Be Well: Feeling Exhausted? It Might Be Adrenal Fatigue

Feel like you’re so stressed, even your stress is stressed out? As a collective, we’ve all seen better days—no doubt. However, if you find yourself perma-exhausted with unrelenting brain fog, your adrenal glands could be the culprit.

Be Well by Mpls. St. Paul Magazine

Dragging your feet at the end of the day? Find yourself longing for a nap by noon? Come to think of it, do you ever feel rested? As Americans, it is part of our culture to burn the candle at both ends. We rise to all occasions at both home and work—to our own detriment. It’s no wonder so many of us are exhausted, anxious, and overwhelmed.

A controversial term, adrenal fatigue is often used to describe a host of vague but debilitating symptoms. Described as the depletion of cortisol from the adrenal glands, Western medicine providers do not believe this catch-all diagnosis exists. After all, conventional doctors train in acute care. They prefer to find a specific problem to fix and prescribe short-term solutions.

HPA Dysfunction, Explained

Paul Ratté, a naturopathic doctor, functional medicine specialist, and professor of nutrition at Northwestern Health Sciences University says adrenal fatigue is a misnomer. “The term hypothalamic-pituitary-adrenal (HPA) axis dysfunction describes this collection of symptoms more accurately,” he explains. “But it’s a mouthful!” The HPA axis is a neurobiological system charged with regulating the body’s stress response. The chronic activation of this collection of organs can destabilize the body’s hormones and neurotransmitters. When imbalanced, these interconnected substances—including cortisol, adrenaline, and norepinephrine—cause the stress-response function to go haywire. Symptoms in HPA axis dysfunction can appear as:

  • Exhaustion
  • Weight gain/loss
  • Insomnia
  • Lack of concentration/focus
  • Increased depression and anxiety
  • Sudden hair loss
  • Brain fog or difficulty concentrating
  • Cravings for salty or sugary foods

Once relied upon to help us flee from predators, the fight-or-flight response releases stress hormones when we feel threatened. Today, we’re not often running for our lives. However, our bodies can’t distinguish between the imminent danger of a nearby bear and the intense anxiety of losing a job or our health. When we experience constant stress, our hormones keep flowing. “Fight-or-flight is still useful in modern times, but it’s not sustainable day-to-day,” says Dr. Ratté. “It’s as if we have turned on a faucet and can’t turn it off. If you remain in a constant state of stress, you’re eventually going to fall apart.”

He advises patients on preventing and treating HPA axis dysfunction by applying a holistic approach to health and wellness. “There are no magic pills or miracle supplements that can fix the problem. You have to treat the root cause of the problem,” he says. “You need to understand why you keep your foot on the accelerator and figure out how to take it off.”

“”Fight-or-flight is still useful in modern times, but it’s not sustainable day-to-day. It’s as if we have turned on a faucet and can’t turn it off. If you remain in a constant state of stress, you’re eventually going to fall apart.” Paul Ratté, Northwestern Health Sciences University

Sleep: The Ultimate Rx

Sleep. Is. Crucial. Without it, your adrenal glands can’t do their job of repairing your body while you rest. Consistent sleep can go a long way towards resolving HPA axis dysregulation. Good sleep hygiene takes discipline, but it’s achievable. Consider the following:

  • Go to bed at the same time every night. An erratic sleep schedule can throw off your serotonin levels. This vital hormone and neurotransmitter is essential in regulating the body’s sleep-wake cycle.
  • Create a dark sleep environment and avoid the blue light of screens. Melatonin, the neurohormone that helps us sleep, is activated by darkness.
  • Avoid stimulating activities, like reading the news or watching Netflix, 30-60 minutes before bedtime.
  • Down-regulate. Whether you practice yoga or play the piano, find time to unwind. Remember, the antidote to fight-and-flight is rest-and-digest. Choose a calming activity that will kick your parasympathetic nervous system into gear.
  • Save caffeinated drinks for the morning. Drinking coffee or soda after 3pm can keep some people awake all night long.

Eat Like it’s 1869 Again

If you can make healthy food choices eighty percent of the time, you’re in pretty good shape. Dr. Ratté suggests following the rule of 1869—as in the year. “If a food was not around before then, you should limit the amount you eat.” Processed foods like margarine and highly refined flours became commercially available in the 1870s.

But eating healthy isn’t just about adding a daily dose of fruits and vegetables. It also requires you to recognize and limit harmful foods. For example, taking fish oil supplements to support mental health can be helpful, but not if you’re washing it down with a McDonald’s hamburger, fries, and shake. “It’s true that studies show cultures who eat more fruits and vegetables have lower rates of chronic illness,” says Dr. Ratté. “However, we don’t realize that their good health may have more to do with something that they’re not eating than what they are.”

To build up your body’s resiliency, try to avoid:

  • Refined and processed carbohydrates
  • Prepared foods
  • Caffeinated drinks
  • Sugar
  • Alcohol

Blood Glucose: It’s A Balancing Act

Another underlying contributor to HPA dysfunction is blood sugar imbalance. Constant stress and high levels of cortisol raise blood glucose, and so do carbohydrates. Carbs, which give us quick bursts of energy, are not the enemy. But not all carbs are created equal. Carbs with high fiber content, like whole-grain bread or sweet potatoes, provide us energy to get through the day. Dr. Ratté stresses the importance of eating balanced meals made up of protein, healthy fat, and fiber. And, of course, staying hydrated by drinking at least half of your body weight in water.