Adrenal fatigue is not a real medical diagnosis. However, the phenomenon is alluding to an imbalance in terms of the levels of your adrenal hormones, related to the signaling between your brain, adrenal glands, thyroid, and gut. Adrenal hormones include cortisol, aldosterone, adrenaline, and noradrenaline.There are actual medical diseases that involve very abnormal levels of adrenal hormones such as Cushings disease – high cortisol.  However, the term ‘adrenal fatigue’ refers more to a departure from optimal levels that doesn’t reach an extreme. If you suspect adrenal fatigue or an imbalance of adrenal hormones and ask your conventional provider to check you, they will likely test your cortisol levels and tell you that you’re normal.  That’s becaue they’re using the reference ranges for the traditional, overt adrenal disease. However, Empowered Nutrition, we acknowledge that many people have imbalances of their adrenal hormones that impact their health, yet do not meet the traditional cut-offs for overt disease.  

Here are some of the things we see with adrenal imbalance:

• Irregular blood sugar, especially at night and upon waking (CAR)
• Weight gain, especially central, that is resistant to most diet attempts
• Anxiety or depression
• Low energy, especially in the afternoon
• Low libido
• Irregular menstrual cycle
• Symptomatic menstrual cycles: PMS, PMDD, cramping
• Slow digestion/constipation
• Feeling cold often
• Low circulation in extremities
• Sleep challenges: night waking, hard to get to sleep, early waking

Remember, the adrenals are the foundation that then impact the sex hormones and thyroid so you will see symptoms related to any of the three. Some of the most common scenarios where we see adrenal dysregulation are:

• Busy/tired moms – missing sleep due to kids, just an overall high burden, trying to balance work with parenting and self care
• Excess fasting
• Excess high intensity exercise, especially fasted
• Excess dieting – calorie or carb restriction 
• Other high stressors: carers, high-stress job, divorce, chronic illness
• Past trauma: early life trauma that is emotional, sexual, or physical: this can manifest in adrenal dysregulation due to chronic sympathetic tone, event if current life is normal.  

If you suspect adrenal imbalance, there are a few ways to test:

• Indirect: wear a CGM – there are certain patterns that match this.  Specifically, it will be high readings overnight/during sleep and when waking/still fasted.
• Get a cortisol curve: a one-point test doesn’t work.  We use the Adrenocortext from Genova.  It measures cortisol across the day, including the CAR, plus DHEA – an important precursor to cortisol.
• Combine adrenals with sex hormones: we use DUTCH testing that shows the metabolites on both sides of the coin, from precursors to active hormones to the metabolites.  

Whether you test or not, there are few tried and true steps that you can take to support your adrenal health.  These are the things that we find to be most helpful for our clients:

• Diet: ensure regular meals across a 12-hour period with some slow carb at each meal, coupled with protein and/or fat.  Avoid refined carbs, processed food, and excess caffeine.  Minimize alcohol.  Don’t overly-restrict energy – only a minor deficit or none.  Get help if you need it.
• Sleep: prioritize this.  No blue lights for 3 hours before bed.  Get a tracker if you need to, so that you can quantify it.  The Oura ring will tell you if your sleep is sufficient to keep your HRV, resting heart rate, and body temp optimized.
• Exercise: avoid fasted, high-intensity exercise, especially caffeinated.  Instead of Crossfit-esque workouts, transition to traditional weight lifting, and cardio that shifts between steady state and occasional FED intervals/high intensity.
• Mental health: at a minimum, start a daily practice of meditation or biofeedback such as HeartMath.  Get a therapist – almost everyone can benefit.  If you have past trauma especially, look into brain re-training approaches such as the Gupta program or DNRS.
  

Hopefully this helps and feel free to reach out if you want help with assessing and optimizing your adrenal health!  

Links from this episode: 

DNRS: https://retrainingthebrain.com/

Gupta program: https://www.guptaprogram.com/ 

Oura ring: https://ouraring.com/ 

HeartMath: https://www.heartmath.com/ 

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