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Adrenal fatigueThe new healTh epidemic

Tired of feeling tired? Many doctors at the forefront of wellness now believe enjoying all-day energy, a sharper brain, optimal immunity and better health could be as simple as nurturing two tiny glands

By Bonnie Cleaver Illustrations Tanya Cooper

L ike most women, Claire Bellamy*, 43, had a pretty stalwart approach to coping when the pressure was on: “Head down, tail up and just push through it.” And normally, it got her through just fine. That is, until 2011, when working full-time and studying

for her masters at the same time her father was battling cancer culminated in a maelstrom of stress that battered her health. “I was picking up every cold going around, I felt like I was running at 60% capacity and even doing a full detox where I avoided alcohol, sugar, red meat, dairy and processed foods, which normally made me feel better, had no impact whatsoever on my energy levels,” she recalls. Then, midway through 2012, Claire came down with a flu that saw her bed-bound for two weeks. “Six weeks after the flu, I was still struggling to get out of bed,” she explains. “I was waking up feeling unrested, my body ached, my memory was deteriorating and despite being in my early 40s I felt like I was 80 years old.”

Trips to her GP and numerous tests hadn’t unearthed any health issues, but sensing something wasn’t right, Claire finally booked in to see a naturopath. “I described my symptoms and the naturopath said to me, ‘I believe you have adrenal fatigue.’ After running adrenal tests, she confirmed I was suffering from the condition

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and that my body was in a state of complete exhaustion. She explained that, in essence, I had nothing left in my ‘tank’ and had basically been running on empty.”

Adrenal fatigue was a new term to Claire—and no doubt to many others. We’re all too familiar with regular daily grind-induced fatigue, and we’ve heard of the chronic kind, but adrenal? It’s slipped under the health radar—until now.

the siLent heaLth saboteUr While few people know about adrenal fatigue, it’s been cited as a silent health epidemic, thought to affect up to 80% of the population at some stage. “I’ve tested hundreds of patients and I haven’t found anyone with healthy adrenal glands,” admits Sherrill Sellman, naturopath and author of Hormone Heresy: What Women Must Know About Their Hormones. “It seems everyone is in some stage of adrenal distress.”

Sellman isn’t the only health professional who believes adrenal fatigue—a state of persistent exhaustion caused by poor adrenal gland function—is a cause for concern. “My impression is that it’s becoming more common, particularly in the 30- to 60-year-old age group, and I suspect that’s a result of people leading increasingly busy, hardworking lifestyles,” adds integrative GP and adrenal fatigue specialist Dr Peter Dobie.

But if it’s so prevalent, how come doctors rarely mention it when we complain of feeling tired and run-down? Surely if there’s an underlying cause of our widespread weariness, we should know about it? “The reason doctors don’t flag it is because they’re taught in medical school that the adrenal glands are either working perfectly well or not working at all, which is a condition called Addison’s disease,” explains Dr Dobie. “However, an increasing number of doctors, myself included, believe there’s a grey area or intermediate zone of adrenal function where the adrenals are working, but not as well as they should be.”

Curious if you fall into this grey zone? While the most common clue is persistent tiredness, there’s a host of indicators, from low immunity to a lacklustre libido, mental fuzziness and a craving for sweet or salty foods. See our box on page 101 for a list of symptoms that can point to out-of-whack adrenal glands.

meet YoUr adrenaLs Wondering what these mysterious parts of your anatomy are? Perched on top of each kidney, the adrenal glands are smaller than a walnut and weigh less than a grape. They may be diminutive in size, but these petite powerhouses have a tremendous impact on your overall health. “The adrenal glands are part of the endocrine system, which along with other glands, including the thyroid and pituitary glands, is responsible for pumping out a whole lot of hormones that help regulate various essential bodily functions,” explains naturopath Victoria O’Sullivan.

The adrenal glands produce around 50 different hormones, which influence everything from how we handle stress to our metabolism, inflammatory response, blood glucose levels, blood pressure and our fluid and electrolyte balance. “The adrenal glands have fundamental functions in the body and are primary to our immune system function, our reproductive function and even our neurological system. If they become exhausted, it can initiate a domino effect where many other systems start

to go down,” explains Sellman. “For instance, if the adrenals are overworked, they can impact hormones leading to high oestrogen, insulin and cortisol levels while lowering thyroid, progesterone and testosterone levels. These changes can, in turn, trigger hypoglycaemia, PMS and other hormonal imbalances, a compromised immune system, chronic inflammation, insomnia, anxiety, memory loss and increased belly fat.”

Clearly, keeping these influential glands in good nick is vital to overall health. And if you’re a woman over 40, balanced, properly functioning adrenals are crucial if you want to set yourself up for a smooth transition through menopause and beyond. “Heading into menopause, the adrenal glands start to take over the production of oestrogen as the ovaries’ production declines, but if your adrenals are exhausted, they won’t be up to the job of managing the oestrogen response, which can aggravate menopausal symptoms,” explains O’Sullivan.

One more reason to care about your adrenal glands: they play a role in how well you age. “As people get older, levels of most hormones in the body drop, which contributes to the ageing process,” explains Dr Dobie. “If your cortisol levels are dropping more than normal as a result of poor adrenal function, it can lead to accelerated ageing.” Something none of us want!

the cortisoL connectionWhile the adrenals secrete a range of hormones, the predominant stress hormone they produce—and the chief culprit behind adrenal fatigue—is cortisol. Dubbed the “stress hormone”, we need small bursts of cortisol to help us ride out stressful events, but on the flipside it’s important that cortisol levels subside after your stressor (whether it’s a sabre-toothed tiger or simply your demanding boss) has subsided. “Cortisol is all about balance—if it’s too high or too low, it dysregulates other systems, so it has to be just right,” notes Sellman. Problem is, for many of us, our nonstop, pressured lives mean we’re on a permanent cortisol jag. And over time, this can paradoxically lead to not enough of the stuff to meet our body’s needs.

Enter the three stages of the stress response, a process deeply enmeshed with adrenal fatigue. “The first stage is the Alarm response, also known as ‘fight and flight’, where cortisol elevates and we are predominantly pumping out adrenalin. That happens because we are geared for survival,” explains Shannon McNeill, head naturopath at Gwinganna Lifestyle Retreat in Queensland. “Back in hunter-gatherer days, we rested and restored so the body could ‘reset’ from this stage, but these days we just keep pushing ourselves.”

The result? We create stage 1 stress repeatedly, which eventually progresses to stage 2, known as Adaptation or Resistance, and is the equivalent of adrenal dysfunction or insufficiency. “That’s when cortisol really kicks in and starts to become dysfunctional, in that instead of being elevated in the morning to help us face the day and tapering off as the day goes on, it’s usually elevated at night, which can disrupt sleep and affect blood sugar patterns so you have energy slumps mid-morning and at 3pm, and also create that feeling of being ‘tired but wired’,” explains O’Sullivan.

Keep forging ahead without taking time out to recharge and you’ll eventually hit stage 3 of the stress response: Exhaustion, the equivalent of full-blown adrenal fatigue.

The adrenal glands produce around 50 different hormones, which influence everything from how we handle stress to our metabolism

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“That’s where cortisol can actually be very low or bottom out,” says McNeill. You know you’ve reached stage 3 if you’re zapped from the moment you get out of bed right through the day. “At this stage, you’re depleted and exhausted, you might be craving sugar or salt, your mood can be affected, your immune system may start to crash with frequent colds and flus, and you experience increased sensitivity to the foods you’re eating and various allergies,” adds O’Sullivan.

stress in aLL its formsFrom your rushed daily commute to looming work deadlines and multiple to-do lists, it’s no secret that modern life can be taxing at times. And it’s this chronic, persistent stress that’s at the heart of adrenal fatigue. “Our culture simply doesn’t know how to look after our adrenals: we don’t know how to rest, we don’t get enough sleep, we don’t eat properly and we’re dealing with systemic inflammation, which calls on the adrenals to work harder and harder until they run out of steam,” says Sellman. “Particularly as women we’re not taught about how we need to find a balance or about the importance of taking time off and saying no when we need to.”

Compounding this is the fact that it’s not just the typical ‘too much to do, too little time’ type of stress that saps the adrenals. “Stress can be mental, physical or emotional, encompassing everything from eating food that doesn’t

agree with you, to heavy metals and environmental pollutants, underlying infections or bad bacteria in the gut, undiagnosed allergies, chronic pain and also dealing with emotional issues like grief, depression or unhappy relationships,” explains O’Sullivan. “The body can interpret all of these things as stress.”

Interestingly, while naturopaths and many integrative doctors are well-versed in adrenal fatigue, Chinese medicine practitioners also have a take on the condition and what can trigger it. Viewed as an imbalance in a person’s ‘kidney energy’, it’s thought adrenal fatigue arises when kidney ‘yang’ (that is, warm and dynamic energy) is depleted. “We believe in this case that there is not enough warmth in the body, which can occur due to an ‘invasion of cold,’ for instance from walking around with bare feet on concrete or marble floors,” explains Chinese medicine practitioner Clare Pyers. “It can also be a result of eating or drinking foods straight out of the fridge or freezer like ice cream and chilled water, or consuming too many ‘cold natured’ foods, like raw fruit and vegetables, especially in winter when ideally all of the foods we eat should be cooked.”

The good news is, a healthy lifestyle goes a long way towards repairing and fortifying our adrenals—and it can unlock new levels of vitality in the process. “You can heal and restore the proper functioning of your adrenals if you address the root cause and really look at what it takes to nourish your body,” says Sellman. “Above all, adrenal fatigue is a message that you’re out of balance and that it’s time to revaluate the way you’re living.”

rediscover YoUr energY For Claire Bellamy, a life overhaul was exactly what it took to help start the journey towards adrenal recovery. Think enlisting the guidance of both a naturopath and an integrative GP, taking a spectrum of supplements, adopting early nights, daily yoga and meditation, avoiding sugar and alcohol, and perhaps most importantly of all, cultivating a new philosophy of self-care. “I had to learn to stop my old habit of pushing through fatigue and instead listen to my body, recognise I can’t do everything and that if I don’t stop and rest when I’m tired, it impacts further down the line,” she reflects. “We feel so guilty for relaxing, but sometimes doing nothing actually does lots for your body.”

Taking regular time out is one way to dial down your stress levels and bolster your adrenals. But it’s also vital to examine the main sources of your stress—whether it’s marathon working hours, draining relationships or taking on too many things—and ask yourself if they are truly sustainable. Of course, it’s impossible to sidestep stress entirely, and that’s where a positive mindset comes in. “It’s about changing how we talk to ourselves, so instead of saying, ‘I’m under the pump and exhausted,’ you’d say, ‘That’s when the best of me comes out,’ ” suggests O’Sullivan. “Sometimes a subtle change in our language has a powerful effect on our ability to perceive stress.”

Another essential step to repairing your adrenals is getting sufficient shut-eye, with experts recommending setting a 10pm lights-out rule. “Sleep is the best tonic because we do all our restoration then; we even reset and recalibrate our cortisol,” says McNeill. As if we needed another excuse to visit the land of nod!

whY what YoU eat coUnts First, the somewhat inconvenient truth: if you do have adrenal fatigue, there’s a good chance you’re rather partial to caffeine and/or sugar. Unfortunately, these energy quick-fixes are doing your body no favours. Sweet treats affect your blood sugar response, causing eventual crashes in your energy levels after you scoff them, and exacerbating the hypoglycaemia that people with adrenal fatigue often experience. As for your latte habit? “It can contribute to adrenal depletion because of the adrenalin response of caffeine on your nervous system,” explains McNeill.

Now, for the better news: eating well and adding in specific supplements can make such a dramatic impact to your energy levels, you won’t actually need that double-shot cappuccino and muffin to feel human. “I recommend eating mainly whole grains, lean protein, good fats and lots of fibrous vegetables which are like the ‘logs’ on your energy fire, rather than ‘kindling’ such

❑ do you often wake up tired, despite having a full night’s sleep?

❑ are you easily fatigued and lethargic? does everything seem like a chore?

❑ do you suffer from mid-morning and afternoon energy slumps?

❑ do you often feel your best after 6pm and get a ‘second wind’ late at night?

❑ do you suffer from insomnia or have difficulty sleeping?

❑ has your ability to handle stress and pressure decreased? do you feel overwhelmed?

❑ do you suffer from recurrent colds, flus, sore throats and skin infections?

❑ do you often feel unwell or below par?

❑ are pms symptoms, such as cramps, bloating and headaches, a regular occurrence?

❑ do you have fibromyalgia, pcos, thyroid issues, food sensitivities or digestive complaints?

❑ do you have low blood pressure or feel light-headed or dizzy when standing up rapidly?

❑ have you been prescribed antibiotics several times in the last couple of years?

❑ is your short-term memory fuzzy and thinking clearly difficult at times?

❑ do you struggle with mood issues, such as feelings of hopelessness, irritability or anxiety?

❑ do you crave sweet or salty foods?

❑ do you rely on caffeinated drinks in the morning?

❑ are your lymph nodes in the neck frequently swollen?

❑ do you tend to tremble when under pressure?

❑ do you suffer from hypoglycaemia?

❑ is your libido lower than normal?

❑ do you often have allergic reactions?

❑ have you experienced weight gain, particularly around the middle?

Getting sufficient shut-eye can repair the adrenals. To wake up fresh, experts recommend setting a 10pm lights-out rule

could it really be adrenal fatigue?

Like regularly servicing a car, your adrenal glands need TLC to stay

healthy. Worried they could be running below par? While precise symptoms

vary, the list below is a handy guideline to symptoms that may merit a visit to your naturopath or integrative doctor

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as starchy carbs and stimulants such as caffeine, which just lead to energy crashes,” notes O’Sullivan. Where possible, eating organic produce will also help by reducing stress on the liver, which may not work as optimally in cases of adrenal fatigue.

And when it comes to supplements? It’s best to tap the guidance of a health practitioner, as the exact remedies you need may depend on what stage of adrenal fatigue you’re at. Still, it’s handy to know that some of the key supplements used in adrenal fatigue include B vitamins, magnesium, vitamin C and zinc. Herbs like withania, rhodiola, ginseng, licorice, lavender and wild oats are common health boosters, and in Chinese medicine, herbs like Korean ginseng, eucommia bark and cuscuta seed.

In most cases, natural supplements are all that’s needed. “Occasionally I do treat people with small doses of cortisol taken by mouth for three to six months while the adrenals recover their function, but that’s only in severe cases,” says Dr Dobie.

YoUr energY revoLUtionExercise is a vital part of any wellness strategy, but in adrenal fatigue it’s important to strike the right balance. Think restorative exercise like yoga, tai chi and walking, and if you need something slightly more vigorous, stick to brief 20 minute bursts. “Ask yourself if you feel energised after training, or washed out for the rest of the day,” advises McNeill.

Pyers also recommends Chinese medicine therapies like acupuncture, as well as moxibustion, a form of heat therapy whereby a herbal ‘cigar’ made of mugwort is burned on or near the skin. “It helps warm the meridians [energy points] which disperses cold, and is very nourishing if you’re fatigued,” she says.

From tweaking your diet to experimenting with natural therapies, adrenal support strategies can be a turning point in your energy levels. “The more you can restore your adrenals to optimal function, the more you get your life back,” reflects Sellman. “You have the energy to fulfil your passion and purpose, and you become the healthy, empowered person you are meant to be.” Sound good? Just show those little glands some TLC, and get set for an energy revolution.

Q I’m constantly tired. Is there a way to find out for sure if it’s adrenal fatigue?

a along with assessing your symptoms (see p 101), the typical way that

a naturopath or integrative doctor will diagnose adrenal fatigue is with a simple saliva test. this involves you taking saliva specimens at four points throughout the day, which are then analysed to gauge your cortisol levels. while you can measure cortisol (the chief hormone of concern in adrenal fatigue) with a blood test, saliva testing gives a more accurate picture of how your adrenals are functioning. “that’s because a blood test is a one-off spot test, but we want to see what’s happening over the whole day,” explains o’sullivan. if you see a chinese medicine practitioner, you can expect them to inspect your tongue, pulse and place their hands on your abdomen for clues to adrenal fatigue, such as a soft, weak pulse.

QWhat should the results say about my adrenal glands and overall health?

aa healthy test would reveal higher cortisol in the morning, tapering off

across the day. having low morning cortisol (which zaps your morning get-up-and-go) or elevated evening cortisol (where you come alive at night and may have trouble sleeping) indicates run-down adrenals, while low cortisol throughout the day suggests more severe adrenal fatigue.

Q So how is the condition usually treated? Do lifestyle changes help?

a Your health practitioner will likely compile a holistic lifestyle program for

you, incorporating everything from stress management to diet, sleep, supplements and possibly complementary therapies such as acupuncture or kinesiology. while it’s probable you’ll feel better soon, it’s a healing process you need to be patient with. “i always tell people recovery takes a minimum of three months,” says mcneill. Keen to find an adrenal-savvy natural practitioner near you? the natural therapy pages is a good place to start (naturaltherapypages.com.au).

Flick your vitality switch with expert tips for fighting fatigue, boosting energy levels—and keeping them there—at preventionmag.com.au/health

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