Adrenal Fatigue: Are We Burning Ourselves Out?

'm seeing more and more patients who suffer physically from burnout -- they're tired, but they can't sleep, their blood pressure is off, etc. These symptoms stem from adrenal imbalance.
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How many people do you know who seem attached to their iPhone, iPad or Blackberry, or who stay up late at night on their computers? What about those people who wake up at 3 or 4 a.m. to go to the gym before work and then stay at work until 8 or 9 p.m.? Let me guess. Lots! Ladies and gentlemen, we are pushing the envelope day and night. We are trying to do so much, so well, that we've forgotten to come up for air. And now our bodies are beginning to pay the price.

I'm seeing more and more patients who suffer physically from burnout -- they're tired, but they can't sleep, their blood pressure is off, they're using sugar and caffeine to get through the day, they can't think clearly and they have a general sense of feeling overwhelmed. These symptoms stem from adrenal imbalance. Our adrenal glands are primarily responsible for our stress response, but they also play major roles in sleep, blood sugar balance, hormonal balance, blood pressure and more.

For people who come to their doctors with symptoms of adrenal imbalance, the answer -- after several tests -- is often, "There's nothing wrong with you," or "This is what happens when you get older," or the patient may walk out with a prescription to treat blood pressure or insomnia, or even an antidepressant.

The fact is, conventional medicine rarely mentions the adrenal glands unless a major diagnosis like Cushing's or Addison's disease is present. In fact, the Endocrine Society doesn't even recognize adrenal fatigue as a legitimate medical diagnosis. A prominent quote on their Myth vs. Fact sheet on adrenal fatigue, states: "'Adrenal fatigue' is not a real medical condition. There is no test that can detect adrenal fatigue." [1]

If the Endocrine Society needs a test to make adrenal fatigue real, what about other legitimate medical diagnoses that aren't detected by tests? Diagnoses like depression, Parkinson's disease, dementia and irritable bowel syndrome are often determined and treated based on symptoms -- not by lab tests.

Perhaps we're calling adrenal fatigue by the wrong name. After all, there is no such thing as heart fatigue or thyroid fatigue. But so what? The reality is, people are feeling sick, they're coming to me and hundreds of other Functional Medicine practitioners across the country to get help, and when we treat them for adrenal fatigue, they get better. Isn't that what it's all about?

Adrenal Fatigue: Wrong Name, But Certainly Worth Treating
After writing my book, "Are You Tired and Wired?" about the effects of stress and high cortisol, I've come to realize that better names for adrenal imbalance would be hypercortisolism or hypocortisolism. One of the major hormones the adrenal glands release in response to stress is cortisol. And chronic high cortisol is actually at the root of many health issues. So hypocortisolism means there isn't enough cortisol on board, and hypercortisolism implies that you're releasing too much cortisol.

Conventional medicine recognizes Addison's disease (also known as adrenal insufficiency), which arises from low cortisol, and Cushing's disease, which is associated with too much cortisol. These diseases are on either end of the adrenal spectrum, but there is no recognition that there may be an imbalance -- a clue that may be addressed before drug interventions -- that leads up to either condition. From what I've seen, cortisol ramps up as people thrive on high-adrenaline, high-stress lifestyles and then can eventually slow down to what we call adrenal fatigue. Some people stay here for years, others eventually end up with Addison's. For more information on the adrenal spectrum, you can read my article "Adrenal Extremes."

The bottom line is that most things in nature happen gradually over time, and as much as it may seem like we wake up one morning with cancer or heart disease or Type 2 diabetes, these diseases develop over many years in our bodies. What's wonderful about functional medicine and other natural health approaches is that we pay close attention to trends. And if we find abnormalities early enough, many disorders can be cured or resolved before they develop into major diagnoses.

Prevention is certainly important, but what's often most rewarding is that my patients feel so much better when we implement strategies for adrenal health. They begin to take more time for themselves, slow down, sleep better and eat more healthfully.

Conventional Medicine Comes Around Eventually
When I began practicing in the 1980s, there were many things we were doing at the Women to Women Clinic that conventional medicine didn't recognize. For example, in 1985, HRT was given to almost every woman in menopause. It was supposed to help women's hearts, bones, brains and so on. But we weren't convinced. We'd seen plenty of women sail through menopause with more natural support, including dietary support, herbs, or bioidentical hormones. Just under 20 years went by before conventional medicine let go of its love affair with hormone replacement therapy. And interestingly enough, many practitioners now try to use more natural support before prescribing Premarin or Prempro.

Ulcer treatment is another example. Functional Medicine practitioners learned early on that some ulcers were caused by bacteria known as H. pylori. Our ulcer patients at the clinic were getting better with antibiotic treatment, but it took years before conventional medicine accepted this as legitimate.

It's frustrating that it takes the conventional medical world a long time to respond to these medical nuances, but I have faith that it will. Eventually, we will have a diagnosis for adrenal fatigue (or whatever name it takes on), and more and more stressed out Americans will begin to feel better.

Let's Put the Focus on Feeling Better
I truly believe that adrenal fatigue is a modern disease that has resulted from our high-stress lives. We are constantly plugged in and on the go, not to mention our poor nutrition and sleep. It's no wonder the adrenal glands -- our stress responders -- are becoming imbalanced. I understand that this way of life is relatively new and that it may take conventional medicine a few years to catch up. But let's hope it doesn't take too long.

For me, it doesn't really matter what name we call it; our focus as health care practitioners should be on helping people feel better. And the fact is, when we start to treat adrenal imbalance with rest, diet and nutrition, herbs and finding more enjoyment in life, we see positive results. Aside from my book, I've written several articles on adrenal health. So take a look and spread the word about adrenal health -- it may be your key to health.

[1] Chubinskaya, K., et al. 2010. The Hormone Foundation and the Endocrine Society. Myth vs. Fact. Adrenal fatigue. URL (PDF):

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