Adrenal Fatigue

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In my previous article I discussed Susan, a 38-year-old woman with insomnia that gradually increased over the past two years. Her sleeplessness came from adrenal fatigue. Disruption of the adrenal hormones can result in adrenal fatigue, which frequently interferes with sleep. This article about adrenal fatigue explores the hormones involved and the symptoms of this condition so you can recognize it.

Adrenal Gland Hormones And Stress

Each of your adrenal glands sits on top of a kidney. They each have a middle (medulla) and outer (cortex) portion that performs separate functions.

In moments of stress, the adrenal medulla produces epinephrine (adrenaline), a necessary contributor to your fight-or-flight mode. Adrenaline does some amazing things really fast in your body: It increases the heart rate and the force of each contraction, constricts your blood vessels, opens your small lung airways, converts fat and glycogen into glucose for energy use, increases your metabolic rate (momentarily), and dilates your pupils.

Your adrenal cortex produces your sex hormones, fluid-balance hormones and cortisol.

I would like to focus on cortisol, especially on what happens when cortisol is low. Cortisol is your anti-stress hormone. It is secreted by the adrenal gland as a response to physical or mental stress in order to quickly free up your energy reserves. It stimulates appetite, improves digestion and acts as an anti-inflammatory (i.e. hydrocortisone).

Incidentally, you may already know a little about the anti-inflammatory effects of cortisol because of a similar molecule administered by doctors called prednisone. When prednisone is used at the usual doses of 10 to 60 mg daily doses for short durations, it dramatically stops the allergic reactions and inflammation that lead to rashes, asthma, joint pain and almost any autoimmune disease. Cortisol is similar to this substance. However, the physiological replacement dose is equal to only 1 to 3 mg of prednisone and is much safer for long-term use (unlike prednisone).

Cortisol is secreted from your adrenal gland into your bloodstream in highest amounts in the morning when you need it to get going with your day. There is a normal drop to a low level in the evening so your body can prepare for sleep.

Effects Of Cortisol Insufficiency

First, cortisol is mood calming. It lowers the excessive output of adrenaline a stimulating neurotransmitter.

Insufficient cortisol is a known major cause of emotional outbursts in the face of mental or physical stress. [1] Insufficient cortisol may also cause you to react to stress with a variety of inappropriate or excessive emotions. Depression, extreme moodiness, memory loss, confusion, absentmindedness, excessive anxiety and panic attacks have been seen to resolve with cortisol supplementation.

What happens when you stress yourself mentally or physically for many years? The natural effect for a large percentage of people is simply that the adrenal gland cannot keep up the demand for cortisol.

There are some typical life conditions that predispose a person for getting adrenal fatigue and cortisol insufficiency. These can include one or more major stressful events or long periods of stress. It may stem from being overworked with little play or relaxation for long periods of time.

Chronic physical illness or post-traumatic stress syndrome can also be a set-up for adrenal fatigue. Alcoholism or drug abuse, prolonged use of steroid therapy (i.e., prednisone, etc.) are other predisposing conditions.

Physical Effects

The physical effects of insufficient cortisol are many. When your cortisol levels are low, you suffer a few or many of the following:

  • Your ability to handle stress is decreased; you are less productive at work.
  • You don’t think as clearly as you used to, especially when hurried or under pressure.
  • You tend to shake or get nervous stomach indigestion when under pressure.
  • Your sex drive is noticeably less than it used to be.
  • You feel lightheaded when rising quickly from a sitting or lying position.
  • You may experience difficulty waking up in the morning, much more energy after the noon meal and an afternoon energy lull from 3 p.m. to 6 p.m.
  • You suffer from being chronically fatigued and cannot relieve tiredness by sleeping.
  • You need to lie down after mental or emotional stress.
  • Your muscles are weaker than they should be.
  • You have an increased frequency or severity of allergic reactions.
  • A white line remains for a minute or more when you scratch your skin.
  • Your blood pressure is low.
  • You get low energy or moody if you do not eat regularly.
  • Feelings of hopelessness or despair increase.
  • You have decreased tolerance; you get more easily irritated by people than you used to.
  • Sweet and salty food cravings strike you.
  • Stress headaches interrupt your day.
  • You break out with skin rashes, eczema, psoriasis, vitiligo (white spots), keloids (thick scars) or irregular brown spots.
  • You experience heavy sweating in armpits.

I have characterized the person with adrenal fatigue. It is a real physical condition. Unfortunately, few doctors know much about because it is not taught in the mainstream medical schools. (When it comes to the adrenals, medical schools teach only about Addison’s disease, or complete adrenal failure).

The treatment is not complicated, but it does require some real lifestyle intervention, some natural supplements and tests. I’ll cover this in my next article for Easy Health Options.

To feeling good for life,

Michael Cutler, M.D.
Easy Health Options


[1] Hertoghe, Thierry: The Hormone Handbook, International Medical Publications, U.K., 2006

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Dr. Michael Cutler

By Dr. Michael Cutler

Dr. Michael Cutler is a graduate of Tulane University School of Medicine and is a board-certified family physician with more than 20 years of experience. He serves as a medical liaison to alternative and traditional practicing physicians. His practice focuses on an integrative solution to health problems. Dr. Cutler is a sought-after speaker and lecturer on experiencing optimum health through natural medicines and founder of the original Easy Health Options™ newsletter — an advisory on natural healing therapies and nutrients. His current practice is San Diego Integrative Medicine, near San Diego, California.