It’s almost 11am and where am I, again, for the 3rd day in a row? Laying on the couch staring aimlessly at nothing on tv. My mind is cloudy and my body is heavy and listless. I have never felt this exhausted in my life (oh except my brief stint with mono when I was 18). I don’t know that I could have gotten off the couch if $10,000 presented itself to me for doing so. I am going on month 3 (or is it 4?) of this pattern with no conceivable end in sight. Have I eaten something weird, is this cyclical, am I depressed? What on earth is going on??!! I’m a nutrition coach, I help people get healthy! Why can’t I fix myself? These thoughts rolled around in my head endlessly torturing my mind until I drifted back to sleep, again. And on it went.
I know what this is. I know what it stems from and why it’s happening. This did not happen overnight, but has been building for some time. Let’s back up a little over a year ago and talk about how this started. I was in a job that I was good at, but completely miserable doing. So miserable I would just burst into tears Sunday night thinking about going back and giving myself a pep talk or listen to empowering music on the way to work, just so I could make it through the day. Most people didn’t know this was going on (and had been for almost 2 years!). My body and mind was screaming for a change, but it was too scary to think about doing anything else. Then a little over a year ago I lost this job and the healing started. First I just took a nice long break. I slept, I visited with friends, I worked on our home. I just tried to breathe. But in true American form, I felt I wasn’t being productive enough, so I jumped headfirst into starting my own business. Without much direction or idea what this looked like, I started the process of re-creating myself. There were of course wonderful things about this. I am passionate about what I do today thanks to the opportunity to change my path, but I also have kept some poor habits as well. Working harder instead of smarter, burning out, not being organized or knowing when to say no, and not letting go when it’s time. I can unfortunately (yes unfortunately!) be extremely loyal, to the point that I do not walk away when my intuition tells me to. What does all of this cause…stress. And my body was beginning to react in scary ways. I felt depressed, hopeless, not good enough to do what I was doing, and so tired the idea of doing anything but lay listlessly on the couch felt like it would take an act of God to simply stand up. Why was I feeling this way? Two words: Adrenal fatigue.
What in the world is adrenal fatigue and why should we care? We often think about adrenaline when we think about our adrenals, but they really do so much more than this. Our adrenals produce hormones that help us get up and go, they are related to our blood sugar levels, and they work with the other hormones in our endocrine system to make sure things are running smoothly and that is just the basics! Hormones are chemical messengers our body sends out to keep us balanced. And guess what? When one of these systems isn’t functioning well, the other ones likely aren’t either. So when we talk about adrenal fatigue, we may as well talk about overall hormone imbalance and blood sugar regulation too! Our bodies are so amazing, designed to work as a whole instead of systems working in isolation. Adrenal fatigue can be hard to diagnose properly and in the mainstream medical community is often ignored and considered a mental health issue often ending with anti-depressants being prescribed which can actually aggravate the issue. Let’s delve into this a bit deeper so hang with me!
Fatigue is on the rise. As a culture we are more exhausted, more stressed out, busier, and sicker than ever. So many things contribute to our overall exhaustion including work, family, relationships, finances and just overall busyness. One of the areas that is most taxed in our bodies is our adrenal glands. Adrenal fatigue is a relatively new concept and as a disorder is not commonly recognized by mainstream healthcare. For those dealing with this problem, it is very real. The adrenal glands are two cone shaped glands that sit one on top of each kidney. These glands consist of the cortex or outer layer and medulla or inner layer. The cortex secretes the cortical hormones including cortisol which controls how the body uses fat, protein, carbohydrates, and minerals, helps reduce inflammation, and affects metabolism; aldosterone which is in charge of sodium excretion and potassium loss, maintaining blood volume and pressure; and gonadocorticoids which act on the ovaries and testes affecting sperm production, body hair in female and work with adrenocorticotropic hormones (ACTH) which triggers the adrenals to produce cortisol. The medulla is linked to our fight or flight system or the sympathetic nervous system and releases the adrenaline hormones epinephrine and norepinephrine. These hormones help to raise heart rate and blood pressure, increase carbohydrate metabolism, and help the body get ready to respond to a stressor. We’re going to stick with cortisol for a bit.
Cortisol is not the enemy it is a vital component of our sleep/wake system and our ability to respond to stress. The hypothalamus receives a signal from the hippocampus and then releases the hormone CRH or corticotropin-releasing hormone. CRH signals the anterior pituitary gland to release ACTH. This hormone is released into the blood stream and makes its way to the adrenal glands where it stimulates the cortex hormones to be released including cortisol. This makes up part of our HPA axis or hypothalamus, pituitary, adrenal axis. In a fight or flight response, cortisol redirects energy to the parts of the body that require it for action. This is done by “stimulating gluconeogenesis, the production of glucose from the fatty acids and amino acids in the liver. Under normal circumstances, this rapid rise in glucose would cause increased insulin secretion, which would shuttle glucose into storage…The increased glucose provides quick fuel for the body.” (1) After the stress response is over, the adrenals reduce the cortisol output and in a negative feedback response, send signals to the hypothalamus and pituitary to stop producing CRH & ACTH and the body comes back to homeostasis. As part of our natural sleep/wake cycle, cortisol is considered the waking hormone and works with its opposite hormone melatonin or the sleeping hormone which is released by the pineal gland. In a healthy individual our cortisol levels fluctuate through the day in relation to our circadian rhythm. Cortisol is lowest in the early hours of the morning, around 2-3am, increases a few hours before waking 5-6am, and is highest right after waking. Cortisol then slowly decreases throughout the day in preparation for our body to sleep again that evening. The lowering of cortisol overnight helps with our memory and the increase for the day helps with autonomic body functions.
So how does adrenal fatigue work? I’m glad you asked! Adrenal fatigue comes into play when we are under chronic stress and our body either becomes depleted of this necessary hormone or our cells receptors become overwhelmed (yes we can be cortisol resistant just like insulin resistant!!!) and no longer able to receive cortisol thereby exhausting the function of the adrenal glands. When cortisol rises in response to a trigger by fight or flight mechanism like when you get cut off in traffic, glucose rises along with it to prepare the body to act. The problem is that when we are under chronic stress, like being unhappy in a job or dealing with the daily grind, our body is in constant fight or flight and just as this may trigger cortisol resistance it can also trigger insulin resistance as our body works to deal with the excess glucose being released by the liver. Yikes! We do not want our cells to be resistant to these important hormones! When cortisol remains elevated we also may begin to see, “muscle wasting…type 2 diabetes, obesity, metabolic syndrome…depression and alterations in memory…fatty acid uptake by intra-abdominal adipocytes is stimulated, leading to the characteristic excess abdominal fat. (1) Other contributing factors can be environmental or food sensitivities, lack of sleep, exposure to EMF’s, poor diet, overuse of stimulates including caffeine and energy drinks, chronic trauma, and over exercising. In response to our heightened sympathetic nervous system response, the body shuts down any systems that are not immediately necessary for survival such as digestion, reproduction, growth, immune function, and protein synthesis. Under constant stress, the reduction of function of these systems causes widespread imbalances throughout the body. When we are constantly stressed out (even if you don’t necessarily feel “stressed” your body recognizes it anyway) your digestion will not function properly meaning reduced nutrient absorption. Guess what this means? Fewer nutrients are now available to help your stressed body heal and more issues may start to rise.
The symptoms of adrenal fatigue are vast, which is one of the reasons it can be difficult to identify. Just a handful of the symptoms involved according to Dr. Lam of drlam.com, Adrenal Fatigue Center, include (4):
- Unable to fall asleep despite being tired, waking up tired after a full nights sleep, feeling tired between 3-5, stimulants needed to wake up & keep going!
- Wake up in the middle of the night for no reason, Heart palpitations at night or when stressed
- Low Blood pressure consistently
- Low thyroid function often despite thyroid medications, Low libido and lack of sex drive, Cold hands and feet, Grave’s disease, Hashimoto’s thyroiditis
- Depression, often unresolved after anti-depressant, Fogging thinking
- Endometriosis, Dysmenorrhea advancing to amenorrhea, Premature Menopause ·
- Irritable under stress, Anxiety, Feeling “wired” and unable to relax, Feeling of adrenaline rushes in the body
- Coffee, tea or energy drinks triggering adrenaline rush and adrenal crashes (If you feel tired after drinking coffee you may have taxed adrenals!)
- Feeling tired between 9:00 and 10:00 PM, but resists going to bed
- Craving for fatty food and food high in protein, Craving for salty food such as potato chips
- Exercise helps first, but then makes fatigue worse, Short of breath even though breathing is fine
- Chemical sensitivities to paint, fingernail polish, plastics, Electromagnetic force sensitivity, including cell phone and computer monitors, Delay food sensitivity, especially to dairy and gluten, Temperature intolerance, especially to heat or sunlight
- Abdominal fat accumulation for no apparent reason, Constipation for no apparent reason, Joint pain of unknown origin, Muscle mass loss, Muscle pain of unknown reason, Inability to concentrate or focus, Gastritis despite normal labs, Dizziness for no known cause, Irritable Bowl Syndrome with more constipation then diarrhea
- Low back pain with no history of trauma and normal examination, Legs that feel heavy at times, Dark Circle under eyes that does not go away with rest, Chronic Fatigue Syndrome unimproved with medicine
- Fibromyalgia unresolved after conventional help, Systemic Candida that gets worse when under stress, Electrolyte imbalance despite normal laboratory values
WOW!! No wonder this is such a tough nut to crack! With all of these symptoms, and many of them symptoms of other disorders, we can see why the adrenals aren’t looked at often enough. When they are looked at, it’s often to perform a blood test for cortisol. Remember earlier I was saying cortisol fluctuates throughout the day. So if we take a blood test right this minute we’re only seeing where you are right now which could show a normal result, but you still feel exhausted or anxious, or depressed, or dizzy, or crashing after coffee.
Adrenal Fatigue Syndrome has four stages the body goes through as it continues into dysregulation and eventually reaching exhaustion. The four stages include: 1. Alarm Reaction, 2. Resistance Response, 3. Adrenal Fatigue, and 4. Adrenal Failure.
Alarm reaction or Early Fatigue stage occurs in response to more stress and increases its activity to counteract the stressors. This causes the pituitary gland to release more ACTH into the blood stream to stimulate the adrenal glands to produce more cortisol to assist the body in dealing with the stressor. During this stage there may not be many noticeable symptoms with the exception of a little more tiredness than normal.
In the Resistance Response stage, the body is now under chronic stress and the adrenals begin to be taxed, no longer able to keep up the output of cortisol needed to bring the body back into balance. Even though the release of ACTH remains high, the adrenals begin to slow down the output of cortisol as they begin the path to exhaustion. Due to the excess cortisol that has been in the body, cell receptors can also begin to reduce the amount of cortisol allowed into the cells leading to cortisol resistance. We also begin to see pregnenolone steal during this phase. Pregnenolone is a precursor to our steroid hormones and needed for production of cortisol, estrogen, progesterone, testosterone, and DHEA. This process begins to inhibit the production of the sex hormones as the cortisol “steals” the pregnenolone needed to deal with its increased output. This down-regulates (causes low function) the production of the sex hormones leading to further imbalances in the body. Cortisol levels become low in the morning when they’re needed to get us moving and remain normal in the evening when we need them to reduce to help us sleep. Common symptoms at this stage include, “Anxiety starts to set in, and the person becomes easily irritable. Insomnia becomes more common, as it takes longer to fall asleep. There are also frequent awakenings as well. Infections can become recurrent, and PMS and menstrual irregularities surface, symptoms suggestive of hypothyroidism (such as a sensation of feeling cold along with a sluggish metabolism) become prevalent.” (5). Mild fatigue is involved at this stage.
Stage 3 or Adrenal Fatigue, begins when our body can no longer produce enough cortisol to bring our bodies back into a state of balance. We get the wired and tired feeling as our body ramps up and crashes over and over trying to balance the system. Fatigue will be more extreme and begin to affect daily activities. Overall hormone imbalances will also become worse and DHEA levels will continue to fall. As we are no longer able to release enough cortisol it will also be more difficult for our body to signal the release of glucose for energy which further exacerbates our fatigue and lack of get up and go.
Then we enter the final stage, adrenal failure, which is a critical stage that can cause severe impairment and even be fatal. The body down-regulates the production of cortisol even further to utilize it only in emergencies to keep the body alive. Some of the symptoms at this point mirror Addison’s disease, which is adrenal insufficiency, “Fatigue becomes extreme, with weight loss, muscle weakness, loss of appetite, nausea, vomiting, hypoglycemia, headache, sweating, irregular menstrual cycles, depression, orthostatic hypotension, dehydration, and electrolyte imbalances. The body appears to have lost its normal homeostasis and is breaking down. If not attended to, the natural progression of this condition may be fatal.” (5).
So how can we test our adrenal function? Cortisol and DHEA levels are the best markers for identifying a sub-functional system (sub functional means you are not in the extremes of the condition, but still have symptoms even though levels may show normal range). Cortisol can be tested using a saliva test that is taken at 4 points throughout the day. Since cortisol levels fluctuate it is important to have more than just a snapshot at one point in the day to determine its level at all points in the day. DHEA can be tested at any point during the day. Although these can help identify adrenal dysfunction these tests can also show normal levels when symptoms are still presented again making it difficult to diagnose.
Is your stress in overdrive? As yourself these questoins from The Paleo Approach by Dr. Sarah Ballantyne:
Do you feel stressed? Anxious? Depressed? Do you have a temper or feel like everything is just too much sometimes? Do you handle your life well if you stick with routine, but the wheels fall off the wagon as soon as something unplanned occurs? Do you have sugar cravings? Do you feel the need for coffee or energy shots to get you through the day? Do you have trouble falling asleep or staying asleep? Is it hard to get out of bed in the morning? Do you have to pee in the middle of the night? Do your moods feel blunted or exaggerated? Do you have unresolved inflammation? Do you catch every cold going around? Does it seem to take forever to get over the mildest infection or heal from a minor scrape? These are all signs of cortisol imbalance.
If you answered yes to many of these questions there are some things you can do on your own to begin repairing these systems. Cleaning up the diet, removing junk foods, reducing sugar, possibly reducing grains, reducing or eliminating caffeine and other stimulants, making sure to have adequate protein and fatty acids in the diet, removing food sensitivities, and adding vitamin C rich foods including bell peppers, citrus fruits, and greens to support the adrenal glands can help start to rebalance these glands. Some adaptogens may prove helpful including ashwaganda, Echinacea, astragalus, and ginseng in improving adrenal function. EFA’s such as fish oil, cod liver oil, krill oil, or evening primrose may assist in re-balancing the body. Magnesium, sodium, potassium, coQ10, and a B complex may help with energy levels. In addition to nutrients rest and reducing stress is key. Without addressing these issues, the best diet in the world will not outweigh a stressful lifestyle. Placing sleep at the top of the priority list and finding ways to deal with stress such as cultivating hobbies, meditation, light exercise, spending time with friends, gardening, or focusing on any activity that brings relaxation. Exercise should remain light during the healing phase utilizing walking, light weights, yoga, or light aerobic exercise being cautious to monitor energy levels.
So what am I doing to help with mine? First of all I need to talk about my amazing husband David. He has supported me from day one in building my business and not just getting a regular job which is huge! He supports me daily with encouragement, feedback, and helping anyway he can. We work hard to live within our means so we do not need a huge income to be comfortable. Our relationship has grown leaps and bounds over the last year in improving our communication and relying on each other in our partnership. Now I move on to removing the 3-4 cups of coffee I was drinking per day (yes per day!). I am still working on this one as I love coffee, but I’m down to 1 mug of decaf per day. Next week I plan to go to every other day and so on until I can remove it completely for 30 days. I chose to do this in steps as I see no reason to increase stress on my body when I’m trying to decrease it! I take a few supplements daily including ashwaganda, vitamin C, B complex, fermented cod-liver oil and astragalus. I have placed sleep back on the priority list by working on getting to bed by 10 every night. I have come to realize that pretty much NOTHING I’m doing at night past this time is more important than proper sleep! We do not put a high enough price on sleep, but it is one of the most important priorities for my adrenal healing and I have noticed a substantial difference. I have also brought home cooked meals back into my list of top items. I was keeping too busy to make this a worthwhile daily task and guess what! Again, just as with my sleeping habits, there was almost NOTHING that I was doing that was more important than taking 30 minutes – 1 hour to prepare a meal. Again, this is one of my priorities and may not be available for you, but I urge you to consider food. I have fermented foods and broth every day to help with digestion and improve my immune system. I also do not skip meals (especially coffee for breakfast). Not eating enough is very stressful for the body! Nutrients mean a healthy functioning body. Now let’s talk about stress. One of the ways I have started dealing with stress is to create systems for my business to allow me to work smarter, not harder. I also was recently introduced to the concept of the big enough business. In other words, am I trying to make a huge corporation, or do I want a business that is effective for the audience, affords me the lifestyle I would like, and allows me to work the hours I feel are appropriate? Well I want the latter so I am working towards the goal of a big enough business. This has created freedom for me within the building of my business. It does not and should not consume me. The next way I started to deal with stress is by letting go of commitments that I can no longer keep in a healthy way and focus my energy into things that build me up. This is a weakness of mine so dealing with it has been difficult, but a necessary step towards healthy relationships and better business decisions. Now these are my priorities and may not be yours and that is ok! You’ll find what means the most for you to work on. There is no perfect model to follow, only what’s perfect for you.
All in all, my energy has improved 100 FOLD! I have not had a wiped out day on the couch in almost 1 month after 4 months of debilitating fatigue on a weekly basis. My mind is clearer, I feel empowered and confident, and appreciate each day that I get to spend with family, friends, and the amazing people I get to meet every week in my business. I know this is not the end and I will have to be mindful of how I feel. Mindfulness does not mean stressing out about it or obsessing over how I feel every minute. It means checking in daily and seeing how I feel today and acknowledge that feeling, good or bad and being ok with it. It’s one day at a time around here and I plan to enjoy each and every one! I’d love to hear from you! Please share your stories of freedom from adrenal fatigue and what you have done to heal!
The Adrenal Fatigue Solution
Looking for more information on healing from adrenal fatigue? The Adrenal Fatigue Solution by Fawne Hansen and Dr. Eric Wood not only provides both comprehensive information and implementation strategies, but is also reader friendly and easy to follow for the lay person. I highly recommend giving it a read! You can purchase your ebook HERE!
Check out the Fired Up and Focused Challenge by Rachel Cook for more info on building your smart business. It changed the way I think about being a business owner!
All information provided within this page is for informational and educational purposes only and should not be considered medical advice or instruction. Please consult a qualified health professional on any health related issue you have. Any statements or claims about the possible health benefits provided by any foods or supplements have not been evaluated by the Food & Drug Administration and are therefore not intended to diagnose, treat, cure or prevent any disease.
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