What is adrenal fatigue?
The adrenal glands sit on top of your kidneys and secrete hormones that help regulate your metabolism, blood pressure, and other essential function in your body. They’re also the body’s stress handler. Jacob Teitelbaum, MD, director of the Practitioners Alliance Network and author of the best-selling From Fatigued to Fantastic! explains, “Most of us learned about the ‘fight or flight reaction’ to stress in grade school. If we’re under attack, our adrenal glands fire to raise our blood sugar to supply quick energy to fight or run. Through most of human history, this might occur once every couple months. Now, with the increased speed of modern life, the fight-or-flight reaction is often being triggered dozens of times every day. This can cause exhaustion of the adrenal stress handler glands.” With this condition, you will get repeated drops of blood sugar causing moodiness, fatigue, and anxiety, leaving you feeling very stressed out. Here’s how to manage stress effectively.
Is it real?
According to the Mayo Clinic, this condition often shows up in popular health books and on alternative medicine websites but isn’t an accepted medical diagnosis. According to Dr. Teitelbaum, “Physicians are not trained about this. Rather, we are only trained about an illness that destroys the adrenal gland, called Addison’s disease. This only affects about one in 10,000 people. As we have no clear-cut medical definition yet for adrenal fatigue, many doctors pretend it doesn’t exist. Sadly, this is what medicine historically has also done for multiple sclerosis, lupus, and fibromyalgia.” For those who do have this condition, it can be very disheartening to have a doctor not identify nor acknowledge their struggles. Here’s how to choose the best primary care doctor for you.
How many people have it?
Dr. Teitelbaum believes adrenal fatigue is becoming an epidemic. “Estimates are that it affects 16 to 67 percent of the population at different levels of severity,” he says. Although anyone at any age may suffer, people who have a tremendous amount of stress in their lives for personal or professional reasons are most susceptible. Check out the 7 types of stress and how to ease them.
How is it diagnosed?
Some doctors will draw blood to check levels of the stress hormone cortisol, although adrenal fatigue doctors aren’t fond of this test since it only measures the cortisol in your blood at the moment of the test—and levels vary widely throughout the day. An Adrenal Stress Index Test is more effective, according to Dr. Teitelbaum, because it tests a person’s saliva four times over the course of one day and will show the accurate function of the adrenal glands. However, the best indication of trouble is the patient’s symptoms. “The easiest way to tell is if you get irritable when hungry,” Dr. Teitelbaum says. He believes listening to the patient’s body is often the most accurate way to diagnose. Don’t miss these surprising energy boosters that aren’t coffee.
What are the symptoms?
Symptoms can vary widely but generally consist of fatigue, a crash of energy in the afternoon, reliance on caffeine, frequent and lengthy infections (like sore throats and colds), lightheadedness, a racing mind at bedtime, waking up in the middle of the night for an hour or more—often between the hours of 2:00 and 4:00 a.m.—low blood sugar, craving salty foods, craving carbs, anxiety, depression, weight gain, brain fog, darkened pigmentation around the eyes in particular, joint pain, body aches, a feeling of constant stress, and hair loss.
Why doesn’t mainstream medicine recognize adrenal fatigue?
Mark Menolascino, MD, medical director of the Meno Clinic Center for Functional Medicine in Wyoming, often discusses the mystery epidemic of adrenal fatigue with fellow physicians. He shares, “When I talk to my fellow internal medicine MD’s, they all think I am talking about Addison’s disease, the complete autoimmune-induced failure of the adrenals. Yet this is more of a dysregulation or imbalance than a true failure—though it can progress from fatigue to adrenal failure.” The condition has yet to gain acceptance due primarily to a lack of evidence. PubMed.gov says that the condition has not been recognized by any endocrinology society, pointing out that the studies that have been done have conflicting results.
The three phases of adrenal fatigue
According to Dr. Menolascino, adrenal fatigue can have three stages:
- Stage 1 is over-activation of the adrenals, and it happens during or immediately after stress—either physical or mental. Cortisol is typically elevated during this time with DHEA (hormone) normal.
- Stage 2 is highlighted by what looks like normal patterns of the stress hormone cortisol, yet the overall levels are low and DHEA is depleted. Fatigue sets in, joint pain can be present, menstrual cycles become irregular, the so-called “cortisol roll” around your belly starts, your mood drops, and sleep becomes less restorative.
- Stage 3 is persistent, around-the-clock fatigue, irritability.
Dr. Menolascino says, “The good news is that there is a model to assess what stage you are in and how to get you back to your desired state of full energy, optimal body weight, restful sleep, and overall balance. The process is not expensive and doesn’t involve medication or 30 vitamins.” However, he warns, there are many scams purporting to treat the condition, so use caution when you seek treatment.
Treating adrenal fatigue
One thing that many practitioners recommend is avoiding strenuous exercise. Says Dr. Menolascino: “This is not something you can ‘exercise your way out of.’ Too much physical stress or exercise further depletes you, and I tell my clients to ‘put some back in your stress savings account.’ When you feel a little better, go at 90 percent instead of your usual pace to help build back up your reserve.” Gentle stretching and yoga can help during your time of healing.
Dr. Teitelbaum suggests following these five tips:
- Swear off excess sweets. The highs and lows from eating too much sugar (especially sodas and fruit juices) exhaust your glucose-controlling adrenal glands.
- Cut excess caffeine. Caffeine amplifies symptoms of low blood sugar.
- Eat more protein. Protein-rich foods include meat, poultry, fish, eggs, cheese, beans and nuts—all of which help stabilize blood sugar levels. Try a 1-ounce protein (NOT carbs) snack at bedtime, such as a hard-boiled egg or some meat, fish, or cheese, to see if this helps you sleep through the night.
- Eat a little, and often. Five (or even six) smaller, high-protein, low-sugar meals a day are best.
- Drink more water, eat more salt. They help your adrenal glands regulate blood volume and blood pressure. Increase your intake to a level that feels good. If you’re thirsty, drink. If you crave salt, add more of it to your foods.
Laura Richards is a Boston-based writer, journalist, and mother of four. She has written numerous articles for Reader’s Digest and other outlets including The Washington Post, U.S. News & World Report, The Boston Globe Magazine, Redbook, Good Housekeeping, Woman’s Day, House Beautiful, and Martha Stewart Living. She can be found on Twitter @ModMothering