What is “adrenal fatigue”?

“Adrenal fatigue” has become a popularized term for symptoms related to chronic stress.

In a healthy stress response, our bodies release cortisol from the adrenal glands, enabling us to activate or mobilize in order to meet a challenge in our environment. This could be a physical demand like going to the gym, or an emotional demand like arguing with a loved one. In a functional stress response, cortisol will spike to meet the demand and then fall back down when we’ve dealt with the event or issue.

In the case of “adrenal fatigue,” the release and regulation of cortisol from the adrenal glands has become dysfunctional. Over time when chronic stress is present in your environment, the brain and the adrenal glands stop communicating properly. If this goes unresolved long term, cortisol production can go way down – hence “adrenal fatigue.” But more accurately, this scenario is a case of hypothalamic-pituitary-adrenal or HPA axis dysregulation. This simply means that the brain and the adrenals are no longer working in harmony.

If the brain is communicating “I’m stressed!” all day long to the adrenal glands, they try their best to respond appropriately, but over time this can cause alterations in function. Typically, cortisol will have a normal moderate spike in the morning to energize us for the day and then taper down over the course of the afternoon and into the evening. In a dysregulated cortisol pattern, we might see that the cortisol curve is occurring at the wrong time of day, that it is too robust indicating higher cortisol, or too flattened, indicating lowered functional levels.

Pathologically, excess cortisol is known as Cushing’s syndrome and is most commonly related to long term corticosteroid use. Conversely, low cortisol is a sign of Addison’s disease in which adrenal function has become compromised due to autoimmune activity in the body. HPA axis dysregulation makes up the space between these diagnoses, when the adrenal function relating to cortisol is not compromised to the level of disease, but function is not optimal and you may be experiencing symptoms.

Symptoms of HPA axis dysregulation have a lot to do with feeling like you are not able to cope with life’s stressors. You may be tired or have dysfunctional energy patterns, like being exhausted in the morning and energized at bedtime. If the HPA axis is thrown off, you can also have generalized symptoms like headaches, blood sugar issues, low libido, and anxiety.

If you have been struggling with stress management, or you resonate with these symptoms, it may be time to look at cortisol. In order to get to the bottom of HPA axis dysregulation, we need to look at several cortisol samples throughout the course of the day. This can be done with either saliva or urinary testing at home. Once we know what level of dysregulation is occurring for you, we use integrative approaches for balancing the stress response, including targeted supplementation, typically with adaptogenic herbs (look out for another blog post on these!), as well as lifestyle and dietary measures to support healing.

Because adrenal function impacts the rest of the hormone cascade, including insulin, thyroid, and sex hormones, at IHM we will often investigate these systems at the same time and work to rebalance the body as a whole. 

If you are interested in getting to the bottom of your symptoms and curious about how stress might be playing a role in your health, give us a call at 903-595-8077!