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Adrenal Fatigue is an umbrella term for a group of symptoms caused by the adrenal glands functioning at less than optimum capacity and as a result, fail to produce adequate amounts of hormones needed by the body. The adrenal glands are walnut-sized glands on top of our kidneys and they supply our body with over 50 different hormones like epinephrine, cortisol, progesterone, estrogen, testosterone and DHEA among others.
Although Adrenal Fatigue is nothing new, it was first diagnosed over 100 years ago and has been successfully treated for several decades, most medical doctors are not aware of this condition. For several reasons that mainly have to do with the close relation between medicine and the pharmaceutical industry, the medical community has ignored the existence of Adrenal Fatigue over the past 40 years. Due to this lack of knowledge, individuals continue to suffer because of improper diagnosis and treatment.
The term Adrenal Fatigue is actually a misnomer. A better label would be “HPA axis dysfunction” as the adrenal glands work in concert with the hypothalamus (part of your forebrain), the pituitary gland (just below the hypothalamus) to regulate the stress response, digestion, immune system, libido, mood, energy levels and metabolism. Because the term Adrenal Fatigue has drawn much popular attention over the last few years we will stay with this term on our website to prevent further confusion.
The development of Adrenal Fatigue is usually caused by financial, emotional, mental or physical stress (poor nutrition, over exercise, acute / chronic infections such as influenza, bronchitis or pneumonia). After experiencing many of these stressors over an extended period of time, the adrenal glands are not able to keep up with the body’s demand and will produce less and less cortisol, the body’s dominant stress hormone. Adrenal Fatigue is a multi stage process. First, there is a rise to unusually high levels of stress hormones. After a while, the body reacts by reducing sex hormone levels to compensate for the elevated stress hormone levels (see “Pregnenolone Steal” section below). Later the stress hormones start to drop, unable to sustain the pressure. The lower levels of cortisol and adrenaline, together with the disruption in the daily cortisol cycle, are what generally cause many of the Adrenal Fatigue symptoms. The constant tiredness, inability to focus, disrupted sleep cycles and more are all results of the stress hormones not being at its optimal level.
Briefly touched upon above, the Pregnenolone Steal is one of the body’s coping mechanisms to deal with stress. To better understand this phenomenenon let’s start at the beginning. Cholesterol is the raw material for the creation of all the steroid hormones that are created by a variety of tissues, most prominently the adrenal glands and gonads (ovary and testis). As the diagram below illustrates, under normal circumstances pregnenolone, which is made from cholesterol, is converted into progesterone and DHEA (Dehydroepiandrosterone). The body then uses DHEA to make both testosterone and the estrogen hormones (estrone, estriol, and estradiol) or the “sex hormones”.
When under stress, the body is hyperstimulated to produce cortisol, the body’s primary stress hormone, and pregnenolone is diverted (stolen) from other pathways. So, instead of pregnenolone taking the normal route of progesterone or DHEA -> testosterone -> and the estrogen hormones, it is “stolen” or diverted away to convert into cortisol (via progesterone). This phenomenon is called the Pregnenolone Steal and as mentioned happens under stress.
As a result DHEA production suffers because now less pregnenolone is available and the body can only create (sufficient) DHEA from pregnenolone, as such hormone production of progesterone, DHEA, testosterone and the estrogens is going to suffer. The increase in the production of cortisol (and the accompanying diversion of pregnenolone) leads to fatigue and other symptoms related to chronic stress and over time. If stress continues, the Pregnenolone Steal has more damaging effects resulting from the loss of balance amongst the steroidal hormones to the impairment of all the metabolic processes that depend on their availability.(1,2)
In a healthy individual the adrenal glands instantly respond to a stressful situation by increasing production of adrenaline, cortisol and other hormones that speed up heart rate, increase blood pressure, slow digestion, increase the amount of oxygen you breathe in, shunt blood flow to major muscle groups, release energy stores for immediate use and change various other autonomic nervous functions, giving the body a burst of energy and strength. But this important defence system, that’s also known as the fight-or-flight response, is 40.000 years old. It was meant to be triggered occasionally and only for short-term use so that our early ancestors could deal with physical threats in which the emergency resolved very quickly in a few seconds or minutes, such as a sabre-toothed tiger or warrior from another tribe. Because of this emergency aspect, the stress reaction takes priority over all other metabolic functions in the body.
Unfortunately the modern day stressful events such as health worries, financial problems, work stress, noisy neighbours, relationship troubles can not be resolved by fighting or running away, but these psychological stressors still trigger the fight-or-flight response. When stressors become unrelentingly frequent, or chronic and remain unresolved as can be the case with the above psychological stressors, stress-related health conditions arise as the body remains in perpetual stress response mode.
As the name implies, the most telling symptom of Adrenal Fatigue is — you guessed it — fatigue. But the kind of fatigue experienced here is when the tiredness and sense of being sleepy extends through the whole day and does not go away after a good night’s sleep. Energy levels are only boosted up usually late in the evening as caused by the sufferer’s disrupted cortisol cycle. As a result, people experiencing Adrenal Fatigue often feel the need for stimulants like coffee and sugary foods and drinks to get going in the morning and through the day.
Adrenal Fatigue is not a readily identifiable condition such as measles or influenza so you may look and behave relatively normal without showing obvious signs of physical illness when suffering from it. But those with Adrenal Fatigue feel far from normal and often report feeling “grey” throughout day, tiredness and a general sense of unwellness. Often also reported are a general lack of enthusiasm or difficulty in keeping up with everything that goes on around. Aside from the physical symptoms, Adrenal Fatigue can have a profound impact on emotional and psychological health and with respect to relationships, social life and work. In the more serious cases, the activity of the adrenal glands is so diminished that an individual may have difficulty getting out of bed for more than a few hours per day, limiting the ability to work, to take part in daily activities, relationships, exercising, social events and community activities.(3,4,5,6)
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