Are you tired all the time, awake late at night, or waking throughout the night? Do you have cold hands and feet, lightheadedness, fainting, brain fog, headaches, allergies, frequent infections, low thyroid function, menstrual irregularities, blurry vision or cravings for sugar? are you overwhelmed, worrying-all-the-time, or feeling shaky and irritable between meals, to name a few, and your blood work is basically "normal?"

It comes in various colors and shades, but comes down to one common issue: Adrenal Exhaustion. 

Not defined by conventional medical care.  Without an ICD9 code.  Not distinguished in standard endocrinology textbooks. Doesn't show up on regular blood work. Still very real. 

The first to identify Adrenal Exhaustion (also known as adrenal fatigue or adrenal stress) was Hans Selye, who called it Adrenal Maladaptive Syndrome.  he described three stages: 1. Alarm phase (elevated cortisol, DHEA and adrenaline) 2. Resistance phase (high or normal cortisol and adrenaline, low DHEA) and 3. Exhaustion phase (cortisol and adrenaline low). 

Saliva testing of cortisol levels, and urine testing of adrenaline levels (two substances produced by the adrenal glands) have further helped us to understand the potential shifts in adrenal function that lead to symptoms of “not feeling quite right.”

That is exactly what many patients say when they come to see me: “I feel off.”  

The adrenal glands, and often unheard-of body part located above the kidneys, is absolutely key to keeping our bodies on track.  The adrenals are responsible for responding when we go more then 3-4 hours without eating (with a hormone called glucagon that raises glucose in the blood by taking it from muscle).  

The adrenals are also the source of the much-needed, but often overly stimulated, stress hormone cortisol.  Without cortisol, energy levels are on the floor, and with too much, inflammatory levels soar.  so it is the perfect amount that we seek, and yet if we make choices that create stress for our bodies, then our adrenals have no choice but to respond.  

With stress, the other adrenal-produced substance that can wreak havoc is adrenaline, the substance that leads to a sympathetic response, stimulating the body to respond to a threat.  While we wouldn’t want to be without it in case we need it, we also don’t live the life of a caveman hunting for food.  It would be better to use it only in true emergencies and not all day, every day.  Otherwise, anxiety and insomnia become prevalent experiences. 

So what happens when the adrenals don’t work as well as they could?  One can imagine that energy levels, blood sugar balance and sleep will be impacted.  Still there is more.  The substances produced by the adrenals send messages all over the body, impacting every other major system including digestion, immune system, endocrine system (all glands that make hormones such as thyroid, pancreas, ovaries) and the nervous system.   

This is why it is so common for people who have been under acute and/or long-term stress to develop symptoms in various areas, most commonly the digestive tract (GERD, IBS, colitis), immune system (frequent infections, allergies, auto-immunity, cancer), hormonal imbalances (hypo/hyper thyroid, insulin resistance, menstrual irregularities), and nervous system (anxiety, depression, insomnia).  

I figure it is a matter of genetics that determines how much stress and for how long, before the body starts to show signs that the adrenals are no longer keeping up.  While some people are genetically predisposed to having the digestive symptoms first, others begin with frequent infections or mood changes (for example).  

No matter how and where the symptoms arise, the important part is to address not only the local imbalance (support digestion for example), but to figure out exactly what the adrenals needs at that point in time to regain a healthy ability to respond to stress. 

The good news is that nutrients and herbs can help the adrenals to recover.  Based on information derived from the test mentioned above, it is possible to know whether cortisol is high or low, and at what time of day.  It is also possible to see what adrenaline is up to.  then, using herbs at specific dosages, we can shift the amounts toward healthy levels.  

However, to create long term adrenal health, and to not step right back in the same hole again, it is important to look at how you are treating your body.  

The best ways to allow the adrenals to come back on line, is to minimize even the smallest stresses.  Avoid situations that cause the adrenals to kick into action beginning with eating every 3-4 hours, so that blood sugar levels will be managed by the way food comes in, not by the hormones in the body that compensate for wide swings in frequency and amount of glucose.  next is to get adequate sleep (8 hours).  

Take another look at the manner in which your day is arranged. Do you have time to eat?  Do you have access to foods that are healthy for you? are there predictable times for you to rest and relax? is exercise a built-in part of your day? What needs to change for these things to be possible? 

It is possible for the adrenals to recover, but it’s not going to happen by continuing in the same manner that exhausted them in the first place.  when signs of adrenal exhaustion appear, it is a clear sign that your body needs attention: to be fed and rested regularly!

During recovery from adrenal exhaustion, it is quite common to experience periods of improved energy and symptoms, followed by short periods of what feels like back tracking.  It can be frustrating to feel worse, once you just started to feel better…so while you are on the path to recovery, think of the dips as part of the process, and a reminder to take it easy on your body.  It can help to journal, so that you can observe your overall progress over months, versus the way you feel any single day.

While yes, as described in my article titled “It All Starts with Stress” which was published in Integrative Medicine: a Clinician’s Journal in June-July 2009, research does demonstrate that adrenal health is the core of overall health, it is also important to support the other systems in the body (digestion, immune, etc) in order to facilitate healing.  

That being said, one of the first steps to healing is to assess your adrenal stress by doing a urine and saliva panel.  This will provide information about exactly where to begin to support your body to heal.  

If you are ready to take those steps, and would like my help to do so, please click here to submit an intake form and let’s get started as soon as possible! 

Warm regards, 

DONIELLE WILSON is a women’s health expert and Naturopathic Doctor with a private practice in new York City, Port Jefferson, NY, and Connecticut. she specializes in showing women and their loved ones how to achieve their wellness goals by finally getting the answers they’ve been looking for to their most perplexing health challenges. To learn more about Dr. Doni and her unique approach to achieving health naturally, please visit Dr. Doni today.