Your health is on a continuum. On one end you have optimal health, and on the other, you have chronic illness. Your adrenal health works in the same way. You can be one step away from healthy and functioning, or you can have full-blown Addison’s disease, also known as chronic adrenal insufficiency. This creates a very large gap, and I find that many people fall somewhere within this spectrum.
To receive an Addison’s diagnosis, you must have lost 90% of your adrenal glands’ function, but you can still have adrenal issues without this diagnosis. Anything between optimal health and Addison’s disease is referred to as adrenal fatigue, a mild form of adrenal insufficiency that occurs when your adrenal glands are over stressed.
The primary role of your adrenal glands is to produce and regulate the stress hormone cortisol. Your adrenal glands also produce sex hormones, estrogen and progesterone, and they produce your neurotransmitters, adrenaline (epinephrine), norepinephrine, and dopamine. These hormones and neurotransmitters regulate your metabolism and communicate with other organs, like your brain, kidneys, and reproductive system. However, chronic stress can suppress your adrenal glands, causing them to release insufficient amounts of these necessary hormones.
Causes of Stress:
- lack of sleep
- poor diet (processed, junk food)
- stimulants (caffeine, sugar)
- rigorous work schedule
- emotional trauma (unhealthy relationships, death of a loved one)
- over training (marathons, training without rest days)
- lack of fun and excitement
We live in a very stressful world. We work 80-hour weeks, sacrifice our sleep, drink two cups of coffee to stay awake during the day, reach for sugary foods for more energy, and these habits affect us emotionally, mentally, physically, and spiritually.
When you engage in stressful activities, your body enters into the fight-or-flight mode, where it believes that you need a surge of energy in order to survive. The primary stress hormone in your body is cortisol. Since its function is to provide you with a burst of energy, cortisol increases your blood sugar, suppresses your immune system to save energy, and begins breaking down your storage of protein and carbohydrate. Over time, high levels of cortisol can lead to insulin resistance, weaken your immune system, and eventually cause muscle wasting, if not properly addressed.
Signs of Adrenal Fatigue:
- unexplained weight loss or weight gain
- body aches and muscle pain
- fatigue (difficulty getting out of bed in the morning)
- low blood pressure
- salt and sugar cravings
- shakiness or lightheadedness after skipping a meal
- dizziness upon standing
- feeling of tired and wired
- sleep disturbance
- low libido
- thyroid imbalances
- hair loss
- blurred vision
- severe allergies
The Adrenal and Thyroid Connection
To recap what we discussed earlier, adrenal glands produce hormones that impact your major metabolic processes, just like your thyroid. Chronic stress puts your adrenals on overdrive for extended periods of time leaving you in a state of adrenal fatigue. The flooding and eventual plummeting of stress hormones has many negative impacts on the thyroid. It slows thyroid production and inhibits your ability to convert thyroid hormones to their active form causing hypothyroid symptoms.
It also increases thyroid hormone resistance. Inflammatory immune cells called cytokines are released in the stress response, which make thyroid receptors less sensitive to thyroid hormones. This means that even if you’re taking thyroid medication and your thyroid hormone levels are normal, you can still be suffering from underactive thyroid symptoms.
Meanwhile, when your body is in stress mode, your immune system is suppressed, partially so that your body can focus fully on overcoming the stressor, and partially because stress causes inflammation. This causes your immune system to slow down to prevent a state of chronic inflammation. When your immune system is stressed, you become more susceptible to viral infections, some of which can trigger autoimmune thyroid disease.
You can read more on how the adrenal glands play a role in thyroid health in my new book, The Thyroid Connection.
How to Test For Adrenal Fatigue:
Since we live in a toxic, high-stress world, I assume that most of my patients have some amount of adrenal fatigue. I listen to the symptoms and lifestyle of my patients in order to assess whether someone has adrenal fatigue.
Functional Medicine Adrenal Stress Profile
In my clinic, I use a saliva test from BioHealth Laboratory to measure stress hormone levels at four different points throughout the day, which provides a more complete picture. You can order your own adrenal profile through me, and I will review your results and work with you on dietary, lifestyle, and supplement changes to support your adrenals.
Below are the first 5 steps I'd recommend to anyone who may be suffering from adrenal fatigue:
1. Do not read an article on the internet, diagnose yourself, and begin experimental treatment with your adrenals.
While this may seem counterintuitive as you are currently reading an article on adrenal fatigue, please read on. Do not take advice from an article regarding supplements, medications, or diet without consulting with a qualified physician who either specializes in adrenal fatigue or is well-versed and experienced in treating it.
2. Read Stop The Thyroid Madness.
Or, if you cannot afford the book, go to the author's website StopTheThyroidMadness.com and click on the tab "What We've Learned." Pay close attention to the section "Ducks In a Row," which I found particularly helpful. This will help you (1) Identify a physician who is best to treat you, and (2) explain what you need to know going into the appointment. If I would have had this book at the beginning of my health crisis, I would have shaved a year and half off of healing.
3. Team with an integrative physician and a health coach.
This is a doctor who specializes in both Western and Eastern medicine and thus combines a holistic approach with potential medications. I believe that this type of physician is best equipped to handle adrenal fatigue. You can also consider a functional medicine physician, which is a doctor trained to look at the body as a whole with an emphasis on searching for the underlying cause of your health deterioration rather than the symptoms.
4. Find out if you have adrenal fatigue.
There are two legitimate ways of finding out you have Adrenal Fatigue. You can do traditional blood work or your doctor can order a Cortisol and Hormone Saliva test with me. You want to do a 24 Hour Adrenal Saliva Kit, even though most doctors recommend a blood test.
To understand why I recommend the saliva test, it helps to understand a bit more about adrenal fatigue and its relationship to cortisol. If your cortisol levels are swinging wildly or flat, you have an adrenal problem. So it helps to be able to measure variations in cortisol throughout the day, which is what a saliva test does.
As explained in Stop The Thyroid Madness, "saliva testing will measure your cellular levels at four key times in a 24 hour period — revealing whether you have high cortisol (which can have similar symptoms to low cortisol), or a mix of highs and lows or a majority of lows, which is extremely problematic."
"Unfortunately, doctors tend to recommend a one-time blood test, or an ACTH Stimulation test, or a 24-hour urine test, but patients have found none to be adequate or complete measures to discern sluggish adrenals. Blood is measuring both your bound and unbound cortisol–not helpful, nor does it tell what goes on at different times during the day."
5. Work with a nutritionist or dietician in your doctor's office.
Your diet will play a huge role in your healing from Adrenal Fatigue. If your physician does not recognize that diet plays a huge role, get another doctor immediately. If your doctor does recognize the importance of diet in healing your adrenals but does not work with a nutritionis, find one that he or she will team with. Please take your diet as seriously as you are taking your fatigue!
I believe these are the very first five steps to take to addressing adrenal fatigue and if you take these steps, you are well ahead of where you would be with any other approach.