Stress makes your stress response system, especially your adrenal glands, work hard to produce hormones that help your body cope with and adapt to the stressor. Adrenal hormone production requires a lot of energy and specific nutrients. The more stress, the more energy and nutrients required. 

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With chronic or severe stress, your adrenal glands may fatigue and although they still work as hard as they can, they are not able to adequately keep up with your level of stress. This can leave you feeling fatigued, overwhelmed and down; as well as lower your blood sugar, immune function and libido; slow digestion and new cell growth; and make it harder to sleep and to think clearly.

 

Adrenal fatigue is an increasingly common yet sometimes controversial diagnosis used to indicate depletion of the adrenal glands. Cortisol is a hormone released by the adrenals for use in the regulation of blood pressure. In response to stress, the adrenals release greater amounts of cortisol.

 

Adrenal fatigue is thought to occur when the adrenals have become overtaxed by excess cortisol release and can no longer produce levels of cortisol necessary for optimal body function.

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James L. Wilson, PhD, who coined the term adrenal fatigue in his book Adrenal Fatigue: The 21st Century Syndrome, describes the adrenals as “two little glands that sit over your kidneys and are about the size of two large grapes and weigh about five-to-eight grams.”

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According to Wilson, “The adrenals put out over fifty hormones. We often only hear about DHA and cortisol, but forty percent of women’s estrogen or progesterone are made in the adrenal glands and about forty percent of testosterone in males is made in the adrenal glands.”

 

Practitioners who treat adrenal fatigue consider the expansive function of these glands and the range of deficiencies that may occur when the adrenals aren’t functioning optimally. “They have a very profound effect on the entire body,” says Dr. Wilson. “They’re the glands that first respond to stress, but also the first to suffer as a result of stress.”

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Common symptoms of adrenal fatigue are thought to include:

• fatigue, particularly upon waking, with intermittent “crashes” throughout the day

• poor stress response and mood regulation

• cognitive issues or “brain fog”

• increased energy levels in the evenings 

• cravings for salty and sweet foods 

• overuse of caffeine and other stimulants 

• a compromised immune system

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Less common symptoms are believed to include:

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• insomnia

• frequent urination

• loss of muscle tone

• poor circulation

• depression

• weight gain 

• decreased libido

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Any kind of excess stress causes the adrenals to increase cortisol production. Adrenal fatigue is thought to occur when the adrenals have been overworked to a degree that they can no longer secrete levels of cortisol that are adequate for optimal function.

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Potential stressors include environmental and dietary influences, as well as anxiety and emotional stresses. Experiences such as grief, trauma, and autoimmune conditions are considered to have a possible chronic negative impact on adrenal function. An overuse of antibiotics is also believed to possibly have detrimental effects on cortisol production.

 

Some studies argue against adrenal fatigue as a diagnostic category. Symptoms related to adrenal dysfunction are also referred to as “adrenal disorder” or “adrenal insufficiency.” Some researchers maintain that adrenal fatigue does not exist.

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A 2016 review published in the medical journal BMC Endocrine Disorders examined fifty recent studies and concluded that there is no statistically verifiable relationship between adrenal deficiency and fatigue.

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Practitioners such as Dr. Wilson, however, disagree.

 

“The research for this goes back years. Henry Harrower, one of the original editors of The Journal of Endocrinology, wrote quite a bit about low adrenal function. It was known by different names such as hypo-cortisolism and Minor Addison’s Disease,” says Wilson.

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A 2011 evidence-based review published in Integrative Medicine states, “Studies have shown a correlation between hypo-cortisolism and numerous disease states, such as metabolic syndrome and fibromyalgia, as well as chronic pain syndromes, cardio-metabolic disease, mood disorders, autoimmune diseases, and malignancies.”

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Adrenal fatigue has become increasingly recognized by naturopaths, homeopaths, and doctors of functional medicine. However, many traditional medicine doctors uphold that it isn’t a viable medical condition, in part due to how generalized its alleged symptoms are and the fact that they can apply to many other causes such as depression or hypothyroidism.

 

Doctors who test specifically for adrenal fatigue most often do so using urine or saliva tests to measure cortisol levels. “You also have to get an idea about the stress in people’s life,” states Dr. Wilson.

 

“You can have a patient who has normal cortisol levels but who’s exhausted and working fourteen hour days. They’re worried about their mortgage, so there’s clearly a problem there—they need more cortisol than normal, so there’s going to be a crash.”

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Because cortisol levels vary throughout the day, doctors treating adrenal fatigue suggest that it is important to administer comprehensive tests as well as to understand a patient’s daily energy patterns in order to better assess the way cortisol production cycles over the course of a day.

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“It’s not a disease,” says Dr. Wilson. “It’s a syndrome that results from being stressed to a point at which the body can’t respond in an optimal way.” He draws connections between adrenal fatigue and nearly all autoimmune diseases, since the mental and physical stresses accompanying such conditions also affect the adrenals.

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Doctors who treat adrenal fatigue also suggest that conditions such as clinical depression and PTSD often tax the adrenals in ways that can cause chronic deficiency.

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“About twenty-five percent of what’s considered clinical depression also involves low cortisol while about seventy-five percent of clinical depression also involves high cortisol,” says Dr. Wilson. “So, it’s pervasive, with the adrenal having so much to do with proper immune function, proper blood sugar balance, and with brain function.

 

There’s thousands of cortisol receptors in every part of the brain, and they work in conjunction with each other and with the other neurotransmitters.”

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Treatments

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Presently, there is no pharmaceutical treatment for adrenal fatigue, which some naturopaths and doctors of osteopathy consider to be a factor in traditional medicine’s view of the condition. Suggested natural remedies include lifestyle changes such as a low-sugar/low-caffeine diet, avoidance of junk food, a healthy sleep schedule, and nutritional supplementation.

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Supplements thought to help ease adrenal fatigue include:

• Vitamin C

• Magnesium

• B vitamins

• Coenzyme Q10

• Ashwagandha

• Rhodiola

• Licorice Root

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Other healthy routines such as adequate daily hydration, managing blood sugar through a balanced eating schedule, and meditation are also believed to have positive effects on restoring the adrenal glands to optimal function.