I will never see an adrenal fatigue patient again. I am done. After 15 years, I am not going to do it anymore. You will not convince me different. All the way from adrenal fatigue being a minimal inconvenience to it crippling someone’s life, I have seen it all. But no matter how simple or how complex the case, it is time to move away from adrenal fatigue. Now, I am not shunning anyone that deals with adrenal fatigue. I am simply saying that I am taking a stance to move forward. But why you ask?
You are probably wondering why I have made the decision to never again see an adrenal fatigue patient. To understand the transition, allow me to ask you the question, “Is adrenal fatigue real?” It is a commonly misused term. The definition seems to be ambiguous and changes depending on who you talk to. This is one reason conventional doctors and functional medicine doctors have difficulty being on the same page about this topic. Conventional doctors see adrenal fatigue as Addison’s disease. The adrenal gland fails to produce cortisol. On the functional side, the challenge of understanding adrenal fatigue grows even more.
Has the adrenal gland stopped producing cortisol? Is there an insufficiency of cortisol production (as opposed to no production)? Could adrenal fatigue simply be another way of saying you are fatigued from excess stress? You see from my questions that it can be hard to put an exact definition to the term. And the confusion grows even greater when you start talking about insufficiency of cortisol. Are y0u minimally, moderately or severally deficient in cortisol? At best we have attempted to apply labels and definitions that offer little clarity.
The origins of the term adrenal fatigue originated with a scientist studying rats. We learned that there are different stages of the stress response. It was truly pioneering work of the day that got us to this point. But in today’s world there is 24-7 unrelenting stress. It takes a toll on us. Our reactions to stress now do not conveniently follow the original model of stages. But this is what is more important. The reaction to stress goes well beyond cortisol. Therefore, trying to classify adrenal fatigue using outdated stages and labels no longer works. Frankly, I have not seen that using the labeling system provided any additional benefit to my patients outcomes. I no longer use it.
As I have grown in my understanding, I have had a moment of clarity. The adrenal glands were never the problem. As I previously eluded to, the term adrenal fatigue assumes the adrenal gland lacks the ability to produce cortisol. This could be an absolute inability or partial. Nonetheless, I want to pose a question. What if the adrenal gland has the ability, but lacks the resources to produce cortisol. Wouldn’t the presentation be the same? A gland deficient of the necessary precursors to support its activity appears dysfunctional. So rather than apply a label of adrenal fatigue, why not investigate the nutrients needed for optimal adrenal gland function.
Too often I have seen individuals carrying around the label, and mental weight, of adrenal fatigue. Herbs and adrenal tonics have been the recommendations of choice with little, if any, benefit. This is not to say those don’t have a role. While I even recommend these myself from time to time, they do not trump the basic precursors that are necessary to promote optimal function of the adrenal gland. Key nutrients like B5 are highly under-utilized and without it, hormone production is minimal. You cannot use an adrenal tonic to modulate a hormone that you are not producing enough of because of a B5 deficiency.
Other nutrients are key as well. These include tyrosine, GABA, B6, folate and B12.
Recently a patient said to me, “I have done everything that I can to support the adrenals (adrenal gland).” However, one key point had been overlooked. The response to stress, and what is often labeled as adrenal fatigue, is not simply related to cortisol. In fact, to narrow the conversation down to helping the adrenal glands produce more cortisol overlooks an equally important contributor to the stress response. The nervous system plays a vital role in responding to stress. So is the adrenal gland fatigued, the nervous system or both?
The famous line from the Wizard of Oz movie, “Lions and Tigers and Bears, Oh My!”, beautifully illustrates the nervous system stress response. As I recall, the characters in this classic movie were always on edge. They were always waiting for the next bad event to take place. Their adrenaline was constantly pumping! If this sounds like you, and you are fatigued, I have news for you.
Your nervous system has tanked. A little adrenaline periodically keeps the nervous system primed and you alert. A lot of adrenaline constantly wears you out resulting in persistent fatigue.
Unfortunately, nervous system fatigue is often called adrenal fatigue. Yes, the adrenal glands are responsible for producing adrenaline (epinephrine) and noradrenaline (norepinephrine), but it is the nervous system that drives this stimulation. Supporting the adrenal glands without supporting the nervous system is an effort in futility. The two are so intertwined that they cannot be separated and must be supported together.
The reason I will never see another adrenal fatigue patient is not because I have a dislike for working with them or don’t feel like the adrenal gland needs support. To the contrary, the adrenal gland needs more support now than ever. Stress is much more of a factor than in the past. My reasoning stems deeper. Adrenal fatigue describes only a fraction of the contribution to being exhausted. Rather than taking such a narrow view, I commit to looking for the multiple factors that contribute to fatigue; adrenal glands, nervous system, nutrient deficiencies, toxicity and more. I will not be guilty of putting someone in the box of adrenal fatigue ever again.