The pace of modern life isn’t easy. Between putting in long hours at work, juggling an endless list of chores and errands, staying on top of social and family commitments, raise your hand if you’re left feeling tired and anxious all the time. As if that wasn’t enough, you probably also feel the pressure to do more and have a passion project or side hustle, make more money just in case.
For a period of time, this pace of life can be sustained with the help of caffeine or sleeping in on weekends. But if you’re doing it regularly and not taking enough breaks, it will catch up to you. Strange symptoms may already have started to kick in, like laying wide awake in bed at night, not waking up rested (ever), waking up in the middle of the night to pee, or not being able to complete your sentences with ease.
If you feel like I just entered your brain, it’s important that you take the time to read this article. While the common term for this phenomenon is ‘burnout’, the scientific name for this is adrenal fatigue. It’s extremely common, poorly understood and can have big implications for your long term health such as weight gain, skin problems and consistently low energy levels.
Back Up – What Are Adrenal Glands?
Ever heard of ‘adrenaline’ or had an ‘adrenaline rush’? Bingo. Adrenaline is a stress hormone produced by the adrenal glands; we each have two glands that sit on top of each kidney. They produce many important hormones related to stress, reproductive health, metabolism and regulating blood pressure.
However, the ones we have the most control over are the stress hormones:
Adrenaline and norepinephrine
These are the short-term stress hormones. They are released in a state of ‘fight or flight’ or an emergency to help you survive. For example, if you’ve ever had a car swerve at you and nearly hit you, you’ve probably experienced the sensation of a racing heart, breathing heavily and reacting extremely quickly.
Adrenaline and norepinephrine make sure to release a quick supply of glucose and oxygen to your brain and limbs, where energy is required the most. In order to deliver those substances to your brain and muscles quickly, your heart rate, blood pressure and breathing rate are all sped up.
This is the long-term stress hormone and it becomes elevated when you’re in a state of chronic stress. Essentially, it is cortisol’s job to regulate other functions in the body in response to that stress, such as blood sugar, metabolism, immune system, blood pressure and more.
Some stress is normal, and for that reason cortisol peaks during the day and then starts to decline in the evening closer towards bedtime. Unfortunately, when you’re in a state of chronic stress your cortisol levels will be elevated higher than normal, and will also struggle to decline in the evening.
What is Adrenal Fatigue?
If you stare at a screen for 12 hours a day, you’ll get headaches and your vision will worsen over time. Why? Because you wore out your eyes by putting so much strain on them all the time.
Similarly, if you’re constantly stressed you will put a lot of strain on your adrenal glands, and they will get worn out and not be able to perform as well. Eventually, you’ll reach the point where your adrenal glands cannot produce cortisol as efficiently anymore, and you’ll need stimulants to prop yourself up during the day, whether it’s coffee, tea, sugary foods or just a lot of carbs to give you energy to get through the day.
Adrenal Fatigue Symptoms
Before I provide you with the long list of symptoms, I want you to understand a few core concepts:
The ‘cortisol steal’:
Your adrenal glands have multiple functions and producing stress hormones is just one of them. If you’re constantly stressed though, it’s like your brain saying ‘stop the factory lines! Divert all raw materials towards making stress hormones’, which means the other hormones get neglected.One example of hormones that get neglected are the sex hormones, such as estrogen and testosterone. This is why high stress directly impacts your libido, fertility and PMS symptoms.
If you look in the diagram below (yes, scary scientific stuff I know), you’ll see that pregnenolone and progesterone are being used to make cortisol, instead of being converted into sex hormones or the anti-aging hormone DHEA.
Stress and blood sugar:
One of the main roles of stress hormones is to release more glucose as an energy source, which leads to higher circulating blood sugar levels. From an evolutionary standpoint this makes sense: if you had to run from a tiger, that quick release of glucose helped you get the energy to run and save your life.However, these days that ‘tiger’ is really a ‘big meeting’ or ‘deadline’ and that excess glucose and energy is not being used efficiently since we sit at a desk all day. Instead, it spikes blood sugar and leads to more cravings, weight gain and irritability.
Cortisol vs. melatonin:
Cortisol has an inverse relationship with our sleep hormone, melatonin. The latter cannot be produced unless cortisol has started to dip at night. If you’re stressed, overthinking or working late, it will literally block your brain from being able to fall asleep and lead to insomnia.
See how disrupting just one hormone leads impacts the rest of the body?
If you’re unsure whether you fall into the three categories above, go through this list of common symptoms. If you resonate with most of them, it’s a pretty big red flag. (1)
- Sensitive to bright lights
- Tightness or ‘lump’ in throat
- Inability to cope with stressful events
- Mood swings, tendency to cry easily
- Difficulty relaxing
- More than usual neck, head, shoulder tension
- Weakness, fatigue
- Recurrent infections i.e. always getting sick
- Low libido
- Brain fog, memory problems
- Food cravings i.e. salt, sugar
- Blood sugar disorders
- Frequent urination in the middle of the night
- Weight gain
- Digestion problems
Adrenal Fatigue Causes
Well, by now it should be obvious that the major culprit is stress. But it’s more than just emotional stress that can impact our adrenal glands; below are some of the more silent causes overburden the body, and reduce it’s ability to cope with stressful events.
- Diet high in refined carbohydrates such as sugar, white flour, processed grains
- In order to process and metabolize sugar, your body requires some B vitamins, some vitamin C, and also some trace minerals to absorb and use the energy
- These are the very same nutrients that support healthy adrenal function
- Stimulants give us an artificial boost by triggering the release of stress hormones; for someone with adrenal fatigue, this makes the situation worse by trapping them in a vicious cycle
- Pesticides, herbicides, fungicides
- Traces of toxic ingredients build up over time and throw our hormones out of balance. When one is out of balance, it affects the rest as well
- Heavy metals
- Preservatives, additives, artificial dyes
- Inadequate sleep
- Less sleep leads to a greater need for stimulants, poor food choices and insufficient time for the adrenal glands (along with the rest of the body) to rest and repair
Adrenal Function Test
You can easily get a sense if you have adrenal fatigue if you feel burnt out or resonate with the symptoms above. But if you’d like to take a more accurate test, all you’ll need is a blood pressure monitor. If you don’t have one at home, you can grab one at a local pharmacy.
Typically, normal blood pressure readings are 120/80. When you’re standing up, the systolic reading (120) should be approximately 10 points higher i.e. 130/80. If it turns out to be lower than 120, that means your adrenal glands aren’t functioning as well as they should. (2)
Here are the steps you need to take:
- Lie down and rest for 5 minutes
- Take your blood pressure and note down the reading
- Then stand up and immediately take your blood pressure again. Note down the reading.
Ideally, take this test 2-3 times to confirm the reading. If you found that your systolic reading stayed the same at 120 or was slightly lower when you stood up, the information below will help you.
Adrenal Fatigue Treatment
Surprise, surprise! The most important method of treating adrenal fatigue is stress management and taking the time to relax. Before diving into a long list of ideas to get stared, below are two very popular methods that are used for stress, that only take a few minutes and can be done immediately.
- Lie down on your back on a yoga mat or your bed
- Contract a muscle group forcefully for a period of 1-2 seconds and then let is relax completely
- Systematically go through all the muscle groups in your body i.e. face, neck, shoulder, arms (from top to bottom)
- Repeat this 2-3 times in total
- Find a comfortable and quiet place to sit down
- Place your feet slightly apart. Place on hand on your belly button, the other on your chest.
- Inhale with your nose and exhale through your mouth
- Inhale for a count of four – hold for 2 – release for 6
- Feel your belly rise and fall
- Repeat as many times as needed
- Go for walk breaks at work, or long morning walks
- Meditate (have you tried Headspace?)
- Yoga (if you’re burnt out, aim for yin restorative yoga vs. power yoga)
- Write in a journal for 5 minutes each day (a gratitude journal helps reduce anxiety)
- Take out a few hours a week to enjoy a hobby or interest
- Start colouring
- Do some gardening
- Go for a monthly massage
- Take a bath with essential oils, Epsom salts or a bath bomb
- Get lost in a fiction book
- Hang out with old friends who know you the best
- If the gym is stressful for you, do a dance class or go for a swim
- Do nothing (I know, crazy right?)
- Use essential oils
- Smell receptors in the body connect to the brain’s limbic system (the area responsible for emotions); this is the reason aromatherapy is used for relaxation
- The following scents are excellent for stress relief: lavender, vanilla, ylang ylang, rose, chamomile, lemon balm
- You can place a few drops in a diffuser, into your bath, on your pillow, or smell it straight from the bottle (I like these roll-on aromatherapy bottles from Veeva).
There are certain herbs known as ‘adaptogens’, which help the body adapt to stressful situations, build stamina, endurance, and help bring the body back into balance. In essence, they help you recover from burnout and prevent it from happening again. The beauty of adaptogens is that they have been around for centuries in ancient civilizations, such as holy basil in India or ginseng in China.
If you’re looking to try one out, you can get adaptogens at any health food store in the form of a capsule, a powder to add to your smoothie, as a tincture to mix into water or even a herbal tea. I would recommend cycling on and off an adaptogen to let it fully have an effect. I typically take one for three months, then cycle off for a month at a time.
Below are the top 3 that I would recommend based on both personal experience and clinical research done on humans till date:
- There is a patented extract from ashwagandha called sensoril, which has proven to have great antistress and adaptogenic effects
- In one study it was shown to significantly reduce anxiety, cortisol, blood pressure and a marker of inflammation called C-reactive protein
- Dosage: 125-250mg per day (3)
- Produces greater feelings of relaxation and anti-anxiety effects
- In one study patients found their performance improved, ability to concentrate, and reduced cortisol response upon waking up (4)
- Daily dosage: 360 to 600mg with 1% rosavin standardized extract; 180 to 300mg for 2% rosavin, 100 to 200mg for 3.6% rosavin (5)
Ginseng (Siberian and Panax)
- Studies have confirmed that both can significantly reduce stress, anxiety. In one study, a group of nurses who were taking ginseng felt found their performance improved – they were more alert, yet more tranquil (6)
- Use Siberian ginseng for mild to moderate stress, and Panax Ginseng for recovery from extreme stress as it is more potent
- Daily dosage: 2-4ml, 1-3 times per day (fluid), 250-500mg, 1-3 times per day (powdered extract in capsule) (7)
The first step for an adrenal fatigue diet is simply eating real, whole foods with an emphasis on fresh fruits and vegetables. Eliminate the junk, caffeine and processed food as much as possible.
Next, there are certain nutrients that are important for adrenal health. The nutrients below help in the manufacture of adrenal hormones, and during times of stress become depleted:
- Found in: papaya, pineapple, strawberries, bell peppers, broccoli, oranges
- Supplement dosage: 1000mg daily (or up to 5-6g daily in divided doses)
- Found in: legumes, cauliflower, broccoli, salmon, sweet potatoes, tomatoes
- Supplement dosage: B-100 complex daily
- Found in: turkey, grass-fed beef, avocado, pistachio nuts, pinto beans
- Supplement dosage: B-100 complex daily
- Found in: pumpkin seeds, dark chocolate, garlic, sesame seeds, chickpeas
- Supplement dosage: 15-30mg
- Found in: dark leafy greens, avocado, pumpkin seeds, dark chocolate, banana, almonds
- Supplement dosage: magnesium bisglycinate 200mg daily
If you have mild or moderate adrenal fatigue, I’d stick to just eating foods higher in these nutrients. However if it is severe and you need to recover, perhaps consider an adrenal fatigue supplements that contain these nutrients along with a list of botanicals. Some brands I suggest are:
Where Should You Start?
If the symptoms in this article resonated with you, start with the simplest and most obvious place – taking a break. Slow down and find more time to relax, and let that to-do list fall to the wayside for a little while. learn to become aware of signs such as a lump in your throat or not feeling refreshed when you wake up, see it as a signal to slow down.
Awareness and slowing down is truly the first step, and then you can focus on building in healthier habits. I understand the habits can take time, so this is one of the few times I would actually recommend going for a supplement as soon as possible to gain some momentum, start the recovery process then build from there.
(1) Hinton, L., & McBurney, T. (2013). Nutritional Symptomatology (1st ed., p. 48-49).
(2) Balch, P. (2010). Prescription for Nutritional Healing (1st ed., p. 153). New York: Penguin Group.
(3) Auddy B, Hazra J, Mitra A, et al. A standardized Withania somenifera extract significantly reduces stress-related parameters in chronically stressed humans: a double-blind, randomized, placebo-controlled study. Journal of the American Neutraceutical Association 2008;11:50-56.
(4) Olsson EM, von Scheele B, Panossian AG. A randomized, double-blind, placebo-controlled, parallel-group study of the standardised extract shr-5 of the roots of Rhodiola rosea in the treatment of subjects with stress-related fatigue. Planta Medica 2009 Feb; 75)2):105-112.
(5) Murray, M., & Pizzorno, J. (2012). The encyclopedia of natural medicine (3rd ed., p. 216). New York: Simon & Schuster, Inc.
(6) Hallstrom C, Fulder S, Carruthers M. Effect of ginseng on the performance of nuses on night duty. Comparative Medicine East & West 1982;6:277-282.
(7) Murray, M., & Pizzorno, J. (2012). The encyclopedia of natural medicine (3rd ed., p. 215). New York: Simon & Schuster, Inc.