest periodically. As you recover from hypoadrenia, the iris will hold its contraction for longer, and your pupil will remain smaller for longer periods. This diminished ability of the iris to remain contracted is present in moderate to severe adrenally fatigued people.

Causes Of Adrenal Dysfunction Include:

  1. The major cause is sudden extreme or chronic prolonged stress. We think of stress as emotional, (unhappy relationships, separation, divorce, death of a loved one financial difficulties, traumas/shocks, etc) but it can be physical (e.g., accidents, surgery, prolonged illness, especially from a toxic liver and/or congested kidneys), nutritional (e.g., long-term deficiencies or excesses of nutrients, allergies), environmental (e.g., chemical sensitivities, metal toxicities, electromagnetic fields), thermal (e.g., prolonged excessive heat or cold), most pharmaceutical drugs (especially hormone pills), overwork, unhappy relationship, etc., all of which adversely affect the adrenals.
  2. Frequent over-consumption of sugar (including in most processed foods, honey, marmalade, golden syrup, fruit juices, fizzy drinks), caffeine, alcohol, tobacco, marijuana, etc all of which stress the pancreas and the adrenals. Avoidance of high glycemic-index foods is very important in the adrenal stress syndrome;
  3. Fasting, which further overtaxes weak adrenals as they attempt to maintain blood sugar levels.
  4. Overuse of steroidal medications for medical treatment of arthritis, asthma, inflammatory bowel disease such as ulcerative colitis, etc., or hydro cortisone creams for skin rash and itching–these deplete both the adrenals and the immune system.
  5. Spinal vertebral misalignment and subluxations, particularly of the vertebrae C 7 through to T 10. See you Chiropractor or Osteopath. Poor posture and stress can and often contribute.
  6. Food Allergies or food intolerances.

Symptoms Of Adrenal Fatigue

Decreased ability to handle stress, the small things that never got to you finally are! You get more anxious more easily; the kids are really getting to you, you may have been yelling more at them (or your co-workers) lately. Are you too tired to enjoy your life?
Lethargy, everything seems like a chore. Even the simple jobs require an increased effort. Decreased productivity, you spend more time on the job but actually achieve less. You can be more fuzzy mentally, you lose track of your thoughts, memory becomes more hazy, especially short term.
Less enjoyment or happiness in life, someone may even diagnose you as having ‘depression’. Your partner is getting less attractive by the day, more irritating, and you wonder how you kept the relationship going for so long. And,…… sex is the last thing on your mind if you can’t even lift your head off the pillow. Are you heading for burnout?
You may have difficulty getting up in the morning, you get up but feel that you could easily sleep several more hours. Fatigue is not relieved by sleep. Even after a good night’s sleep, you still don’t feel refreshed. You don’t really wake up until about 9.00 to 10.00am, you may have an energy drop in the afternoon (between 2.00 to 4.00pm) and could even feel a bit like you have been ‘drugged’ to some extent. You probably feel better after your evening meal, and may even get ‘second-wind’ later at night from 10.00 to 11.00pm, and may well stay up to 1.00 am or beyond. This pattern is not uncommon with hypoadrenia, and I find it particularly so with patients who work from home, or where both people in the relationship have got jobs and the kids to juggle.
More time required to recover from an illness. The cough you got two months ago is still hanging on. You seem to get recurrent colds, flu, sore throats, skin infections, etc. Have been on antibiotics several times in the past few years? You may well have recurrent sinusitis, asthma, hay fever, pneumonia or bronchitis.
Can’t really skip meals, you may need to ‘drive’ yourself every few hours with coffee, cola drinks, sweet snacks, just to keep going. Headaches come from not enough fluid or food, and it can seem like you constantly need ‘something’ just to keep you going.

Increased PMT, bloated, tired, cranky, craving chocolate.


Adrenal Fatigue Treatment

How To Reverse Adrenal Fatigue

  • Lifestyle. Doctors knew as early as the 1900s that unless a person changed their lifestyle to reduce the source/s of adrenal strain and developed alternative lifestyles to allow their adrenal glands to recover, they seldom saw complete healing. Relaxation is very important for recovery, slowing down your breathing, breathing deeply and abdominal breathing, not shallow breaths, progressive relaxation like meditation or Tai Chi are both excellent. Holidays are important, and so is working on improving the quality of your sleep. Do you live to work, or work to live? You can read more about lifestyle tips here.
  • Foods. It is very important that you eat breakfast, and that you definitely eat before 10.00am. Between 6.00 to  8.00 am your cortisol levels rise rapidly. In addition, poor liver function often accompanies low adrenal function. A liver herb or supplement can really help here. Check with your practitioner first. Have an early (rather than later in the afternoon) lunch, and importantly, have a small snack early afternoon. A high-quality protein snack will suffice. Make sure you ample protein, carbohydrate and fats in your diet. Totally avoid (for 3 months completely) sweet foods and stimulants such as coffee, tea, and chocolate.
  • Supplements. I recommend treatment for adrenal fatigue. In addition, a good Omega3 supplement is an excellent addition to an adrenal fatigue program.
  • Herbal medicines. There are several, including withania, ginseng, rhodiola, and more.

References:

  • Adrenal Fatigue, The 21st Century Stress Syndrome,   James L. Wilson, ND. March 2000 Smart Publications USA.
  • Britton, S. W., et al. Further experiments on cortico-adrenal extract: its efficacy by mouth. Science. 74:440-441, 1931.
  • Kelly, G. S. Nutritional and botanical interventions to assist with the adaptation to stress. Alternative Medicine Review. 4(4):249-265, 1999.
  • Mann, D. Take it easy: controlling cortisol production is key to controlling stress. Better Nutrition. 61(1):22, 1999.
  • Segala, M. (editor). Disease Prevention and Treatment 3rd Edition. Life Extension Media. Florida, USA. 2000:9.
  • Smith, T. J. Renewal: The Anti-Ageing Revolution. Rodale Press Inc. Emmanus, Pa, USA. 1998.

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