Adrenal Fatigue

website image man with letter on bench

Stress and Burn-out


The adrenal glands may be small but they are vitally important for our overall health. Located above the kidneys and walnut-sized, they produce important hormones:

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  • Mineralocorticoids – which regulate mineral and fluid balance in the body, including bllod pressure maintenance
  • Glucocorticoids – such as cortisol, which contribute to quelling inflammation in the body by working the immune system, and blood sugar control
  • Sex hormone precursors such as DHEA, androgens and estrogens
  • Epinephrine (adrenalin) ,norepinephrine and dopamine – which help us manage our primitive stress response

Adrenal gland function has become increasingly central in health discussions because the modern world’s fast-paced nature forces many of us to go into more or less constant “fight-or-flight” reactions – which is mostly mediated by the adrenal’s adrenalin and cortisol. As the demands on the adrenals overwhelm their natural capacity, we gradually start entering in a state of adrenal fatigue.

Common symptoms of adrenal fatigue include:

  • Fatigue which is not relieved by rest or adequate sleep
  • Cravings for sugar or salt
  • Need for stimulants such as caffeine and sugar to “keep going”
  • Recurrent infections (colds, flus, mycoplasma [very common in Singapore]) & allergies – these require that the adrenals put out more cortisol as an anti-inflammatory, leading to adrenal fatigue
  • Feeling dizzy when standing up
  • Muscle weakness or cramps

These symptoms can range from mild to extreme and most adults will not present with all symptoms at once but rather three or four. When adrenal fatigue has persevered for long enough, the health of other hormonal glands can be affected. Thus, it is not unusual to see a link between suboptimal adrenal function and:

  • Thyroid abnormalities – in particular, low thyroid function in women
  • Sex hormone imbalances – such as PMS or irregular menstrual cycle in women, or low sperm count in men

There is no blood test for adrenal fatigue and it is a condition that generally goes unrecognized in the conventional medical world. Diagnosis is generally made by analyzing symptoms, although salivary hormone testing may at times be useful.

Common causes of adrenal fatigue are:

  • Stress and overwork
  • Excessive worry
  • A long period of physical stress and sleep deprivation – such as after pregnancy, lactation and sleep deprivation due to a new baby
  • Recurrent infections & allergies – we see this very commonly in Singapore
  • Vigorous physical activity – overdoing exercise in already stressful times can further deplete the adrenals
  • Stimulant overuse – although at times, we strongly rely on caffeine/sugar/chocolate because of a state of adrenal fatigue, such that a vicious cycle is easily established
  • Poor nutritional intake – when under stress, the adrenals require B vitamins, zinc, selenium and vitamins A, C and E – as well as large amounts of protein in the diet many of which are not in the diet of people under stress, who will generally lean towards a high-carbohydrate diet with relatively few micronutrients

Adrenal fatigue can be corrected with naturopathic medicine by using:

  • Lifestyle changes – mindfulness and implementing stress-coping mechanisms in place
  • Nutritional changes – focusing on high micronutrient content and detoxification
  • Herbs and supplements – such as American ginseng, schizandra, ashwagandha or other adrenal-tonifying herbs and combined with supplemental vitamins necessary for good adrenal function