Adrenal Fatigue- is there more to it than what you’ve been hearing? Is it even a *real* thing?
This is such a personal topic for me, and one I’ve been interested in for several years. I’ve seen LOTS of discussion on adrenal fatigue online, and spent hours researching, reading the latest books, etc. But for all of the things I was doing right, my health was still spiraling downward.
I knew that my typical bloodwork would again be “normal” and that I’d get a shrug and an offer for anti-depressants from a regular doctor. But I KNEW something was wrong. And I knew I needed help.
Last year, I sought help from a holistic doctor- Dr. Rob at Alternacare, and he opened my eyes to the *real* issue with adrenal fatigue. You got to meet Dr. Rob a couple weeks ago here on my blog, and he answered my questions about what the difference is between a “regular” [allopathic] doctor, and a holistic doctor.
Today, Dr. Rob and I sit down and chat about adrenal fatigue…is it a real thing? What causes it? And can a person actually recover? After a year of working with Dr. Rob, I would consider myself recovered from pretty deep adrenal dysfunction. So I consider him to be qualified to answer my questions and yours. I hope you’re as interested as I am in this topic, and many, many thanks to Dr. Rob for taking time to share this information with us.
Full Disclosure: I am so grateful for Dr. Rob’s help, and I want to share this info with others. I am not being compensated for this post. He’s just here to share as a friend and as my personal doctor.
Adrenal Fatigue Interview with Dr. Rob
Gwen: Can you give us a basic description of what “Adrenal Fatigue” means?
Dr. Rob: It means the glands are no longer able to produce their hormones in the correct quantity or the correct balance for optimal function.
Symptoms of Adrenal Fatigue
Gwen: Right. We’ve talked before about how the adrenals do so much more than just provide energy- they also regulate between meal blood sugar levels, modulate the immune system, run our hormonal sleep/wake cycle, and control the adrenaline fight or flight response. The adrenals produce the precursor to all of the sex hormones (pregnenolone), as well as cortisol that plays *so* many different roles in the body.
So that’s why the symptom lists are usually SO long…the adrenals are tied in with so many other systems. Instead of telling us EVERY symptom that a patient with adrenal fatigue can have, boil it down for us…what are the most common symptoms that would tip you off that a patient is dealing with adrenal issues?
Dr. Rob: Here is just a partial list of symptoms that I commonly see associated with adrenal insufficiency, and the body type that starts to happen with adrenal dysfunction. A person doesn’t have to have *all* of these symptoms, but these are the ones that when I see a cluster of them, I start to think adrenals:
- Fatigue—specifically in the morning, after lunch and throughout the day, however, they sometimes feel more awake in the evenings.
- Anxiety, excessive worry or depression
- Sleeping problems—either trouble falling asleep or the more common symptom of the person falling asleep ok but waking up in the middle of the night and have trouble falling back to sleep.
- Belly fat or midsection weight gain.
- Cravings for salty foods
- Swelling in the face, puffiness around the eyelids, eyes and a fuller or rounder face
- Facial hair
- Brain Fog
- Unresolved pain or inflammation. Because the adrenals are the anti-inflammatory glands of the body when they become fatigued their ability to produce the correct amount of anti-inflammatory hormone is reduced. As a result of this, there is more inflammation in their body. Old injures act back up and new ones can be more common.
Gwen: What are some uncommon symptoms that you see, that we’d not normally associate with adrenal issues?
Dr. Rob: Thyroid dysfunction. In some cases the adrenals will start to overproduce cortisol. Excess cortisol interferes with thyroid function and can cause a false hypothyroidism.
Gwen: No way! I’ve never heard of it that way before…but those are the two things *everyone* tries to diagnose with online: you’ve either got thyroid problems or adrenal problems. Or candida…ha! It’s so interesting that they can play off of one another that way. I forget how interconnected our bodies are.
OK, so here’s the key question: what are some of the most common causes of adrenal fatigue that you see?
Causes of Adrenal Fatigue
Dr. Rob: Often some type of internal inflammatory causing compound such as; a toxin, food sensitivity, pathogen (parasite, bacteria, mold, and yeast) or deficiency.
Cortisol is one of the most powerful anti-inflammatory hormones in the body. So it’s not a bad thing per se. For example, if a person has a parasite somewhere in the digestive tract, it will produce inflammation in the gut. The adrenals respond to this by raising cortisol. If the parasite is not found and dealt with, then the inflammation is going to remain at high levels constantly.
Subsequently, the adrenals will be forced to continually release cortisol (sometimes producing belly fat, insomnia and food cravings), however, the glands can’t maintain this level of cortisol production forever.
As the need for more cortisol climbs, the adrenals will then start to steal from the raw materials of other hormones they produce in order to keep the cortisol levels up. Because the adrenals also create the raw materials for sex hormones, you start to see other hormone imbalances crop up.
This “pregnenolone steal” is like robbing from Peter to pay Paul. It causes the other hormones levels to fall, setting up imbalances between the adrenal hormones. Eventually, all the adrenal hormones go low and the person feels absolutely horrible.
Gwen: Wow! So, wait…EVERYONE is talking about “adrenal exhaustion” like it’s some sort of flaw in the adrenal glands. And in a way it *is* accurate to say that they’re exhausted and not functioning well. But most of the treatment approaches that I’ve seen (conventional and natural) are just focused around supporting the adrenals.
But It sounds like you’re saying that there is usually *something else* driving this…and the glands are just doing their job, but are unable to keep up. If that’s the case, then only supporting the glands is not ever going to be enough. Can a person treat at home effectively if they don’t know what the cause is? Is testing necessary?
Dr. Rob: ABSOLUTELY! You have to find the thing that is wrong inside the person’s body that’s stressing the gland. There is something wrong causing excessive inflammation in the body that must be found. Unless you have access to a crystal ball, you are probably not going to know what is causing the adrenal stress without labs.
As a result, you will take adrenal supplements forever and always be looking for the next best thing to finally help you overcome your symptoms. You can’t fix a hole in the roof by placing a bucket under the leak. You’ll keep the floor dry but that’s about it. You have to find that hole in the roof and you have to find the thing or things stressing the adrenals and handle them.
Testing for Adrenal Fatigue
Gwen: What type of testing do you recommend for those who think that they might have adrenal fatigue? (Root cause)
Dr. Rob: Oh, there are hundreds of potential test so it really just depends on what I think the cause is. When we work with a patient at AlternaCare we do a very comprehensive history, which helps give us clues as to the cause of the adrenal stress.
If we think it is a heavy metal then we’ll do a special type of heavy metals test done through a 24 hour urine collection. If we think it is a pathogen of some sort then we look at different options like energetic biofeedback test on their urine, saliva and DNA, a stool study, or various tests done via blood. It just depends.
Gwen: There is some controversy as to whether or not the term “Adrenal Fatigue” is accurate…what is your take on it? Some people say it’s more accurate to say “HPA axis dysfunction” instead of “Adrenal Fatigue”
Dr. Rob: Adrenal fatigue is not a recognized diagnosis at this time in the medical world. There is Cushings disease, where the adrenal glands overproduce cortisol, and on the other end of the scale is Addison’s Disease, where the adrenals no longer are able to produce sufficient hormones, and prescription hormone replacement is needed.
Between the ranges for those two diagnosis, functional medicine recognizes patterns that indicate that a person is heading in one direction or another. I think the term adrenal fatigue is accurate in that it describes the state of the gland, however, HPA axis dysfunction would probably be a better term as it is really the hypothalamus that starts to malfunction, which then affects the adrenal glands.
HPA stands for the hypothalamus, Pituitary and Adrenal glands. The hypothalamus and pituitary glands are located in the brain and the adrenals are located right above the kidneys.
When referring to the body the term “Axis” means things connected to one another often in a line. So we have the Hypothalamus connected to the pituitary, the pituitary connected to the adrenals and the adrenals connected back to the hypothalamus.
By “connected” I mean they communicate directly to one another via the hormones they produce. I won’t go into more detail here but I will say it is first the adrenals responding to an abnormal stress and when they have responded to this stress too long (like the parasite example I gave above) it alters the connection between the adrenals and hypothalamus—breaking down the HPA axis.
Gwen: I’ve been reading a book called “Rethinking Fatigue: the Adrenal Myth” by Nora Gedaudas, in which she downplays the role of the adrenals, and focuses a lot more on the role of the brain, the immune system, and diet than on the glands themselves. What is your take on this approach?
Dr. Rob: Yes I agree with this. The adrenal issue or adrenal fatigue is often a secondary problem. Meaning the adrenal glands are just responding to an infection, or toxin or deficiency state in the body.
When these adrenal stresses are not removed from the body the gland has no choice but to fatigue. Imagine yourself having to exercise forever. Like no break. Continual exercise. Eventually, you’d pass out because of the fatigue.
If there is a stress in your body (like in the examples I’ve given) and that stress is never removed, you are asking your adrenals to exercise continually. The adrenals are just doing their job. They are responding to the stress of an immune challenge such as a parasite or bacteria.
If the bacteria or parasite is not handled then the glands will never be free of this stress. Much like the person who never gets a break from exercise the adrenal glands will eventually fatigue.
Excuse the redundancy but this is really a key part of handling adrenal fatigue. The person MUST find that thing that is stressing the glands or else they will never fully heal.
Gwen: I don’t mind the repetition, because I’ve never heard adrenal fatigue explained this way, and it’s SO eye opening! So, I know in my own case that chronic infection WAS an issue, and what was so puzzling for me was that I had absolutely NO symptoms of stomach problems. And you said that’s not all that unusual. My only symptoms were my adrenals starting to go haywire.
In addition to handling the root cause, I know you also had me support my adrenals while I was healing. What are the most common supplements that are used for adrenal issues and what do they do?
Dr. Rob: I’d estimate as many as 50% of people who have a parasite, h. pylori or other chronic infection, and some forms of yeast overgrowth are asymptomatic as far as traditional GI symptoms.
As far as supplements, there are a boat load but I’ll give you in my opinion 3 of the most common. I’m not saying I’m a proponent of the below items, they are just commonly used.
- Raw Adrenal Glandular: This is like rent-a-gland. A cow’s adrenal gland has many hormones in it such as, DHEA—an important adrenal hormone. If your adrenals are fatigued and can’t make the right amount of hormone you can supplement by simply eating the adrenal gland of a cow or pig. I know, gross! However, this will not fix the chronically fatigued adrenal gland. It’s a Band-Aid at best.
- Licorice Root: which essentially helps to extend the time cortisol stays in the body.
- Eleuthero: helps to support the glands in producing their hormones.
Gwen: I recognize a couple of those from the blends I was on. And I wasn’t crazy about the idea of raw glandulars, so I think we skipped that part with my protocol…but a majority of the focus was NOT on adrenal supplements. It was overall healing and tailored week after week to looking at what my body needed to continue that process.
Oftentimes I’m asked “What did you take to fix your adrenal fatigue.” Well, it really doesn’t work that way at all. We did different things almost every week with supplements and foods depending on where I was in my healing protocol. I have a chart full of protocols that I’ve been on with you, and mine would look different than another patient’s chart. I like how individualized holistic medicine is. That’s a HUGE difference from a regular doctor’s office.
OK, next question: Assume that a person is ready to start making changes, and working on the root cause to their adrenal dysfunction. What are the MOST important lifestyle changes that a person who suspects adrenal fatigue should move toward?
Dr. Rob: As long as there are no liver issues or significant gut issues then eating some protein and fat every 3 hours (about 4 to 5 small meals per day) would be important since the adrenal glands help to regulate your blood sugar between meals. Making sure that you’re eating regularly during the day will help take stress off of the adrenals so that they’re not on duty with blood sugar modulation for hours on end.
Getting to sleep by 10pm…often easier said than done for the adrenal case.
Working on changing your attitude about stressful things. Meaning two people can be exposed to losing a dollar. One person will say to himself, well that stinks, but luckily I can make another dollar and go about his day.
Another person will lose a dollar and become very upset with himself and life. Did someone steal my dollar?! I bet it was my coworker! I’m going to talk to him! Or maybe I lost it at the dry cleaners. Stupid me! I should know better than to go to that dry cleaners. This type of thinking will definitely cause the adrenals to over produce cortisol and adrenalin, which is taxing to the gland. So just a shift in one’s attitude can help.
If they are exercising, ensure that the exercise is not too intense, as intense exercise can sometimes further stress and damage the adrenals.
Gwen: On the diet plans that you had me on, I recognized lots of the food choices since I had already been on the Trim Healthy Mama eating plan. It meshed really well with the food plans you had for me, and I was grateful for the education about healthy carbs and fats.
I’d also like to add another two more things to your list that were important for me: entertainment choices can really push the adrenals. When I was at my worst, I could feel the adrenal surges during the suspenseful music in movies or even TV shows. The fun, exhilarating feeling of watching a good action movie or show, or playing a video game can be too much for someone whose adrenals are already being over tapped.
And the other thing is avoiding caffeine and stimulants (sniff- like sweet tea and my lovely hot teas) that push the already tired adrenals. But I’m SO happy to report that I have recovered so much that I can enjoy teas and fun movies again with no problems. It’s just not a daily thing for me now.
Next question: oftentimes, adrenal fatigue is associated with other issues, like Lyme disease, thyroid problems, hormone imbalance, fibromyalgia, etc. How would you prioritize and decide which aspects to treat first if you’ve got a cluster of symptoms like this?
Dr. Rob: Well that is a very in depth question and something that is really beyond a blog and more for a 100 hour certification course in how to repair the adrenal glands. I’ll say this, it is not just about knowing what numbers make up the combination to open the lock but you also need to know the order in which to use the numbers.
This is what I specialize in and really has taken me years and years to develop. Knowing the correct order or sequence in which to help the body heal. That is vital and probably the main reason why some people don’t every really recover from Adrenal Fatigue.
Lots of times the patient knows what’s wrong with their body but either the provider they are working with you the patient himself doesn’t know the correct order to address the problems that are present in the body.
Gwen: SO true! I would never have figured out how to get better on my own…no matter how much information I knew or books I’d read. I may one day go for that certification course though, because I really love learning about how the body works.
Are you still taking patients, and can you treat long distance cases?
Dr. Rob: Absolutely! There are a lot of people out there that are suffering from various health issues and it really is a passion of mine to help. I have worked with people from 30+ other states and 14 countries, in fact, about 35% of the people I work with are long distance cases. To learn more about working with Alternacare long distance, click here.
I’ve developed a specialized system for getting great results with the people from far away. The way it works is this; first we do a very comprehensive consultation combined with an Online Health Evaluation. With that information we can usually identify the organ or gland in their body that is breaking down.
We then will recommend labs that help us identify what is stress that week organ or gland. The lab kit is sent to the person’s home and they will perform the lab from the comfort of their own home. They then send the lab kit in and their samples get analyzed.
We then have more of an understanding as to what is wrong with their body and where their symptoms are coming from. We review the lab findings with them and the customized, one of a kind treatment program for that person.
They then start the first step on their program that will often have a few nutritional supplements and an eating program in it. We will follow up with them in a few weeks and then discuss their progress and the next step to their program which may contain an entirely different eating program. Since each person is unique it is their own personalized program.
To get in touch with Dr. Rob, you can contact his awesome *AWESOME* staff here at Alternacare’s website, and fill out the online health evaluation and they’ll be in touch.
His staff is so amazing. My husband made an appointment on a different day than mine, and they called me to tell me that they’d re-arranged the schedule so that we could have back to back appointments and ride together…without me even asking! I’ve never seen an office that dedicated to their customers.
Gwen: Thank you SO much for being here with us today, Dr. Rob! I have a few other final questions that were submitted from the Herbal Chick Chat group on Facebook, if you don’t mind a few more.
Questions from the Chick Chat group:
Q: Can a stressful pregnancy/birth result in adrenal fatigue for the child?
A: I’d not say adrenal fatigue per say but stress definitely robs the body of nutrition. If the pregnant mom didn’t correct the nutritional deficiency then the child might not get what he or she needs to properly develop. That could mean a malfunctioning adrenals, thyroid, pituitary, stomach, kidney and so on. Just depends on the degree of deficiency and the lack of proper development in that part of the child’s body.
Q: What are the best supplements and lifestyle changes that you can do for kids who show stress patterns similar to adrenal fatigue?
A: Well, that is a broad question that really needs more in depth evaluation for the individual child. There are a lot of things that can produce this in a child. In general, proper sleep, good quality exercise and a great wholefood diet would be key.
Q: What kind of diet is good for Adrenal fatigue?
A: Well sugar is the enemy of the adrenals. So we want lots of whole foods containing healthy fats from foods like avocado, coconut, almonds, etc. Healthy proteins from wild caught fish-especially salmon, free range organic meats-especially the darker ones, and eggs. Some carbohydrates from berries and gluten free low glycemic grains. Ideally 4 to 5 small meals per day work well for adrenal fatigue.
Do you have questions for Dr. Rob regarding adrenal fatigue? Ask below in the comments, and he’ll answer.
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