What is “Adrenal Fatigue”

What is Adrenal fatigue? and does it exist? Apparently not! However, if you have been told you have it, you will know that every day feels like wading through treacle in a space suit!

Adrenal fatigue or burnout syndrome has been causing confusion amongst professional medical and health practitioners for years. Medical experts have long disregarded adrenal fatigue as nonsense which is incredibly frustrating for the patient and extremely difficult to accept when you are feeling so exhausted and unwell and looking for answers, however, there is no clinical or scientific evidence of adrenal fatigue being a diagnosable condition according to experts, so what is it?

Sufferers commonly complain of; brain fog, fatigue, poor sleep, low mood, headaches, but could these symptoms be attributed to a different body system imbalance? and poor nutrition? I have found many clients who come to me seeking help for their crushing fatigue also have undiscovered nutritional deficiencies and a problem in the gut that might seem unrelated. Whether the symptoms are bloating, IBS, constipation or diarrhoea, I often find the root cause lies in the gastro-intestinal tract which impacts on their energy levels and ability to cope with stress often resulting in anxiety and low mood.

Does it start in the gut?

From my experience with my clients who come to me with gut dysfunction such as IBS, I would say that nearly all of them also complain of anxiety, bloating and fatigue. This also just happens to coincide with changes in hormones for women around late 40’s, so there is certainly some exploration of hormones to be considered.

IBS, yet another “mysterious condition”  (you know how I feel about this by now? if not, read: at-last-the-secret-to-solving-ibs-is-revealed) that can often develop after gastrointestinal infection and often correlates with fatigue. In a study by Hanevik et al., 2o14, that followed up 1252 patients who had got a nasty gut infection called Giardiasis they found that nearly half of them still had IBS and 23% still had chronic fatigue 6 years later! 

IBS and gut problems are often disregarded as a potential source for symptoms of fatigue but I have over 7 years of experience and can tell you that once we improve the balance of bacteria in the gut, and restore gut integrity, energy levels improve and mood becomes more stable and the fatigue disappears.

What do the adrenal glands do?

The adrenals are two small glands that sit on top of the kidneys responsible for producing two critical hormones that are vital to life: cortisol and aldosterone. Aldosterone’s main role is to regulate salt and water in the body which directly effects blood pressure and Cortisol primary function is to act a bit like an in built alarm system; helping the body respond to stress and also has an effect on metabolism and the immune response.Without these hormones we would die.

Changes to output of aldosterone and cortisol fluctuate throughout the day but levels of both are usually highest in the morning and also when we are stressed. Cortisol levels generally drop throughout the day resulting in lowest levels when we are ready for bed which is a normal diurnal rhythm. People who do shift work often have a reversed cortisol pattern so we can see that cortisol levels change in response to your daily activities. I often find that my clients who have chronic fatigue get a “second wind” late at night which reflects a similar wakeful response to shift workers as cortisol is too high when it should be winding down ready for bedtime.

True adrenal insufficiency

The theory of how Adrenal fatigue develops suggests that when we are under stress our nervous system triggers the adrenals to release cortisol into the bloodstream and with prolonged exposure to stress our adrenal glands can become fatigued leading to low levels of cortisol being released. The Endocrinology Society claims “no scientific proof exists to support adrenal fatigue as a true medical condition” which leaves many thousands of people with no solution as it seems to have many health professionals stumped.

A rare, long term condition called Addison’s Disease does exist when the adrenal glands are unable to produce sufficient cortisol. Symptoms are fatigue, low mood, weakness and increased thirst. This is a dangerous condition that requires a blood test for diagnosis and would require that the patient takes hormone replacement for the remainder of their life.

Deficiencies

A common overlap between symptoms of adrenal fatigue/chronic fatigue/fibromyalgia can be down to some very common deficiencies. In the UK we are largely deficient in vitamin D, magnesium, energy-releasing nutrients and lots of these can be corrected through small dietary modifications. There are a series of tests that I run to rule these out or if we need to, we can implement a very targeted and strategic supplement plan to get things back on track quickly. 

Fibromyalgia

Fibromyalgia is a painful and debilitating disorder that effects around 2% of the adult population mostly aged between 20-60 year and more common in women.  It is difficult to identify and get a true diagnosis because the symptoms are commonly  confused with other disorders. This is why unravelling your timeline and history of events can be so helpful because I have commonly traced back to infection, trauma, stressful event or surgery. Once we understand when and how it started we can start to piece things back together again which can take time however, in some cases the turnaround can be swift resulting in better energy and generally feeling better and happier. 

Testing

Cortisol levels can be tested via urine, blood and saliva. The testing method most commonly used for adrenal fatigue is a saliva test which has limitations unable to reflect a true picture of circulating cortisol in the bloodstream which changes constantly. In a recent review of 58 studies  https://pubmed.ncbi.nlm.nih.gov/27557747/ found there was no significant difference between cortisol levels in the majority of fatigued Vs. healthy patient’s after testing cortisol four times in a 24-hour period and concluded “This systematic review proves that there is no substantiation that “adrenal fatigue” is an actual medical condition. Therefore, adrenal fatigue is still a myth” 

Adrenal fatigue was often broken down into phases to help you understand which “stage” of depletion you were in from stage 1-4, but this has also been proven to be unfounded now it is understood that cortisol levels naturally drop and recover over days and weeks even after comparing cortisol levels in normal Vs. PTSD patients.

The salivary cortisol test used by many health professionals to identify adrenal fatigue and still used today has been a mainstay of functional testing for chronic fatigue syndrome for years, but what do they really tell us and how clinically relevant are they?

I don’t use salivary cortisol testing for adrenal fatigue in my practice and never have. I have found after listening carefully to my client’s story and taking a detailed history that there is often a triggering event that initiated the onset of fatigue. The event may be an infection, illness,  a stressful event, even a trauma or injury. The event may have resulted in needing to take medication, antibiotics or an operation. These “events” cause a disruption to the integrity of the gut lining and gut microbiome balance is disturbed resulting in a malaise that is experienced slightly differently by each individual but fatigue is the single most common symptom. It is upsetting to be told that you have a non-existant condition when you feel so unwell and know something is wrong is insulting and depressing. The symptoms are obviously real to my clients who will often describe “I feel like I am functioning at half capacity” or “I feel like I am wading through treacle” or “I wake up feeling exhausted” so there is clearly something going on that needs investigating further. 

Test don’t guess

If you have suffered with fatigue for too long, and don’t know what causes is it time to find the root cause? by working closely with a client and listening to their story I can help you find answers. For example, I always check for common deficiencies that cause fatigue such as vitamin D is extremely common. Read my other blog on this here vitamin-d-nutrient-and-deficiency

Nutrient deficiency is so easily corrected once you know what you are dealing with and can make a huge difference to how you feel very quickly after supplementing at the right level. However, I always make sure the nutrients are obtained through diet taking a food first policy avoiding the need for costly supplements wherever possible. You can ask me for more information on a simple home test kit that will test for some basic nutrients and hormones that you need to function and could be a reason for you feeling so tired and consider my Gut Transformation package which is the very best way to work with me to get laser-targeted focus and results to transform your gut health and restore your energy and wellbeing.

Try my top tips

• Reduce your stress; easier said than done I know, but stress drains us mentally and physically and uses up critical co-factors such as magnesium that we need to make energy. Find ways to reduce your stress such as walking in nature, a soak in a hot bath, meditation etc.

• Get enough sleep; Broken or poor quality sleep and too many late nights affect our coping strategies the next day and obviously leaves you feeling fatigued. Read my article on sleep here are-late-nights-affecting-your-metabolism

• Eat regularly; don’t skip meals or leave longer gaps than 5 hours between meals.

• Choose quality, unprocessed food. Ditch the fast food and ultra-processed foods which leave you feeling sluggish. Speak to me to make sure you are meeting all of your nutritional needs. 

• Join my next online healthy eating programme for step by step guidance on what to eat and when and how. Join Eat Better Feel Better now – the next group start January 2022 

• Take my health quiz to find out how healthy you are and get my personal recommendation for next steps to take.

• Book a call with me to discuss any troublesome symptoms and I will help you.

• Subscribe to my monthly newsletter for top nutrition tips and free healthy recipes

Here are links to some amazing people that I work with that could compliment good nutrition and gut health.

Amber Kelly craniosacral Therapist https://www.amberkelly.co.uk/

Amanda Turner Hatha yoga https://www.amandaturneryoga.co.uk/

Rachel Whitehead Emotional Freedom Technique  https://www.releasefindpeace.co.uk/