I would like to start by asking you a question? When is the last time you felt exhausted, anxious, and overwhelmed. Start by thinking back to this last time. Unfortunately, if you’re like many women I know, you won’t have to think back too far!
Now, ask yourself what you assumed the cause of this feeling was. Perhaps it was the stress of an upcoming event or deadline, or just a very long day. Maybe you didn’t sleep well, or drank a little bit more wine than you normally would over the weekend. You might suspect or even know that you have a hormonal imbalance, adrenal fatigue, or another underlying issue that is contributing to your symptoms and feelings.
How about your gut? Did you know that a digestive system imbalance could be contributing to fatigue, anxiety, and any number of other symptoms of adrenal dysfunction?
There has been an explosion of research over the last few years linking the gut to the brain and to all kinds of health concerns, and more and more people are now at least somewhat aware of the connections. Still, we just don’t tend to think of the gut when we think of symptoms like tiredness or moodiness, and we don’t always make the connection to adrenal fatigue.
One of the most important components of functional medicine is making the connections that might otherwise be missed.
Gut health and adrenal health are linked in all kinds of ways, and often need to be addressed together in order to heal and achieve optimal wellness. Let’s take a look together at the profound connections between these two areas, and what we can do to restore balance and healthy function to both the stress response and the gut.
The Connection Between Adrenal Fatigue and Gut Health
When women come to see me about adrenal fatigue (whether they already know that they have it or not), I often learn as I’m taking a detailed history and asking questions that they are experiencing at least some degree of digestive dysfunction in addition to their other symptoms. In some cases, they’ve already been diagnosed with a gastrointestinal condition like IBS, and in other cases, they are experiencing undiagnosed symptoms like bloating, abdominal pain or discomfort, gas, constipation, or food sensitivities.
Depending on how severe your digestive symptoms are (especially compared to any other symptoms you’re experiencing), it may or may not seem like a high priority issue. The thing is, gut health has a huge impact on adrenal health and vice versa, whether or not gastrointestinal symptoms are problematic enough to raise the red flag.
As with many connections between different systems in the body, the relationship between gut health and adrenal health is kind of like a circle. They’ve worked together forever, and we can’t always pinpoint where or when the relationship became dysfunctional. Imbalances in the gut contribute to adrenal fatigue or dysfunction, and adrenal fatigue contributes to issues in the gut.
And of course, the vicious cycle of stress impacting gut health and vice versa leads to more dysfunction related to hormonal and neurotransmitter balance, immune system function, thyroid function, and more.
What Stresses Out the Gut?
Let’s go back to what we know about adrenal fatigue for a second. The adrenal glands and the rest of the HPA axis are responsible for producing hormones in response to stress, and thereby regulating our stress response. Adrenal fatigue, which can lead to all kinds of symptoms that interfere with our quality of life, occurs when stress is high and/or chronic to the point of the adrenal glands not being able to function properly.
Although major traumatic events and extremely high-stress situations can certainly lead to adrenal fatigue, in a lot of cases I find that the biggest problem is chronic, “low-level” stress. This is the kind of stress that just lingers around all the time, meaning that our bodies are in a near-constant state of fight-or-flight, instead of returning to normal after a danger has passed.
It’s important to understand that when we talk about stress for our bodies, we’re not just talking about emotional and mental stress (worries related to family, relationships, work, money, etc). Stressors can (and do) also include things like chronic exposure to toxins, inflammatory foods, or hidden imbalances within the body.
The body responds to stressors like inflammatory foods in the same way it responds to stressors like getting into an argument with a loved one. And here’s the thing: anything that is stressful for the gut is stressful for the entire body and mind.
Common stressors related to gut health can include things like food sensitivities (especially the hidden ones), foods that are inflammatory or difficult to digest, the presence of parasites, an overgrowth of bacteria in the small intestine (SIBO), a yeast overgrowth or candida, dysbiosis (an imbalance between “good” and “bad” gut bacteria), nutritional deficiencies, the use of certain kinds of medications, and more.
The underlying, low-level, chronic stress caused by these triggers and imbalances can lead to or exacerbate adrenal dysfunction, and perpetuate the vicious cycle.
It can be so frustrating to feel like you’re doing everything right when it comes to healing from adrenal fatigue, but you’re still suffering. The thing is, many gut stressors are hard to find. Even if you’re eating a healthy diet, if you have a moderate food sensitivity that you’re unaware of, or if you have a leaky gut or another functional digestive issue that is keeping you from processing nutrients properly, you might end up hitting a wall.
That’s why it’s so important for women (and their physicians!) to really investigate and search for where some of our less obvious stressors might be– including in the gut– so that we know which areas we need to target.
This is especially true if you’ve already spent some time working on healing from adrenal fatigue, but you’re still not where you want to be. If it feels like something is missing, an imbalance in the gut just might be the key.
How Stress Affects Digestion
Our stress response is designed to help us in situations that are very challenging or truly dangerous. In order to keep us sharp and focused on dealing with the stressful situation (both internally and externally), our stress response slows down or shuts off functions that seem to be less pressing. This includes immune system function, reproductive function, and digestion.
This is actually very helpful in the face of a truly stressful event! But when stress is constant, including from exposure to toxins, gut imbalances, and overly stressful day-to-day lives, essential systems and processes like digestion are never really given the chance to function at their normal levels and do their jobs.
Chronically high levels of cortisol (the infamous “stress hormone”) can inhibit digestive function, leading to digestive issues as well as a reduction of healthy bacteria in the gut. Stress is actually a common cause of dysbiosis (an imbalance between friendly and unfriendly bacteria in the gut microbiome), which can contribute to health problems of all kinds, including (you guessed it) adrenal fatigue.
Adrenal Fatigue and Leaky Gut
One of the most common issues I see associated with adrenal fatigue is leaky gut. You may have heard the term leaky gut before, but here’s a quick refresher. Basically, our intestinal walls are protective barriers, designed to allow only certain things (like nutrients) out from the gut and into the bloodstream. Leaky gut occurs when this barrier becomes problematically permeable, and allows substances like undigested food particles and bacteria to slip through into the bloodstream.
When these foreign substances manage to leak out into the bloodstream, our immune system sounds the alarm, which can contribute to all kinds of issues including autoimmunity, increased food sensitivities, and chronic inflammation.
Elevated cortisol levels can actually increase gut permeability. Dysbiosis also contributes to leaky gut, and we just learned that chronic stress and high cortisol can contribute to dysbiosis, too.
Of course, leaky gut and the resulting immune system issues all create more stress within the body.
How to Restore Gut Health and Heal from Adrenal Fatigue
There are a number of great strategies I use in my practice to help restore gut health and adrenal function, naturally. Here are some of my top tips for you.
- Try Probiotics: Probiotics are friendly bacteria that can be taken as supplements or found in certain kinds of food. The use of probiotic supplements in the treatment of a multitude of different conditions has been studied with positive results, as they help to repopulate the gut microbiome with the healthy bacteria we need to restore balance. Research has shown that cortisol levels can be lowered by taking a probiotic. Probiotics have also been found to reduce gastrointestinal symptoms associated with stress. Probiotic foods (fermented superfoods like kefir and kombucha) can also be added to the diet.
- Eat a Clean Diet: Inflammatory foods including sugar, gluten, dairy, and processed foods are stressors for the gut and the rest of the body. Caffeine and alcohol are stressors, too. The cleaner your diet, and the more you can build your meals out of fresh, whole foods, especially clean protein, superfoods like dark, leafy greens, and healthy fats like avocados, the less stress you will be putting on the gut and the adrenals.
- Look Into Specialized Testing: One of the best tools we have in functional medicine is specialized testing that allows us to explore factors that are very unique to each individual. Especially if you have made healthy lifestyle changes and are still struggling and confused, it’s worth looking into specific functional medicine tests that might help to fill in the pieces of the puzzle. Testing for IgG food sensitivities (different from food allergies) is huge, because many of us don’t even realize that our bodies are sensitive to certain healthy foods. Gut microbiome testing can also help to identify where there may be gut issues that are hindering the healing process.
- Check Your Magnesium Intake: Magnesium is one of the most important nutrients for helping to normalize the stress response, heal from adrenal fatigue, and achieve optimal health, but many of us are deficient in it, especially if we have a leaky gut or another digestive issue that is keeping us from absorbing enough of it from our diet. Eat plenty of magnesium-rich dark, leafy greens like spinach and swiss chard, and consider supplementation if you are deficient.
- Work on Stress Management and Relaxation: Healing from adrenal fatigue and restoring gut health requires that stress of all kinds is addressed. It’s important to take time for yourself to relax, practice yoga or meditation, spend time in nature or unwinding with loved ones, and learn to say no when you need to! It’s the only way you’ll be able to really recover. Getting enough good quality sleep is another absolute must!
- Eat Mindfully and When Relaxed: Eating when stressed, nervous, in a rush, or distracted makes it harder for us to digest food properly. Even if you’re eating a healthy diet, if you’re forcing a meal down while standing up at the kitchen sink about to rush out the door, your gut and the rest of your body will be stressed. Work on creating an environment that allows you to relax while you eat, and focus on eating. It can even help to get into the habit of taking a few deep, cleansing breaths before every meal.
Restoring gut health and adrenal function naturally is possible, and it all starts with understanding how connected these two areas really are. Keep these connections in mind as you go along your healing journey, and know that I really believe you can get to the bottom of your adrenal fatigue and any gut imbalances, and feel like the best version of yourself!
Reviewed by Dr. Mark Menolascino, MD