Answer yes or no to the following:
- You spend every morning in a "fog" and just can't seem to wake up without excess caffeine.
- You frequently feel overwhelmed.
- You have trouble falling or staying asleep at night.
- You feel unusually cranky, emotional, or frustrated.
- You're lethargic most of the day.
- When you get sick it takes a long time to recover.
Did you answer yes to any of these? These are the most common symptoms of adrenal fatigue, a controversial subject practically ignored by the medical community, but a very real condition that requires your attention... especially if your answers were mostly yes.
As we get busier, eat more crap, rest less, and live in constant states of stress, it's no surprise that this condition is so common. But if you can optimize your adrenal glands and fix this condition (or prevent it), you'll have one less roadblock to deal with in your quest for physical perfection.
Defining Adrenal Fatigue
Adrenal fatigue is a collection of symptoms that occur when your level of stress – be it physical, emotional, mental, or a combination – overwhelms your body's ability to compensate for that stress .
The adrenal glands are two endocrine glands that sit on top of the kidneys. When you encounter stress, the adrenals produce adrenaline (epinephrine), noradrenaline (norepinephrine), and cortisol. This hormonal release is often called "fight or flight" and is designed to prepare you for immediate physical challenges.
Your body is made to handle stress quite well when it's acute and short lived, as there are strong homeostatic mechanisms in place with our sympathetic (jack you up) nervous system, and parasympathetic (calm you down) nervous system.
The whole system is beautifully designed and worked well for our ancestors, who typically faced intense but brief stressful situations like warding off a hungry predator.
Now think of what stress is today: A strange number on your wife's caller ID, Junior coming home smelling like Keith Richards' tour bus, your boss warning you about irregularities in your expense report... the stress adds up.
It's chronic, low-grade stress that never quite goes away that leads to physical problems.
A Medical Perspective
Adrenal fatigue is often described in the medical community as hypoadrenia or low-functioning adrenals. This is largely a result of the adrenals being overworked by chronic stress so that they literally start to wear out. A worst-case scenario would lead to Addison's disease, a condition where the adrenals fail to produce sufficient cortisol.
Asking your physician to check you out for adrenal fatigue can be frustrating. Your doctor will most likely use a test to look at your cortisol levels. There's a range they consider normal; let's say that's 20-60.
If you are 19, you're low, so you have Addison's Disease (not enough cortisol). If you're 61, you're high, and have Cushing's Syndrome (too much cortisol).
But if you're clearly low (around 21-25), although not quite into Addison's territory, most doctors will stop there and call you "normal."
According to some progressive doctors, what you really have is adrenal fatigue, but because there's no formal recognition of it, there's no ICD code (International Classification of Disease). To most doctors, no ICD code means that adrenal fatigue doesn't exist!
The take-home message is, don't just assume your typical doc will be helpful if you think you suffer from adrenal fatigue.
Tests For Adrenal Fatigue
Here's a quick guideline to the most common tests:
- Saliva Testing Adrenal expert Dr. James Wilson advocates this, as saliva hormone levels are more reflective of hormone levels within cells, where hormonal reactions take place. They're easy to do – spit in a vial and you're in business.
- Blood Testing You can measure aldosterone and cortisol this way, but the knock is that you'll only see levels that are circulating in your blood, not in your tissues or cells.
- Hair Mineral Testing This is a method advocated by Dr. Lawrence Wilson. He looks at various mineral levels in the hair such as sodium, potassium, and magnesium.
- Ragland Test A simple test you can do at home. Lie down for 3 to 5 minutes and then measure your blood pressure with a blood pressure gauge. Now get up and retest it. If it drops, it's a classic sign of adrenal fatigue. Normally your blood pressure would rise or at minimum stay the same.
- Iris Contraction Test This was discovered in 1924 by Dr. Arroyo and is another easy test you can do at home. Shine a light across your eyes and have someone watch your pupil dilation carefully. If you have adrenal fatigue, your pupil will stay contracted, and even when it does start to dilate, it will alternately contract and dilate.
Fixing Adrenal Fatigue
The good news is that part of the issue is easy to fix through diet and sleep. The bad news is that there are lifestyle changes that you may have to take on, and that can be easier said than done.
Improve your Diet
When you eat is of utmost importance for those suffering from adrenal fatigue. Going long periods without eating is a mistake because it results in a perpetual cycle of adrenal stress.
The adrenal hormone cortisol helps keep your blood sugar at adequate levels to meet energy demands. If you have adrenal fatigue, your adrenals aren't making enough cortisol, making it harder to maintain normal blood sugar levels. Most people with adrenal fatigue have hypoglycemia as well.
What's especially important is to not skip breakfast. Between 6 and 8 AM, cortisol levels usually rise, peaking around 8 AM for most. This can kill your morning appetite, but you must eat by 10 AM at the latest and begin to restore glycogen supply.
Have an early lunch, a snack at 2 or 3 PM, a healthy dinner, and then another snack later. There are many popular styles of eating in the bodybuilding world, but frequent, small, nourishing meals are the best if you have adrenal fatigue.
What to Eat
What you should eat is quite simple. You want meals to be balanced with fats, carbs, and proteins.
These foods are all converted into energy at different rates, and will supply a steady supply of energy for a longer time. Eating all three of these at each meal lessens the strain on your adrenals. Forget the low-carb or low-fat approaches to eating. For the guy or gal with adrenal fatigue, balance is the key.
- Protein Eat grass-fed beef, whole eggs, poultry, or high-quality protein shakes such as Metabolic Drive® at every meal. I'm not a believer in soy protein because of the anti-nutrients in it, and vegetarians do seem to have a harder time recovering from adrenal fatigue.
- Carbohydrates Eat unrefined grains such as brown rice, oatmeal, buckwheat, and quinoa as opposed to refined carbs, which cause your body to cannibalize nutrients to metabolize them. Don't go into "nutritional bankruptcy." You'd be sucking all the nutrients out of your body to metabolize the crap you're eating, as opposed to putting nutrients into the body.
- Fats Your adrenal glands love essential fatty acids. Make sure you're getting adequate omega-3s by way of EPA and DHA from products like Flameout® or from food sources such as wild Alaskan salmon. (I don't care for flax seed oil because your body has a tough time converting the alpha linolenic acid to the usable form of DHA.)
Cook in saturated fats like coconut oil, butter, and cocoa butter to avoid eating rancid oil, and include monounsaturated fats like those found in olive oil. The value of placing these fats in each meal is not only for the nutritional benefit, but to slow down the digestion of the meal.
Note: Don't forget about salt!
Overworked adrenals have a hard time producing adequate amounts of aldosterone, and as aldosterone levels fall, sodium is removed from the blood and excreted through the urine. Be sure to add Celtic sea salt to foods or even a few pinches to 2-3 glasses of water daily.
Drinks with low sodium and high potassium are not the answer – this is the exact opposite of what someone with low cortisol and sodium depletion needs.
What Not to Eat
- Alcohol, coffee, and sugar You have to let your adrenals fully recover from the stress that hammered them. When you take in caffeine and sugar to get energized, it prevents the adrenals from producing the right level of energy naturally. The same is true with alcohol. Drinking to relax inhibits the adrenals from performing that task on their own.
- Certain fruits in the morning Fruits that are high in potassium and fructose should not be eaten in the morning. Remember, too much potassium isn't good for someone who's already sodium depleted. Dr. James Wilson recommends that you limit bananas, raisins, dates, figs, oranges, and grapefruit, opting for papaya, mango, plums, pears, kiwi, apples, grapes, and cherries instead.
- Trans fats Healthy fats help to build cell membranes, but trans fats use up enzymes that the good fats would be using to help make healthy cell membranes, nerves, etc. Not good.
- Refined sugars Remember the relationship between hypoglycemia and adrenal fatigue: the quick surge you get in blood sugar from eating these items will result in a massive insulin dump leaving you with low blood sugar. Avoid this stressful cycle to your adrenals.
Change Your Lifestyle
The first thing that comes to mind when solving the riddle of adrenal fatigue is to sleep more and get more rest in general. Those are great things to change, but you need to go deeper.
Ditch the Life-Suckers
Life-suckers are the people in your life that give you a sense of uneasiness, anger, or frustration when you're around them. They're constantly negative, always complaining, and never see the bright side of things.
You have to make it a point to limit these interactions as best you can (if it's not a spouse or family member). I'm not suggesting to run away from your problems, as they're usually opportunities for growth, but if someone has been dragging you down for months, maybe even years, you may want to take a little "break" from that relationship.
I've adopted some rules here that have definitely lowered my day-to-day levels of stress:
- Don't even talk to the "life-suckers" for a while. Maybe they'll go away, and if they don't, at some point you can talk to them and tell them why their behavior is sucking the life out of you.
- If it's someone you have to talk to, set and stick to a time limit with them. I have a five-minute rule. After whatever time limit you set is up, just let the person know you have to go. Don't get sucked into an exhaustive two-hour conversation.
- Don't be afraid to say no. You can't please everyone, and always saying yes could lead to overextension or putting yourself in stressful situations you just don't need.
- Make tough decisions. Not only can people suck the life out of you, so can situations. Many times it's a job. I knew a guy who would continually talk about how much he hated his job. Finally, I said bluntly, "Just quit, dude. Your other two choices are to just stop worrying about the tedious bullshit or start looking for a new job. But just do one of those three things, please!" The next time I saw him he was Mr. Happy-Go-Lucky. He'd changed positions, and thanked me for giving him a kick in the ass. The lesson here is to do one of the following: accept and adapt, change the situation, or walk away.
- Laugh. Laughter increases the parasympathetic supply to the adrenals. When you're laughing and having a good time, free of stress and enjoying life, your adrenal glands are usually at rest and can repair. Talk more to people that make you laugh, go to places that make you smile, and just don't take life too seriously. When I'm laughing and happy, I sleep better, my appetite is better, and I train harder.
- Sleep more. I remember Mike Mentzer talking about how he didn't sleep because sleep was time he wasn't being productive. If you subscribe to that philosophy, you may want to reconsider it. The prevailing thought is that the sleep between 7 and 9 AM is extremely restorative. If you suspect you have adrenal fatigue and work an 8 to 5 shift, try to sleep in until 9 AM on the weekends. When you consider that cortisol levels normally rise between 6 and 8 AM, those with adrenal fatigue won't have the rises and drops that a person with healthy adrenals would have.
There are other things you can do to improve sleep, such as having a snack of high-quality protein, unrefined carbs, and healthy fat right before bed. Again, a strong relationship exists between adrenal fatigue and low blood sugar, which may plummet so low at night you might awaken.
You should also make sure to retire before 10 PM, as most people with adrenal fatigue have a pattern of "waking back up" at 11:30 PM or so, and then going to sleep can be very challenging.
Use Nutritional Supplements
Supplements can be a great aid in your efforts to beat adrenal fatigue. Here are a few to try:
- Melatonin Helps reestablish better sleep patterns. Try 2 mg nightly.
- Vitamin C This should be your number-one supplement if you have adrenal fatigue. There's a direct relationship between how much cortisol is made and how much Vitamin C is used. If you're constantly under stress, the resulting cortisol will deplete Vitamin C levels. Try 2 grams daily. Be sure your supplement of choice includes bioflavonoids in a 2:1 ratio of ascorbic acid to bioflavonoids.
- Vitamin E Vitamin E works closely with Vitamin C to neutralize free radicals. (When the body makes adrenal hormones, free radicals are generated.) I'd caution you against taking just any Vitamin E supplement. Too much of the d-alpha form can do more harm than good. Look for a supplement with mixed tocopherols. Shoot for 800 mgs a day. Food-wise, red palm oil has all the E tocopherols in an extremely usable form. I highly recommend it.
- Magnesium Magnesium is responsible for hundreds of enzymatic reactions in your body. Magnesium (and other minerals) are best absorbed at night and with a digestive aid such as betaine HCL. You can find magnesium in Elitepro™ Minerals and ZMA®.
- Licorice Root This is the herb that's best known for helping to combat adrenal fatigue. It can also be used to decrease symptoms of hypoglycemia. Don't eat the candy; drink the herbal version of tea.
Small Stressors Add Up
Your body is good at dealing with acute stress, not daily chronic stress. It'll wreck your best efforts in the gym, or even worse, lead to degenerative diseases such as diabetes.
Whether your goal is a mammoth squat, bodybuilding mastery, or just outrageous health, respect your body and protect your adrenals. You won't regret it.
- I Bengston, et al,. "The Cortisol Awakening Response and the Metabolic Syndrome in a Population-Based Sample of Middle-Aged Men and Women," Metabolism 59, no. 7 (July 2010) 1012:1019
- H. Raff, "Utility of Salivary Cortisol Measurements in Cushing's Syndrome and Adrenal Insufficiency," Journal of Clinical Endocrinology and Metabolism 94, no. 10 (October 2009): 3647-3655
- Tintera JW. The Hypoadrenia Corticol State and its Management. New York State Journal of Medicine 55 (13): 1-14, 1955
- Wilson, J. (2001) Adrenal Fatigue the 21st Century Stress Syndrome. Petaluma, CA 94955: Smart Publications
- Pick, M. Perloff, R. M. (1995). The dynamics of persuasion. Hillsdale, NJ: Erlbaum.