by Dr. Will Cole
Chronic fatigue affects more than 1 million people in the United States, and those are just the extreme cases. We are a society that works hard, doesn’t sleep enough, and often seems to run on fumes and caffeine. Many of us constantly crave sugary foods and suffer from debilitating exhaustion. That exhaustion can be caused by different things, and chronic fatigue is multifaceted, but in many cases, one common aspect of the condition is something called adrenal fatigue.
The adrenal glands, which sit on top of your kidneys like little kidney baseball caps, release several important hormones one of which is cortisol. Cortisol is one of your primary stress-related hormones and regulates your energy. Normally, it rises in the morning to help you wake up, then slowly goes down throughout the day, sinking at night so you can sleep well. Cortisol also helps regulate your blood sugar and pressure.
The problem starts when cortisol stays high when it shouldn’t, often due to chronic stress. The result can be adrenal fatigue, which is not actually an adrenal problem but rather a brain problem. Typically, adrenal fatigue is when the brain-adrenal (HPA) axis isn’t working, so that the brain is not communicating appropriately with the adrenal glands to regulate cortisol. Symptoms include:
- Trouble getting started in the morning
- Cravings for salty or sugary foods
- Low libido
- Afternoon fatigue
- Getting a “second wind” in the evening
- Trouble staying asleep
- Dizziness when standing up quickly
- Afternoon headaches
- Blood sugar issues
- Chronic inflammation
- Thinner, weaker nails
- Difficulty losing weight
As a functional medicine practitioner, I’m normally the one guiding people out of their health problems, so when I saw the symptoms of adrenal fatigue creeping into my own life, I knew I had to start practicing what I teach. Here are the steps I took to rehab my own adrenals. and what I recommend for many of my patients:
1. Run labs to assess adrenal function and more.
In addition to conventional blood labs, I recommend:
- Adrenal fatigue labs: This lab involves spitting into several vials throughout the day. It’s a lot of spit, but it gives you and your doctor a lot of information about your brain-adrenal function. When I did these labs, I learned I did indeed have adrenal (HPA) dysfunction, as I suspected.
- Microbiome labs: The microbiome refers to the community of trillions of bacteria and fungi in your gut. Because gut health is the foundation of total health, especially brain and hormonal health, it is important to discover what is going on and deal with any underlying gut problems such as leaky gut syndrome, candida overgrowth, and small intestinal bacterial overgrowth in order to recover from adrenal fatigue.
- Methylation labs: Methylation is a collection of biochemical actions in the body that happen 1 billion times every second. Healthy methylation helps to maintain a healthy brain, gut, hormones, and detox pathways, and also protects your DNA. However, some of us have genetic mutations that impair the methylation process. I have multiple methylation gene mutations, one of which is the MTHFR gene mutation, making me less able to absorb certain essential vitamins. This was useful information because I was then better able to supplement to make up for my nutritional deficiencies.
2. Jump start your hormone rehab with a 90-day diet reset.
Food is medicine. I always ate healthy, other than my favorite “healthy junk foods” of gluten-free pizza and stevia soda. However, I knew that if I was going to rehab my adrenal fatigue, I had to take my food medicine plan to the next level by making sure my diet was on point for hormone health. Here’s the 90-day food plan I used to improve my sleep and energy.
3. Eat nutrient-dense proteins.
Oysters are packed with zinc, and having a balanced trace mineral ratio between copper and zinc can help with healthy neurotransmitter function and adaptogen to stress. Increased copper and decreased zinc has been shown to contribute to brain stress and anxiety. Oysters – superfood of the sea – are a great way to achieve this balance to help ease your stress levels.
There is some truth to the notion that a post-Thanksgiving meal heavy on the turkey will put you into a “food coma.” The reason is the calming amino acid tryptophan in the turkey. Tryptophan is a precursor to the neurotransmitter serotonin, which helps you feel calm and better able to deal with anxiety.
Grass-fed organ meats
Organ meats like liver are some of the best sources of nutrients needed to beat fatigue, like zinc and vitamin D. They also contain copious amounts of choline and other B vitamins needed for methylation.
4. Eat more green superfoods.
Plant foods like Swiss chard and spinach are rich in magnesium, the original nutritional “chill pill,” which helps to regulate and optimize communication in the brain-adrenal axis.
This sulfur-rich vegetable also contains the beneficial B vitamin folate. Low levels of folate are linked to neurotransmitter impairment, which can lead to brain-hormonal problems.
5. Eat healthy fats every day.
Avocados contain beneficial B vitamins and monounsaturated fats that boost neurotransmitter production and brain health. This fatty super fruit also contains potassium, which naturally helps to lower blood pressure.
Bacterial imbalances in your gut can contribute to brain problems because the gut and brain “talk” to each other through the vagus nerve. Kefir is rich in beneficial bacteria for your microbiome and also has fat soluble vitamins A, D, and K2, which are important for brain health, so it helps out from both ends of this critical connection.
Coconut oil is super versatile – you can cook with it, put it in smoothies, or just eat it off a spoon like I do. It offers good fats like medium-chain triglycerides (MCTs) that can help with brain function.
Omega-rich foods like Alaskan salmon can help decrease inflammation, which is crucial for brain and hormonal health.
6. Sip on herbal tea.
This soothing, mild herbal tea isn’t actually from the tea plant. It’s made from an herb that has been shown to help decrease anxiety, depression, and stress symptoms in just a few weeks.
Another non-tea “tea,” this one comes from the African red bush, typically known as Rooibos, and can have a balancing effect on cortisol.
7. Try natural medicines.
Because so much of adrenal fatigue is really brain-based, most of the natural medicines I use focus on supporting optimal brain health and the brain’s response to stress. Explore blends of adaptogenic herbs like ashwagandha, eleuthero ginseng, holy basil, and rhodiola rosea to give your adrenal axis some TLC. I also incorporated phosphatidylserine supplements into my routine. (Of course, consult your doctor before implementing any herbs or supplements.)
8. Increase magnesium intake.
In addition to eating magnesium-rich foods, supplementing with magnesium can take its benefits to the next level. Magnesium helps support the adrenal glands, relaxes stressed muscles and nerves, and promotes quality sleep. I am a fan of magnesium threonate, which studies suggest can be beneficial to the brain. I also put magnesium oil on my skin.
9. Bring down inflammation.
Curcumin, a compound in the turmeric root, has potent antioxidant properties, as well as a neuroprotective quality. Bonus: It’s a mood-enhancer, too. In a randomized controlled trial, turmeric appeared to act as an effective option for depression, which can occur concurrently with adrenal fatigue.
10. Improve sleep habits.
When I was working to rehab my adrenals, I needed to recommit to getting a good night’s sleep, and that meant breaking the bad habit of staying up too late. I know it’s difficult when you work all day, get home late, and just want time to unwind, but your brain and adrenals recuperate overnight while you sleep, and they need time, too.
I now try to avoid caffeine in the afternoon. This is difficult, as I am a self-admitted tea addict, but I opt for the caffeine-free chamomile or rooibos instead if it’s after lunch. Other ways to promote quality sleep include turning off the TV, computer, and smartphone a few hours before bed (those screens and artificial light can overstimulate the brain, block melatonin production, and negatively impact sleep quality), and eating an ounce or two of clean protein like organic turkey, along with 2 tablespoons of coconut oil right before bed. This has a balancing effect on blood sugar throughout the night.
11. Learn stress management techniques.
Stress can have devastating effects on health. Even if you do everything else right health-wise, if you don’t manage your stress, none of it will mean much. During my healing journey I practiced mindfulness meditation and other stress-busting strategies to bring mindfulness into my day, like taking time-outs for slow, deep breathing. This is a simple way to defuse stress levels and calm the brain-adrenal axis. I’m also a big fan of listening to Eckhart Tolle audiobooks when I’m in the car.
12. Start practicing yoga regularly.
Another great way to manage cortisol while also getting in better shape is yoga, which can bring both more alertness and more stillness into your life. I recommend the awesome video courses from my mindbodygreen siblings Lauren Imparato, Tara Stiles, and Michael Taylor, for easy access to yoga at home.
13. Spend more time outdoors.
Because I have a job that’s indoors, I need to make it a point to get outside more often. I believe there is something coded in our DNA that gives each of us an affinity with the sun and fresh air, so that we seek out these health-boosting influences. I also like to practice earthing, or walking barefoot outside, as much as I can to help de-stress. Something about that skin-on-earth connection feels literally grounding and refreshing.
14. Get vitamin D levels into a healthy range.
Spending more time outside in the sun also helps boost levels of vitamin D, because your body manufactures this important vitamin/hormone when it senses sun on your skin. Vitamin D, is responsible for regulating over 200 genetic pathways, so make sure your levels are high enough. I recommend an optimal range of around 60 to 80 ng/ml. Ask your doctor about a simple blood test to help you keep track.
15. Learn to say “no.”
This one is still hard for me – I don’t want to disappoint anybody and there is always more work to be done. But managing stress means creating space in your life to refuel, spend time with the people you love, and doing what you need to do for you and you alone. Don’t just pencil it in. It’s as important as anything else you do for your health, and maybe more so.
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