Adrenal Fatigue: Signs, Testing & Treatment
Do you roll out of bed and put your feet on the floor feeling as if you took a full box of sleeping pills mixed with alcohol last night? You walk around in the morning feeling as if you need a gallon of coffee and a jumpstart from Scarface’s personal stash just to feel ‘normal’? Do you feel as if you are constantly overwhelmed, have trouble falling or staying asleep? Do you feel unusually cranky, emotional or frustrated? Are you lethargic most of the day or does it take a long time to recover from being sick?
If you happened to answer yes to any of these questions, then you might just be a likely candidate to be suffering from adrenal fatigue, an extremely controversial subject that will have more than person up in a bunch. It’s widely ignored by many in the field of strength and conditioning, but it is a very real condition that definitely requires your attention, especially if you found yourself answering yes to most of the above.
Many of us describe our lives as busier by the day, eating less clean, getting less sleep and living under the constant state of stress, so it’s no surprise how common this condition really is. While it may not seem like something that requires your immediate attention, if you have efficient adrenal glands by addressing this situation or better yet taking the steps to preventing it, you can set the ship straight and be back on your way to your ideal physical level.
Defining the Beast
Adrenal fatigue may seem pretty simple by some definitions: Fatigue of the Adrenal Glands. However, we need to look a little deeper than that. It in reality is a collection of symptoms that occur when your level of stress from a combination of physical, emotional, mental or all the above put your body in a state of being overwhelmed and reduces the ability to compensate efficiently for that stress. When threatened, we have what is known as the ‘fight or flight’ response that causes a release in adrenaline to ‘prepare for battle’. This is triggered by a release of hormones, just like many procedures in the body.
By design, this is a fantastic mechanism that allows your body to handle this stress quite well, however only if it is acute and short lived. This was an ideal system indeed for our ancestors who would be faced with many daily ‘survival’ situations of stress such as protecting themselves from a threatening creature while out hunting. These days, hunting has been replaced by the nagging of your boss, finding a bag of weed in your teenager’s room or an unrecognized dude chatting up your woman at the bar. Face it, it’s not just about an occasional ‘fight or flight’, were surrounded by stress and what was once a crucial survival mechanism is now working against us. These frequent, sometimes chronic stresses that never quite dissipate are what lead to our adrenal fatigue syndrome.
The first hormone released is epinephrine. This causes increased blood pressure, respiration rate, increased glucose, and the dilation of the pupils. All of these mechanisms are triggered for the sole purpose of getting you out of a potential life-threatening situation, all via an automated reaction from your brain.
Simultaneously, your body is releasing a hormone called Corticotrophin Releasing Hormone, also known as CRH for short. This causes another chain reaction causing the pituitary gland to release a hormone called adrenocorticotropic hormone (ACTH) that signals your body to produce the hormone cortisol.
Now, unlike the rapid signal of epinephrine release, the cortisol release will be much slower as the hormone had to travel to the bloodstream, with the primary purpose of increasing blood glucose to provide fuel for your muscles and brain during the ‘fight or flight’ situation. Having this hormone released frequently is problematic as it can lead to a number of issues such as a suppression of pituitary function and translate to low testosterone levels. Cause and effect at its finest, huh?
Finally, there is a third hormone released from the adrenal glands called aldosterone that chiefly regulates the sodium and potassium levels in the body. If this particular hormone is out of whack in terms of normal levels, you will surely notice when training.
Now, that we understand what is going on in the body during the ‘fight or flight’ process, we can examine what is commonly believed to be the progression for adrenal fatigue.
1. The body senses that it is undergoing a stressful situation, and unfortunately how major or minor it is, will elicit a reaction, meaning the aforementioned hormone release. This repeated over and over again in non-life-threatening situations like many undergo today, is the main issue at hand.
2. If the stressful situations are prolonged, the adrenal glands will start to be part of ‘fatigued’ state, and use other hormones to help produce cortisol of all things. The levels of actual cortisol at this point are really irrelevant it seems as they may be already high or normal at this point, combined with the possibility of low DHEA levels. Both of these scenarios can lead to a negative impact on testosterone levels.
3. The final part of this fatigue process is known as the state of having low adrenal function along with low cortisol and/or DHEA levels, with the situation being broadly described as ‘adrenal fatigue’.
Above is the traditional model and is contested by some as the ‘old school’ method, but that is a completely different article we’re talking about with that discussion. For now, we will stick with the key points of the new findings. It has been found that individuals can completely skip the first two phases and go directly to the exhaustion phase or have low cortisol. It has also been observed that you can go from low directly to high cortisol or even suffer from high cortisol their entire lives. We must not just rely on the understanding of the above fight or flight rationale, but also incorporate the connections between our brain, immune and endocrine system as a whole.
What’s the big deal about cortisol anyway?
Cortisol is a catabolic hormone, that often gets a very negative wrap for the most part, and it certainly isn’t going away any time soon. With products aimed to lower/control cortisol in an effort to lose fat as well as prevent muscle breakdown, it certainly an important factor to consider, but at the same time, it is important to understand why it matters.
Having your cortisol levels too high can be problematic in regards to getting the most payback from your efforts at the gym. It has the possibility of suppressing the TSH hormone, decreased conversion of T4 to T3, increasing the production of T3 to rT3 and decreased cellular thyroid binding. In a simpler version of this, it can make you store body fat among a host of other negative aspects. Along with the decrease in thyroid hormone efficiency, it can increase your blood glucose levels, suppress pituitary function by lowering luteinizing hormone and testosterone, decrease liver detoxification rates, decrease your immune system function and finally, insomnia.
On the other hand, you can have issues if your cortisol levels are functioning at too low of a level. If they’re too low, you can have negative impacts such as suppression of the immune system, hypoglycemic tendencies resulting in blood sugar and insulin spikes as well as an increased tendency for inflammation.
Diagnostic For the Medically Inclined (Or Lack Thereof)
Adrenal fatigue is often known as low-functioning adrenal glands or simply hypoadrenia (hypo meaning low. The most discouraging part of this whole ordeal is having a diagnosis from your doctor to determine whether or not you are suffering from the disease, and chances are, they will most likely make a determination from your cortisol readings, typically between 20 to 60. If they happen to measure it and it appears anywhere below the 20 mark, they will diagnose you with Addison’s disease (too low cortisol), and if is anywhere above that 60 mark, they will diagnose you with Cushing’s syndrome (too high cortisol).
Now most will sit back and be satisfied that there is a defined ‘range’ for cortisol to be at, but you shouldn’t stop there. Just because you are above the minimum mark of 20, it doesn’t mean that you aren’t suffering from adrenal fatigue. Many doctors will just say you are ‘normal’, so I urge you to press a little further should the need arise. You may need to consult an endocrinologist even, as your typical doctor might not be trained in diagnosing such a condition.
Now, not everyone will be going to a doctor to get a diagnosis of their suspected adrenal fatigue, but if you do, there is actually quite an array of various options that they might use to diagnose the syndrome and they might even tell you to perform some of these tests at home.
1. Saliva Testing: This is strongly advocated by many of the top experts in the field of endocrinology as the hormone levels in saliva are more reflective of hormone levels within cells, on top of being easy to administer since it requires a quick saliva sample.
2. Blood Tests: Blood testing is another common method for evaluation of the possibility of adrenal fatigue. However, many will question or discount the results of this testing type since it only evaluates the levels that are circulating in the blood, and not in the cells or tissue.
3. Hair Mineral Testing: This is a method that some alternative medicine doctors will utilize and it includes looking at the various minerals such as magnesium, potassium and sodium in the hair.
4. Ragland Test: This is one of the simplest tests that there is, and you can do it at home if you have a blood pressure cuffs. Just lie down for about 5 minutes and then measure your blood pressure. Get up and then retest it. If you see that it has dropped, it’s a telltale sign of adrenal fatigue as normally, it would stay the same.
5. Iris Contraction: This is one of the easiest tests to date and of course has its own set of flaws, but nearly anyone can do this. Simple have someone shine a light across your eyes and watch your pupil’s dilation. If it stays contracted for a prolonged period or alternately contract/dilate when it is dilating again, it’s a sign that you have adrenal fatigue.
What Can I Do to Fix It?
Fix Your Diet
What to Eat
The most important factor to alter when you are dealing with adrenal fatigue is your diet, starting with addressing times that you go a long time without eating as it can start with a perpetual cycle of adrenal fatigue inducing stress.
By controlling your diet better, you’ll help keep your blood sugar at adequate levels and meet you energy demands of your everyday life and training. Those suffering from adrenal fatigue have difficulties producing enough cortisol, making it harder for them to maintain their normal blood sugar ranges, and thus resulting in many suffering from adrenal fatigue to have hypoglycemia. One of the quickest fix is to make sure you aren’t skipping breakfast because your cortisol levels usually rise between 6 AM and 8 AM, peaking around the 8 AM mark for most.
By letting them rise uncontrolled, you’ll kill your appetite and lose your chance to begin resupplying your glycogen if you aren’t eating by 10 AM. Also, I recommend eating an early lunch, a mid-afternoon meal around 3 PM, a clean dinner and then a pre-bed meal. Yes, I know that as soon as I post this, someone is going to jump up and contest the frequent meal method of eating, but for the purpose of treating adrenal fatigue, it’s the best approach.
Now, of course we are going to maintain that ‘clean’ attitude when it comes to our diet, especially in the case of working to fix adrenal fatigue syndrome. It is really quite simple in terms of what you should follow, by just eating balanced meals with proteins, carbs and fats. If you’re reading this article, chances are you are already familiar that foods are broken down into energy at different rates, so by having a mix, you’ll be providing a steady supply of energy for a longer duration rather than consuming them all from one source. By eating all three at a meal, you’ll lessen the strain on your adrenal glands. Also, it is pretty much the worst time to be adhering to a low-carb or low-fat dietary plan as you’re trying to maintain balance to restore order to your adrenal glands.
Food choices should be as natural as possible as with any diet for a health conscious individual, and that means the less processing the better. Protein sources that are good include whole eggs, protein shakes, grass fed beef, and chicken. I’m not going to advocate using soy-protein, not just because it’s proposed estrogenic effects, but because of the anti-nutrients it possesses and that it is commonly observed that those practicing vegetarian lifestyles have a hard time recovering from this type of disorder.
Carbohydrates should be low glycemic as usual and include primarily unrefined grains such as oatmeal, quinoa, brown rice, buckwheat, and the like. Not only will you have a slower blood sugar response by consuming primarily these foods, but you’ll also get a healthy dose of fiber to increase digestion health and prevent your body from expending crucial nutrients to metabolize the more refined grains.
Finally, fats are the most important of all the macronutrients when it comes to maintaining adrenal and overall health. It is important to make sure you’re getting plenty of omega-3 fatty acids from EPA and DHA as well. Supplementation with fish-oil is a great way to ensure you’re getting adequate amounts alongside your daily food intake. Don’t be shy when it comes to your fat sources, as some of the best ones include wild salmon, almonds, walnuts, avocado, etc. Flax seed isn’t bad either, but it is harder to convert the alpha linoleic acid into the body’s preferred form of DHA, so take that into consideration and don’t bank on it providing the entire amount. It is also a great idea to cook with the oils rich in saturated fats such as cocoa butter and coconut oil, or oils rich in unsaturated fats such as olive oil. Not only will it aid in slowing down the digestion of a meal even more, but it will provide the added nutrition benefits.
Micronutrients & Minerals
If you already haven’t taken your micronutrient and mineral intake into consideration, it wouldn’t hurt to do so. Not only can you be short changing yourself in your diet, but having something astray in this department can lead you to a detrimental effect on your gym efforts. One way to ensure that you’re getting enough of each micronutrient is to take a daily multivitamin as an ‘insurance policy’ to just make sure all your bases are covered. In terms of minerals, we will cover one of the most crucial of all when it comes to athletic performance and of course, treating adrenal fatigue: salt.
While salt is typically one of the most over-consumed minerals in the American diet these days in the age of processed foods, for the health conscious individual, under consumption of this mineral can actually be an issue. We’re constantly bombarded with media reports of the dangers of a high sodium diet; so naturally, many are going to make a conscious effort to reduce their sodium intake. Pair that with the fact that if you’re eating clean, you probably aren’t consuming very many processed foods and you’re going to be running the risk of inadequate salt consumption.
This is important as earlier we discussed the hormone aldosterone. If you are suffering from adrenal fatigue, your adrenal glands have a hard time producing adequate amounts of aldosterone and as your aldosterone levels fall, sodium is removed from the body and excreted through the urine, compounding the issue of inadequate sodium intake. Also, if you’re one consuming drinks that are high in potassium and low in sodium, I’d recommend you ditch them for the time being as this is the exact opposite of what a sodium depleted individual is looking for.
What Not To Eat
Aside from the obvious foods to avoid such as processed garbage like fast food and pre-packaged meals, there are certain items that should be avoided during a recovery phase from adrenal fatigue, with the first being high potassium foods in the morning. The reason for this is that too much potassium exaggerates the sodium deficiency issue, so you’ll want to avoid high potassium foods such as certain sports drinks, grapefruit, bananas, oranges, raisins and dates during the morning hours and instead consume kiwi, apples, cherries, pears and mango instead.
The next items to avoid are sugar, coffee, and alcohol. These three items put quite the pounding on your adrenal glands and in the recovery process; their intake should be kept to a minimum in order to help with recovery. By consuming coffee (or any other caffeine source) or sugar, you’re not letting your body use its own natural process to excite and energize your system, therefore interfering with the adrenals natural ability to produce the correct energy levels on its own. Alcohol can be along these same lines as it causes the body to relax, and doesn’t give your adrenal glands a chance to do this on their own either.
The final two items to be leery of when recovering from adrenal fatigue is refined sugars and Trans saturated fats. Sugars provide that quick, immediate surge to get you up and running, but also result in a huge rush of blood sugar and result in a massive insulin release causing you to end up with low blood sugar, pounding your adrenal glands further. For those already suffering from adrenal fatigue induced hypoglycemia, I can’t imagine this would be a fun scenario. Trans fats on the other hand are something that should not only be avoided when recovering from adrenal fatigue, but should be cut out of everyone’s diet. You see, the healthy, natural fats help build up cells and their membranes, but trans fats actually use up the enzymes that the natural fats would be using to produce the membranes for your body. I’m sure you don’t need to be a rocket scientist to figure out that isn’t a good deal.