Are you tired but wired? Teary, stressed, exhausted, with brain fog and feel as though you have no energy? Do you have constant highs and lows at inappropriate times of the day, wired at bedtime but exhausted in the morning? Are you tired but can’t seem to sleep? And can’t get out of bed in the morning? Are you constantly falling ill with colds and various bugs?  Do you experience panic attacks and palpitations?

You may have adrenal fatigue.

What is adrenal fatigue?

Also known as hypothalamus, pituitary adrenal axis dysfunction (HPA axis for short), adrenal fatigue occurs as a result of prolonged stress over a long period of time. When stress is ongoing, your body gets stuck in high alert mode, and stress hormones are being constantly pumped out by your adrenal glands. The adrenals start to struggle keeping up with constantly releasing hormones and adrenal fatigue sets in. Stresses may be from different causes such as:

• Mental/Emotional:work pressures, financial or relationship problems, unresolved trauma/abuse, feeling unworthy, low self-esteem, and pushing yourself to over-achieve constantly. Also, feeling directionless, with a lack of purpose can lead to feeling low, flat or even depressed which can be stressful.
• Physical:Illness e.g. from infections, prolonged chronic illness, allergies and food sensitivities; lack of sleep; or injury/pain and exhaustion from sport, where over-training/over exercising can cause or worsen adrenal fatigue.
• Toxic chemical overload:Liver overload from toxins e.g. xenoestrogens, antibiotics, prescription drugs; or living/working near places that are highly toxic e.g. factories. Chemotherapy and radiation can also contribute.
• Diet:Poor diet, with too much caffeine, too many unhealthy carbs and high-sugar foods can stimulate repeated cortisol release, setting up the adrenal fatigue pattern. Chronic gut issues like constipation, diarrhea, bloating, IBS, “leaky gut” and unaddressed food sensitivities can also cause adrenal fatigue.

How does it unfold?

There are 3 stages and knowing which stage you are at is important for both treatment and recovery.

1. Stage 1-cortisol is elevated, DHEA (in adults) dives down and pregnenolone is normal, so we start to steal pregnenolone to feed the cortisol pathway. Symptoms are mild – poor sleep, feeling tired but wired, muscle aches and pains, weight gain, difficulty losing weight, afternoon fatigue, needing stimulants e.g. coffee or carbs to keep going, energy fluctuations with the lows leaving you worn out. Your body however, can still produce the required hormones.
2. Stage 2-cortisol, DHEA and pregnenolone are all lower (because we’ve started stealing pregnenolone). As the brain realises that high cortisol is damaging, it shuts down messages to adrenals to keep producing cortisol in response to stress. Fatigue, anxiety, weight gain and need for stimulants increase. Stressful episodes result in repeated triggering of adrenal glands. This can cause high cortisol release one moment and low release the next. Energy is low.
3. Stage 3-you are now in adrenal exhaustion. The progression to this stage may have taken a few years. Cortisol, DHEA and pregnenolone levels all decline and fatigue turns into exhaustion. Immune system is compromised so you succumb to lots of minor illnesses such as infections and colds. You are now struggling to get through the day. Due to the gradual decline in your health you have forgotten how good you used to feel. This is your new normal.

Your adrenals have been overtaxed for a long period of time by the constant triggering of the body’s stress response. Your body knows that you shouldn’t have so much cortisol in your system, so becomes cortisol resistant, shutting down some of its cortisol receptors to try improve your hormonal balance. Due to this shutdown, instead of your cortisol level rising in the morning and lowering in the evening like it used to, it no longer peaks first thing in the morning to give you energy. Instead it just flat-lines the whole day, leaving you exhausted all the time.

What can you do?

• Eat regular meals: This keeps your blood sugars and energy stable, and reassures your body that you’re not in crisis. The opposite happens when you skip meals – particularly breakfast. Once your blood sugars get too low your body identifies this as a threat and triggers adrenaline and cortisol. Have a good breakfast to help increase your cortisol levels at the beginning of the day.
• Eliminate problem foods and eat right for your body: Common culprits include wheat, soy, dairy, corn and eggs. Food sensitivities and unhealthy food choices can create an adrenal response and can add another stress load. Addressing this can help ensure you eat the best diet for hormone balance, regaining energy and reducing anxiety. A food diary and an elimination diet can be helpful.
• Minimise sugar intake: Cut back on sugar in all its different forms including honey and agave syrup. Look out for hidden sources of sugar in packaged foods such as dextrose and maltose. Choose lower fructose varieties of fruit, such as berries and kiwi fruit. Very sweet foods put your body under the stress of having to quickly pump out insulin to lower the high blood glucose levels. Your bodyregards blood sugar surges as a threatand will trigger more stress hormones in response.
• Adopt healthy sleep habits and get enough sleep: This is key to recovery. No amount of supplements and herbs will help adrenal fatigue if you are not getting 8 hours of quality sleep and rest. To heal from adrenal exhaustion you should be in bed by 9 to 10pm every night. Practice sleep hygiene habits-especially no screen-time just before bed.
• Don’t engage in intense exercise every day. Intense exercise (marathons, HIIT) actually increases cortisol levels. Some research suggests that for people who have gained weight, doing intense workouts may actually be counterproductive because it raises stress hormones.
• Instead try more moderate type exerciseg. walking which usually results in feel uplifted, not depleted, also moderate weight training, slower bike rides, dancing and swimming.
• Also more gentle forms of exercise: slow your exercise pace to get more benefit. Balance your moderate and gentle exercise such as yoga and tai chi.  Yoga is calming and connects your mind, breathe and body. It induces a relaxation response which helps lower your cortisol levels. At the same time it boosts your alpha brain activity, which promotes greater calm.
• Relaxing activities –watch a comedy series or film- laughter directly reduces levels of cortisol and epinephrine and helps the immune system; reading for pleasure, listening to music e.g. classical or ambient music. Listen to mediation apps with relaxing soundscapes from nature and other audio tracks designed to help you wind down.
• Enjoy a relaxing aromatherapy bath:Add some candles and close your eyes.
• Schedule a massage for an hour of relaxation whenever you have time and can afford it.
• Spending time with a pet can also be relaxing and healing
• Ensure adequate intake of vital nutrients-via diet or supplements. These include:
• Vitamin C:Is directly involved in production of cortisol in your adrenals, so an important building block in recovery from adrenal fatigue.
• Vitamin B:B vitamins are important in cell metabolism. When you’re stressed you burn through your B vitamins, so a good B complex is important.
• Magnesium:This important calming mineral helps relax both your nervous system and muscles.
• Other helpful supplements include Omega-3 fatty acids, Acetyl-L-Carnitine, and Co Q10

Plus try some herbal medicines particularly adaptogenic, nervine and adrenally restorative herbs- such as Licorice, Rehmannia, Withania, Siberian ginseng, Valerian, Skullcap, Passionflower, Melissa, Bacopa, St John’s Wort, Panax ginseng, Astragalus, Oats and  Rhodiola.

Other helpful herbs to address adrenal fatigue include those beneficial for liver support, gut health and the immune system as all these areas will need help. Your Naturopath can advise you on the best herbal remedies for support.