Out of all the health issues my patients come to me with, fatigue is by far the most common. I witness the epidemic of extreme exhaustion on a daily basis.
Patients wake up feeling exhausted, craving cups of caffeine. They are irritable and "hangry" for salty or sugary foods. They can't lose weight, despite dieting and exercise, and have little to no sex drive. Their energy level crashes in the afternoon, but they often get a "second wind" before bed. Then they have trouble winding down in the evening, only to have another night of restless sleep.
Sadly, many think this is normal. That's because they look around and see everyone looking just as tired and miserable as they are. But just because something is common doesn't make it normal.
This is not normal — this is the epidemic of adrenal fatigue.
What are the adrenal glands?
Your adrenal glands sit on top of your kidneys, like little kidney baseball caps. They regulate many critical hormonal jobs in your body, including the release of your main stress hormone, cortisol.
Our bodies are built for stressful events, and throughout time they have adapted to them. We are here today because the human species can handle stressful events. 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, ramping up blood pressure and blood sugar, which were needed to cope with the stressful event.
When things calm down, cortisol secretion then decreases, along with your blood pressure and blood sugar levels. Normal balance is intact.
So what is adrenal fatigue?
Cortisol is neither bad or good — it just is. But problems occur when there's an imbalance in cortisol.
In a healthy individual, cortisol is higher in the morning and slowly flows lower throughout the day. Melatonin, your "sleepy time" hormone, is inversely proportional to cortisol. So when cortisol is high, melatonin is low and vice versa.
Adrenal fatigue happens when there's an imbalance in this cortisol rhythm: Cortisol is high when it should be low, low when it should be high, or always high or always low.
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 communications called the hypothalamic-pituitary-adrenal axis (HPA Axis), or simply the brain-adrenal 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 — not the adrenal glands themselves.
What causes adrenal fatigue?
Our modern life, with its many ongoing stressors, can turn on your stress response and throw away the key. Unlike acute stress, for which we’re biologically hardwired, chronic stress turns on the fight-or-flight response without any rest.
If the stress response doesn’t leave, those cortisol triggers never stop. Some chronic stressors that can lead to adrenal fatigue include: