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Adrenal Fatigue: Explanation, 27 Symptoms, 1 Cause + 7 Tips
When you talk about adrenal fatigue, everything automatically revolves around stress, tension and burn-out. However, one should not succumb to the illusion that the general practitioner diagnoses 'adrenal fatigue'.
According to conventional medicine, there is no such thing as adrenal fatigue. The adrenal glands work or they don't work, everything in between is often dismissed as nonsense. The probability is then also quite high that the associated symptoms will be classified as depression and that you will simply be prescribed antidepressants.
But is adrenal fatigue really just something you imagine? A diagnosis that naturopaths came up with to give a name to inexplicable symptoms? I have examined all of this and would like to share my results with you here.
In this article, you will learn:
- Why the family doctor does not recognize adrenal fatigue.
- How to make and get a diagnosis.
- Why stress can lead to adrenal fatigue.
- What can be done to get well again.
What is adrenal fatigue?
The term 'adrenal fatigue' is in itself a somewhat inadequate translation of the English term adrenal fatigue. A more accurate translation for adrenal fatigue would be 'adrenal fatigue ‘. A fairly long translation, admittedly, which is probably why the term adrenal fatigue is a bit more manageable.
However, the poor translation is also (partly) a reason why conventional medicine does not like to hear the term adrenal fatigue. Adrenal fatigue, or adrenal fatigue, as it is sometimes called, would mean that the adrenal glands are no longer working at all. However, this rarely occurs, e.g. in Addison's disease (adrenal insufficiency) or Cushing's syndrome.
The term adrenal fatigue was founded in 1998 by Dr. James L. Wilson made it up. He was a naturopath and a chiropractor. This natural healer assumed that excessive stimulation of the adrenal glands leads to an imbalance in the hormonal balance over time. The main focus is on the hormones cortisol and DHEA.
The excessive stimulation of the adrenal glands means that the cortisol levels either rise far too high or are far too low at another point in time (cortisol deficiency).
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What causes adrenal fatigue?
To sum it up very briefly: The adrenal fatigue results from the fact that the adrenal glands can no longer cope with the daily stress.
Adrenal fatigue doesn't just happen. Much precedes it. The adrenal glands only become unbalanced when they are chronically and heavily stressed over a long period of time.
The adrenal glands are located on the kidneys, at the level of the lowest ribs, on the back of the body. They are about the size of your own thumb.
The small organs are responsible for producing and regulating some very important hormones. It's about over 50 different hormones that play a role in pretty much every body function. They also influence your emotional state and therefore your thinking.
The adrenal glands produce the hormone (and neurotransmitter) adrenaline. This hormone ensures that people are able to perform tremendously in certain situations, such as the girl who lifted a burning truck that her father was trapped under. Lifting a truck is usually impossible. However, due to the dangerous situation, the body produces adrenaline, which supplies the muscles with more oxygen and energy. This gives you temporary 'supernatural' powers.
Adrenaline has contributed to the survival of the human race over the centuries. When in danger, the body produces adrenaline, which makes it much easier for us to fight or flee. That way, our chances of survival increase.
A great deal of adrenaline is released when danger is imminent. Then the following happens in the body:
- The heartbeat and breathing increase, as a result of which more oxygen-rich blood reaches the muscles and the brain, which in turn makes you more attentive and also more concentrated.
- The blood pressure rises because the blood vessels constrict.
- The pupils dilate, which improves perception.
- Less blood is 'wasted' on bodily functions that do not have a priority when there is danger, such as digestion.
- More glucose is transported to the muscles.
- The memory is sharpened so that similar dangerous situations can be recognized immediately in the future.
- The blood will clot faster.
The metabolism in particular is significantly affected by this. Normal digestion is shut down and at the same time different processes take place, with which energy is transported to the muscles as quickly and as much as possible.
When the danger has passed, the body will return to normal so that normal functions such as digestion can continue. The body does this by neutralizing the adrenaline. It does this with the help of the hormone cortisol.
Cortisol is often referred to as the stress hormone, although it is actually the opposite. It's a stressfulResponse-Hormone that is produced when the stressful situation is over.
Now you might be wondering what adrenaline production has to do with adrenal fatigue when there is impending danger. The problem here is that the body reacts the same way to all forms of stress.
Physiologically, the body reacts in exactly the same way, regardless of whether a fighting dog is about to sprint at you or whether you have to create a deadline at work. In either case, the body will produce adrenaline. It is also desirable in both cases that the adrenaline is produced. You can use it to escape the attack dog better because the muscles are better supplied with oxygen and energy.
And through the improved concentration and better memory, the deadline at work will also be easier to meet. And when the dog is back on the leash and the deadline is reached, the body will produce cortisol to get back into normal mode. Often it is only then that you realize how tired you are, because the efforts made logically consume a lot of energy.
So far so good. The body does exactly what it should. The problem now, however, is that we are often exposed to constant stress these days. Not only at work, but also in our entire environment. This is why our adrenaline and cortisol levels are constantly out of balance, which leads to our adrenal glands becoming 'tired'.
It is not at all bad if there is a real burn at work from time to time and you experience moments of stress as a result, as long as it stays with 'now and then'. However, when this becomes normal, day after day, all year round, the case is very different.
Forms of stress
As mentioned earlier, it's not work alone that can create the stress. The body reacts in exactly the same way to any form of stress. And with many things we are not even aware that they are (additionally) stressing us. I would like to list a few here:
- Job; Too many and too difficult tasks, too much effort, too little rest, too simple tasks, pointless or aimless work, too little responsibility, no say
- Family; Upbringing the children
- Deaths in the family or in the circle of acquaintances
- Pregnancy, birth of a child
- Career steps
- A very expensive purchase; House or car
- Divorce, relationship problems
- Restructuring at work, dismissal
- Marriage (wedding anniversary preparations)
- Diseases such as type 2 diabetes (source)
- Depression (source)
- Chronic pain, rheumatism
- Illnesses of related persons
- Financial problems, debts
- Taking medication
- Contaminated food
- Air pollution
- Unhealthy diet (including the consequences of a crash diet or dependence on caffeinated beverages such as coffee or energy drinks)
- Sleep badly, the quality is very important here, less the quantity (source).
- Physical overload; be overtrained, as can be the case with top athletes.
- To be badly affected by the events in the world.
There are, of course, many more stress triggers, but this list will certainly give you a glimpse of everything that can cause stress in life.
Each of these stressors on their own is unlikely to be too much of a problem, but all of them taken together can create serious problems. The adrenal glands may not tire immediately just because you have a strenuous job, but if you also have to care for a disabled child, have financial worries, and eat unhealthily, the body will be under constant stress with the adrenal glands constantly working overtime to have to do.
In addition, every person reacts differently to certain stressful situations and also deals with them differently. One of them may not be able to close his eyes because of his debts and only see problems, the other, on the other hand, simply tells himself that it will work out again and stays relaxed.
We just heard what exactly causes adrenaline in the body. But it is also good to know what exactly the hormone cortisol does in the body.
Cortisol is always in the body, with and without stress. If the cortisol is out of balance (as in the case of adrenal fatigue), this has a negative effect on health, because the hormone plays a role in the following processes:
- The defense system
- The sleep rhythm
If you have adrenal fatigue, you will likely be more susceptible to colds and viruses, gain weight more easily, and have trouble sleeping more quickly.
It is not uncommon for people who tend to be overstretched to have a tummy. Due to the influence of cortisol, the body will store fat more quickly, which makes it very difficult to lose weight. This is why it is so difficult to lose weight when you are under stress.
When the adrenal glands are working well, cortisol levels will fluctuate throughout the day. When you wake up, your cortisol level will be quite high, which will make you feel more alert.
In people with adrenal fatigue, cortisol levels will lose their rhythm. Often those affected become really active after 9 p.m., while they were very tired during the day. The disturbed cortisol often causes problems falling asleep and getting up becomes more difficult.
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We now know that chronic psychological, emotional and / or physiological stress leads to adrenal fatigue over time. But how do you know if you really have adrenal fatigue?
There is no official diagnosis for adrenal fatigue. If you take it to a conventional doctor, the doctor will answer that the adrenal glands are either working normally, not working at all (Cushing's syndrome), or not working well (Addison's disease).
Addison is a very rare disease that only affects a few thousand people in Germany. The likelihood of suffering from it is therefore very low. Adrenal fatigue, on the other hand, is much more likely.
For diagnosis, you can have a blood test carried out, be examined by a (natural) doctor or make your own diagnosis based on the symptoms or blood values.
You don't necessarily have to go to your family doctor for a blood test. There are offers on the Internet that you can use for this. During these examinations, the cortisol level is determined in the morning.
A saliva test offers even more security. Then the amount of cortisol and DHEA in the saliva is determined at different times of the day. The relationship between cortisol and DHEA shows how severe the adrenal fatigue is.
The symptoms of adrenal fatigue are discussed in the next section.
A hormone test will examine the hormone cortisol. This can be done through the saliva or through a urine or blood test. However, the saliva test is the most reliable.
Since cortisol levels fluctuate throughout the day, it is important to measure the levels at different times. Important measuring moments are the peak in the morning and how quickly it drops again. It is best to have an experienced (natural) doctor interpret the different measured values of the different measuring torques.
Once you have started the appropriate treatment, the cortisol measurements can be repeated at set times to determine whether the treatment is working.
Many doctors will also check thyroid function by examining thyroid hormones, which are closely related to hormones in the adrenal glands.
Other tests that can help diagnose adrenal fatigue:
- ACTH stimulation test; The test measures the amount of adrenocorticotropin. ACTH is a hormone produced by the pituitary gland (a gland in the brain) that stimulates the production of cortisol in the adrenal glands. This test measures whether the adrenal glands are still producing enough cortisol in response to ACTH. If so, the adrenal glands are functioning normally.
- The relationship between 17-HP and cortisol; 17-HP is a component of cortisol. If the ratio between 17-HP and cortisol is quite high, it is a sign that the adrenal glands are having trouble converting the 17-HP to cortisol.
- The relationship between cortisol and DHEA; This test can be used to determine which phase of adrenal fatigue you are in. The production of stress hormones (cortisol) will also affect the production of sex hormones (DHEA). By looking at this ratio too, the degree of adrenal fatigue can be assessed.
- The testing of neurotransmitters; With adrenal fatigue you can also see that the production of certain neurotransmitters is no longer normal.
- TSH test; Measurement of the amount of thyroid stimulating hormone in the blood. This hormone leads to the production of the Thyroid hormones T3 and T4which are also measured in the process. These hormones in turn influence the adrenal glands and vice versa.
The symptoms of adrenal fatigue
When the adrenal glands stop producing the right amount of hormones at the right time, it affects almost every function in the body.
Here are the symptoms of adrenal fatigue (source):
- Bad reaction to a stressful situation, can take little
- Always be (very) exhausted during the day
- In the evening, on the other hand, have more energy
- In the mood for something sweet or salty
- Needing / consuming stimulants such as sugar and caffeine
- Problems getting up
- Little resistance
- Sleep poorly, insomnia
- Auto immune reactions
- Brain Fog
- Weight gain
- Lower libido
- Capricious and irritable quickly
- Hair loss
- The hormonal balance is out of whack
- Increased insulin resistance
- Slight dizziness
- Loss of muscle mass (possibly together with muscle pain) and loss of bone mass
- Dry skin
- Frequent urination
- Easier problems with allergies or asthma
- Extreme exhaustion after exercising
- Low blood pressure
- Lower back pain
- Low blood sugar level
The first 8 symptoms are the most common and are the strongest signs of adrenal fatigue.
If you recognize any of the symptoms listed above in yourself, you may have adrenal fatigue. Warning: the symptoms listed here can also have another cause.
If you have a great desire for sweet or salty food in the evening, are very low on energy during the day, get energy in the evening and sleep poorly, this can be a good indicator of possible adrenal fatigue.
What to do with adrenal fatigue
One has to reduce stress in order to recover from adrenal fatigue. This does not only mean psychological stress, but also physiological stress.
If you just keep doing the same thing, you can't expect it to just get better on its own. It starts with stress, then the tension and suddenly there is burnout or depression. You should keep in mind that the recovery phase from a burn-out takes just as long as the period of time that caused the burn-out. So the earlier you tackle the problem, the better.
As far as stress is concerned, one should analyze what exactly is causing stress in one's own life. Can these sources of stress be eliminated? Or can learn to deal with the pressure better?
For most people, job stress will be the biggest stressor. Reducing this stress does not immediately mean that you have to find another job, although that too can be the last resort when all other options are gone.
But you can first try to find practical solutions that can reduce the work pressure. Maybe you can get reinforcements in your department so that you don't have to worry about fewer tasks yourself. Perhaps you can also take on a different role in the same company, or you not only get responsibility for something, but also the associated opportunities. All of these options should be explored as you work.
Since it is quite difficult to change your surroundings, it is most effective to change yourself. How do you deal with stress yourself? Do you actually divide your time sensibly? Aren't you doing too much at once? You can learn to deal with stress better and to plan your time. There are thousands of books (and websites) to consult about this, so I don't want to go into this any further. And if you still get stuck, you can always call in the help of a psychologist or a trainer.
Always work on your recovery first before going overboard again. Do you want a new car? Then wait for it if you don't need it very much. Such large expenses create extra (unnecessary) stress.
Do you feel burned out? Then this is probably not the ideal time to think about expanding the family. First, make sure your own health is back to normal. Once you have a child to look after, you will have a lot less time for yourself.
Perhaps you also have sources of stress that you cannot turn off. Maybe you have to care for a sick child or a spouse. Of course, you can't just stop with this care, but you can try to seek help. In addition, you can look for ways that will help you deal better with the situation without always completely disregarding yourself.
Above all, one should take a close look at the sources of stress that can certainly be changed. With a few changes in behavior, a great deal can often be achieved in the short term.
Another thing that helps is not to go to bed and get up late and at set times. You should plan for 8 to 10 hours of sleep and adjust your rhythm accordingly. And even if you can't fall asleep straight away, you have at least rested, which helps. Ideally, you get up at sunrise and take a short walk first. The morning light will ensure an improved day-night rhythm and will also make you fall asleep better in the evening.
In your spare time, try to do things that give you energy instead of activities that cost you energy. The things you enjoy doing usually give you energy. For example, you can get mental energy from a walk on the beach, even if it costs you physical energy.
You should also get rid of your bad habits or at least reduce them. If you enjoy indulging in alcohol, you should stop or at least drink less and less often.
The same goes for smoking. Also, keep in mind that quitting smoking is also a source of stress, but it shouldn't be an excuse to stop smoking. However, if you are having trouble quitting, putting it off for a while until you have gotten to grips with other sources of stress in your life can help.
A few more tips: Avoid negative people as much as possible. Do things that you enjoy doing. Pamper yourself a little (with a massage or a visit to the sauna, for example) and seek help in dealing with traumatic experiences.
Create moments of relaxation. Mindfulness, relaxation and meditation exercises help many people. If you are more of the physical type, yoga (source) may be something that suits you better.
Exercise and sport are good, but you shouldn't overdo them, because that means extra stress for the body. You should never exercise for more than 45 minutes at a time if you have adrenal fatigue. You should also not train too intensively and allow yourself enough moments of rest.
Unhealthy diet is a great source of stress for the body. You should stop doing this immediately and start eating healthily instead of stuffing your body with loads of crap. Diet plays an important role in adrenal fatigue and can be easily adjusted. By adjusting your diet, you can get an improvement very quickly.
Adjust diet in case of adrenal fatigue
Basically, if you have adrenal fatigue, just follow the guidelines of a healthy diet. You can then focus on factors that promote recovery. In the following I will list what is important here.
# 1: stop using sugar and artificial sweeteners
Sugar is never good for you, and if you also have adrenal fatigue, it's especially bad.
Avoid all foods that have added sugar and artificial sweeteners. Pay attention to the aliases on the packaging and don't forget that sugar is also used in foods in which you probably would never have expected it. It is often found in sausages, ready-made soups, breakfast cereals and bread rolls, for example.
You can sweeten your food better with the natural sweetener stevia (in moderation) or with raw honey.
Quitting sweets will not be easy if you have adrenal fatigue because the body then literally ’screams’ for sugar. This phase will have to be overcome. The dependence on sugar will then quickly subside.
If you are someone who eats a lot of sweet things, suddenly stopping sweetly will lead to a lot of stress. That is why you should reduce your sugar consumption slowly, over the course of 2 to 3 weeks. Do you often feel like doing something late at night? Then you should get sugar-free snacks at home; e.g. nuts, cheese or a boiled egg.
# 2: stop using caffeine
Yes, you don't like to hear that as a passionate coffee drinker. However, caffeine disrupts the natural sleep cycle, making it difficult for the adrenal glands to regenerate.
If you really can't do without coffee, you should at least limit your consumption to one cup in the morning.
# 3: The right carbohydrates
When you are stressed, you need more carbohydrates. They fill you up (only) temporarily and make you feel good, but in the long run they will cost you more energy. This puts even more stress on the adrenal glands. It is mainly about a certain type of carbohydrate.
The carbohydrates that should be avoided are the refined carbohydrates. They're found in bread, cookies, pastries, bars, and a host of other processed foods. Better to feed your body with unprocessed foods. They have the right type of carbohydrate in them. You can find an overview of good carbohydrates here.
If you have digestive problems and are often tired, you could also try a gluten-free diet. Here you can find out everything about gluten and what consequences it can have on your body.
A low-FODMAP diet (diet with certain carbohydrates) can also be helpful. Here you can read more about a gluten-free and low-FODMAP diet for digestive problems.
# 4: avoid trans fats
Trans fats cause an increase in inflammation levels, insulin resistance, abdominal fat and cholesterol (source, source, source, source), in short: they are a source of stress for the body.
Trans fats are often found in margarine, baking and frying fats, pastries, coffee creamers and ready-to-eat meals. You can recognize them on the packaging by terms such as vegetable fat - partially hydrogenated, hydrogenated fat or hydrogenated fat.
Choose healthy fat such as coconut oil, extra virgin olive oil or ghee.
# 5: Processed foods
Processed foods should be avoided as much as possible and unprocessed foods should be used instead. In a diet designed to promote recovery, there is no place for junk food or ready-made meals that come from factories.
Processed foods usually contain added sugar, refined carbohydrates, flavor enhancers or other E numbers that only unnecessarily burden the body.
# 6: superfood
Certain foods also give the body extra support in case of adrenal fatigue. Even in small quantities, these foods provide the body with many micronutrients, with which they provide extra nourishment. Examples would be:
- Avocado (rich in healthy fatty acids and micronutrients)
- Oily fish like salmon, mackerel, and herring (rich in omega-3 fatty acids)
- Unburned nuts like walnuts and almonds (rich in omega-3s and minerals)
- Seeds like chia seeds and flax seeds (rich in omega-3 and fiber)
- Himalayan salt, it contains less sodium and more other minerals than common table salt. It helps the adrenal glands function.
- Broccoli, cauliflower and Brussels sprouts
- Fermented foods like kefir due to the probiotics in them.
# 7: herbs and supplements
Certain herbs and supplements can also support the adrenal glands:
- B vitamins
- vitamin C
- Vitamin D
- Omega-3 oil capsules
- Rhodiola rosea
- Holy Basil (Tulsi)
- Chinese split basket (Schisandra chinensis)
- Rosemary and lavender oil
The adaptogenic herbs aashwagandha, rhodiola rosea, holy basil and schisandra have been shown to reduce cortisol levels and stress reactions (source, source, source).
Vitamin C minimizes the effects of stress and it shortens the time it takes to recover from stressful events (source).
Even if you don't know exactly why, magnesium supplements are also good if you suffer from adrenal fatigue (source).
Vitamin D is involved in many processes in the body, including the function of the adrenal glands (source). Vitamin D is produced in the skin when exposed to sunlight. But because the sun doesn't always shine and we don't get outside as often as we should, many people suffer from a vitamin D deficiency. You can supplement the vitamin D with vitamin D supplements. The best way to do this is to take vitamin D3 supplements at a dose of 5,000 IU per day.
A vitamin B12 deficiency is also associated with adrenal fatigue (source). Especially if you follow a vegetarian or vegan diet, it is very important to also take vitamin B12 supplements.
A deficiency in vitamin B5 (pantothenic acid) is also often found in people with adrenal fatigue (source). Pantothenic acid is naturally found in meat, eggs, dairy products, whole grains, legumes, fruits and vegetables. You can also take these vitamins in the form of dietary supplements.
Selenium deficiency also affects the function of the adrenal glands (source). It is a trace element that also acts as an antioxidant and is also important for the thyroid. It occurs in meat and fish as well as in plant-based foods, e.g. in cereals and vegetables. In the case of plant-based foods, it is difficult to say how much selenium they contain, because the soil on which the vegetables were grown is crucial. You can therefore also take selenium supplements or a multivitamin preparation that also contains selenium.
When inhaled, lavender oil can lower high levels of cortisol (source, source). Rosemary oil vapors can also help lower cortisol levels (source). However, rosemary oil is not intended for consumption, it would make you vomit.
However, it should not be forgotten that certain herbs can also influence the effects of certain drugs; especially Rhodiola rosea is known for this. Therefore you should ask the pharmacist whether it is safe to use certain herbs when using medication.
While there is no evidence of this, many people still recommend never taking multiple adaptogenic herbs at the same time. You should only take one variety a day and then alternate each day. It is also not recommended to use these herbs if you are pregnant or breastfeeding.
How long is the recovery?
The stronger the adrenal fatigue is and the longer one has suffered from it, the longer it will take to recover. No exact times can be given for this; Every person is different and reacts differently to measures taken (such as a healthy diet and dietary supplements).
Even if I don't like to say it, unfortunately adrenal fatigue doesn't just go away that quickly.
As a guideline, the following can be assumed:
- Half a year to a full year with a slight adrenal fatigue
- One year to one and a half years for moderate adrenal fatigue
- Up to 2 years with severe adrenal fatigue
Explanation of the graphic
This graphic shows the general progression of adrenal fatigue during the recovery phase.
The most important symptom during the crash phase is a lack of energy. At this stage one is not yet aware of adrenal fatigue.
Once you become aware of your adrenal fatigue, you can work on your recovery. Recovery will not be linear back to normal energy levels, but will take place in several steps and cycles.
The more severe the adrenal fatigue, the more cycles you will have to go through. Mild adrenal fatigue can lead to full recovery in just one cycle.
The graphic shows that it is important to work on your recovery immediately and to be aware that you have adrenal fatigue; the recovery process takes much longer than the crash phase.
The 3 phases of each recovery cycle are the stabilization / plateau period, preparation / preparation period and the honeymoon period. This is good to know so that you don't lose heart if you find yourself in a period in which no progress seems to be taking place, although you are doing or not doing the right thing. Then you are sure to be in a plateau period.
During the plateau period, the body builds strength for the next cycle of recovery. During this period you do not notice any improvement in your own condition. This period can last from a few weeks to months.
This plateau period is the 'most dangerous' period because it is easy to lose motivation. Because you don't see any improvement, you don't get any reward for all of your efforts to live more stress-free. With the loss of motivation, you quickly fall back into old behavior and eating patterns, i.e. into a lifestyle that has given you adrenal fatigue.
In the preparation period you can already see slight improvements if you take good care of your body. Small improvements in the hormonal balance are noticeable, but without really very strong improvements in symptoms. This period can last anywhere from one to six weeks.
The preparation period is followed by the honeymoon period. You will then see very clearly that you have more energy and can deal with stress better. The blood pressure will stabilize and you will sleep better. At this stage you make great strides towards recovery. But if you have severe adrenal fatigue, this phase will only last a few days, so you won't get very far in your recovery.
In the case of mild adrenal fatigue, this phase can last up to 12 weeks, so that you can go very far with your recovery. Even during the honeymoon period, it is very important that you continue to eat and live healthily so that your recovery can continue.
You notice that you are recovering from the adrenal fatigue because you have more and more energy and the symptoms slowly but surely decrease and fade into the background. If you really want to measure your recovery, you can use the diagnostic tools that I presented earlier in the article. A frequently used method is to measure cortisol levels from the saliva.
Remember that when you recover from adrenal fatigue, you are still very prone to relapse. If you indulge in too much alcohol for a few evenings, eat poorly and sleep little (e.g. because it is the holidays; Christmas, New Year's Eve or even Carnival), you can destroy an entire recovery cycle and fall back to a lower level.
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