How to Recover Naturally from Adrenal Fatigue

I was losing A LOT of hair, barely sleeping and feeling anxious and exhausted all the time. My family could hardly recognize me, and I felt like a stranger in my skin. I have always been a very calm person, even under pressure. However, when I finally decided to seek support, the mere thought of driving my kids to school almost gave me a panic attack. After an extensive ‘health interview,’ it turned out that my adrenal glands were part of my issue and thorough testing (which conventional doctors refused to do), revealed that I had adrenal fatigue. I was stunned and outraged! No one had ever said anything about my adrenal glands!

This story is just one real case scenario of one of my patients (Angie K., 33). However, there are (too) many of you out there who suffer from similar symptoms and are at a loss as to how to deal with how they feel. So, in this article, I’ll cover the basics of ‘adrenal fatigue,’ the most popular myths associated with it and how to treat it naturally.

What exactly are the adrenal glands?

Also known as the suprarenal glands, the adrenal glands lie just on top of the kidneys. These little glands have a flat pyramidal shape and weigh only 3.5 to 5g! Along with the hypothalamus and the pituitary gland, the adrenal glands control our energy, metabolism, and hormonal balance. Together, they form part of the Hypothalamus Pituitary Adrenal (HPA) axis.

The adrenal glands consist of:

(i) The adrenal cortex which is subdivided into three zones, each of which secretes different hormones namely:

– The mineralocorticoids which are involved in mineral balance. Aldosterone is the principal mineralocorticoid produced by the adrenal glands – this hormone plays a crucial role in the regulation of blood pressure.

– The glucocorticoids which affect glucose homeostasis (blood sugar control), metabolism and regulate resistance to stress. These include cortisol (hydrocortisone), corticosterone and cortisone.

– The androgens which are steroid hormones that exert masculinizing effects. The major androgen secreted by the adrenal gland is dehydroepiandrosterone (DHEA).

(ii) The adrenal medulla which produces three catecholamine hormones namely norepinephrine, epinephrine, and dopamine.

As you can see, the adrenal glands are master regulators that, not only crank out 57 different hormones but also manage how other hormones work!

Did you know?
In women, these androgens promote libido (sex drive) and are converted into estrogens (feminizing sex steroids) by other body tissues. However, after puberty in males, the androgen testosterone is released in much larger quantities – these render the effects of adrenal androgens insignificant.

What’s the link between the adrenal glands and stress control?

The HPA axis acts as a feedback loop: in a nutshell, when you’re stressed, the hypothalamus will release Corticotropin Releasing Hormone (CRH) which signals the pituitary gland to release Adrenocorticotropic Hormone (ACTH).

This ACTH then ‘tells’ the adrenal glands to release cortisol, the ‘fight-or-flight’ hormone, which will then:

  • Promote the release of sugar into the blood (as a means to create a burst of energy that will help the body deal with the stressor).
  • Suppress the digestive and reproductive systems and lower immune system responses (so as to direct all the energy available to either fighting or fleeing.

Once the stressor is gone, negative feedback cycles turn off the HPA axis – this stops cortisol release.

Now that you know what the adrenal glands are and how they function; let’s tackle the first myth.

Myth 1: The adrenal glands get fatigued.

Let set the record straight: the adrenal glands don’t get tired. They don’t burn out. They don’t stop working. They don’t collapse.

You see, the term ‘adrenal fatigue’ is utilized only to make the concept of adrenal dysfunction easier to grasp – it refers to a collection of symptoms and is not a disease. However, the issue with this term is that it gives the impression that the adrenals are unable to produce enough hormones. There are some health conditions where the adrenals cannot make enough hormones – these include Cushing’s syndrome (an excess of cortisol in the blood) and Addison’s disease (primary adrenal insufficiency). However, adrenal fatigue is completely different from these health issues.

In adrenal fatigue, the adrenals are still making cortisol, and it is highly likely that routine cortisol tests will show that your cortisol is within the normal range since that range was designed to diagnose Cushing’s syndrome or Addison’s disease.

And the problem is that most conventional doctors equate adrenal dysfunction to either of these life-threatening diseases. So if you tell these doctors that you have adrenal fatigue, they’ll probably look at you like you have two heads and probably tell you that your symptoms are ‘all in your head.’

So what exactly is ‘adrenal fatigue’?

Fig. 1. A simplified schematic representation of the central and peripheral components of the stress system, their functional interrelations and their relations to other central systems involved in the stress response. The CRH/ AVP neurons and central catecholaminergic neurons of the LC/NE system reciprocally innervate and activate each other. The HPA axis is controlled by several feedback loops that tend to normalize the time-integrated secretion of cortisol, yet glucocorticoids stimulate the fear centers in the amygdala. Activation of the HPA axis leads to suppression of the GH/IGF- 1, LH/testosterone/E2 and TSH/T3 axes; activation of the sympathetic system increases IL-6 secretion. Solid lines indicate stimulation; dashed lines indicate inhibition. (Adapted from Chrousos and Gold [1]). 

Image Source: Tsigos & Chrousos, 2002

As shown in the diagram above, the HPA axis consists of several feedback loops that enable the body to regulate the synthesis of stress hormones like cortisol. These prevent chronic stress from over stimulating the body, allowing it to reduce its physiological activation to certain stressors. This healthy process, known as ‘habituation’ or ‘adaptation,’ prevents the adverse effects of chronic HPA activation.

However, some individuals can become unable to properly habituate to the daily stress they face, especially if that stress is more significant than simply being stuck in a traffic jam on the way to work.

Think of stressors like:

  • Consistently not getting enough quality sleep
  • Shift work
  • Eating a diet that revolves around processed foods
  • Not consuming enough nutrients (even though you may be eating a Paleo diet)
  • Poor gut health
  • Chronic disease
  • Facing serious financial issues
  • Caring for a sick relative
  • Being in an abusive relationship
  • Overtraining

So, each time these individuals face their stressor, they activate their HPA axis, marking the start of the stress response. Eventually, as the adrenals keep pumping out more and more cortisol, the body becomes less sensitive to it, and a state of cortisol resistance develops, marking the debut of HPA axis dysfunction. Instead of only turning on during acute stress and turning off once the stressor goes away, the HPA axis is constantly activated until the mechanisms that switch it off stop working.

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2 Comments

  1. Stephanie says:

    Hi Shari, Thank you this information. I have been searching for info on adrenal fatigue and this really helps me understand what’s going on.
    I am anxiously awaiting the results of the full cortisol saliva test. I have symptoms that are not labeled here and I’m wondering what you think about untreated autoimmune diseases (such as MS) and HPA axis dysfunction. Would there be adrenal fatigue due to years of untreated symptoms of an autoimmune disease? Or does the adrenal fatigue cause symptoms that, after years, start to mimic diseases such as MS? I have tingling in extremities, bad headaches, blurry vision, sleep apnea, neck and back pain, tinnitus and altered hearing above some other symptoms that are listed here.

    • Shari Hussenbocus, Naturopathic RD, CDE says:

      Hello Stephanie,
      I’m glad you found the info helpful. HPA axis dysfunction (HPA-D) comes with many, many symptoms since it affects SO many other biochemical and physiological pathways.

      It’s difficult to say which one came first since I don’t know your medical history. But here’s what I can tell you: chronic stress affects cortisol levels which in turn increase intestinal permeability (leaky gut), one of the key factors in the development of autoimmune diseases. In other words, anything that chronically upsets your cortisol levels (stress, lack of sleep, western diet etc), can affect your HPA axis and lead to HPA-D while also causing leaky gut which can then pave the way for an autoimmune disease. Does this make sense?

      Your symptoms are similar to those of MS but you’d have to run tests for that. I will be posting an article on autoimmune diseases soon — check it out, I think it can help you.

      Sending some tropical sunshine your way – I wish you all the best 🙂
      Shari

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