What is adrenal fatigue?

In a permanent state of exhaustion and stress coupled with a foggy head? You could be suffering from adrenal fatigue. I'll explain.


So let’s start with the adrenal glands as they are central to adrenal fatigue. Your adrenal glands are small organs that sit on top of your kidneys. They are in charge of secreting many of your vital hormones: mineralocorticoid like aldosterone to regulate your blood pressure, sex hormones (steroids) like testosterone and DHEA, the anti-ageing hormone, catecholamines like adrenaline, and glucocorticoid like cortisol, your main energy hormone.

In the Paleolithic era a ‘fight or flight’ response, when danger was encountered, was necessary for survival. During such a response, cortisol and adrenaline rise to mobilise you away from the stressor. After the danger has passed, the two hormone levels can get back to normal quite quickly.

Throughout time, however, our bodies have evolved to be constantly in fight-or-flight mode, given everyday life stressors. As you might expect cortisol levels, in a modern scenario, are constantly high.

Constant secretion of cortisol can exhaust your adrenal glands and make your cells resistant to cortisol, which can lead to a long term result in chronic low cortisol levels.

That is when we can talk about adrenal fatigue. Some people, however, stay for years in stage one of adrenal fatigue (high cortisol, constantly wired and overexerting themselves) and it's only when they start feeling less energetic that they realise there may be a problem. Sometimes this is too late and healing may take much longer.

So what is adrenal fatigue?

Cortisol is neither bad or good - it just is. The problem arises when there is an imbalance of cortisol.

In a healthy individual, cortisol reaches its highest in the morning, after waking up and slowly falls as the day passes, to reach its lowest prior to sleep. Melatonin, your sleep hormone, is inversely proportional to cortisol. So when cortisol is high, melatonin is low and vice versa.

Adrenal fatigue happens when there’s an imbalance in this cortisol diurnal rhythm: cortisol is high when it should be low, low when it should be high, or always high or always low. 

There are many patterns, with the most common being very high cortisol throughout the day (people that overdrive themselves and never take a break or do not deal with stress), low cortisol throughout the day and a spike prior to sleep (in people that wake up unrefreshed but have trouble falling asleep), low throughout the day (in adrenal exhaustion, encountered in people that feel tired all the time and it usually happens when they have been pushing themselves too hard for years).

Take the adrenal fatigue quiz to get an insight into whether you're struggling with this condition.

Cup of coffee and open book on bed

What causes adrenal fatigue?

Our modern busy lives, with their many ongoing stressors. Unlike acute stress, for which we’re biologically hardwired, chronic stress turns on the fight-or-flight response without any rest.

Some examples are:

  • emotional/mental stress
  • excessive exercise
  • sleeping less than six to eight hours per day
  • processed diets, refined sugar
  • food intolerance
  • suboptimal digestion
  • dysbiosis (unbalanced microbiome)
  • leaky gut’.
  • toxin overload/suboptimal detoxification
  • autoimmune conditions

Where should you start?

1. Consider having laboratory testing: there are plenty of functional labs that you can ask for a comprehensive adrenal stress profile (saliva or urine test). The results should be interpreted by a qualified practitioner.

2. Adapt nutrition and lifestyle: if you don’t have the budget for an adrenal stress index test right now, you can still start nourishing your adrenals through nutrition, lifestyle changes, and quality supplementation which should always be done with the support of a trained nutrition professional. Feel free to reach out to me via my profile page. 

The views expressed in this article are those of the author. All articles published on Nutritionist Resource are reviewed by our editorial team.

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