What is Adrenal Fatigue?

‘One of the most important things that people suffering from adrenal fatigue syndrome can do is take control of their lives. They need to keep on fighting for what they need and want.’

Adrenal fatigue is the collective term given to describe the signs and symptoms of someone who has been in a chronic state of stress for many years. These people are stuck in a state of stress and their adrenal glands are continuously producing unhealthy levels of cortisol and other hormones. This slowly starts to take its toll on their health because other bodily systems like the immune, cardiovascular and digestive system are compromised. Interestingly, the adrenal glands keep producing enough cortisol to keep us going. They respond to how we are responding to our environments.  It’s the subsequent effect on other bodily functions that causes disease. The term given to describe adrenal fatigue in traditional Chinese medicine is Kidney Yin and Kidney Yang deficiency and can be successfully treated to bring you back into homeostasis.

The adrenals are a walnut shaped gland on the top of each of your kidneys and they are responsible for the production and regulation of cortisol, mineral hormones, sex hormones, noradrenaline and adrenaline. There is two parts to the adrenal gland. The adrenal medulla which is governed by the sympathetic nervous system (noradrenaline and adrenaline) and the adrenal cortex (cortisol, androgens) which is governed by the pituitary gland and is part of the HPA – Hypothalamic Pituitary Adrenal gland axis. (1)

The adrenal glands make up one part of a complicated system of glands and hormones within the endocrine system. The hormones involved regulate the activity of smooth muscle, cardiac muscle and some glands, alter metabolism, spur growth and development, influence reproductive processes and participate in circadian (daily) rhythms. (3) 

Adrenal fatigue falls in between two other well known syndromes related to the adrenal glands:
Cushings Syndrome is when excessive levels of cortisol is produced which is caused by adrenal tumors  or over use of glucocorticoids and;
Addisons Disease is when too little cortisol is produced and is caused by an auto immune destruction of the adrenal cortex and or an abrupt cessation of steroid medication.

5 Major Symptoms of Adrenal Fatigue Syndrome

1. An Existential long term angst

2. Decreased ability to handle stress

3. Insomnia- Cortisol rhythm unbalanced

4. Suffer from reoccurring coughs, colds and sinus problems especially when you slow down for example on a weekend break away or before a holiday.

5. Sudden extreme irritability when hunger. You need to eat now or somebody is going to get the brunt of your mood.

Types of people who are at greater risk of Adrenal Fatigue Syndrome.

• The offspring of alcoholic/workaholic parents

• The offspring of parents with mental health issues

• Type A’s and D’s

• Survivors of abuse including war crimes, bullying, sexual and physical assault etc.

• People with anxiety disorders like post traumatic stress disorder, generalised anxiety disorder, panic disorder

• People who have suffered a severe shock. (eg. near drowning)

• Shift workers

• People on zero hours contracts

• People in financial debt

• The unemployed

• The sleep deprived

Other Signs and Symptoms

These symptoms are common and enough for someone to start questioning their health. Some of the symptoms are debilitating. Remember that having some of these symptoms does not necessarily mean that you have adrenal fatigue. Remember to always consult your doctor first if you are concerned by any of these symptoms. There are numerous symptoms that adrenal fatigue can cause like:

• Feeling light headed when standing up

• Low blood pressure

• Reoccurring respiratory problems like colds and sore throats

• Low stress threshold

• Irritability when hungry

• Cravings for salt and sugar

• Insomnia

• Allergies

• Excessive PMS

• Weight gain or inability to gain weight

• Muscle wastage

• Anxiety and depression

• Brain fog

• Dark circles under eyes

• Hormone imbalances

• Digestive problems

• Weak Ligaments

• Heart palpitations

• Suppresses the immune system

• Ulceration of the gastrointestinal tract

• Irritable bowel syndrome

• Hypertension

• Asthma

• Rheumatoid arthritis

• Migraine headaches

• Diabetes Type 2

• Cardiovascular problems

• High Cholesterol

What is Stress?

We all get stressed from time to time. What stresses me out might not stress you out and we all adapt to stress over time. Scientists have different views on stress. The psychologists believe that ‘stress leads to strain’. Physiologists however see stress as the ‘response’ to certain stimuli whether real or imaginary. They say ‘strain leads to stress’.  (1)

Our genes, constitution, conditioning, and life experiences will all contribute to how we respond to change, demands or threats and how we respond to everyday life has a particular effect on how our adrenal glands behave.

 The Way We Respond to Stress

‘The stress response’ was designed to allow our ancestors to deal with physical dangers. The stresses that we perceive today are different. There are threats to our self-esteem, emotional well-being and job security from stimulus through various environments both offline and online. Some people might feel threatened continuously.   We’ve all received a violent video through a Whatsapp group and after watching it for a minute you suddenly find your body pumped up. It might be late at night and now your heart rate has increased and you’re alert. You’ve just lost an hour’s sleep.

Some situations threaten us so much (road rage) that we start to fight mentally and our body prepares for fight as a result. The problem in today’s society is that in non-life threatening situations our emotional interpretation of the event is often inappropriate. We therefore need to learn how to handle non-life threatening situations so as not to tip the stress balance into the distress zone.

The Stress Response – How the Body Responds to Stress

We need certain stress to meet everyday challenges. This is called Eustress and is a healthy stress . Harmful stress (a stressor) which causes distress produces a stress response like a strong emotional reaction, blood loss or poison. The stress response occurs in three stages. The fight or flight response, the resistance reaction and eventually exhaustion.

+ The fight or flight response

Initiated by nerve impulses from the hypothalamus to the sympathetic division of the autonomic nervous system including the adrenal medulla, quickly mobilizes the body’s resources for immediate physical activity. Huge amounts of glucose and oxygen are sent to the vital organs for us to fight or flee. Non-essential body functions such as the digestive, urinary and reproductive activities are inhibited.

+ The resistance reaction

Adrenal cortex increases release of cortisol. Many other hormones play their part during this stage also. The resistance stage helps the body continue fighting a stressor long after the fight or flight response dissipates. This is why your heart continues to pound for several minutes even after the stressor is removed. Generally, it is successful in seeing us through a stressful episode, and our bodies then return to normal. Occasionally, however, the resistance stage fails to combat the stressor or you experience perpetual stressors one after the other and the body moves into a state of exhaustion (adrenal fatigue)

+ Exhaustion

The resources of the body may eventually become so depleted that they cannot sustain the resistance stage, and exhaustion ensues. Prolonged exposure to high levels of cortisol and other hormones involved in the resistance reaction cause wasting of muscle, infertility, suppression of the immune system, mental health issues, ulceration of the gastrointestinal tract and failure of the pancreatic beta cells. In addition, pathological changes may occur because resistance reactions persist after the stressor has been removed. Eg PSTD and other anxiety disorders

How I treat Adrenal Fatigue Syndrome

I offer an holistic approach to unhealthy stress and adrenal fatigue no matter what your symptom’s. My approach includes looking at all aspects of your life including lifestyle, nutrition and exercise. I use acupuncture, supplements, essential oils, Chinese herbs, affirmations and complex homeopathic remedies to get you back on track. I can also test for food intolerances which might be slowing you down. A good place to start is with a blood test. Make sure you are being tested for progesterone, DHEA and cortisol levels. Saliva tests are now available too.  Consult your doctor about these tests.

People with adrenal fatigue need to stop triggering their adrenal glands. They need to slow down. Become aware of your triggers. Certain people, situations, consumables. Avoid them for a while until you get your stress response down to normal levels.  Become mindful of how you are around people. Try a change of attitude towards your family and job for example – choose to be more grateful for them. A simple hack is to pretend you are meeting people for the first time even though you have met them thousands of times. You will see them in a new light and release past experiences.  Also, are you suited to your role at work?

Focus on Yin building activities and foods. Yin building activities are activities that are non competitive, relaxing, capture your imagination. Acupuncture, massage, yin yoga, nature, hanging out with great friends, light reading, arts and crafts.  These changes will change the neurological pathways and slowly decrease the release of cortisol. Feeling happy, secure, loved and supported all regulate the hormones secreted by the adrenal glands to normal levels.

You can start to slowly bring back certain people, situations and consumables and not be stressed by them. However, you might choose to avoid them still.

As an acupuncturist, I want to use my skills to combat adrenal fatigue syndrome. The various stress responses have varying effects on the body. The effects range from both the physical and mental/emotional.  There is a wealth of information in chapter three of the book ‘Manage your stress for a happier life’ by Terry Looker and Olga Gregson.

During the fight response, we are angry and aggressive. There can also be feelings of pleasantness and excitement (noradrenaline) which constricts the blood vessels.  We are rarely in a physical fight though but the biological response is the same. In Chinese medicine we know that anger affects the liver. We use certain points on the body to give the person reprieve from this. GB 34 and liver 3 are common. Disharmony in the liver can have a knock on effect. It can cause symptoms of IBS such as constipation and diarrhoea, irritability, mood disorders and insomnia. The constriction of the blood vessels can lead to heart and circulatory disease.

If we choose to run or withdraw from a situation. Adrenaline is the overriding hormone. Blood pressure and blood sugar rises, blood vessels constrict (pale face). We have heart palpitations. The corresponding emotion is fear. There are feelings of uncertainty, worry, insecurity and anxiety. In Chinese medicine we know that fear affects the kidneys and worry affects the spleen.Popular acupuncture points are Kid 3, Kid 1, Ren 12, Sp 3, Sp 6.

If we feel like we are not in control of our lives, let people walk all over us and have feelings of failure, helplessness, hopelessness, chronic anxiety and depression. These are signs and symptoms of too much cortisol in the system for too long.  From a Traditional Chinese medical point of view, these feelings have a huge effect on the liver, spleen, lungs and kidneys. Acupuncture points to combat this are GB 34, Liv 3, Kid 3, Sp 3, Sp 6, lu 9, lu 7. and various calming points like Yintang, he 7, P6 & Ren 12.

From a Physical Perspective

Prolonged periods of distress effects every part of the body. Here are some of the major effects:

+ Muscle wastage, type 2 diabetes and stress

Adrenal fatigue causes muscle wastage since cortisol intervenes in carbohydrate metabolism by promoting the conversion of proteins in the liver into glucose when an increased glucose demand exists. This opposes the action of insulin which means excessive glucose in the bloodstream. Prolonged levels of high blood sugars causes type 2 diabetes and also contributes to atherosclerosis. Prolonged levels of cortisol can affect the proper functioning of the thyroid gland which can slow down our metabolism causing weight gain. (1)(7)

+ Immunity and stress

The immune system suffers because excessive levels of cortisol suppresses the immune system and reduces the body’s ability to deal with infection and increases susceptibility to diseases. This is because excessive and prolonged levels of cortisol is known to affect the production of antibodies. Some immune system related diseases are rheumatoid arthritis, allergies, skin conditions and asthma. (1)

+ The heart and stress

The cardiovascular system especially the heart is affected by the stress response. Excessive levels of noradrenaline can lead to heart and circulatory disease, as noradrenaline’s most potent action is to constrict blood vessels. Over time, this will cause high blood pressure, atherosclerosis, myocardial ischaemia, angina and possibly stroke. Also, far more cholesterol is produced during periods of stress than can be obtained from food. (1)

+ Digestion and stress

The digestive system completely slows down during times of chronic stress. This can lead to indigestion, digestive disorders like barrets eophagus and hiatus hernia. The lining of the intestinal tract is inhibited and doesn’t absorb the nutrients from food. This affects the bodies healing processes. The stomach is affected and acid builds up causing acid reflux.

+ Fertility and stress

The reproductive system is affected by adrenal fatigue. Emotional factors brought about by prolonged elevated levels of cortisol are thought to account for around 25% of all infertility problems. The cortisol imbalance has a knock on effect on other sex hormones (low progesterone) and disrupts normal ovulation and menstrual cycles. Men are affected with symptoms of impotence and premature ejaculation. (1) (6)

Thankfully adrenal fatigue is a very treatable syndrome. One of the most important things that people suffering from adrenal fatigue can do is take control of their lives. They need to keep on fighting for what they need and want. You can use acupuncture to help you achieve this and get you into a relaxed and happy space. I will discuss other ways to achieve this as well.

Dietary and Supplement Advice

• Balanced diet.

• Minimal caffeine

• Minimal sugar

+ Focus on

• Increase water and salt (a pinch of quality salt, for example Himalayan sea salt (no table salt) in 500ml water every morning)
• Multiple small meals high in protein
• Meals high in tryptophan (Salmon,eggs, spinach, seeds, bananas, oats)
• High protein snack before bedtime

+ What Supplements to take for adrenal fatigue syndrome?

Here is a mixture of vitamins, minerals, adaptagens and Chinese herbs:

Vit C, B Vitamins, Probiotics, Magnesium, Omega 3, L-Theanine, lemon balm extract, Saffron extract, liquorice, Chinese herbs, Long Dan Xie Gan Tang and Ba Wei Di Huang wan. adaptogens like ashwagandha, eleuthero, maca, rhodiola rosea, holy basil, panax ginseng, schisandra.

Consult a qualified nutritional therapist and/or herbalist for the best combination.

My smoothie recipe for Adrenal Fatigue Syndrome

• A cup of water

• A ½ cup of Frozen Berries of choice

• One banana

• 16g of plant based protein powder

• 1 teaspoon of chia seeds

• 1 teaspoon of maca powder

• 2 heaped tablespoons of Soya Yoghurt

• 1 drop of doterra lemon or squeeze half a lemon

Affirmation for Adrenal Fatigue Syndrome

I am loved, I am safe, I am in control of my life. Say it as much as you remember.

References:

1. Manage your stress for a happier life. Terry Looker, Olga Gregson, 2010. MacMillian.

2. https://csrf.net/doctors-answers/diagnosis-qa/normal-values-of-cortisol-and-acth/

3. Anatomy & Physiology, Gerard, J. Tortora & Bryan Derrickson, 13th Ed. Wiley.

4. The body. Naumann & Gobel Verlagsgesellschaft mbH, Contmedia GmbH

5. Dr Jacob Teitelbaum https://www.youtube.com/watch?v=ZVQhiDpEBZg

6. https://drbrighten.com/boost-low-progesterone/

7. https://www.choicesmarkets.com/health-article/the-stress-weight-connection-cortisol-and-your-metabolism/