My husband, John, is visiting the blog today with an article about adrenal fatigue and recovering from the effects of non-celiac gluten sensitivity. – Barbara
Most of us who are recovering from the long-term effects of celiac disease, non-celiac gluten sensitivity, and other chronic illnesses know that our times of feeling well can come in cycles. Sometimes we feel great and rejoice in the fact that we are really making advances. But other times we feel just terrible, and not only for a day or two but maybe for weeks or even longer. I’m going through one of those down periods right now. I’m not just tired. I’m constantly fatigued! Again!
The question is why? I was doing so well. I was feeling better, pretty good as a matter of fact. My diet has been healthy (moderate paleo with absolutely, positively no gluten cross-contamination, and a daily juicing of greens). I have been walking and exercising regularly. My sleep schedule is not where I want it to be, but I seldom get less than 7 hours a night. But then in February, the fatigue started to creep back. At first, it wasn’t every day: just a day here, a day there. But by March it was present most days. Though its intensity was not as great as years ago, I had many of the same old problems: fatigue, fibromyalgia, neck and back pain, a higher pulse rate at night, brain fog, etc. I didn’t end up incapacitated. But it was enough that I had to limit my activities.
This time, however, I have a pretty good idea of what’s causing my body to react this way. It’s stress!!!
Work is demanding more of my time. This entails dealing with people who, because they pay you for a service, feel they have the right to make your life miserable. I have been spending more time helping Barbara and Nicole with this blog. Michael and Peter have been preparing for two major speech and debate tournaments. I’m their coach. My dad is 81 years old. If you have elderly parents, you know what’s involved. And because of the miserable weather here, I feel like I have been a shut-in for 5 months ( I can’t wait to get my vegetable garden going. This is a major stress reliever for me. But it’s in the lower 40s today!!!). I’m feeling physically and mentally overwhelmed, again.
Two and a half years ago, after searching for two decades for an answer for my chronic fatigue, I was recommended to an alternative M.D. At my first visit, he concurred that my diet and exercise programs were for the most part, adequate. However, he told me I had to find a way to deal with stress. Not only was I working too hard, but other life issues were probably overwhelming my body’s immune and nervous system. One of the supplements he gave me was called Adrenal Essence. He said it would help my adrenal glands function better. He didn’t really go into detail on how stress affects the adrenals or how it contributes to chronic fatigue. At the next visit after receiving my test reports, he told me that I did indeed have some kind of inflammatory response going on inside my body and that my nighttime cortisol level was elevated. He recommended a supplement called Seriphos. He said that would help as well.
I took the supplements and did certain things to lighten my schedule and avoided negative situations as much as possible. Not surprisingly, I did eventually feel much better. Unfortunately, he didn’t explain the significance of an elevated cortisol level, nor did I know enough about cortisol at the time to ask him what my other daily levels were. Since then, I decided to do my homework.
Cortisol, also known as the “stress hormone”, is produced in humans by the cortex of the adrenal glands. It is released in response to stress and low blood sugar. However, cortisol has a normal, daily cycle within the human body. Below is a graph depicting how normal cortisol levels vary throughout the day. As we can see, cortisol levels are lowest at about 11:00 PM – 12:00 AM and start to rise just before waking. They peak around 10:00 AM, and then slowly decrease throughout the evening.My levels were high at night; the complete opposite of what they should have been. Obviously, there was something wrong.
Developing good stress management is one area of health that has been particularly difficult for me. Theoretically, I know what to do. Doing it is another thing. This seems to be the case with many who have chronic illnesses. Recently I have come to understand a little more clearly how the body reacts to stress, especially in regards to the adrenal glands and cortisol production. This opened my eyes to the harmful effects chronic stress can have on the body, especially in the area of adrenal fatigue. This understanding has motivated me to take my chronic stress a little more seriously.
Is Adrenal Fatigue The Correct Term?
Adrenal Fatigue is a common term in today’s alternative and integrative medical discussions. However, the term Adrenal Fatigue may be a misnomer. The condition is really a syndrome, meaning it is a collection of associated medical signs and symptoms. Therefore, the condition should better be called Adrenal Fatigue Syndrome. With Adrenal Fatigue Syndrome, there is nothing intrinsically wrong with the adrenal glands, unlike Addison’s disease where there is a problem with adrenal gland performance. Because of this, most mainstream physicians don’t recognize Adrenal Fatigue Syndrome as a medical condition.
Further many practitioners today, instead of using the term Adrenal Fatigue Syndrome, are adopting the term “Dysregulation of the HPA axis.” Did he say HPA axis? That’s right. When I first heard that term, I thought it had something to do with eastern medicine. Nope. It stands for a complex set of reactions between the hypothalamus gland, the pituitary gland, and the adrenal glands. When a person experiences some kind of chronic physical or emotional stress, the normal interactions between these structures may begin to be impaired. When this happens, what most people call Adrenal Fatigue can begin. Since most people use the term Adrenal Fatigue, I will use the terms interchangeably.
What IS The HPA Axis?
When a person is exposed to physical or emotional stress, whether it’s running from a bear in the woods or listening to your boss berate you for his mistake, the body’s HPA Axis is activated. First, the hypothalamus secretes corticotrophin-releasing hormone. This sends a message to the pituitary that stimulates the pituitary’s adrenocorticotropic hormone (ACTH) production. This hormone prompts our adrenals to make cortisol.Cortisol has a number of functions in the body’s reaction to stress.
- Increases the availability of blood glucose. This allows the body to produce adequate fuel for a possible fight or flight scenario.
- Suppresses the immune system and inflammatory pathways (not immediately needed in a threat scenario).
- Inhibits digestive motility (not immediately needed in a threat scenario).
The adrenals also release adrenaline, which raises the heart rate and increases blood pressure. These responses are all vital in allowing the body to deal with perceived threats to its existence.
This interaction between the members of the HPA Axis will continue until the hormone levels reach the point your body needs to deal with the stressor. Then the cortisol released by the adrenal glands inhibits the hypothalamus and pituitary glands from sending signals to the adrenals to produce more cortisol. What a magnificent feedback loop the body has been designed with.
Chronic Stress And The HPA Axis
Now, this all works perfectly fine if the stressor that caused the reaction eventually disappears. LOL, how many of our stressors would we like to disappear permanently? Considering the rigors of 21st century living, most of us are not unfamiliar with stress. However, what happens if our bodies are under constant stress?
Constant stress can cause the HPA Axis to be continually activated. Cortisol levels in the body then remain high. Remember, though, what we said about cortisol levels and its affect on the immune system. It suppresses it. That means your body’s immunity against disease is significantly diminished. Because digestion is not important to the fight or flight response, it’s also effectively shut down, as is healthy endocrine function. Also, cortisol raises blood glucose levels. This can cause all kinds of medical problems. To understand the relationship between high cortisol levels and weight gain, click here.
Even though someone may be under chronic stress, exhibit high cortisol levels, and have the above symptoms, they may still not be experiencing adrenal fatigue. Their HPA Axis may be able to handle the stress placed on it. Different people react differently and have a different genetic make-up. Their adrenal glands may be stronger and enable them to cope with stress better. This does not mean that they won’t suffer some of the problems associated with stress, but their adrenals are not necessarily fatigued.
It doesn’t necessarily mean that they will not suffer adrenal fatigue in the future. However, at the moment, their adrenals can produce the amount of cortisol necessary to deal with the stress.
However, if another person is experiencing chronic stress, and this can even be a constant low-level kind of stress such as sitting in traffic for two hours of each day, over-exercising, playing traffic cop daily amongst your 4 homeschooled kids (OK, that’s a big stressor), whatever, the HPA Axis may be under constant activation. Chronic stress then becomes cumulative and results in a progressive dysfunction of the HPA Axis, to the point where the adrenals are not able to provide sufficient cortisol to regulate many of the body’s functions. Cortisol levels in the body are then found to be chronically low.
Many practitioners believe that this progression from a point where there is high cortisol levels to a point where the adrenals cannot produce enough cortisol to maintain homeostasis in the body occurs in stages. See here & here. The final stage is considered an “adrenal burn out” phase and is very dangerous to the health of the person. It may also be extremely difficult for one to recover from this phase.
The Causes of Adrenal Fatigue
#1 Emotional Stress
In our busy lives today, emotional stress can come from many areas whether it be from work or within the home. You know what they are: unfulfilling jobs, newborns who for whatever reason just won’t sleep at night, relationship troubles, caring for elderly parents, the death of a loved one, moving, homeschooling your children. These situations may be manageable in the short term but over a period of time the stress can become chronic and lead to adrenal fatigue. To read how college students can be susceptible to adrenal fatigue, click here.
In my situation, it had simply been the case of doing too much for too long. Running a demanding business with constant deadlines, producing historical videos, helping with the blog, raising and homeschooling four children (our oldest is now 26), participating in all the activities that go along with that… well, you get the picture. Oh, throw in gluten sensitivity as well.
Diet also can have a profound affect on the stress response. A diet high in sugar, excessive caffeine intake, food intolerances, and highly processed foods can also increase the stress response. To read a scientific article on the effects of caffeine on cortisol production in men and women, click here.
#3 Lack of Sleep
Sleep is necessary in order to allow the body to heal both physically and mentally. Most experts say we need a minimum of at least 7-8 hours of sleep per night. It is estimated that 40% of Americans get 6 or less hours of sleep a night. But in 1942, 84% got 7 or more hours of sleep. Remember, at night normal cortisol levels drop. This is in preparation for the body’s sleep cycle. A high cortisol level at night could reverse this process causing insomnia. A lack of proper sleep simply increases chronic stress on the body. I wonder why so many people are stressed out today… hmm.
#4 Chronic Disease & Infection (Inflammation)
Any kind of chronic disease or infection will place stress on the adrenal glands. This could include things such as autoimmune diseases, arthritis, diabetes, colitis, Crohn’s disease, celiac disease, IBS, asthma, fibromyalgia, viral infections, Candida infections and bacterial infections such as H.pylori, Giardia, Lyme Disease and even a chronically infected root canal. Unfortunately, the treatment for many of these diseases also puts stress on the adrenals.
Of course, any physical trauma to the body will cause adrenal stress. This includes stress from surgical procedures.
#6 Exposure to Toxic Chemicals
Any exposure to toxic chemicals may cause stress to our bodies. This may come in the form of mercury amalgams, pesticides and chemicals in our food, water supply, cleaning products, work place materials, etc.
# 7 Excess Exercise
How To Keep Our Adrenals Healthy
First, if you believe you are experiencing adrenal fatigue, definitely seek out a qualified medical practitioner who is experienced with this syndrome. And have your daily cortisol levels checked over multiple days if possible. Since the syndrome is extremely complicated and contains many phases, people react differently to different protocols. Therefore, an experienced clinician is necessary to guide a patient through treatment.
However, there are some actions we can take to keep our HPA Axis regulated and our adrenals healthy.
#1 Remove the Chronic Stressor
Of course, whatever is stressing the body must be removed. Emotional stressors such as marital, family, relationship or financial problems need to be dealt with and normalized. Physical stressors should also be pinpointed and removed.
#2 Get the Required Amount of Sleep Every Day
Good sleep habits are essential for adrenal health. Most clinicians recommend that a person get at least 7 – 8 hours of sleep each night and perhaps more if they are under chronic stress. They also say that one should be asleep by 10 PM. This is the reason why: cortisol levels are lowest around 10 PM. This allows the body to enter into a state of repair. Most physical repair in the body takes place between 10 PM and 2 AM.
I have always had trouble implementing a disciplined sleep routine. There was always one more thing that had to be done before turning in. Also, I’m a night owl by nature. Hmm. I wonder why? Remember my nighttime cortisol levels were high. This meant that my adrenals were in hyper drive, not only pumping out too much cortisol but adrenaline as well. My body wasn’t healing properly, and I was the classic “tired but wired” person. At one point, insomnia did become a problem.
In order to get a good night sleep, experts recommend trying these things.
- Be in bed by 10 PM and get at least 8 hours sleep. Try to keep the same daily schedule. Those with adrenal fatigue may need more sleep. Daytime naps help.
- Sleep in a cool, dark, quiet room
- Turn off TVs, computers, cell phones, etc., two hours before bedtime. This seems easier said than done. There has been some research that blue light from computers disrupts the sleep cycle. See here. If it is absolutely necessary to use the computer at night, here are some options. First, there is a program one can install on the computer that makes the computer’s display adapt to the proper type of light for the time of day. It is called f.lux. Second, some choose to wear these oranged-lensed glasses that block out blue light. See them here.
- Employ proper breathing techniques at bedtime. At one point I was experiencing moderate insomnia (a classic sign of adrenal fatigue). I had trouble falling asleep, and sometimes when I did fall asleep, I would wake up 2 hrs later unable to fall back asleep. One thing that worked really well for me was practicing proper breathing techniques before I fell asleep. With adrenal fatigue, the sympathetic and parasympathetic nervous systems may become imbalanced. Often the sympathetic system will dominate (more adrenaline, etc.). Proper breathing is helpful in restoring this balance.
- Change your alarm. It may not be wise to wake up to an alarm that mimics a prison escape. LOL, you get the picture. There are alarm apps that present a gentler, more peaceful way to wake up. After all, we do want to reduce stress.
- Don’t exercise at night. Again, with adrenal fatigue, the sympathetic nervous system is already on overdrive. There is no reason to stimulate it more.
- No caffeine at all for those with adrenal fatigue, and not a good idea at night if one wants to get a good night sleep.
It is generally accepted in the medical community that exercise reduces stress. See here. So anything that reduces stress should be good for adrenals, right? Yes, exercise is a key component in adrenal healing. However, if someone is experiencing adrenal fatigue, they may have to be very careful of what kind of exercise they participate in. Since there are different phases of adrenal fatigue, over-exercise can make some patients even worse. Those with advanced adrenal fatigue should employ an exercise program under their practitioner’s supervision.
I had already implemented a program of consistent walking when I found out my adrenals were out of whack. It probably kept my adrenals from worsening. Barbara and I have been doing a daily brisk 40-minute walk for about 7 years now. We started out with a brief stroll around the neighborhood and then worked up to where we are now. This has worked wonders for my stress management. During the winter months, I use a treadmill. Unfortunately, it broke this winter and it took several months to get a new one. Here is the new one I purchased. It’s the top dog in its price range. The whole family loves it and uses it.
It is difficult for me to make suggestions here as there are so many different opinions. I basically am on a moderate paleo diet. I don’t eat any grains, even rice. I don’t consume lactose, sugar or any artificial sweeteners. I may occasionally eat a yam. I do juice about 30 ounces of raw vegetables and some fruits daily. Here are some practical suggestions that most professionals in the adrenal stress field agree should be followed if someone is under adrenal fatigue or wants to limit stress on the HPA Axis:
- Do not skip breakfast (a member of my family knows I am talking about her). With this meal, include protein and avoid fruits that have a high glycemic index. Remember, cortisol is higher in the morning and already raising blood sugar levels.
- Eat high-quality proteins and healthy fats with each meal
- Each 5 -6 small meals during the day
- No refined flour products (No gluten!)
- Avoid fruits that have a high glycemic index. Avoid sugar, caffeine, trans-fats, alcohol
- Try to use organic produce, grass-fed meats and wild caught fish when possible
- Drink sufficient filtered water
I won’t go into all the supplements I take (I already mentioned two). Remember they are called supplements for a reason. They supplement an already good diet. These are some of the most commonly recommended supplements by practitioners to maintain adrenal health:
- Vitamin D3
- B vitamins
- Vitamin C
- Omega-rich oils
- Digestive enzymes
In cases of advanced adrenal fatigue, some more aggressive means of supplementation might be necessary. Please consult your experienced healthcare professional.
#6 Spiritual Rejuvenation
Many experts on stress reduction recommend some type of meditation practice. Since I am a Christian, I meditate on God’s word and pray. This reminds me that there is a bigger plan involved than the one I can perceive at the moment. “So do not fear, for I am with you; do not be dismayed, for I am your God. I will strengthen you and help you; I will uphold you with my righteous right hand.” (Isaiah 41:10).
#7 Life Style Changes
- Learn to say NO!
- Limit multitasking
- Slow down and cut back
Sometimes we have to do less. If we take on too much, the stress we put on ourselves may become chronic and do us severe harm.
Thanks for dropping by. I hope this post has been informative and will help others who are struggling to regain a sense of well-being.
Disclaimer: Please note that I am not a practicing medical professional but just sharing with you what is working for me. I am in the process of healing and will keep adjusting what I’m doing. The information on this website is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. All content, including text, graphics, images, and information, is for general information purposes only. I highly recommend you seek out professional advice for yourself and only use my tips as a starting point.
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