What is adrenal fatigue

A 40-year-old company executive and mother of two children came to me as she just felt she could no longer cope with her life. Everything had become so overwhelming that she felt unable to do even simple things, except when she forced herself. She enjoyed her job and loved her family, but since she had been working from home and trying to manage the different lives she was totally exhausted. These comments are word pictures of the classic state associated with adrenal fatigue and exhaustion.

She also had a myriad of other symptoms that supported this diagnosis. On being questioned, she revealed that she was having difficulty getting to sleep at night, with extreme tiredness during the day and having to have a strong coffee or two to get started in the morning, which also helped relieve the headache she was waking up with most days.

She was putting on weight — about 5kg in the last few months — due to several factors such as not doing as much exercise, for example at the gym on her workplace premises, and she now felt her muscles had become quite weak.

Her diet had deteriorated and she was constantly craving salt and sugar, snacking on chips and chocolate when she was stressed. She was also experiencing a range of digestive symptoms like bloating, stomach pain and heartburn, especially after eating concentrated protein foods, and she suffered alternating constipation and diarrhoea. She was drinking far more wine in the evenings to try and relax in order to sleep.

Her blood pressure was slightly raised above what had been normal — it was now 140/90 compared to her earlier 110/70 — and this also concerned her. She was depressed and irritable all the time, particularly with her family, and felt she looked dreadful; she did have pronounced dark circles under eyes, which is a common sign of adrenal problems and lack of sleep. She was taking the contraceptive pill which kept her periods regular but felt they were much lighter than before. Her hair was falling out and she could pick up handfuls of it in the shower. She also felt she was catching every respiratory infection that the kids were bringing home and was having trouble getting over them.

Treatment

To manage this problem there were various aspects that we needed to consider. This was difficult due to her exhaustion, so we introduced treatment slowly and at a level she could manage. It would have been counterproductive to increase her stress levels further.

The first task was to decide on and set boundaries with her employer and with the family. This would allow her to proceed with the time and space she needed for improving her health.The first task was to decide on and set boundaries with her employer and with the family. This would allow her to proceed with the time and space she needed for improving her health.

Exercise was next: just getting out and walking in the sun would help. Initially it didn’t have to be substantial but it did have to be regular. As a show of support, her family often joined her which she really enjoyed, and the health of all them improved.

In managing the stress response, exercise to utilise the energy from the sugars and fats dumped into the blood by adrenalin and relaxation are essential.

A daily relaxing walk in the sun, ideally for 30 minutes in the early morning or late afternoon, in a local park or beach covers several bases for adrenal restoration. She decided to add in two tai chi classes per week as this also combined exercise and relaxation and she had wanted to do this for years.

Improving sleep was the next step. Relaxing before going to bed, removing all electronic equipment from the bedroom, having the room dark and quiet and a comfortable bed are all important. Not working on computers or watching television at night helps. These suggestions, along with sunshine during the day, improve melatonin production. We added a melatonin supplement to be taken after dark, and after a few days she started sleeping better.

Diet is critical. Reducing the coffee to one per day, reducing the sugars and salt and replacing these with nuts and low-GI fruits helped. Protein foods such as fish and eggs also helped stabilise blood sugar. Increasing her vegetable intake, adding bone broth, small amounts of seaweeds for minerals and fermented foods such as kefir (coconut if no dairy), kimchi, sauerkraut etc all helped improve gut function and immunity. I recommended two litres of filtered or alkaline water per day and indicated that taking time out to eat in a relaxing environment was important.

We discussed intermittent fasting. Sixteen to 18 hours of fasting while avoiding any stimulants, coffee, alcohol etc takes a lot of reorganising initially, but research shows distinct benefits in improving adrenal function. She liked this idea, and as she was sleeping better she found she could manage her eating times between 10.30am and 6.30pm, allowing her to share the evening meal with her family.

I recommended supplements including coenzyme Q10, vitamin C for adrenal function, vitamins D and K2, activated B vitamins and magnesium morning and night. I also recommended zinc to improve immunity, and glucofactors to stabilise her food cravings were also successful.

I prescribed adaptogenic herbs and included Rhodiola, ashwagandha and Siberian ginseng, along with hawthorn to help manage the blood pressure and strengthen her heart.

I also prescribed a second herb mix to reduce respiratory infections, support the lungs and to build immunity, and chose astragalus, thyme, mullein and elderberry.

While it took some time and organisation, she started noticing enough improvement within a couple of weeks that she was encouraged to continue with the program and continues with minimal changes today.