Not surprisingly, adrenal fatigue has become an epidemic in the Western world. And especially in the last year when we've had a pandemic to cope with!
The problem is that as a condition, it's not really recognised by the medical world and symptoms are often mixed up with other conditions like depression, anxiety and insomnia for which there are medication treatments.
But whatever you call it, adrenal fatigue or cortisol imbalance is definitely real. So it's important to spot the signs and do something about it before it turns into full burn out.
This is a personal one for me too. I have struggled with my cortisol balance since my early 40's, and have to constantly prioritise my adrenal health to avoid burning out.
You can watch the video below or listen to the podcast.
What is adrenal fatigue?
The term ‘adrenal fatigue' was first proposed as a new condition by Dr James Wilson in his book of the same name in 1998. He explains that when the adrenal glands are overstimulated for long periods of time, it can affect your production of cortisol and DHEA.
Cortisol is your main stress hormone and is there to protect you from danger. In the old days our fight or flight response would kick in if we were being attacked by lions, but these days it's more likely activated by work deadlines and emails…..and global pandemics!
Our stress response was designed to be TEMPORARY – switched off when the danger had passed. But our modern day stress doesn’t get switched off. It’s constant and long lasting. And it's this chronic unrelenting cortisol release that is the problem.
We need cortisol, but we need it to be balanced. A good cortisol response in the morning wakes us up and gives us the energy and reserves to get us through the day. When you’ve had sustained high cortisol levels, this can put a huge burden on your adrenal glands.
After a while they can struggle to maintain the huge demand for cortisol. This is when cortisol output can be too low. If left untreated, this can lead to long term chronic fatigue and other heatlh issues.
Things to watch out for
- Tired all the time – Whether your cortisol levels are high or low, it will take a toll on your energy levels. If they are high and you are under chronic stress, it will be hard for your blood sugar to stay in balance and the dips will make you feel tired. This often happens in the afternoon – cravings for sugar, coffee and carbs are especially common in that mid afternoon slump. It makes sense. Your body is low on sugar and is sending you a powerful message; “feed me sugar or I will send you off to sleep!”
- High blood pressure – Cortisol increases blood pressure, in order to get oxygen into your muscles and cells quickly. Longlasting high blood pressure is a risk factor for heart disease.
- Weakened immune system – High cortisol depletes your vitamin C stores, along with your B vitamins and essential minerals. It also reduces the production of immune cells, leaving you more open to picking up that cold or virus that is going around.
- Brain fog or memory loss – this can affect many people when they’re stressed. Think interview situations or exams – how easy is it to forget something important just because you’re under pressure? Cortisol is messing with your neurotransmitters, and if you are peri-menopausal (over 35) this can get a whole lot worse.
- PMS – Cortisol competes with progesterone receptors, so stress can lead to oestrogen dominance and PMS symptoms (heavy, painful periods, breast tenderness, bloating, irritability).
- Mood issues – depression, anxiety, mood swings can all be caused by high or low cortisol levels.
- Poor Sleep – inability to fall asleep, racing thoughts, or frequently waking up can be signs that your stress hormones are messing with your body clock and sleep hormones
- Digestive issues – You know that sick feeling in your gut when you are stressed or anxious? We have more nerve cells in our gut than in our brain – after all this is where our ‘gut instinct’ comes from. Emotions and stress are felt in this area and this can seriously impair our digestion. Cortisol doesn’t care about digesting food when you’re facing a tiger, so it shuts much of the system down, giving you uncomfortable symptoms and making it much harder to digest your food and absorb your nutrients.
- Low libido and infertility – Cortisol and the sex hormones are all made from the same precursor hormone, pregnenolone. So guess what happens when we are stressed? Pregnenolone gets the message to make more cortisol instead of sex hormones (as we know that our stress response takes priority over our reproductive function when we need to run away). Cortisol also increases another hormone, prolactin, which can stop us ovulating. So our sex hormones take a back seat, our testosterone and libido disappears and forget about getting pregnant. Sensibly the body is trying to protect us. It doesn’t want you bringing a baby into a dangerous world.
- Fat around the middle – That spare tyre around your middle – it just won’t go, no matter what diet you try or how much exercise you do? Not only do we have 4 times more cortisol receptors in our abdominal fat than any other fat, but cortisol stimulates appetite – sugar and carbs are vital when you need energy to run from that tiger. But when food is readily available and there is no tiger to run from, the sugar you have eaten doesn’t get used as energy and is stored away as fat. Your blood sugar surge has increased insulin levels (your fat storing hormone), leading to a blood sugar crash, and another uncontrollable craving for a biscuit, pastry or bar of chocolate. And here we go again……
So what can we do to avoid or recover from adrenal fatigue?
- Prioritise rest and relaxation – and I mean make it NON NEGOTIABLE. That means making sure nothing comes in the way of your relax time (and sleep).
- Work on your digital wellbeing – nothing stresses us out more than too much screen time. Have gadget free days or limit the time you check your phone/email.
- Do something you love every day– yoga, massage, meditation, long baths, reading, dancing, cooking, gardening -whatever floats your boat – just do it !
- Breathe – just the act of deep breathing from your belly switches off your cortisol response. How amazingly easy is that? You can do that in bed!
- Stop feeling guilty – so many women feel guilty when relaxing. WHY? If you don’t relax, everyone around you is going to suffer! Call it giving back…
- Nourish your adrenals – make sure you are supplementing those nutrients that stress is depleting (Vit C, B vits, Magnesium, zinc) with good quality supplements
- Adaptogenic herbs – these can help to balance cortisol levels – including rhodiola, ashwagandha, licorice and Siberian ginseng.
- Balance your blood sugar – avoid refined carbs and sugar, and eat plenty of protein and healthy fats at each meal with lots of veg.
- Limit caffeine and alcohol – both of these increase the burden on your adrenals
- Don’t do strenuous exercise – if you are low on energy, too much physical activity can deplete your reserves – try gentle walking or yoga instead.
Testing for adrenal hormones
Symptoms are a good indication, but they can be similar to other conditions so an adrenal stress test can help to identify any stress hormone imbalance. It was testing that finally made me realise I was pushing too hard and had to slow down!
The same 24 hour urine test that we use for sex hormones, can also measure your levels of cortisol over 4 points during the day – morning cortisol being the highest (to wake you up) and evening the lowest (to wind you down). When your levels are too low, it is an indication that your adrenals are struggling to produce enough cortisol.
Remember that your health is the most important thing in the world, so if you recognise any of the symptoms, make sure you prioritise the steps above AND get some help if you feel like you can’t do this alone.
(Adrenal fatigue should not be confused with medical conditions such as adrenal failure, adrenal insufficiency or Addison’s itself where the adrenal glands are not functioning).