Adrenal Fatique Revisited

    Adrenal fatigue, also known as ‘burnout’, is affecting more and more people in modern societies. The good news is that this condition can be assessed and treated holistically.

    If you wake up feeling as though you have been run over by a bus; suffer from body aches; relentless fatigue; disturbed sleep; anxiety; depression; digestive problems; memory loss; struggle to lose weight; and crave sugary and salty foods, the chances are you have adrenal fatigue – a condition with a slow and insidious onset that goes largely undiagnosed.


    The condition is often associated with chronic, long-term stress commonly brought on by the fast pace of modern living or an event or illness that is both mentally and physically challenging. Adrenal fatigue occurs when the adrenal glands (situated above the kidneys) become overburdened and secrete reduced amounts of hormones including cortisol, aldosterone, pregnenolone, dehydroepiandrosterone (DHEA) and adrenaline. A poorly functioning adrenal system will lead to an imbalance of the hormones that regulate blood pressure, cortisol, metabolism and mineral uptake such as potassium and sodium. This in turn can impact on the immune function, sleep, mood, energy levels and a healthy stress response. The most common symptom of this condition is severe fatigue that cannot be relieved by prolonged rest or sufficient amounts of sleep.


    Unlike other forms of adrenal dysfunction, such as Addison’s disease and adrenal insufficiency, adrenal fatigue is not accepted as a medical diagnosis. This is because the standard blood tests used to detect the severely depleted hormone levels in Addison’s disease and adrenal insufficiency are not sensitive enough to detect the subclinical hormone levels of adrenal fatigue. Consequently adrenal fatigue patients are told they are ‘normal’ while, in fact, they are suffering with clear signs and symptoms.

    So the challenge arises because the diagnosis is usually based on how the patient is feeling rather than on the results of a medical test. Subjective testing involves patient response to various questions, and stress assessments can classify the stage of stress the patient has reached.

    The objective testing of cortisol levels in blood, saliva and urine may measure subtle changes in adrenal function. In fact, free cortisol and DHEA levels in saliva is a more accurate test and can prove useful when deciding on treatment.

    Adrenal Fatique Revisited


    Chronic stress is the main cause of adrenal fatigue as it induces the production of large amounts of stress hormones (most importantly cortisol) from the adrenal glands. As the stressor/s persist, so does the release of these hormones until the adrenals reach ‘burnout’ and the supply of hormones runs low. Consequently the above-mentioned symptoms occur.

    Stressors include:


    • Recurrent diseases, infections or illnesses
    • Some allergies
    • Past accidents, injuries and traumas
    • Major surgery
    • Side effects from medications
    • Chronic pain
    • Chronic inflammation
    • Excess carbohydrates and insufficient protein
    • Excess sugars, low blood-sugar levels
    • Poor sleep
    • Excessive exercise


    • Anger, fear, anxiety, worry, guilt
    • Depression


    • Toxic chemicals and pollutants in our food chain, work and home environments
    • Intense or prolonged noise
    • Intense heat or cold
    • Overwork, mental strain
    • Disrupted light cycles (sleeping during the day, awake at night)

    Stress is a natural part of life. What matters is how you respond to the stress. You can treat the underlying causes of adrenal fatigue by taking care of your body proactively, minimising stress, and applying healthy lifestyle techniques.

    Adrenal Fatique Revisited


    As certified nutritional therapist Jacqueline Wildish says, ‘Our physiological evolution has not kept pace with our social evolution and herein lies the source of many of the health problems of our times.’Today, managing lifestyle factors is the most important component in overcoming a stress-based condition such as adrenal fatigue. Evaluate and identify the things in your life that are causing stress and then modify your lifestyle to improve on your ability to handle it. You will not fix the underlying problem of physical, mental and chemical stress by taking nutritional supplements alone so remember to address and im- prove the core pillars (a healthy diet, exercise and quality sleep) of how the body responds to stress naturally.


    Proper nutrition is crucial to keeping your body and hormones balanced and first-choice therapy should be to supply the adrenal glands with normalising adrenal nutrients and herbals. Processed foods and excess chemicals will cause blood sugar levels to fluctuate and cause the body to secrete excess cortisol. Though a critical hormone, cortisol also contributes to weight gain and weight loss resistance.


    There are many dietary supplements aimed at people with adrenal fatigue. The main nutritional supplements that can help adrenal fatigue are omega-3 fatty acids, magnesium and vitamins A, B3, B6, C and D. They can help to strengthen your system and improve your overall health.

    Herbs that aid in recovery from adrenal fatigue include: liquorice root, Cordyceps mushroom, ashwagandha root and leaf, echinacea, rhodiola (golden root), Chinese ginseng and Siberian ginseng.

    Avoid caffeine and sugar as they place unneeded stress on your adrenal glands over time.


    One of the best ways to maintain and bal- ance hormones is through exercise. Hormo- nal balance is critical to the maintenance of adrenal health. Hormonal problems are very common and worsen as we age; go through menopause; and never address the underlying causes.

    A well-known stress reducer and body detoxifier, exercise can at times prove more effective than antidepressants in improving mood. Whether adrenal fatigue is an official medical diagnosis or just a classification of symptoms, lifestyle improvements are the key to recovery.

    Natural sleep

    Medically induced sleep is not the answer. What is needed is sleep achieved through the natural sleep cycles. If you have trouble sleeping, start a sleep routine: avoid bright light and television or computer stimulation; eat a healthy supper, have a warm bath; and read a book – these activities will ‘train’ your brain and body to relax and sleep.


    1. Alarm: Identification of a threat and reaction via the fight-or-flight response as mediated by adrenaline. Stress should be short-term and the body returns to normal function once the stressor is removed.

    2. Resistance: If the stressor persists, the body, through the release of cortisol, adapts and builds up resistance to the stress response. In the long-term there is a heightened risk of chronic illness.

    3. Exhaustion: If the stress persists, we are progressively drained of necessary nutrients and resources needed for optimal function and we are faced with mental and physical exhaustion.

    Adrenal Fatique Revisited


    So plan for change and don’t stress about it in the meanwhile! Poor lifestyle habits are generally learned over years or decades and often influenced by one’s family, community and culture. Systematically and consistently apply new ways of thinking and behaving to achieve healthier choices. Regardless of your health condition, you can take responsibility to restore hormonal balance.


    1. Wildish J. Running on empty? Adrenal fatigue – a sign of the times. The South African Journal of Natural Medicine 2008: 34 (69 – 75)

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