Are you “running on empty”? It might be adrenal fatigue! 

(orginally published in InnerSelf Newspaper)

Been under long term stress?  Feeling ratty, teary, fragile?  Perhaps having temper flares? Find your energy “crashes” in an unpredictable fashion?  Is your weight fluctuating, sleep affected?  Waking up “exhausted?”

All of these symptoms can be a sign of adrenal fatigue or insufficiency – a subtle, chronic depletion of your ability to cope effectively with stress.  Adrenal fatigue may not be apparent on routine blood tests yet adrenal fatigue, insufficiency or “burn-out” is a common debilitating condition.

Luckily adrenal fatigue responds beautifully to a range of natural approaches including herbal and nutritional medicines as well dietary and lifestyle approaches.

What is adrenal fatigue?

Our adrenal glands sit on top of our kidneys and are responsible for producing a range of hormones including those associated with our ability to cope with stress such as adrenalin that is responsible for the “fight/flight” response.  In cases of long term chronic stress, even if of relatively low intensity, adrenal hormone production may become low and/or erratic – decreasing our ability to cope with stress effectively on a physiologic level.   Emotionally and mentally this may present as sudden feelings of panic, bouts of crying or anger and a sense of not being able to cope.  The physical body often feels exhausted and fragile yet sleep is often poor.  Dizziness upon standing or blood sugar “lows” can be other symptoms. Sometimes sudden full blown anxiety attacks can occur unexpectedly including physical symptoms such as a rapid heart rate and breathing, sweating, flushing or blanching of the skin and shaking.  These are all signs of a sudden erratic release of adrenalin from the adrenal glands and of course the fear that results from having these symptoms can escalate the situation further.  Adrenal fatigue can also be quite subtle – you may even feel you are coping ok yet still sense a persistent underlying current of anxiety or fragility – like a bright flame burning without any fuel to back it up.  A sense of having no reserves or resilience is a common sign of adrenal fatigue or “burnout”.

Another cause of adrenal “burn-out” or fatigue is the use of certain prescription drugs such as prednisolone, hydrocortisone and dexamethasone.  These steroid drugs given for a variety of medical conditions can decrease the production of natural adrenal hormones and abrupt cessation of these drugs is a common cause of adrenal insufficiency syndrome.  Adrenal hormone function can also be affected by other drugs including many used for high blood pressure which is why fatigue is a common side effect of these drugs.

Diagnosing adrenal fatigue

 Adrenal fatigue is often a diagnosis of exclusion – one must rule out other potential causes of low energy.  These include low thyroid function, anaemia, diabetes, poor digestion and nutrient assimilation, clinical or situational depression, chronic insomnia, post viral chronic fatigue syndromes and serious illness such as cancer or multiple sclerosis.  Low oestrogen states during the perimenopausal years and menopause are also associated with a subjective feeling of fatigue.  It is also important to note that adrenal fatigue may accompany any of these conditions as they themselves can lead to long term chronic stress. Specific laboratory hormone tests are also utilised to support a diagnosis of adrenal fatigue. These include levels of the adrenal hormones DHEA and cortisol usually determined from samples of saliva.

 Natural medicine approaches

 Mother nature has given us the most valuable antidote to adrenal fatigue – the adaptogen herbs! Adaptogens help us adapt to stressful situations more effectively by balancing our adrenal hormone production and release leading to a gradual return of energy and resilience.  Adaptogens are the ideal choice for anyone with symptoms of chronic stress, endocrine or immune dysfunction. Common adaptogen herbs include the ginsengs and licorice. There are numerous less well known adaptogens used by medical herbalists including Withania somnifera (also known as Ashwaganda), Astragalus and Shatavari. As all herbs have potential toxicities and contraindications so please seek the advice of a qualified herbalist before using them.

Diet and lifestyle are very important factors in recovering from adrenal fatigue.  Deficiencies in Vitamin C, Vitamin E, Vitamin B5, B6, Magnesium, Calcium and a range of trace minerals have been associated with improper functional of the adrenal glands. 1 Nutrient deficiencies can be determined through investigations such as a Hair Mineral Analysis which also identifies toxic metal accumulation.  In general the recommended diet is plant based, includes adequate fibre, protein and good fats as well as a wide variety of brightly coloured vegetables and fruit. It is also important to avoid foods that are likely to cause sensitivities as well sugar, white flour, caffeine and alcohol. Finally, lifestyle approaches such as meditation, yoga and regular exercise are extremely important aspects of recovery from this debilitating condition.

1 Friedman, M “Fundamentals of Naturopathic Endocrinology”, page 132, CCNM Press, 2005