Adrenal Fatigue or Adrenal Exhaustion

Adrenal fatigue and adrenal exhaustion, are practically an epidemic in our society today and is responsible for a vast number of debilitating symptoms, and yet most people are unaware that they have the condition. Adrenal fatigue, also sometimes referred to as adrenal insufficiency, develops when the adrenal glands no longer produce their hormones adequately and do not function optimally.

The adrenal glands are two small glands about the size of a walnut sitting on top of your kidneys that play a very large role in your level of emotional and physical health. They are responsible for the production of hormones that are critical to many body functions and systems like maintaining blood sugar, managing stress and fatigue, regulating the immune system and inflammatory response, normalizing blood pressure and regulating our fight or flight response system. Malfunctioning or depleted adrenal glands lead to excessive fatigue, exhaustion, cravings for sweets and caffeine, inability to handle stress, unstable blood sugar and a variety of other debilitating symptoms.

The outer portion of the gland is called the adrenal cortex and this is where cortisol, aldosterone, DHEA and a small amount of sex hormones are produced. The inner portion of the gland is called the medulla and it produces norepinephrine and epinephrine, also known as adrenaline and noradrenaline.

The most crucial stress hormone produced by the adrenals is cortisol. When the adrenals are fatigued or exhausted they no longer produce enough cortisol. When there isn't sufficient cortisol in the body, then the individual is susceptible to auto-immune disorders, chronic pain syndromes, chronic fatigue, asthma, allergies and more. In an attempt to self-medicate the many symptoms that occur as a result of a malfunctioning adrenal gland, the individual often reaches for drugs and alcohol, or caffeine and sugar which only perpetuates the problem even further.

However, another important adrenal hormone that you don't hear too much about is aldosterone. It regulates the balance of sodium and potassium in the body, which in turn helps in controlling blood pressure, electrolytes and the distribution of fluids. It too can become depleted and contribute to adrenal fatigue. Low levels of aldosterone often accompany low levels of cortisol, but not always. DHEA is another hormone produced in the cortex that may also be deficient and contribute to adrenal fatigue and hormone imbalances.

The longer one goes without adrenals that function adequately the more symptoms that develop. Over time other organ systems begin to malfunction as well as they try to compensate for the weary adrenal glands.

Adrenal fatigue usually occurs in phases and the further you progress through the phases the more symptomatic you will be and the more serious the issue becomes. In the early phases of adrenal fatigue, you may respond quite well to a variety of natural treatments, but as it progresses the substances that would normally help in this situation actually perpetuate the problem.

When adrenal fatigue progresses to the last phase, it is called adrenal exhaustion. At this point the adrenals are hardly functioning at all and the individual has a hard time staying ambulatory throughout the day and dealing with any stress seems like a monumental task. Their overall health at this point is severely compromised. This is a dangerous stage and requires the guidance of a skilled physician with expertise in advanced adrenal exhaustion. If not attended to adequately, advanced adrenal exhaustion can result in death.

How Does Adrenal Fatigue Develop? - Causes of Adrenal Fatigue

Stress hormones are needed when we are facing a dangerous, threatening or emergency situation, they provide us with extra strength, energy and alertness to deal effectively with the situation at hand. However, overstimulation of the stress hormones is what leads to adrenal fatigue.

The primary system involved in the bodies stress response system is known as the HPA axis, which involves a complex interaction between the hypothalamus, pituitary and adrenal glands. It is responsible for controlling essentially all the bodies hormones, nervous system activity, storage and expenditure of energy, as well as regulating the immune system, controlling reactions to stress and a variety of other body processes like digestion, mood, emotions and sexuality.

When you're under stress, the hypothalamus releases a hormone called corticotrophin releasing factor, or CRF, which then flows through your pituitary gland and stimulates the release of adrenocoricotropic hormone, or ACTH, which then stimulates the adrenal glands to release cortisol. This process makes you alert and gives you the energy needed to deal with the stressful event.

In a normal circumstance, once the threat (the stressful event) passes then the hormones recede and the body returns to its non-stress state. However, in the fast paced, high stress life that most people live in these days and the diet they eat this cycle is ongoing. Overstimulation of the adrenal glands keeps the system releasing stress hormones on a regular basis. The body is in a constant state of fight or flight and eventually burns itself out. When cortisol is released too much and too frequently, then eventually the adrenals stop putting out cortisol out at the levels that are required for optimal functioning - adrenal fatigue occurs.

Overstimulating could occur from a one time event where there is intense stress such the loss of a loved one or a medical crises, or it can be the result of chronic, ongoing stress in your daily life that eventually builds up and grates away at the adrenals slowly.

Overstimulation is caused by the following primary factors:

1. Excessive stress

   Too much stress in our life is #1 on the list of causes of adrenal fatigue. This can be from the demands of your job, raising a family, financial struggles, health conditions, too many responsibilities, relationship difficulties etc. Anything in your life that causes you ongoing stress can lead to adrenal fatigue.

   If you grew up with child abuse in your childhood, then you are likely to develop adrenal fatigue very young. A child living with child abuse is in a constant state of fight or flight. Their adrenal glands never get a break as their body is continually releasing high levels of stress hormones like cortisol.

   In fearful circumstances like abuse, stress floods the brain with cortisol repetitively and excessively. Over time this repetition damages the brain and the adrenal glands. In an attempt to adapt to this situation, the brain then lowers the threshold at which cortisol is produced to a dramatically lower level, however the system remains in a hypersensitive state.

   When a child is exposed to continuous and overwhelming stress early in life, such as abuse, it alters the production and release of their stress-regulating hormones like cortisol and essential neurotransmitters like epinephrine, dopamine, serotonin and GABA.

   The scenario I just described above is also true of other high stress events like living with domestic violence, surviving a natural disaster, prisoners of war, civilians living in a war zone, living with a chronic health condition, poverty or any other event that threatens your livelihood and puts you in a constant state of hypervigilance.

2. Sugar, white flour and other refined foods

   The human body was not genetically designed to consume white refined sugar, white flour and other refined junk food, because they are void of any nutritional value. A diet lacking in nutrients put a continuous strain on the adrenal glands as well as the liver, pancreas and other organ systems and is the second leading contributor in the causes of adrenal fatigue.

   When we eat sugar, white flour and other refined foods, they are absorbed very quickly by the body and bring our blood glucose levels up too quickly to an excessively high level. This sends an emergency signal to the pancreas to bring the blood sugar levels back down, so it releases an excessive amount of insulin to deal with the excessively high levels of blood glucose.

   This in turn causes the body to call on the adrenal glands to release cortisol to bring the blood sugar levels back up, because it works in conjunction with insulin to keep blood sugar in balance. Every time you eat sugar and refined foods the pancreas and the adrenals go through this cycle and this puts too much demand on them.

   In time as the adrenal glands are called on over and over to regulate this vicious pattern, the adrenal glands become depleted and they no longer release the amount of cortisol that is necessary for adequate functioning and thus blood sugar stays in a consistently lower state and this leads to the problem of hypoglycemia in addition to adrenal fatigue.

3. Caffeine

   Caffeine elevates our stress hormones. It triggers the body to release norepinephrine and epinephrine, the hormones involved in our stress response system, also known as the fight or flight response. As we discussed above, stress hormones are needed when we are facing a dangerous, threatening or emergency situation, they provide us with extra strength, energy and alertness to deal effectively with the situation at hand. However, in the case of caffeine there is no emergency to deal with and your body is put into the stressful fight or flight response on an ongoing basis for no reason at all. Your body is in a chronic state of stress.

   An hour or so after you ingest caffeine the stress hormones dissipate and then you feel tired, hungry and cranky so you reach our for more caffeine. This cycle puts excessive wear and tear on the adrenal glands and over time leads to adrenal fatigue.

4. Nicotine

   Nicotine causes the liver to release high levels of sugar, which as we learned above, when high levels of sugar are in the blood the pancreas is alerted to release insulin to bring the sugar levels down. This results in a plunging of the blood sugar level and the excessive release of insulin and cortisol. Every time you light up your causing this vicious cycle to ensue and will eventually burn out the adrenals.

5. Environmental toxins

   Common everyday chemicals found in your personal care products, cleaning supplies, perfume, air fresheners, cologne, dish soap, cosmetics, housing construction, laundry soap, pesticides, herbicides, etc. contain endocrine disruptors and are also a leading cause of adrenal fatigue.

   The adrenal glands are one of the main glands involved in the endocrine system. Hormone/Endocrine disruptors enter the body through our food, air and water and attach to our hormone receptor sites and impede normal functioning of the endocrine system, which results in a variety of abnormal reactions throughout the body. Keeping the endocrine system in balance is a very delicate process and it takes very little amounts of toxins to cause damage.

   In some cases endocrine disruptors mimic our hormones, which causes an excess, while in other cases it blocks hormones from being produced or functioning as they should.

   The body is not capable of breaking down these kinds of toxic chemicals. Once they are taken in by the body, they are extremely difficult, and sometimes impossible to eliminate. They accumulate in our tissues and fat cells and continually recirculate throughout the body.

   When the adrenal glands don't function properly, you can't cope or manage your stress adequately. This results in a vicious cycle where the fatigued adrenal glands cause even more stress and the elevated levels of stress continuously drain the adrenal glands even more.

6. Candida overgrowth

   Candida is a catch 22. On one hand it is believed that weak adrenals will allow Candida albicans to proliferate in the body, however, on the other hand, the toxins Candida emits alter and disrupt neurotransmitters and hormones in the body, thus disrupt the endocrine system and weaken the adrenal glands.

Other common causes of overstimulation that leads to adrenal insufficiency may include chronic illness, chronic infection, excessive exercise, gluten intolerance, malabsorption or maldigestion, surgery, sleep deprivation, hypoglycemia and alcohol and drug addiction -- however on the flip side, sometimes people with adrenal fatigue become an alcoholic or an addict in an attempt to soothe their symptoms from under working adrenals. Since the adrenal glands work in conjunction with the hypothalamus and pituitary, a problem in either one of these areas can contribute to how well the adrenals function as well. The adrenal glands are regulated by the pituitary and the pituitary is monitored by the hypothalamus.

Adrenal Fatigue Symptoms

It's very important to keep in mind that the symptoms of adrenal fatigue are shared with a variety of other conditions like thyroid disorders, hypoglycemia, neurotransmitter imbalances, hormonal imbalances and many others. One should always seek the advice of a qualified healthcare practitioner who is highly skilled and knowledgeable about adrenal disorders and have adrenal insufficiency testing to rule out any other possible conditions before assuming adrenal fatigue.

People in the advanced stage of adrenal exhaustion can't stand up for very long, because they feel too weak. They must be sitting or lying down the majority of the day. Standing is essentially impossible.

• The primary symptom of adrenal fatigue is relentless fatigue that is not relieved by any amount of sleep or rest.
• You feel weak, exhausted and tired for no apparent reason on a regular basis
• You have difficulty getting out of bed in the morning, even when you had a reasonable amount of sleep
• You are slow to bounce back from an illness or stressful situations
• Cravings for salty food or sweets
• Inability to lose weight or weight gain, particularly in the waist area
• Lightheadedness when you rise from sitting position
• The need for stimulants to function in the morning or keep going through the day
• Trembling when stressed out
• Increase in PMS symptoms and/or menstrual flow that is heavy and stops and starts over
• Feel slightly better for a brief period after eating
• Frequent occurrence of flu or respiratory conditions
• Forgetfulness
• Feel too tired to enjoy life
• You have more energy and feel more alert in the evening (however, this is true only in the early stages of adrenal fatigue. If you have advanced to the more severe stage of adrenal exhaustion, you don't have energy at any point of the day, including the evening.)
• Inability to handle stress is another classic hallmark in the list of adrenal fatigue symptoms

• Back or neck pain with no apparent reason
• Food allergies
• Low body temperature
• Feel better when not dealing with stress
• Low sex drive
• Difficulty in achieving daily tasks
• Dry skin
• Nervousness
• Constipation and/or diarrhea
• Heart Palpitations
• Mild Depression
• Anxiety
• Hair Loss
• Low blood sugar

Conditions associated with adrenal fatigue

Weak and malfunctioning adrenal glands are believed to be a major contributor in the following conditions:

• MCS - multiple chemical sensitivity
• CFS - chronic fatigue syndrome
• FMS - Fibromyalgia
• Rheumatoid arthritis
• Anxiety disorders
• Hormonal Imbalances
• Mild Depression
• Neurotransmitter Deficiencies
• PMS - premenstrual syndrome
• Autoimmune disorders
• Frequent infections
• Thyroid disorders
• Hypoglycemia
• Allergies
• Headaches
• Candida overgrowth

Additionally, it's also important to note that not everyone with adrenal fatigue will experience all symptoms that are possible. One person may have only a few symptoms, while another person may be completely incapacitated with symptoms. It depends on the degree of damage that is done to a particular person's adrenals and many other factors such as age, other conditions that may be present, the integrity of other organ systems in each person, which phase of fatigue they have progressed to, etc.

Adrenal Fatigue Diet

The adrenal fatigue diet should be free of sugar, white flour, caffeine, refined carbohydrates, alcohol, hydrogenated fats, soda pop and other junk food.

It should be organic and include three meals or five smaller meals a day that are filled with and abundance of nutrient rich foods like fresh vegetables and fruits, nuts, seeds and healthy oils like walnut oil and olive oil.

A diet for adrenal fatigue should be high in meat protein like chicken, turkey, beef and buffalo or other meats like pheasant, duck and ostrich. Eggs are good too.

An adrenal fatigue diet should include lots of water, that is preferably filtered and free of chlorine and other contaminants.

Some people find an 1/8 to 1/4 tsp of sea salt added to an 8 oz glass of water to be helpful, unless you have high blood pressure. This helps those who have a low level of aldosterone. If you have an exacerbation of symptoms when trying this technique, then you should discontinue.

Avoid eating fruit on an empty stomach. Eat them with a protein and a fat. Try sticking to fruits that are lower in sugar like raspberries, blueberries, blackberries, blueberries, strawberries, apples, pears, plums and kiwis.

Salt your food as preferred to taste pleasant, but use sea salt.

It should also be limiting in complex carbohydrates, because even complex carbohydrates break down into sugar in the body and too many of them will strain the adrenals as well as lead to neurotransmitter deficiencies and upset hormone levels.

The best adrenal fatigue diet is a slightly modified version of the Paleolithic diet, which includes a generous amount of meat protein and fat, an abundance of low carb vegetables and a small amount of fruit, nuts and seeds. Grains, beans and potatoes should be restricted or avoided all together. This will help provide a nice even amount of energy throughout the day and give the body the types of foods it was designed to eat.

Provide Adrenal Support with Comprehensive Adrenal Fatigue Treatment

Adrenal fatigue treatment may consist of providing adrenal support through a variety of lifestyle changes, diet, nutritional supplements, glandulars and adrenal hormone replacement.

However, the steps one takes for recovery depend on what phase of adrenal fatigue you are in and how your body responds. Once again, it is really important to seek the guidance of a skilled physician with expertise in adrenal fatigue, who also understands the advanced stage of adrenal exhaustion.

For the person who is in the stage of adrenal exhaustion, it is crucial that they take the right steps in the right order. The dosage of nutrients must be correct for their body and herbs or nutrients that stimulate the gland will only make matters worse. The healing plan will be unique for each person depending on their situation.

For example, someone who is in the early stages of adrenal fatigue may find an adrenal glandular to be very beneficial, but someone who is already in the adrenal exhaustion phase is likely to have an exacerbation of symptoms from a glandular. People in the early stages of adrenal fatigue will need a different dosage of vitamin C and pantethine than a person with adrenal exhaustion. Someone in the earlier stages may benefit from licorice, while the person in exhaustion will become more incapacitated.

• Reduce excess stress and rest as much as possible. This is the crucial first step.
• No caffeine
• No alcohol or drugs - alcohol is an extremely refined sugar.
• No sugar, white flour or refined foods.
• Get regular exercise -- mild.

Exercise that is too demanding, extreme or strenuous will put too much stress on the adrenals and deplete them further. However, mild exercise will help them function better.
• Get adequate sleep and go to bed no later than 11 p.m. The adrenals do the majority of their repair work between the hours of 10 p.m. and 1 a.m.
• Use stress relieving and relaxation activities on a regular basis like meditation, deep breathing exercises, soothing music, writing, time with nature, art or any other outlet for creativity to provide adrenal support.
• Add 1/8 to 1/4 of a teaspoon of sea salt to your drinking water -- not if you have high blood pressure or experience negative symptoms when this is tried. This helps address low levels of aldosterone.
• Cortisol -- A therapeutic dose of hydrocortisone is often used for adrenal fatigue treatment to support the adrenal glands. First a saliva test is performed to measure your cortisol levels in the morning, noon, afternoon and evening. Then depending on what your results are ,cortisol is supplemented. Usually 5 or 10 mg of cortisol is administered for each time slot that indicates low output of cortisol. Using hydrocortisone in low level therapeutic dosages such as this, do not have the negative consequences on health that other cortisone products like prednisone have. Natural cortisol is another option as well. However, it's important to be aware that taking cortisol does not heal the glands, it works like a band-aid, and the adrenals can continue to deteriorate if they are not nurtured back to life.
• Nutritional Supplements, Herbs and Glandulars -- There are numerous nutritional supplements and herbs that are frequently used to provide adrenal support. It will vary from practitioner to practitioner and person to person who has adrenal fatigue. The two most important nutrients for anyone with adrenal fatigue or adrenal exhaustion are vitamin C and pantethine. Pantethine is a more absorbable form of pantothenic acid. Others may include the B vitamins, d-ribose, licorice, Siberian ginseng, Rhodiola rosea, adrenal glandulars, magnesium, chromium and glutamine.

  It’s important to note that although d-ribose is considered to be one of the most beneficial nutrients for someone with adrenal fatigue or adrenal exhaustion, that for some people it feeds Candida and thus can't be taken. You will find that many of the specialists in adrenal fatigue will claim that d-ribose will not feed Candida, but that is not true. In theory it is not supposed to, but what occurs in real life is often different than theory. If someone tells you otherwise, they do not have a thorough understanding of Candida. D-ribose can and does feed Candida for some people, it depends on the strain of yeast one has and the level of overgrowth. That was my experience personally. Some physicians will recommend people with Candida cut their dosage of d-ribose into several small doses throughout the day and be sure to take it with a meal. That didn't work for me. Even 1/16 of a teaspoon on a full stomach feeds my Candida. However, for some people that does seem to work.

  You should also be aware that doses of vitamin C and pantethine will be much higher than the doses that the average person will take. A form of vitamin C called liposomal vitamin C is recommended because it has a much higher rate of absorption. It is believed that only about 10% of traditional vitamin C makes it into the cell, while liposomal has an absorption ability of about 95%. However, most liposomal vitamin C contains soy derivatives, so if you are severely estrogen dominant or have problems with soy, you may not be able to tolerate it. I have not been able to find a source of liposomal vitamin C that I can take because of this factor.

  Additionally, it is often combined with a variety of other ingredients like peppermint, orange oil or alcohol, which is problematic for many severely sensitive people, like myself. Ascorbyl palmitate is another recommended form of Vitamin C because it is more absorbable than ascorbic acid. Ascorbyl palmitate is fat soluble, which means it can be stored in the fat and called upon throughout the day as needed. Ascorbic acid is water soluble, which means it must be used by the body at the time of consumption and any excess is flushed out with urination. My body responded very well to ascorbyl palmitate. A combination of all three forms is recommended to keep a high flow of vitamin C throughout the body at all times.

There is disagreement in the natural health field on whether glandulars should be used. Some experts feel they are harmless and helpful, while others feel they can lead to dependence. So this is something you want to take into consideration when making a decision. Additionally, people with advanced adrenal fatigue, or those who have adrenal exhaustion, often feel worse when taking glandulars as well as a variety of the other natural supplements that are supposed to give the adrenal glands a boost like ginseng, licorice, dhea etc. This has been my experience personally in this area as well. I have too much norepinephrine, so taking a supplement that stimulates this hormone only makes me feel worse. Glandulars or any of the herbs that work by stimulating the gland, completely incapacitate me. Always listen to what your body tells you.

Another very important point to keep mind is that any adrenal fatigue or exhaustion treatment protocol one uses should be individualized, based on the unique needs of each person. What works for one person, may be harmful for another. It is always recommended that you work closely with a knowledgeable healthcare provider who can help you determine which steps are best for you to take and find the right balance of nutrients and supplements needed for your biochemistry. The sicker you are, the more important this is.

The road to recovery for adrenal fatigue is usually not a fast one or a straight and narrow path. It takes time and commitment. There are usually a variety of setbacks and progress is a slow process. This is especially true if you are in the adrenal exhaustion phase. The recovery process must include addressing hormonal imbalances and hypothyroidism as well.

My doctor showed me a great little trick to test for adrenal fatigue. Take your blood pressure while sitting down and record the numbers. Keep the cuff around your arm and stand up. Take your blood pressure again immediately after standing. In a healthy person, the blood pressure will rise when they stand. In a person with adrenal fatigue, the blood pressure will drop when they stand.

However, the most common and reliable method for testing the adrenals is with a saliva test. Blood tests are not reliable because they only test for "bound cortisol" while saliva tests for what is free and circulating, which is what we need to know. Many people will text normal on a blood test, but below normal on saliva testing.

Saliva testing can be done very easily with a simple at home test kit. You collect your saliva, mail it back to the lab and they send you your results.

Here's a link to one of the tests I recommend.

*Adrenal Function Test (Full Day Cortisol + DHEA)

The adrenal glands work in conjunction with hormones and neurotransmitters. When there is depletion or malfunctioning in one of these areas there is usually a problem in the other areas, so it is recommended to evaluate these levels as well. Adrenal glands need balanced hormones and neurotransmitters to function properly and neurotransmitters are also impacted by hormone levels and adrenal glands. It's a reciprocal relationship and to restore balance to one, all need to be addressed.