Adrenal Fatigue

A commonly overlooked cause for tiredness and low energy is low adrenal function.  Adrenals are crescent-shaped glands sitting atop each kidney that secrete hormones  critical to maintaining the balance of many body functions. Some of the hormones produced by the adrenals include adrenaline, cortisone, DHEA, and even small amounts of testosterone and estrogen.  Your adrenal glands act as a major defensive shield in dealing with stress, whether the stress is acute or chronic, emotional or physical.If the adrenals were to completely stop functioning, a life-threatening illness called Addison’s Disease is diagnosed and steroids need to be taken by the patient for life.  In its “all or nothing” paradigm, conventional medicine generally does not recognize nor treat milder forms of adrenal insufficiency.  However, integrative health-care practitioners are aware of the importance of identifying and treating low adrenal function, not only to address fatigue, but to also benefit many other symptoms and illnesses that are related to low adrenal function.

In addition to fatigue, adrenal hypofunction can include symptoms of hypoglycemia, emotional volatility, sleep disturbance, sugar and salt cravings, poor endurance and recuperation, and susceptibility to allergies, infections, and inflammation. At the physical level, low adrenal function can manifest as low blood pressure and low body temperatures, dry, thin skin, scalp hair loss, and exacerbation of menopausal symptoms. Almost any health problem, but especially autoimmune disorders, can be worsened when adrenal hypofunction is present, and may be helped by correcting this condition.

Experienced practitioners can often pick up on the diagnosis of adrenal hypofunction simply by taking a good history and examining a patient. However, blood and saliva tests are available to directly assess the function of the adrenal gland. The treatment for low adrenal function is to first identify and reverse or remove whatever the chief stressor to the adrenal might be, and then to supply direct support to the adrenals via herbs, supplements, and even natural hormones if necessary.

The adrenals are weakened by acute or chronic, emotional or physical stress. The stress could be nutritional deficiencies or could be from over-work, trauma, excessive emotions, exposure to toxins, sleep deprivation, or loss of love and emotional support.

It is essential to address emotional stressors and to find ways to alleviate them. Peace, calm, regularity, and a sense of emotional connectedness can go a long way towards restoring that vital battery known as the adrenal.  Daily walks in nature, or healing arts such as yoga and chi kung can also be helpful.

Another key area to address in adrenal fatigue is a diet that stabilizes blood sugars, i.e., one with healthy fats, adequate protein and minimal sugars and refined carbohydrates. Four to six small meals a day is better than a couple large meals. Stimulants such as nicotine and caffeine should be avoided as they are only “whipping a tired horse”.

Supplements that have proven useful in strengthening adrenals include the B vitamins, especially B-5, vitamin C, and magnesium.  Useful herbs include Siberian ginseng and licorice. Licorice contains a substance called glycyrrhiza that works by keeping more of the adrenal hormones in circulation, thereby resting the adrenals. 

If these non-pharmaceutical measures are not enough, the bio-identical adrenal hormone cortisone can be given in sub-physiological doses to support the adrenal gland while it heals with the above-mentioned interventions.

Fortunately, after the evaluation and guidance of a practitioner experienced in treating adrenal hypofunction, much of the healing of the adrenal can be accomplished by dedicated lifestyle changes on the part of the patient.

Anne Walch, MHS PA-C, practices at Asheville Integrative Medicine. She is a physician assistant specializing in nutrition, endocrine disorders, natural hormone therapies and environmental toxins.