ADRENAL FATIGUE
Adrenal Fatigue occurs when the HPA Axis(Hypothalamus Pituitary Adrenal) network dysfunctions due to chronic stress. This stress can be mental/emotional, physical, or even biochemical(food sensitivities/intolerances, parasites, toxins, and/or bacterial or fungal overgrowths). Think of your adrenal health as operating on a spectrum, at one end we have a very healthy well-functioning adrenal gland, and at the other, we have Addison’s Disease where very little cortisol is being produced. Everything less than a healthy well- functioning adrenal gland is classified as one of four phases on this adrenal spectrum.
Phase One: The Alarm Phase: In this phase a stressor has caused your body to have a reaction, and a fight or flight response has been triggered causing your body to be flooded with anti-stress hormones such as cortisol, adrenaline, and norepinephrine. An example of this kind of stressor would be a near miss car accident. This response is normal and appropriate when an acute stressor such as the one mentioned above occurs, then once the stress is resolved,(you realize the accident was only a near miss and not the real thing) the hormones return to pre-stress levels. However, if the stressor is prolonged, such as constant stress at work, or struggles with children or spouses, this stage becomes chronic, and you may notice you need caffeine or energy drinks just to stay focused and on task.
Phase Two: The Resistance Phase: In this phase your stressor(s) have become chronic, and the adrenal glands, due to near constant demand, are no longer producing enough cortisol to meet your needs. You may now rely on caffeine to get you through your day. Fatigue begins to set in and it affects daily activities. You may notice irritability, anxiety, more frequent infections(colds/flu) and your sleep patterns may be disturbed or you may wake from a full night’s sleep still not feeling rested.
Phase Three: Adrenal Exhaustion: In this phase there is a significant drop in cortisol production, however, your body is still trying to cope with the ever present stressor(s). During this phase, the body will start to experience crashes. There will be periods of highs and lows throughout the day, times when you are productive and times when you simply can’t do anymore. Even if you try to rest, you may find it takes longer and longer to “get a second wind” to complete tasks. Motivation is scarce and fatigue dominates your life. This is your body’s way of trying to slow things down, and everything from your digestion to your libido will be affected. You may notice increased digestive symptoms starting to develop or worsen and constipation may occur more frequently. You may start to experience muscle and joint pain, thyroid dysfunction, hormonal changes, low blood pressure, hair loss, circulation issues(cold hands and feet) IBS, skin issues, brain fog, cravings, and/or heart palpitations.
Phase Four: Burnout: This phase is rare and occurs when patients are nearing the other end of the adrenal spectrum heading towards Addison’s Disease. Immediate medical intervention is required. Fortunately, most patients seek help before reaching this stage of adrenal fatigue.
If a patient were to present to conventional medicine with any of the above symptoms that commonly occur with adrenal fatigue, depending upon that doctor’s specialty, you would be treated very differently. For example: if you complained of fatigue to your primary care, they may only test the thyroid and prescribe thyroid medication. An endocrinologist may run lab tests to check for hormonal imbalances and if an imbalance is found, the patient would be put on hormone replacement therapy. While it would be true that both of these conditions are contributing to this patient’s symptoms, they may not be the root cause. Conventional medicine will rarely, if ever, test or address a patient’s adrenals. Functional Medicine, because it always looks for root cause, will run comprehensive testing to determine all of the contributing factors of a patient’s symptoms and devise an individualized plan to address the imbalances found.