Fatigue is one of the most common complaints of people seeking medical treatment. It often occurs gradually with drops in energy at certain times in the day, waking up tired, or just an overall lack of energy. It often builds over months and years to the point that most people think of it as a part of “getting old”.
A good conventional practitioner will test for the typical culprits - iron deficiency, vitamin B-12 deficiency, low thyroid function, etc. Many of my patients have perfectly normal test results, but still feel tired.
Many alternative medicine practitioners will expand their search for the cause of fatigue to include low stomach acid, vitamin D deficiency, dysbiosis, and digestive malabsorption problems.
All of the conditions listed above can cause a lack of energy and should be investigated and addressed if they are the real cause of the tiredness. Functional medicine practitioners such as me have found that another commonly overlooked condition is often the underlying cause of fatigue: Adrenal Exhaustion.
The Adrenal Glands and Fatigue
The two adrenal glands are located on top of each kidney and produce a number of important hormones and neurotransmitters including Adrenalin and Cortisol. Both of which play an important role in dealing with stressful events and emergencies.
Adrenalin (Epinephrine) is a neurotransmitter that is released from the adrenal when the brain recognizes a threat to the overall well being of a person. With its release, Adrenalin triggers the “fight or flight” mode of the nervous system which triggers a cascade of responses in the body to deal with the threat. Historically, this might have been a lion, tiger, or other hungry predator with gratuitously sharp teeth/claws. This is part of what is referred to as the “Acute Stress Response” process.
Cortisol, a glucocorticoid (a steroid hormone produced from cholesterol), is normally released in response to events and conditions such as waking up in the morning, exercising, and acute stress. Cortisol has an extensive and system-wide role maintaining balance within the body.
In emergency situations cortisol and adrenalin are released. Cortisol’s primary function in acute stress is to redistribute energy – in the form of blood sugar - to parts of the body that need it most (i.e. the brain and major muscles) during “fight or flight” conditions. Cortisol is so important to our survival that production of the other hormones made in the adrenals is temporarily shut down.
In an acute stress response commonly lasting five to ten minutes the priority that cortisol receives from the adrenals isn’t a big deal. It’s when the acute stress response becomes chronic that the entire problem begins.
The Devastating Effects of Chronic Stress
Chronic stress has become an epidemic in the modern world as the demands of daily life are so extensive that our bodies never get a chance to recuperate. More importantly, emotional stress is just one of the three types of stress which also include dietary and pain/inflammation as causes.
When we first begin experiencing chronic stress our bodies compensate by increasing the amount of cortisol in the body. Tests commonly find high levels of cortisol in the saliva (more about this later). To keep up with the demand for cortisol, the adrenals direct the hormone precursors away from producing hormones such as estrogen, progesterone and testosterone all of which are made from cholesterol, just like cortisol.
So, how does this fit in with fatigue you ask? Well, as the body tries to keep higher levels of cortisol to deal with the never-ending stress, the adrenals become exhausted and the cortisol levels plunge as do the other hormones produced by the adrenals. The result is fatigue. No just feeling tired, but completely run down. But a lack of energy isn’t the only symptom. Adrenal fatigue can cause digestive problems, fibromyalgia, migraine headaches, weight gain, female hormone imbalances & menopause symptoms, and even chronic pelvic/hip pain!
Testing and Treatment
The ability to measure the level of adrenal function becomes obviously important considering the information listed in the sections above. Research has found that typical blood tests for adrenal hormone levels are not sensitive enough, so we rely upon salivary testing to give us a clear picture of adrenal status. At our clinic we use the 12 hour saliva adrenal stress index test which tests your cortisol levels during 4 specific times during the day which look not only at the total cortisol level but for any highs and/or lows during the waking hours.
By testing patients for adrenal fatigue, we can individualize their treatments to quickly restore adrenal function allowing the body to repair the damage caused by chronic stress. I commonly find that those suffering from low energy – even those with chronic fatigue rediscover themselves when adrenal function is restored.
If you or a loved one suffers from low energy, insomnia, or chronic fatigue, consider adrenal exhaustion as a possibility. Please call Blue Sky Wellness Studio at 503.517.8222 to schedule an appointment with Dr. Shawn Soszka so you can start feeling energized and youthful again!