Adrenal Fatigue: The Stress Epidemic

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It is the silent epidemic causing burnout and serious health symptoms, but what exactly is Adrenal Fatigue? Pure Health Hub chats to leading Sydney Naturopath Victoria O’Sullivan.

The term Adrenal Fatigue, coined by naturopath Dr James Wilson in 1998, is an umbrella term used to conceptualise the physiological state of HPA (hypothalamic- pituitary-adrenal) axis dysfunction.

The adrenals are responsible for releasing over 50 hormones, including cortisol, a hormone produced by the adrenals for use in the regulation of blood pressure. Adrenal Fatigue refers to the resulting range of deficiencies that may occur when the adrenal gland isn’t functioning optimally.

An epidemic for the age

Sydney Naturopath Victoria O’Sullivan explains that the adrenal gland releases cortisol and adrenaline, the primary stress hormones associated with stress response. It is an important mechanism which helps to support adaption to environmental challenges, triggering our fright, flight-or-fight reactions. Once a perceived threat has passed, hormone levels return to normal.

“While these hormones were useful in a hunter-gatherer context, the modern world has us feeling that everything is an ‘existential threat’ leading to a maladaptive response.” says O’Sullivan.

While we don’t have to share our neighbourhoods with disgruntled woolly mammoths or snarky saber-toothed tigers like our cave-dwelling ancestors, the hurried and harried way we live, work and socialise is causing chronic mental and physical overwhelm. Ergo, the constant feeling of being under siege from everyday stressors causes the fight-or-flight reaction stays turned on and the prolonged excess overexposure to cortisol means our systems don’t have a chance to resume to their regularly scheduled programming.

The symptoms associated with Adrenal Fatigue

Our bodies are overburdened by pervasive stress and this is contributing to a low production of adrenal hormones. This can leave us with feelings of fatigue, impaired sleep and concentration, and can contribute to systemic inflammation, heart disease, and is a hallmark of many mental health disorders including depression and anxiety. It’s also been associated with immune dysfunction and chronic pain.

O’Sullivan explains that Adrenal Fatigue happens in stages. Initially, the body increases cortisol production in an attempt to meet the increased demand imposed by stressors. In this stage patients often report feeling “wired but tired”. This can lead to them becoming hyper vigilant, experiencing issues with insomnia and depression, and develop an inability to “switch off”. In the second phase, adrenal hormone production is down-regulated by the hypothalamus, leading to subjective feeling of exhaustion. At this stage, cells may become resistant to cortisol leading to state of chronic low-grade inflammation.

Women and Adrenal Fatigue

O’Sullivan suggests says that while prolonged, persistent stress is the most common cause of adrenal gland hypofunction, chronic inflammation, immune system dysregulation and genetic predisposition may also play a role.

Women appear to be more prone to adrenal disorders and there is no conclusive clinical answer as to why, O’Sullivan says that current research suggests that a combination of differences in psychological responses to stress, life circumstances and the biological effects of oestrogen and progesterone on the HPA axis could play a role.

There’s also a connection between post-menopause symptoms and Adrenal Fatigue. “As the ovarian production of oestrogen declines, adrenal hormones are required for the peripheral production of oestrogen through conversion by enzymes such as aromatase. This can make menopausal symptoms such as hot flushes and night sweats worse”, says O’Sullivan.

“Supporting the HPA axis throughout peri menopause can help to mitigate these symptoms. Additionally, HPA dysregulation has been shown to narrow the ‘thermo-neutral zone’, reducing our tolerance to temperature fluctuation. However, the provision of nervous system supporting nutrients such as magnesium B5 & B6 can help to mitigate this”.

A balanced argument

In the interest of balance, it must be said that many medical doctors aren’t on board the adrenal fatigue bandwagon, arguing against it as a diagnostic category. Indeed, many doctors pay little attention to the connection between stress and HPA axis function in patients unless they present with specific manifestations like Addison’s disease, or adrenal insufficiency, a recognised disorder in which the adrenal glands don’t produce enough hormones.

But this doesn’t mean that the symptoms you may be feeling aren’t very real. While it is essential to have a thorough evaluation with a medical doctor to ensure there are no other underlying causes for the symptoms associated with adrenal fatigue, there’s no denying that stress can not only exacerbate a breakdown in psychological, body, and brain function, it can cause it. Consequently, Adrenal Fatigue has become increasingly researched and recognised by practitioners.

What’s the fix?

Naturopaths and complementary medicine practitioners like O’Sullivan are having great success in correcting and reversing the symptoms and conditions related to Adrenal Fatigue. This begins with educating patients on lifestyle interventions that can help reverse the hypothalamic induced down regulation of cortisol production.

Along with ensuring adequate sleep, regulating Blood Sugar levels, reducing the use of stimulants such as caffeine and the implementation of stress management techniques, O’Sullivan also endorses the use of adaptogenic herbs including ginseng, withania and liquorice, as appropriate, along with nutritional support with nutrients such as magnesium, vitamin C, B5 & B3.

Disclaimer: This article provides general information only, and does not constitute health or medical advice. If you have any concerns regarding your health, seek immediate medical attention.