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  • Dr. Nancy

Do My Adrenal Glands Actually Fatigue?

Waking up and feeling no incentive and no inspiration to get out of bed and start the day may sound like a normal everyday occurrence. What you may not know though, is that it could be a sign of issues in the inter-workings of your body.

You may think you just have sleep issues or that you are worn out and tired. You suddenly feel tired in the middle of the day and just pass it off as too much accumulated stress.

No! This is NOT normal!

Just breathe!

Too often we overlook these subtle warning signs. When in reality, they may be symptoms of a budding medical condition. A condition that feeds on lack of motivation, overwhelming stress, and chronic fatigue: I’m talking about Adrenal Fatigue, or more accurately Hypothalamic Pituitary Adrenal Axis (HPA Axis) dysfunction.

The problem isn’t isolated in your adrenals, those tiny glands that sit on top of your kidneys. In fact, your brain tells your adrenal glands what to do through a complex web of communications called the hypothalamic-pituitary-adrenal axis (HPA axis).

Adrenal fatigue is really a dysfunction of your brain’s communication with your adrenals – not the adrenal glands themselves.

HPA Axis dysfunction is a much more common condition than you might think. The basis is that chronic stress (even low-grade) can result in overstimulation of the adrenal glands. This can cause an imbalance of cortisol production and an insensitivity to cortisol itself, which in turn causes extreme fatigue.

The constant activation of the stress-response system erodes resilience and it depletes your energy reserves. Resilience is your immediate capacity to respond to stress. Your energy or metabolic reserve is the long-term capacity of your body to withstand stress.

There are 4 triggers of HPA Axis dysfunction:

1. Perceived stress

Perceived stress is important because it emphasizes the fact that people perceive stress in different ways. This often shows up as worry, dread or anxiety. Something that’s stressful for one person may not be stressful for another.

2. Anything that causes inflammation

Even if you have little to know perceived stress, HPA axis dysfunction can have inflammation at its root. Obesity, autoimmune conditions, an inflammatory diet and gut issues are sources of inflammation, for example.

3. High or low blood sugar

Blood sugar imbalances can contribute to hormone imbalance, especially concerning insulin, leptin and cortisol.

4. Circadian rhythm disruption

This is a growing problem because we spend so much time indoors. Not getting natural sunlight during the day and being exposed to blue light at night work to disrupt cortisol balance.

Spotting the Symptoms

At the onset of HPA axis dysfunction, the symptoms can be mild and often ignored or chalked up to being “normal”. Because symptoms can be non-specific and can be indicative of other diseases such as depression, sleep apnea, fibromyalgia, and certain autoimmune diseases, it can be hard to diagnosis.

Common symptoms include:

  • Slow to start in the morning

  • Cravings for salty or sugary foods

  • Low libido

  • Fatigue in the afternoon

  • A “second wind” in the evening

  • Inability to stay asleep

  • Dizziness when standing up quickly

  • Afternoon headaches

  • Blood sugar issues

  • Chronic inflammation

  • Weak nails and brittle hair

  • Moodiness

  • Difficulty losing weight

Stress and HPA Axis Dysfunction

As the body encounters everyday bouts of stress and anxiety, the brain signals the adrenal glands to let out a healthy dose of the hormone cortisol. This is a normal stress response. As the stress passes, cortisol levels drop.

However, repeated exposure to stressors desensitizes the feedback response resulting in a sustained HPA axis activation and sustained cortisol release. This causes an imbalance of the cortisol rhythm. Cortisol can end up being low when it should be high, high when it should be low or always low or always high.

It is virtually impossible to eliminate all stress from your life. Afterall, the source of stress can be physical, chemical or emotional and be perceived or real. Regardless of the source of stress, your brain and body respond the same.

Some underlying causes of chronic stress that might be contributing to your fatigue include:

  • autoimmune conditions

  • viruses, bacteria and parasites

  • excessive exercise

  • food intolerances

  • poor gut health

  • toxins

Tips for Overcoming HPA Axis Dysfunction

It is important to determine the underlying factors that are contributing to the HPA Axis dysfunction. Often times by addressing the 4 triggers (perceived stress, inflammation, blood sugar and circadian rhythm) the body can rebalance the HPA Axis and optimize your energy levels.

There is no way to supplement and eat yourself out of this alone. You need to address the stress component.

Limiting processed food, sugar, alcohol and caffeine should be your top priority. It is also important to pinpoint your other key areas of stress and work to modify them.

Diet and lifestyle approaches go a long way in helping to re-establish the communication between your brain and adrenal glands. These habits help to build a solid foundation and boost your resilience.

Here are some successful lifestyle habits to optimize your HPA Axis:

  • Practice meditation/yoga/ deep breathing daily

  • Plan your days and tasks by top productivity or priority

  • Work to re-sync your circadian rhythm

  • Walk outside daily for a minimum of 30 minutes

  • Eat the rainbow every day

  • Chiropractic provides an answer to optimizing the communication between your brain and your body

Rehabbing the brain-adrenal connection takes time and what works for one person may not work for you. Above all, give yourself some grace. The last thing you need is more stress.



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Gideon Powell
Gideon Powell
Dec 23, 2021

Thank you for opening my eyes to such a disease as HPA Axis dysfunction. I consider it necessary to seek treatment on time.

Dr. Nancy
Dec 29, 2021
Replying to

I am happy that you found value in my post!

And, I want to clarify that HPA Axis dysfunction is not a disease per se. It is an imbalance.

It is important to listen to your body and take action promptly. Minor shifts in diet and lifestyle habits are easier to make in response to an imbalance, as opposed to working on reversing a full blown disease process that has been brewing for decades.

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