The Functional Medicine Approach to Adrenal Fatigue

The Functional Medicine Approach to Adrenal Fatigue

By |2019-09-22T17:17:53-05:00September 22nd, 2019|

You’re exhausted and anxious all the time, even after you sleep at night. You’ve been struggling to lose weight and nothing works. Sometimes you feel like you’re losing your mind. Does this sound familiar?

So many women come to me complaining of these symptoms. They’ve gone the conventional route but their doctor can’t tell them what’s wrong. They are told there’s nothing wrong, that it’s “all in their head.” But these poor women, worn out and terrified, are right — there is something serious going on.

My diagnosis can be controversial in the medical community, with many conventional practitioners insisting it doesn’t exist. Even endocrinologists call it a myth. I’ve seen enough women follow my protocol for healing with great success to believe that these professionals are missing the point when they argue like this. Adrenal fatigue – or whatever you choose to call it – is a real condition, affecting far too many women. Let’s take a look at what I mean by adrenal fatigue, where it comes from, how stress is a factor, and what we do about it from a functional medicine standpoint.

Is Adrenal Fatigue Real?

Some of my patients ask me if adrenal fatigue is “real”. The truth is, the term “adrenal fatigue” is not necessarily the most accurate way to describe what’s going on with our adrenal function when we become burned out– but the condition it aims to describe is real! No matter what we call it, the fact that our adrenal function and our stress response can become impaired as a result of chronic stress is a reality, and it’s one that should be taken seriously.

The point is, our adrenals are real. Our stress response is real. Our stressors are real. Your symptoms are real. And in functional medicine, we want to get to the root cause of your symptoms and what is affecting your stress response.

I’m less worried about exactly how we label your condition than I am about how we’re going to get you back to optimal health!

One of the biggest challenges when it comes to adrenal fatigue is the fact that symptoms can seem unrelated or even vague. This is what leads to a lot of dismissals or misdiagnoses by conventional doctors. So many different conditions come with fatigue and other symptoms of adrenal dysfunction, which can make it hard to pin down.

I’ve had so many patients tell me that their doctors seem to think their symptoms are all in their head, because they can’t find anything “wrong” within their conventional medical framework.

Our Culture of Exhaustion

As a society, we have come to accept exhaustion as a fact of modern life. We are all overloaded! We’re trying to juggle work, family, and a million obligations, not to mention our constant exposure to environmental toxins, refined foods, screens and devices, and all of these other stressors that bog our bodies down.

We’re being taught to power through our marathon days by guzzling coffee, or by eating sugary foods as an afternoon pick-me-up. We’re working more and more hours at our day jobs and picking up extra work on the side to make ends meet, on top of caring for our kids and homes and families.

It’s no wonder we’re exhausted! In fact, up to 90% of primary care visits in the US are related to stress. So why are complaints of fatigue being brushed off as nothing?

What Conventional Doctors Don’t Understand About Adrenal Health

Fatigue is one of the most common complaints in medicine, across the board. But since so many different conditions cause or lead to fatigue, it can also be one of the hardest things to pinpoint. Unfortunately, this often leads to it just being ignored! If blood tests and other investigations come up inconclusive, you’re told that everything is fine.

One of the main arguments against adrenal fatigue in the conventional medicine world is the idea that proponents of this diagnosis are causing patients and their functional medicine practitioners to “miss” serious disease. This has not been my experience at all!

My experience has been that dismissing concerns of adrenal dysfunction after ruling out conventional medical diagnoses is what’s causing patients and their doctors to miss what’s really going on.

If you’re experiencing symptoms like fatigue, anxiety, low blood sugar, or difficulty losing weight, it is absolutely important to rule out conventional medical causes first. But most of my patients who are coming to me have already done that. They’ve seen their doctors, they’ve had their tests done, and they’re still unwell. They come to me at a time when, after conventional medicine has failed to uncover the cause of their problems, they’ve been told that there’s nothing wrong. That’s when it’s time to investigate adrenal function!

Have your symptoms been dismissed? Don’t stop now! I am here to tell you that it is not in your head, your symptoms do exist and matter, and you deserve to get back to feeling like you!

Adrenal Health Exists on a Spectrum

One of the fundamental aspects of functional medicine is understanding that health, illness, and most conditions exist on a spectrum. So, for example, if your blood test results indicate that you’re just below the threshold for a particular condition or a deficiency, which means that you don’t fit the “diagnostic criteria”, it doesn’t mean that there’s nothing wrong. You don’t need to wait until things get worse before being taken seriously!

Adrenal health and function, like most things, also exists on a spectrum. Conventional medicine recognizes a few medical conditions related to the adrenals; namely, Addison’s disease, or chronic adrenal insufficiency, which is what happens when you have lost 90% of your adrenal function.

Before that happens, low or impaired adrenal function is not really recognized. But I doubt that anybody is just waking up one morning having gone from 100% adrenal function to 10% overnight!

On the flip side, Cushing’s disease means your body is consistently overproducing cortisol. This chronic excess of this critical stress hormone can cause irritability, depression, anxiety, and also has some physical symptoms: fat in the abdominal region, moon-like face, and a fatty lump on the back of the neck. This disease, at the opposite end of the spectrum, can make women feel perpetually “wired” but exhausted at the same time.

These are the clinical extremes, and often the only adrenal dysfunction recognized. But there is a whole universe of possible adrenal dysfunction in the space between perfect function and complete adrenal insufficiency. This is the space in which we see a lot of adrenal fatigue, to varying degrees.

The Adrenals & the Stress Response System

The adrenal glands, which sit on top of the kidneys, produce hormones that are required for our stress response. The most famous of these is cortisol, but the adrenals are also responsible for producing DHEA, estrogen, progesterone, adrenaline, and dopamine, which communicate with the rest of the body.

Adrenal fatigue is not a condition of the adrenal glands alone. Our stress response system is complex! Adrenal dysfunction as we know it is a problem that involves the whole system, which includes not only the adrenal glands but the brain.

Again, the big issue when we’re talking about adrenal fatigue is stress, or an overactivated stress response system. We are living in this world that is throwing constant stressors at us all day long, and we are letting our stress response battery run lower and lower.

So, how does the stress response actually work? You’ve probably heard the term “fight or flight mode”. This is what the body enters into when faced with a stressor, in order to help us survive. The adrenal glands release the stress hormone, cortisol, as part of the process. Our energy and resources pool together to allow us to fight or run from the stressor. Other essential tasks, like digestion, immune system function, and rest, take a backseat. Our heart rate increases and our muscles tense up.

You’ve probably heard me talk about this before, but it’s worth remembering! We were not designed to be in this constant state of “must survive” that chronic stress pushes our bodies into. In order to thrive, we have to understand what’s going on inside when invisible, day-to-day stressors overwhelm us.

The thing is, our bodies are often experiencing stress even when we don’t feel “stressed” in the common sense of the word. Eating inflammatory foods, constantly reacting to emails and notifications, being exposed to chemicals, sleeping poorly, all of these things contribute to stress overload, too. The body doesn’t really discern between stress caused by your job and stress caused by your eating habits!

We were built to bounce back from stress to a certain extent, but when it’s constant, we can end up depleting our reserves, and running dry.

Adrenal Fatigue Symptoms

An overall feeling of exhaustion is probably the most recognizable symptom of adrenal fatigue, but there are so many other possible symptoms. If you suffer from adrenal fatigue or dysfunction, you may have some or all of these symptoms. Some of my patients only experience a couple of these. You may also experience symptoms not listed here.

Here are some of the most common adrenal fatigue symptoms that I see:

– Chronic fatigue

– Trouble getting out of bed in the morning

– Anxiety

– Difficulty sleeping

– Thyroid imbalance

– Trouble losing weight or unexplained weight gain (or loss)

– Cravings for salt, sugar, or carbs

– Heart palpitations

– Aches or muscle pain

– Dizziness upon standing

– Low mood or depression

– Weakened immune system; getting sick more frequently

– Hormonal imbalances

– Low libido

– Hair loss

– Fatigue in the afternoon

What Causes Adrenal Fatigue?

Adrenal fatigue doesn’t have a clear-cut definition or strict criteria for diagnosis, which is a concern within conventional medicine. But within functional medicine, we are less concerned with labeling it, and more concerned with understanding what’s going on within the body, and healing the root cause.

In the case of adrenal dysfunction of any kind, this means really investigating our stressors! What has caused our adrenal glands and our stress response system to burn out, and what can we do differently, in order to heal and get our lives back?

There are so many different kinds of stress that, when left to build up overtime, can lead to adrenal fatigue or dysfunction. These include what we typically think of as stressors (the stress we feel about money, work, relationships, family, etc) as well as poor sleep, eating inflammatory foods, overuse of sugar or caffeine, getting too much exposure to blue light from screens at night, imbalances in the gut… the list goes on and on. These many, many stressors drain us emotionally, mentally, and physically.

Identifying adrenal dysfunction is important, but it’s equally important to recognize that these glands themselves are not the root cause; neither is cortisol. Stress is the root cause!

How to Heal Adrenal Fatigue with a Functional Medicine Approach

You can treat adrenal fatigue or dysfunction naturally, by following a functional medicine approach– addressing the root cause. Let me show you what I mean!

One of the biggest issues with adrenal fatigue is that when we start to experience the early warning signs of too much stress (like feeling more tired than usual), rather than taking a step back and allowing our bodies to rest and heal, we find ways to push forward.

This is understandable in a world that can make us feel like we don’t really have a choice! Our deadlines, responsibilities, and schedules offer no give. So, when we start to feel overtired, we fuel ourselves with more coffee, more sugar, whatever gets us through the day. If we have trouble sleeping, we take something to get us through the night, or we simply stay up, and operate on less sleep and more caffeine.

But here’s the thing. All of these coping mechanisms that we use to deal with fatigue and stress just add to the burden and worsen the problem.

In order to truly get your energy and your life back, you need to find ways to reduce stress and heal your adrenals. The good news is that it is possible and it is achievable, naturally! But there are no shortcuts.

There are some supplements that may be helpful when it comes to healing the adrenals, and adopting a whole-food, anti-inflammatory diet is essential, but these steps alone are not enough.

Recovering from adrenal fatigue generally requires a lot of lifestyle changes. Revising your habits and reducing stress of all kinds will also help to prevent the problem from recurring.

5 Tips for Recovering from Adrenal Fatigue

  1. First and foremost, find ways to build more rest and relaxation into your life! Take hot baths with essential oils or epsom salts, practice yoga, take leisurely walks in nature. I’m telling you, your body and mind will thank you for it! Meditation and mindfulness are also important practices to learn and adopt.
  2. Too much vigorous exercise can be problematic when recovering from adrenal fatigue, but regular, light exercise and movement (like walking or cycling) is a good idea. Bonus points for being outdoors! Try not to get your heart rate over 90.
  3. Sticking to a consistent routine is always helpful when it comes to returning your body to it’s natural rhythms. As much as you can, try to go to bed at the same time (and get 8 hours of sleep!), wake up at the same time, and have your meals at the same time.
  4. Learn how to say the magic word: NO! And recognize when you need to.
  5. Reduce intake of sugar, gluten, dairy, alcohol, and fried foods. Try to reduce your caffeine intake, especially later in the day. Fill your diet with nourishing, anti-inflammatory, whole foods. Enjoy ample healthy fats like avocado and wild fish, dark green, leafy vegetables, and anti-inflammatory herbs like turmeric and ginger.

Adaptogenic herbs like rhodiola can also be helpful, as well as supplementation with B vitamins, zinc, magnesium, and vitamin C. Supplementation should be discussed with your practitioner first.

If you’ve been confused about what adrenal fatigue really means and why your doctor may have dismissed it, I hope this has helped to clear a few things up! Remember that no matter what we call it, if you’re experiencing it, it is real! You deserve to take a step back and get to the bottom of it, so that you can heal. I’m on your side, and you can do this!

Reviewed by Dr. Mark Menolascino, MD

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