Adrenal fatigue is a term often used to describe a range of symptoms related to the malfunctioning of the adrenal glands due to chronic stress. While this concept remains controversial within the medical community, many people experience symptoms such as exhaustion, insomnia, and a lowered tolerance for stress, which proponents of the theory attribute to overworked adrenal glands. This article aims to provide a comprehensive understanding of what adrenal fatigue is, its potential causes, symptoms, and how natural remedies can assist in managing it. By exploring the adrenal glands' role in the body and the impact of chronic stress, this article will shed light on how individuals can work towards regaining hormonal balance and well-being.

What and Where are the Adrenals?

The adrenal glands are small, triangular-shaped glands that sit atop each kidney. Despite their size, they play a vital role in producing hormones that regulate metabolism, the immune response, and stress reactions. Each adrenal gland is composed of two distinct parts: the outer Adrenal Cortex and the inner Adrenal Medulla, both of which have unique functions.

The Adrenal Medulla: Stress and the Fight-or-Flight Response

The adrenal medulla is responsible for producing two critical hormones: adrenaline (epinephrine) and norepinephrine, both of which are essential for the body's "fight-or-flight" response.

• Adrenaline (Epinephrine): Released in response to stress, adrenaline prepares the body for quick action. It increases heart rate, dilates airways, and mobilizes energy from stored glucose.
• Norepinephrine: This hormone works in tandem with adrenaline to raise blood pressure, enhance focus, and sharpen the body's response to stress.

Together, these hormones enable the body to cope with immediate threats by boosting physical and mental performance. However, chronic mental stress can overstimulate this system, leading to imbalances.

• Adrenaline (Epinephrine):
  • Adrenaline is released in response to stress, fear, or excitement. It's often referred to as the "emergency hormone" because it prepares the body for quick action in potentially dangerous situations.
  • Adrenaline increases heart rate, dilates the airways in the lungs to enhance oxygen intake, and redirects blood flow to the muscles and brain, all of which are essential for a rapid response.
  • This hormone helps mobilize energy stores by increasing the breakdown of glycogen (stored glucose) in the liver, providing extra energy for immediate use.
• Norepinephrine:
  • Norepinephrine is similar to adrenaline and is often released alongside it in response to stress.
  • It also contributes to the "fight or flight" response by increasing heart rate, constricting blood vessels to raise blood pressure, and redirecting blood flow to vital organs.
  • Norepinephrine plays a role in maintaining alertness and focus during stressful situations.

Fight or Flight

The complete adrenal system is closely tied to what we refer to as the "fight or flight" response, serving its purpose of enabling the body to acclimate to a state of stress.

Originally intended for short-term scenarios, this system was designed for immediate responses rather than prolonged use. However, we often find ourselves dealing with extended periods of persistent mental stress.

Our bodies were designed to take more physical stress over mental.

• Our bodies need more blood flow to certain muscles
• More heightened energy in your brain to be able to focus in on certain things.
• Be able to solve certain problems relating to surivve
• quick energy (glucose energey)
• You don't need energy to certain body systems like reproductive organs, immune system, or digestion.

These hormones go through almost every cell in the body and start to change certain things to adapt the body to prepare for this stress situation.

What is the significance of that?

If you are under chronic mental stress or you have major losses in your life (or surgeries and/or trauma)

Note: These stresses above acumulate over time and creates situations where the adrenals become disfunctional to a certain degree. While this isn't necessarily a disease it's more a sub-clinical issue of the adrenal.

At first you have a higher level of these hormones, and then overtime you start developing cortisol resistance just like insulin resistance where now the cortisol doesn't work but you have high levels of cortisol and symptoms of low cortisol.

The Adrenal Cortex: Hormones That Maintain Balance

The adrenal cortex produces three major types of hormones:

Androgens: These are sex hormones, including dehydroepiandrosterone (DHEA), that contribute to overall hormone balance. Although primary sex hormone production occurs in the gonads, the adrenal glands produce supplemental amounts.

Glucocorticoids (e.g., Cortisol): Known as the "stress hormone," cortisol regulates metabolism, immune response, and blood sugar levels. Under prolonged stress, high levels of cortisol can lead to "cortisol resistance," where the body becomes less responsive to cortisol despite its elevated levels.

Mineralocorticoids (e.g., Aldosterone): This hormone helps regulate electrolyte balance and blood pressure. Dysregulation of aldosterone can result in imbalances of sodium and potassium, further complicating stress responses.

Glucocorticoids (Sugar hormones):

• The primary glucocorticoid produced by the adrenal glands is cortisol, which is often referred to as the "stress hormone."
• Cortisol plays a key role in regulating metabolism, immune response, and blood sugar levels.
• It helps the body respond to stress by increasing glucose production, which provides energy to deal with stressors.

Mineralocorticoids (Salt hormones):

• The main mineralocorticoid produced by the adrenal glands is aldosterone.
• Aldosterone plays a vital role in regulating the balance of electrolytes (sodium and potassium) and fluid levels in the body.
• It helps control blood pressure and the balance of water and salt in the body.

Androgens (Sex hormones):

• The adrenal glands also produce a small amount of sex hormones, including androgens (male sex hormones) like dehydroepiandrosterone (DHEA).
• While the primary production of sex hormones occurs in the gonads (testes in males, ovaries in females), the adrenal glands contribute to the overall hormone balance.

Adrenal Body Type

With an adrenal body type, you become more active at night, especially around 2am where you wake up and you're thinking about problems etc... Climbing up stairs will cause breathlessness and you may crave salty food.

There are 4 different phases of sleep that a person can go through:

• Deep sleep (delta wave)
• REM (superficial)

The purpose of sleep is to get rid of alot of toxins in the brain, and metabolites that are generated throughout the day. You're also getting a rejuvenation of neurotransmitters.

• Sleep is required for the recovery of stress yet stress inhibits sleep

Cortisol messes up the adrenal circadian wave because everything is backwards with the adrenals. The lower point of cortisol is normally around 2am and the highest point is at 8am in the morning. So with adrenal failure, you'll see it's just the opposite. You're very awake at 2am but want to sleep at 8am.

The Concept of Adrenal Fatigue

Adrenal fatigue theorists suggest that prolonged stress causes the adrenal glands to become "fatigued," resulting in suboptimal hormone production, particularly cortisol. This concept is not widely accepted in mainstream medicine due to a lack of conclusive evidence, but the symptoms it describes—chronic exhaustion, mental fog, and lowered stress tolerance—are very real for many.

Those experiencing adrenal fatigue may initially produce excessive cortisol, which over time leads to a kind of "cortisol resistance," similar to insulin resistance in diabetes. This means the body stops responding effectively to cortisol, even though its levels remain high.

Potential Symptoms of Adrenal Fatigue

1. Tolerance for stress is lowered - they can't tolerate babysitting a room full of children at a daycare center for more than 8 hours. They can't tolerate a slow driver infront of them for a period of 2.5 hours. Can't tolerate incompetent people. Unless you're in an environment where everything is logical and purposeful, you get impatient and irritable.
   
2. Excessive thinking and analysis of things (especially when you're trying to sleep)
   
3. Excessive sugar generation as an energy source for the adrenals: The adrenal hormone cortisole is also known as "glucocorticoids" - you actually turn protein into glucose, so you're running your body on gluose. Your adrenals cause your liver to make more sugar to run on sugar fuel because it's "quick energy". The problem is that stress = sugar and even though you're not eating sugar, you're getting a lot of sugar in the bloodstream and that can cause blood-sugar problems and even diabetes.
   • All that sugar is being converted into cholesterol (not the friendly type), conversion of fat in the liver. Fat in the visceral organs (storing fat is a survival mechanism)
   • Reference: CIBA collection of medical illustrations volume 4 endocrine system
     
4. Hyperacitity (Gastritis): Can experience ulcers from stress. Stress activates acidity which then burns a hole right through your stomach.
   
5. Blood pressure increase
   
6. increase in heart rate
   
7. Symptoms of Asthma
   
8. Increase in inflammation - Inflammation comes from a healing repsonse, trauma, the immune system. The immune system controls inflammation in the body regardless of where it comes from in the body. The unique thing about the adrenal system is that it's shunting energy away from the immune system and this is why the white blood cells is supressed during stress.
   • When you have high levels of stress (increase in cortisol) your immume system becomes suppressed.
   • Very worst case is that this can lead to an auto-immune disease
   • Any condition that involves inflammation, is a condition that involves the adrenal glands
     
9. You lose calcium and potassium - When you start losing potassium, the PH level in your body changes to a more alkaline state. This can effect breathing (e.g. Hypoxia)
   • Loss of potassium = more alkaline state
     
10. Loss of Vitamin D - Cortisol is very similar in function to Vitamin D (they are both anti-inflmmatories) and so any condition that you have that has a problem with cortisol, recommend Vitamin D as a remedy.
    
11. Memory loss and brain fog (you're more awake at 2am then when you are trying to wake up in the mornings)

Testing for Adrenal Fatigue

Testing adrenal function is more complex than a single blood test due to the circadian rhythm of cortisol levels. One common at-home test is Ragland's test, which involves measuring blood pressure while lying down and standing up. A significant drop in systolic blood pressure may indicate adrenal dysfunction.

Another test for adrenal fatigue involves measuring CO2 tolerance by assessing the length of an exhalation after deep breaths. Shorter exhalation times are often linked with adrenal fatigue.

How can someone know when something is wrong in the body in relation to the adrenals?

These hormones travel on the circadian wave. So if you check 1 blood test or saliva test with your cortisol, you're just getting a snapshot of what's happening at that period of time.

The best at-home tests for adrenal fatigue (Ragland's test):

The adrenal glands have no parasympathetic innovation. In other words, the glands have no off switch, only an on switch.

To properly find out you would need to test every 4 hours.

First test is called the Ragland's test - All you need is a blood pressure cuff

• Check your blood pressure laying down while relaxing
  • Systolic is the top number (We are interested in this one): Measures the sympathetic nervous system
  • Diastolic is the bottom number: Measuring the parasympathetic system.
• Then check your blood pressure standing up

When you lie down and then stand up, the top number should go up a certain amount (~6-10 points).

If it goes up more than that or goes down then that normally means there is an adrenal disfunction.:

How does this measure work?

The adrenal glands have no parasympathetic innovation. In other words, the glands have no off switch, only an on switch.

Normally when you lie down and then stand up there is an adrenal adaptation that increases the blood pressure and the pulse rate in order to be able to push the blood into the brain (you may have noticed this before when you stand up very quickly and you feel dizzy - that is because of a failure in the adrenal system to pump the blood pressure up into the brain fast enough).

The second test evaluates your CO2 tolerance:

1. Inhale / exhale 3x (Nose only)
2. 4th inhalation fully fill lungs
3. Measure the time of exhalation:
   • < 20 sec - poor (normally means you have adrenal fatigue)
   • 20-40 sec - average
   • 40-60 sec - intermediate
   • 60-80 sec - advanced

The more exercise and fitness you do get your body in shape, the more you will be able to handle stress.

How to Fix the Adrenal Body Type

Individuals with adrenal fatigue often exhibit specific physical traits and behavioral patterns. For example, they may be more active at night, crave salty foods, and experience breathlessness during simple physical activities like climbing stairs.

The disrupted circadian rhythm, caused by cortisol imbalances, results in peak cortisol levels occurring during the night (when the body should be resting) and low levels in the morning (when energy is needed most).

Suggested Remedies:

1. Stress Management: Reducing mental stress through mindfulness, meditation, and relaxation techniques is vital.
2. Proper Nutrition: Focus on a diet rich in potassium, Vitamin C, sodium from natural sources like sea salt, and Vitamin B1 (found in nutritional yeast).
3. Exercise: Engage in physical activities that promote stress relief, such as walking, aerobic exercise, or high-intensity training.
4. Sleep Hygiene: Prioritize restorative sleep by maintaining a consistent sleep schedule and creating a relaxing bedtime routine.

Best Natural Remedies for Adrenal Fatigue

Nutritional Support:

• Vitamin C: Critical for the production of cortisol and adrenaline. Foods high in Vitamin C include sauerkraut, bell peppers, and leafy greens.
• Potassium: Helps calm the body and regulate electrolyte balance. Potassium-rich foods include avocados, spinach, and bananas.
• Sodium: Adequate sodium levels help support blood pressure regulation and cortisol function. Sea salt is a preferred source.
• Vitamin B1: Important for maintaining nervous system health. Found in foods like unfortified nutritional yeast.

Adaptogenic Herbs:

• Ashwagandha: Known for its ability to reduce stress and support adrenal health, ashwagandha is an adaptogen that may help restore balance to cortisol levels.

Best nutrients for adrenal stress

Vitamin C

Cortisol and adrenaline need Vitamin C as a precursor.
- Sauerkraut (700mg)
- Bellpeppers
- leafy greens
- Lemons / limes / berries

Potassium

Calms things down for you

Sodium

Want to get it from sea salt or salt already in your food:

Electrolyte Balance: Sodium is one of the body's essential electrolytes, and it plays a key role in maintaining proper fluid balance, nerve function, and muscle contractions. Proponents argue that increasing sodium intake may help support electrolyte balance and alleviate some symptoms associated with adrenal fatigue.

Blood Pressure Regulation: Adequate sodium intake is important for regulating blood pressure. Some proponents suggest that individuals with adrenal fatigue may experience low blood pressure, and increasing sodium intake could help normalize it.

Cortisol Regulation: Sodium is believed to influence cortisol levels, a hormone produced by the adrenal glands. Supporters of this approach argue that higher sodium intake may support better cortisol regulation in individuals with supposed adrenal fatigue.

Vitamin B1

One of the most important nutrients for the autonomic nervous system)

- Nutritional yeast