NCEA Level 1: Adrenal fatigue

Counting down the days until you can switch the ‘out of office’ alert on your email and sign off for a couple of weeks? Same here. So many people I’ve talked to recently have been saying how burnt out they feel this year and, maybe it’s that we’ve all got short memories, but it seems so much worse than last year. One conversation in particular got me wondering at what point does ‘dire need of a break’ switch over to full-blown fatigue that won’t be reversed by two weeks in the sun. Before I actually did much reading around the topic I used to roll my eyes when I heard that yet another person was experiencing ‘adrenal fatigue.’ It seemed like an all-too common diagnosis and fashionable, like running skorts. It’s fair to say this speaks to my ignorance in the topic, rather than any research I conducted on what the potential causes were and how to try to stop them at the pass. A year down the track the reading I’ve done suggests that adrenal fatigue could be more common than I thought – certainly our lifestyles lend themselves to a state where we don’t let ourselves recover from the normal hustle and bustle of everyday life. So when does ‘burnt out’ turn into ‘adrenal fatigue’ and what are some of the things you can do to prevent it? I’m not claiming to be an expert in the area – nor is this going to be a comprehensive post that details all of the complexities of adrenal fatigue – but it will at least provide some basic information on what the condition is, and what dietary measures to take to prevent it from happening to you.

A bit of anatomy: your adrenal glands sit atop of your kidneys and produce hormones that are responsible for reacting to stressful situations in everyday life.  The glands are connected to the hypothalamus and the pituatary glands (collectively known as the HPA axis) and the hypothalamus is the ‘stress centre’; when the body recognises stress, the hypothalamus responds by releasing a hormone called corticotrophin-releasing hormone, which travels to the pituatary gland and stimulates the release of another hormone (adrenal corticotrophin hormone – ACTH) which goes through the blood to the adrenal cortex and stimulates the release of cortisol. Cortisol is one of three hormones the body produces in relation to stress – other hormones are norepinephrine, and Dehydroepiandrosterone (DHEA).

Norepinephrine (or adrenaline) is your ‘flight or fight’ hormone, and is released in response to a perception of threat. Its effects in the body (to sharpen the brain, make your heart pump blood to the muscles faster, increase blood pressure and pain tolerance) were necessary when we went in to battle. Nowadays, though, the battles we fight (peak hour traffic, work deadlines, an unexpectedly large bill) are not the same as they once were – obviously – though your body doesn’t make the distinction between the different types of threats; it recognises these as stress and responds accordingly. Over time these everyday occurrences can build up and suddenly your body’s ability to produce adrenaline is diminshed – leaving you in a position where there is too little adrenaline when you actually need it.

Cortisol is released as a back up to adrenaline to respond to stress. It helps with increasing appetite, releasing stored energy to be used when required (by dumping glucose into your blood stream, ready for quick utilisation), and helps reduce the effects of infection or inflammation on your body’s immune system. However, it’s not designed to cope with stress that is chronic, and therefore constantly high levels of cortisol can have adverse effects on musculoskeletal system (muscle and bone loss), can lead to kidney damage, spiking blood sugar levels (therefore stimulating unwanted insulin release and resulting in roller coaster energy levels) and increased vulnerability to bacteria and viruses through its immunosuppressant activity. The presence of cortisol in the body is proportional to the amount of DHEA. DHEA is the precursor to sex hormones (testosterone and oestrogen) and works much in the same way as adrenaline does– but also guards against the detrimental affects of chronically high cortisol levels.

Under ‘normal’ conditions, your ability to respond to stress is taken care of by these three hormones. However, under periods of prolonged stress, the adrenal glands become exhausted by constantly producing adrenaline, and (as the back ups) cortisol and DHEA. Over time the ability to produce the hormones is compromised, with levels of DHEA being the first hormone to be reduced. This leads to fluctuations in the levels of cortisol and adrenaline being produced, and over time, adrenal fatigue; a diminished ability to produce the hormones. Severe cases can result in very low levels of cortisol being produced.

How can you tell if you are just stressed and tired, or if you are actually suffering from adrenal fatigue? Short of a diagnosis from a qualified practitioner (which is fairly non-invasive, requiring repeated measures of salivary cortisol throughout the day), symptoms of adrenal fatigue can look like any number of health issues:

  • Inability to wake up and feel on task until mid-morning;
  • Physical fatigue;
  • Afternoon lull between around 2-4pm
  • Mood disorders (in part due to blood sugar crashes);
  • Inability to concentrate;
  • Insomnia (though exhausted) and waking frequently throughout the night;
  • Loss of libido;
  • Memory loss;
  • Weight gain;
  • Thinning of hair;
  • Mild depression;
  • Increased allergies or asthma symptoms (as there isn’t enough cortisol to suppress the immune system anymore);
  • Hypotension (low blood pressure) and dizziness if you stand quickly from sitting;
  • Craving for salt (as the adrenal glands require sodium for functioning properly)

So you can see that many of these symptoms are also related to a number of other health conditions, and while you may experience a number of these, it doesn’t necessarily mean you have adrenal fatigue. Regardless, the dietary strategies below could help prevent any stress hormone imbalance  from turning  full-blown adrenal fatigue.

Start with a paleo-approach to diet. unsurprisingly, a whole food diet that is comprised of minimally processed foods, rich in nutrients from vegetables, meat, nuts, fruit and starchy carbohydrates, eating all macronutrients at each meal will help provide stable blood sugars and prevent blood sugar crashes. As cortisol releases stored carbohydrate (CHO) into the bloodstream and there isn’t enough cortisol in the system, this will help balance energy levels.

Don’t go too low on the CHO. It’s likely that you’ll naturally lower your CHO by making a change toward real food but you don’t want to go too low in a misguided belief that the lower the better. This can stress your system more as a low CHO diet will increase cortisol production. You are better to try and eat balanced amounts throughout the day along with fat and protein to maintain blood glucose levels – so try and keep it above 100g CHO per day (if not 150g per day). But again, this is individual and depends on your level of intake now.

Vitamin C: This is stored in our adrenal glands and could be important for functioning – indeed it is thought the Inuit used to eat adrenal glands to prevent scurvy (a disease that occurs through vitamin c deficiency).

Magnesium: this helps stimulate the release of ACTH which is required for cortisol production. I would typically recommend magnesium for anyone under times of stress and a powder form that is in a chelate (combined) with an amino acid to help the body absorb it.

Vit B6: This B vitamin is important for the production of cortisol so supplementing with a good quality B complex vitamin is warranted.

Probiotics: encourage growth of good bacteria (such as fermented foods – sauerkraut, kefir, yoghurt with acidophilus bifidus) which positively influences the HPA axis, and is important in overall health and gut bacteria.

These are recommendations that could be some good initial steps to addressing fatigue and burn out. However if you are already doing these things, or if these make little difference to how you feel, then seeing a practitioner such as a naturopath who is qualified to make some more specific recommendations with regards to adrenal fatigue and supplements is warranted. Friends of mine recommend Adrenalfatigue.co.nz a go-to website for in-depth information on treatment.

On a final note though, all the dietary manipulations and supplements in the world will not help if the underlying reasons for the adrenal burnout in the first place aren’t addressed.

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