by Dr. Will Cole
As a functional medicine practitioner, one of the most common issues I see is never-ending fatigue. My patients wake up reaching for caffeine, are irritable throughout the day, and are constantly craving sugary and salty foods in a state of hanger. They have trouble losing weight despite their best efforts to eat well and exercise and they have a diminished sex drive. By the afternoon, their energy levels are at zero, but once the evening comes, they get a ‘second wind’ and end up having yet another night of poor sleep.
While this is common for the majority, it is certainly not normal. This is an epidemic of adrenal fatigue.
Your adrenal glands
The adrenal glands sit directly on top of your kidneys and their main responsibility is to regulate the release of cortisol, your main stress hormone.
Our bodies are built to handle stress. For example, in the past when our ancestors were threatened by a predator, the sympathetic response – our body’s fight-or-flight mode – would be activated. This would release cortisol and raise blood pressure and blood sugar to help deal with the stress. Once the threat was gone our cortisol, blood sugar, and blood pressure went back to normal.
What is adrenal fatigue
Healthy cortisol levels should be high in the morning and slowly taper off throughout the day. Your sleep hormone melatonin is inversely proportional to cortisol, so when cortisol is high melatonin is low to help with waking, and when melatonin is high cortisol is low to help you sleep. Adrenal fatigue happens when there is an imbalance in this cortisol rhythm, causing it to be too high or too low at inopportune times.
In order to understand adrenal fatigue, we first must understand where it originates. Your brain instructs your adrenal glands through the hypothalamic-pituitary-adrenal axis (HPA) Axis, also known as the brain-adrenal axis. Your hypothalamus then releases corticotropin-releasing hormone (CRH) which tells the pituitary gland to release the adrenocorticotropic hormone (ACTH) which finally tells your adrenal cortex to release cortisol. Therefore, we can see that adrenal fatigue is not an adrenal gland problem, it is a problem with your brain’s communication with your adrenals.
With our lives full of constant stress, our cortisol never gets the chance to even out again. Some chronic stressors include:
Some of the symptoms of adrenal fatigue include:
- Slow to start in the morning
- Cravings for sugary or salty foods
- Low libido
- Afternoon fatigue
- A second wind in the evening
- Trouble staying asleep
- Dizziness when standing quickly
- Afternoon headaches
- Blood sugar problems
- Chronic inflammation
- Weak nails
- Mood swings
- Weight loss resistance
If you think you are struggle with adrenal fatigue I recommend:
1. Have labs run.
A 24-hour adrenal stress index is a saliva test that looks at your HPA axis quality, cortisol levels, and other hormones during a 24 hour period. Since adrenal fatigue originates in your brain it is also important to run labs to rule out any possible brain inflammation that could be contributing to your fatigue.
2. Manage chronic stressors.
Removing toxins, avoiding stressful situations, and testing for food intolerances can help you take back control of your health.
3. Use food as medicine.
Food can either be our most powerful healer or our biggest destroyer. Avocados and oysters do wonders for calming the brain and rebalancing hormones.
4. Practice mindfulness techniques.
Reducing emotional stress using mindfulness tools like focused breathing can help you stay calm and soothe your brain-adrenal axis.
5. Try yoga or tai chi.
These are two of my favorite ways to also help balance out chronic stress.
6. Add in natural medicines.
It takes time to rebalance the brain-adrenal connection. It’s important to note that what works for one person doesn’t always work for the next, so it’s essential to talk with your doctor about what natural medicines will work for your specific health case. These are some of my favorites:
- Adaptogenic herbs: Rhodiola rosea, holy basil, ashwagandha, and eleuthero ginseng work to regulate cortisol.
- Magnesium: Known as the original chill pill, it works to relax tense muscles, supports the adrenal glands, and promotes better sleep.
- Methylation support: Activated B12 and folate support your body’s methylation pathways to support the melatonin-cortisol connection.
- GABA support: GABA is your calming neurotransmitter. Passion flower and amino acids like theanine, taurine, and glycine act on the gabaminergic pathways in your brain to promote calm.
7. Get enough sleep.
Sleep gives your brain and adrenals time to regroup. Give your brain time to wind down before bed by turning off the TV and putting away your phone an hour or two before bed.
8. Consider functional medicine.
Depending on your level of brain-adrenal dysfunction working with a qualified functional medicine practitioner can be beneficial. You may need to replace a small amount of the missing adrenal hormones for a period of time. Pregnenolone, the precursor to cortisol and specific amounts of DHEA can stimulate your body to start producing it naturally.
If you want to learn more about your own health case please check out our free health evaluation. We offer in person as well as phone and webcam consultations for people across the country and around the world.
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