What do Academy Award-winning actress Gwyneth Paltrow, extreme skier and author of The Art of FEAR Kristen Ulmer, and singer and Instagram personality Kristina Cassandra “KC” Concepcion all have in common? Aside from having great minds for business and very successful careers, each is reported to suffer from Adrenal fatigue — a mild form of adrenal insufficiency.

If you’re unfamiliar with the condition, Adrenal fatigue may occur when the adrenal glands, positioned on top of the kidneys, produce too much or too little stress hormones (including cortisol and adrenaline) due to long-term exposure and response to stress.

Conventional medicine recognizes two adrenal-related diagnoses:

  • Addison’s Disease (low cortisol)
  • Cushing’s Syndrome (high cortisol)

Each of these two diagnoses is relatively rare and requires immediate attention. However, high or low cortisol in the absence of adrenal disease can cause fatigue, body aches, and a host of other symptoms commonly seen in clinical practice. Clusters of these symptoms are what clinicians commonly diagnose as adrenal fatigue.

Defining “Stress”

In the context of adrenal fatigue, stress is anything that triggers the adrenal gland to produce and release stress hormones, including:

  • Fear, which triggers the fight-or-flight response
  • Physical injuries or chronic pain
  • Diets high in carbohydrates, sugar, or caffeine
  • Alcohol and substance abuse
  • Chronic infections including Epstein Barr, Herpes, H-Pylori, and Lyme’s disease
  • Environmental toxins including heavy metals, black mold, and endocrine disruptors in plastics
  • Poor sleep
  • Life stressors, including divorce, job loss, death of a close family member or friend, relationship conflict, and problems at work

The stress toll on the adrenal glands varies according to the number of stressors and their intensity and duration. As long as you are subject to stress, your adrenal glands operate in stress mode.

Adrenal fatigue may affect thyroid function.

Adrenal function and thyroid function impact each other. Cortisol can interfere with the conversion of thyroid hormone into its active form, thereby slowing metabolism. By assessing cortisol levels and taking steps to balance cortisol, a patient suffering with hypothyroid or unexplained health problems often starts to feel better. For more about hypothyroid, see my post “New Thyroid Treatment Options for Tampa Residents.”

Recognizing the Difference between Adrenaline and Cortisol

Although adrenaline (epinephrine) and cortisol (hydrocortisone), are both stress hormones, they play very different roles:

  • Adrenaline primarily increases heart rate, respiration, and the force of muscle contractions.
  • Cortisol acts on fat cells, the liver, and the pancreas to increase glucose levels to provide energy for muscles. It also temporarily inhibits certain bodily functions, including digestion, growth, reproduction, and the immune response.

Adrenal Fatigue Symptoms

The increased secretion of stress hormones is designed to give the body a temporary surge in energy and strength to escape or ward off danger. It is designed for a sprint, not a marathon. Chronic stress leads to high levels of stress hormones for as long as the adrenal glands can keep pace followed by insufficient levels as the adrenal glands become exhausted.

Having too much or too little adrenaline is rare, so the focus of adrenal fatigue is on cortisol levels.

Symptoms of high cortisol:

  • Anxiety, mood swings, or irritability
  • Progressive weight gain around the abdomen and upper back, face, fat hump at the base of the neck
  • Restless sleep
  • Blood sugar dysregulation
  • Female facial hair or female balding
  • Menstrual abnormalities
  • Fatigue
  • Muscle wasting or weakness
  • Back pain
  • Thin skin
  • Decreased bone mineral density
  • Poor concentration
  • Swelling of the hands or feet
  • Low libido
  • Acne
  • Impaired memory
  • High blood pressure
  • Easy bruising
  • Poor skin healing

Symptoms of low cortisol:

  • Lightheadedness
  • Hypoglycemia
  • Salt cravings
  • Weakness
  • Fatigue/sleepiness
  • Increased heart rate
  • Low blood pressure
  • Restless sleep
  • Swelling
  • Muscle pain
  • Joint pain
  • Sore throat
  • Headaches
  • Dizziness upon standing
  • Abdominal pain
  • Apathy
  • Impaired concentration or memory
  • Confusion
  • Anxiety

I often see patients with a grouping of symptoms of both high and low cortisol. A patient will come in after suffering through a traumatic event, such as divorce or a stressful situation that persisted for years, such as caring for a sick family member, working in a stressful environment, or being stuck in a challenging relationship.

They have gained weight due to excess cortisol production and now suffer with anxiety, poor sleep, and exhaustion. Some have high blood pressure, but many have symptoms of low cortisol, including low blood pressure, because their adrenal glands suffer the fatigue of having produced high levels of cortisol for such a long period of time.

Adrenal Fatigue Diagnosis

Adrenal fatigue (high or low cortisol) is one of the most commonly missed diagnoses I see in my practice. Most endocrinologists and primary care physicians suppress the symptoms of adrenal fatigue with anti-anxiety medication or antidepressants. This approach usually produces some initial symptomatic relief. Over time, however, the patient continues to feel exhausted and gains more weight, and the poor sleep patterns often resume.

An accurate diagnosis begins by carefully listening to the patient’s symptoms and history. A careful examination of the patient’s past and present life stress is critical to understanding the progression of adrenal fatigue. Conducting a thorough metabolic survey provides a checklist of adrenal symptoms and is used on subsequent visits to monitor progress.

Physical examination is performed to see if there is low or high blood pressure, abdominal weight gain, cold hands or feet, dry skin, brittle nails, which can all be indicators of deficiencies related to high stress levels and the subsequent upregulation of inflammation.

Lab tests checking salivary cortisol throughout the day can pinpoint the problem and help guide the appropriate treatment plan.

Adrenal Fatigue Treatment

Adrenal fatigue treatment involves treating the whole person and all sources of stress, including work, relationships, diet, other health conditions, and environmental toxins. The first step is to identify and remove or reduce the stressors.

A variety of vitamins, minerals, adaptogenic herbs, and antioxidants can be used to improve the health and healthy function of the adrenal glands. (Adaptogenic refers to substances that stabilize physiological processes and restore homeostasis — the ability of the body to regulate itself.)

Usually within several days to weeks patients start to feel more energy, experience more restful sleep, and have the “lift” they need to initiate lifestyle changes that support adrenal health. Such changes may include adjusting activity levels, modifying diet, and avoiding stimulants.

If you experience any of the symptoms described in this post or other unexplained symptoms, I encourage you to schedule an appointment with a doctor who has expertise in diagnosing and treating adrenal fatigue and hypothyroid. With an accurate diagnosis and the right treatment, healthy function can be restored, and you will be well on your way to optimal health and fitness. Don’t suffer unnecessarily.

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Dr. Matt LewisAbout the Author: Dr. Matt Lewis, D.C., CFMP®, specializes in diagnosing and treating the underlying causes of the symptoms related to chronic and unexplained illness through nutrition, lifestyle, chiropractic, and other natural approaches to whole-health healing in Tampa, Florida. He earned his B.S. in Biology from Shenandoah University, his Doctorate in Chiropractic from Life University, his CFMP® from Functional Medicine University, and his certification as a Digestive Health Specialist (DHS) through the Food Enzyme Institute. Dr. Lewis’ passion for health and wellness stems from his own personal experience. With a family history of autoimmune conditions and diabetes, and his own lab tests showing his genetic susceptibility to Hashimoto’s thyroiditis (autoimmune thyroid), he has learned how to restore his own health and vigor to prevent the onset of these illnesses and live an incredibly active life. Through this process, he acquired a deeper understanding of health and wellness, which he now offers his patients in Tampa.

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Dr. Matt