The Adrenal Fatigue Signs
Adrenal fatigue is a silent condition that can linger for years before going diagnosed. Check out these 9 common (but often misdiagnosed) adrenal fatigue signs and find out how to heal adrenal fatigue naturally.
Adrenal Fatigue (also known as: “HPA Axis Dysfunction” or “chronic stress”) is a health condition that affects approximately 80% (8 in 10) people at some point in their lifetime (Gallup, 2017).
It is defined as a “collection of unspecified signs and symptoms,” onset by stress, itself that significantly impacts one’s health and/or quality of life.
Physically, adrenal fatigue or HPA Axis Dysfunction, presents as an imbalance in your body’s natural cortisol levels—either too much or too little—to help your body naturally deal with the stress response. This articles will present to you different adrenal fatigue signs.
Hold Up!…What is Cortisol Exactly?!
Cortisol is your “stress hormone”—the hormone that kicks into gear when your body is under stress to help you fight or fly.
Not all stress is a bad thing, and you certainly want that cortisol to “work” for you when you are running from a bear in the wild or dodging a thunderstorm without shelter.
As humans, our stress response has served us well for many years to help us survive, and then ideally, eventually, recover, come down and go back to “normal” when we escape the bear or storm blows over.
Unfortunately however, given our modern day lifestyles, our stressors have become a little more blurried. We no longer live in the wild, running from bears or dodging thunderstorms.
The stressors we face are more long lasting and “hidden”—so much so that they can perpetuate, continuing to drive cortisol up in our autonomic nervous system, long after we THINK stress has passed.(Note: It’s important to note that “adrenal fatigue signs” does not necessarily mean you are fatigued or your cortisol is LOW. In fact, your cortisol hormone levels can actually be very high. More on this later).
In short: Cortisol (or cortisol imbalances) drives all adrenal fatigue signs.
How do you know if you have adrenal fatigue?!
Adrenal fatigue, or HPA Axis Dysfunction, is diagnosed by assessment—both by evaluating whether you have some of the most common adrenal fatigue signs, as well as a DUTCH hormone test, revealing the exact patterns of your cortisol (stress hormones) and sex hormones in your body.
SIGNS & SYMPTOMS
Do You Have Adrenal Fatigue Signs & Symptoms?: Self-Assessment
Self assessment is the first step to start for determining if you have adrenal fatigue—evaluating your own adrenal fatigue signs.
Common Adrenal Fatigue Signs & Symptoms
- Unwanted weight gain or weight loss
- Low immune system (easily catch colds, flu)
- Lack of energy or usual gusto (particularly mornings and afternoons), lethargy
- Mild depression and/or increased anxiety/nervousness
- Feeling wired and tired at night
- Low Libido
- Dry skin
- Decreased ability to handle stress
- Food allergies and intolerances
- Low body temperature
- Anxiety, depression and nervousness
- Hair loss
- Shortness of breath
- Feel better (temporarily) after eating
- Blood sugar imbalances
- Skin breakouts and acne
- Need coffee or stimulants to get going
- Cravings for sugar or caffeine
- Cravings for salt or crunchy things
- Increased symptoms of PMS for women. Periods are heavy and then stop, or are almost stopped on the 4th day, only to start flow again on the 5th or 6th day.
- Difficulties getting up in the morning
- Unable to remember things
- Feel tired from 9-10 pm
- Lightheaded when rising from lying down
- Pain between shoulder blades
- Unable to hold corrective adjustment or need for mobility/massage often without improvements
- Tremble under pressure
- Autoimmune conditions
- Constipation, bloating, alternating constipation/diarrhea, IBS and gut conditions
- Dry or thin skin
- Heart palpitations
- Exercise intolerance
- Feel better generally when there is less stress (like vacation)
- One leg longer than the other
Phew! That is quite the list!
While, not one of these signs alone means you have “adrenal fatigue,” several of these signs accumulated at once (5+) over the course of several weeks may indicate your body is in “stress mode.”
Unfortunately, given that there is such a wide array of adrenal fatigue signs, adrenal fatigue easily slides under the radar.In fact, many of these signs and symptoms are easily confused or mis-diagnosed as other ailments—completely missing the “root cause” at all (stress).
Here’s a highlight of a few of the most common adrenal fatigue signs that go undiagnosed by many doctors:
9 Adrenal Fatigue Signs (Your Doctor Won’t Tell You About)
Click on each sign to learn a little bit more about common adrenal fatigue signs that go under the radar:
Chronic Constipation, Loose Stools or a Mix of Both (IBS)
Chronic gut issues got you down—no matter how many probiotics you take or healthy food you eat? Similar to the little kid who is constipated or has a poopy diaper—making a face and a fuss over the issue—gut issues arise from the stress we hold inside. Stress is uncomfortable (for the gut) and the stress response (i.e. elevated cortisol) short circuits the normal process of digestion. In addition, the stress from lack of sleep (less than 7 hours per night) also further affects digestion, since full detoxification, digestion and elimination happens while we rest and sleep.
Needing Coffee/Caffeine to Function
Coffee is not innately a bad thing, but when we “need it” for energy, chances are our natural energy system is off. Coffee is a natural stimulant (even decaf) that elevates cortisol. When we make caffeine and coffee consumption a regular habit, we train our cortisol levels to rely on caffeine and stimulants to function. When we don’t have it? May day! If you aren’t human without coffee, this may indicate something else is going on underneath the hood.
Unwanted Weight Gain or Weight Loss
Weight won’t come off—no matter how clean you eat or how much you workout?! Or find the weight “falls off” without even trying—maybe even to an unhealthy level? Since your hormone balance helps keep your weight in check, when your cortisol is off, along with your other hormones, then weight issues may arise.
Decreased Exercise Performance
Find yourself struggling to keep up with your routine you’ve always had? Or have the mental strength and energy to get through the workout, but your performance is declining or not improving? Exercise is a natural (healthy) stressor. However, the “Goldilocks” approach is a must. Without enough recovery, rest or variety between workouts, eventually the body may let you know, resulting in decreased performance or “gains.” Similar to running from a bear, our body can only run from a bear for so long before it poops out, or workouts that you once considered “easy,” become challenging or almost intolerable for some as other symptoms arise when you do workout (such as: shortness of breath, muscle fatigue or soreness, low energy, decreased blood pressure, increased or decreased heart rate, decline in strength or power output, looking at the clock for when the workout is over).
1 in 5 people struggle with anxiety—many of these cases seemingly unexplainable. “I’m just an anxious person,” “My mom had anxiety too—it runs in my family,” “I’ve always had it.” However, when we look to the cause or trigger behind anxiety, 9 times out of 10, HPA Axis Dysfunction or adrenal fatigue is at play. How does this happen? From gut dysfunction and bacterial or fungal overgrowth, to lack of sleep, dehydration, environmental toxins, nutrient imbalances, light exposure (at the wrong times), lack of human connection, lack of nature, all work no play, burning a candle at both ends, etc. —there are tons of “stressors” that lead the body to physiologically struggle with anxiety.
In fact, gut issues in particular are one of the top driving stressors for many psychological imbalances. Given that 31 hormones alone are produced in the gut—including serotonin (your “feel good” brain chemicals) AND your healthy bacteria in the gut work to help lower cortisol )the notorious “stress” hormone), when your gut is imbalanced, you can bet your bottom dollar other parts of your health get imbalanced too (hello anxiety!)
Hypoglycemia & Hyperglycemia
Riding the “blood sugar” roller coaster throughout the day goes hand in hand with cortisol imbalances. Like caffeine, cortisol loves glucose (i.e. sugar) and needs glucose and sugar to function at it’s peak. Hence, when your body experiences a dip in blood sugar (hypoglycemia), it also sends your cortisol into a low dip (adrenal fatigue).
As Dr. Wilson explains in his book “Adrenal Fatigue in the 21st Century,” “Hypoglycemia commonly occurs during adrenal fatigue when low epinephrine, norepinephrine and cortisol are combined with the high insulin levels of stress. The low levels of adrenal hormones that can occur during adrenal fatigue may fail to raise blood glucose enough to meet the increased demand.
Hypoglycemia is characterized by:
- Muscle twitches and tremors
- Reactive hypoglycemia (blood sugar lowers after you eat a meal, rather than rises)
- Sleepiness or feeling low on energy
- Can’t go long without food between meals
- Electrolyte imbalances
Naturally, you then crave fuel—especially carbs, sugar or a snack to spike it. The result? A cortisol and blood sugar spike that may take your blood sugar over the top (i.e. hyperglycemia) until the next lull when the sugar wears off. Up and down, up and down.
Unfortunately, the hypoglycemia symptoms experienced in HPA Axis Dysfunction are often than not sub-clinical—meaning that the person experiences ALL the symptoms of clinical hypoglycemia symptoms even though the blood sugar reading is “normal” (60-70 mg/dl). On blood work, their fasting serum blood sugar and glucose tolerance tests are usually normal. Conventional doctors not aware of the adrenal signs will often miss this.
Lack of Appetite
Simply put: Cortisol blunts hunger cues. In fact, under eating is common in adrenal fatigue—not because you’re dieting or trying to, but because you are simply not hungry. This often happens for chronic dieters who, at one time, ate a very restrictive diet, only to find that when they go back to eating more food or being off the diet, they are no longer very hungry. Chronic undereating also is a common phenomenon that occurs for those who switch to a “clean diet,” vegan or paleo diet—cutting out entire food groups, accidentally failing to replace lost calories with other sources of fuel. The result? A stress response in the body—slowing the body’s metabolism down and suppressing your appetite included.
Sodium, potassium, magnesium, chloride and calcium are key body “regulators” in healthy persons that help maintain fluid balance. When the body is imbalanced in adrenal fatigue, hydration status and cellular balance also gets off due to cortisol’s influence on our key water regulators (antidiuretic hormone (ADH) and aldosterone))! Individuals with adrenal fatigue are more likely to experience dehydration, shortness of breath, heart palpitations and general weakness—directly influenced by electrolyte imbalances. Dr. Lam explains this phenomenon well in his article on Electrolyte Imbalance here.
The hormones produced by your adrenal glands, particularly cortisol, play an important role in regulating your immune system. If your cortisol levels go too low or too high, this can lead to infections, chronic inflammation, autoimmune diseases or allergies. In short spurts, cortisol can boost your immunity by limiting inflammation.
After assessing your current presentation of signs and symptoms, formal hormone assessment and testing is the next recommended step for understanding your cortisol and hormone patterns (high, low, disrupted, etc.).
Do You Have Adrenal Fatigue Signs & Symptoms?: DUTCH Cortisol Test
The other measure of adrenal fatigue is a urine-saliva hormone test known as the “DUTCH Plus Test.”
To date, the DUTCH Plus Test is the gold standard for measuring your cortisol levels and patterns over the course of an entire day (or 28 days), as opposed to a blood test (one-stick in time) or saliva samples alone.
The thing that makes the DUTCH Plus Test unique is that it captures the cortisol awakening response (CAR) that sets the tone for your personal unique pattern of cortisol for the rest of the day.
Since cortisol (stress hormones) are highest in the morning, identifying what your personal cortisol baseline is in the first 30-minutes of waking with the DUTCH Plus allows the other collection samples throughout the rest of the day to be reported accurately in reference to your baseline.
But Stress is Normal Right?
“But isn’t stress inevitable…a normal part of life?!”
Yes, stress IS inevitable, but when the amount of stressors in your life SURPASSES your body’s own ability to recover from that stress is when adrenal fatigue arises.
Essentially, adrenal fatigue happens when your body is UNABLE to “be human” in its fullest capacity—healthy, balanced, able to fight off stress then recover, and in harmony with the world around it.
What Causes Adrenal Fatigue?: Stress 101
It’s crucial to understand that “adrenal fatigue” (or HPA Axis Dysfunction) can be caused by several aspects of our modern lifestyles.
Although most people typically think of stress as psychosocial and emotional stress, (and those definitely are big contributors), stress is most broadly defined as “any event in which environmental demands, internal demands, or both tax or exceed the adaptive resources of an individual.”
Any trigger or event that causes “wear and tear” on the body is a stressor.
It does NOT have to be psychological or emotional.
For example, you can seemingly have “everything going for you”—not a care in the world (successful, wealthy, busy social life, big social media following), and on vacation on a beach in Costa Rica, but still be under a crazy amount stress if you have an undiagnosed parasitic infection in your gut, an autoimmune condition, iron overload, and hormone imbalances (a missing period, PCOS, pre-mature menopause, etc.).
So, if stress is normal, how does your body get “overloaded” or “over stressed” in the first place?
There are 5 primary types of stressors of adrenal fatigue including:
5 Most Common Stressors of Adrenal Fatigue
Lack of Basic Health Needs
- Poor quality diet
- Hydration & quality water
- Lack of sleep
- Sedentary lifestyle
- Overtraining (lack of recovery)
- Blood sugar imbalances (lack of protein, lack of fat)
- Nutrient deficiencies
- Packaged and processed foods
Gut & Hormone Imbalances
- Underlying gut dysfunction (Parasites, bacterial overgrowth, yeast overgrowth)
- Food intolerances
- Leaky gut
- Hormone imbalances (birth control, steroids, etc.)
Circadian Rhythm Dysfunction
- Light exposure at the wrong times
- Jet lag
- Caffeine consumption
- Blue light/LED light (screens)
- Shift work
- Burning a candle at both ends
- Traumatic event (car wreck, etc.)
- Long term medication use (NSAID, antibiotic, steroids, SSRIS)
- Food additives
- Poor quality air
- Plastic tupperware
- Tap water
- Type A personality—and difficulty listening to your body over your schedule
- Relationship stress
- Financial stress/pressures
- Lack of control
- Not talking about your stress (bottling it up)
- Lack of play/fun
- Not doing things you love
- Serotonin suppression (“feel good” brain chemicals)
- Social Media comparison/endless scrolling
- Trying to be all things to all people/people pleasing
- FOMO (lack of downtime for yourself)
- News binging
WHAT TO DO ABOUT IT
Adrenal fatigue recovery is no one-size-fits-all approach. Treatment usually consists of a combination of nutrition, lifestyle, and supplement/herb recommendations.
Treatment ALSO depends on how long you have struggled with adrenal fatigue, as well as what type of adrenal fatigue you have (is your cortisol high or low?). This is why salivary-urine hormone testing is highly recommended (not blood testing, as it will not catch the presentation of your cortisol patterns).
A common roadblock many people run into with adrenal fatigue is self-diagnosis and then self-hacked protocols with various supplements to try to “fix it.”
Unfortunately, you CANNOT supplement your way out of a poor diet or stressful lifestyle. in addition, if you take the wrong supplement for you (such as a formula with licorice, if your cortisol is already high), you may be doing more harm than good for your body.
That said, here are a few universal adrenal fatigue recovery must-haves for any adrenal fatigue treatment plan.
4 Adrenal Fatigue Treatment Must Haves
Eat a Nutrient-Dense Diet
- Eat a real food, nutrient-dense diet, composed of a serving of sustainable protein, veggies and healthy fats with each meal. A Paleo or Autoimmune Protocol template are good places to start.
- Steer clear of sugar, artificial sweeteners, soy, dairy, gluten and packaged/processe food
- Cut the coffee (4-8 weeks)
- For those in the initial stages of healing (4-8 weeks), mini meals may be better (3 small meals and 2-3 snacks, with an emphasis on protein, healthy fats, and moderate carbs)
- No extreme cleanses or diets; some people may do best off of a moderate-lower carb and moderate-higher fat for blood sugar reasons, but carbs are still your friend
- For those who have been overdoing it in the gym, take a break (30-60 days) from intense exercise (CrossFit, HIIT, heavy weight lifting, intense spin classes, yoga with weights), and replace with moderate weight lifting and light aerobic activity (walking, swimming, spinning)
- Incorporate at least 1-2 complete rest days from the gym in favor of recovery; Sometimes a complete break (1-4 weeks) from movement may be beneficial and necessary.
- Focus more on walking, yoga, pilates, moderate weight lifting, and low-intensity aerobic activities (Biking, swimming, Tai Chi) that allow your body to recover and regain strength
Rest & Recovery
- Sleep 7-9 hours, if you can go to bed by 10 pm and wakeup around 7 am
- Incorporate “recovery” into your healing (mobility work, sun light therapy, float tank therapy, acupuncture, massage, as you get stronger: sauna)
- Consider counseling, working with a coach or mindfulness based stress reduction
- Biofeedback, like HeartMath’s Inner Balance, is also effective for gaining control of your stress patterns
Supplements & Herbs
- Probiotic & Prebiotic. Your gut is the gateway to health! (Hormones included). Support a healthy gut eco-system with a soil based probiotic and easily digested prebiotic (1 tsp) daily.
- Basic Nutrients for strengthening your adrenal glands include:
- Ashwaganda and Rhodiola are 2 herbs that promote general cortisol balance. I like the blend by HPA Balance for both high and low cortisol presentations.
- Phosphatidylserine (PS). A naturally occurring phospholipid essential for the membranes of all cells, especially in the central nervous system that works to reduce periods of “high” stress. I love APEX Adrena Calm lotion —it works instantly to combat the stress response.
- Lavender Essential Oil tends to have a calming affect for those who are “wound up” and Peppermint Essential Oil has a “boosting” effect for those who need a pick me up.
- Anti-Inflammatory Supplements. Calm internal stress with CBD Oil and Liposomal Curcumin for body balance.
- Melatonin. Your sleep hormone—supports better sleep if you are wound up at night. It also helps regulate other hormones and maintains the body’s circadian rhythm. Try Sleep Remedy before bed.
- Customize. Test your cortisol with the DUTCH Test to determine your cortisol presentation before supplementing specifically for cortisol imbalances. Connect with Dr. Lauryn for your own test and personal healing plan today.