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Are you prepared to hear the powerful truth behind the myth of adrenal fatigue? While you might have heard the term before, chances are you are not getting the whole story. I want to help you learn a little bit more, and to guide you through the action steps that you can take to take your health back. Ready to learn more? Let’s get started right here, right now.
Adrenal Fatigue: The Basics
It all starts with a little bit of a paradox. The popular idea of adrenal fatigue is really not a valid concept, but the whole concept of adrenals (and their relevance to your overall health) is hugely important.
This goes back to a concept I think you should know about. It’s that the overall facets of health are often mired in unnecessary controversy. This means that small terms can often delay legitimate developments and our overall knowledge about our health.
Bottom Line: As much as adrenal fatigue is not specifically a thing, it certainly does not discount how important your adrenals are in relation to your body – and your overall health.
Adrenal Fatigue: Misconceptions
The conventional view is based on the idea that the adrenal glands, which produce more than 57 hormones, are beat up, worn out, and unable to make adequate amounts of cortisol. This, as per this theory, is what is suggested as the cause of this “fatigue.”
Sounds perfectly reasonable, right? Well, the problem is that it is not true! What happens in the body is that there is a substantial change that occurs in the body, especially as it relates to being in a state of chronic stress. It does involve the adrenal glands, and it can definitely involve symptoms, and you can fix it by lifestyle measures – thankfully, that is all perfectly true.
So, how have we gone so far down this path of not understanding exactly what adrenal fatigue is? Well, I want to do some exploring and figure it out – that way, you’re never left wondering what your adrenal glands are doing (and how they are feeling).
The History of Adrenal Fatigue
The weight of the adrenal fatigue concept really started to show itself in around the year 2000. The phrase itself took hold not necessarily as the concept itself, but as a placeholder. The idea informing it was that there was something occurring in the body, under chronic stress, that caused many symptoms like:
- Muscle pain
- Mood changes
- Sugar cravings
- Salt cravings
Key Insight: Because these same things could happen severely in the case of adrenal insufficiency, or Addison’s disease, which is a rare but real disease. Some thought that a weaker version of that condition would be best termed as “adrenal fatigue.” And, so, the concept was born.
While it might have made some sort of intuitive sense, it just was not accurate. Unfortunately, what it did was create a large rift between the alternative world and the conventional world of medicine.
The Conventional Perspective
In response to this idea of adrenal fatigue, the conventional world heard that and thought that an easy way to figure it out would be to test for it. It is easy because you can measure both how much the glands are producing, and how much they are being told to produce, too.
Imagine a car. If a car has an engine that’s falling apart, you could hit the gas as hard as you wanted, but the car would not move because the engine would not move. In the case of the adrenals you can also measure how much you are telling them to work (the gas pedal), and how much they are putting out (the engine), and correlate that to how you feel (whether the car moves or remains still).
Bottom Line: What they found was that those who suggested they had adrenal fatigue, there was no disconnect. Their adrenals were making exactly how much their body told them to make. So, the topic was dismissed in conventional terms and discussions.
One of the guiding concepts of adrenal health is known as the HPA axis. This axis consists of three key sets of glands, which include:
- Hypothalamic glands
- Pituitary glands
- Adrenal glands
This is a system of glands that control your body’s stress response. It governs your fight-or-flight response, the control of electrolytes in fluid, control of blood sugar, hunger, metabolism, fertility, hormone activation, all sorts of important things.
The fact of the matter is that the data is completely clear that the HPA pathway can be thrown off by chronic stressors (1). This means that consistent points of stress to the body can, essentially, throw the axis into a consistent state of imbalance.
What Is A Stress?
Let’s pull back for a moment. I want to first investigate what we might consider a “stress” – just so that we can contextualize it outside of the typically emotional stress that we might associate with the world.
A stress is something that puts the body in a state of disequilibrium. That includes the psychological stress that we might face on a daily basis, such as:
- The nasty boss
- Financial pressures
But, it also includes a lot of things that you might not typically identify as being related to stress on the body. Things like:
- Erratic blood sugar
- A poor night’s sleep
- High amounts of plastic fumes in the air
Bottom Line: Whether it’s how you feel mentally or physically, there are a load of stressors that your body might be encountering – whether you know it or not.
The Alternative Perspective
There are more and more people, in the natural health space, who have been seeing through this myth of adrenal fatigue. The main observation is that the adrenals do not really become “fatigued” unless you have adrenal insufficiency.
The drawback, though, is that people have long held a placeholder for a condition wherein there is too much disrupting their chemistry. Even though the concept is erroneous, which means that it is essentially incorrect, there is a real phenomenon behind it that people are feeling.
Bottom Line: If the concept of “adrenal fatigue” was true, the logic would be to put out more adrenal hormone to solve it.
What we have learned is that the key is the HPA axis. You can call it adrenal dysfunction, or adrenal stress, or even cortisol slope, but this is the ticket.
Many studies have looked at the times in which our bodies make cortisol (2) (3). Specifically, they have looked at how your morning cortisol compares to your evening cortisol. When your healthy, those two things make a slope – you have high cortisol in the morning, and low cortisol in the evening. It’s so perfect you could ski down it!
This is where chronic stressors come to play. When we deal with chronic stress in our system, no matter where it might be coming from, it can alter this slope completely. It can be reversed (with low cortisol in the morning and high cortisol in the evening), depressed (low cortisol all day), or amplified (high cortisol all day).
Key Insight: To date, this concept of cortisol slope has been the subject of 16,000 clinical studies (4).
Cortisol Imbalance: Symptoms
When your cortisol slope is not right, it can be the driver of many symptoms in your body. These can include:
- Easy weight gain
- Digestive disturbances
Bottom Line: A lot of these symptoms were simply ascribed to adrenal fatigue. Given what we know about the concept now, I think it more appropriate that we take these symptoms and apply them more specifically to the concept of adrenal dysfunction, stress, or cortisol slope.
There are more far-reaching implications for the importance of cortisol slope, rather than just the symptoms that we mentioned above. These include:
- Greater risk for disease
- Shorter lifespan
The Whitehall II Study
One of the most fascinating studies that I have read about, with regards to cortisol slope, is known as the Whitehall II study (5). Conducted in the United Kingdom, amongst thousands of participants, they focused on a collection of tests including:
- Blood sugar
- Body weight
- Blood pressure
- Cortisol slope
Many who have launched attacks on the legitimacy of adrenal fatigue have done so by delegitimating salivary cortisol testing. On the other hand, there is a lot of research which suggests the opposite – that salivary cortisol is a useful tool in the medical community (6).
Key Insight: In particular, during the Whitehall II study, the salivary cortisol slope was a strong predictor in terms of death than anything else (even smoking status). Make no mistake about it, it does correlate with your health status.
Action Steps: Cortisol Slope
The beautiful thing about cortisol slope is that it can shift and that it can improve. The main things to disrupt are:
- Changes in blood sugar
- Problems with sleep
- Early-life traumas
- Chronic ongoing stress
- Changes in lifestyle
Test, Don’t Guess
But, it can get better. The first thing you need to do, as always, is to get an accurate diagnosis. This will help determine whether or not your cortisol is affecting your health. Personally, I encourage a two-pronged approach:
- Mapping out your symptoms – The easiest way to do that is to take the Adrenal Quiz (7). It’s free, and it will help give you a foundational understanding of whether or not your adrenals are working well. If not, it will even tell you where you are at in terms of your adrenal health, too.
- Medical Testing – I encourage medical testing because there are those, however rare they may be, who have adrenal insufficiency (which means that they have undiagnosed Addison’s disease). Simple blood tests for cortisol and ACTH, alongside salivary tests, can help run the gamut of how relevant adrenal health is to you.
Your Adrenals & Your Diet
The next step, after you get some diagnosis of your symptoms, is to focus on your diet. You are what you eat, and sometimes it feels like truer words have never been spoken. When you focus on what you’re putting into your body, you’ll often be surprised at how much you get out of it.
You can have adrenal stress for reasons that go way beyond your diet, and might not have anything to do with it. But, your diet can still be used as a tool to leverage your adrenals back into a healthy daily rhythm.
Key Insight: I have written a lot about eating with your adrenals in mind. You can check out the Adrenal Reset Diet (8) to get started today.
The basic idea is that carbohydrates share a special relationship with cortisol (9). That comes down to the fact that cortisol is used in order to regulate blood sugar. This means that if you lack carbohydrates, your body will raise your cortisol in order to make more blood sugar.
On the flip side of the coin, if you have carbohydrates, you can let your cortisol levels go lower. The strategy is to tailor your diet of carbs in order to get your cortisol levels to the right levels, at the appropriate times (as we discussed before, we want them high in the morning, and low in the evening – like a perfect ski hill).
Key Insight: We can call this concept carb cycling, and it can have an immense impact on your cortisol levels – and your overall health. It has also been researched as a way of getting past weight loss plateaus, too (10).
The other thing about your diet is that there are foods which are inherently dangerous to your body, because of their effect on your blood sugar. If you want to improve your adrenals, the more you avoid these the better you might do. The “big three” include:
- Fried foods
For different reasons, these types of foods can create oxidative stress, throw off your blood sugar, and can make life harder for your adrenals.
There are also certain herbs that can benefit your adrenals. Things like reishi, tulsi, lemon balm, and magnolia bark. I have profiled these herbs before and would love for you to learn a little bit more about them (11).
Designing Your Recovery
What I want you to know is that your adrenal function is huge. It’s huge for your health, and it’s huge for your overall happiness. In fact, it may be the largest determinant of how you feel, how your immune system works, how your thyroid is functioning, how you are sleeping, whether your brain is working at its best, and even your potential lifespan.
The best thing about it is that you can make it better, starting today. When you have the opportunity to design your recovery, and to create a plan so that you can:
- Learn more, and
- Take the appropriate action steps
When your health is in your hands, you can definitely get better. Even in the worst stages, I have seen time and time again that people can rebound back to their best selves in only a couple of months.
Adrenal 101: What You Need To Know
In my estimation, the adrenal fatigue model was ultimately a clumsy way of dealing with a really complex (and real) issue for many people. For this reason, the concept has been dismissed, even though it dismisses some crucial health factors, like:
- Stress on health
- The HPA axis
- The relevance of your lifestyle
- Improving on resilience
Bottom Line: Now that we have begun to turn the page, and have really started to embrace and widen our knowledge on adrenal health, I hope that we can embrace a better understanding of what adrenal fatigue means – even when the name does it little justice.
Know Your Adrenals Today
If you did not notice it earlier, I really want you to be able to get a better understanding of your adrenals. That is why I always advocate for taking the Adrenal Quiz (12). Give yourself a better and more nuanced understanding of your adrenal health, and please take some time out to take the test today. Your body would be sure to thank you in advance.
Dr. Alan Glen Christianson (Dr. C) is a Naturopathic Endocrinologist and the author of The NY Times bestselling Adrenal Reset Diet.
Dr. C’s gift for figuring out what really works has helped hundreds of thousands of people reverse thyroid disease, lose weight, and regain energy. Learn more about the surprising story that started his quest.