Adrenal fatigue has become a widely diagnosed condition by both practitioners and patients within the functional and integrative medicine world, being used to describe a wide range of symptoms from brain fog and lethargy to allergies and weight gain. It’s a very nonspecific condition that’s associated with a lot of health issues. Due to the expansive influence of the adrenals on different physiological functions, symptoms of adrenal fatigue can be hard to differentiate from other disorders. It’s not always easily recognizable and while the validity of adrenal fatigue is complicated, most sources will agree that adrenal fatigue symptoms include brain fog, insulin resistance, irritability, and persistent fatigue. So in our aim to answer the tricky question, “What is adrenal fatigue?”, We stick to a holistic but analytical approach and focus on what’s happening on a physiological level. In reference to adrenal fatigue, it’s commonly thought that the adrenal glands have become fatigued or burnt out and therefore they can’t properly release cortisol anymore. However, a highly respected clinician and educator in the fields of Functional and Integrative Medicine, Chris Kresser, M.S., L.Ac., has recently proposed a more accurate perception of what is happening in our body. He suggests that it’s time we take a closer look at some of the basic physiology in the works regarding adrenal fatigue.

Focus on the core root of the condition.

The foundation of adrenal fatigue is basically that our adrenal glands are unable to properly produce cortisol or are in a low cortisol state as a result of prolonged exposure to stress. There have been several studies conducted testing salivary cortisol levels, which is the most common test done in order to diagnose patients with adrenal fatigue. However, in a systematic review results showed that when checked four times in a 24-hour period, there was no difference in cortisol levels between fatigued and healthy patients in 61.5% of 57 different studies.  

It’s looking like the symptoms that stem from adrenal fatigue are really caused by a dysfunction in the whole HPA axis and we’ll tell you why. Our stress response system comprises of two main components, one being the HPA axis which controls our intermediate to the long term stress response. It’s a glandular communication/feedback network where the hypothalamus, pituitary, and adrenal glands talk to each other in order to control the release of hormones. Even small stressors that come from being late for work or being stuck in traffic trigger the body’s fight-or-flight response. This intrinsic system is meant to monitor our bodies resources and even save our lives in times of danger. However, our stress response system that protects us in the short term from acute stress can actually become harmful or damaging over the long term. Overstimulation to our stress response system is constantly occurring in today’s fast-paced cultures and ‘adrenal fatigue’ is the result.  As a part of our body’s way to protect itself from stress, the hypothalamus suppresses the body’s response to stimulation for the entire HPA axis which stops giving our adrenal glands proper signals to produce cortisol. As Kresser explains, This is a protective mechanism from the body in an attempt to prevent any harm coming from this exposure to high cortisol from stress. However, unfortunately, that ends up leading to a decreased ability to produce cortisol in the face of future stress. That has to do with the brain and it doesn’t have to do with the adrenals not being able to produce it. This lack of proper cortisol production is the reason for the symptom of fatigue. The key concept here is that mechanisms that protect us from acute stress in the short term can actually be very damaging to our health in the long run.

Although adrenal fatigue is not a recognized condition, the symptoms that come from consistent activation on the HPA axis that people feel is very real and should be managed properly to avoid long-term damage. There are several ways that one can begin the healing process like managing stress levels, regulating the circadian rhythm, lowering high levels of inflammation (spec. In the gut), exercise, etc. Consistent supplementation of adaptogenic herbs through tea or tinctures is a popular and simple way to begin nourishing the adrenal glands and rebalancing the HPA axis. We will go over common but effective methods to heal in a future post but for now, to learn more about the power of adaptogens, check out this post!
June 20, 2019 — allyson tovar