Adrenal Fatigue For Dummies
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At the most basic level, adrenal fatigue refers to chronically overworked and overstressed adrenal glands that can become completely exhausted over time. Picture yourself working double shifts for a month straight with little sleep and little opportunity to take a break and recover.

You're tired and worn out, right? During the development of adrenal fatigue, the adrenal glands act the same way; they're constantly working hard with little or no chance to rest. Over time, they become unable to do their job effectively.

Adrenal fatigue is an example of organ dysfunction in response to inflammation. Early on, sustained inflammation and illness stimulate the adrenals to produce cortisol. Eventually, the adrenal glands are so fatigued that they aren't able to produce enough of the hormones such as cortisol and aldosterone that the body needs to function on a daily basis.

Adrenal fatigue develops in five stages. Before you review these stages, consider the following factors, which are important in the development of adrenal fatigue.

Everyone is different; some people are able to deal with a particular stressor for years before developing adrenal fatigue. For others, a single traumatic event triggers the development of adrenal fatigue. Thus, the time for someone to develop adrenal fatigue differs. That being said, it's often a chronic process that develops over a period of months to years.

Heredity’s role in adrenal fatigue

Some experts hypothesize that some people are born with more adrenal reserve than others — in other words, their adrenal glands have a better constitution, which delays the development of adrenal fatigue. Their adrenal glands seem to be better able to deal with a chronic illness and stress compared to other people's. The support for this idea is anecdotal, based on conversations with other alternative healthcare practitioners.

A 2013 article from the journal Annals of the New York Academy of Sciences cites data that supports the idea that some people are genetically susceptible to chronic inflammation. This genetic component may be related to an abnormality in the steroid (cortisol) receptor, more commonly referred to as the glucocorticoid receptor (GR).

Abnormalities in the GR may be responsible for the development of certain autoimmune diseases as well as the decrease in cortisol production by the adrenal glands.

The article hypothesizes that abnormalities of the GR not only increase total body inflammation but also impair the actions of the hypothalamic-pituitary-adrenal (HPA) axis and affect the ability of the adrenal glands to produce cortisol. How much an individual is affected by abnormalities in this receptor may determine the degree to which he or she is prone to develop inflammation and chronic illness as well as adrenal fatigue.

Early stressors as indicators of adrenal fatigue

Health professionals often think of adrenal fatigue as an adult syndrome; however, early stressors may significantly impact cortisol secretion later in life.

A 2011 article from the journal Endocrinology examined the relationships among several stress-related disorders, including chronic pain, chronic fatigue, and post-traumatic stress disorder. Despite the significant physical and psychological stress that these syndromes can cause, researchers found very low cortisol levels in the blood. (A typical response to stress is increased cortisol in the blood; cortisol eventually drops back to a normal level after the stress passes.)

The investigators concluded that the younger the age of the person when the stress began, the greater the likelihood of developing lower cortisol levels earlier in life. For someone subjected to repeated stressors at a young age, a type of “developmental programming” may occur: Over time, the repeated stresses cause changes in the body's “software” that permanently decrease the amount of cortisol produced by the adrenal glands.

Children and teenagers are now being diagnosed with inflammatory conditions that were once thought to affect only adults, including diabetes and obesity. Adrenal fatigue is linked to inflammation, so if you had one of these conditions as a child, you may be more likely to develop adrenal fatigue at a younger age.

Basic evaluation of environmental and psychological factors in adrenal fatigue

Concerning the development of adrenal fatigue, you can't ignore environmental factors or the things that people do to themselves. People drink alcohol to excess, smoke too many cigarettes, and even use drugs such as heroin and cocaine. These activities can fatigue the adrenal glands big time.

Smoking increases the body's inflammatory response dramatically. Cigarettes contain toxins and heavy metals, including cadmium and lead, which are also acute stressors for the adrenals. Cocaine increases the workload of the adrenal glands by pushing them to make higher amounts of epinephrine and norepinephrine.

The mega levels of these hormones produced after cocaine ingestion not only stress out the adrenal glands but can also cause dangerously high blood pressures and increase the risk of developing an acute stroke and/or heart attack.

Psychological stressors are just as potent as physical and environmental ones. An article from Biological Psychiatry in February 2013 demonstrated that in someone diagnosed with major depression, not only is the functioning of the adrenal glands altered, but so is the interaction among the hypothalamus, pituitary, and adrenal glands. Abnormal functioning of these glands can produce low levels of cortisol, and this can be a cause of depression.

About This Article

This article is from the book:

About the book authors:

Dr. Richard Snyder, DO, is board certified in both internal medicine and nephrology, as well as a clinical professor at the Philadelphia College of Osteopathic Medicine.

Wendy Jo Peterson, MS, RD, is a registered dietitian with a master’s degree in nutritional sciences as well as a specialist in sports dietetics. She is the coauthor of Mediterranean Diet Cookbook For Dummies.

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