Arenal Fatigue. Adrenal Insufficiency. Adrenal Exhaustion. Adrenal Burnout.Wired and Tired. Call it what you will, but you should definitely inform yourself about it because it’s a growing epidemic in the Western industrialized world, and nearly 80% of Americans deal with it at some point, if not chronically. You may be one of them.

Here are the common symptoms of Adrenal Fatigue:

  • Feel Wired but Tired
  • Anxiety / Panic Attacks / Depression
  • Low Blood Pressure
  • Dizziness / Light-headedness, especially upon standing
  • Poor Memory / Focus / Concentration
  • Insomnia (difficulty falling asleep or staying asleep, especially between 1-5 A.M.)
  • Difficulty waking in the morning (regardless of how much sleep you’ve gotten)
  • Growing dependence on stimulants to “energize” you
  • Blood Sugar Imbalances
  • Weight Gain or Weight Loss
  • Easily Overwhelmed
  • Decreased Libido
  • Hormonal Imbalances
  • Low Back Pain/Ache
  • Environmental Sensitivities to Light, Sound, Touch, and/or Movement
  • Frequent Urination, especially at Night
  • Irritability
  • Dry Skin
  • Excessive or Scanty Perspiration
  • Nausea
  • Total Feeling of Exhaustion
  • Feel Tired around 9-10 P.M. but then getting a “Second Wind” if avoiding going to bed then
  • Dark Circles / Puffiness Under Eyes
  • Headaches / Migraines
  • Increased Allergies / Food Sensitivities
  • Impaired Digestion
  • Fluctuations in Energy Levels throughout the Day and Night
  • Mood Swings
  • Sugar Cravings
  • Salt Cravings
  • Frequent Feelings of Dehydration and Thirst 
  • Difficulty Relaxing / Hyperactivity / Nervousness / Fidgety
  • Loss of Muscle Tone
  • Hair Loss / Dry Brittle Hair / Thinning Hair / Premature Graying
  • Pale Lips
  • Loss of Willpower and Motivation

Sound Familiar? I bet.

So, what is Adrenal Fatigue???

Simply put, Adrenal Fatigue is untreated chronic stress, causing major imbalances in all bodily systems, eventually leading to systemic hypo-functioning and complete exhaustion.

What are adrenals and why are they so important?

The adrenals are two small glands that sit on top of your kidneys and are part of the Neuroendocrine system. These small walnut-sized glands are powerful workhorses for you. They are life-saving organs because they control your body’s hormones and help you survive in stressful situations. They are responsible for the “fight-or-flight” response and secrete many of our most important hormones, such as: cortisol, adrenaline, estrogen, testosterone, progesterone, and DHEA, just to name a few. 

Because cortisol is intended to be released when you feel a threat of survival, it is very energizing and propels you into action. The human body was designed to respond effectively to stress and then have longer periods of rest in between. Unfortunately, our modern-day lifestyle is so full of constant stressors (think: traffic/road rage, trying to get to appointments on time, work and school responsibilities and deadlines, interpersonal conflicts, compounding emails, text messages, phone calls that need to be returned, not to mention all the internal, environmental, and physical stressors that we all deal with). It’s no wonder nearly 80% of the population has adrenal fatigue!

So, to summarize: when the body and mind are under chronic stress, the constant release of stress hormones, most notably cortisol, become overspent. Eventually, you use up your cortisol reserve and you stop releasing it. When there is no cortisol, there is no energy. This is the point when adrenal fatigue becomes adrenal “exhaustion” or “burnout”.

To compensate, adrenaline tends to kick in, which is why many people may feel wired, but tired, and may have anxiety and insomnia, for instance. 

How Adrenal Fatigue Affects the rest of your Body: 

When your poor little adrenals are constantly stressed, this sets off autoimmune and inflammatory responses throughout your entire body:

The hypothalamus-pituitary-adrenal feedback loop (HPA Axis) regulates the secretion of cortisol. The HPA Axis is a line of communication that loops from the brain to the adrenals, and then back to the brain again. When the brain picks up stress signals from the body, it responds by sending a message to the adrenal glands, saying “Make cortisol!”. Cortisol shuts down inflammation in the body (that is why doctors prescribe it to reduce pain). Shutting down inflammation is not a good thing as inflammation is your body’s attempt at self-healing. Cortisol also shuts down the immune system. It raises blood sugar. And it prevents the formation of proteins, specifically collagen (welcoming wrinkles!). Cortisol also raises blood pressure and blocks the formation of bone, causing brittle bones, which leads to osteoporosis.

Digestive function also shuts down in response to fight-or-flight signaling. This can cause loss of appetite, gas, cramping, and constipation. When transit time in the gut is drastically slowed, this leads to many gut disorders. The fermenting stagnant food feeds bad gut bugs so that they begin to overpopulate. The pathogen’s  waste byproduct creates inflammation in the gut walls, leading to Leaky Gut Syndrome and other lovely diagnoses such Irritable Bowel Syndrome (IBS), Candida/Yeast Overgrowth, Small Intestinal Bacterial Overgrowth (SIBO), parasites, etc. Leaky Gut also tends to cause a host of food and environmental sensitivities, allergies, arthritis / joint pain / muscular pain, and other autoimmune responses.

Causes of Adrenal Fatigue

The root cause of adrenal fatigue is chronic unresolved stress. This stress may be emotional, mental, physical, or external, such as: poor diet, heavy metal toxicity, extreme shock and/or trauma, excessive exercise, physical trauma, overwork with little to no rest, over-indulgence in stimulants like coffee, tea, energy drinks, soda, tobacco, narcotics, excessive use of cortisone therapy, lack of sleep, and/or chronic infections. 

Unfortunately, the body does not recognize the difference between real and imagined stress and so reacts the exact same way to both. For example, constantly worrying about losing your job and not being able to support yourself and/or your family can and will cause the same over-taxing of the adrenals and suppression of the immune system as actually losing your job and financial security. 

Stages of Adrenal Fatigue

In normal functioning of the adrenal glands, your body normally vacillates between high cortisol levels during wakeful periods and low cortisol levels for for sleep periods, all within the normal range of cortisol, one of the main stress hormones that the adrenal gland secretes. This means being awake, alert, and oriented in the daytime, followed by its complementary opposite of being in deep restorative sleep at overnight. This is the ideal foundation from which a healthy adrenal response operates. This is also how our prehistoric hunter-gatherer societies lived in balance. They would have short and intense bursts of stress response typically when they were hunting or being hunted, which typically only lasted for a few minutes at a time, followed by long spans of relaxation and/or socializing. In the modern world, most people’s stress response is constant and chronic, never turning off and normalizing, preventing them from being able to relax and live the life they want to live.  

The 3 stages of Adrenal Fatigue Syndrome:

Stage 1: The alarm fight-or-flight state of adrenal gland function is seen in this stage, which is associated with a higher than normal release of cortisol and epinephrine. As long as appropriate lifestyle habits, diet, and good nutrition are maintained, an individual can return to a normal state regularly. 

Stage 2: This the suppression stage of adrenal exhaustion. There will be increased amounts of cortisol, epinephrine (adrenaline), and norepinephrine. Cortisol will cause high blood sugar, the breakdown of muscle, inflammation, and a negative influence of insulin receptors to prevent a storage of glucose. There will also be an increase in oxidative stress, which results in both local and systemic inflammation, requiring even more cortisol to be secreted. Blood pressure increases and the kidneys must process more minerals. Sex hormones (estrogen and testosterone) become imbalanced, digestion weakens leading to symptoms of acid reflux, bloating, gastritis, and constipation. Anxiety and depression increase and the thyroid has to work even harder to provide the body with thyroid hormones to support increased metabolic pathways. Systemic symptoms and conditions are common in this stage.

Stage 3: In this stage, the adrenals are exhausted or “burned out” because you are no longer able to produce adequate cortisol levels. There may be abnormal fluctuations in cortisol output, less in the morning and more at night, but the overall daily amount is decreased. Common conditions in this stage are: chronic fatigue, fibromyalgia, hypotension, chemical sensitivities, odor sensitivities, atypical depression or apathy, lowered resistance to infection. Hypoglycemia is common and symptoms of this include: light-headedness, dizziness, shakiness, irritability, etc. The body will attempt to compensate for the lack of cortisol with surges of adrenaline. Therefore, anxiety, irritability, confusion, and lack of focus are very common in the exhaustion phase. 

Testing for Adrenal Fatigue

The gold-standard test for Adrenal fatigue is the Cortisol Saliva Test. In order to properly assess the health of your adrenal glands, you need to get four readings of your cortisol levels, over the course of one full day/24-hour period. Doing so in necessary because of the sleep-wake cycle and the general nature of cortisol, which is released throughout the day in a rhythmic nature. 

Cortisol salivary tests are minimally invasive and only require spit collections throughout the testing day. They are also relatively inexpensive compared to other lab tests, and are easily collected in your house, rather than a lab. 

Why your Doctor probably can’t help your Adrenal Fatigue

Most conventional physicians only receive medical training about extreme adrenal disorders, such as Cushing’s and Addison’s Diseases, which have standardized testing and drug treatment. Therefore, they don’t know how to recognize and treat the all-too-common Adrenal Fatigue Syndrome epidemic (which falls somewhere in between the aforementioned diseases). Instead, they typically just want to prescribe pharmaceutical drugs for each separate symptom you report, which not only fails to address the root cause of the imbalance, but actually worsens things greatly. Most pharmaceuticals have multiple side effects and strain the already overburdened liver and kidneys (remember the adrenal are part of the kidney system!), so this can and does compound the problems. Find a Functional Medicine Practitioner who most likely is educated in Adrenal Fatigue Syndrome and knows what to look for, how to test for it, and how to treat it. 

Treatment for Adrenal Fatigue

The best thing one can do to begin the recovery process of taxed adrenals is to rest and de-stress. This is critical and can also be really enjoyable.

Getting to bed early (ideally before midnight)

Napping or resting when fatigued or exhausted and sleeping in, when possible

Eliminating or decreasing intense exercise in the beginning of the recovery process to conserve energy for healing and replacing it with Yin or Restorative Yoga

Eliminating or greatly reducing caffeine and other energy drinks

Feeding the adrenals the nutrients they need:

This includes minerals and Whole-food Vitamin C (NOT synthetic and isolated Ascorbic Acid, which is what most supplements contain).  My favorite “Adrenal Cocktail” is It can be taken anytime you feel out of balance, with either not enough energy or too much. It balances your adrenals in the direction they need to go in, at the time of ingestion. Taking an adrenal glandular will also help to rebuild your adrenal glands. My favorite one is: Also, using Celtic or Real Salt liberally on food and in water, will help to rebalance minerals that are so desperately needed when dealing with adrenal burnout.

Finally, acupuncture is incredibly helpful for strengthening the adrenals. Many treatments can be needle-free, minimizing any stress for those who are needle-phobic.