“ADRENAL FATIGUE” DOES NOT EXIST, HERE IS WHAT DOES

If you have been diagnosed with Adrenal Fatigue by your alternative health care practitioner, and you are feeling upset with the title of this blog, I assure you there is a reason for your symptoms, but it is not Adrenal Fatigue.  Read on to find out.

Adrenal Fatigue is a buzzword explaining symptoms of extreme fatigue, difficulty waking up in the morning and/or falling asleep in the evening, salt cravings, and inability to handle stress.  Adrenal Fatigue is a popular self-diagnosis or a diagnosis used by alternative healthcare practitioners.  Adrenal Fatigue is an enticing diagnosis.  I used to take it as fact until I did more research on the subject.

WHAT IS “ADRENAL FATIGUE”

The Adrenal Fatigue Model is described as a stress-related condition, which causes your adrenal glands to weaken.  It states that when the adrenal glands are overstimulated for too long, they begin to lose the ability to produce hormones such as cortisol, DHEA, and pregnenolone.

Adrenal Fatigue is described as a 3-stage descent in adrenal hormones, ending in burnout.

• Stage 1 – Is coined the Alarm Stage.  Here, there is an increase in cortisol and a decrease in pregnenolone and DHEA.  This stage can last months or years.
• Stage 2 – Cortisol begins to decrease.  Cortisol may actually be within the normal range, but DHEA and pregnenolone levels are low.
• Stage 3 – All three hormones, cortisol, DHEA & pregnenolone continue to fall until they reach exhaustion or burnout.

THE ADRENAL FATIGUE MODEL IS NOT SUPPORTED BY SCIENCE

First of all, Adrenal Fatigue is not a condition recognized by the medical community or reputable organizations such as Hormone Health Network.

Also, the concept of Adrenal Fatigue is not supported in the scientific literature. A quick search on PubMed shows very few published papers that have “Adrenal Fatigue” in the title or abstract.  In fact, an article may pop up, titled “Adrenal Fatigue does not Exist: a Systematic Review“, which discredits the theory of Adrenal Fatigue.

HPA-AXIS DYSFUNCTION, THE TRUE CAUSE

While Adrenal Fatigue is not recognized in the scientific literature, disruption of the Hypothalamic-Pituitary-Adrenal Axis (HPA-Axis) is.

The HPA-Axis controls our natural reaction to stressors.  It involves the interaction between three endocrine glands; the hypothalamus, pituitary, and adrenal glands.  Please watch this video, which explains the basic actions of the HPA-Axis.

Chronic stressors can cause a dysfunction in the natural rhythm of the HPA-Axis.  Each and every cell in the body is affected by the HPA-Axis, therefore HPA-Axis Dysfunction can cause a wide variety of symptoms, which includes the symptoms that we have been told are caused by Adrenal Fatigue.

HPA-Axis Dysfunction is associated with an array of chronic conditions such as; infertility, IBS/IBD, psoriasis, eczema, depression, anxiety, and nearly all autoimmune conditions.  It is almost impossible to successfully treat chronic disease without addressing the HPA-Axis.

In his fabulous book, The Role of Stress and the HPA Axis in Chronic Disease Management, Thomas Guilliams, Ph.D. explains the four types of stressors which lead to HPA-Axis Dysfunction:

• Perceived Stress – Everyone knows, and can relate to this one.  Stress related to work, relationships, finances, or kids fit in here.  Our body doesn’t know the difference between a perceived threat, or real threat.  Running from a bear, and financial stress is all the same to our HPA-Axis.
• Inflammation – Cortisol is a powerful anti-inflammatory substance. Chronic or acute inflammation stimulates cortisol release, which triggers the HPA-Axis (1).  Check out my Turmeric & Ginger Elixir Recipe for a tasty anti-inflammatory treat.
• Circadian Rhythm Disruption – The HPA-Axis and our circadian rhythm work intimately with each other.  Sleep deprivation, working night shift, using electronics before bed, working indoors without natural light, and jet lag all disrupt our circadian rhythm, which ends up disrupting our HPA-Axis (2).
• Blood Sugar Dysregulation – The HPA-Axis partially controls our blood sugar.  When we are stimulated into a fight-or-flight situation, cortisol is released.  Cortisol increases our blood sugar, giving our muscles immediate energy in preparation for running for our lives or throwing punches and kicks.  Alternatively, a poor diet causing a continual up and down fluctuation in blood sugar (think sugar crashes), will stimulate cortisol production when blood sugar drops.  This cortisol produced due to low blood sugar also stimulates the HPA-Axis (3).  A classic symptom here is getting hangry between meals, rather than just hungry.

As you may have noticed from these very common everyday stressors, we live in a society that nearly guarantees HPA-Axis Dysfunction.

WHY WE SHOULD LAY THE ADRENAL FATIGUE MODEL TO REST, AND FOLLOW THE HPA-AXIS MODEL

• The Adrenal Fatigue Model is an incredibly simplistic, incomplete, and even an untrue explanation of the chronic stimulation of the stress response in humans.
• Terminology such as Stage 1, Stage 2, and Stage 3 in the Adrenal Fatigue Model is poor.  The HPA-Axis Dysregulation Model offers us precise terms such as; hypocortisolism, hypercortisolism, low/high cortisol binding globulin, free cortisol, metabolized cortisol, cortisol awakening response, impaired cortisol signaling, downregulation of cortisol receptors, decreased cortisol bioavailability, downregulation of the HPA-Axis, disrupted diurnal rhythm, etc.
• Dr. Guilliams explains four stressors (perceived stress, inflammation, disrupted circadian rhythm, and blood sugar dysregulation) which can cause HPA-Axis Dysregulation.  Whereas, the Adrenal Fatigue Model just takes into account perceived stress.  These additional three stressors are very important to consider.  For example, a person could be independently wealthy, relaxing on a warm sunny beach in Mexico without a care in the world.  But, if they have a gut infection, undiagnosed gluten intolerance or stay on their computer right up until bedtime, they will still be under stress and their HPA-Axis will be chronically activated.
• The Adrenal Fatigue Model limits our ability to treat the real issue.  Treating clients using the HPA-Axis Model gives us much more leverage and better ability to successfully treat our clients.
• If we as alternative health care practitioners want to be taken seriously by the medical community, we can’t make up diagnoses based on false evidence.  We need to follow the evidence in the current scientific literature.

WHAT YOU CAN DO

If you suspect you are suffering from HPA-Axis Dysfunction, you can start by modifying your lifestyle:

• Incorporate stress management into your daily life.  You don’t need to meditate for hours, start with just two minutes a day.  Then slowly increase, two minutes twice a day, then three times a day.
• Try yoga, or tai chi, or hiking in the forest.
• Get acupuncture or massage.
• Get 8 hours of sleep a night.
• Get outside for at least half an hour in the morning, and/or work near a window.  By exposing yourself to sunlight, you let your body know when it is daytime.  This can help reset your circadian rhythm.
• Turn off all screens two hours before bedtime, and download f.lux onto your computer.
• If you work nights, reconsider your career.  (I worked nights for 4 months, and it turned me into a crazy person.  I understand what it is like).
• Work with a knowledgeable nutritionist if you get hangry too often.
• Look for sources of inflammation – diet, gut health, food intolerances, toxic mold exposure, heavy metal toxicity, etc.

If it all seems like too much, or you are too exhausted to figure out where your HPA-Axis Dysfunction is stemming from, I suggest working with a qualified healthcare practitioner.

I WOULD LIKE TO HEAR FROM YOU!

What are your thoughts?  Will you adopt the HPA-Axis Model and drop the Adrenal Fatigue Model?  Have you suffered from HPA-Axis Dysfunction?

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Lindsay Rusk Health is a dedicated resource for people who are interested in health and improving their health.  Therefore, this post may contain affiliate links.  These links add no extra cost to you.  I recommend products and brands that I personally use for myself or my family. For more information, see my Terms + Disclosure.