All About Adrenal Fatigue

If you always feel exhausted and haven’t been able to figure out why, you may be suffering from adrenal fatigue, otherwise known in medical terms as HPA-Axis Dysfunction.


What are Adrenal Glands?


Your adrenal glands sit above your kidneys and produce over 50 hormones that are involved in almost every bodily function. These glands play a very important role in the stress response. When the brain registers a threat, the adrenal glands release cortisol and adrenaline hormones, also known as the fight or flight response. These hormones flood our blood with sugar and give us the energy needed to escape the immediate threat. These glands also release other hormones that slow down digestion, break down muscle, and alter other bodily functions that are not necessary for immediate survival. If someone is under high stress for prolonged periods, the constant elevation in fight or flight hormones can cause negative effects, like anxiety, weight gain, fatigue, and insomnia. After very long periods of high stress, the adrenals can eventually decrease the amount of hormones it is making (where the term “adrenal fatigue” came from), which can lead to symptoms like profound fatigue.



Is Adrenal Fatigue a Real Thing?


If you search the phrase ‘adrenal fatigue’ you will find conflicting information on whether or not adrenal fatigue exists. The reason for this confusion is that there is no official diagnosis for adrenal fatigue. The symptoms can be vague and related to numerous other conditions. But do I see it in patients? You bet I do!


What Causes Adrenal Fatigue?


Adrenal fatigue is believed to be caused by an overstimulation of the nervous system that leads to an inconsistent level of cortisol in the bloodstream. This can be from chronic stress, lack of sleep, poor diet, or a traumatic event.


Common Symptoms of Adrenal Fatigue/HPA Axis Dysfunction


If this describes an average day for you, you may be suffering from adrenal fatigue:


  • Wake up feeling exhausted even after getting a decent night’s sleep

  • Get an energy boost late in the morning

  • Energy levels crash after lunch

  • Get a boost of energy later in the evening

  • Poor exercise tolerance and/or slow recovery

These are some common symptoms of adrenal fatigue that you may be experiencing:

  • Chronic fatigue

  • Brain fog

  • Hair loss

  • Lightheadedness

  • Hormone imbalance

  • Low libido

  • Depression

  • Irritability

  • Weight gain

  • Poor sleep quality

It’s important to note that these symptoms can also be caused by other ailments. It’s important to rule out other causes before determining if you have adrenal fatigue.



Testing and Treatment Options


If you bring this up to your primary care physician, they will probably test you for Addison’s disease, which is a primary adrenal insufficiency, usually caused by an autoimmune disease. In Addison’s disease, cortisol secretion is inappropriately low and is treated with steroid replacement. However, this is not the same as adrenal fatigue/HPA Axis Dysfunction.


For those with adrenal fatigue, cortisol levels typically show up in the “acceptable range” on a standard one-time blood draw. However, through integrative medicine testing companies, we can now do salivary and urine tests with multiple data points, allowing for diagnosis of more subtle adrenal dysfunction. We’ve all experienced a doctor telling us that everything looks “normal” even though we are feeling terrible. That’s where more detailed testing comes in!


For treatment, lifestyle modifications, including stress reduction and adequate sleep, and supplements can help relieve symptoms. Be sure to speak with your doctor before taking any supplements or herbal treatments, as they may interact with certain medications.


If you think you might be suffering from adrenal fatigue, I recommend finding a functional medicine provider. If you are in Minnesota or Wisconsin, please consider reaching out to me at Twin Cities Integrative Medicine to schedule an appointment. I look forward to seeing you!