Adrenal Fatigue: When You’re Tired of Being Tired

GASed: Tired of Being Tired

An MD friend of mine (yes ND and MD can be friends!) asked me what adrenal fatigue is. This is not something that is part of the conventional medical speak, and so, when a patient walks into an MD’s office and says, “My naturopath says I have adrenal fatigue”, they scratch their heads and wonder what in the world is their ND talking about. Not because they don’t believe it doesn’t exist, just because they have not heard of it. So, patients, here is what you can tell your docs when they look at you with a puzzled stare.

The way I discuss adrenal fatigue is by looking at Hans Selye’s General Adaptation Syndrome (GAS) Model. Here it is:

1: Alarm: Upon perceiving a stressor, the body reacts with a “fight-or-flight” response and the sympathetic nervous system is stimulated as the body’s resources are mobilized to meet the threat or danger. Cortisol goes up to allow you to enter into the fight or flight mode.

2: Resistance: The body resists and compensates as the parasympathetic nervous system attempts to return many physiological functions to normal levels while body focuses resources against the stressor and remains on alert. Increase in cortisol if often noted here.

3: Exhaustion: If the stressor or stressors continue beyond the body’s capacity, the resources become exhausted and the body is susceptible to disease. Low cortisol output.

Now here is the catch: In this day and age, our stressors are not shorted lived. We have work stress, family stress, disease stress (yes chronic disease is a stressor), financial stress, stress, stress, stress. Our bodies can only sustain fight or flight for so long before functionally it gives up the ghost.

Symptoms of adrenal fatigue are, you guessed it, fatigue! Also memory loss, lack of concentration, excess sleep or poor sleep (light sleep or insomnia), sensitivity to noise, light and difficulty responding to any minute stressor.

There are tests that can be done to assess adrenal fatigue and certainly ways to fix it.

You can do a simple orthostatic blood pressure check:

From sitting or lying to standing. If the blood pressure drops instead of rises on arising, it is called postural hypotension. Low blood pressure symptoms include dizziness and light-headedness. In Adrenal Fatigue, low blood pressure usually occurs at rest. It is generally prominent when there is postural change.

Salivary cortisol

Salivary cortisol measures 4 points of cortisol in the day, giving a picture of how you are doing throughout the day. Saliva is a very convenient and effective way to measure cortisol levels because, unlike a blood draw, there is generally no anticipatory increase in cortisol levels. The reference ranges are also tighter than blood and give a better picture of what is going on.

Changes to address adrenal fatigue are numerous and varied depending on your health history and your symptoms. Typically, lifestyle interventions are recommended including yoga, tai chi, behavioural therapy, engaging in a balance between work and home life, etc. There are many herbals to choose from to support the physiological processes as well. These are generally best guided by your health care practitioner. Picking the right one out of dozens takes a little finessing.

All in all, I do believe that adrenal fatigue exists, at least in the naturopathic world! It does go by other names too, including “burn out” and “major stress”. It’s often also misdiagnosed as depression.

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