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Adrenal Fatigue 101

How to thrive after Adrenal Fatigue

In today’s hectic society, just about everyone is run down and exhausted. Between working full time, running kids around, taking care of parents and in-laws, and making sure the house doesn’t implode on top of it all, it’s no wonder you’re drained. We live in a world of feeling “on” 24/7. With the anxiety of keeping up appearances on social media, and smart phones that keep us connected even when we’re yearning to unplug, we’re facing unprecedented levels of stress and burnout.

If you’re wondering why you’re exhausted all the time no matter what you do, the answer may be a growing phenomenon called Adrenal Fatigue.

Symptoms of Adrenal Fatigue

You may have Adrenal Fatigue if you experience some of the following symptoms

  • Persistent fatigue that does not improve with sleep
  • Relying on sugar and caffeine to get through the afternoon
  • Blood sugar fluctuations, such as hypoglycemia (dizzyness and headache, etc.)
  • Difficulty falling asleep
  • Waking in the early morning, such as 2-4am
  • Feeling overwhelmed and/or depressed
  • Recurrent infections/poor immunity
  • Persistent headaches
  • Brain fog/poor memory
  • Feeling more tired, instead of energized, after exercise
  • No libido
  • Low-normal blood pressure
  • And more...1,2,3

To understand Adrenal Fatigue, it’s crucial to understand the body’s stress system.

Your Stress System

In simplified terms, your body’s defense mechanism--or your “fight or flight” response--shoots out lots of adrenaline and cortisol (your body’s primary stress hormone) to help you get away from danger. The physical response to this hormone surge is higher blood pressure, increased breathing and heart rate, blood flow diverts from the digestive tract to muscles, and pupils dilate, These are all physical adaptations in order to flee. Once the danger is gone, all your stress hormones and adrenaline come back into normal range.4

But fight or flight is not the only function of cortisol. Your primary stress hormone has its own rhythm. Cortisol is supposed to rise in the morning to motivate you to get out of bed, and then it falls toward night time so that you can ease into sleep.5Our adrenal glands know this rhythm very well, and they stick to it unless there is a problem or imbalance in the whole stress system.

That’s where chronic stress comes in.

In today’s world, actual physical danger is very infrequent; but our stress system, or HPA axis, gets activated by plenty more than being chased by a mountain lion. Work deadlines, long commutes, credit card debt, rushing kids around to activities -- all of these daily stresses are perceived by the body as a threat to your safety, causing the body to secrete low levels of cortisol on an ongoing basis. For short bursts of time, cortisol is your ally, but when it’s out of range for too long due to mounting stress levels, the natural cortisol rhythm becomes disrupted. The result of this disruption is variable, but often cortisol is too low in the morning6and too high at night, leaving plenty of people exhausted when they’re supposed to be awake and then desperately tired but too wired to sleep.

Cortisol also affects a host of other hormones. Stress can disrupt menstrual cycles, inhibit libido or sexual function7, slow down the thyroid (and therefore, the metabolism)8, worsen blood sugar9problems, ignite inflammatory conditions, and interfere with proper immune function10.

Adrenal Fatigue 101

How to Deal with Adrenal Fatigue

Unfortunately, adrenal fatigue is not something that simply passes, or resolves spontaneously. If you continue to be stressed out and push through the fatigue, you can worsen your feelings of exhaustion.

Fortunately, many people have walked this path before and have managed to reset their natural cortisol rhythm and bounce back to themselves again, but it takes a multi-faceted approach and some lifestyle considerations in order to work.

Here are some of the ways you can help balance your adrenal glands and heal your body. 

Foods and Gut

Hippocrates said it: “Let thy food be thy medicine”, and what you avoid putting into your body is as crucial as what you choose to let in. Certain foods can cause inflammation in the gut11, causing downstream effects in other systems, such as your stress system, depleting you of nutrients, and worsening fatigue12. After all, fighting inflammation is tiring for the body.

Here are some foods to avoid

Gluten and Dairy - wheat used to be a benign plant and milk was once a hearty beverage, but farming practices have changed, and a lot of people are sensitive to the proteins in wheat and dairy, particularly gluten and casein. These proteins can cause inflammation in the gut which prevents nutrient absorption and makes you feel totally wiped.13

Processed sugars and refined carbohydrates - these ingredients typically live in fast and prepared foods and will cause your blood sugar to rise and fall like a roller coaster. These blood sugar swings are hard on cortisol. In turn, imbalanced cortisol makes it more difficult to keep your blood sugar in control.14

Food to include

Fruits and Vegetables - and a lot of them. These nutrient powerhouses pack the vitamins and minerals your body needs to heal.15While supplementing additional nutrients may be necessary at first, it’s best to get as much nutrition from your food as you can.

Complex carbohydrates - in order to have even energy levels throughout the day, you need to combine protein, fat and carbohydrates in your meals and snacks throughout the day. Adrenal fatigue is not a great state in which to do a fast, as your blood sugar levels are more volatile when your cortisol is out of balance.16

Protein – should be eaten at every meal for its amino acid content. These provide the building blocks of all the tissues in your body, and have positive immune stimulating effects. Protein helps keep blood sugar balanced, easing the stress that diet can have on the body.17

Herbs

Fortunately, there are many herbs shown by research to help balance your cortisol levels.  These herbs are called “adaptogenic” herbs, and help in reducing the harmful effects of stress on the body in a variety of ways.

Holy Basil - lifts mood and provides anti-oxidant benefits to keep cells healthy and to reduce the effects of stress.18

Rhodiola - rhodiola has research supporting its cortisol-lowering properties, enhances mental and physical performance, and increases energy.19

Ashwagandha - this herb has been studied to reduce sleeplessness and feelings of anxiousness as well as nourishing the adrenals in states of burnout.20

Other herbs that have been shown to calm stress levels include lemon balm21, valerian22, passionflower23. If you calm the nervous system, you can avoid the stress-fatigue cycle.

Vitamins/Minerals

At times of constant go-go-go, you use up more vitamins and minerals than when you are relaxed because your body and mind are humming on overdrive. You want to replete these nutrients so that the bodily systems that rely on them keep running smoothly.

Magnesium - needed for over 350 reactions in the body, magnesium is a critical mineral you may not be getting enough of. In addition to being crucial for our body’s cellular energy cycle, magnesium is crucial for good sleep, good bowel movements, and muscle relaxation.24

B Vitamins - B vitamins are needed for healthy liver and hormone function in addition to providing ingredients for adrenal hormone function. These vitamins are used for healthy mood and nervous system regulation.25

Vitamin C - you need loads of Vitamin C for cortisol production as well as for antioxidant and immune support.26

Exercise

When you’re burned out and depleted, you don’t have much energy left for rigorous exercise. Gentle exercise reduces stress levels27, gets the lymphatic system moving (which is crucial for gentle detoxification and reducing inflammation) and improves mood, among other things. Choosing low intensity exercise such as walking, swimming, or yoga is a better choice than Crossfit or triathlon training, for example, if you’ve got nothing left to give. There are different types of yoga, such as yin or restorative yoga, that are specifically designed with specific sequences of poses to help replete the burned out and exhausted.

Mind-Body

In order to pull yourself out of this state and keep you feeling vibrant and fulfilled, you need to make some lifestyle changes. These changes can be some of the most difficult to implement, as they often involve managing the expectations of others. Implementing healthy boundaries, learning to say no, asking for or hiring some help so that you don’t have to do/manage everything yourself are all crucial self-care habits. They may be tough to initiate but once you have them in place, they will keep benefitting you for years to come. 

If you think you may need some counselling or therapy, please by all means enlist the help of a psychotherapist - there should be absolutely no stigma in seeking some mental health maintenance.

Gratitude practices28such as journaling and meditation have been shown to reduce stress.29These practices are easy, inexpensive, and there are plenty of cost-effective resources out there to help you integrate mindfulness and gratitude into your life.

If you need more help, please reach out. Not asking for help is one of the traits we value in society that puts so many at risk for Adrenal Fatigue.

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4 Charkoudian N, Rabbitts JA. Sympathetic neural mechanisms in human cardiovascular health and disease. Mayo Clin Proc. 2009;84(9):822-30.

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8 Xia L, Chen GH, Li ZH, Jiang S, Shen J. Alterations in hypothalamus-pituitary-adrenal/thyroid axes and gonadotropin-releasing hormone in the patients with primary insomnia: a clinical research. PLoS One. 2013;8(8):e71065. Published 2013 Aug 9. doi:10.1371/journal.pone.0071065

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12 Morris G, Berk M, Carvalho AF, Caso JR, Sanz Y, Maes M. The Role of Microbiota and Intestinal Permeability in the Pathophysiology of Autoimmune and Neuroimmune Processes with an Emphasis on Inflammatory Bowel Disease Type 1 Diabetes and Chronic Fatigue Syndrome.Curr Pharm Des. 2016;22(40):6058-6075. Review. PubMed PMID: 27634186

13 Catassi C. Gluten Sensitivity.Ann Nutr Metab. 2015;67 Suppl 2:16-26. doi: 10.1159/000440990. Epub 2015 Nov 26. PubMed PMID: 26605537.

14 Shearrer GE, Daniels MJ, Toledo-Corral CM, Weigensberg MJ, Spruijt-Metz D, Davis JN. Associations among sugar sweetened beverage intake, visceral fat, and cortisol awakening response in minority youth. Physiol Behav. 2016;167:188-193.

15 Naveen S, Siddalingaswamy M, Singsit D, Khanum F. Anti-depressive effect of polyphenols and omega-3 fatty acid from pomegranate peel and flax seed in mice exposed to chronic mild stress.Psychiatry Clin Neurosci. 2013 Nov;67(7):501-8. doi: 10.1111/pcn.12100. Epub 2013 Oct 24. PubMed PMID: 24152226.

16 Pharr JR. Carbohydrate Consumption and Fatigue: A Review, Nevada J Pub Health. 2010:1(6)

17 Mu WC, VanHoosier E, Elks CM, Grant RW. Long-Term Effects of Dietary Protein and Branched-Chain Amino Acids on Metabolism and Inflammation in Mice. Nutrients. 2018;10(7):918. Published 2018 Jul 18. doi:10.3390/nu10070918

18 Jothie Richard E, Illuri R, Bethapudi B, Anandhakumar S, Bhaskar A, Chinampudur Velusami C, Mundkinajeddu D, Agarwal A. Anti-stress Activity of Ocimum sanctum: Possible Effects on Hypothalamic-Pituitary-Adrenal Axis.Phytother Res. 2016 May;30(5):805-14. doi: 10.1002/ptr.5584. Epub 2016 Feb 22. PubMed PMID: 26899341.

19 Jówko E, Sadowski J, Długołęcka B, Gierczuk D, Opaszowski B, Cieśliński I. Effects ofRhodiola roseasupplementation on mental performance, physical capacity, and oxidative stress biomarkers in healthy men. J Sport Health Sci. 2016;7(4):473-480.

20 Pratte MA, Nanavati KB, Young V, Morley CP. An alternative treatment for anxiety: a systematic review of human trial results reported for the Ayurvedic herb ashwagandha (Withania somnifera). J Altern Complement Med. 2014;20(12):901-8.

21 Scholey A, Gibbs A, Neale C, et al. Anti-stress effects of lemon balm-containing foods. Nutrients. 2014;6(11):4805-21. Published 2014 Oct 30. doi:10.3390/nu6114805

22 Bent S, Padula A, Moore D, Patterson M, Mehling W. Valerian for sleep: a systematic review and meta-analysis. Am J Med. 2006;119(12):1005-12.

23 Lakhan SE, Vieira KF. Nutritional and herbal supplements for anxiety and anxiety-related disorders: systematic review. Nutr J. 2010;9:42. Published 2010 Oct 7. doi:10.1186/1475-2891-9-42

24 Nielsen FH. Magnesium deficiency and increased inflammation: current perspectives. J Inflamm Res. 2018;11:25-34. Published 2018 Jan 18. doi:10.2147/JIR.S136742

25 Camfield DA, Wetherell MA, Scholey AB, et al. The effects of multivitamin supplementation on diurnal cortisol secretion and perceived stress. Nutrients. 2013;5(11):4429-50. Published 2013 Nov 11. doi:10.3390/nu5114429

26 Yimcharoen M, Kittikunnathum S, Suknikorn C, et al. Effects of ascorbic acid supplementation on oxidative stress markers in healthy women following a single bout of exercise. J Int Soc Sports Nutr. 2019;16(1):2. Published 2019 Jan 21. doi:10.1186/s12970-019-0269-8

27 Butzer B, Day D, Potts A, et al. Effects of a classroom-based yoga intervention on cortisol and behavior in second- and third-grade students: a pilot study. J Evid Based Complementary Altern Med. 2014;20(1):41-9.

28 Kyeong S, Kim J, Kim DJ, Kim HE, Kim JJ. Effects of gratitude meditation on neural network functional connectivity and brain-heart coupling. Sci Rep. 2017;7(1):5058. Published 2017 Jul 11. doi:10.1038/s41598-017-05520-9

29 Janssen M, Heerkens Y, Kuijer W, van der Heijden B, Engels J. Effects of Mindfulness-Based Stress Reduction on employees' mental health: A systematic review. PLoS One. 2018;13(1):e0191332. Published 2018 Jan 24. doi:10.1371/journal.pone.0191332