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The MSN Healthcare Health Blog offers news and analysis on weight loss, fatigue, personal health, and health news. It includes contributions from Dr. Mark Neumann and others. Click now.


9 Adrenal Fatigue Symptoms You Need To Know

Mark Neumann

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The body is like a factory with various bits and pieces keeping it running. When this factory is running smoothly, we find ourselves active, healthy and happy. Sometimes, it just so happens that we have to work harder and deal with greater stress than normal. This overactivity results in the body feeling tired, but with adequate rest, the body bounces back. 

However, when the factory has to bear this overextension for a long time, that is, in the case of chronic stress, it is harder for the body to recover. This could render long-term damage to the organs and overall state of the body. 

Chronic stress is very common and can be caused by work pressure, career changes, the death of a loved one, moving, illness, and failed relationships. One of the main responses of the body to stress is the production of stress hormones. Stress hormones include cortisol, glucagon, human growth hormone, epinephrine (adrenaline) and norepinephrine. Out of these, cortisol, epinephrine and norepinephrine are secreted from the adrenal glands.  

Adrenal glands are triangular shaped glands that sit on top of the kidneys like a cap. In chronic stress, the adrenal glands would keep producing these stress hormones until a certain point when the adrenal glands would become exhausted. This is known as adrenal fatigue, not to be confused with adrenal insufficiency and Addison’s disease.

What is Adrenal Insufficiency?

Adrenal insufficiency refers to a condition in which the adrenal glands produce an inadequate amount of steroid hormones, primarily cortisol (glucocorticoid) and aldosterone (mineralocorticoid). Adrenal insufficiency can be due to an autoimmune disorder or less commonly, the result of a fungal infection.

What is Addison’s Disease?

Addison’s disease, or Addison disease, is an adrenocortical insufficiency due to the destruction or dysfunction of the entire adrenal cortex. It affects glucocorticoid and mineralocorticoid production and function. The onset of Addison’s disease usually occurs when 90% or more of both adrenal cortices are dysfunctional or destroyed.

What is Adrenal Fatigue?

Adrenal fatigue, also known as hypoadrenia, is a term that was coined by a chiropractor, James Wilson, in 1998. It is the condition in which the adrenal glands are exhausted due to overproduction of cortisol and aldosterone for a long time, and are now unable to produce adequate quantities of hormones, primarily cortisol, due to chronic stress or infection. However, adrenal fatigue should not be confused with a number of other forms of adrenal dysfunction such as adrenal insufficiency or Addison's disease (explained above).

Symptoms of Adrenal Fatigue

Following is a list of the main symptoms that you may experience if you have adrenal fatigue:

1.   Fatigue

The adrenal glands sit on top of the kidneys and help regulate our metabolism. Hormones like cortisol are formed by the adrenals. Cortisol is a stress hormone, i.e. it makes sure there is an adequate glucose level in the blood in case of emergencies by utilizing glucose that has been stored in the cells. The adrenal fatigue theory suggests that prolonged exposure to stress can drain and exhaust the adrenal glands, thus, leading to a low cortisol state.  

So, in case of adrenal fatigue, there will be lower metabolism, and there will be a lesser amount of cortisol. This would lead to lower levels of glucose in the blood. Since glucose is the main provider of energy in the body, our body would be tired and muscles would ache. 

2. Weight Gain

Since hypoadrenia causes decreased metabolism, it is pretty evident that the food we intake will be broken down but not converted to energy with as much regularity. Nutrients will be deposited in the form of fats, whereas glucose will also be stored in cells. This accumulation of nutrients without their utilization for energy and heat can result in an increase in weight. 

An increase in body mass index (BMI) can lead to obesity. A huge proportion of the world’s population suffers from obesity. Obesity isn’t just being overweight, it is the common point from which so many complex and life threatening diseases can originate. Obese people are at risk of developing cardiovascular diseases, infertility problems, diabetes, and a whole host of other chronic issues.

3. Depression

Adrenal hormones are also involved in controlling mood, mental states and cognitive function in complex ways. Hypothalamic-pituitary-adrenal (HPA) axis function is typically affected during depression. According to research, stress has been associated with anxiety and depression. On the contrary, people going through adrenal fatigue and concomitant low cortisol/low DHEA have been observed clinically to often also experience mild depression, brain fog, difficulty concentrating and difficulty remembering things. They generally feel less tolerant than they normally would and are more easily frustrated.  

Depression causes feelings of sadness and/or a loss of interest in activities that were once enjoyable. It can lead to a variety of emotional and physical problems. It can also decrease a person’s ability to function at work and at home. This could lead to problems in career, relationships, and general well-being. 

The hippocampus, located near the center of the brain, stores memories and regulates the production of cortisol. The body releases cortisol during times of physical and mental stress, including during times of depression. Problems can occur when excessive amounts of cortisol are sent to the brain due to chronic stressful events and chemical imbalances in the body. Persistent stress and irregular cortisol levels can cause damage to the hippocampus and cause it to shrink. 

The primary treatment for depression is antidepressants, hand in hand with psychotherapy, although there are many natural ways to treat the feelings of depression as well. Every person is different so different people require a different combination of medicines that suit their needs best. 

There are various antidepressants available in the pharmaceutical industry:

1.    Selective serotonin reuptake inhibitors (SSRIs) increase the amount of serotonin in the body and these include fluoxetine (Prozac), paroxetine (Paxil), and citalopram (Celexa).

2.    Serotonin-norepinephrine reuptake inhibitors (SNRIs) and tricyclic antidepressants are used together. These in combination alter the amounts of serotonin and norepinephrine in the brain and thus  help boost mood and energy levels. Examples of SNRIs include duloxetine (Cymbalta) and venlafaxine (Effexor XR). Imipramine (Tofranil), nortriptyline (Pamelor), and trimipramine (Surmontil) are examples of tricyclic antidepressants.

3.    Norepinephrine-dopamine reuptake inhibitors (NDRIs) are medications that increase levels of the mood-boosting chemicals like norepinephrine and dopamine in the brain. Bupropion (Wellbutrin) is a type of norepinephrine dopamine reuptake inhibitor (NDRI) that may be used to treat depression.

4.    Monoamine oxidase inhibitors (MAOIs) are drugs that increase the amount of norepinephrine, serotonin, and dopamine in the brain. They can also improve brain cell communication.

5.    Atypical antidepressants include tranquilizers, mood stabilizers, and antipsychotics. These drugs can block brain cell communication in order to relax the body.

4. Brain Fog

Clouding of consciousness, also known as brain fog or mental fog, is a term used in medicine denoting an abnormality in the regulation of the overall level of consciousness that is mild and less severe than delirium. Brain fog is not in itself a disorder but a set of symptoms that is characterized by confusion, forgetfulness, and a lack of focus and mental clarity.  

Brain fog may cause confusion and disorientation, affecting memory, information processing, and spatial awareness. Brain fog can make a person feel as if the processes of thinking, understanding, and recalling are not working as they normally should. Memory and thought process seem to be cloudy. Brain fog is different from depersonalization.

The chemistry lies in the chemical imbalance of the body. Problems can occur when excessive and then insufficient amounts of cortisol are sent to the brain due to a chronic stressful event and chemical imbalance in the body.  Persistent stress and irregular cortisol levels can cause damage to the hippocampus and it can shrink. Shrinkage of the hippocampus is the reason for forgetfulness, cloudy thinking and brain fog. Perception, memory, learning, executive functions, language, constructive abilities, voluntary motor control, attention, and mental speed may be impaired.

5. Insomnia and Sleep Issues 

Increased stress can lead to an exhaustion of the adrenal glands. This can cause a hormone imbalance and an aberration in hypothalamic-pituitary-adrenal (HPA) axis function. A person with adrenal fatigue can have insomnia and sleep problems due to this. 

Adrenal Fatigue is an imbalance of the hormone cortisol. Normally, we are supposed to get 3 main surges of cortisol during the day, but none at night time. However, in a patient with adrenal fatigue, the opposite of normal occurs, and you have low cortisol in the morning with peaks in the evening. Cortisol keeps us active and energized throughout the day, but when we have cortisol surges at the wrong time, it is difficult to keep up with daily tasks as a patient with adrenal fatigue would feel tired and low in the morning and find that they’re more active during the night. 

Insomnia, also known as sleeplessness, refers to the clinical condition where a person is unable to get an adequate amount of sleep, as they either have difficulty going to sleep or staying asleep. They may also wake up during the night and have trouble going back to sleep. People with insomnia can have burnout symptoms where they may be irritable, easily aroused, and aggressive. 

According to doctors, insomnia can be treated with central nervous system (CNS) depressants like Benzodiazepines (BZDs). Ramelteon and Zaleplon are most often prescribed to insomniac patients. Other household and alternative medicine therapies include Valerian, which is a dietary supplement that has been used since ancient times for insomnia and nervousness. 

Chamomile, like valerian, is a traditional herbal remedy that has been used since ancient times to fight insomnia and a wide range of other health complaints. Chamomile is often brewed in boiling water to make an herbal tea. Drinking chamomile tea before bedtime can aid sleep.

Some general  lifestyle practices that can aid in going to sleep and staying asleep are:

  1. Sleeping and waking up at the same time each day, as this can create a steady pattern which may help to prevent insomnia

  2. Avoidance of vigorous workouts, however, exercise earlier in the day may be beneficial

  3. Avoiding caffeinated drinks, like coffee or coke,  a few hours before going to sleep

  4. Avoiding or limiting daytime naps

  5. Treating or addressing pain at bedtime

  6. Avoiding large meals, heavy beverages, alcohol, and nicotine before bedtime, as these may lead to an upset stomach and alter glucose levels in the blood

  7. Finding soothing ways to relax into sleep, including use of a white noise machine

  8. Making sure the bedroom is dark, cool, and free of devices, such as clocks, a cell phone, or television.

  9. Sleep with a positive attitude. Write in a gratitude journal before bed.

  10. Try relaxing activities before sleeping, like reading a good book

  11. Use your bed only for absolute necessities, and avoid lying around in bed for too long

  12. Stop checking the time!

6. State of Overwhelm

In early stages of adrenal fatigue, there are excess levels of cortisol and other stress hormones like human growth hormone, aldosterone, epinephrine (adrenaline) and norepinephrine secreted by the adrenal glands. However, in later, chronic stages of adrenal fatigue, the adrenals are exhausted and do not have the capacity to secrete enough cortisol.

When there is a decline in stress hormone secretion, like glucagon, cortisol, epinephrine and norepinephrine, it becomes difficult for the glucose levels in the blood to be maintained. In such a case, during fight or flight situations, a person may become easily overwhelmed.

This response can be due to a physical, mental or an emotional stimulus. This is why it is necessary to remove that prolonged stressful stimulus so that the body can have time to compose itself and the adrenal glands can get rid of their fatigue.

7. Fibromyalgia and Increase in Aches and Pains

Increased aches and pains can be linked to a number of things. If you haven’t been sleeping the recommended 6 to 8 hours per day for several consecutive days, or when you haven’t been sleeping at all, your body starts giving in and you start to experience random pains here and there in the body. This is because the body hasn’t been able to rejuvenate properly. 

It is said that the body rests and rejuvenates itself during sleep. When the body does not get the chance to, a hormone imbalance may result and lead to aches and pains. However, there have also been studies that showed that a majority of fibromyalgia patients had difficulty going to sleep. It has been hypothesized that the pain makes sleep more difficult and sleep deprivation exacerbates pain.

Some key findings indicate that sleep and pain are intricately linked. Studies of patients experiencing post-op pain show disturbed sleep, reduced rapid eye movement (REM) sleep, and a normalization of sleep as recovery proceeds. Similarly, people with fibromyalgia may also experience an alteration in their patterns of slow wave sleep, which is the deepest stage of sleep.

Hence, adrenal fatigue can cause sleeplessness and you can have different types of pain with different areas of origin. The best way to manage this pain is to attempt to manage the root cause. It is advised to remove the source of stress so this vicious chain of sleeplessness can be broken. However, if that is not quite feasible, then it’s best to treat the imbalance of hormones and chemicals. Doctors can often help restore the fluctuating cortisol levels. 

Other options include fixing the disturbed sleep cycle. If the body gets its rest, then the aching would subside. CNS depressants like benzodiazepines are prescribed by doctors which help the patient become drowsy in order to sleep peacefully. Natural sleep remedies include herbal teas like chamomile. Lifestyle changes are also recommended as an aid. For effective pain management, various over the counter (OTC) painkillers like acetaminophen, aspirin, or ibuprofen can be taken if needed. Topical painkillers are also as option, as they are equally effective and cause less damage to organs.

8. Decreased Libido

The adrenal gland is responsible for the production of various sex hormones, in addition to stress hormones. The adrenal gland is triangular in shape and has 3 layers. The outermost layer secretes glucocorticoids, like cortisol. The next inner layer secretes mineralocorticoids like aldosterone, whereas the innermost layer secretes sex hormones like testosterone and dehydroepiandrosterone (DHEA). 

In the case of adrenal fatigue, the adrenal gland fails to produce these hormones in the amount they originally and previously had been. This has an immense effect on an individual who is suffering from adrenal fatigue. 

Adrenal fatigue affects both men and women alike. It is often not known by many, but women also produce aldosterone and testosterone. Most know estrogen as the female sex hormone, but androgens and testosterone also play a great role in female sex drive. 

Certainly, the amount of testosterone women make is much smaller compared to men; however, it is still a significant player in the female libido. Many women who suffer from prolonged illness-related or emotional stress often find that they have a much lower libido than before.

Most people would say that when they are stressed, the furthest thing from their mind is sex. This stress can be due to a number of reasons, from financial issues to physical self-esteem issues. Stressing about physical appearance, such as obesity, can lower libido. Obesity is influenced greatly by the adrenal glands. If the body cannot mobilize fat to make energy, then the adrenal gland becomes dysfunctional.

So, the greater the stress, the greater the production of corticosteroids, until the adrenals hit a limit and they run out of further capacity. This is known as adrenal fatigue.

When this occurs, the adrenal glands have lost the once well-oiled capacity of producing normal levels of sex hormones and this would result in decreased libido.

Both men and women can be affected by a declining libido due to stress. It especially impacts men who have had prostate issues or surgery, or are taking medications that interfere with erections. In addition, when men worry about sexual performance, adrenaline pours into the bloodstream and anxiety further depletes sexual desire.

9. Poor Memory

Another important symptom of adrenal fatigue is poor memory. The brain is responsible for all sorts of thoughts, memories, social behaviors and decisions. The hippocampus stores memories. It also regulates the production of the hormone cortisol. The body releases cortisol during times of physical and mental stress, and also, depression. Problems can occur when initially great amounts of cortisol and then insufficient amounts of cortisol are sent to the brain due to chronic stressful events and chemical imbalances in the body. 

Persistent stress and irregular cortisol levels can also cause damage to the hippocampus and it can shrink. Shrinkage of hippocampus can be a reason for forgetfulness. 

Other symptoms of adrenal fatigue include the following:

●     Multiple food and/or inhalant allergies

●     Increased effort to perform daily tasks

●     Decreased ability to handle stress

●     Dry and thin skin

●     Low blood sugar (hypoglycemia)

●     Low body temperature

●     Palpitations

●     Unexplained hair loss

●     Alternating diarrhea or constipation (IBS)

 If you have any of the above mentioned symptoms then it is best to consult with a Functional Medicine Physician. The doctor will monitor your cortisol levels and determine if you have adrenal fatigue or not.

Mother Nature cares for every child and being. She provides treatment for every illness that is known. If you have adrenal fatigue, it is best to maintain a healthy diet and make sure you are getting ample vitamin A, B complex, C and E. 

RELATED ARTICLE: 11 Best Foods for Adrenal Fatigue + Adrenal Fatigue Diet Plan

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