You may have heard the term “adrenal fatigue” thrown around by now — it’s a hot topic in the wellness space given its symptoms of burnout, chronic stress, exhaustion and more. It’s also a debated condition in Western medicine, as it represents a group of symptoms and is not an official medical diagnosis or a diagnosis with scientific backing.
So what is it all about — and does it even really exist? Well, it’s complicated. Let’s dive into this grouping of symptoms and see what they are all about.
What is adrenal fatigue?
The term adrenal fatigue was coined in 1998 by chiropractor James Wilson, but it has been contested by much of the medical world since then. “Adrenal fatigue is a term applied to a collection of symptoms, often somewhat disregarded in the medical community,” explains Erin Lovell Verinder, nutritionist, naturopath and author of Plants for the People (due to be released in early 2020).
“Another term for adrenal fatigue that is perhaps more fitting from a physiological angle is HPA axis dysregulation (HPA-D). There is an inherent relationship and essential flow that happens between the hypothalamic-pituitary-adrenal axis,” she says. “When this central stress response system is put under pressure and slips into imbalance, cortisol — our key stress responding hormone — dysregulates, followed by symptoms often felt loud and clear.”
Adrenal fatigue is not a condition recognized by the Endocrine Society, which does not believe there is adequate scientific proof for the diagnosis, given the lack of scientific research proving that your adrenals, can, in fact, be fatigued.
HPA-D, however, is more widely accepted and studied, and is likely a contributing factor to adrenal fatigue symptoms, given the HPA axis plays an important role in regulating stress and homeostasis in the body. Studies show that dysregulation in the HPA axis can play a role in physical and psychiatric disorders such as obesity, PTSD, depression and anxiety.
What are the symptoms of adrenal fatigue or HPA axis dysregulation?
One of the controversial elements of adrenal fatigue is that it encompasses many different symptoms, which may not be exclusive to the disorder.
According to Lovell Verinder, symptoms of the disorder include the following:
- Exhaustion, especially in the daytime
- Deep fatigue
- Difficulty rising from sleep in the morning
- Poor sleep quality and trouble staying asleep
- Inability to control stress response and handle stress overall
- Panic sensations in the body
- Anxiety attacks
- Thinning hair and loss of body hair
- Craving salty foods
- Muscular weakness
- Low appetite
- Weight gain
- Carrying extra weight around the abdomen
- Thyroid issues
- Energy improves and peaks in the evening
- Sensitivity to stimulants (caffeine) or relying on them heavily to get through the day for energy
- Weakened immunity
- Digestive issues
- Low libido
- Insulin resistance and blood sugar regulation issues
Given the wide range of symptoms, it is important to see a doctor to rule out other, more serious, underlying conditions.
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What causes adrenal fatigue?
Symptoms of adrenal fatigue or HPA-D are largely considered to be caused by environmental and lifestyle factors in addition to chronic stress. “A hectic lifestyle, enduring stressful situations, a poor diet, ongoing poor sleep habits and too many stimulants (such as coffee) can all create the perfect storm leading to burnout/adrenal fatigue/HPA axis dysregulation,” says Lovell Verinder.
In addition to stress, existing body imbalances may set the stage for these symptoms to kick in. “Often there are underlying causes of inflammation in the body, gut dysbiosis (SIBO, parasites, fungal and bacterial overgrowths) that can be contributing to a burdened system — these need to be addressed and healed to in turn regulate the HPA axis,” she shared. Healing your symptoms, therefore, may require healing other underlying causes.
How can you prevent or balance the symptoms of adrenal fatigue?
Preventing and treating adrenal fatigue or HPA-D requires similar lifestyle changes beneficial to healing many chronic imbalances in the body — reducing stress through practices like meditation and breathwork, practicing movement, drinking lots of water, supporting your overall gut health, and eating a well-balanced, vegetable-heavy diet.
“Eat a healthy balanced diet with a focus on balancing your blood sugar with quality proteins, great sources of fats and many plant-rich veggies, and eating every 3-4 hours (even just a small snack between main meals),” Lovell Verinder says. “Move your body daily, be mindful of not pushing yourself too hard with intensive exercise when you are feeling tired. Adjust your pace and welcome in gentle body movement — even a walk in nature is a wonderful way to exercise.”
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She also advises carving out and adhering to boundaries around your personal and professional life, having more fun and creating rituals that “connect you to your inner zen.”
Another healthy habit Lovell Verinder recommends is focusing on your sleep habits, including powering down electronics for a period before going to bed and in the morning, and choosing wisely which electronics to allow in your bedroom.
“Power down from screens ideally two hours before you sleep at night, and avoid screens as much as possible upon rising. Take your time to wake up naturally. Both of these practices really assist your body to regulate happy hormones and not overstimulate your system by allowing the body to flow with the natural cycle of nature — the sun and the moon.”
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How you begin your day matters, too. “Avoid an alarm in the morning where possible, alarms are truly startling for our bodies — and if you are on the edge or anywhere near to adrenal fatigue it’s important to avoid this if at all reasonable. Do your best to wake with the sunlight and wind down as the sun sets,” she says. “Welcome in more passive activities — reading a book, having a restful bath
Most importantly, Lovell Verinder emphasizes, you need to really address the root causes of your stress, and work toward eliminating or reducing them, not just managing them with supplements or meditation.
“It’s so important to reduce perceived stressors. If this is work, relationships or any other element, such as the environment you live in, it’s key to begin to make positive changes. We cannot out-supplement behavior and lifestyle. It’s very, very important to address this alongside nutritional changes,” she shared.
I think I may have adrenal fatigue or HPA-D or whatever we want to call it. What should I do now?
Since the symptoms may be indicative of something else, it’s important to see a doctor to start to dig into your symptoms and potential causes. If your practitioner does believe you have HPA-D, Lovell Verinder urges you to rest and focus on taking care of yourself.
“Rest is incredibly important and honestly is paramount to repair adrenal fatigue. It takes time to regain your footing if you are experiencing adrenal fatigue symptoms. But you absolutely can get better and you will if you give yourself the time and are committed to changing habits and recalibration,” she said.
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She also encourages exploration of relevant herbs and supplements, perhaps in consultation with an herbalist, nutritionist or naturopath. “Research adaptogenic herbs, like ashwagandha and astragalus, and rebuild vitality with herbal tea infusions such as nettle leaf. Consider supplementation to restore any sub-optimal levels of nutrients in the body, such as magnesium and vitamin C,” Lovell Verinder says.
Whether you have adrenal fatigue, HPA-D or you have experienced some of the aforementioned symptoms, it’s important to explore regulating your stress levels. Stress is considered one of the top health problems in America, and we know it can weaken our immune systems, serving as a breeding ground for disease and discomfort.
If you are chronically stressed, anxious and tired, it’s in your best interest to explore redesigning your lifestyle to reduce your stress and optimize your health.
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