Feeling tired lately? Not just want-to-go-to-bed-early tired, but so weary that you simply struggle through your workouts or can scarcely muster the power to drive to the gym or tie your shoes for a run? Depleted cortisol levels could be to blame.
Cortisol is a hormone secreted through the adrenal glands, small triangular glands located on top of both kidneys. Cortisol’s main job would be to mobilize your body’s reaction to emotional, physical, or psychological stresses, whether or not they arise from an injury, from the bad day at work or from an awful commute. Hence cortisol’s reputation as “the stress hormone.”
Cortisol is powerful stuff, and great to possess available in a pinch. Get overly stressed regularly, though (a condition known as chronic stress), as well as your adrenal glands go into overdrive. They obligingly churn out increasing quantities of the hormone, which tends to inhibit the release of other hormones, including a lot of those that are key to digestion and healing.
Having constantly elevated cortisol levels can, over time, lead to a variety of ailments, including weight gain and a weakened immune system. And finally, if your overtaxed adrenal glands go too long without getting a chance to rest and recuperate, they are able to get worn out — so worn-out that they lose their ability to create even normal, baseline amounts of cortisol. The result? You get fatigued. Very fatigued.
A “Real” Problem?
Ask your physician about adrenal fatigue and you may just obtain a blank stare or be told it doesn’t really exist. This is because mainstream medicine does not yet recognize adrenal fatigue being an official health condition.
“The conventional medical model is a disease-based model,” explains James Wilson, ND, DC, PhD, author of Adrenal Fatigue: The Twenty-first century Stress Syndrome. “But adrenal fatigue isn’t an illness — it’s a subfunctioning of the adrenals.” And so, he explains, the condition isn’t even on the radar of numerous conventional docs.
There is a recognized disease where the adrenal glands fail almost completely: Addison’s disease, which affects about one out of 100,000 people. Doctors address it with synthetic cortisol and diagnose it with a simple clinical test by which they inject patients with ACTH — the body’s chemical signal to release cortisol — and then measure the strength from the ensuing cortisol response.
The problem with this test, according to Wilson, is that it’s all or nothing. Only patients who are found to be almost incapable of producing cortisol are identified as having Addison’s disease. Everyone else, including anyone whose adrenals are quite weak, but not weak enough to be life-threatening, is considered healthy. In other words, “You’re normal until you take one more step off the cliff and then ‘suddenly’ you have Addison’s disease,” says Wilson.
This loser-take-all diagnosis may soon change, though, with preventive treatment options becoming more widely embraced. Medical researchers are now observing chronically low cortisol levels (called hypocortisolism) in patients having a host of stress-related diseases and disorders apart from Addison’s disease. These include posttraumatic stress disorder, chronic fatigue syndrome, fibromyalgia, rheumatoid arthritis, asthma and even some allergies.
Symptoms and Solutions
Wilson notes that long before it causes disease, adrenal fatigue can produce a host of disruptive signs and symptoms. In addition to persistent fatigue, these include subclinical depression, low sex drive, hypoglycemia (low blood sugar levels) and weakened immune reaction to infections. “The symptoms of adrenal fatigue are many and varied,” Wilson explains, “because cortisol would go to virtually every part of the body. So when cortisol levels drop, lots of different systems could be affected. There’s no single sign or symptom that indicates, ‘Aha! We've adrenal fatigue.’”
Long before it causes disease, adrenal fatigue can produce a host of disruptive signs or symptoms. In addition to persistent fatigue, included in this are subclinical depression, low sex drive, hypoglycemia (low blood sugar) and weakened immune reaction to infections.
One of the most frustrating aspects of adrenal fatigue is that its dragged-down symptoms can perform a real number on your fitness regimen. When you’re feeling tired, depressed or always battling a cold, maintaining your workout routine could be darn near impossible. But ironically, the easiest method to fight adrenal fatigue is to — you guessed it — exercise.
Moderate exercise not only strengthens weakened adrenal glands but also stimulates the immune system, eases stress, improves mood and addresses pretty much every other direct and indirect consequence of adrenal fatigue, based on Wilson. A study in the journal Endocrinology (July 2003) found that regular exercise increased the size and cortisol output capacity of the adrenal glands in mice.
But not just any type of exercise will do. Wilson suggests an average program that equally balances cardio and weight training. The general consensus is that although both kinds of exercise have been shown to increase cortisol production individually, a tag-team approach will probably be most beneficial.
Breaking the Cycle
Working out can be challenging if you already suffer from adrenal fatigue, since you simply may not feel that you will find the energy. So it’s important that you do whatever you can to overcome that inertia.
To begin with, “exercise at a time of day when you have a tendency to feel comparatively good,” Wilson says. It appears obvious, he notes, but it’s important because individuals with adrenal fatigue tend to notice a consistent fatigue pattern, rich in energy points around noon and 6 p.m. By timing your workouts to coincide with your own personal high points (whenever they occur), you are able to break the Catch-22 cycle that keeps you down.
You should also closely gauge your response to your workouts and adjust them as needed. For instance, if you suddenly hit the wall in the center of a particular session, don’t push yourself. Perform a shorter or easier workout compared to one you planned, or, if required, call it a day, rest up and check out again tomorrow. If you’re finding that your typical training sessions are taxing you more than ever before, cut back. “If you become inordinately fatigued within 1 hour 30 minutes after your workout,” notes Wilson, “or if you’re more tired the following morning after a workout, that’s an indication you’ve overdone it.”
Finally, attempt to maintain the frequency of your exercise. Aim for easy workouts that allow you to train four or five times a week. Gradually, as the adrenal glands recover, you’ll have the ability to do longer and more intense workouts. Which will help bring your whole body up to date.
This article has been updated. It originally appeared in the March 2005 issue of Experience Life magazine.
Adrenal Evaluation
Suspect you might be suffering from adrenal fatigue? Take a salivary cortisol test to find out. Several laboratories do these evaluations by mail, plus they don't require a prescription. (For a list of labs, go to www.adrenalfatigue.org.) You just collect your saliva inside a vial four times a day and send the vials to the laboratory for analysis. Average price is $60. Results arrive in about fourteen days.
Adjust for Your Adrenals
Because adrenal fatigue is the result of a too-taxing lifestyle, it usually takes lifestyle changes to resolve the problem. Here are the priorities to emphasize:
HEALTHY EATING: Hypoglycemia, or low blood sugar levels, is a common problem for adrenal fatigue sufferers, so your eating should be designed around supporting consistent blood-sugar levels. That means no skipping breakfast. Make sure of eating small, frequent meals during the day, and maybe having a light, healthy snack before going to bed. Each meal should include a good dose of healthy carbohydrates (blood sugar levels comes from carbs), but attempt to focus on low-glycemic-index foods like brown rice and vegetables, which produce a steadier, longer-lasting glucose elevation than high-glycemicindex foods, particularly those made from refined flours and simple sugars. (For any list of low-glycemic foods, go to www.glycemicindex.com.)
SLEEP: If you have adrenal fatigue, shoot for at least 8 hours of sleep each night, and make an effort to get to bed fairly early. Based on Wilson, when people with adrenal fatigue stay up late, they tend to get a “second wind” – often around 11 p.m. Then they may end up staying awake all night. The reasons for this phenomenon aren't clear, but Wilson speculates it's because of a natural, small rise in cortisol secretion around that time, that make falling asleep more difficult.
STRESS MANAGEMENT: A few proven techniques – reframing and relaxing – can be used to reduce the stress that inflames adrenal fatigue. Reframing is the art of consciously evolving mental poison into neutral or positive ones. This may mean challenging negative assumptions and tendencies to assign blame, or it may be as simple as choosing to reflect on positive things rather than brooding on the things you dread. Learned Optimism, by psychologist Martin E. P. Seligman, PhD, provides a variety of methods for developing a better outlook through reframing. Simple relaxation exercises, for example visualization, meditation or even just lying still and focusing on your breathing for a few moments, may also have a profound effect.
MODERATE TRAINING: Getting adequate exercise is essential to general health, but putting excessive physical strain on the body can also tax already-depleted adrenals. If you've been pushing yourself harder than what feels good – and feeling the results of adrenal fatigue – dial back the intensity for a while and give your adrenals adequate time for you to refuel. When you resume, aim for gradual, incremental increases in intensity and be sure you have built in adequate recovery time.