Our world has become so fast-paced it’s hard to keep up. You feel exhausted, sleep is difficult, and stress and anxiety are as common as the common cold.
It may be hard to believe, but all of these symptoms have the same root cause: adrenal fatigue/dysfunction.
In this article, we’ll discuss what adrenal fatigue is, why it’s controversial, and what you can do to restore health to your adrenals so you can restore your sparkle.
What is Adrenal Fatigue?
Your adrenal glands are two small but mighty glands that are located on the top of your kidneys. They secrete numerous hormones that carry out essential functions in your body, including the stress hormone cortisol.
The term “adrenal fatigue” was coined by chiropractor and naturopath Dr. James L. Wilson in 1998. According to Dr. Wilson, circulating cortisol levels are tightly controlled, ensuring an adequate supply of cortisol for cells, tissues, and organs. This highly fine-tuned system works wonderfully as long as the stresses don’t last too long and aren’t too numerous or severe.
But we live in a stressful world. Stress can be physical, hormonal, physiological, mental, biochemical, emotional, real – and even imagined.
This means we often endure prolonged, multiple, and intense stress. To make matters worse, the standard American diet doesn’t replenish the nutrients that are used up in greater quantities during times of high stress.1 Therefore, many people are left in an untenable position – experiencing constant high levels of stress with fewer nutrients to support their adrenal glands.
Symptoms of Adrenal Fatigue
If your adrenal glands aren’t strong enough to withstand the constant challenges, adrenal fatigue results and may lead to a host of symptoms like:2,3
- Early morning fatigue, even with sufficient sleep
- Decreased stamina and energy
- Decreased productivity
- Cravings for salt or sugar
- Body aches
- Low blood pressure
- Abdominal pain, nausea, vomiting, and/or diarrhea
- Low blood sugar
- Feeling depressed or irritable
- Trouble falling asleep at night
- Irregular or no menstrual periods
- Low libido
So clearly, someone with adrenal symptoms will be feeling pretty uncomfortable.
Is Adrenal Fatigue Real?
Adrenal fatigue isn’t a diagnosis recognized by conventional medical specialties. In 2016, a review of 58 studies was published in the journal BMC Endocrine Disorders in which the authors concluded that “there is no substantiation that ‘adrenal fatigue’ is an actual medical condition.”4
The 58 studies included in the analysis varied in the methods they used to detect adrenal fatigue, a limitation acknowledged by the authors. Nonetheless, the results were conflicting – and in many cases, there were no differences in cortisol levels between healthy subjects and fatigued subjects.5
Because no formal criteria exist for the definition and diagnosis of adrenal fatigue, it became known as a myth among conventional medicine practitioners.
“Adrenal fatigue” may not be an accurate diagnosis, but what we understand now is that people who experience these symptoms do have something going on involving their adrenal glands, though it’s more complex than originally thought. It involves something called the hypothalamic-pituitary-adrenal (HPA) axis.
What is the HPA Axis?
The HPA axis is an intricate, yet robust, neuroendocrine network that serves as your body’s main stress response system. Let’s briefly discuss each component of the axis:
- Hypothalamus: This is the part of your brain that coordinates your endocrine system. Think of it as a command center. The hypothalamus affects the functions of the pituitary gland, thyroid gland, adrenal glands, kidneys, musculoskeletal system, and reproductive organs.6
- Pituitary gland: This pea-sized gland is located at the base of your brain below your hypothalamus. Known as the “master gland,” your pituitary gland produces a variety of hormones in response to signals from the hypothalamus, which are released to control different organs and glands throughout your body.
- Adrenal glands: As mentioned above, your adrenal glands are small, triangle-shaped glands that sit on top of each kidney. They receive signals from the pituitary gland and respond by producing three hormones: mineralocorticoids, glucocorticoids, and adrenal androgens.
When your brain perceives something as dangerous, a structure in your brain called the amygdala sends a distress signal to your hypothalamus, which activates your sympathetic nervous system. The activation results in the release of epinephrine, which brings about a number of physiological changes like increased heart rate and alertness. All of these changes occur so quickly that you’re not even aware of them.
As the surge of epinephrine subsides (within minutes), the hypothalamus activates the HPA axis. If the brain continues to perceive a threat, the hypothalamus releases corticotropin-releasing hormone. This hormone travels to the pituitary gland and tells it to release adrenocorticotropic hormone (ACTH).
Once the ACTH enters the bloodstream, it makes its way to the adrenal glands, prompting them to release glucocorticoids, including cortisol. When the threat passes, cortisol levels fall, and your body is able to relax.
HPA Axis Dysfunction
The HPA axis enables your body to deal with acute stress efficiently. But research shows that hyperactivation of the HPA axis – from chronic stress and inflammation, for example – can lead to HPA axis dysfunction.
There’s no doubt that higher levels of cortisol are needed at certain times. But scientists have learned that chronic elevations of cortisol levels can induce inflammation, structural changes in your brain, and changes in neurotransmitter activity.7 This makes HPA dysfunction a major risk factor for negative health outcomes such as:8,9,10,11
- Depression
- Anxiety
- Post-traumatic stress disorder
- Metabolic disorders
- Cardiovascular diseases
- Reproductive disorders
- Sleep disorders
- Immune dysfunction
Over time, HPA axis dysfunction may lead to depleted levels of cortisol and other hormones.
One study found that HPA axis dysfunction was found in a high proportion of patients diagnosed with chronic fatigue syndrome.12 The same study found that women demonstrated an increased frequency of HPA axis dysfunction compared to men.
Given the increasing amount of scientific evidence, we can say yes, HPA axis dysfunction is very real.
And it’s precisely the amount of affirmative research that differentiates HPA axis dysfunction from adrenal fatigue.
How to Reverse Adrenal Fatigue Naturally
The good news is that adrenal fatigue (or HPA axis dysfunction) is reversible with simple lifestyle changes. Unlike prescription medications that mask your symptoms, these natural approaches can help break the existing patterns in your body’s response to stress.
Here are my top 8 recommendations.
1. Start With Your Diet
Nutritional support for adrenal health often requires an individualized approach. If you can, I recommend working with a qualified healthcare practitioner or nutritionist. In general, key nutrients that may help replenish your adrenals include:
- Vitamin C: Deficiency in this vitamin is associated with stress-related disorders.13 Studies also suggest that vitamin C supplementation can decrease cortisol levels after a stressful event.14
- Vitamin B: A 12-week study found that supplementation with high doses of B vitamins significantly reduced workplace stress.15 These findings were supported by a large analysis involving more than 7,000 adults.16 Rather than trying to pick out the best type of vitamin B, research shows that it’s best to incorporate all 8 into your diet with a B-complex.17
- Omega-3 fatty acids: A small study involving 7 subjects showed that supplementation with fish oil may help block adrenal activation triggered by stress.18 In another study, participants received high doses of omega-3 fatty acids. Those who took the highest dose (2.5 grams per day) showed lower cortisol and stress-related inflammation.19
- Magnesium: Deficiency in this essential mineral has been shown to induce HPA axis dysregulation.20 Supplementation of magnesium may increase production of the brain-derived neurotrophic factor, which plays a role in neuronal development and survival.21
- Sodium: No cell in your body can survive without salt. Low sodium levels can exacerbate symptoms of low cortisol. Make sure to include enough sodium in your diet.
Do your best to avoid eating highly processed foods, which may perpetuate chronic stress and inflammation. Whole, unprocessed foods are always best.
2. Supplement With the Right Herbs
Herbs can be a powerful tool when used correctly. Here are a few herbs that support a balanced HPA axis:
- Ashwagandha: This herb has a balancing effect and may lower stress and anxiety levels.22
- Eleuthero: Eleuthero is deeply nourishing and has traditionally been used as an adaptogen, which means it may help your body better adapt to stress.
- Shatavari: Shatavari is a popular herb used by Ayurvedic practitioners. It is commonly used to support female reproductive health, and research findings suggest that it may help reduce anxiety as well.23
- Maca: Maca root is another popular adaptogenic herb. Scientific studies on animals show that maca may help maintain healthy levels of cortisol.24
3. Sleep and Rest
Prioritize getting 7 to 9 hours of sleep each night. This is easier said than done for many people, but it’s critical to give your body and mind breaks throughout the day. That might mean saying “no” more than you have been.
If you know in advance that something stressful will happen, try to schedule it so that you have time to relax and de-stress afterwards.
It’s also important to honor your body’s circadian rhythm. In other words, do your best to sleep at the same time each night, ideally by 10:00 PM. And get 20-30 minutes of direct sunlight first thing in the morning.
4. Engage in Low-Impact Exercise and Meditation
Many women try to force themselves to keep up with their exercise routines despite their fatigue. But it’s important to listen to your body, especially when you’re not feeling your best. Your fatigue is your body’s way of telling you it’s time to rest, so listen to it.
According to one article in the Journal of Novel Physiotherapies, chronic overtraining can also lead to adrenal depletion.25 Instead of high-intensity workouts, opt for low-impact exercises, such as walking, light weight-lifting, yoga, or pilates. I also recommend making time for meditation in your daily schedule.
5. Identify and Manage Sources of Stress
Identify the main source(s) of your stress. Remember that stressors aren’t limited to physical or psychological stressors. They can also be things like illnesses, hormones, finances, relationships, etc.
If any of your stressors are things you can reduce or cut out of your life, consider doing so. For the ones you can’t avoid, you may be able to change how you respond to them. For example, taking a walk at lunchtime can help relieve some stress from your mornings.
6. Avoid Dieting
When you’re suffering from HPA dysfunction, it’s not the time to be dieting. Some women may be able to fast in moderation, but I recommend eating regularly. Research shows that fasting stresses the body, which means HPA axis activation.26
7. Support Your Gut Microbiome
The gut-brain axis is the bidirectional communication system between your gut and brain. This means that HPA axis dysfunction can have an adverse effect on your gut microbiome, and gut dysbiosis can negatively impact the HPA axis.27
To support your gut microbiome, be sure to eat both probiotic- and prebiotic-rich foods.
8. Consider Alternatives to Birth Control Pills
For several decades, researchers have been documenting the negative impact of birth control pills on the HPA axis. Women on birth control pills have higher resting cortisol levels, and they also display a diminished cortisol response to psychological stress.28,29 And as we’ve discussed above, a dysregulated stress response is a major risk factor for many conditions like neuropsychiatric disorders.
The precise mechanism behind the effect of birth control pills on the HPA axis is not well understood. If you have a history of using birth control pills or are currently using them, work with a specialist to restore your adrenal health.
Nourish Your Adrenals With a Naturopathic Women’s Health Specialist in Boston
It’s possible to heal your adrenals, but healing takes time. Remember to be kind to yourself.
If you need extra support, I’m here to help. As a naturopath and a women’s hormone specialist, I’m dedicated to restoring the sparkle in women who are struggling with adrenal fatigue and HPA axis dysfunction. I’ll help you restore balance to your body so you can get back to enjoying more energy, better moods, and less stress.
Ready to get started? Schedule a free consultation with me today.
- https://www.sciencedirect.com/science/article/abs/pii/S2212962614000054
- https://www.mayoclinic.org/diseases-conditions/addisons-disease/expert-answers/adrenal-fatigue/faq-20057906
- https://www.sciencedirect.com/science/article/abs/pii/S2212962614000054
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4997656/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4997656/
- https://www.ncbi.nlm.nih.gov/books/NBK535380/
- https://www.sciencedirect.com/science/article/pii/S2352289522000418
- https://www.frontiersin.org/articles/10.3389/fphar.2013.00158/full
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5666903/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4688585/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3572859/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4045534/
- https://pubmed.ncbi.nlm.nih.gov/32745879/
- https://ccforum.biomedcentral.com/articles/10.1186/s13054-019-2332-x
- https://onlinelibrary.wiley.com/doi/10.1002/hup.1229
- https://pubmed.ncbi.nlm.nih.gov/33848753/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6770181/
- https://pubmed.ncbi.nlm.nih.gov/12909818/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8510994/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3198864/
- https://www.sciencedirect.com/science/article/abs/pii/S2405457721000061
- https://ods.od.nih.gov/factsheets/Ashwagandha-HealthProfessional/
- https://link.springer.com/article/10.1007/s10571-014-0035-z
- https://www.siftdesk.org/article-details/Antianxiety-and-anti-depressant-effects-of-Maca-emL-meyeniiem-ethanolic-extract-on-chronic-unpredictable-mild-stress-of-rats-through-hypothalamic-pituitary-adrenal-axis/466
- https://pubmed.ncbi.nlm.nih.gov/23667795/
- https://pubmed.ncbi.nlm.nih.gov/26586092/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6469458/
- https://pubmed.ncbi.nlm.nih.gov/23672966/
- https://pubmed.ncbi.nlm.nih.gov/23698556/