Fatigue Is A Common Condition
Fatigue and exhaustion are two of the main reasons people come to seek medical treatment from naturopathic doctors. In fact, exhaustion is so common in my patients; I consider it the most common condition I treat. But is exhaustion the same thing as adrenal fatigue? And just because you are feeling exhausted, does that mean you have it?
There are a multitude of reasons that a person may be feeling exhausted, and a thorough intake is necessary to determine the cause. Poor sleep quality, anemia, chronic infections, hypothyroidism, autoimmune conditions, and a host of chronic diseases may also be responsible for chronic fatigue.
Too often I am asked to address the question of what adrenal fatigue is, and if exhaustion is the same thing. While the two conditions are related, exhaustion may have a host of causes, and it should not be assumed that the cause is due to adrenal fatigue.
The adrenal glands, are diamond shaped structures that sit on the top of our kidneys, and are responsible for producing several types of hormones that include, aldosterone, which helps maintain healthy sodium levels in the blood, DHEA, a precursor sex hormone, Norepinephrine and adrenaline, which act as regulators of heart rate, blood sugar and acts as vasoconstrictive agents.
And finally, cortisol, which helps maintain our circadian rhythm, slows down the metabolism during times of chronic stress and famine, and acts as a powerful anti-inflammatory.
A Working Theory Of Adrenal Fatigue And Human Evolution
From a medical anthropological perspective, human beings have found ways to adapt to a multitude of stresses, both acute and chronic. The ability of the body to maintain homeostasis in the face of various stressors is known as adaptability, and was necessary to human survival and evolution.
An example of acute stress could be described as running from a potential danger, such as being hunted by another animal or in wartime. An example of chronic stress would be a long-term stress like famine or long-term poverty, which was thought to result in thrifty genes; an evolutionary adaptation that allowed for changes in metabolism in response to famine.
Famine And Elevated Cortisol Levels
Famine was not unusual, or even rare, in early agricultural societies—and was even expected at certain times of the year.
An example of where we would see a high incidence of famine would be at certain times of the year, or during times of prolonged drought and wartime.
Another time when famine was noted was during certain periods in pre and early agricultural Europe. Fasting would often go on for several days, weeks or months—resulting in a high number of deaths during the wintertime. Irish folktales are rife with stories of life in early Ireland, when famine, disease, and early death, were quite common. 1
Throughout human history and throughout the world, even in early hunter and gatherer communities, there are reports of war and famine. This fact has lead many medical anthropologist to conclude that rising cortisol levels in the presence of chronic stress was an adaptive response necessary to human survival. A chronic elevation in cortisol meant a slowing down of the metabolism; allowing for higher survival rates in populations experiencing calorie restriction for prolonged periods of time.
The ability to store food helped decrease some of the mortality rates common during lean times, but it by no means did away with high death rates that resulted when food access was minimal.
Food storage became one way to protect human beings from starvation, is thought to be well over 25,000 years old, and seems to have intensified when human beings began to engage in agriculture approximately 11,000 years ago.
War was not uncommon during prolonged famine, as one clan, or group, sought to dominate and access food supplies from the other.2
This history certainly explains how, at least in many populations, human beings were forced to adapt to periods of prolonged stress.
These prolonged periods of stress may have promoted the adaptive response of rising cortisol levels: insuring a slower metabolism that would prevent starvation during famine. Cortisol not only increases belly fat, it desensitizes the tissue to glucose, slowing down metabolism. In today’s modern world, stress may look different, but the stress response is not.3
A common theme I hear from my patients, and often associated with exhaustion, includes fears of rising housing cost, the loss of a job, physical illness, and the fear of fractured homes and a difficult family life.
Diagnosing adrenal fatigue is based on symptoms and comprehensive lab testing; often by process of elimination. For example, if a patient’s labs return with no evidence of another condition, like anemia, infection or hypothyroidism, and the individual is maintaining a healthy sleep routine, then a 24 hour saliva cortisol test to rule out adrenal fatigue is warranted.
A person who has been exposed to chronic stress may experience poor sleep and mood changes, as well as a weakened immune system. An example of a weakened immune system, due to chronic stress, would be a student who experiences anxiety and poor sleep quality during midterms—only to break out with a case of shingles a few weeks later. Shingles outbreaks are heavily tied to a weakened immune system brought about by chronic stress.
Treating Adrenal Fatigue
There are different approaches to treating adrenal fatigue, but one of the first things that I suggest patients do is remove the cause. This may mean leaving a job, a toxic relationship, or simply finding new ways to cope with difficult situations.
A diet that is nutrient dense, and high in antioxidants, will insure that anyone dealing with stress is meeting the necessary nutritional goals to maintain good health. While I do not encourage starvation diets, nutrient dense diets can also help insure that any chronic stress you may be experiencing does not lead to resistant weight-loss.
Because your immune system may be vulnerable during times of chronic stress, I prescribe Vitamin D 5000 IU by Thorne Research.
Multivitamins for General Health
For general health, I also prescribe a good multivitamin. My favorite multivitamin for men is Basic Nutrients III by Thorne Research. For women I choose Basic Nutrients IV by Thorne research. If the man is over the age of 40, I prescribe Al’s Formula by Thorne Research, and for women over 40 Meta-Fem by Thorne Research is probably the highest quality multivitamin on the market.
If the fatigue is also accompanied by anemia, I advice taking Ferrasorb by Thorne Research, which contains the form of iron known as, bis-glycinate, and is thought to be far easier to absorb than ferrous sulfate.
There are some great adaptogenic formulas on the market. Many of these formulas are based on Chinese medicine, and the herbs used are referred to as the “Jing herbs.” Some of the best formulas by far come from Dragon Herbs.
I especially like their Tonic Alchemy formula, which can be taken daily for overall health and immune support. This product can be added to any smoothie recipe to help boost your smoothies antioxidant and adrenal support properties.
Another great product by Dragon Herbs is Super Adaptogen, This product contains many of the supportive herbs thought to improve energy, mood and memory.
Of course, if you need additional support for you health challenges, please feel free to contact me. I am available both at my offices, and by phone via telemedicine.
I look forward to offering you my help!