Adrenal Gland Function & Fatigue

While doing the google search rounds to figure out what’s causing your body to be sore all the time and why you can’t fall asleep at night, you stumble upon an article that brings up “Adrenal Fatigue”. What is this, and why is it so hard to find substantial information about it? This is a rather controversial term that has been used for quite some time in herbalist, naturopathic and integrative health communities, though it is more readily being spotted in mainstream media these days. 

Before unpacking the concept of adrenal fatigue, we have to make sure we have a good understanding of the adrenal glands and how they work. The adrenal glands are two small glands that are part of the endocrine system, and there is one located above each kidney. They produce a number of hormones that are essential to our everyday function, including aldosterone, epinephrine, and the steroid we’re going to focus on – cortisol.

Cortisol is the main stress hormone present in our bodies. When we experience something stressful, our brain sends a signal to the pituitary gland that gets relayed to the adrenal gland, which in turn produces cortisol that is released into the bloodstream to circulate. This pathway is known as the hypothalamic-pituitary-adrenal axis, or HPA axis. The cortisol that is excreted is a sign to the rest of our body that we’re in trouble, and it initiates several physiological changes that prepare the body to deal with that stressful event. You’ve probably heard this referred to as the “fight or flight” response. 

The fight or flight response is integral in life-or-death situations. This was especially useful to our ancestors – maybe a predator was encountered while hunting for food and that terrified hunter needed a burst of energy to either fight it off or run to safety. Interestingly, our bodies respond in a similar way to perceived threats (i.e. preparing for a public speech). Giving a presentation isn’t going to be the death of us, but It’s all the same to our hypothalamus. This presents some issues, as unlike our neanderthal predecessors that only ran into a bear every once and a while, many of us are surrounded by stressful situations daily, and our bodies weren’t designed to be in the fight or flight response for extended periods of time.

This is where the idea of “adrenal fatigue” comes in. Coined by chiropractor James Wilson in 1998, the theory is that when the adrenal system is overworked due to excessive/chronic stress, it stops functioning properly and causes an over- or under- release of cortisol. The symptoms typically include brain fog, general fatigue, issues with falling asleep and waking up in the morning, anxiety, depression, digestive issues, body aches, hair loss etc. It is generally treated by holistic health practitioners with adjustments to lifestyle and diet, cutting out alcohol and other drugs, and herbal supplementation.

Allopathic medicine takes issue with using adrenal fatigue as a diagnosis, as the symptoms are vague and far-reaching. Western practitioners claim that a lot of these symptoms can be caused by a number of conditions, which can in turn lead to the misdiagnosis of a patient. Additionally, there hasn’t been any formal research conducted that verifies that the adrenal gland starts malfunctioning when overused. The closest recognized disease to adrenal fatigue is Addison’s Disease, or primary adrenal sufficiency. That being said, there are many studies that show the correlation between prolonged/excess cortisol levels in the bloodstream and a number of the symptoms associated with adrenal fatigue. Other conditions associated with cortisol dysregulation include osteoporosis and increased risk of stroke, heart disease and even Alzheimer’s and dementia.

Whether you want to call it adrenal fatigue, cortisol dysregulation or just straight up being too stressed out, it’s important to recognize the potential damage that our bodies are subject to with our busy lifestyles. Eating healthy foods, taking time for self-care, stepping back when you have to, meditation and herbal supplementation some of the ways to counteract excess cortisol release. Adaptogenic herbs such as tulsi holy basil, ashwagandha, eleuthero and most medicinal mushrooms are well known for their protective action on the adrenal system.