Adrenal Fatigue has come to be the go-to name for anyone exhibiting signs of overwhelming fatigue, anxiety, low sex drive, inability to recover from physical or mental exertion, and a number of other symptoms that have become very common in American society.
But go do a search of the medical literature for the term “Adrenal Fatigue”… a search of research that’s been published, not just a simple Google search.
PubMed (the search engine I used for this search) contains over 4,000 peer reviewed publications and hundreds of thousands of articles. It is the go-to source for scientific literature. Know what you find here?
10 results. 10!
So, there is very, VERY little in the published scientific literature to support the idea of the adrenal glands being fatigued.
What’s going on then?
There are 3 mechanisms of adrenal dysregulation that can present identical to so-called adrenal fatigue, and account for the vast majority of adrenal imbalances.
Let’s take a look at each one…
This might be a little difficult to wrap your head around given the information presented by most of the alternative medicine world.
You probably have beat over the head with the term adrenal fatigue and the idea that your adrenal glands are somehow incapable of producing enough cortisol.
I fell into this category too! I fell right into that line of thinking where the adrenal glands somehow crapped out and wouldn’t produce enough cortisol.
Once you start digging into the research though, it becomes clear that that is not usually the case.
In the case of increased perceived stress, chronic inflammation, circadian rhythm disruption and Cushing’s syndrome, you could actually have an increased total free cortisol on a saliva or urine test.
Now, Cushing’s is relatively rare. If you did have Cushing’s, your total free cortisol would be 3-4 times the upper limit of normal. As I said, this is relatively rare.
On the other hand, increased stress and chronic inflammation are so common, it almost goes without saying.
Likewise, disruption of the circadian rhythm is more and more common. Those that have to work shift work and get put on 2nd or 3rd shift may have alterations to their internal clock.
People who may work “normal” hours, but spend all of their time inside and get very little time in the sun will likely have a disrupted circadian rhythm.
And spending time on the computer or watching TV late into the evening can have the same effect on circadian rhythm.
Light training, being sure to get 20-30 minutes of sunlight exposure early in the day and decreasing exposure to blue light in the evening can help reset the internal clock.
And as you can imagine, stress management plays a huge role in helping decrease cortisol levels to normal for those with high cortisol.
Consistently high levels of cortisol can have an effect on how our body handles cortisol in the form of cortisol resistance.
When we’re talking about cortisol resistance, we’re talking about at the cellular level.
Almost every cell in our body has receptors for cortisol and when cortisol binds to these receptors, they create some kind of effect, ranging from increased heart rate and sweating to decreased bowel motility. This is why when cortisol is out of whack, it can cause symptoms throughout the body.
Cortisol is intended to be elevated for short periods of time (during acute stress) and then it is supposed to decrease to baseline. When levels stay elevated for longer periods of time, the body tries to protect itself from the effects of cortisol.
It does this by decreasing the number of cortisol receptors and/or decreasing the sensitivity of the receptors.
Ultimately, you end up with a situation where your cells are no longer responding to cortisol in an appropriate manner. Your body is no longer able to mount a successful response to stress.
Stress management and helping the body to re-establish normal cortisol production and sensitivity is needed to correct this type of dysfunction.
Disruption of the Diurnal Rhythm
Finally, symptoms of a disrupted diurnal rhythm can imitate adrenal fatigue and typical adrenal fatigue treatments are going to have minimal effectiveness.
When you start testing cortisol levels, it’s not uncommon to see a disrupted rhythm, regardless of whether there is a high amount of total cortisol throughout the day, a normal amount or even a low amount.
Your cortisol levels should peak in the morning about 30-45 minutes after you wake up and the first couple of hours after waking should account for about 50% of your total cortisol produced during the day.
However, people will often have low cortisol in the morning and higher cortisol in the evening, leading to sleep problems, anxiety, daytime sleepiness, etc.
Diurnal cortisol rhythm can be interrupted by sleep disturbances, circadian disruption, perceived stress, fatigue, and trauma.
It’s important to address the underlying cause of the rhythm disruption in order to help get the body back on track.
If you’ve had your cortisol tested, but not sure if one of these might apply to you, reach out to me by emailing me your results that you have and I will help you interpret the test results. I do answer all emails personally, so it might take me a couple days to get back to you, but I WILL get back to you.
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