Do you have ongoing fatigue, no matter how much you sleep or nap? Are you tired on waking, or experiencing brain fog when trying to concentrate? Do you feel dizzy if you stand up suddenly (orthostatic hypotension)? You may be in an adrenal fatigue state.
Given the long-term high stress levels so common in modern life, it’s no surprise that many people’s adrenal glands become tired and depleted. Anything overtaxed for too long will decline sooner or later!
Adrenal fatigue can lead to disruptions in the balance of other hormones by disrupting the HPA axis (hypothalamus-pituitary-adrenal axis), which coordinates so many of our hormone systems. HPA dysfunction can contribute to fertility issues, make perimenopause a rocky transition, and is a major contributor to metabolic syndrome, with chronically high blood sugar, high insulin and increased belly fat.
We often see worsening PMS, more headaches, more allergies, getting sick more frequently, and slower recovery in our patients with adrenal fatigue.
The Cortisol Curve:
Our daily cortisol production has a circadian rhythm, often referred to as the “cortisol curve”.
Secretion of cortisol should be low throughout the night when we sleep. It starts to rise a bit before we wake up, in fact it’s the main thing that wakes us. Cortisol keeps rising for a short time after waking, to the peak level it’s going to be all day. Then it gradually declines throughout the day, before making a small reprise in the evening before bed. At least that’s how it should go if your adrenals are doing well. It is believed that shift workers, despite trying to sleep during the day, are always fighting against this natural rhythm, and are more likely to suffer from adrenal fatigue.
That rise in cortisol in the morning is called the cortisol awakening response (CAR). When our adrenals are worn down, that rise is often blunted. You may feel unrested and unable to get your day started. Long term stress skews the cortisol curve, and a flatter curve correlates with worse health.
Evening exercise fights against the natural cortisol awakening response - don’t go to the gym in the evening if you are adrenally fatigued. The body is better primed for exercise in the morning. Exercise gently: think a walk in the woods, or stretching yoga, not noisy intense gym workouts with instructors yelling at you to do more.
How Can I Restore My Adrenal System?
The adrenal system thrives on regularity, routine and consistency in times to eat, work, exercise and sleep. A regular schedule for these things should be a priority for anyone trying to restore their adrenal system.
If you feel sluggish in the morning, 5-10 minutes of sunlight outdoors after rising can help to reset CAR and be helpful in restoring a good circadian rhythm.
Taking vacations, or at least getting time off from work when you can completely disconnect, is very restorative.
Do a stress assessment of your life: what tasks, responsibilities, people and situations are sources of stress for you? Dump as many of these stressors as you can! Sometimes we must learn to say “No”.
Plan for more fun! Think of things you loved to do in the past but have not pursued because life got in the way. Playing a musical instrument, participating in a game or sport, or drawing and painting can all bring more joy to life. There’s a reason adult colouring books are so popular!
Rest is critical but often not sufficient: you may want to see an ND for a personalized protocol that suits you.
To help restore the adrenals, most people can safely take some simple supplements:
Vitamin C: the adrenal glands have a high need for this nutrient, more than almost any other tissue in the body
Vitamin B5, also called pantothenic acid
The herb licorice is a great adrenal restorative. Be aware it can raise blood pressure and is not indicated for people with hypertension
Tulsi tea is gentle and calming for almost everyone, as is Linden flower tea, often recommended for children
Is There a Test for Adrenal Function?
If you want to get tested for adrenal function, you have several options. In-office naturopathic urine testing can quantify adrenal function, as a good starting point. Your naturopathic doctor can perform a physical test for orthostatic hypotension: this is a drop in blood pressure when going from lying down to standing up. Because cortisol has a particular circadian secretion, a more advanced 4-point urine test can show where your peaks and dips of cortisol occur through the day, which gives us clues as to what might be triggering these ups and downs.
A resource we have often recommended over the years is a book by Canadian doctor and author Gabor Mate: When the Body Says No. This book explores our physical and emotional response to stress, and provides easy self-assessments and tools for anyone experiencing constant stress.
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