Last Updated on October 31, 2024
Adrenal fatigue symptoms are very common… especially in women. A lot of my clients have no idea that their lack of motivation, fatigue, fertility issues, and other pesky symptoms are being caused by adrenal fatigue and insufficiency.
Adrenal “fatigue” is one of the most common hormone imbalances I come across as a health practitioner when I run functional labs.
But adrenal fatigue isn’t really accepted in the medical community even though it’s a legitimate concern in the holistic realm. In fact, most medical doctors don’t acknowledge it, accept it, or test for it. I’ll explain why… keep reading…
That’s why I’m doing a deep dive into adrenal fatigue and insufficiency and their symptoms so you know what to look out for.
I’ve battled adrenal overproduction and underproduction and NONE of my doctor’s acknowledged what I’m sharing with you today. So if your doctors have told you you’re ‘normal’ even though you’ve experienced symptoms, this is for you!
You’ll learn:
- What Adrenal fatigue (and adrenal sufficiency) really is
- The Symptoms of Adrenal Fatigue
- The Symptoms of Adrenal Insufficiency (so you can see the difference)
- What causes Adrenal Fatigue and
- How to Test for it and
- How to fix adrenal fatigue quickly and naturally
Let’s dig in!
What Is Adrenal Insufficiency aka Fatigue?
Adrenal fatigue, often used interchangeably with adrenal insufficiency, refers to the idea that chronic stress exhausts the adrenal glands, impairing their ability to produce adequate stress hormones like cortisol.
The theory suggests that, under prolonged stress, the adrenal glands “fatigue” due to being overworked, and lead to symptoms such as fatigue, brain fog, sleep disturbances, sugar cravings, and irritability due to the reduced production of cortisol and chronic exposure to high levels of cortisol/chronic nervous system dysregulation.
However, there’s a distinction between adrenal fatigue and adrenal insufficiency in medical terms:
Adrenal Insufficiency: This is a recognized medical condition where the adrenal glands cannot produce enough hormones. It has two primary forms:
- Primary Adrenal Insufficiency (Addison’s disease), usually due to autoimmune damage to the adrenal glands. This is what traditional cortisol lab work (by western medical doctors test for… if cortisol is too low you may be diagnosed with Addison’s disease, if it’s too high you may have Cushing’s disease).
- Secondary Adrenal Insufficiency, which often results from issues with the pituitary gland, which signals the adrenal glands to produce cortisol.
Doctor’s typically test for low cortisol via a standard metabolic panel that involves a fasted blood draw in the morning. The problem? Cortisol is supposed to be highest in the morning and blood draws are painful (perceived as ‘stressful’) and that can boost cortisol on your results. So you can have low cortisol but the test itself can be stressful enough to make it appear in range/normal. The only exception is when the adrenals no longer function and you physically can’t produce cortisol anymore. This is when you’d require additional tests to confirm Addison’s disease. If cortisol is too high in this test, you’d get a diagnosis of Cushing’s Disease FYI.
Adrenal Fatigue: This is not an officially recognized “medical diagnosis.’ Many practitioners see it as a state where prolonged stress affects adrenal function, but it’s not detected through standard blood tests like adrenal insufficiency. Adrenal fatigue happens due to chronically elevated cortisol and nervous system dysregulation. Adrenal fatigue can be tested with functional cortisol tests, In functional cortisol labs, cortisol levels are tested multiple times throughout the day via saliva. In this test both free and bound cortisol is tested and patterns of cortisol throughout the day can determine the ‘true’ status of your adrenals and if they’re functioning properly.
Here’s what you need to know (in the simplest terms):
- In general, adrenal fatigue is what happens BEFORE adrenal insufficiency.
- Adrenal fatigue is the ‘smoke’ before the adrenal insufficiency ‘fire.’
- Adrenal fatigue will happen before a diagnosis can occur – only if the root cause is lifestyle/stress… unless you have Addison’s disease or a pituitary issue… then you may skip straight to a diagnosis.
- Adrenal insufficiency, these symptoms are due to an actual deficiency in adrenal hormones (cortisol and aldosterone), whereas in adrenal fatigue, they’re believed to be due to the body’s impaired ability to regulate stress (commonly because of lifestyle).
- Fatigue can be reversed and prevented. In most cases, adrenal insufficiency that results in a diagnosis cannot. However, lifestyle and stress management can help alleviate symptoms associated with both.
- Cortisol is a MAJOR player in the metabolism, meaning any imbalance in it (high or low) can cause physical health and mood/mental health symptoms as well as weight gain/stubborn fat
- If cortisol is ‘normal’ on traditional cortisol blood draw test you can actually have adrenal fatigue.
You can have overworked adrenals for years, sometimes decades, before the adrenal and pituitary start to fail enough for ‘adrenal insufficiency’ to register on standard lab work.
That means you can have issues producing cortisol, or have irregular daily cortisol patterns, that result in some pretty debilitating symptoms, that are not normal or healthy (physically or mentally).
I’ve discussed that high cortisol can cause some major symptoms as well as how high cortisol can cause health and weight issues.
But cortisol that is too low can cause equally harmful symptoms that make it hard to feel good, be healthy, and lose weight.
All hormones need to be in balance. If they’re too high or too low they’re problematic.
It’s also normal for all hormones to spike high or low, but the body should be able to get back in balance and repair the damage done from the temporary spike/decline of the hormone.
Adrenal issues and symptoms occur when the body can’t get back into balance.
If your body can’t get enough cortisol/can’t balance (due to loss of function or lifestyle) you will start to experience symptoms of adrenal fatigue and eventual insufficiency.
What are the Symptoms of Adrenal Fatigue?
Now that you know what adrenal fatigue is, let’s review all of the symptoms of adrenal fatigue and insufficiency.
Please note, the symptoms of adrenal fatigue and fatigue tend to be the same… but fatigue symptoms are less severe, frequent, and easier to ‘fix’ compared to those of insufficiency. For example:
Adrenal Fatigue = tired sometimes, and sleep no longer boosts energy like it used to. Left untreated may lead to insufficiency.
Adrenal Insufficiency = Tired 24/7, regardless of how much sleep you get. Left untreated will lead to a diagnosis of Addison’s disease or possibly death.
Remember, in adrenal insufficiency, these symptoms are due to an actual deficiency in adrenal hormones (cortisol and aldosterone), whereas in adrenal fatigue, they’re believed to be due to the body’s impaired ability to regulate stress.
Even though symptoms of adrenal fatigue and adrenal insufficiency can overlap but have key differences in severity and origin.
Here’s a breakdown:
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Symptoms of Adrenal Fatigue
These are often described as more subtle, chronic, and related to prolonged stress. Symptoms can include:
- Persistent fatigue, even after rest
- Difficulty getting up in the morning
- Trouble handling stress
- Brain fog or difficulty concentrating
- Sugar or salt cravings
- Low energy levels throughout the day
- Mild depression or irritability
- Difficulty sleeping, or waking up feeling unrefreshed
- Lowered immunity, leading to frequent infections
Adrenal fatigue symptoms can also be more nonspecific, meaning they could also apply to other conditions. The following expanded adrenal fatigue symptoms are commonly clustered with the primary adrenal fatigue symptoms listed above:
- Mood changes: Anxiety, depression, irritability, or feeling overwhelmed
- Poor stress tolerance: Feeling easily stressed or struggling to handle even minor stressors
- Libido changes: Decreased sex drive
- Skin issues: Dull or dry skin, slow wound healing
- Digestive problems: Bloating, constipation, or irregular bowel movements, possibly tied to imbalanced cortisol affecting digestion
- Menstrual irregularities: Irregular or painful periods in women, which may stem from hormonal imbalances
- Blood sugar fluctuations: Feeling “hangry” or jittery if meals are delayed, due to fluctuating blood sugar levels
- Mental fog: Difficulty with memory, concentration, or general cognitive performance
- Unexplained weight gain or loss: Typically weight gain, especially around the abdomen, possibly due to cortisol imbalances
- Lightheadedness: Particularly when standing up too quickly (mild postural hypotension)
- Weakened immune function: Increased susceptibility to colds and infections
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Symptoms of Adrenal Insufficiency
These symptoms are typically more pronounced and can be life-threatening if left untreated. Key symptoms include:
- Severe fatigue and muscle weakness
- Loss of appetite and unintentional weight loss
- Low blood pressure, which can lead to fainting
- Darkening of the skin (especially in Addison’s disease)
- Salt cravings
- Low blood sugar (hypoglycemia)
- Nausea, vomiting, or diarrhea
- Joint or muscle pain
- Dizziness or fainting spells, particularly when standing
With true (critical) adrenal insufficiency, the symptoms tend to be more severe and sometimes sudden, especially in cases of Addison’s disease or adrenal crises:
- Chronic exhaustion: Severe fatigue that doesn’t improve with sleep or rest, making daily activities hard
- Severe hypotension: Extremely low blood pressure, even when lying down, which can lead to dizziness and fainting
- Dehydration: Due to low aldosterone, which regulates salt and water balance
- Hyperpigmentation: Dark patches of skin, especially in areas like knuckles, knees, elbows, and scars
- Salt cravings: Driven by low aldosterone levels, causing sodium deficiency
- Nausea and vomiting: Often accompanied by abdominal pain
- Severe abdominal pain: Often unexplained, especially in Addison’s disease
- Joint and muscle pain: Pain without a clear cause
- Weight loss: Often rapid and unintentional due to lack of appetite and nausea
- Irritability or confusion: Due to low blood pressure, blood sugar fluctuations, and imbalanced cortisol levels
- Sweating and shivering: Even in comfortable environments, sometimes accompanied by cold intolerance
- Low blood sugar (hypoglycemia): Which can lead to shakiness, irritability, confusion, and sometimes fainting
- Electrolyte imbalances: Including low sodium, high potassium, or both, leading to further weakness and potential heart issues
What Causes Adrenal Fatigue?
Adrenal fatigue is thought to be caused by chronic stress over an extended period. The idea is that prolonged physical, emotional, or mental stress can overwork the adrenal glands, which produce hormones like cortisol and adrenaline to help the body manage stress.
Over time, this stress response is believed to wear down the adrenal glands, reducing their ability to maintain optimal hormone levels, particularly cortisol.
While not a formally recognized medical diagnosis, here are some commonly cited factors that may contribute to adrenal fatigue:
- Chronic Stress: High-stress levels, whether due to work, personal relationships, financial issues, or traumatic events, can keep the adrenal glands in overdrive, demanding continuous production of cortisol.
- Poor Sleep: Inadequate or poor-quality sleep disrupts the body’s natural cortisol rhythm, contributing to hormonal imbalances. Lack of sleep can add stress, compounding the issue.
- Poor Diet: Diets high in sugar, refined carbs, caffeine, and processed foods can destabilize blood sugar levels and impact cortisol production. Additionally, a lack of essential nutrients can reduce the body’s ability to cope with stress.
- Stimulant Use: Excessive caffeine or other stimulants to “push through” fatigue may overstimulate the adrenal glands, leading to further exhaustion over time.
- Infections and Illness: Chronic illnesses or infections (like Lyme disease or chronic fatigue syndrome) can tax the adrenal glands by continually activating the immune system and stress response.
- Emotional Strain: Long-term emotional challenges, such as grief, depression, or anxiety, can activate the body’s stress response, impacting adrenal function.
- Overwork and Lack of Rest: Frequently working long hours or not taking time off for rest and recovery can contribute to chronic stress and drain energy reserves, potentially affecting adrenal function.
- Lack of Physical Activity or Overexercising: Sedentary lifestyles can reduce overall resilience to stress, while overexercising can overly tax the adrenal glands by keeping cortisol levels elevated.
Although adrenal fatigue remains a debated concept, some people find that addressing stress, diet, sleep, and lifestyle factors improves their well-being.
Adrenal insufficiency occurs when the adrenal glands don’t produce enough cortisol (and, in some cases, aldosterone), leading to significant hormonal imbalances that impact many body systems. Unlike adrenal fatigue, adrenal insufficiency is a recognized medical condition and can be life-threatening if untreated. It can result from various causes, classified into two main types: primary adrenal insufficiency (Addison’s disease) and secondary adrenal insufficiency.
Primary Adrenal Insufficiency (Addison’s Disease)
This condition occurs when the adrenal glands are damaged and can’t produce sufficient cortisol and aldosterone. Causes include:
- Autoimmune Response: The most common cause of Addison’s disease, where the immune system mistakenly attacks the adrenal cortex (outer layer of the adrenal glands), reducing hormone production.
- Infections: Certain infections, such as tuberculosis (TB), HIV, or fungal infections, can damage the adrenal glands.
- Cancer: Cancers that spread (metastasize) to the adrenal glands or adrenal cancer itself can lead to adrenal insufficiency.
- Genetic Disorders: Some genetic conditions, such as congenital adrenal hyperplasia, can impair adrenal gland function and lead to hormone deficiencies.
- Hemorrhage or Injury: Physical trauma or bleeding into the adrenal glands can cause sudden adrenal damage, known as an adrenal crisis.
- Certain Medications: Medications like antifungal drugs or treatments that inhibit steroid production can interfere with adrenal function in rare cases.
Secondary Adrenal Insufficiency
Secondary adrenal insufficiency results from issues with the pituitary gland (located in the brain), which produces adrenocorticotropic hormone (ACTH). ACTH signals the adrenal glands to release cortisol. Causes of secondary adrenal insufficiency include:
- Long-Term Corticosteroid Use: Prolonged use of corticosteroids (e.g., prednisone) for chronic conditions (like asthma, arthritis, or autoimmune diseases) can suppress the pituitary’s production of ACTH, leading to adrenal insufficiency if steroids are abruptly stopped.
- Pituitary Disorders: Tumors, surgery, radiation, or inflammation of the pituitary gland can interfere with ACTH production, resulting in decreased cortisol production by the adrenal glands.
- Brain Injury: Traumatic brain injuries can impair the pituitary gland’s function, affecting cortisol production.
- Sheehan’s Syndrome: A rare condition in which severe blood loss during childbirth damages the pituitary gland, potentially leading to secondary adrenal insufficiency.
Tertiary Adrenal Insufficiency
This is a less common form, typically resulting from issues with the hypothalamus (another part of the brain that signals the pituitary gland). Causes can include prolonged stress or use of corticosteroids, which disrupt the hypothalamic-pituitary-adrenal (HPA) axis, impairing the signal cascade that prompts cortisol release.
Regardless of the type, adrenal insufficiency requires medical intervention, often involving hormone replacement therapy to manage symptoms and maintain health.
How to know if you have Adrenal Fatigue?
If you have symptoms and risk factors then there’s a big chance your adrenal function is being impaired. The only way to ‘officially” confirm this is with functional lab work.
Remember traditional blood draw labs can render inaccuracies because cortisol is naturally high in the morning and fasted blood draws are stressful and can skew results. Blood draw labs also only test for ‘free’ cortisol.
But there are cortisol binding globulins that absorb coritsol once released… that means you need to test both free and bound cortisol to really know what’s going on.
You also need to test cortisol multiple times a day to get an accurate picuture of trends in cortisol levels to see how and when you’re producing it… or not.
There are different ways to test for adrenal fatigue.
Functional Labs for Adrenal Fatigue
Functional practitioners typically suggest a range of tests to assess adrenal function, hormone levels, stress responses, and more. While adrenal fatigue isn’t an official medical diagnosis, these tests can help gauge cortisol patterns, overall adrenal health, and find the root cause of the adrenal fatigue.
Here are some functional labs commonly used:
Salivary Cortisol Test
- Purpose: Measures cortisol levels at four points throughout the day (morning, noon, afternoon, and evening) to assess the body’s cortisol rhythm, which can provide insights into the stress response and potential adrenal imbalances.
- What to Expect: In adrenal fatigue, cortisol levels may be elevated in early stages but tend to drop below optimal levels in later stages.
Dried Urine Test for Comprehensive Hormones (DUTCH Test)
- Purpose: The DUTCH test measures cortisol, cortisone, and other adrenal-related metabolites over a full day to map cortisol rhythms and hormone metabolism.
- What to Expect: This test offers a comprehensive profile of adrenal and other hormones (like sex hormones) to help assess the stress response and HPA (hypothalamic-pituitary-adrenal) axis function.
Thyroid Panel
- Purpose: Measures thyroid function (TSH, Free T3, Free T4, and thyroid antibodies) since adrenal stress can impact thyroid function.
- What to Expect: Thyroid imbalances, often seen in chronic stress, can accompany or exacerbate adrenal fatigue symptoms.
Comprehensive Metabolic Panel (CMP)
- Purpose: Assesses liver, kidney, and electrolyte balance, as these can be impacted by adrenal function.
- What to Expect: Low sodium or high potassium can sometimes indicate issues with aldosterone, a hormone from the adrenal cortex that helps regulate electrolytes.
Vitamin and Mineral Panels aka Nutrient Deficiencies
- Purpose: Evaluates levels of vitamins and minerals essential for adrenal health, like Vitamin B12, Vitamin D, magnesium, and potassium.
- What to Expect: Deficiencies in these nutrients can contribute to symptoms associated with adrenal fatigue, including fatigue, stress intolerance, and mood imbalances.
Functional labs for adrenal fatigue are recommended on a case by case basis basis to help pinpoint the root cause of your symptoms and then develop a custom treatment plan.
Custom treatment plans are highly recommended in adrenal fatigue cases because different stages of adrenal fatigue/insufficiency have significantly different approaches to healing despite symptoms being similar.
For example, exercise may be appropriate or the absolute worst thing you could do… depending on the symptoms and stage of adrenal fatigue.
HOW TO FIX ADRENAL FATIGUE NATURALLY?
You can often balance cortisol and the adrenals and reduce symptoms quickly and naturally. The main priority should be to get the right nutrients needed to repair damage, optimize the adrenals and hormones, detox excessive cortisol, and calm the nervous system. Otherwise, the adrenals can remain taxed and cortisol production can’t balance.
Here are the most effective strategies to reverse adrenal fatigue:
- Eat a Balanced Diet: Focus on consuming plenty of fruits, vegetables, whole grains, lean proteins, and healthy fats. I recommend eating for your unique metabolic needs as different metabolic types digest & absorb nutrients differently. You have to eat the things you actually need and can absorb to reverse adrenal fatigue. Take my Metabolic Type Quiz & Training to discover your metabolic type and the best diet you.
- Take this Multivitamin/Multi-mineral: Stress causes nutrient deficiencies and imbalances and you can repair hormones while in a deficient/imbalanced state. This supplement has everything you need to reverse deficiency, optimize hormone function, energy, detox, heal, and more!
- Practice Stress Management: Techniques such as resting, meditation, and breathing exercises can be effective to reduce stress so the adrenals are less fatigued.
- Do Somatic Exercises: Somatic exercises are particularly effective in balancing the nervous system, reduce cortisol, and balance hormones in the process. Stress is a root cause of ALL hormone issues. Luckily, somatic exercise stop stress, balance the nervous system, and make it significantly easier to balance hormones, feel great, and lose weight. If you feel stressed, struggled with hormone imbalance, and stubborn weight my Somatic Exercise Program will get you feeling better and losing weight quickly and naturally.
- Maintain a Healthy Weight: Focus on achieving and maintaining a weight that’s healthy for you. The more excess body fat you have typically means you’ll experience more challenging symptoms. Reducing body fat can help minimize symptoms. But dropping body fat too low can actually imbalance hormones and make issues worse. Reducing body fat to appropriate levels is key!
- Enhance Sleep Hygiene: Improve sleep quality and get a minimum of 7-8 hours of deep sleep a day to keep hormones balanced. Deep sleep is also the best way to detox stress hormones! Use these 12 Tips for Better Sleep to get the quality sleep you need.
- Limit Alcohol and Caffeine: Reducing these can help alleviate some symptoms.
- Quit Smoking: Avoid tobacco products, as they can overburden the liver and make symptoms worse.
- Quality Supplementation: Some supplements help balance hormones better than others. Check out supplements for hormones to learn more and see what I recommend most for hormone balance. If you’re stressed pick ONE of the supplements above that best matches your unique needs.
- Take this one, if you’re seasonally or situationally stressed – but not if you have blood pressure issues.
- Take this one, if you’re chronically stressed and it’s making you (chronically) tired or affecting your sleep.
- Take this one, if you’re chronically stressed and it’s affecting your mood, energy, and triggering other health issues like digestive, hormonal, inflammation, etc.
If you’re experiencing adrenal fatigue or insufficiency, it’s important to address your lifestyle and use a tailored treatment plan to enhance your overall well-being. Functional labs are recommended to pinpoint the root cause of adrenal fatigue.
If you’re interested in a personalized treatment plan and functional labs – you can apply to work with me here.
Regardless of what you choose to do, it you have symptoms of adrenal fatigue treatment should be a priority as it’s impossible to look and feel good if you don’t. And if you don’t do anything it will get worse.
My tips & recommendations will definitely help.
But they can only work, if you work them. So work them, because they’ll make you look and feel so much better!
Your Coach & Biggest Cheerleader,
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