Adrenal Fatigue 101

Adrenal fatigue is the latest wellness industry buzzword and is being used to diagnose everything from low mood or energy to poor sleep and mental clarity. We debunk the myths to help you understand how to manage this increasingly prevalent condition.

These days, it seems adrenal fatigue is everywhere. Everyone has it and it is the cause of pretty much every health ailment and inconvenience. Tired? It must be adrenal fatigue. Lacking focus or motivation at work? It’s probably because your adrenals aren’t working. The problem with adrenal fatigue, naturopath Reece Carter says, is that people think its symptoms are something beyond their control. Instead of treating it like a signpost, a warning sign that lifestyle changes need to be made, people treat it like a diagnosis and assume they can do nothing to fix it. 

“This is where people seem to get confused,” Reece says. “They say, ‘Oh I have adrenal fatigue’. But the thing is, adrenal fatigue is not a diagnosis; it’s a useful concept in terms of treating people who have been through extreme periods of chronic stress, but the common discourse of, ‘Oh my adrenal glands aren’t working anymore, they’ve somehow failed’, is incorrect. The concept of adrenal fatigue is being misunderstood and therefore treated as a diagnosis.”

1 . WHAT IS IT REALLY?

Adrenal fatigue is a physiological reaction to prolonged periods of acute, chronic stress, characterised by altered levels of adrenaline and cortisol in the body for an extended period of time. This can result in two outcomes: higher than normal levels of these hormones, which is what causes that “tired but wired” feeling or, perhaps less commonly, lower than normal levels, which causes a lack of energy and, in extreme cases, can contribute to the development of conditions such as chronic fatigue and fibromyalgia. Our adrenal glands produce adrenaline and cortisol – our stress hormones – which have, in recent years, been given a bad rap. These hormones, in small spurts, are not harmful to health. It’s only when our bodies experience prolonged periods of increased stress hormones, to the point where these raised levels become the body’s new normal, that they start to have a negative impact. 

“On their own, stress hormones are not necessarily a bad thing; they’re our get-up-and-go hormones,” Reece says. “Adrenaline and cortisol are great for jumping out of the way of a bus or running away from a sabre-tooth tiger, but we use them in everyday life to be successful in our careers, to be good parents, to have active social lives, etc. We are go-go-go the whole time but the body is just not designed to do that.” 

2 . WHAT CAUSES IT?

Adrenal fatigue is, overwhelmingly, caused by lifestyle factors, the biggest one being stress. Stress, Reece says, is a perfectly natural reaction but we are supposed to use it in short, sharp bursts. “Adrenal fatigue refers to prolonged and improper activation of those hormonal pathways. What happens when we have that prolonged stress is there is confusion in the HPA axis – the hypothalamus, pituitary and adrenal glands. Together, these three glands form the path of the endocrine system, or the hormonal system, which is responsible for managing and regulating stress. The HPA axis also works alongside the sympathetic nervous system, the primary function of which is to prepare the body for intense physical activity and stimulate the body’s fight-or-flight response. 

3 .  THE STRESS FACTOR

The HPA axis relies on a series of hormonal signals to keep the sympathetic nervous system activated. If the brain perceives something as dangerous, it sends a hormone to the adrenal glands prompting them to release cortisol, which keeps the body revved up and on high alert. When that danger passes, cortisol levels fall. 

We are go-go-go the whole time but the body is just not designed to do that.

This is parasympathetic nervous system — which is like a brake pedal — coming in to reduce that stress response. “If you get used to operating in that sympathetic nervous system, which a lot of us do because our lifestyles demand it, you get hard wired to be constantly in that stress state so your body kind of adapts to it,” Reece explains. “When we are relying on that stress reaction to get us through the day, it throws the HPA axis out of whack and that can manifest in a number of different ways for people.” 

People think of stress as feeling overwhelmed or tearing hair out, but it is just the process of being on. “Most people these days accept stress as part of the course, as an unavoidable part of life in an increasingly connected and fast-paced world,” Reece says. “Even if you’re a Type-A personality who loves work and enjoys high pressure, it’s still causing the body stress. That’s why now, more than ever, it is important to pay attention to your body’s signals and learn when you need to slow down and give yourself time to rejuvenate, recharge and reset the batteries; think of your brain as being like a computer. The longer you leave it switched on, the slower and more sluggish its performance. “If your body’s cortisol levels are in overdrive, chances are you’re probably experiencing that tired but wired feeling. You might feel restless or agitated, as well as mentally foggy,” Reece says. Really low cortisol, on the other hand, leaves you feeling depleted, like you can’t pull yourself out of bed.” 

4 . HOW TO TREAT IT

First things first, adrenal fatigue needs to be seen as a signpost to lifestyle change; you are not going to be able to continue the way you are and patch yourself up with herbs or nutritionals. The best ways to start tackling adrenal fatigue are to do things that support and promote downtime. Whether that be to slowly start reducing coffee. Aim for one only, before midday, then start slowly weening off it or having a technology cut off-time in the evening.  “First, get your sleep right. Set a time of day that you will do no more work and commit to it. Cortisol should be highest in the morning then drop off from about lunch time. If you have a high level in the evening, that is when you have problems because it interrupts your circadian rhythm, which impacts sleep. Also make sure blood sugar levels are stable by eating regularly, snacking regularly and having protein at every meal.”