Have you ever caught yourself thinking, Wow, I'm burned out! It's a feeling most people can identify with. But what does that really mean, and how does it happen?
I recently saw a patient whose story exemplifies true burnout. She was a 44-year-old working mom with two young kids, a high-powered job and busy city life. She had always been on the go — even her vacations were more like sightseeing missions than breaks.
She complained that she had started gaining weight a year earlier, and it wouldn't budge despite her usual cardio routine. She'd gone on a pretty strict Paleo diet, which meant restricting carbs, but she wasn't losing weight.
Her main issue, though, wasn't the weight; it was that recently her energy had "tanked." When she fell asleep she felt "knocked out," but still woke up feeling exhausted after eight hours.
Her brain felt foggy, she was irritable, and she was drinking three cups of coffee a day to get through her afternoon slump. At night she became super mom, cooking and taking care of the kids. Usually she was at her laptop until about midnight, which is when she physically couldn't keep her eyes open. Everything she described was classic for adrenal fatigue, but I wanted to make sure we were on the right track.
We tested her cortisol levels using a saliva test, and found that not only did she have the symptoms of stage 3 adrenal fatigue, the test confirmed it. Instead of following a curve that starts high on waking in the morning and trends down to its lowest point at night, her cortisol curve was a flat line. Her DHEA, another adrenal hormone, was also low, as were her free T3 — the active thyroid hormone — and her levels of B12, vitamin D, zinc, magnesium and selenium.
We put her on an adrenal reboot program, and in about six weeks she was feeling better. In three months she felt the best she had in years.
But before we get to her plan, we should back up and talk about what it means to have adrenal fatigue.
What is adrenal fatigue?
Adrenal fatigue is a phenomenon characterized by a disruption of your adrenal glands' ability to make cortisol in the right amounts at the right times in response to stress.
The adrenals are the body's hormonal powerhouse. Two little glands that sit on top of your kidneys, they're the linchpin of a feedback loop coordinating nearly every hormone in your body.
The Three Stages Of Adrenal Fatigue
There are three stages of adrenal fatigue. Each one is associated with a different type of cortisol imbalance, and typically people progress from stage 1 to stage 3 sequentially over time.
Stage 1: Wired and tired
This stage is characterized by high cortisol levels, especially at night, leading to insomnia, insulin resistance and abdominal weight gain. People often feel energized but in an edgy "wired" way.
Stage 2: Stressed and tired
In this stage, many people wake up early in the morning (often around 3am) and are unable to fall back asleep. Later in the day some stressor kicks in, and they feel more awake. Their cortisol peaks early, flattens out, but often has midday or early evening rise.
Stage 3: Burnout
This stage is characterized by exhaustion regardless of hours slept, a flat cortisol curve, and in some cases low DHEA and thyroid hormone levels. My patient was in stage three — a dangerous place to be because it's associated with higher risk of autoimmune disease.
To get her back from the brink of hormonal collapse she did the following 9 Step protocol.
1. Follow the adrenal diet.
This means getting rid of foods that you are sensitive to and foods that cause inflammation, and eating lots of brightly colored vegetables, lean clean protein, and whole grain gluten-free carbs.
In my patient's case this meant eliminating dairy, which it turned out she was sensitive to, eating more vegetables, and eating more carbs. A strict no-carb diet can stress the body even more, worsening adrenal burnout. Of course, we didn't tell her to eat cookies and cakes, but rather quinoa, lentils and buckwheat.
2. Go to bed early.
Getting to bed before 11pm is a must in any stage of adrenal fatigue. Many people get a second cortisol surge after 11pm, which further disrupts sleep patterns.
3. Flood the adrenals with B vitamins.
B vitamins (B5 and B6 in particular) are food for the adrenals and can be low in a high-fat, low-carb diet. B12 and folate also help with energy production.
4. Cool inflammation.
Using omega-3 fatty acids, curcumin, and vitamin C supplements we lowered her systemic inflammation levels allowing the adrenals to recover.
5. Replace important nutrients.
Vitamin D, selenium, magnesium and zinc are all important for proper thyroid function and adrenal function.
6. Focus on hydration.
Dehydration is also a hallmark of adrenal fatigue. My patient took a multi trace mineral supplement so she would absorb more water into her cells. You can also add fresh lemon juice or Himalayan sea salt to your water instead.
7. Use adaptogenic herbs.
My patient's formula was designed for stage 3 specifically, and included licorice root, ashwagandha and rehmannia, a Chinese formulation that helps balance and stimulate the adrenals.
8. Build rest into the day.
The last thing my patient needed was high-intensity cardio that would further burn her out. We added Iyengar yoga into her schedule twice a week and taught her to take two 20-minute rest breaks a day; these weren't naps, but time outs alone to breathe and restore.
9. Change your perspective.
Is your definition of success killing you? In many cases, what you perceive as success is driving you into adrenal overload. Helping my patient internalize the idea that "it" doesn't have to be perfect to be great made a huge difference in her stress levels.
We did not start her on any kind of hormone replacement. In some cases hormone therapy can be helpful, and if someone has an autoimmune disease called Addison's, it can be necessary. But for most people who live their way into stage 1, 2 or 3 adrenal fatigue, it's just a matter of living their way right back out of it and into balance with their bodies.
If you want to learn how to not just beat fatigue and fogginess but live at your highest capacity and radiate positive energy, check out my video course, The Stress Solution: How To Live With Grace & Ease No Matter What Comes Your Way.
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