Exhausted? It Might Be “Adrenal Fatigue”
For several years, Gail has been looking after her father, who has Alzheimer’s disease. She continues to work full time as a legal secretary, takes care of three dogs, and tends to her husband, who has chronic low back pain. It’s an exhausting schedule. She falls into bed at night very tired but is unable to sleep well. She told her doctor she has brain fog, ceaseless fatigue, and gets through her day by drinking several cups of coffee and occasional sweets for added energy. She believes she has adrenal fatigue.
So-called adrenal fatigue is an attempt to explain the impact of stress on the body. The term has been popularized by mainstream media and is a diagnosis of alternative medicine practitioners. But adrenal fatigue, as it has been defined, does not meet the criteria of a bona fide medical condition. The concern by some medical doctors is that this unverified diagnosis may fail to reveal what’s really happening.
Researching the Claim
Evidence-based medical researchers systematically scoured thousands of published studies and found conflicting results, unsubstantiated research methods, and invalid conclusions regarding the causes for what’s called adrenal fatigue. In short, they concluded that there is no scientific basis for it. The detailed report was published in the peer-reviewed journal BMC Endocrine Disorders.
On the other hand, proponents for the adrenal fatigue diagnosis say that existing blood tests are not sensitive enough to detect small declines in adrenal function, but that the body knows and reacts to the deficits.
The Distress of Stress
Regardless of personal beliefs, what’s real is a person’s symptoms. Stress most certainly impacts health and well-being. Left untreated, stress can lead to all kinds of problems, including high blood pressure, heart disease, digestive issues, and depression, just to name a few.
The symptoms diagnosed to be adrenal fatigue can have many causes. To discern what’s really happening, validated evidentiary investigation is recommended.
“A physician should realize and acknowledge that the symptoms are real and bother the patient,” says Run Yu, MD, PhD, Professor of Medicine, Division of Endocrinology, UCLA David Geffen School of Medicine. “If no classical illnesses are found through physical exams, lab tests, or imaging, potential life stressors and mental illnesses should be discussed. Behavioral therapies with a qualified therapist should be tried.”
Adrenal Gland Function and Disorders
The adrenal glands sit atop the kidneys like small hats. The hormones they produce play a key role in overall health and energy levels. Their many vital functions include regulating blood pressure, maintaining proper salt and water balance, controlling the “fight or flight” stress response, managing inflammation, and moderating blood sugar levels. With so many regulatory functions, it’s clear that a disruption in the adrenal glands can affect health in many ways.
There are a number of adrenal gland disorders that can lead to adrenal insufficiency if not proper treated. For example, Addison’s disease is condition in which adrenal glands do not produce enough hormones, such as glucocorticoid and cortisol. The condition is quite rare. According to the National Institutes of Health, Addison’s disease affects about 100 to 140 of every 1 million people in developed countries. Symptoms of the disease include abdominal pain, weight loss, and fatigue; treatment involves replacing the missing hormones. In contrast, in Cushing’s syndrome, also called hypercortisolism, the body produces too much cortisol. This can be caused by taking a synthetic hormone to treat an inflammatory disease. Cushing’s is also rare. Symptoms include upper body obesity, thin arms and legs, easy bruising, severe fatigue and muscle weakness. Treatment depends upon the cause of cortisol overproduction.
Other causes of gland disorders include genetic mutations, tumors, infections, and a problem in another gland, such as the pituitary, which helps to regulate the adrenal gland. Surgery or medicine can treat many gland disorders.
Like everything else in the body, the adrenal glands do not act in isolation. There are many players that influence what they do.
Function and Dysfunction Along the HPA Axis
According to Dr. Yu, adrenal fatigue likely reflects a functional (but not structural) abnormality of the hypothalamic-pituitary-adrenal (HPA) axis. This axis is a major processing network for stress. It involves complex interactions in the hypothalamus and pituitary glands in the brain and the adrenal glands. When the HPA axis is stimulated by stress, various hormones flood the bloodstream. These hormones include cortisol, which stimulates your skeletal muscles so that you can flee from a dangerous situation. There is also an increase in blood glucose, which provides vital energy to cells, further enabling you to deal with the stressor. Cortisol also shuts down certain functions that are deemed unnecessary during a crisis. The sex drive, for example, is not needed when you’re in a crisis and/or fighting for your life. Cortisol can also suppress the immune system, making a person more vulnerable to illnesses.
Also associated with stress and a poorly functioning HPA axis are a number of fatigue-related conditions, such as fibromyalgia, post-traumatic stress disorder, and some types of depression.
Alleviating Symptoms
Though adrenal fatigue is not a recognized condition, some of the treatments for it involve actions that can help reduce stress and improve general health. These include reducing or eliminating caffeine and sugar, regularly getting a good night’s sleep, hydrating properly, avoiding junk food, exercising, and eating a balanced diet. Stress- reduction practices are also very helpful. They can be as simple as taking a few slow breaths, sitting quietly in nature, getting a massage, or doing physical activity that you enjoy.
There are also resources that can help with overwhelming situations, such as caring for chronically ill loved ones. Sometimes people shoulder too much responsibility, perhaps believing that everything will fall apart if they don’t take matters into their own hands. A mental health professional can debunk those beliefs, assist people in reorienting their thinking, and offer guidance on getting support from others. Learning to say no, for example, can be a very powerful way to say yes to your own health.
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