Updated: Mar 14
This guest post is written by Brie Wieselman, a Functional Medicine Practitioner, hormonal expert and gut specialist. You can learn more about her at her website https://briewieselman.com/ or join her community on Instagram.
In the last 10 years, adrenal fatigue has gone from virtually unheard of to something everyone has heard of (and has an opinion about).
And while I think that more people knowing about adrenal fatigue is a good thing, there is a problem: most people (and practitioners) actually misunderstand it.
What Adrenal Fatigue Isn’t
First things first: Adrenal Fatigue is not a disease.
It’s actually a syndrome that occurs as a consequence of chronic stress without relief.
The name is misleading because it sounds like your adrenals (the glands that sit on top of your kidneys and produce a variety of hormones) get worn out and stop producing hormones - most importantly, cortisol aka “the stress hormone.” But that’s not actually what happens: you adrenal glands don’t get tired - they can actually be working overtime!
Instead, adrenal fatigue is truly caused by miscommunication between the brain and the hypothalamic-pituitary-adrenal system caused by stress. Because the name “adrenal fatigue” is so misleading, many practitioners now call it “HPA Axis Dysregulation.”
But whatever name you use, the cause is the same.
Adrenal Fatigue Is Really A Brain Problem
The HPA Axis is our body’s central stress response syndrome. When your brain perceives stress (and that can be anything from physical danger, to emotions running high, to chronic low grade inflammation from a gut infection, to having low blood sugar!) the hypothalamus shouts at the pituitary to do something about it. The pituitary in turn signals the adrenal glands (by releasing a hormone called ACTH) to crank up the production line on cortisol, to help deal with the situation.
When stressors are short-term, this system works really well: when the stressor is gone, the signaling stops and cortisol levels can return to normal. But when you’re faced with chronic stressors, this system is thrown off and the brain can’t communicate properly with the adrenal glands. Cortisol production either stays too high or shuts down entirely.
The symptoms of adrenal fatigue are caused by a breakdown in the signalling from the brain to your adrenal glands. In other words, the problem is in the software, not in the hardware!
Treat The Brain - Not The Adrenals!
Lots of practitioners want to treat adrenal fatigue by looking at the adrenal glands themselves - but that’s not really where the problem is originating. Instead, I like to look at the brain and stress management first.
The modern world is rife with chronic stressors: everything from your kids, to your job, to the food you eat and the air you breathe. We can’t control the stressors, but we can control HOW our brain (and body) react.
Learning how to manage your body’s stress response is the key to preventing and healing adrenal fatigue.
(It’s the old adage about how we can’t control what happens to us - but we CAN control how we react.)
So what can you do to manage your stress response? Finding a way of moving and eating that supports your health is the first place to start. Using known adaptogens (like lemon balm, ashwagandha and rhodiola, and specific nutrients) is the second step. If you find yourself still not feeling up to par, you might benefit from advanced testing for circadian adrenal hormone levels, with a trained Functional Medicine Practitioner who can help you personalize a treatment plan to reach your goals.