Why Adrenal Fatigue Doesn’t Exist
If you’ve spent any amount of time in wellness circles, you’ve probably heard of adrenal fatigue. Adrenal fatigue is the concept that, after a prolonged period of stress, your body’s production of stress hormones shuts down. You might have even experienced this phenomenon yourself: you’re wired and hypervigilant for a period of time, but when the stressor doesn’t go away, you develop lethargy, fatigue, brain fog, and a host of other symptoms. What you’re experiencing is real. Adrenal fatigue is not. Let me explain.
When we are stressed, our brain sends a message to the adrenal glands to secrete the stress hormone cortisol. Cortisol helps us adapt to stress. Evolutionarily, it tells your body that there is a threat, and that it needs to shift gears to mobilize resources for, say, a fight with a lion or a period of starvation. Cortisol is “catabolic:” it breaks things down to be used for survival now, and puts a brake on the production of nonessential processes like making sex hormones and even the immune system.
The problem with modern day stressors is that they’re more likely to be psychosocial than physical. In other words, the lion never comes, but we are constantly running from it. The cortisol response – which is adaptive – isn’t meant to be sustained for long periods of time because cortisol takes a toll on your body. This is called “allostatic load,” or the price you pay for the physiological accommodation to stress.
From here you might assume that the adrenal glands just peter out and stop producing cortisol – hence the term “adrenal fatigue” – but that’s not what happens. Fortunately, it’s very, very hard to burn out the adrenal glands. Our adrenals are crucial to our survival. They not only produce cortisol, but they are also responsible for hormones associated with blood pressure regulation and neurotransmitters like adrenaline that keep us alive. So you’re not going to burn out your adrenals, even if you try. They’re too important, and (lucky for us) too resilient.
Instead, what happens is that cortisol eventually takes a toll on your brain. It’s not just catabolic to your body, but to your brain as well. It especially decreases the size of an area called the hippocampus. Since the hippocampus is involved with memory, many people who have had severe or chronic stress may have experienced memory loss or brain fog. Hippocampal damage sends a message to another brain region called the hypothalamus, which is in charge of something called the “HPA axis.” The “A” in “HPA axis” stands for “adrenal.” So essentially, brain damage puts the brakes on the adrenal gland, and the adrenal gland stops secreting cortisol.
So your adrenals don’t fatigue. It’s your brain that signals to your adrenal glands to stop producing cortisol so the cortisol will stop damaging your body. This is why your experience of long-term stress is real, but the term “adrenal fatigue” is misleading.
So at this point you’d think that all is right with the world because you no longer have cortisol wreaking havoc on your body, right? Wrong. The low-cortisol state is actually the worst thing that can happen. We need cortisol to survive. When your brain is constantly shutting its production down, we get into a pro-inflammatory state. Cortisol suppresses the immune system, remember? So when we don’t have enough cortisol, our immune system goes un-checked and we can develop autoimmunity and fibromyalgia. The pro-inflammatory state associated with low cortisol has even been shown to increase cardiovascular mortality. In fact, every disease state you can think of will get worse when our secretion of cortisol is impaired.
So what to do? Don’t lose hope. There are ways to correct a low-cortisol state, including lifestyle changes, herbal supplements, and drugs. But the most important thing to do if you’re experiencing chronic stress is to seek professional support.
Here are some tips to manage chronic stress:
Seek professional support (see, I said it again)
Decrease added sugar in your diet
Limit caffeine and alcohol
Engage in mindfulness, prayer, breath work or meditation
Double down on sleep hygiene
Consider vitamin D and omega-3 fatty acids
In good health,
Gina