What You Need To Know About Adrenal Fatigue + How To Fix It

Functional Medicine Practitioner By William Cole, D.C., IFMCP
Functional Medicine Practitioner
Dr. Will Cole, D.C., IFMCP, is a leading functional medicine expert who specializes in clinically investigating underlying factors of chronic disease and customizing a functional medicine approach for thyroid issues, autoimmune conditions, hormonal imbalances, digestive disorders, and brain problems. Cole is also the bestselling author of Ketotarian and The Inflammation Spectrum.

"Adrenal Fatigue" is a term that you hear a lot in the health community, but what is it exactly? In this article you'll learn the causes of adrenal fatigue, how it can impact how you feel, and what you can do about it!

Your adrenal glands sit on top of your kidneys and regulate many critical hormonal jobs in your body. One of those jobs is the secretion of your body's main stress hormone, cortisol. Our bodies have been designed for stressful events, and throughout time they have adapted to them. If our ancestors were chased by a predator, the sympathetic response, our body's fight-or-flight mode, would be activated. During this stress response, cortisol would be released, upregulating blood pressure and blood sugar, which were needed for the stressful event. When things calm down, cortisol secretion decreases, along with your blood pressure and blood sugar levels. Normal balance is intact.

Our modern life, with its many chronic stressors, can turn on your stress response and throw away the key. Unlike acute stress, for which we're biologically hard-wired, chronic stress turns on the fight-or-flight response, without any rest. If the chronic stress response doesn't leave, those cortisol triggers never stop. But we haven't genetically adapted to the onslaught of modern chronic stressors. Balance is not intact.

Some chronic stressors that can lead to adrenal fatigue are:

These stressors can cause cortisol to remain high for a long time. Chronically high cortisol levels can tire your poor adrenal glands out — welcome to adrenal fatigue. Because of the adrenal glands' important role in your health, adrenal fatigue can cause a wide variety of symptoms, such as:

  • trouble falling asleep or staying asleep
  • irritability
  • fatigue
  • blood sugar fluctuations
  • changes in blood pressure
  • low immune system
  • digestive issues
  • brain fog
  • dizziness
  • increased allergies
  • asthma
  • weight fluctuations
  • depression
  • decreased sex drive

In Functional Medicine, instead of just treating symptoms, my main focus is to address the underlying biochemical mechanisms that are at play. The secret to understanding adrenal fatigue is understanding its origin: your brain!

Your brain tells your adrenal glands what to do through a complex web of communication called the hypothalamic-pituitary-adrenal axis (HPA Axis).

Your hypothalamus releases corticotropin-releasing hormone (CRH), which tells the pituitary gland to release the adrenocorticotropic hormone (ACTH). ACTH then tells your adrenal cortex to release cortisol. Adrenal fatigue is really a dysfunction of your brain's communication with your adrenals (HPA axis), not the adrenal gland itself!

Given modern medicine's model of labeling a disease and matching it with a corresponding pharmaceutical drug, it's no wonder why I see many people struggling with adrenal fatigue and they don't even know it. Adrenal fatigue is nuanced and multifaceted and is drastically under diagnosed. There are three main stages of adrenal fatigue: The first stage is marked with high cortisol. The second stage you can see normal cortisol levels, which makes it difficult to detect. The third phase of adrenal fatigue is where we find low cortisol.

So what is the solution?

1. Get a comprehensive diagnosis.

One of the labs I run on my patients is a 24-Hour Adrenal Stress Index, a salivary test which tracks your cortisol levels, HPA axis quality, and other hormone levels throughout the day to get a comprehensive view of what's going on in your particular case.

2. Remove your chronic stressors.

Removing or limiting the stressors listed above will be essential to breaking the chronic stress cycle, regaining your health and feeling like yourself again.

3. Individualized care.

A health program should be tailored for your specific needs and labs. Although individual protocols will vary, in addition to herbal remedies they will often call for carefully replacing a small portion of the exact level of the missing adrenal hormones. Specific amounts of DHEA and the precursor to cortisol called pregnenolone, will stimulate your body to begin producing it naturally.

William Cole, D.C., IFMCP
William Cole, D.C., IFMCP
Will Cole, D.C., IFMCP, is a leading functional-medicine expert and a Doctor of Chiropractic. He...
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