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Adrenal Fatigue

Are your Adrenals working?

Treating hypothyroidism without treating the adrenals, is one of the biggest reasons people continue to feel exhausted despite receiving treatment with thyroid hormones.

Patients may initially report feeling more energetic after starting thyroid hormones, but this is usually followed by feeling worse and worse… until they are right back to where they were before they started the thyroid medications. Usually, thyroid blood tests show normal or optimal levels. 

Many symptoms of hypothyroidism overlap with symptoms of underactive adrenals.

What Are the Adrenals?

The adrenals are two small glands, located on top of each kidney, that release “stress hormones” which impact many important functions throughout the body. They help establish your stress tolerance, tame inflammation, regulate blood sugar and body fat, control potassium and sodium levels (impacting blood sugar), and influence sex drive and anti-aging. 

Cortisol is a hormone that is required for life — we could not live without it, and it is an important anti-inflammatory hormone.

Dr Wentz found that the majority of people with Hashimoto’s have low levels of cortisol.

What Causes Adrenal Fatigue?

In most cases of adrenal fatigue, there is a "communication breakdown" in the HPA axis. The HPA axis describes the interactive feedback loop that takes place between the hypothalamus, pituitary gland and the adrenals. 

The hypothalamus is like the CEO of our body’s production of hormones. It scans messages from our environment and other endocrine glands, as well as checks the body’s overall hormonal status, before passing on the order for more hormones to the pituitary gland. 

The pituitary gland then acts as a project manager and will pull together individual workers (like the thyroid gland, the adrenal gland, and the gonads) to do their jobs. The pituitary will also make sure the workers have adequate resources to do their jobs by managing growth and repair, as well as electrolyte/water balance.

Root Cause: STRESS

One of the most common causes of adrenal fatigue is stress, which creates an intense demand for stress hormones such as cortisol and adrenaline.

The HPA axis works in response to two types of stress: immediate stress and chronic stress. 

In cases of immediate stress, the hypothalamus activates our fight-or-flight response. As part of this response, the adrenals pump out extra hormones, and our bodies go from the state of relaxing, digesting and healing, to a survival state.

Our body’s energy is shifted from activities not essential to survival. 

Once we’ve escaped from the emergency situation, the focus once again turns to body maintenance and upkeep.

In cases of chronic stress, the never-ending presence of stressful, yet non-life-threatening, situations can lead to the constant activation of the stress response.

To help meet the demand for cortisol, your body will decrease the production of other hormones normally produced by the adrenals such as progesterone, DHEA, and testosterone.

Eventually, with enough chronic stress, the HPA axis becomes overwhelmed and desensitized. Additionally, a person may run out of nutrients that are required for proper adrenal function.

Common Symptoms of Adrenal Dysfunction

Symptoms of poor adrenal function may include the following:

  • Feeling overwhelmed
  • Feeling tired despite adequate sleep
  • Trouble falling asleep or staying asleep
  • Difficulty getting up in the morning
  • Dependency on caffeine
  • Cravings for salty foods (a.k.a. the “I just ate a whole bag of chips syndrome”)
  • Cravings for sweet foods
  • Increased effort required for everyday activities
  • Intolerance to exercise
  • Low blood pressure
  • Feeling faint/dizzy when getting up quickly
  • Easily startled
  • Mental fog or trouble concentrating
  • Alternating diarrhea/constipation
  • Low blood sugar
  • Decreased sex drive
  • Decreased ability to handle stress
  • Longer healing time
  • Mild depression
  • Less enjoyment in life
  • Feeling worse after skipping meals
  • Increased PMS
  • Reduced ability to make decisions
  • Reduced productivity
  • Poor memory

Testing for Adrenal Issues

Adrenal saliva tests provide a way to test our current adrenal function. 

Normally functioning adrenals are supposed to put out the most cortisol in the morning, and the levels of cortisol should decline during the day, until very little cortisol is secreted at bedtime. A cortisol kick in the morning helps us to get out of bed bright-eyed and bushy tailed, ready to face the day. Low cortisol secretion at bedtime helps us relax and sleep.

Normal vs. Burnout Cortisol Levels Infographic

Symptoms associated with low cortisol:

  • Anxiety
  • Depression
  • Headaches
  • Insomnia
  • Chronic pain
  • Itching and rashes
  • Low blood pressure
  • Chronic inflammation

Symptoms associated with low DHEA:

  • Anxiety
  • Depression
  • Headaches
  • Insomnia
  • Weight loss
  • Poor immune function
  • Chronic inflammation 

Testing for Adrenal Fatigue

If you think you might have adrenal fatigue, you can arrange a couple of functional tests. 

Adrenal Fatigue

Adrenal Function Profile

Saliva testing for DHEA and diurnal cortisol levels at 4 time points during the day is a comprehensive test that can assess full adrenal function. It can be used for identifying adrenal imbalances caused by too much or too little hormone, match tested hormone levels with symptoms to help individualize a treatment plan, retest to monitor and adjust treatment as needed or track progress with follow-up test reports.

dutch adrenal

The DUTCH Adrenal test provides free cortisol patterns that parallel saliva with the addition of metabolite measurements for an improved marker for total cortisol production.  This test is run on LC-MS/MS: the most accurate way to test cortisol and metabolites!

Interpreting your results

Once you received your test results, you might benefit from a more in-depth interpretation and personalised action plan. 

Adrenal fatigue report

Our Adrenal Report is a comprehensive document, about 40 pages, which explains to you in more detail how your adrenals works, what all the test results mean, how you can help yourself with lifestyle changes and supplements.

Book a consultation with Shoela

If your adrenal test shows abnormalities, we recommend getting in touch with our affiliate practitioner Shoela. We know her personally. She is very experienced and knowledgeable.