We’re often faced with long term, high levels of stress (read more here). Our bodies are fantastic at allowing us to function well under high stress for a certain period of time, but what happens when we’re no longer able to cope? Eventually our adrenal glands crash, and they stop producing enough cortisol. This state of abnormally low cortisol is referred to as adrenal fatigue.

What is a normal cortisol rhythm?

Normally cortisol is highest in the morning, which allows us to get up and have energy to start the day. Cortisol gradually declines over the remainder of the day, and is lowest from 12am – 4am. At night, cortisol is inhibited by melatonin, which is the hormone that allows us to get a deep, restful sleep. Bursts of cortisol are also released in response to stressful situations as part of our “fight or flight” response.

How does adrenal fatigue occur?

When we experience highly stressful situations for a long period of time, the adrenal glands release higher levels of cortisol than normal to allow us to cope and survive under stressful conditions. However, the adrenal glands aren’t designed to continually produce high cortisol levels forever, so eventually, they run out of steam and crash. After they have crashed, the adrenals release lower than normal amounts of cortisol, which leads feelings of fatigue among many other symptoms.

Hints you may have adrenal fatigue:

• You are/were under long-term emotional stress, and you’re no longer coping well
• You are/were under long-term physical stress, including chronic illness, marathon training, pain, sickness or injury, and you feel rundown or heal slowly
• Difficulty getting out of bed, even after sleeping well
• Feeling tired during the day, regardless of how well you’ve slept
• Relying on caffeine to give you energy
• Feeling rundown or overwhelmed
• Over-reacting, feeling anxious, “snapping”, or crying more easily
• Difficulty recovering from stressful events, injuries or illnesses
• Craving salt
• Dizziness when you stand up quickly
• Abdominal weight gain, or difficulty losing weight
• Difficulty concentrating, poor memory

The best way to understand your cortisol rhythm is to have it tested. The Adrenal Stress Index test uses saliva to test cortisol at four points during the day. This allows your Naturopathic Doctor to assess and treat your cortisol accordingly, although sometimes symptoms alone are enough to start treatment.

How is Adrenal Fatigue treated?

Adrenal fatigue is treated in two parts. We must first limit stress (remember that your body isn’t producing the hormones you need to cope with stress), and then we must rebuild the adrenal glands so that they’ll produce cortisol in a normal rhythm. You may also need to address the thyroid, insulin resistance, and the sex hormones, as they are often affected during adrenal fatigue.

a) Limit Stress

The body sees all stressors as being same: physical stress, emotional stress, illness, pain, abnormal eating patterns, and abnormal sleeping patterns. So to treat adrenal fatigue, we need to address all these possible areas of stress:

1. Limit workouts to gentle, balanced exercise such as walking or yoga.
2. Reduce emotional stress by avoiding triggers, learning to say “no”, asking for help, and doing regular deep breathing and meditation.
3. Seek out therapies such as massage, naturopathy, osteopathy or physiotherapy to heal pain and improve chronic illness.
4. Eat regularly, limiting sugar and empty carbs, and instead filling up on protein, vegetables and quality fats.
5. Develop a bedtime routine, turn off electronics at least 30 minutes before bed, sleep in a pitch-black room, and go to bed and wake up at consistent times.

b) Rebuild the Adrenals 

Herbs like Eleuthrococcus, Panax ginseng, Astragalus, Licorice, Schizandra and Ashwaganda can help to rebuild the adrenal glands to help regulate cortisol, and all have slightly different effects in the body. Supplements such as magnesium, vitamin C, pantothenic acid (vitamin B5), vitamin B6 and zinc can help to rebuild the adrenal glands.

Always speak with your Naturopathic Doctor before taking any supplements or herbs, as they may not be safe or the right choice for you.