Reducing the Fatiguing Symptoms of Adrenal Fatigue

Overview

The human body has been wired with an incredible emergency response system in order to handle stressors, whether they are internal, external, physical, psychological, or biochemical.1  When a threat is sensed, the body responds with a well-planned management sequence.  Interestingly, prevalence of the ailment is difficult to determine as there is some disagreement that adrenal fatigue evens exists.21,2

The senses are responsible for delivering input to various parts of  the brain.  One of those impressive parts is  the hypothalamus, and one of its functions is to sense stress.  It then releases corticotropin hormone (CRH) in order to stimulate the anterior pituitary to excrete adrenocorticotropic hormone (ACTH), which then initiates the release of cortisol by the adrenal cortex.2  This helps to activate the appropriate nervous system that responds to stress:  the sympathetic or “fight or flight” nervous system.2  Neurotransmitters are released in order to divert energy, blood, and oxygen to the appropriate organs imperative to “fight or flee”, the brain, heart and muscle.1  Adrenal insufficiency is when the adrenals cannot keep up with this demand.1 

Studies have shown the protective functions of B vitamins, and their ability to assist the adrenals with the stress response.  They are also a cofactor in necessary neurotransmitter production for the hormones involved.3  Vitamin C is needed by the adrenals for functioning more than any other organ in the body, responsible for the metabolism of dopamine and norepinephrine and used in the stress response by both segments of the adrenal glands:  the cortex and the medulla.4  Deficiencies in these key nutrients can disrupt the delicate balance of neurotransmitters and hormones required for the innate and evolutionary skill of sensing and handling threat.

Therapeutic Foods

An anti-inflammatory diet, combined with a low glycemic index is a thoughtful choice when it comes to supporting the adrenals due to their ability to reduce internal stress and inflammation and reduce blood sugar highs and lows.1,2  An anti-inflammatory diet pursues a balance of the macronutrients and a focus on omega 3 fatty acids to reduce biophysical stress through inflammation.5  Quality whole meats like chicken and fish, and plant proteins like legumes and beans, along with fruits and vegetables make up the core of the diet.  Processed, refined, packaged foods are avoided.  As of 2019, 21 human trials had been done pertaining to the viability of the anti-inflammatory diet on inflammatory markers and fatigue.6  Rather than being evident, the studies were indicative of its effectiveness, though more studies need to be done.6

Quality sources of proteins and fats are promoted on the diet and work well for adrenal fatigue due to the energy derived.  Omega 3 fats are supportive of nerve and cardiovascular health, two systems heavily impacted in the innate stress response. Consumption of fish 2-3 x/week is the recommendation.2,7,8.

Other foods to include are those rich in vitamin C like cherries and citrus, and many other fruits, vegetables, and herbs.9  Vitamin C is require for the creation of L-carnitine, another nutrient associated with adrenal insufficiency and responsible for getting fatty acids into the mitochondria to provide energy for the cells.1  75mg for women and 90mg for men, per day, is the standard RDA value, while 250mg is recommended for adrenal support.1

Determining the root cause of the adrenal fatigue is an important factor for treatment.  Depending on the source of stress, pharmacological interventions might include anti depressant therapy.  These drugs can deplete nutrients like sodium and potassium and select B vitamins.10  A diet focused on nutrients from fruits and vegetables can work to replenish those affected.

One difficulty arising from this diet is the variety of anti-inflammatory diet variations promoted.  It would be advisable for the client to work closely with your trusted nutritionist or practitioner to identify the right variation for you.

Supplements To Try

Ashwaganda is commonly considered to be the primary adaptogen, shown to offset many of the biophysical changes seen with stress, namely, blood sugar and cortisol levels.1,2   2-3g of the powdered herb twice daily is recommended.11  While ashwaganda is generally well tolerated, GI upset can occur with higher doses.1

Rhodiola rosea has been considered an efficient adaptogenic botanical for adrenal stress due markedly to the influence it has over building resistance to stressors including physical, biochemical and emotional.12  An animal study of three varying doses showed anti-depressant, anti-anxiolytic effects off of a single dose, not dependent on dosage size. 12  100-300mg 3 times daily is recommended.13,14  Rhodiola is generally considered safe, but it should be noted in advance that Rhodiola can cause dry mouth and dizziness.1

People to Add To Your Team

Lifestyle therapists or wellness therapists particularly trained in lifestyle help clients to reduce the sources of stress, organize their time and learn from potential limiting beliefs.  They assist with sleep needs and meal timing as well as to be accountable for supportive lifestyle choices to prevent burnout and overwhelm that is seen with adrenal fatigue.15,16   One case study demonstrated improvement in stress related symptoms over a 6 month program of nutritional, supplemental, and lifestyle support.16  For chronic stressors that are causing physical impairment, working with a coach of this nature can help make decisions and help you stick to them.

Conclusion

The body has an amazing innate response system to stress, however it needs to be counterbalanced by down time and proper nutrients.  Recognizing stressors, reducing inflammatory causes, and appropriate nutrition can be key to reducing the fatiguing symptoms that come with adrenal fatigue.

References

1. Rakel D. Integrative Medicine. In: Integrative Medicine. 4th ed. Elsevier; 2018:320-333.

2. Ross K. Adrenal Health. Present as part a Masters degree Clin Nutr Tempe, AZ.

3. Head, Kathleen, Kelly G. Nutrients and botanicals for treatment of stress: adrenal fatigue, neurotransmitter imbalance, anxiety, and restless sleep. Altern Med Rev.:114-140. https://pubmed.ncbi.nlm.nih.gov/19594222/

4. Patak P, Willenberg HS, Bornstein SR. Vitamin C is an important cofactor for both adrenal cortex and adrenal medulla. Endocr Res. 2004;30(4):871-875. doi:10.1081/ERC-200044126

5. Sears B. Anti-inflammatory Diets. J Am Coll Nutr. 2015;34 Suppl 1:14-21. doi:10.1080/07315724.2015.1080105

6. Haß U, Herpich C, Norman K. Anti-Inflammatory Diets and Fatigue. Nutrients. 2019;11(10). doi:10.3390/NU11102315

7. Di Pasquale MG. The essentials of essential fatty acids. J Diet Suppl. 2009;6(2):143-161. doi:10.1080/19390210902861841

8. Kiecolt-Glaser JK, Belury MA, Andridge R, Malarkey WB, Glaser R. Omega-3 supplementation lowers inflammation and anxiety in medical students: a randomized controlled trial. Brain Behav Immun. 2011;25(8):1725-1734. doi:10.1016/J.BBI.2011.07.229

9. Vitamin C - Health Professional Fact Sheet. Accessed March 1, 2022. https://ods.od.nih.gov/factsheets/Vitaminc-Healthprofessional/

10. Medicines TN. Natural Medicines Database. https://naturalmedicines-therapeuticresearch-com.scnmlib.idm.oclc.org/#A

11. Kelly G. Nutritional and Botanical Interventions for the Adaptation to Stress. Altern Med Rev. Published online 1999:249-265. https://pubmed.ncbi.nlm.nih.gov/10468649/

12. Perfumi M, Mattioli L. ADAPTOGENIC AND CNS ACTIVITIES OF RHODIOLA ROSEA Adaptogenic and Central Nervous System Effects of Single Doses of 3% Rosavin and 1% Salidroside Rhodiola rosea L. Extract in Mice. Phytother Res. 2007;21(27):37-43. doi:10.1002/ptr

13. Kelly GS. Nutritional and botanical interventions to assist with the adaptation to stress. Altern Med Rev. 1999;4(4):249-265.

14. Panossian A, Wikman G. Evidence-based efficacy of adaptogens in fatigue, and molecular mechanisms related to their stress-protective activity. Curr Clin Pharmacol. 2009;4(3):198-219. doi:10.2174/157488409789375311

15. Wilson JL. Clinical perspective on stress, cortisol and adrenal fatigue. Adv Integr Med. 2014;1(2):93-96. doi:10.1016/J.AIMED.2014.05.002

16. Davis S. Reversal of Irritable Bowel Syndrome, Sleep Disturbance, and Fatigue With an Elimination Diet, Lifestyle Modification, and Dietary Supplements: A Case Report. Integr Med A Clin J. 2016;15(5):60. Accessed March 1, 2022. /pmc/articles/PMC5145014/