We've become tired of...Adrenal Fatigue — it’s so passé
I think it only fair to warn you before we begin...
If you’re just looking for the general jist on this topic of stress-related fatigue, then I recommend you only read the first segment I’ve written. Here, I’ve tried to summarise some rather complicated — but exciting — new science for you.
However, if you’re looking for some bedtime reading — to facilitate a drowsy state — then might I suggest you read the whole blog-post…? 😉
You say you want a revolution... I tell you that it's evolution.
In order to recognise previously unacknowledged symptoms of stress-related fatigue, Natural Health Practitioners started referring to this as ‘Adrenal Fatigue’. Adrenal Fatigue provided a paradigm that gave authenticity to a very real set of stress-related symptoms that were fueling a person’s lethargy.
Note: Please see below for a list of these symptoms.
The concept of Adrenal Fatigue was based on people having a consistent set of health-related symptoms, who were also found to have low cortisol output (from their adrenal glands). It was thought that the cause of this low cortisol was malfunctioning or sluggish adrenal glands, hence ‘Adrenal Fatigue’. While low cortisol is still considered to be the cause of these symptoms, it has now been shown that the problem doesn’t stem from the adrenal glands themselves, rather they are just responding to what they are being told to do by the brain.
The latest research indicates that having low cortisol is actually caused by stress-related fatigue.
And not the other way around as previously thought!
Low cortisol then, has little to do with the capacity or functioning of the adrenal glands, rather it is the brain protecting the tissues — primarily itself — from this hormone1.
‘Adrenal Fatigue’ therefore isn’t an accurate description of this issue anymore: The correct terminology for this condition is now: HPA Dysfunction.
Note: HPA Dysfunction stands for Hypothalamic-Pituitary-Adrenal Dysfunction.
The upshot of this?
We shouldn’t be focusing on the adrenal glands anymore or trying to resuscitate them back to life. The brain is the boss of the adrenal glands. And, it’s the brain that’s giving the order to reduce cortisol output.
We should instead be focused on protecting brain health and supporting our Mitochondrion. Healthy mitochondria makes us more resilient to stress, long-term inflammation, and infections.
So, in light of this evolving science, the treatment protocol for: HPA Dysfunction will now focus first + foremost on the use of adaptogenic herbs, and on the use of supplements such as CoEnzyme Q10, Magnesium + B-group Vitamins.
The current dietary + lifestyle recommendations (sleep, exercise, and leisure) remain the same.
Note: Depending upon the specific cause of HPA Dysfunction, the treatment protocol will be adapted to the individual’s requirements.
Possible causes of HPA Dysfunction
MORE OBVIOUS CAUSES
Blood sugar deregulation
Low physical activity
MORE OBSCURE CAUSES
Stealth co-infections (as in — “I’ve never felt well since I got a virus in ______ ” Insert foreign country).
'You just need a good holiday' was the orthodox terminology used before the advent of 'Adrenal Fatigue' by natural health practitioners.
This would make a nice place to ‘leave it’ — if that was enough information for you!
If you dial back the stress, you will turn up the cortisol.
Let’s say you have been diagnosed with having low cortisol. What does this mean for you? Well, in isolation it doesn’t really mean much of anything2. Having your blood serum cortisol levels assessed is only one part of the puzzle.
Note: I’ll discuss other possible cortisol testing procedures with you in a future blog-post.
Cortisol results always need to be reviewed within the context of each individual case. There really is no one-size-fits-all approach.
If your cortisol level is out of range e.g. it is low — this doesn’t mean that your adrenal glands have ‘worn out’; or that they have run out of ‘go-go juice’. What it means is that there is something awry happening further up-stream that is causing your adrenal glands to ‘turn down’ the cortisol. This is done to protect your brain1 from the damaging effects of having too much cortisol due to long-term or severe stress.
So, what is actually required to treat stress-related fatigue is to initially (and primarily) address the most obvious reasons for HPA Dysfunction, such as high stress, chronic inflammation, and poor nutrient levels.
Being 'tired' is the most common health complaint. However, most orthodox blood-tests indicate, 'you're not tired - you're a Hypochondriac...'
It really did look like your Adrenal Glands had gone on strike
When your adrenal glands are only outputting a low amount of cortisol — because the brain has ‘turned down’ their activity — you literally feel like you’re dragging your sorry self around.
These were considered the classic ‘Adrenal Fatigue’ symptoms:
You feel mentally + physically exhausted — and unrefreshed by sleep.
Your energy is worst first thing in the morning but gets better as the day wears on.
You find it difficult to lose weight and your appetite actually increases when stressed.
This is low — particularly when you get up to stand. And, you may crave salty food.
This is low — and you may feel the constant need to eat.
05—Cognition + Mental Disposition
You experience ‘Brain Fog’ (not being able to think straight), you have poor memory, and poor word recall.
You are unable to handle any stress — and you tire easily.
You have a tendency toward depression.
This is poor — because you have no motivation and no stamina to see things through.
However, in light of the evolving science, all of these symptoms are being created by the effects of chronic stressors on the brain + poor mitochondrial function.
Your body might be fatigued but your adrenal glands certainly aren't.
"Low cortisol" is generally associated with the following stress-related conditions
THE MORE OBVIOUS CONDITIONS ASSOCIATED WITH THIS
Chronic Fatigue Syndrome (CFS)
Post-traumatic stress disorder (PTSD)
THE LESS OBVIOUS HEALTH CONDITIONS ASSOCIATED WITH THIS
Low blood pressure
Low blood sugar levels
You know how you need money to make money? You also need energy to make energy.
It’s a problem — you’re fatigued, but you need energy to make energy.
The Mitochondria are the powerhouses of our cells because they create the energy necessary to run our bodies efficiently. Not only this, but we are constantly finding out more about the amazing abilities of these tiny organelles. For example, if we have healthy mitochondrion, then we are more resilient to the damaging effects of stress, chronic inflammation and infection. This makes supporting mitochondrial function an important part of any stress reducing treatment protocol.
Producing energy and priming your ‘powerhouses’ to protect you from the causes of fatigue relies on a consistent supply of nutrients. If your mitochondrion do not receive adequate nutrition, they cannot perform optimally. Therefore, we need to rebuild + fuel them by using specific nutrients such as Coenzyme Q10, Magnesium, and B vitamins.
Your adrenal glands indirectly provide you with energy, by mobilising your body’s reserves. However, your mitochondrion are the chief determinent of your energy levels.
Ironically enough, it turns out the orthodox medical world was right. Stress-related fatigue really is all in your head (well, in your brain at least) :-)
You need to increase your resilience to stress and recharge your batteries
01—Adaptogenic herbs protect us from stress
From a medicinal herb perspective, things won’t change much here. The emphasis here will shift to be on adaptogenic herbs, rather than adrenal tonics. (Although a lot of herbs do both actions). Adaptogenic herbs work on specifically correcting HPA dysfunction.
For HPA dysfunction the following herbs should be used: Rhodiola (a favourite of mine), Indian Ginseng, Siberian Ginseng, and American Ginseng.
02—The primary ingredients you need for energy production
Eat foods rich in protein, fat, and carbohydrates (unrefined & unprocessed).
Avoid stimulants such as caffeine, which can drain your energy as they deplete vitalising nutrients.
03—The primary actions you need to take for energy production
Aim to get to bed before 10pm + try to sleep for seven to nine hours each night.
De-stress by spending time in nature, meditating and having fun.
Engage in moderate exercise 3-5 x per week.
Moderate exercise stimulates your body to make new mitochondria, resulting in more energy.
Note: When feeling very fatigued (but otherwise well), go for a short 20 min ‘meander’to boost your energy level.
04—THESE SUPPLEMENTS Make you more resilient to stress + CREATE ENERGY
Research has shown that the most consistent finding in fatigued people is reduced serum levels of coenzyme Q10. Coenzyme Q10 is antioxidant, anti-flammatory, stress- protective, and supports energy production. And, the more deficient you are in this vitamin, the worse you’ll be at being — well, energetic.
A tell-tale sign of CoQ10 depletion is ‘brain deficiency’. You may experience signs of brain fog, poor memory + poor word recall as well.
This mineral reduces inflammation (particularly in the brain) and among other beneficial actions, taking magnesium is like giving your brain a hug — because it reduces anxiety + depression, it induces sleep, it modulates the HPA axis, and it gives you energy by promoting mitochondrial function.
B’s are super important for energy production because they are involved in the Kreb’s Cycle and Electron Transport Chain. (Basically they play an important role in mitochondrial function.)
B-group vitamins also prevent brain ‘decline’, as certain B-group vitamins can promote the positive rewiring of the brain as well as reducing brain inflammation.
Acetyl-L-carnitine is also another helpful nutrient here — as it brings fats into our mitochondria to burn for energy.
Note: It’s REALLY important to take the right types of herbs + nutrients, at the right dose, at the right time, for the right time-frame. Please talk to your Naturopath (me!) about these nutrients and their suitability for you.
We've got more important things to focus on - than your adrenal glands!
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Lisa Fitzgibbon is a qualified (2006), experienced and registered Naturopath and Medical Herbalist. She runs her own private practice OOMPH, in Grey Lynn (Auckland, New Zealand). Lisa has been involved in the Natural Health industry for 13 years. She draws on her professional training and experience, as well as her own personal experience to bring you realistic, holistic health advice.
Book online to see Lisa at OOMPH.