Is adrenal fatigue real?

Adrenal fatigue is often used to describe the fatigue or burnout experienced after a longer period of stress. While this term has been useful in providing the language behind various health-related events that haven’t always been widely accepted or recognized, it isn’t the most up-to-date (or accurate) representation of how the stress response impacts our health.

The collection of signs associated with adrenal fatigue include low energy, impaired memory and cognition, occasional mood fluctuations, sleep disturbances, a lack of mental and emotional resilience and the inability to cope with stress. While adrenal fatigue isn’t a medically recognized state, this cluster of signs may indicate that the body’s stress response needs some support.

The adrenal glands

These two small glands can be found resting on top of the kidneys, and despite their size, they are responsible for encouraging a cascade of hormonal reactions. The adrenal glands produce hormones that help regulate the immune system, metabolism, blood pressure, the stress response among many other essential functions.

The stress response

Also known as ‘fight or flight’, the stress response is something that is hard-wired into all of us, and it’s evolved to help the body cope with – you guessed it, stress. The purpose of the stress response is to help mobilize the body’s energy and address challenges in the face of perceived danger. This means that when the stress response is activated, you will experience changes on a physiological level. Your heart rate increases, blood pumps to your muscles and hormones like cortisol and adrenaline are released to help you utilize energy.

This response is a survival mechanism that once kept humans feeling safe from extreme dangers like famine, floods or being chased by a hungry saber-toothed tiger. But what happens if there’s no immediate threat to your survival? Instead, it could be that you’re just about to walk into a job interview, or you’re preparing to give an important presentation. While these situations aren't life-threatening, they can still induce the same ‘fight or flight’ response based on how you feel about them.

With the consistent exposure to these everyday triggers, your stress response can become overstimulated and overreactive. This means that overtime, not only will you be less able to cope with stress, but you can also be more prone to feeling stressed out by things that never used to phase you.

Stress hormones

The effects that stress has on the body have a lot to do with your stress hormones. As your chief stress hormone, cortisol is produced by the adrenal glands and regulated by the HPA-axis (hypothalamic-pituitary-adrenal axis) when your fight or flight response is triggered. Cortisol naturally increases when we wake up and drops again at the end of the day. It helps us stay alert, and in a healthy stress response, cortisol rises to help the body make use of its energy reserves, then returns back to normal levels once the perceived stress has passed. If you’re dealing with constant stress – whether that’s financially, physically, work related or within your personal life, if you don’t have a successful coping strategy, your stress response can become dysregulated, and cortisol can remain high. While this stress hormone is crucial for normal body function, it can cause a host of imbalances when it’s produced in excess.

Putting it all together: HPA-axis dysfunction

What’s really happening when adrenal fatigue is suspected is a dysfunctional line of communication along the HPA-axis. The HPA-axis is the communication between the hypothalamus, pituitary and adrenal glands that plays an important role in the stress response. Ongoing stress drives the hyperactivation of the HPA axis – which promotes the excess production of cortisol.

Overtime excess cortisol production can impact memory, learning, and how we stabilize emotions. It can impair mood resilience, cognitive function and increase our sensitivity to stress, further exacerbating fatigue and burnout. If you feel like you’re experiencing these effects to an extreme, it’s best to consult your healthcare provider.

How to support the HPA axis

Keep your blood sugar balanced

Adrenaline is an important hormone for the regulation of blood sugar levels, and it’s responsible for converting glycogen (stored glucose) into usable glucose when blood sugar levels drop. Glucose is the body’s preferred fuel/energy source, and when the body is stressed, hormones like adrenaline and cortisol trigger a rise in glucose to meet the increased energy demands. While this response is beneficial in some situations, it can become problematic to continue spiking your blood sugar levels if you’re experiencing a consistent amount of stress.

In the same way that stress can cause imbalanced blood sugar levels, when your blood sugar levels are imbalanced - it can also trigger your stress response. Anytime you skip meals or reach for something high in added sugars, you may be setting yourself up for a blood sugar rollercoaster that can create stress internally. Starting your day with a protein-rich breakfast and eating frequent meals throughout the day will help you maintain steady blood sugar levels and support a balanced stress response.

Prioritize sleep

When it comes to combatting fatigue, practicing good sleep habits is essential. Aim to get around 7-9 hours of quality sleep each night. Establish a consistent sleep schedule by going to bed and waking up at the same time every day, even on the weekends. And try to create a relaxing bedtime routine to help your body wind down.

Address cell stress

You are made up of over 37 trillion cells, and inside them are tiny organelles called mitochondria. Mitochondria are responsible for generating 90% of the body’s energy, but during this process they create free radicals as a by-product.

Free radicals are highly reactive molecules, and if too many accumulate within the body it can cause damage to your cells. While mitochondria work hard to defend themselves against free radical damage, our antioxidant levels naturally decline as we age – which puts more stress on our cells to meet the energy demands of the body.

Additionally, when day-to-day stress activates the 'fight or flight’ response in your brain, your cells are signaled to produce even more energy to help the body respond to stress, which places a heavy burden on mitochondria. Mitochondria in the adrenal glands are particularly important as they play a role in our sleep/wake cycle and regulate our stress hormone - cortisol. Supporting the health of your cells (and the mitochondria that give them energy) is the most important step. Supplementing with an antioxidant that can target the mitochondria is key to staying on top of your cell health.

Replete your nutrient stores

Stress of any kind increases the demands of your body. The adrenals require specific nutrients like vitamin C, zinc and B vitamins to function, and if you’re low in any of these important nutrients – the body may struggle to regulate your stress response.

When you’re experiencing more frequent states of fight or flight, your mitochondria will struggle to meet these increased energy demands if you’re not providing them with the right fuel.

Stay hydrated

The adrenal glands are responsible for regulating blood pressure, which is why either high or low blood pressure can be seen in some people who experience HPA-axis dysfunction. Drinking plenty of water and consuming electrolytes with low added sugars can be beneficial, in addition to staying away from sugary drinks that may contribute to blood sugar fluctuations.