Can the Adrenal Glands Really Get "Fatigued"?

October 06, 2019

"If you're feeling stressed, worn down, and fatigued, start taking some of these steps."

In part one of his adrenal series, Dr. Keller Wortham, MD, gave us an overview of what the adrenal glands are, what they do, and went over some health problems that can occur as a result of issues with these important glands.

In today's part 2, Dr. Keller will clear up some myths about the controversial condition known as "adrenal fatigue". Learn the history of this condition, symptoms commonly associated with it, and what they might actually signify. Plus, find out what can be done to address those symptoms!

Video Highlights

  • 00:02: Recap of part one
  • 01:04: Adrenal Fatigue
  • 02:49: Problems with the Adrenal Fatigue Theory
  • 04:31: So What If You Have These Symptoms?
  • 09:14: Addressing and Managing Stress
  • 13:18: Wrap-Up

In part one, we talked about the adrenal glands, those wonderful little glands that sit on top of our kidneys and are responsible for so many important hormones that help keep our body going, and help regulate our metabolism, blood pressure, and our fight or flight response.  Dr. Keller also mentioned that he sees a lot of patients who complain of feeling burned out, and have been told by their chiropractors or have read online that they may be suffering from adrenal fatigue. 

In that episode, we talked about some of the things that can go wrong with the adrenals, but adrenal fatigue wasn’t among them. So that’s what we’re going to dive into today.

Adrenal Fatigue

The term “adrenal fatigue” was coined in 1998 by a doctor named James Wilson, a PhD and naturopath, who basically described adrenal fatigue as a group of related signs and symptoms that occur as a result of the adrenal glands functioning below their necessary level. 

The adrenal glands are responsible for responding to stress, and when they respond to stress, they pump out little bursts of cortisol. Dr. Wilson’s theory was that if you're under stress for a long period of time — perhaps due to the death of a loved one, a financial burden, or some other chronic issue — that your adrenal glands are having to keep up with that stress and churn out cortisol to manage that stress, which results in those glands getting worn out.  According to his theory, symptoms of adrenal fatigue might include: brain fog, low energy, a depressed mood, cravings for salt and sugar, lightheadedness, and other vague symptoms.  So, the question is, was Dr. Wilson right? Is this something that can actually happen?  

Well, there are a few problems with the hypothesis that this Dr. Wilson came out with.

Problems with the Adrenal Fatigue Theory

  • First of all, those symptoms that we just listed are pretty general, and there are a lot of other health conditions that could cause similar symptoms, including: depression, sleep apnea, fibromyalgia, hypothyroidism, prediabetes, and diabetes. There are so many other things that can cause those symptoms that it's hard to just pin them on something like adrenal fatigue.  
  • A second issue is that it's been very hard to find any specific test, including blood tests, that can consistently find a biochemical change in the body that identifies this condition of adrenal fatigue. You can even go so far as to check cortisol levels in the body and other hormone levels and see if you can find that trend, but none of these tests have been able to find something that can consistently be identified with this condition. In fact, 14,000 endocrinologists — the group of doctors who deal with the endocrine glands — have come out strongly in their public education arm and issued a statement saying that adrenal fatigue is not a real medical condition. According to these endocrinologists, “there are no scientific facts to support the theory that long term mental, emotional, or physical stress drains the adrenal glands.”  

So, that's a pretty strong point of view. They're basically saying that Dr. Wilson made up this condition called adrenal fatigue syndrome, but the doctors who specialize in understanding adrenal glands don’t believe it exists.

So What If You Have These Symptoms?

Saying that adrenal fatigue is not a true medical condition doesn’t help those of you who might be suffering from this group of symptoms. Many people are experiencing fatigue, brain fog, sugar cravings, and the other associated symptoms. So, what do they mean, if not adrenal fatigue? Well, there are a couple of important points to be made about that.

The first thing is you should talk with your doctor to get a thorough workup. Since these symptoms are general, there are a lot of conditions that could be causing them, which you need to rule out such as: anemia, sleep apnea, an autoimmune disease, infections, mental illness like depression, and problems with the heart, kidneys, and your liver. All of these things can cause the symptoms that we mentioned.  

So, your doctor might want to do blood tests to check your thyroid, your electrolytes, and your white and red blood cell counts. They might also do other tests, like a sleep study to screen for sleep apnea, and then move on to talking about your lifestyle, other symptoms you might be experiencing, and other things that could be influencing your health overall. 

They may also check specific hormone levels that are related to the adrenals. Cortisol is obviously a really important one, because cortisol is the hormone that can crash over time, according to the adrenal fatigue theory. There are a couple of ways to check cortisol: you can measure the amount in the blood, and in the saliva, and use those numbers to establish whether there really is a cortisol deficiency. But there's a little bit of a problem with that — you see, cortisol is a hormone that is always fluctuating, depending on how stressed you are in that moment. Sometimes it can even go up because you're stressed about getting a blood test done! It can also be affected by your circadian rhythm, which is when you're asleep and when you're awake. So, there are definitely changes in the levels of cortisol throughout the day —  your cortisol may be higher in the morning than in the afternoon or vice versa, which means the results of any cortisol blood test can be affected by those same factors. If you check salivary cortisol levels, on the other hand, the doctor might send you home with some vials, in which you collect saliva at different times of the day. That way, they can map out the cortisol levels and see if the cortisol has a pattern of kind of spiking in the morning and then tapering off over the course of the day.

Even if there is a pattern, though, does it mean the adrenals are fatigued, or is it just related to your lifestyle stressors, the way you're sleeping and your diet? 

If you run all the tests and rule out other diseases and conditions, and the tests have come back normal and confirmed that cortisol levels are where they should be, then what? According to Dr. Keller, this happens frequently. If that’s the case, and you still feel like your symptoms line up with adrenal fatigue, then the next step is to ask yourself why your adrenals would become fatigued. Remember, according to Dr. Wilson’s theory, the adrenals become burned out because of long periods of chronic stress. And while adrenal fatigue may not be a true condition, chronic stress can lead to some of those symptoms, so if you’re experiencing long periods of stress, you may be able to address the symptoms at the root by addressing underlying causes. 

Addressing and Managing Stress

Are you stressed all the time because you're not getting enough sleep, or not exercising? Are there financial stressors that you may have some control over, or relational stressors that you need to address? If you’re not dealing with another condition like diabetes, anemia, or sleep apnea, then you need to identify the causes of your stress, and find ways to manage those primary stressors.

Of course, some things are out of our control. While you often don't have control about the stressors that come into your life, you have a lot of control over how you perceive and process them. And that starts with going back to the fundamentals. So let’s look at some fundamental ways to reduce stress:

Get Better Sleep 

If you're not getting adequate sleep, ask yourself what the problem might be. If you need some help, there are sleep aids out there, including natural options like the Smarter Sleep supplement. It has melatonin in it, which has been very helpful in inducing sleep in many people. Getting eight hours of sleep is so important… in fact, it's one of the most important things you can do for your body, and to help keep your adrenals stress-free.  

Exercise  

Exercise is so important, that we probably sound like a broken record always talking about it. If you can get 30 minutes of exercise just three or four times per week, that can really help boost your mood, reduce cortisol levels, and help keep your adrenal glands supported and healthy. And again, you don't have to be running marathons, you can just go for a walk, or do some push-ups and sit-ups. Of course, there are a lot of other benefits to exercising as well, so really try to get your workout in.

Good Diet

What we put into our body has such an effect on all of our systems. If you're eating a bunch of junk food, or processed foods with chemicals and preservatives and not a lot of nutrients, then you're not setting yourself up to have the building blocks for a healthy life. We know that sometimes it's hard to get the right doses of fruits and vegetables that we need in our diet, so if you really feel like you're undershooting, get a multivitamin, such as the Smarter Multivitamin. It comes in a men’s and a women’s formulas, and it’s plant-based, organic, and easily absorbed. 

Vitamin D

We talked recently about the importance of getting enough vitamin D. Low vitamin D levels can certainly contribute to fatigue, so have your doctor test you for a vitamin D deficiency. If your levels are low, make sure you’re taking a plant-based vitamin D supplement to get them back up to where they need to be. 

Master the Art of Calm

We know “just stay calm” is easier said than done. Again, we often don't have control about the stresses that are coming into our life, but we do have a lot of control over what we do with those stresses — whether we internalize them, or let them roll off, or whether we learn to process them in such a way that they don’t cause major disruption to our bodies and lives. 

Wrap-Up

The jury may still be out on whether or not adrenal fatigue is a real diagnosis. We tend to think we can trust the endocrinologists who say they have not found any evidence of it, but when it comes down to it, people do experience those symptoms, and they can be really disruptive. If it means that you're overstressed, start tackling the stress itself, instead of going online and trying to find treatments for adrenal fatigue. If you're feeling stressed, worn down, and fatigued, start taking some of these steps. If you have more questions about adrenal fatigue or anything about the adrenals, then feel free to write to us here at Smarter Nutrition and we’ll be sure to try to answer them.

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