Are you tired all the time? Does your body feel weak no matter how much rest you have, your cravings for salt or sugar are out of control and your memory has gone on holidays? Have you gone through an extended period of severe stress? You may have adrenal fatigue.
The adrenal glands sit on top of the kidneys and are responsible for producing a number of important hormones including cortisol, adrenaline and noradrenaline. Cortisol regulates sleep cycles and sugar metabolism, while adrenaline and noradrenaline speed up metabolism during times of stress, to help us cope and push through. These hormones are essential for healthy every day functioning, however they are not supposed to be in high demand at all times. When you go through a prolonged stressful period, the adrenal glands are working overtime trying to produce enough of these hormones to keep up with demand. Eventually the body is too depleted of the nutrients required to make these hormones and the adrenals too overworked to make them, so even though you may still be stressed, the body is not able to mount a normal stress response.
There are three stages of adrenal fatigue: alarm, resistance and exhaustion.
ALARM: This is the “fight or flight” response, which readies the body for action in response to danger or high stress. During this stage there is increased secretion of cortisol and noradrenaline to ensure survival, and blood is directed away from the digestive system to the muscles and heart. This is a positive response when it is only short term, as it helps you run away from danger, get all your assignments done or fight back when attacked.
RESISTANCE: If the alarm stage persists for an extended period, target tissues for the adrenal hormones become overstimulated, receptors may become desensitised, and tissue damage can occur. Weight gain may occur due to high cortisol levels and carbohydrate cravings.
EXHAUSTION: The initial increase in cortisol is followed by a decline to below normal levels as the adrenal glands can not keep up with demand for the production of stress hormones. The body has lost its ability to cope after long term severe stress. Low cortisol results in increased inflammation, which may cause pain, depression and tissue damage. Severe mental and physical fatigue occurs. Gastric ulcers may develop and the adrenal glands may become enlarged.
Some of the symptoms of adrenal fatigue include: lethargy, weakness, low blood pressure, low blood sugar, moodiness, dry skin, brittle or peeling nails, poor memory, poor circulation, heart palpitations, anxiety, recurrent infections due to reduced immunity, chronic lower back pain, sugar cravings and salt cravings.
If you suspect you have adrenal fatigue, it’s a good idea to visit your pharmacy, naturopath or GP to have your blood pressure assessed. If you have a blood pressure monitor at home you can also do this test for postural hypotension:
Lie down for five minutes then take your blood pressure. Stand up (carefully) and immediately take your blood pressure again and then compare the two readings. Ideally, your standing systolic blood pressure (the top number) should be about 10 points higher than when you were lying down. If your reading is lower when standing, this indicates that you likely have adrenal fatigue and should investigate this further.
You may want to undertake further tests to assess or rule out any other causes of fatigue, and also have any prescribed medications reviewed. Some tests that may be relevant for you include cortisol, ACTH, glucose tolerance, insulin tolerance, inflammatory markers, electrolytes, lipid studies (since cortisol is made from cholesterol), thyroid studies and viruses (such as Epstein-Barr virus, Cytomegalovirus, Ross River virus and other viruses that can cause extreme fatigue). Long term use of corticosteroids (often prescribed for asthma, arthritis and allergies) increases the risk of developing adrenal fatigue, so if you are taking these, alternatives may need to be considered in consultation with your doctor.
Since adrenal fatigue is usually caused by stress – and the best way to treat any illness is to treat the cause – your number one priority should be to identify and reduce stress in your life. Most people who get adrenal fatigue are Type A personalities who love to work hard and push themselves, so recovering from adrenal fatigue will be a learning curve and requires a change in mindset. To get your energy back and feel vital and active again you will need to first rest, cut back on your work or sport or social life, and prioritise your health (and yourself – no more people pleasing!).
Below are some naturopathic treatments worth considering when recovering from adrenal fatigue. As with all illnesses, it is best to book an appointment with a qualified naturopath who can assess your individual needs and prescribe a tailored treatment plan.
Reduce caffeine intake (gradually, to minimise withdrawal effects) and other stimulants.
Reduce sugar intake and adopt a low glycaemic index diet.
Increase healthy protein intake to help balance blood sugar levels and aid neurotransmitter synthesis (fish, nuts, seeds, protein powders in smoothies).
Increase fresh fruit and vegetables, including fresh juices for maximum cell nutrition.
Avoid soft drinks, processed deli meats, deep fried foods and other junk foods.
Add superfoods to your diet, such as raw cacao, which is rich in magnesium and vitamin C; and maca which helps the body adapt to stress, supports adrenal and thyroid function, and increases strength and stamina.
Ensure you are drinking adequate, quality water.
Eat certified organic where possible or grow your own food, as pesticides can inhibit the body’s ability to produce energy.
Astragalus (Astragalus membranaceus)
Astragalus is an adaptogen, meaning it helps the body adapt to stress, and minimises any negative effects of stress. It also enhances immunity and prevents infections, and helps the body to recover from debility and fatigue. As well as being beneficial in cases of adrenal fatigue, this herb is indicated for chronic infections, post viral syndrome, chronic fatigue syndrome and fibromyalgia.
Bacopa (Bacopa monnieri, aka Brahmi)
Bacopa enhances cognitive function, improving memory and concentration. It is especially good for medium and long term memory. It also reduces anxiety, and supports thyroid function and healthy sleep.
Korean ginseng (Panax ginseng)
Korean ginseng is an adrenal tonic which has long been used to alleviate physical fatigue and stress. It increases energy, improves mood, boosts immunity and helps the body adapt to stress.
Licorice (Glycyrrhiza glabra)
Licorice is an adaptogenic and adrenal restorative herb. It helps to regulate blood sugar and blood pressure and is also antiinflammatory. Licorice increases the amount of circulating cortisol by suppressing the conversion of active cortisol to inactive cortisol. It is excellent in cases of adrenal exhaustion when cortisol is low, however is not suitable in the alarm phase.
Rhodiola (Rhodiola rosea)
Rhodiola improves physical performance and fitness, helps the body adapt to stress and reduces physical and mental fatigue.
Siberian Ginseng (Eleutherococcus senticosus, aka Eleuthero)
Siberian ginseng helps to improve physical and mental performance. It modulates the immune system and helps the body adapt to stress.
Withania (Withania somnifera, aka Ashwaganda)
Withania is adaptogenic and antiinflammatory. It supports the nervous system and enhances mood and energy levels. It is a wonderful herb for convalescence and also has anticancer properties.
Herbal medicines are best prescribed by a qualified naturopath or herbalist, especially if you have diagnosed health conditions or are taking pharmaceutical medications. It is important to take the right herbs for your specific case, in the right form (ideally a liquid extract or tincture), at the right dose. Do not take licorice if you have high blood pressure, or during pregnancy.
Vitamin B complex: all B vitamins are essential for adrenal function and energy production.
Vitamin C: essential for adrenal function and immunity.
Magnesium: an important cofactor in energy production and blood glucose regulation; also essential for healthy mood. Avoid magnesium oxide (usually the cheap supplements) and go for magnesium diglycinate, bisglycinate or citrate to ensure maximum absorption and efficacy.
L-tyrosine: increases the body’s natural supply of adrenaline and thyroid hormones, aids in adrenal gland function, is a precursor for dopamine, noradrenaline and adrenaline, improves mood.
Coenzyme Q10: carries oxygen to all cells and is essential for energy production.
Nutrient supplements are best prescribed by a qualified naturopath or nutritionist to ensure you are taking the correct form at the right dose, and to avoid any negative drug-herb-nutrient interactions. Do not take L-tyrosine if you are taking MAO inhibitor drugs.
Rest: It’s important not to push yourself too much when you have adrenal fatigue, as this can make your symptoms worse, prolong recovery and even lead to chronic fatigue syndrome. Rest when you need to, and don’t feel guilty about it.
Sleep routine: If you’re having trouble getting to sleep or staying asleep, try putting your phone in another room when you go to bed (mobile phones inhibit deep sleep), writing in a journal before lights out (a great technique if you have a busy mind), applying lavender oil to the temples and playing meditation music in the bedroom. It’s important to have a dark room at night, but it’s equally important to allow natural daylight to enter your room in the morning, as the sun’s gradual rising coincides with a gradual rise in cortisol to wake you up. If you wake up in a dark room to an alarm, it’s a shock to the system and you will most likely feel tired upon waking. Herbal medicines such as valerian, hops and passionflower can alleviate insomnia and rebalance sleep cycles.
Reduce stress in your life: Reconsider your social circles (avoid anyone who drains your energy), cut back your hours at work if needed, stop playing sport if it’s wiping you out, and reduce your screen time. Consider investing in a weekly massage or yoga class, and commit to spending more time in nature, meditating, colouring, playing music, reading, journalling, spending time with good people, or doing anything else that reduces your stress.
Acupuncture: Reduces stress and restores energy (“chi”) flow through adrenals and nervous system.
Aromatherapy, reiki, crystal bed healing, flower essences, floatation therapy or counselling are other modalities you may want to consider, as resonates with you.
Exercise: Regular, moderate exercise is very beneficial during the alarm stage to bring stress hormones back under control and reduce stress, depression and anxiety. If you are in the exhaustion stage where exercise makes you feel totally wiped out, you are doing too much. This is not a normal exercise scenario where pushing will help you progress. Too much exercise can send your health backwards, so it’s important to STOP, and then seek help from an exercise physiologist who can guide you through graded exercise therapy.
If you smoke, drink a lot of alcohol or take recreational drugs, cut back and work towards quitting.
If you are struggling with fatigue, it’s best to book in to see a qualified naturopath who can assess your case and provide a tailored prescription for your recovery. Many GPs do not recognise or acknowledge adrenal fatigue and there are limited options for pharmaceutical treatment. To ensure full recovery and prevent falling into this cycle in the future, it’s important for you to consider areas of your life that may have contributed to your current state of health, and learn new ways to look after yourself in a balanced way, for optimal health and vitality.