Adrenal Fatigue, the New Normal for Americans.

We are experiencing more burnout and fatigue today than ever before. It has become an epidemic in and of itself. Since Covid, the dramatic increase in social isolation, financial strain, health challenges and increasing mental health struggles has somehow impacted all of us, directly or indirectly.

Very likely you, or someone you know, has said more than once, “I never feel rested, no matter what I do, I can’t seem to catch up on my rest.”

Adrenal Fatigue presents in two ways: (severe and prolonged)

(1) Adrenal Fatigue and (2) Adrenal Insufficiency. A.F., as by current conventional medical standards, is described a clinical presentation of symptoms, that is not (yet) a medical diagnosis. In contrast, Adrenal Insufficiency is a potentially life-threatening medical diagnosis. To fully understand, let’s examine the job of the adrenal glands in the body.

Purpose of the Adrenal Glands:

The adrenal glands are small organs that sit on top of the kidneys. They are part of a system called the HPA Axis (hypothalamic-pituitary axis). These vital organs are involved in numerous physiological events within the body, specifically, the stress response.

Each adrenal gland has dual parts: (1) the cortex (outside) and (2) the medulla (inside). They secrete different hormones. The medulla, the smaller region of the adrenal gland, secretes epinephrine and norepinephrine (catecholamines). Catecholamines are the “fight or flight” hormones. This is the body’s response to acute stress. The release of these hormones gets your heart racing and your body prepared to ‘fight or flight’, as a means of self-preservation.

The larger region is called the cortex and it secretes several hormones: cortisol, aldosterone, testosterone, and DHEA (glucocorticoids). Glucocorticoids are responsible for assisting with regulating blood sugar, insulin levels, metabolism, anti-inflammatory responses, sexual function, and immune system suppression.

What Happens When the Mind and Body Perceive Stress?

Our human brain is so intuitive, when something is perceived as stressful, it makes a decision in nano-seconds. If it is a threat, there is a decision made to either fight, escape, or adapt to it. For example, imagine running away from a bear, or facing a mental-emotional crisis, or perhaps more relevant, the latest barraged of fear-based news the globe over. Regardless of the stressor, the HPA Axis is engaged, triggering various hormones to be secreted to prepare the body for action.

In a perfect world, once the stressor is removed, the body and mind get feedback that the stress is declining and the body’s goal becomes to restore balance (called homeostasis). However, if the stress persists at a high level, as it has for so many over the past two years, the HPA Axis thinks it is constantly in “fight or flee mode.” This is when adrenal dysfunction (fatigue) occurs.

Adrenal Fatigue or Insufficiency: What’s the Difference?
Chronic stress can have harmful effects, in many different ways. For most people, the human body is resilient, and it isn’t immediately thrust into a state of physiological fatigue, so intense that the adrenal glands lose their ability to function. It’s more common for people to progress from health to illness over time. When dysfunction occurs and if not addressed, then it can become a life-threatening illness such as adrenal insufficiency.

Addison’s Disease (adrenal insufficiency) is a rare and potentially life-threatening illness. A person with Addison’s Disease does not make enough essential hormones, specifically cortisol to sustain life. Addison’s Disease is screened by a doctor who orders specific blood tests that measure cortisol and other hormones.

The clinical presentation of adrenal fatigue symptoms is not yet considered a clinical diagnosis but it is recognized through a set of symptoms and / or certain lab values, like dysregulated cortisol patterns. There are many parallels between adrenal fatigue and Addison’s Disease which may include:

Exhaustion that does not resolve in a reasonable time or occurs in flares
Mental – Emotional: Depression, lack of passion and motivation, apathy
Body aches not explained by other illness or physical exertion
Poor cognitive function and brain fog Digestive problems Sleep disturbances
Nervousness How to Restore Balance to Adrenal Function with Natural Approaches?
When considering restoring adrenal function, holistic doctors always go back to the basics. Depending on each individual’s needs, a program to restore balance to the adrenal glands and overall health would incorporate:

Elimination diet to detox the body and identify food sensitivities, removed processed foods, and addressing nutrient deficiencies,
Increase medicinal food approach – whole foods, dark leafy greens, colorful veggies, lean meats Coaching/ counseling to recognize, prevent, and manage stress, while removing physiological impact of emotional, physical and environmental stress Stress reduction and management techniques (yoga, meditation, mindful movement/walking, breath work) Supporting healing through the use of individualized supplements and botanicals Hydrotherapy and craniosacral therapy
An individualized exercise routine Enhancing social support Sufficient hydration
Life, especially as of late, can be challenging, but it doesn’t have to wreak havoc on: our bodies, health, and quality of life. Chronic stress of any kind eventually takes a toll on the body, it can even be life threatening if not properly addressed. Knowing this is half the battle. Arm yourself with knowledge to DO something to protect your health and wellbeing.

There are many medical conditions where fatigue is the primary symptom and many possible root causes. A holistic doctor will work with you to understand why you have these symptoms, find and treat the root cause, and restore balance to the body. This is a multifaceted approach. Chronic fatigue develops over time; therefore, it takes time to unravel and identify the root cause.

Sometimes the solutions can be difficult to see on our own and may be impossible without medical testing and advice. If you are experiencing persistent and ongoing fatigue, call and make an appointment today with Dr. Dengler at Vitality Health and Wellness Center: Meadville: (814) 720-4825 or Grove City: (724) 458-5522. She will help you get to the root cause and help you restore your health.

Resources:

Wilson JL. Adrenal Fatigue the 21st Century Stress Syndrome. 1st ed. 2001.

Adrenal Insufficiency (Addison’s Disease) Johns Hopkins Medicine. https://www.hopkinsmedicine.org/health/conditions-and-diseases/underactive-adrenal-glands–addisons-disease

Mayo Clinic. “Adrenal Fatigue: What causes it?” https://www.mayoclinic.org/diseases-conditions/addisons-disease/expert-answers/adrenal-fatigue/faq-20057906

Endocrine Society. “The Myth of Adrenal Fatigue.” Posted by Eric Seaborg Sep 2017 at https://endocrinenews.endocrine.org/myth-adrenal-fatigue/

Jankord R, Herman JP. “Limbic regulation of hypothalamos-pituitary-adrenocortical function during acute and chronic stress.” Ann N Y Acad Sci. (2008 Dec) 1148:64-73. doi: 10.1196/annals.1410.012. PMID: 19120092. https://pubmed.ncbi.nlm.nih.gov/19120092/

Bancos I, et al. “Diagnosis and management of adrenal insufficiency.” Lancet Diabetes Endocrinol. (2015 Mar) 3(3):216-26. https://pubmed.ncbi.nlm.nih.gov/25098712/

Cadegiani FA, Kater CE. “Adrenal fatigue does not exist: a systematic review.” BMC Endocr Disord. (2016 Aug 24) 16(1):48. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4997656/

Herman JP, et al. “Regulation of the Hypothalamic-Pituitary-Adrenocortical Stress Response.” Compr Physiol. (2016 Mar 15) 6(2):603-21. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4867107/

The Washington Post (online) “Is adrenal fatigue real? Forget the label and treat the stress.” https://www.washingtonpost.com/lifestyle/wellness/is-adrenal-fatigue-real-forget-the-label-and-treat-the-stress/2017/04/04/6952b2b6-1889-11e7-9887-1a5314b56a08_story.html

Ulrich-Lai YM, Figueiredo HF, Ostrander MM, Choi DC, Engeland WC, Herman JP. “Chronic stress induces adrenal hyperplasia and hypertrophy in a subregion-specific manner.” Am J Physiol Endocrinol Metab. (2006) 291:E965-973. http://ajpendo.physiology.org/content/291/5/E965.long

Naturopathic Pediatrics: What Is Adrenal Fatigue? https://naturopathicpediatrics.com/2011/10/29/what-is-adrenal-fatigue-2/